2022-05-16T15:43:55-05:00 2021-06-30 366055558 GRANT THORNTON LLP 171 N CLARK ST STE 200 CHICAGO IL 60601 990 2020-07-01 912154438 ST VINCENT MEDICAL CENTER STVI 8185321020 6300 CANOGA AVE NO 1500W WOODLAND HILLS CA 91367 HOWARD GROBSTEIN LIQUIDATING TRUSTEE 8185321020 2022-05-16 1 HOWARD GROBSTEIN 999009999 BRIDGET T ROCHE P00666837 3128560200 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z X HOWARD GROBSTEIN 6300 CANOGA AVE NO 1500W WOODLAND HILLS CA 91367 3232402 0 X HTTPS://VERITY.ORG/ X 2001 CA ST. VINCENT MEDICAL CENTER IS A 366-BED, SHORT-TERM ACUTE CARE, GENERAL HOSPITAL (SEE SCHEDULE O) LOCATED IN THE DOWNTOWN AREA OF LOS ANGELES. X 1 0 910 0 0 0 2538812 525 100925553 3206590 33325117 25287 2746745 0 139536227 3232402 0 29999782 0 0 62850368 1949773 0 0 0 126118163 7377122 188968531 39326677 -49432304 -36094275 122061692 1242140 575304015 0 -453242323 1242140 X ST. VINCENT MEDICAL CENTER WAS ORGANIZED FOR THE PURPOSES OF (I) MAINTAINING AN ACUTE CARE HOSPITAL AND RELATED FACILITIES, (II) PROMOTING RESEARCH RELATED TO HEALTHCARE SERVICES, (III) MAINTAINING HEALTH PLANS USING SYSTEMS DESIGNED TO MAXIMIZE (SEE SCHEDULE O) (CONTINUED ON SCHEDULE O)BENEFITS TO THE COMMUNITIES SERVED, (IV) PROMOTING THE GENERAL HEALTH OF THE COMMUNITY, AND (V) PROVIDING FINANCIAL AND OTHER FORMS OF ASSISTANCE FOR THE BENEFIT OF OTHER HEALTHCARE FACILITIES AFFILIATED WITH VERITY.IN JANUARY 2020, ST. VINCENT MEDICAL CENTER STOPPED HOSPITAL OPERATIONS AND CLOSED. THE ASSETS OF ST. VINCENT MEDICAL CENTER WERE SOLD TO DR. PATRICK SOON-SHIONG ON APRIL 16, 2020. 0 0 32048454 29999782 3206590 ST. VINCENT MEDICAL CENTER CEASED HOSPITAL OPERATIONS IN JANUARY 2020. THE ASSETS OF ST. VINCENT MEDICAL CENTER WERE SOLD TO DR. PATRICK SOON-SHIONG ON APRIL 16, 2020. ANY PROGRAM SERVICE ACTIVITIES REPORTED HERE ARE THOSE ESSENTIAL TO TRANSITIONING THE PROGRAMS FROM SVMC. SVMC DID NOT OPERATE A HOSPITAL AT ANY TIME DURING FY20 & FY21. THE ENTITY IS IN THE PROCESS OF WINDING DOWN FOR EVENTUAL DISSOLUTION. 32048454 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 1 68 0 1 910 0 0 0 0 0 0 0 0 0 0 0 0 0 X 1 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X VHS LIQUIDATING TRUST CO HOWARD GROBSTEIN TRUSTEE 8185321020 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 TY CONNER DIRECTOR (THRU 04/2021) 1.00 39.00 X 0 536130 26623 HOWARD GROBSTEIN LIQUIDATING TRUSTEE (BEG 09/2020) 1.00 13.00 X X 0 0 0 JACK KROUSKUP BOARD MEMBER (THRU 04/2021) 1.00 13.00 X 0 100000 0 ANDREW PINES CHAIR (THRU 04/2021) 1.00 13.00 X X 0 75000 0 TERRY BELMONT SECRETARY (THRU 04/2021) 1.00 13.00 X X 0 75000 0 CHRISTOBEL SELECKY BOARD MEMBER (THRU 09/2020) 1.00 2.00 X 0 56250 0 0 842380 26623 0 0 1 0 SHIFTWISE PO BOX 70870 ST PAUL MN 551709705 REGISTRY NURSING 662192 EUROFINS VRL LOS ANGELES LLC PO BOX 84080 CHICAGO IL 606894002 MEDICAL SERVICES 363985 REHABCARE GROUP OF CALIFORNIA LLC PO BOX 502096 ST LOUIS MO 631502096 PURCHASED SERVICES 354868 AXIOM ANESTHESIA GROUP INC PO BOX 4797 PALOS VERDES CA 90274 MEDICAL SERVICES 251667 GCH MEDICAL GROUP INC 637 LUCAS AVENUE LOS ANGELES CA 90017 MEDICAL SERVICES 218000 7 525 525 NET PATIENT REVENUE 621110 3206590 3206590 3206590 25287 25287 3232402 3206590 0 25287 29999782 29999782 675 675 212428 212428 1736670 1736670 512574 512574 301806 301806 ALLOCATED CORPORATE O/H 6153129 6153129 MEDICAL SUPPLIES 98899 98899 310714 310714 39326677 32048454 7278223 0 82666158 1242140 7016276 164449 0 133494 1771726 30309589 0 122061692 1242140 55786178 519517837 0 575304015 0 X -456470185 0 3227862 1242140 -453242323 1242140 122061692 1242140 X -36094275 490578738 X X 0 0 0 X SCHEDULE A, PART I: ST. VINCENT MEDICAL CENTER IS MAINTAINING ITS STATUS ON SCHEDULE A, PART I AS A HOSPITAL AS IT WINDS DOWN. ALTHOUGH THE ORGANIZATION QUALIFIES AS A HOSPITAL FOR PURPOSES OF EXEMPTION ON SCHEDULE A, THE HOSPITAL IS NO LONGER LICENSED AND THUS DOES NOT FILE A SCHEDULE H. 2704921 1462781 1242140 2717962 -13041 2704921 2772204 -54242 2717962 2742801 29403 2772204 2670571 72230 2742801 1.00000 0 0 0 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS THE ENDOWMENT FUNDS ARE INTENDED TO BE USED FOR UNRESTRICTED HOSPITAL PURPOSES. VHS AND FIVE OF ITS CONSOLIDATED CHARITABLE FOUNDATIONS FOLLOW THE UNIFORM PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT (UPMIFA). UPMIFA ELIMINATES THE CONCEPT OF "HISTORIC DOLLAR VALUE AND ALLOWS AN INSTITUTION TO SPEND OR ACCUMULATE AS THE BOARD DETERMINES IS PRUDENT FOR THE USES, BENEFITS, PURPOSES, AND DURATION OF THE ENDOWMENT FUND UNLESS THE GIFT INSTRUMENT STATES A PARTICULAR SPENDING GREATER THAN 7% OF THE AVERAGE FAIR MARKET VALUE (CALCULATED AT LEAST QUARTERLY OVER A MINIMAL PERIOD OF THREE YEARS) IS PRESUMED TO BE IMPRUDENT. 1 VERITY HEALTH SYSTEM OF CALIFORNIA INC 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 912145484 501(C)(3) 29999782 DISSOLUTION TRANSFER 1 0 PART I, LINE 2: THE GRANT TO VERITY HOSPITAL SYSTEM OF CALIFORNIA, INC. REPRESENTS LIQUIDATING DISTRIBUTIONS MADE AS PART OF THE ORGANIZATION'S WIND DOWN. 0 0 0 0 0 0 0 0 0 TY CONNER DIRECTOR (THRU 04/2021) 0 358566 0 177040 0 524 0 6413 0 20210 0 562753 0 0 ACCOUNTS RECIEVABLE 19851032 TAX BASIS 912145484 VERITY HEALTH SYSTEM 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 501(C)(3) 1 0 0 0 SCHEDULE N, PART II: IN ADDITION TO THE ASSETS REPORTED ON PART II, CERTAIN TRANSACTIONS WITHIN THE HEALTH SYSTEM WERE WRITTEN-OFF AS PART OF THE BANKRUPTCY PLAN. PLEASE SEE FORM 990, PART XI, LINE 9 AND SCHEDULE O FOR MORE INFORMATION.SCHEDULE N, PART II, LINE 2A: THE DIRECTORS OF THE ORGANIZATION WERE ALSO THE DIRECTORS OF THE TRANSFEREE ORGANIZATION, VERITY HEALTH SYSTEM OF CALIFORNIA IN FISCAL YEAR 2021 AND CONTINUED AS DIRECTORS OF BOTH ENTITIES AFTER THE TRANSFER OF ASSETS OCCURRED. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS SVMC HAS ONE MEMBER, VHS, A CALIFORNIA NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS WITH POWER TO APPOINT SVMC'S SOLE MEMBER, VHS HAS THE AUTHORITY TO APPOINT, ELECT OR APPROVE THE GOVERNING BODY OF SVMC. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE MEMBER OF SVMC, VHS HAS THE POWER TO TAKE OR APPROVE THE FOLLOWING ACTIONS AS IT RELATES TO SVMC: (A) APPROVE OR CHANGE THE MISSION, ROLE AND PURPOSE OF THIS CORPORATION; (B) AMEND THE BYLAWS AND ARTICLES OF INCORPORATION OF THIS CORPORATION; (C) AUTHORIZE THE BOARD OF DIRECTORS TO AMEND THE BYLAWS, ARTICLES OF INCORPORATION OR OTHER ORGANIZATIONAL DOCUMENTS OF ANY AFFILIATE; (D) APPROVE THE FORMATION, MERGER, DISSOLUTION, CONSOLIDATION, DIVESTITURE, CLOSURE, CHANGE IN CORPORATE MEMBERSHIP OR CONTROL AND REORGANIZATION OF EACH DIRECT AFFILIATE OF THIS CORPORATION; (E) FIX THE NUMBER AND APPOINT AND REMOVE THE DIRECTORS OF THIS CORPORATION; (F) APPOINT AND REMOVE THE CHAIRPERSON OF THE BOARD AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THIS CORPORATION AND OF EACH DIRECT AFFILIATE OR SUBSIDIARY OF THIS CORPORATION; (G) APPROVE THE MERGER, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THIS CORPORATION AND THE DISPOSITION OF THE ASSETS OF THIS CORPORATION UPON DISSOLUTION; (H) APPROVE THE ACQUISITION, SALE, LEASE, MORTGAGE, TRANSFER OR OTHER ALIENATION OF REAL OR PERSONAL PROPERTY OF THIS CORPORATION OTHER THAN IN ACCORDANCE WITH THE SYSTEM AUTHORITY MATRIX; (I) APPROVE THE CAPITAL AND OPERATING BUDGETS OF THIS CORPORATION OR OF ANY AFFILIATE CONTROLLED BY THIS CORPORATION; (J) APPROVE THE INCURRENCE OF DEBT OR GUARANTIES OF THIS CORPORATION OTHER THAN IN ACCORDANCE WITH THE SYSTEM AUTHORITY MATRIX; (K) ESTABLISH POLICY CONCERNING QUALITY OF CARE AND SERVICES FOR THE CORPORATION AND TO APPROVE ANY SUCH POLICIES OF THIS CORPORATION THAT ARE INCONSISTENT WITH THE SYSTEM AUTHORITY MATRIX; (L) ESTABLISH POLICY AND PROCEDURES CONCERNING FINANCE AND RESOURCES FOR THE CORPORATION AND TO APPROVE ANY SUCH POLICIES OR PROCEDURES THAT ARE INCONSISTENT WITH SUCH POLICIES OR PROCEDURES; (M) ESTABLISH CRITERIA FOR THE LONG-RANGE FINANCIAL AND STRATEGIC PLANS OF THE CORPORATION AND TO APPROVE ANY SUCH PLANS; (N) ESTABLISH AN INTERNAL AUDITING PROGRAM AND APPROVE ANY MATERIAL ELEMENT OF THE INTERNAL AUDITING PROGRAM FOR THIS CORPORATION THAT IS INCONSISTENT WITH THE INTERNAL AUDITING PROGRAM ESTABLISHED BY THE CORPORATE MEMBER; (O) APPROVE CAPITAL EXPENDITURES BY THIS CORPORATION OR FOR ANY AFFILIATE CONTROLLED BY THIS CORPORATION OTHER THAN IN ACCORDANCE WITH THE SYSTEM AUTHORITY MATRIX; (P) APPROVE THE TRANSFER OF FUNDS, BY GIFT OR LOAN, BETWEEN THIS CORPORATION AND ONE OR MORE OTHER AFFILIATES OF VERITY AND THIS CORPORATION OR TO ANY OTHER PERSON OR ENTITY OTHER THAN IN ACCORDANCE WITH SYSTEM AUTHORITY MATRIX; AND (Q) APPROVE ANY OTHER ACTION BY THIS CORPORATION OR FOR ANY AFFILIATE CONTROLLED BY THIS CORPORATION THAT HAS BEEN ESTABLISHED BY RESOLUTION OF THE CORPORATE MEMBER AS REQUIRING ITS APPROVAL, INCLUDING, BUT NOT LIMITED TO, ANY APPROVALS OF AUTHORITY NECESSARY TO ENSURE COMPLIANCE WITH ANY CREDIT AGREEMENT, MASTER INDENTURE OR LOAN AGREEMENT TO WHICH THIS CORPORATION OR ANY AFFILIATE CONTROLLED BY THIS CORPORATION IS A PARTY. FORM 990, PART VI, SECTION B, LINE 11B THE INDEPENDENT TAX PREPARERS AND FINANCE STAFF OF VHS AND ITS AFFILIATED COMPANIES (THE ORGANIZATION") WORK TO GATHER THE REQUIRED INFORMATION NECESSARY TO COMPLETE THE FORM 990. THE INITIAL DRAFT FORM 990 IS REVIEWED BY THE ORGANIZATION'S FINANCE DEPARTMENT. AFTER THE FORM 990 IS REVIEWED, RECOMMENDED CHANGES ARE DISCUSSED AND A FINAL FORM 990 IS PREPARED. PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE, THE FINAL FORM 990 IS DISTRIBUTED TO SVMC'S BOARD OF DIRECTORS FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C VHS HAS A CONFLICT OF INTEREST POLICY THAT COVERS VHS AND ALL OF ITS AFFILIATES. THE POLICY PROVIDES FOR A SYSTEMATIC AND ONGOING METHOD OF REQUIRING INDIVIDUALS WHO HAVE DECISION MAKING RESPONSIBILITY TO DISCLOSE AND ADDRESS POTENTIAL AND ACTUAL CONFLICTS OF INTEREST. COVERED INDIVIDUALS ARE REQUIRED TO COMPLETE AN ANNUAL STATEMENT DISCLOSING ANY CONFLICTS OF INTEREST AND HAVE A DUTY TO UPDATE THE DISCLOSURE FOR ANY POTENTIAL CONFLICTS OF INTEREST THAT ARISE DURING THE YEAR. THE PRESIDENT & CEO OF EACH INDIVIDUAL HOSPITAL WITHIN THE HEALTH SYSTEM REPORTS THE CONFLICT OF INTEREST FINDINGS AND RESOLUTIONS TO THEIR RESPECTIVE BOARD OF DIRECTORS. THE POLICY IS REVIEWED ANNUALLY FOR COMPLIANCE BY THE LIQUIDATING TRUSTEE. FORM 990, PART VI, SECTION C, LINE 19 HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC NO DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XII: FINANCIAL STATEMENTS AND REPORTING: ON AUGUST 31, 2018, VHS AND 16 OF ITS AFFILIATED COMPANIES, INCLUDING SVMC, EACH FILED VOLUNTARY PETITIONS FOR RELIEF UNDER CHAPTER 11 OF THE UNITED STATES BANKRUPTCY CODE. THE BANKRUPTCY CASES ARE JOINTLY ADMINISTERED UNDER CASE NO. 18-20151 IN THE UNITED STATES BANKRUPTCY COURT FOR THE CENTRAL DISTRICT OF CALIFORNIA. ON SEPTEMBER 4, 2020, THE EFFECTIVE DATE OF THE PLAN OF LIQUIDATION OCCURRED AND THE PLAN WAS SUBSTANTIALLY CONSUMMATED. ALL CONDITIONS PRECEDENT TO THE EFFECTIVE DATE OF THE PLAN SET FORTH IN SECTION 12.2 OF THE PLAN HAVE EITHER BEEN SATISFIED OR WAIVED IN ACCORDANCE WITH THE PLAN AND THE CONFIRMATION ORDER. ON SEPTEMBER 4, 2020, THE EFFECTIVE DATE OF THE PLAN OF LIQUIDATION OCCURRED AND THE PLAN WAS SUBSTANTIALLY CONSUMMATED. ALL CONDITIONS PRECEDENT TO THE EFFECTIVE DATE OF THE PLAN SET FORTH IN SECTION 12.2 OF THE PLAN HAVE EITHER BEEN SATISFIED OR WAIVED IN ACCORDANCE WITH THE PLAN AND THE CONFIRMATION ORDER. COURT FILINGS ARE AVAILABLE AT KCCLLC.NET/VERITYHEALTH. FORM 990, PART XI: OTHER CHANGES TO NET ASSETS: INTERCOMPANY TRANSFER TO WRITE-OFF BALANCES DUE $490,578,738. ROBERT F KENNEDY MEDICAL CENTER FOUNDATION 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 953745227 INACTIVE CA 501(C)(3) LINE 7 VHS 0 ST FRANCIS MEDICAL CENTER FOUNDATION 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 953190773 HOSPITAL SUPPORT CA 501(C)(3) LINE 12A, I VHS 0 ST VINCENT FOUNDATION 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 953922551 HOSPITAL SUPPORT CA 501(C)(3) LINE 12A, I VHS 1 SAINT LOUISE REGIONAL HOSPITAL FOUNDATION 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 562384735 HOSPITAL SUPPORT CA 501(C)(3) LINE 12A, I VHS 0 SETON MEDICAL CENTER FOUNDATION 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 942824033 HOSPITAL SUPPORT CA 501(C)(3) LINE 12A, I VHS 0 O'CONNOR HOSPITAL FOUNDATION 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 770006295 HOSPITAL SUPPORT CA 501(C)(3) LINE 12A, I VHS 0 ST FRANCIS MEDICAL CENTER 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 912154439 HOSPITAL CA 501(C)(3) LINE 3 VHS 0 SAINT LOUISE REGIONAL HOSPITAL 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 912154437 HOSPITAL CA 501(C)(3) LINE 3 VHS 0 SETON MEDICAL CENTER 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 912154441 HOSPITAL CA 501(C)(3) LINE 3 VHS 0 O'CONNOR HOSPITAL 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 912154436 HOSPITAL CA 501(C)(3) LINE 3 VHS 0 ST VINCENT DIALYSIS CENTER 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 953749293 HOSPITAL CA 501(C)(3) LINE 3 VHS 1 VERITY BUSINESS SERVICES 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 510659139 SUPPORT CA 501(C)(3) LINE 12B, II VHS 0 VERITY MEDICAL FOUNDATION 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 453691852 SUPPORT CA 501(C)(3) LINE 10 VHS 0 VERITY HEALTH SYSTEM OF CALIFORNIA INC 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 912145484 SUPPORT CA 501(C)(3) LINE 12B, II N/A 0 VHS LIQUIDATING TRUST 6300 CANOGA AVE SUITE 1500W WOODLAND HILLS CA 91367 852762852 LIQUIDATION CA T 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 SCHEDULE R, PART II, COLUMN (G) THE REPORTING FOR PART II, COLUMN (G) REFLECTS THE ORGANIZATIONAL STRUCTURE AS PRESENTED IN THE FILING ORGANIZATION'S GOVERNING DOCUMENTS. HOWEVER, IN ACCORDANCE WITH THE ORGANIZATION'S WIND DOWN FOR EVENTUAL DISSOLUTION, BY THE END OF FY21 THE LIQUIDATING TRUSTEE HAD CONTROL OVER ALL OF THE ENTITIES LISTED ON PART II.