SEQUOIA HOSPITAL FOUNDATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- SEQUOIA HOSPITAL FOUNDATION (EIN 94-2909990)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201721359349304527
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-15T11:14:01-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 111986323 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARCUM LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 MONTGOMERY STREET 1900 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94104 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942909990 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEQUOIA HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SEQU | BusinessNameControlTxt |
| Phone | 6503675657 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 170 ALAMEDA DE LAS PULGAS | AddressLine1Txt |
| City | REDWOOD CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94062 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GAIL D RUDOLPH | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 6503675657 | PhoneNum |
| Signature | 2017-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANNE BIANCHINI | PreparerPersonNm |
| PTIN | P00875158 | PTIN |
| Phone | 4154326200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GAIL D RUDOLPH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 170 ALAMEDA DE LAS PULGAS | AddressLine1Txt |
| City | REDWOOD CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94062 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,972,774 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SEQUOIAHOSPITALFOUNDATION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO RAISE FUNDS AND CULTIVATE OTHER RESOURCES TO SUPPORT SEQUOIA HOSPITAL | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 141 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,147,542 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,299,992 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,616,309 | PYInvestmentIncomeAmt |
| CY Investment Income | -$315,983 | CYInvestmentIncomeAmt |
| PY Other Revenue | $748 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $3,764,599 | PYTotalRevenueAmt |
| CY Total Revenue | $3,984,009 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,225,328 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,900,865 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $60,092 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $350,531 | PYOtherExpensesAmt |
| CY Other Expenses | $383,925 | CYOtherExpensesAmt |
| PY Total Expenses | $3,575,859 | PYTotalExpensesAmt |
| CY Total Expenses | $4,284,790 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $188,740 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$300,781 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,493,709 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,593,919 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,765 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,765 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,478,944 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,579,154 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF SEQUOIA HOSPITAL FOUNDATION IS TO DEVELOP AND SECURE FUNDS AND OTHER RESOURCES, TO ENCOURAGE AWARENESS OF THE ONGOING NEEDS AND CAPABILITIES OF SEQUOIA HOSPITAL, AND TO ASSIST SEQUOIA HOSPITAL IN REACHING ITS GOALS AND OBJECTIVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,927,247 | ExpenseAmt |
| Grant | $3,900,865 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | THROUGH ONGOING CAMPAIGNS, ANNUAL APPEALS, SPECIAL EVENTS AND GENEROUS UNSOLICITED CONTRIBUTIONS, SEQUOIA HOSPITAL FOUNDATION (THE FOUNDATION) IS ABLE TO SUPPORT PATIENT CARE, PROGRAMS AND FACILITIES AT SEQUOIA HOSPITAL (THE HOSPITAL). IN CLOSE ALIGNMENT WITH THE HOSPITAL'S STRATEGIC PLAN, THE FOUNDATION RAISES FUNDS AND MAKES GRANTS TO MEET IDENTIFIED HOSPITAL NEEDS. IN ADDITION, THE FOUNDATION IS ACTIVELY RAISING FUNDS TO SUPPORT THE "NEW SEQUOIA HOSPITAL", INCLUDING EXPANDED EMERGENCY ROOM SERVICES, A FAMILY FOCUSED BIRTHING CENTER, GROWTH OF THE HEART AND VASCULAR INSTITUTE AND MUCH MORE. THE FOUNDATION IS PROUD TO SUPPORT THE REBUILDING PROJECT, WHICH WILL KEEP THE HOSPITAL AT THE FOREFRONT OF MEDICAL CARE IN OUR COMMUNITY, OFFERING WORLD-CLASS MEDICAL CARE IN A COMPASSIONATE, CONVENIENT AND PATIENT-FRIENDLY ENVIRONMENT. | Desc |
| Total Program Service Expenses | $3,927,247 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GAIL D RUDOLPH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6503675712 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 170 ALAMEDA DE LAS PULGAS | AddressLine1Txt |
| City | REDWOOD CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94062 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt |
|---|---|---|---|---|---|---|---|
| STEVEN E SAN FILIPPO | |||||||
| IMMEDIATE PAST CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROBERT O'DONNELL | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARTY MILLER | |||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LISA BOOHAR MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LUIS CASTRO MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANDREW CRESCI | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT DEAN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARA GIATTINA MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BEVERLY JOYCE MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MELISSA KONG MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TARA FOWLER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ELLEN HAAS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PARAAG MARATHE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KEN TEHANEY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DEE TOLLES | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOAN ULIBARRI | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GAIL D RUDOLPH | |||||||
| PRESIDENT | 24.00 | Yes (X) | $0 | $253,600 | $34,085 | 16.00 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $253,600 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $34,085 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $176,825 | FundraisingAmt |
| Related Organizations | $378,884 | RelatedOrganizationsAmt |
| All Other Contributions | $3,744,283 | AllOtherContributionsAmt |
| Noncash Contributions | $2,219,925 | NoncashContributionsAmt |
| Total Contributions | $4,299,992 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $303,779 | TotalRevenueColumnAmt |
| Exclusion | $303,779 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,114,154 | SecuritiesAmt |
| Other | $175,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,791,758 | SecuritiesAmt |
| Other | $117,158 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$677,604 | SecuritiesAmt |
| Other | $57,842 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$619,762 | TotalRevenueColumnAmt |
| Exclusion | -$619,762 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $79,849 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $176,825 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $79,849 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,984,009 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$315,983 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,825,461 | TotalAmt |
| Program Services | $3,825,461 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,404 | TotalAmt |
| Program Services | $75,404 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,889 | TotalAmt |
| Management And General | $79,889 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,524 | TotalAmt |
| Management And General | $65,229 | ManagementAndGeneralAmt |
| Fundraising | $28,295 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,342 | TotalAmt |
| Program Services | $8,829 | ProgramServicesAmt |
| Management And General | $5,547 | ManagementAndGeneralAmt |
| Fundraising | $11,966 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,437 | TotalAmt |
| Management And General | $36,670 | ManagementAndGeneralAmt |
| Fundraising | $10,767 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,280 | TotalAmt |
| Management And General | $35,280 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,382 | TotalAmt |
| Program Services | $11,382 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,152 | TotalAmt |
| Management And General | $7,152 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| OTHER | $39,388 | $6,171 | $33,197 | $20 |
| SUPPLIES | $24,137 | $20,942 | $3,195 | |
| SERVICE FEES | $6,878 | $6,878 | ||
| DUES AND SUBSCRIPTIONS | $6,250 | $6,250 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,266 | TotalAmt |
| Management And General | $417 | ManagementAndGeneralAmt |
| Fundraising | $5,849 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,284,790 | TotalAmt |
| Program Services | $3,927,247 | ProgramServicesAmt |
| Management And General | $297,451 | ManagementAndGeneralAmt |
| Fundraising | $60,092 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,238 | BOYAmt |
| EOY | $3,592 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,989 | BOYAmt |
| EOY | $148,857 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $845,335 | BOYAmt |
| EOY | $1,826,271 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $187,538 | BOYAmt |
| EOY | $25,898 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $390,000 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $216,206 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,176 | BOYAmt |
| EOY | $173,794 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,320,353 | BOYAmt |
| EOY | $14,617,255 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $739,080 | BOYAmt |
| EOY | $2,798,252 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,493,709 | BOYAmt |
| EOY | $19,593,919 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,765 | BOYAmt |
| EOY | $14,765 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,765 | BOYAmt |
| EOY | $14,765 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,999,442 | BOYAmt |
| EOY | $8,723,698 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,867,947 | BOYAmt |
| EOY | $9,235,601 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,611,555 | BOYAmt |
| EOY | $1,619,855 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,478,944 | BOYAmt |
| EOY | $19,579,154 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,493,709 | BOYAmt |
| EOY | $19,593,919 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$300,781 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $57,681 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $442,561 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$99,251 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Non Func | Yes (X) | SupportingOrgType3NonFuncInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIGNITY HEALTH DBA SEQUOIA HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941196203 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $3,900,865 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $3,900,865 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | Yes (1) | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (1) | SupportedOrgVoiceInvestmentInd |
Adjusted Net Income AdjustedNetIncomeGrp
Net ST Capital Gain Adj Net Incm NetSTCapitalGainAdjNetIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $147,983 | PriorYearAmt |
| Current Year | $0 | CurrentYearAmt |
Recoveries PY Distributions RecoveriesPYDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
| Current Year | $0 | CurrentYearAmt |
Other Gross Income OtherGrossIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $320,244 | PriorYearAmt |
| Current Year | $303,779 | CurrentYearAmt |
Adjusted Gross Income AdjustedGrossIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $468,227 | PriorYearAmt |
| Current Year | $303,779 | CurrentYearAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
| Current Year | $0 | CurrentYearAmt |
Production Income ProductionIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $89,562 | PriorYearAmt |
| Current Year | $79,889 | CurrentYearAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
| Current Year | $0 | CurrentYearAmt |
Total Adjusted Net Income TotalAdjustedNetIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $378,665 | PriorYearAmt |
| Current Year | $223,890 | CurrentYearAmt |
Minimum Asset Amount MinimumAssetAmountGrp
Average Monthly FMV Of Sec AverageMonthlyFMVOfSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $19,051,449 | PriorYearAmt |
| Current Year | $15,627,832 | CurrentYearAmt |
Average Monthly Cash Balances AverageMonthlyCashBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $148,614 | PriorYearAmt |
| Current Year | $197,852 | CurrentYearAmt |
FMV Other Non Exempt Use Asset FMVOtherNonExemptUseAssetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
| Current Year | $1,800,000 | CurrentYearAmt |
Total FMV Of Non Exempt Use Asset TotalFMVOfNonExemptUseAssetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $19,200,063 | PriorYearAmt |
| Current Year | $17,625,684 | CurrentYearAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discount Claimed | $0 | DiscountClaimedAmt |
Acquisition Indebtedness AcquisitionIndebtednessGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
| Current Year | $0 | CurrentYearAmt |
Adjusted FMV Less Indebtedness AdjustedFMVLessIndebtednessGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $19,200,063 | PriorYearAmt |
| Current Year | $17,625,684 | CurrentYearAmt |
Cash Deemed Charitable CashDeemedCharitableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $288,001 | PriorYearAmt |
| Current Year | $264,385 | CurrentYearAmt |
Net Vl Non Exempt Use Assets NetVlNonExemptUseAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $18,912,062 | PriorYearAmt |
| Current Year | $17,361,299 | CurrentYearAmt |
Pct Of Net Vl Non Exempt Use Ast PctOfNetVlNonExemptUseAstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $661,922 | PriorYearAmt |
| Current Year | $607,645 | CurrentYearAmt |
Recoveries PY Distri Min Asset RecoveriesPYDistriMinAssetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $0 | PriorYearAmt |
| Current Year | $0 | CurrentYearAmt |
Total Minimum Asset TotalMinimumAssetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prior Year | $661,922 | PriorYearAmt |
| Current Year | $607,645 | CurrentYearAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Adj Net Income Distributable | $378,665 | CYAdjNetIncomeDistributableAmt |
| CY Pct85 Adjusted Net Income | $321,865 | CYPct85AdjustedNetIncomeAmt |
| CY Total Min Ast Distributable | $661,922 | CYTotalMinAstDistributableAmt |
| CY Greater Adjusted Minimum | $661,922 | CYGreaterAdjustedMinimumAmt |
| CY Income Tax Imposed PY | $0 | CYIncomeTaxImposedPYAmt |
| CY Distributable As Adjusted | $661,922 | CYDistributableAsAdjustedAmt |
| First Year Type3 Non Func | Yes (X) | FirstYearType3NonFuncInd |
Distributions DistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Paid Accomplish Exempt Prps | $3,900,865 | CYPaidAccomplishExemptPrpsAmt |
| CY Pd In Excess Income Activity | $0 | CYPdInExcessIncomeActivityAmt |
| CY Administrative Expense Paid | $0 | CYAdministrativeExpensePaidAmt |
| Exempt Use Assets Acquis Paid | $0 | ExemptUseAssetsAcquisPaidAmt |
| Qualified Set Aside | $0 | QualifiedSetAsideAmt |
| CY Other Distributions | $0 | CYOtherDistributionsAmt |
| CY Total Annual Distributions | $3,900,865 | CYTotalAnnualDistributionsAmt |
| CY Distri Attentive Suprt Org | $3,900,865 | CYDistriAttentiveSuprtOrgAmt |
| CY Distributable As Adjusted | $661,922 | CYDistributableAsAdjustedAmt |
| CY Distribution Yr | 100.000000000000 | CYDistributionYrRt |
Distribution Allocations DistributionAllocationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Distributable As Adjusted | $661,922 | CYDistributableAsAdjustedAmt |
| Underdistributions | $0 | UnderdistributionsAmt |
| Excess Distribution Cyov Yr2 | $0 | ExcessDistributionCyovYr2Amt |
| Excess Distribution Cyov Yr1 | $0 | ExcessDistributionCyovYr1Amt |
| Total Excess Distribution Cyov | $0 | TotalExcessDistributionCyovAmt |
| Cyov Applied Underdistri PY | $0 | CyovAppliedUnderdistriPYAmt |
| Cyov Applied Underdistr CPY | $0 | CyovAppliedUnderdistrCPYAmt |
| Excess Distribution Cyov | $0 | ExcessDistributionCyovAmt |
| CY Total Annual Distributions | $3,900,865 | CYTotalAnnualDistributionsAmt |
| CY Distrib App Underdistri PY | $0 | CYDistribAppUnderdistriPYAmt |
| CY Distri App Distributable | $661,922 | CYDistriAppDistributableAmt |
| Excess Distribution | $3,238,943 | ExcessDistributionAmt |
| Remaining Underdistri PY | $0 | RemainingUnderdistriPYAmt |
| Remaining Underdistri CY | $0 | RemainingUnderdistriCYAmt |
| Excess Distri Cyov To Next Yr | $3,238,943 | ExcessDistriCyovToNextYrAmt |
| Excess From Year3 | $0 | ExcessFromYear3Amt |
| Excess From Year2 | $0 | ExcessFromYear2Amt |
| Excess From Year1 | $3,238,943 | ExcessFromYear1Amt |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PART IV, SECTION D, LINE 3: | THE FOUNDATION HAS A CLOSE, HISTORICAL, AND CONTINUOUS WORKING RELATIONSHIP WITH THE HOSPITAL. THE HOSPITAL PRESIDENT IS A FOUNDATION BOARD MEMBER; THE BOARD ARE RESPONSIBLE FOR REVIEWING AND APPROVING GRANTS PAID TO THE HOSPITAL. |
| PART V, SECTION D, LINE 8: | THE FOUNDATION WORKS EXCLUSIVELY TO SUPPORT THE HOSPITAL. THEY REGULARLY INTERACT WITH THE HOSPITAL TO ENSURE THEY ARE ABLE TO ASSIST WITH SPECIFIC PURCHASES, PROJECTS OR PROGRAMS IN CLOSE ALIGNMENT WITH THE HOSPITAL'S STRATEGIC PLAN. THIS IS ASSISTED BY REPRESENTATION ON THE BOARD BY THE HOSPITAL PRESIDENT. SUPPORT BY THE FOUNDATION ENABLES THE HOSPITAL TO AVOID THE INTERRUPTION OF CERTAIN FUNCTIONS/ACTIVITIES. |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,278,126 | BeginningYearBalanceAmt |
| Contributions | $8,300 | ContributionsAmt |
| Investment Earnings Or Losses | -$170,016 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $7,116,410 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,962,549 | BeginningYearBalanceAmt |
| Contributions | $5,187,853 | ContributionsAmt |
| Investment Earnings Or Losses | $127,724 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $7,278,126 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,861,586 | BeginningYearBalanceAmt |
| Contributions | $100,963 | ContributionsAmt |
| End Year Balance | $1,962,549 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,839,785 | BeginningYearBalanceAmt |
| Contributions | $21,801 | ContributionsAmt |
| End Year Balance | $1,861,586 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,811,735 | BeginningYearBalanceAmt |
| Contributions | $28,050 | ContributionsAmt |
| End Year Balance | $1,839,785 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.71000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.23000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.06000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $162,412 | OtherCostOrOtherBasisAmt |
| Book Value | $162,412 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $227,588 | OtherCostOrOtherBasisAmt |
| Depreciation | $216,206 | DepreciationAmt |
| Book Value | $11,382 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $173,794 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BENEFICIAL INTEREST IN SPLIT-INTEREST AGREEMENTS | $998,252 |
| LAND HELD FOR SALE | $1,800,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,798,252 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CHARITABLE REMAINDER TRUST | Desc |
| Amt | $14,765 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $14,765 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $4,957,543 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $57,681 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $1,094,993 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$99,251 | OtherRevenueAmt |
| Revenue Not Reported | $1,053,423 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,904,120 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $79,889 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $79,889 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,984,009 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,299,894 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $1,094,993 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $1,094,993 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,204,901 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $79,889 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $79,889 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,284,790 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE FOUNDATION INTENDS TO HOLD ITS ENDOWMENT FUND FOR THE LONG TERM AND USE THE EARNINGS TO SUPPORT THE HOSPITAL. |
| PART X, LINE 2: | THE FOUNDATION IS A QUALIFIED ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND FRANCHISE TAXES UNDER SECTION 23701D OF THE CALIFORNIA REVENUE AND TAXATION CODE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE THE TAX POSITIONS TAKEN AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN AND HAS CONCLUDED THAT AS OF JUNE 30, 2016 AND 2015, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A TAX LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -50,251. BAD DEBT LOSSES -49,000. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GO GALA | Event1Nm |
| Gross Receipts Event1 | $161,161 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $103,202 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $57,959 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $57,959 | OtherDirectExpensesEvent1Amt |
| Event2 | BOOT, SCOOT, AND BOOGIE | Event2Nm |
| Gross Receipts Event2 | $95,513 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $73,623 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $21,890 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $21,890 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $256,674 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $176,825 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $79,849 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $79,849 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $79,849 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $0 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIGNITY HEALTH DBA SEQUOIA HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 170 ALAMEDA DE LAS PULGAS | AddressLine1Txt |
| City | REDWOOD CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94062 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 941196203 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $3,825,461 | CashGrantAmt |
| Purpose Of Grant | TO SUPPORT THE HOSPITAL IN REACHING ITS GOALS AND OBJECTIVES | PurposeOfGrantTxt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | NURSING SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 8 | RecipientCnt |
| Cash Grant | $75,404 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FOUNDATION DISBURSES THE VAST MAJORITY OF ITS GRANTS TO THE HOSPITAL TO FUND SPECIFIC PURCHASES, PROJECTS OR PROGRAMS, IN CLOSE ALIGNMENT WITH THE HOSPITAL'S STRATEGIC PLAN. THE FOUNDATION INVITES GRANT REQUESTS FROM THE HOSPITAL FOR EQUIPMENT AND PROGRAMS TO ENHANCE PATIENT CARE. GRANT REQUESTS ARE CONSIDERED CAREFULLY BY THE FINANCE/GRANTS COMMITTEE AND SENT FOR APPROVAL BY THE BOARD OF DIRECTORS. BEFORE GRANT FUNDS ARE PAID TO THE HOSPITAL, FOUNDATION STAFF PERSONALLY CONFIRM THAT RELEVANT ITEMS HAVE BEEN RECEIVED. GRANT DISBURSEMENTS ARE THEN MADE, BASED ON COPIES OF INVOICES RECEIVED. THE FOUNDATION SUPPORTS THE SEQUOIA HOSPITAL/SAN FRANCISCO STATE UNIVERSITY BACHELOR OF SCIENCE (BSN) IN NURSING SATELLITE PROGRAM AT CANADA COLLEGE THROUGH SCHOLARSHIPS TO STUDENTS FUNDED BY GENEROUS DONORS. THE PROGRAM WAS FOUNDED BY AND RECEIVES CONTINUING SUPPORT FROM A UNIQUE COALITION OF COMMUNITY PARTNERS INCLUDING SEQUOIA HOSPITAL, THE SEQUOIA HEALTHCARE DISTRICT, SAN FRANCISCO STATE UNIVERSITY (SSFU) AND CANADA COLLEGE. SCHOLARSHIPS ARE AWARDED BY THE 6-8 MEMBER SCHOLARSHIP COMMITTEE AFTER A RIGOROUS APPLICATION AND REVIEW PROCESS OVERSEEN BY THE FOUNDATION'S BOARD OF DIRECTORS AND IN CLOSE COLLABORATION WITH THE FINANCIAL AID OFFICE AT SSFU. SCHOLARSHIP AWARDS ARE MADE ONLY WHEN SFSU HAS CONFIRMED THAT THE STUDENTS ARE IN GOOD STANDING AND REGISTERED FOR THE REQUIRED CLASSES IN THE PROGRAM. OCCASIONALLY, THE FOUNDATION AWARDS SMALL GRANTS TO COMMUNITY PARTNERS WHO COLLABORATE WITH THE HOSPITAL FOR SPECIFIC HEALTH, WELLNESS AND OUTREACH PROGRAMS. ALL SUCH GRANTS ARE MADE FROM DONOR FUNDS RESTRICTED TO THESE PROJECTS AND WITH THE APPROVAL OF THE FOUNDATION'S PRESIDENT AS REQUIRED BY POLICY. USE OF THE FUNDS IS VERIFIED WITH EACH COMMUNITY PARTNER. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GAIL D RUDOLPH | PersonNm |
| Title | PRESIDENT | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $225,196 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $27,949 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $455 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $22,195 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $11,890 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $287,685 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $23,645 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Real Estate Residential RealEstateResidentialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,800,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (6 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | OFFICE SUPPLIES, CATERING, MARKETING, TRAVEL, ETC. | 1 | $378,884 | FMV |
| Yes (X) | CASES OF WINE | 10 | $9,000 | FMV |
| Yes (X) | GOLF PACKAGE FOR LEXUS CHARITY | 1 | $5,000 | FMV |
| Yes (X) | LINE ISOLATION MONITOR PANEL | 1 | $2,000 | FMV |
| Yes (X) | OLYMPIC CLUB GOLF FOR RAFFLE | 3 | $1,200 | FMV |
| Yes (X) | CASE OF WINE | 1 | $196 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE PRESIDENT REVIEWS THE FORM 990 FOR ACCURACY AND COMPLETENESS. PRIOR TO FILING, A PUBLIC DISCLOSURE COPY IS PROVIDED TO BOTH THE EXECUTIVE AND AUDIT COMMITTEES FOR THEIR REVIEW AND APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE FOUNDATION'S BOARD MEMBERS ANNUALLY PARTICIPATE IN THE FORMAL PROCESS ESTABLISHED BY DIGNITY HEALTH FOR MONITORING CONFLICTS ON THE BOARDS OF ITS AFFILIATED HOSPITALS. THE CONFLICT OF INTEREST POLICY IS REVIEWED AND ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE COMPLETE AND SUBMITTED BY EACH BOARD MEMBER. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FOUNDATION'S GOVERNING DOCUMENTS, POLICIES, FINANCIAL STATEMENTS AND INFORMATIONAL RETURNS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -50,251. BAD DEBT LOSSES -49,000. |
| FORM 990, PART XII, LINE 2C | NO CHANGE FROM PRIOR YEAR. |
| PART XI, LINE 8: | A PRIOR PERIOD ADJUSTMENT WAS MADE TO RECORD A BENEFICIAL INTEREST IN A CHARITABLE REMAINDER UNITRUST THAT WAS RECEIVED DURING THE YEAR ENDED JUNE 30, 2014, AND THAT HAD BEEN OMITTED IN ERROR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIGNITY HEALTH DBA SEQUOIA HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 170 ALAMEDA DE LAS PULGAS | AddressLine1Txt |
| City | REDWOOD CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94062 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941196203 | EIN |
| Primary Activities | MEDICAL & HEALTHCARE SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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