2024-11-14T17:39:24-06:00 2023-12-31 951777440 GREEN HASSON & JANKS LLP 700 S FLOWER STREET SUITE 3300 LOS ANGELES CA 90017 990 2023-01-01 956100079 SAINT JOHN'S HEALTH CENTER FOUNDATION SAIN 3108298424 2121 SANTA MONICA BOULEVARD SANTA MONICA CA 90404 STELLA NICHOLS CFO 3108298424 2024-11-13 1 1 LIZBETH G NEVAREZ P01399868 3108731600 2024-11-13 2023 2024-10-15 13:58:12Z STELLA NICHOLS 2121 SANTA MONICA BOULEVARD SANTA MONICA CA 90404 83301612 0 X HTTPS://SAINTJOHNSFOUNDATION.ORG X 1948 CA TO PROVIDE LEADERSHIP AND PHILANTHROPIC SUPPORT TO PROVIDENCE SAINT JOHN'S HEALTH CENTER, SAINT JOHN'S CANCER INSTITUTE (FORMERLY JOHN WAYNE CANCER INSTITUTE), AND PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION, THAT SERVE AS CATALYSTS FOR EXCEPTIONAL HEALTH CARE AND RESEARCH. THROUGH THE AFFILIATION ENDOWMENT, PROVIDE DIRECT HEALTH CARE SERVICES INCLUDING WELLNESS PROGRAMS, HEALTH RESEARCH AND EDUCATION TO THE RESIDENTS IN PROVIDENCE SAINT JOHN'S HEALTH CENTER SERVICE AREA (29 ZIP CODES). 123 121 41 216 0 93466 35879255 32299441 0 0 2868339 8115091 117150 37347 38864744 40451879 32364605 23941160 0 0 6933405 6932887 0 0 4559711 2552128 2855345 41850138 33729392 -2985394 6722487 326428369 356971958 14061831 13872458 312366538 343099500 X TO PROVIDE LEADERSHIP AND PHILANTHROPIC SUPPORT TO PROVIDENCE SAINT JOHN'S HEALTH CENTER, JOHN WAYNE CANCER INSTITUTE (RENAMED TO SAINT JOHN'S CANCER INSTITUTE SUBSEQUENT TO YEAR END MAY 2021), AND PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION, THAT SERVE AS CATALYSTS FOR EXCEPTIONAL HEALTH CARE AND RESEARCH. THROUGH THE AFFILIATION ENDOWMENT, PROVIDE DIRECT HEALTH CARE SERVICES INCLUDING WELLNESS PROGRAMS, HEALTH RESEARCH AND EDUCATION TO THE RESIDENTS IN PROVIDENCE SAINT JOHN'S HEALTH CENTER SERVICE AREA (29 ZIP CODES). 0 0 8134207 8134207 TO SUPPORT VARIOUS PROGRAMS AND SERVICES BENEFITTING THE HEART, ORTHO, NURSING AND OTHER VARIOUS DEPARTMENTS OF THE PROVIDENCE SAINT JOHN'S HEALTH CENTER. 7558033 7558033 TO SUPPORT THE ONGOING RESEARCH STUDIES AND TREATMENT MODALITIES AT SAINT JOHN'S CANCER INSTITUTE 6416717 6416717 TO SUPPORT THE ONGOING BRAIN HEALTH RESEARCH STUDIES AND ADVANCEMENT OF TREATMENT MODALITIES AT PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION. 1607000 1607000 AFFILIATION ENDOWMENT TO SUPPORT NONPROFIT TAX-EXEMPT CHARITABLE HEALTHCARE FACILITIES AND CLINICS, INCLUDING, BUT NOT LIMITED TO, GENERAL ACUTE CARE HOSPITALS, IN PROVIDING DIRECT HEALTH CARE SERVICES AND ACCESS THERETO, INCLUDING WELLNESS PROGRAMS, HEALTH RESEARCH AND HEALTH EDUCATION TO IMPROVE HEALTH TO THE RESIDENTS IN PROVIDENCE SAINT JOHN'S HEALTH CENTER'S SERVICE AREA (29 ZIP CODES). 225203 225203 TO SUPPORT THE ONGOING EFFORTS OF SAINT JOHN'S PHYSICIAN PARTNERS, A NETWORK OF PRIMARY CARE AND SPECIALTY CARE PHYSICIANS SERVING THE WESTSIDE LOS ANGELES COMMUNITIES AND BEYOND, IN MAKING ITS SERVICES KNOWN TO PATIENTS THROUGH DEVELOPMENT OF A ROBUST AND INFORMATIVE WEBSITE. 1832203 1832203 23941160 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 1 0 0 1 41 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 123 121 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X STELLA NICHOLS 3108298424 2221 SANTA MONICA BLVD SANTA MONICA CA 90404 SHERYL BOURGEOISPHD PRESIDENT & CEO 40.00 0.00 X X 298099 0 23194 ROBERT KLEIN PRESIDENT & CEO (TERM'D 4/28/2023) 40.00 0.00 X X 906077 0 33797 ROGER WACKER CHAIR (TERM'D 12/31/2023) 5.00 0.00 X 0 0 0 ROBERT AMONIC MD SECRETARY 2.00 0.00 X 0 0 0 CRAIG BENELL TREASURER 2.00 0.00 X 0 0 0 CHARLES ADAMS TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM ANDERSON TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM APFELBAUM TRUSTEE (TERM'D 10/20/2023) 1.00 0.00 X 0 0 0 RAE ARCHIBALD TRUSTEE 2.00 0.00 X 0 0 0 MARGOT ARMBRUSTER TRUSTEE 1.00 0.00 X 0 0 0 J J ASSAF TRUSTEE 1.00 0.00 X 0 0 0 LEE AULT TRUSTEE 1.00 0.00 X 0 0 0 CHRISTINE AVANTI-FISCHER TRUSTEE 1.00 0.00 X 0 0 0 DONNALISA BARNUM TRUSTEE 1.00 0.00 X 0 0 0 KATHY BARRETT TRUSTEE 1.00 0.00 X 0 0 0 FRANK BAXTER TRUSTEE 1.00 0.00 X 0 0 0 RUDOLPH BEDFORD MD TRUSTEE 1.00 0.00 X 0 0 0 JAMES BIRDWELL TRUSTEE 2.00 0.00 X 0 0 0 NORRIS BISHTON TRUSTEE 1.00 0.00 X 0 0 0 ERIC BORSTEIN TRUSTEE (TERM'D 12/31/2023) 1.00 0.00 X 0 0 0 LOREN BORSTEIN TRUSTEE 1.00 0.00 X 0 0 0 JOHN BOWLIN TRUSTEE 1.00 0.00 X 0 0 0 ABBOTT BROWN TRUSTEE 1.00 0.00 X 0 0 0 JULES BUENABENTA TRUSTEE 1.00 0.00 X 0 0 0 CHARLES CALE TRUSTEE (TERM'D 12/31/2023) 1.00 0.00 X 0 0 0 RICK CARUSO TRUSTEE 1.00 0.00 X 0 0 0 HOWARD CHAIT TRUSTEE (TERM'D 11/16/2023) 1.00 0.00 X 0 0 0 ALEX CHAVES TRUSTEE (TERM'D 11/6/2023) 1.00 0.00 X 0 0 0 SCOTT COHEN TRUSTEE 1.00 0.00 X 0 0 0 JONATHAN COLE MD TRUSTEE 1.00 0.00 X 0 0 0 JONATHAN CONGDON TRUSTEE 1.00 0.00 X 0 0 0 CYNTHIA CONNOLLY TRUSTEE (TERM'D 10/4/2023) 1.00 0.00 X 0 0 0 RICHARD CORLIN MD TRUSTEE 1.00 0.00 X 0 0 0 ANGELA COURTIN TRUSTEE (TERM'D 11/14/2023) 1.00 0.00 X 0 0 0 MARIAN CRAVER TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL CROFT TRUSTEE 1.00 0.00 X 0 0 0 RICHARD CROWELL TRUSTEE 1.00 0.00 X 0 0 0 KATHY DANHAKL TRUSTEE 1.00 0.00 X 0 0 0 GEORGE DAVIS TRUSTEE 1.00 0.00 X 0 0 0 LAUREEN DRISCOLL TRUSTEE 1.00 0.00 X 0 0 0 KEVIN EHRHART MD TRUSTEE 1.00 0.00 X 0 0 0 MARC EZRALOW TRUSTEE 1.00 0.00 X 0 0 0 MILES FISHER TRUSTEE 1.00 0.00 X 0 0 0 MARY FLAHERTY TRUSTEE 1.00 0.00 X 0 0 0 FRANCES FLANAGAN TRUSTEE 1.00 0.00 X 0 0 0 BRADFORD FREEMAN TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM GARLAND TRUSTEE 1.00 0.00 X 0 0 0 RISA GERTNER TRUSTEE 1.00 0.00 X 0 0 0 KRISTIN GIBELLO TRUSTEE 1.00 0.00 X 0 0 0 JOHN GOEDERS TRUSTEE 1.00 0.00 X 0 0 0 ALLAN GOLDMAN TRUSTEE 1.00 0.00 X 0 0 0 JAE GOODMAN TRUSTEE (TERM'D 12/31/2023) 1.00 0.00 X 0 0 0 GLENN GORLITSKY MD TRUSTEE 1.00 0.00 X 0 0 0 ARSALAN GOZINI TRUSTEE 1.00 0.00 X 0 0 0 ELIZABETH GREGORY RIORDAN TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL HACKMAN TRUSTEE 1.00 0.00 X 0 0 0 PETER HAIGHT TRUSTEE 1.00 0.00 X 0 0 0 DAVID HO TRUSTEE 1.00 0.00 X 0 0 0 TONIAN HOHBERG TRUSTEE 1.00 0.00 X 0 0 0 MARK HOLSCHER TRUSTEE 1.00 0.00 X 0 0 0 STANLEY IEZMAN TRUSTEE 1.00 0.00 X 0 0 0 BLAKE JOHNSON TRUSTEE 1.00 0.00 X 0 0 0 STEAVEN JONES TRUSTEE 1.00 0.00 X 0 0 0 LAWRENCE JONES MEISTER TRUSTEE 1.00 0.00 X 0 0 0 PAUL KANIN TRUSTEE 1.00 0.00 X 0 0 0 MARY ELLEN KANOFF TRUSTEE 1.00 0.00 X 0 0 0 JORDAN KAPLAN TRUSTEE 1.00 0.00 X 0 0 0 RUSSELL KINO MD TRUSTEE 1.00 0.00 X 0 0 0 SCOTT KLEIN TRUSTEE 1.00 0.00 X 0 0 0 BERNADETTE LEIWEKE TRUSTEE 1.00 0.00 X 0 0 0 ROBERT LEVITT TRUSTEE 1.00 0.00 X 0 0 0 JUDITH LICKLIDER TRUSTEE 1.00 0.00 X 0 0 0 MELVIN LINDSEY TRUSTEE 1.00 0.00 X 0 0 0 JENNIFER LINEHAN KUTRIEH TRUSTEE 1.00 0.00 X 0 0 0 ROBERT LOWE TRUSTEE 1.00 0.00 X 0 0 0 KEVIN MANEMANN TRUSTEE (TERM'D 1/31/2023) 1.00 0.00 X 0 0 0 KATHLEEN MCCARTHY TRUSTEE 1.00 0.00 X 0 0 0 CARL MCKINZIE TRUSTEE 1.00 0.00 X 0 0 0 BRUCE MEYER TRUSTEE 1.00 0.00 X 0 0 0 PETER MULLIN TRUSTEE 1.00 0.00 X 0 0 0 PAUL NATTERSON MD TRUSTEE 1.00 0.00 X 0 0 0 LEE NEIBART TRUSTEE 1.00 0.00 X 0 0 0 LISA NESBITT TRUSTEE 1.00 0.00 X 0 0 0 CHRISTINE NEWMAN TRUSTEE 1.00 0.00 X 0 0 0 CAROL NISHIKUBO TRUSTEE (TERM'D 12/31/2023) 1.00 0.00 X 0 0 0 SHELBY NOTKIN TRUSTEE 2.00 0.00 X 0 0 0 PETER PELIKAN MD TRUSTEE 1.00 0.00 X 0 0 0 MARY PATRICIA PENCE TRUSTEE 1.00 0.00 X 0 0 0 DALLAS PRICE-VAN BREDA TRUSTEE 1.00 0.00 X 0 0 0 ERNIE PRUDENTE MD TRUSTEE 1.00 0.00 X 0 0 0 JUSTIN RAWLINS TRUSTEE 1.00 0.00 X 0 0 0 ERIC REITER TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL RICKS TRUSTEE 1.00 0.00 X 0 0 0 JOHN ROBERTSON MD TRUSTEE 1.00 0.00 X 0 0 0 JEANNE ROBINSON TRUSTEE 1.00 0.00 X 0 0 0 VICTORIA ROGERS TRUSTEE 1.00 0.00 X 0 0 0 THEODORE SCHNEIDER TRUSTEE 1.00 0.00 X 0 0 0 CAROLE SCHWARTZ TRUSTEE 1.00 0.00 X 0 0 0 DONNA SCHWEERS TRUSTEE 1.00 0.00 X 0 0 0 DARREN SEIDEL TRUSTEE 1.00 0.00 X 0 0 0 ROBERT SHUWARGER TRUSTEE 1.00 0.00 X 0 0 0 LAURA SIART TRUSTEE 2.00 0.00 X 0 0 0 WILLIAM SIMON TRUSTEE 1.00 0.00 X 0 0 0 CAROLYN SINGLETON TRUSTEE 1.00 0.00 X 0 0 0 ROSA SINNOTT TRUSTEE 1.00 0.00 X 0 0 0 LORAINE SINSKEY TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL SITRICK TRUSTEE 1.00 0.00 X 0 0 0 CHARLES SMITH TRUSTEE 1.00 0.00 X 0 0 0 JUAN SUAREZ TRUSTEE 1.00 0.00 X 0 0 0 CHARLES THARNSTROM TRUSTEE 1.00 0.00 X 0 0 0 NADINE TILLEY TRUSTEE 1.00 0.00 X 0 0 0 JAMES TOTH TRUSTEE (TERM'D 12/31/2023) 1.00 0.00 X 0 0 0 JOHN TRACY TRUSTEE 1.00 0.00 X 0 0 0 DONNA TUTTLE TRUSTEE 1.00 0.00 X 0 0 0 BENNET VAN DE BUNT TRUSTEE 1.00 0.00 X 0 0 0 BRIAN WEBBER TRUSTEE 1.00 0.00 X 0 0 0 STEPHANIE WESTON TRUSTEE (TERM'D 12/31/2023) 1.00 0.00 X 0 0 0 EDWARD WHITE TRUSTEE 1.00 0.00 X 0 0 0 SHANNON WICKSTROM TRUSTEE 1.00 0.00 X 0 0 0 GRETCHEN WILLISON TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL WISE TRUSTEE 1.00 0.00 X 0 0 0 BRETT WYARD TRUSTEE 1.00 0.00 X 0 0 0 PETER WYMAN TRUSTEE 1.00 0.00 X 0 0 0 STELLA NICHOLS CFO 40.00 0.00 X 471703 0 52067 MICHAEL AVILA SVP DEVELOPMENT (TERM'D 09/13/2023) 40.00 0.00 X 379298 0 22683 ANDY TRILLING VP DEVELOPMENT PRINCIPAL & ESTATE GIFTS 40.00 0.00 X 273133 0 39089 JEANNE GOLDSMITH VP DEVELOPMENT 40.00 0.00 X 233260 0 26110 COOKIE ESTHER GALANTI SENIOR DIRECTOR PHILANTHROPY 40.00 0.00 X 226658 0 28674 THERESA CSISZAR VP STRATEGIC ENGAGEMENT AND STEWARDSHIP 40.00 0.00 X 206508 0 38811 2994736 0 264425 17 0 1 0 MOON TIDE AGENCY LLC 200 N SEPULVEDA BLVD SUITE 110 EL SEGUNDO CA 90245 MAGAZINE PRINTING SERVICE 166089 GRENZEBACH GLIER & ASSOCIATES INC 200 S MICHIGAN AVENUE SUITE 2100 CHICAGO IL 60604 FUNDRAISING AND PHILANTHROPIC MANAGEMENT 153536 KORN FERRY (US) 1900 AVENUE OF THE STARS SUITE 260 LOS ANGELES CA 90067 EXECUTIVE SEARCH 136642 JMC PHILANTHROPIC ADVISORS 2444 WILSHIRE BLVD STE 622 SANTA MONICA CA 90403 PROVIDE SUPPORT & MANAGE AFFIL. ENDOW. 123000 4 395345 31904096 1707866 32299441 7009700 7009700 117150 0 117150 117150 117150 43767851 42662460 1105391 1105391 1105391 88162 395345 186873 -98711 -98711 19308 400 18908 18908 40451879 0 0 8152438 23941160 23941160 1784937 832546 952391 3890619 1786327 2104292 79478 31717 47761 1177853 455645 722208 30208 26011 4197 70750 70750 128670 128670 903195 585222 317973 347570 119009 228561 133433 128684 4749 173632 173632 18220 3692 14528 345423 257878 87545 67920 67920 CHATAUQUA RETREAT 413648 413648 DONOR RECOGNITION 105841 35654 70187 PROSPECT RESEARCH 54622 54622 COMMUNITY SUPPORT 21697 21697 40516 35197 5319 33729392 23941160 5228521 4559711 80293960 77926291 31356552 24358969 8182333 474721 7345532 7707612 74766792 85018980 120993937 150446286 11671596 11513820 326428369 356971958 14061831 13872458 14061831 13872458 X 118665248 141491457 193701290 201608043 312366538 343099500 326428369 356971958 X 6722487 24613684 -603209 X X 0 1 X 1 0 X 77310438 87609073 56225795 35879255 32299441 289324002 77310438 87609073 56225795 35879255 32299441 289324002 50157347 239166655 2141342 1692717 173156 2384937 7126850 13519002 302843004 0.78970 0.77390 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 31117814 10815944 2884909 1130228 43688439 32741593 1033610 -2058529 598860 31117814 28050825 3850001 1566219 725452 32741593 26389403 162398 2276673 777649 28050825 25003770 269880 2006376 890623 26389403 0.21696 0.69802 0.08502 0 0 863600 5278862 6142462 885950 1153921 474721 1565150 7707612 150446286 F 150446286 OBLIGATIONS UNDER CHARITABLE GIFT ANNUITIES 1209628 DUE TO SAINT JOHN'S HEALTH CENTER & INSTITUTES 11184258 DUE TO SAINT JOHN'S HEALTH CENTER (OPERATING EXPENSES) 1478572 13872458 X 64509716 24613684 -427177 24186507 40323209 128670 128670 40451879 33776754 176032 176032 33600722 128670 128670 33729392 PART V, LINE 4: ENDOWMENT FUNDS ARE ESTABLISHED BY DONOR-RESTRICTED GIFTS AND BEQUESTS TO EITHER PROVIDE A PERMANENT ENDOWMENT, WHICH IS TO PROVIDE A PERMANENT SOURCE OF INCOME TO THE FOUNDATION, OR A TERM ENDOWMENT, WHICH IS TO PROVIDE INCOME FOR A SPECIFIED PERIOD TO THE FOUNDATION. PART X, LINE 2: THE FOUNDATION RECOGNIZES THE IMPACT OF TAX POSITIONS IN THE FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. DURING THE YEAR ENDED DECEMBER 31, 2023, THE FOUNDATION PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS AND DID NOT NOTE ANY MATTERS THAT WOULD REQUIRE RECOGNITION IN THE FINANCIAL STATEMENTS OR WHICH MIGHT HAVE AN EFFECT ON ITS TAX-EXEMPT STATUS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF GIFT ANNUITIES RECEIVABLE 700,158. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUSTS 208,906. BAD DEBT -1,512,273. GAMING EXPENSES 400. FUNDRAISING EXPENSES 175,632. PART XII, LINE 2D - OTHER ADJUSTMENTS: GAMING EXPENSES 400. FUNDRAISING EXPENSES 175,632. POWER OF PINK 483507 395345 88162 11241 50833 124799 483507 395345 88162 11241 50833 124799 186873 -98711 19308 400 1 0.73000 19308 400 400 18908 CA 1 0 0 0 STELLA NICHOLS 2221 SANTA MONICA BLVD SANTA MONICA CA 90404 0 1 17377 1 BOYS AND GIRLS CLUB OF SANTA MONICA 1220 LINCOLN BLVD SANTA MONICA CA 90401 951890706 501(C)3 30000 0 TO SUPPORT HEALTHY LIFESTYLE AND SOCIAL-EMOTIONAL HEALTH PROGRAMS. CANCER SUPPORT COMMUNITY LOS ANGELES 1990 SOUTH BUNDY DRIVE SUITE 100 LOS ANGELES CA 90025 330287070 501(C)3 30000 0 TO SUPPORT THE HEART INITIATIVE. CATHOLIC CHARITIES OF LOS ANGELES INC 1531 JAMES M WOOD BLVD LOS ANGELES CA 90015 951690973 501(C)3 75000 0 TO PROVIDE GENERAL OPERATING SUPPORT. CLARIS HEALTH 11500 OLYMPIC BLVD STE 570 LOS ANGELES CA 90064 954806856 501(C)3 25000 0 TO SUPPORT THE EXPANSION OF THE MOBILE UNIT. GROWING HOPE GARDENS 21145 COLINA DRIVE TOPANGA CA 90290 834524045 501(C)3 25000 0 TO SUPPORT THE CULTIVATING HEALTHY COMMUNITIES PROJECT. MEALS ON WHEELS WEST 1823-A MICHIGAN AVENUE SANTA MONICA CA 90404 954613280 501(C)3 37500 0 TO SUPPORT THE FOOD & SHELTER AND COMMUNITY CONNECTIONS PROGRAMS. OPICA 11759 MISSOURI AVENUE LOS ANGELES CA 90025 953493725 501(C)3 21000 0 TO SUPPORT THE OPICA SCHOLARSHIP PROGRAM FOR PNI PATIENTS. PACIFIC PALISADES-MALIBU YMCA 821 VIA DE LA PAZ PACIFIC PALISADES CA 90272 951644052 501(C)3 25000 0 TO SUPPORT THE TEEN COMMUNTY EMPOWERMENT HUB. PROVIDENCE SAINT JOHN'S HEALTH CENTER CHILD AND FAMILY DEVELOPMENT CENTER 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 951684082 501(C)3 100000 0 TO SUPPORT THE PERINATAL WELLNESS PROGRAM. PROVIDENCE SAINT JOHN'S HEALTH CENTER CLEFT PALATE CENTER 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 951684082 501(C)3 150000 0 TO SUPPORT THE JANET K. SALOMONSON, MD SCHOLARSHIP PROGRAM. PROVIDENCE SAINT JOHN'S HEALTH CENTER COMMUNITY BENEFIT PROGRAMS 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 951684082 501(C)3 131000 0 TO SUPPORT THE HOMELESS CARE NAVIGATION PROGRAM. PROVIDENCE SAINT JOHN'S HEALTH CENTER SAINT JOHN'S CANCER INSTITUTE 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 954291515 501(C)3 175000 0 TO SUPPORT THE SJCI ONCOLOGY FELLOWSHIP PROGRAM. SAFE PARKING LA 961 S MARIPOSA AVE LOS ANGELES CA 90006 873148967 501(C)3 10000 0 TO SUPPORT THE HOUSING STABLIZATION SPECIALIST POSITION. SAFE PLACE FOR YOUTH 340 SUNSET AVENUE VENICE CA 90291 841802637 501(C)3 50000 0 TO SUPPORT SPY'S HEALTH & CLINICAL PROGRAMS. SANTA MONICA EDUCATION FOUNDATION 1717 4TH STREET SUITE 132A SANTA MONICA CA 90401 953787674 501(C)3 75000 0 TO SUPPORT THE SANTA MONICA PUBLIC SCHOOL STUDENT WELLNESS PROGRAM. SANTA MONICA FAMILY YMCA 1332 6TH STREET SANTA MONICA CA 90401 951643380 501(C)3 22500 0 TO SUPPORT YOUTH & TEEN SUMMER MEMBERSHIPS AT THE SANTA MONICA Y. SANTA MONICA PREPARATORY 1011 7TH STREET SANTA MONICA CA 90403 237071304 501(C)3 25000 0 TO SUPPORT LAUNCH OF THE BREAKFAST PROGRAM. STEP UP ON SECOND 1460 4TH STREET STE 200 SANTA MONICA CA 90401 954109386 501(C)3 50000 0 TO SUPPORT STEP UP ON SECOND STREETS PROGRAMS IN SANTA MONICA AND THE SAINT JOHN'S CIF CATCHMENT AREA. THE PEOPLE CONCERN 2116 ARLINGTON AVENUE SUITE 100 LOS ANGELES CA 90018 956143865 501(C)3 150000 0 TO SUPPORT THE WESTSIDE INTERIM HOUSING AND WELLNESS SUPPORT PROGRAM ($100,000) AND THE SOJOURN DOMESTIC VIOLENCE SUPPORT PROGRAM ($50,000). THE SALVATION ARMY (SANTA MONICA CORPS) 1533 4TH STREET SANTA MONICA CA 90401 941156347 501(C)3 75000 0 TO SUPPORT THE HOMELESS OUTREACH PROGRAM. THE REGENTS OF THE UNIVERSITY OF CALIFORNIA FBO UCLA VA FAMILY RESOURCE AND 10889 WILSHIRE BLVD SUITE 700 LOS ANGELES CA 90024 943067788 501(C)3 75000 0 TO EXPAND SUPPORT FOR TEMPORARY AND PERMANENTLY HOUSED VETERANS AND THEIR FAMILIES AT THE WEST LOS ANGELES VA CAMPUS. USVETS 800 W SIXTH STREET SUITE 1505 LOS ANGELES CA 90017 954382752 501(C)3 50000 0 TO SUPPORT THE OUTREACH COORDINATOR ROLE BASED AT THE WEST LA VA NORTH CAMPUS VISION TO LEARN 12100 WILSHIRE BLVD SUITE 1275 LOS ANGELES CA 90025 453457853 501(C)3 50000 0 TO SUPPORT VTLS PROGRAMS IN THE SAINT JOHNS HEALTH CENTER SERVICE AREA. WESTSIDE FOOD BANK 1710 22ND STREET SANTA MONICA CA 90404 953685875 501(C)3 75000 0 TO SUPPORT FOOD PURCHASES FOR WSFB FOOD BANK SERVICES. WISE AND HEALTHY AGING 1527 4TH STREET 2 SANTA MONICA CA 90401 952788014 501(C)3 75000 0 TO SUPPORT THE AGING HOMELESS DIVERSION PREVENTION PROJECT. PROVIDENCE SAINT JOHN'S HEALTH CENTER 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 951684082 501(C)3 8134207 0 VARIOUS PROGRAMS AND SERVICES PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION 2125 ARIZONA BLVD SANTA MONICA CA 90404 475552178 501(C)3 6416717 0 RESEARCH SAINT JOHN'S CANCER INSTITUTE (FORMERLY JOHN WAYNE CANCER INSTITUTE) 2200 SANTA MONICA BLVD SANTA MONICA CA 90404 954291515 501(C)3 7558033 0 RESEARCH SAINT JOHN'S PHYSICIAN PARTNERS 20555 EARL STREET TORRANCE CA 90503 814542216 501(C)3 225203 0 VARIOUS PROGRAMS AND SERVICES 25 PART I, LINE 2: FUNDS TO PROVIDENCE SAINT JOHN'S HEALTH CENTER ARE GRANTED AFTER THE EXPENSES HAVE BEEN INCURRED AND SUPPORTED BY COPIES OF INVOICES PAID RELATED TO EACH GRANT. THE ENTITIES SAINT JOHN'S CANCER INSTITUTE, PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION, AND SAINT JOHN'S PHYSICIAN PARTNERS PROVIDE THE SAINT JOHN'S HEALTH CENTER FOUNDATION WITH AN ITEMIZED BILL. SAINT JOHN'S HEALTH CENTER FOUNDATION TRANSFERS THE FUNDS TO EACH RELATED ENTITY THE SUBSEQUENT MONTH. AFFILIATION ENDOWMENT GRANTEES ARE REQUIRED TO SUBMIT REPORTS TO SAINT JOHN'S HEALTH CENTER FOUNDATION INDICATING HOW THE FUNDS WERE SPENT. X 1 1 X X X X X X 1 0 0 0 0 0 0 1 0 ROBERT KLEIN PRESIDENT & CEO (TERM'D 4/28/2023) 418867 0 149710 0 337500 0 27225 0 6572 0 939874 0 0 0 STELLA NICHOLS CFO 369592 0 102111 0 0 0 40635 0 11432 0 523770 0 0 0 MICHAEL AVILA SVP DEVELOPMENT (TERM'D 09/13/2023) 302406 0 76892 0 0 0 7781 0 14902 0 401981 0 0 0 SHERYL BOURGEOISPHD PRESIDENT & CEO 298099 0 0 0 0 0 13280 0 9914 0 321293 0 0 0 ANDY TRILLING VP DEVELOPMENT PRINCIPAL & ESTATE GI 246757 0 26376 0 0 0 19638 0 19451 0 312222 0 0 0 JEANNE GOLDSMITH VP DEVELOPMENT 197136 0 36124 0 0 0 16714 0 9396 0 259370 0 0 0 COOKIE ESTHER GALANTI SENIOR DIRECTOR PHILANTHROPY 204904 0 21754 0 0 0 18430 0 10244 0 255332 0 0 0 THERESA CSISZAR VP STRATEGIC ENGAGEMENT AND STEWARDS 166260 0 40248 0 0 0 16915 0 21896 0 245319 0 0 0 PART I, LINE 1A THE ORGANIZATION PAID $7,802.21 FOR THE CEO/PRESIDENT'S USE OF THE PACIFIC CLUB FOR DONOR CULTIVATION AND RELATIONSHIP BUILDING. PART I, LINE 4A YES, THE FORMER CEO/PRESIDENT ROBERT O. KLEIN RECEIVED THE FIRST 50% OR $337,500 OF THE AGREED UPON TOTAL SEVERANCE PAYMENT OF $675,000 (REMAINING BALANCE TO BE PAID IN 2024). PART I, LINE 7 THE BOARD APPROVED THE BONUS FOR ROBERT O. KLEIN, STELLA NICHOLS, MICHAEL AVILA, ESTHER GALANTI, ANDREW TRILLING, THERESA CSISZAR, AND JEANNE GOLDSMITH. X 36 167490 APPRAISAL X 36 1026051 FAIR MARKET VALUE X 1 430000 COST APPROACH X 6 9663 SELLING PRICE X EVENT GIVEAWAYS 7 53863 SELLING PRICE X OPPORTUNITY DRAWING ITEMS 11 10798 SELLING PRICE X GIFT CARDS 1 10000 SELLING PRICE 1 0 1 1 PART I, COLUMN (B): NONCASH DONATIONS ARE LISTED BY TOTAL NUMBER OF DONORS. PART I, LINE 32B: CARS2CHARITIES FOR VEHICLE DONATIONS. ABELL AUCTION COMPANY: FOR TANGIBLE NON-CASH CONTRIBUTIONS (SUCH AS ARTWORK) THAT ARE NOT HELD IN INVENTORY (OTHER ASSETS). FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS A BOARD COMMITTEE AND SHALL HAVE AT LEAST FIVE (5) TRUSTEES AS MEMBERS, INCLUDING THE CHAIR, THE PRESIDENT, EITHER THE PROVIDENCE CEO OR THE PROVIDENCE COO, AND OTHER TRUSTEES APPOINTED BY THE BOARD. THE EXECUTIVE COMMITTEE SHALL ACT FOR THE FULL BOARD BETWEEN BOARD MEETINGS, EXCEPT THAT THE EXECUTIVE COMMITTEE SHALL NOT TAKE ANY ACTION SPECIFIED IN SECTION 2 OF ARTICLE V OR OUTSIDE THE ORDINARY COURSE OF BUSINESS OR SPECIFICALLY RESERVED TO THE FULL BOARD BY RESOLUTION. THE EXECUTIVE COMMITTEE SHALL BE RESPONSIBLE FOR THE PERIODIC EVALUATION OF THE PERFORMANCE AND COMPENSATION OF THE PRESIDENT & CEO. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO MEMBERS, PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA AND SAINT JOHN'S HEALTH CENTER FOUNDATION GOVERNANCE INC. WHO ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION HAS MEMBERS WHO ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B AN ELECTRONIC COPY OF THE 990 AND ITS SUPPORTING SCHEDULES WERE DISTRIBUTED TO THE SAINT JOHN'S HEALTH CENTER FOUNDATION (FOUNDATION) MANAGEMENT TEAM, AUDIT AND COMPLIANCE COMMITTEE AND GOVERNING BODY FOR THEIR REVIEW PRIOR TO FILING. THE FOUNDATION FORM 990 IS PREPARED AND REVIEWED BY AN INDEPENDENT AUDITING FIRM. FORM 990 IS MADE AVAILABLE TO THE FULL GOVERNING BODY UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST PROCESS IS MANAGED AND MONITORED BY PROVIDENCE RISK AND INTEGRITY SERVICES - COMPLIANCE. ANNUAL QUESTIONNAIRES ARE DISTRIBUTED AND "AFFECTED AND INTERESTED PERSONS" WHO VIOLATE THE POLICY ARE SUBJECT TO APPROPRIATE CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS: COMPENSATION COMMITTEE; INDEPENDENT COMPENSATION CONSULTANTS; COMPENSATION SURVEYS AND STUDIES; APPROVAL BY THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15B: THE ORGANIZATION USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS: COMPENSATION SURVEYS AND STUDIES; COMPENSATION RATES THROUGHOUT PROVIDENCE SYSTEM. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF GIFT ANNUITIES RECEIVABLE 700,158. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUSTS 208,906. BAD DEBT EXPENSE -1,512,273. FORM 990, PART XII, LINE 2C: NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR. SAINT JOHN'S HEALTH CENTER FOUNDATION GOVERNANCE INC 2121 SANTA MONICA BLVD SANTA MONICA CA 90404 473249939 CORPORATE MEMBER CA 501(C)(4) N/A 0 PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION 2125 ARIZONA AVENUE SANTA MONICA CA 90404 475552178 ADVANCE NEUROSCIENCE CLINICAL CARE CA 501(C)(3) LINE 7 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0