2024-04-11T13:39:17-05:00 2023-05-31 346565596 ERNST & YOUNG US LLP 370 17TH STREET SUITE 4800 DENVER CO 80202 990PF 2023-01-01 814260130 INSTITUTE FOR MENTAL HEALTH & WELLNESS INST 4255253985 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 JIM WATSON SECRETARY 9493814000 2024-04-10 1 JIM WATSON 999009999 0 ANDREW JAMESON P01894820 7209314000 2024-10-04 2 AAL1 IAL1 2023 2023-04-26 12:10:37Z X X X 0 X 5000 X 1035528 1035528 891564 891564 891564 1932092 1927092 0 0 0 0 0 303024 272883 0 30141 103800 0 0 70800 51856 0 0 51856 359 0 0 359 2237126 0 0 2237126 2696165 272883 0 2390282 0 0 2696165 272883 0 2390282 -764073 1654209 0 5987868 32000 97577410 0 0 103597278 0 0 1244238 12173485 0 13417723 0 X 90179555 0 90179555 0 103597278 0 90179555 -764073 1573511 90988993 90988993 0 PROVIDENCE ST. JOSEPH HEALTH LONG TERM PORTFOLIO P 2023-05-31 2023-05-31 891564 891564 891564 891564 22994 0 22994 0 22994 92400 0 0 0 92400 0 69406 0 69406 0 0 0 0 0 0 0 0 0 1 1 1 AK CA MT OR WA 1 0 0 0 0 1 WWW.WELLBEINGTRUST.ORG JIM MARTIN 4255253985 1801 LIND AVE SW RENTON WA 98057 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ALI SANTOR 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 DIRECTOR 0.50 0 0 0 DAVID KIM MD 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 DIRECTOR 0.50 0 0 0 DEBRA CANALES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 DIRECTOR 0.50 0 0 0 DOUGAL HEWITT 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 DIRECTOR 0.50 0 0 0 ERIK WEXLER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 DIRECTOR 0.50 0 0 0 JIM WATSON ESQ 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 DIRECTOR 0.50 0 0 0 JOEL GILBERTSON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 DIRECTOR 0.50 0 0 0 OREST HOLUBEC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 DIRECTOR 0.50 0 0 0 ROD F HOCHMAN MD 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 PRESIDENT 1.00 0 0 0 NONE 0 CONTIVIA CONSULTING 121 N 59TH ST SEATTLE WA 98103 CONSULTING SERVICES 97524 0 INSTITUTE FOR MENTAL HEALTH & WELLNESS ("WELL BEING TRUST")IS A FOUNDATION DEDICATED TO ADVANCING THE MENTAL, SOCIAL,AND SPIRITUAL HEALTH FOR ALL.WE BELIEVE THE HEALTH OF OUR MIND IS INSEPARABLE FROM THEHEALTH OF OUR BODY AND SPIRIT. OUR GOAL IS TO SAVE LIVESFROM DEATHS OF DESPAIR AND TO INCREASE EQUITABLE WELL-BEINGFOR ALL. WE ARE COMMITTED TO IMPROVING SYSTEMS OF CARE,COVERAGE, AND COMMUNITY CONDITIONS AS ESSENTIAL TOADDRESSING THE MOST CRITICAL MENTAL HEALTH CHALLENGES FACINGAMERICA.WITH A BOLD MISSION, VISION AND OVERARCHING GOAL, WELL BEINGTRUST IS INVESTING IN APPROACHES THAT HAVE THE POTENTIAL TOMODEL THE WAY FORWARD AND ADVANCE CLINICAL, COMMUNITY ANDCULTURAL CHANGE TO TRANSFORM THE HEALTH OF THE NATION ANDIMPROVE WELL-BEING FOR EVERYONE.WE ARE COMMITTED TO THE FOLLOWING IMPACT STRATEGIES TOACCOMPLISH OUR GOAL:1. ALIGN THE NATION AROUND A CONSENSUS FRAMEWORK FOREXCELLENCE IN MENTAL HEALTH AND WELL-BEING.CONTINUED ON STATEMENT 11 2390282 0 0 5219956 90040756 95260712 0 0 95260712 1428911 93831801 1940911 1940911 22994 22994 1917917 0 1917917 0 1917917 2390282 0 2390282 1917917 0 0 3204974 3823398 7028372 2390282 0 0 0 1917917 472365 0 0 7500737 0 0 0 0 0 0 0 7500737 3204974 3823398 472365 X 0 0 14 1035528 18 891564 0 1927092 0 1927092 0 0 0 0 0 0 0 0 0 1 PROVIDENCE HEALTH ASSURANCE 501(C)(4) BROTHER/SISTER PROVIDENCE HEALTH PLAN 501(C)(4) BROTHER/SISTER PROVIDENCE PLAN PARTNERS 501(C)(4) BROTHER/SISTER PROVIDENCE HEALTH & SERVICES - WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 THIS STATEMENT IS SUBMITTED IN ACCORDANCE WITH REGULATION 1.6043-3(A)(1) AND FORM 990-PF GENERAL INSTRUCTION T TO REPORT THE MERGING OF REMAINING ASSETS FROM INSTITUTE FOR MENTAL HEALTH & WELLNESS TO PROVIDENCE HEALTH & SERVICES - WASHINGTON, PURSUANT TO A MERGER DESCRIBED UNDER IRC SECTION 507(B)(1)(A), EFFECTIVE AS OF 05/31/2023.CASH ASSETS OF $5,209,967, PREPAID EXPENSES OF $32,000, INVESTMENTS OF $100,601,081, ACCOUNTS PAYABLE OF $1,939,633 AND OTHER LIABILITIES OF $12,914,422 WERE MERGED INTO PROVIDENCE HEALTH & SERVICES - WASHINGTON EFFECTIVE 05/31/2023. ATTACHED ARE CERTIFIED COPIES OF INSTITUTE FOR MENTAL HEALTH & WELLNESS AND PROVIDENCE HEALTH & SERVICES - WASHINGTON PLAN OF MERGER, ARTICLES OF MERGER, CERTIFICATE OF MERGER, UNANIMOUS WRITTEN CONSENT OF DIRECTORS, AND WRITTEN CONSENT OF THE SOLE MEMBER. 105843047 SUMMARY OF DIRECT CHARITABLE ACTIVITIES (CONT.): PART VIII-A, LINE 1 2. FACILITATE/CURATE TOOLS AND PRODUCTS TO ACCELERATE PROGRESS TOWARDS EXCELLENCE IN MENTAL HEALTH AND WELL-BEING. 3. ADVANCE MENTAL HEALTH/SUBSTANCE USE DISORDER POLICY AND ADVOCACY AT THE LOCAL, STATE AND FEDERAL LEVELS.4. LEAD/SHAPE THE MENTAL HEALTH AND WELL-BEING MOVEMENT IN THE U.S. INSTITUTE FOR MENTAL HEALTH & WELLNESS DISTRIBUTED ALL ITS ASSETS TO PROVIDENCE HEALTH & SERVICES - WASHINGTON, A RELATED WASHINGTON NONPROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3), DUE TO A MERGER EFFECTIVE 05/31/2023. THE REFUNDS RESULTING FROM THE OVERPAYMENT OF TAX ON FORM 990-PF IN THE AMOUNT OF $69,406 AND ON FORM 990-T IN THE AMOUNT OF $9,343 WILL BE DIRECTED TO PROVIDENCE HEALTH & SERVICES WASHINGTON (EIN: 51-0216586) AS THE SURVIVING ENTITY FROM THE MERGER. TRANSFER OF ASSETS PER MERGER DATED 5/31/2023 90988993 OTHER DIRECT EXPENSES 897761 0 0 897761 SYSTEM COST ALLOCATION 1327609 0 0 1327609 DUES AND SUBSCRIPTIONS 10320 0 0 10320 OFFICE EXPENSES 1011 0 0 1011 LICENSES 425 0 0 425 INTERAFFILIATE TRANSACTION 204049 UNREALIZED GAIN ON INVESTMENTS 1369462 DUE TO AFFILIATES 12173485 0 INVESTMENT MANAGEMENT FEES 272883 272883 0 0 GENERAL CONSULTING FEES 30141 0 0 30141 OTHER TAXES 70800 0 0 70800 FEDERAL INCOME TAX 3000 0 0 0 FEDERAL EXCISE TAX 30000 0 0 0