2012-05-10T15:36:23-05:00 2011-06-30 GRANT THORNTON LLP ONE CALIFORNIA STREET SUITE 2300 SAN FRANCISCO CA 94111 990 2010-07-01 912145484 Daughters of Charity Health System DAUG 6509174501 26000 Altamont Road Los Altos Hills CA 940224317 MICHAEL STUART 6509174501 2012-05-07 true JOE DETRANE 4159863900 2010 2016-02-24 21:20:13Z Robert Issai 26000 Altamont Road Los Altos Hills CA 940224317 98755387 false 0928 X www.dochs.org X 2001 CA SEE ATTACHMENT 1 8 8 74 8 3832 -5218 4873739 4246764 54247369 57060468 3481328 8974835 1105907 28473320 63708343 98755387 17500 619661 0 0 16615728 17154937 0 0 0 73626321 57276889 90259549 75051487 -26551206 23703900 580175167 567660169 661248589 622843685 -81073422 -55183516 IN THE SPIRIT OF OUR FOUNDERS, ST. VINCENT DE PAUL, ST. LOUISE DE MARILLAC, AND ST. ELIZABETH ANN SETON, THE DAUGHTERS OF CHARITY HEALTH SYSTEM IS COMMITTED TO SERVING THE SICK AND THE POOR. WITH JESUS CHRIST AS OUR MODEL, WE ADVANCE AND STRENGTHEN THE HEALING MISSION OF THE CATHOLIC CHURCH BY PROVIDING COMPREHENSIVE, EXCELLENT HEALTH CARE THAT IS COMPASSIONATE AND ATTENTIVE TO THE WHOLE PERSON; BODY, MIND AND SPIRIT. WE PROMOTE HEALTHY FAMILIES, RESPONSIBLE STEWARDSHIP OF THE ENVIRONMENT, AND A JUST SOCIETY THROUGH VALUE-BASED RELATIONSHIPS AND COMMUNITY-BASED COLLABORATION. false false 56443529 619661 57060468 THE DAUGHTERS OF CHARITY HEALTH SYSTEM (SYSTEM) IS A REGIONAL HEALTH SYSTEM IN CALIFORNIA. THE SYSTEM PROVIDES ACUTE, LONG-TERM, COMMUNITY HEALTH, PSYCHIATRIC, REHABILITATION, AND RESIDENTIAL CARE THROUGH HOSPITALS (LOCAL HEALTH MINISTRIES) LOCATED IN NORTHERN AND SOUTHERN CALIFORNIA. THROUGH ITS ACCOUNTING, FINANCE, AND PATIENT FINANCIAL SERVICES DEPARTMENTS, THE ORGANIZATION PROVIDES LEADERSHIP FOR THE SYSTEM AND SUPPORT FOR THE LOCAL HEALTH MINISTRIES. THIS SUPPORT INCLUDES PROVIDING STRATEGIC AND FINANCIAL PLANNING FOR THE LOCAL HEALTH MINISTRIES, INFORMATION REPORTING, NEGOTIATING AND MANAGING CERTAIN SYSTEM-WIDE-CONTRACTS WITH VENDORS TO REDUCE COSTS, INSURANCE VERIFICATION, AND CUSTOMER SERVICE FOR PATIENTS WITH BILLING QUESTIONS. 56443529 true true false true false false false false false true false false true true false false true false false false false false false false false false true false true true false false false false false true false false false false false false false false true true false false false false true 58 0 true 74 true true true true CJ false false false false false false false false X 8 8 false false false false true true true true true false true true true true true true true true true true true true CA X MIKE STUART 6509174500 26000 ALTAMONT ROAD Los Altos Hills CA 940224317 X Sr Marjory Ann Baez DC 1.0 X X 0 0 0 Sr Marion Bill DC 1.0 X X 0 0 0 Sr Betty Marie Dunkel DC 1.0 X 0 0 0 Sr Judith Lynn Gardenhire DC 1.0 X 0 0 0 Sr Christina Maggi DC 1.0 X 0 0 0 Sr Janet Barrett DC 1.0 X X 0 0 0 S Daniel Higgins MD 1.0 X 0 0 0 William Del Biaggio 1.0 X 0 0 0 Robert Issai 40.0 X 1108923 0 284616 Mike Stuart 40.0 X 412410 0 92382 Conway Collis 40.0 X 476264 0 85351 Richard Hutsell 40.0 X 357037 0 144401 Nancy Carragee 40.0 X 243064 0 29102 Gerry Kozai 0.0 X 596899 0 119008 Lorraine Auerbach 0.0 X 499770 0 62938 Margaret Catherine Fickes 0.0 X 478601 0 119879 James Dover 0.0 X 491432 0 65301 Joanne Evelyn Allen 0.0 X 396040 0 107903 Hayden Klaeveman 0.0 X 324536 0 508 5384976 0 1111389 45 true true false ROPES GRAY LLP ONE INTERNATIONAL PLACE BOSTON MA 02110 LEGAL & CONSULTING 3638676 JONES DAY 1755 EMBARCADERO ROAD PALO ALTO CA 94303 LEGAL 1768933 DELOITTE TOUCHE LLP 555 MISSION STREET SUITE 1400 SAN FRANCISCO CA 94105 AUDITING SERVICES 1246245 XROADS SOLUTIONS GROUP LLC 1821 EAST DYER RD SUITE 225 SANTA ANA CA 92705 CONSULTING 885702 THE ALTOS GROUP 13100 SKYLINE BLVD OAKLAND CA 84619 CONSULTING 644474 13 3606764 640000 4246764 REGIONAL LEADERSHIP AND ADMINISTRATION 900099 54833544 54833544 PARTNERSHP INCOME - PROGRAM SERVICES 541900 1950096 1946264 3832 OTHER OPERATING REVENUE 900099 276828 276828 57060468 8974835 8974835 0 0 0 0 0 0 SYSTEM ACTUARIAL PENSION 900099 26787943 26787943 SYSTEM PENSION ACCRUAL REVERSAL 900099 1685377 1685377 28473320 98755387 57056636 3832 37448155 619661 619661 0 0 0 3118141 2338606 779535 0 10134307 7600730 2533577 1974808 1481106 493702 1395812 1046859 348953 531869 398902 132967 23378247 17533685 5844562 536829 402622 134207 2306625 1729969 576656 278683 209012 69671 0 0 1416511 1062383 354128 73655 55241 18414 322592 241944 80648 26124071 19593053 6531018 0 682747 512060 170687 438003 328502 109501 0 141539 106154 35385 372508 279381 93127 0 239919 179939 59980 0 SALES TAXES 180615 135461 45154 RECRUITING 78268 58701 19567 OUTSIDE TRAINING SESSIONS 51632 38724 12908 CATERING 40381 30286 10095 GIFTS & ENTERTAINMENT 17476 13107 4369 596588 447441 149147 75051487 56443529 18607958 0 62762001 41421252 1001510 729921 6142635 16489403 4782650 1006440 50642 3776210 1874382 3442250 508343997 501801133 580175167 567660169 10630666 10791245 462515000 453174000 188102923 158878440 661248589 622843685 X -83125015 -57719417 2051593 2535901 -81073422 -55183516 580175167 567660169 X 23703900 2186006 X X false true true X false X X X false false false ROBERT F KENNEDY MEDICAL CENTER 912154440 03 true 0 O'CONNOR HOSPITAL 912154436 03 true 0 SAINT LOUISE REGIONAL HOSPITAL 912154437 03 true 0 SETON MEDICAL CENTER 912154441 03 true 0 ST FRANCIS MEDICAL CENTER 912154439 03 true 0 ST VINCENT MEDICAL CENTER 912154438 03 true 0 6 Robert F. Kennedy Medical Center, O' Connor Hospital, Saint Louise Regional Hospital, Seton Medical Center, St. Francis Medical Center and St. Vincent Medical Center are affiliated corporations with Daughters of Charity Health System ("DCHS"), as defined in its bylaws. Each local health ministry is controlled by DCHS by operation of DCHS being the sole member corporation of each supported organization and being named as such in the bylaws of each listed supported organization. See Attachment 2 for a description of support provided to each of the affiliated corporations. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false true 214672 false false true 64011 278683 false Schedule C, Part II-B, Line 1i The majority of the lobbying expenditures for FY 2011 regarded the state hospital provider fee program, including legislation required to conform the fee to applicable federal requirements as determined by the federal government and legislation extending the fee an additional 6 months. The original fee program, and extension, yielded $75 million to the Daughters of Charity Health System in FY 2011 on the basis of DCHS' service to Medi-Cal patients. A smaller portion of the expenditures were spent on other legislative matters, specifically the state budget. We have not engaged in any lobbying expenditures to influence general public opinion. 33700 33700 579495 576821 2674 3493211 395919 3097292 676244 0 676244 3776210 DUE FROM RELATED PARTIES 453031552 UNDER BOND INDENTURE AGREEMENT 42807818 2005 DEF COST OF ISSUANCE 840165 2005 DEF UNDERWRITER FEE 1596676 2008A DEF COST OF ISSUANCE 838660 2008A DEF UNDERWRITER FEE 890781 TRF - BANK OF AMERICA 1609507 OTHER RECEIVABLES 148548 DEPOSITS 37426 501801133 0 PENSION OBLIGATION 139210219 LONG-TERM DEBT 18919799 OTHER ACCRUED LIABILITIES 747591 DUE TO GOVERNMENT AGENCIES 831 158878440 SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE DAUGHTERS OF CHARITY HEALTH SYSTEM AND ITS AFFILIATES DO NOT HAVE A LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740) ON THEIR CONSOLIDATED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2011. AS SUCH, THERE WAS NO FIN 48 (ASC 740) DISCLOSURE IN THE FOOTNOTES TO THE CONSOLIDATED FINANCIAL STATEMENTS OF DAUGHTERS OF CHARITY HEALTH SYSTEM. true Robert F Kennedy Medical Center 26000 Altamont Rd Los Altos Hills CA 94022 912145484 501(c)(3) 606561 PROGRAM SERVICE 1 0 GRANTS PAID BY THE DAUGHTERS OF CHARITY HEALTH SYSTEM SCHEDULE I, PARTS I & II As a result of diminished patient volume and continuing financial losses, Robert F. Kennedy Medical Center suspended its hospital operations on December 9, 2004, and is no longer performing patient activities. As of June 30, 2011, remaining net assets, including receivable recoveries recorded during the year, were transferred to Daughters of Charity Health System, its sole corporate member. Included in the transfer were wind-down liabilities of $606,561 that have been assumed by DCHS. X true true X X X X X true true false false false false false false false Robert Issai 884055 0 0 0 224868 0 263785 0 20831 0 1393539 0 0 0 Mike Stuart 398505 0 0 0 13905 0 52808 0 39574 0 504792 0 0 0 Conway Collis 454329 0 0 0 21935 0 78050 0 7301 0 561615 0 0 0 Richard Hutsell 335022 0 0 0 22015 0 101861 0 42540 0 501438 0 0 0 Nancy Carragee 239831 0 0 0 3233 0 11572 0 17530 0 272166 0 0 0 Gerry Kozai 577717 0 0 0 19182 0 90660 0 28348 0 715907 0 0 0 Lorraine Auerbach 426118 0 0 0 73652 0 17692 0 45246 0 562708 0 0 0 Margaret Catherine Fickes 436843 0 0 0 41758 0 80283 0 39596 0 598480 0 0 0 James Dover 424703 0 0 0 66729 0 21684 0 43617 0 556733 0 0 0 Joanne Evelyn Allen 380666 0 0 0 15374 0 79976 0 27927 0 503943 0 0 0 Hayden Klaeveman 0 0 0 0 324536 0 0 0 508 0 325044 0 0 0 BENEFITS PROVIDED BY DCHS SCHEDULE J, PART I, LINE 1A Discretionary spending account: The President and CEO of DCHS is provided a discretionary spending account with an annual limit of $25,000 as part of his employment contract. The payments are reported as taxable compensation and reported on Form W-2. All the compensated individuals listed in Part VII, except the Former VP of Quality, receive an auto allowance. The payments are reported as taxable compensation and reported on Form W-2. Severance Payment Schedule J, Part I, Line 4A The following individual received a severance payment, which is included in compensation reported on schedule J, Part II, column B(III): Hayden Klaeveman $141,844 Nonqualified retirement plan Schedule J, Part I, Line 4B The following Individuals participated in supplemental nonqualified retirement plans, which are included in compensation reported on Schedule J, Part II, Column C: Robert Issai $88,572 Mike Stuart $40,301 Conway Collis $32,500 Gerry Kozai $16,835 Joanne Evelyn Allen $38,496 CA STATEWIDE COMMUNITIES DEV AUTHY 680164610 130911A83 2005-03-18 507644195 EQUIPMENT ACQ. & REFUND 2001 BONDS false false false CA STATEWIDE COMMUNITIES DEV AUTHY 680164610 130795ZS9 2008-11-18 143655000 REFUND 2005 SERIES B BONDS false false false 509644195 27092736 2000000 5329545 30000000 445221914 2005 false true true true 143718230 13714584 3646 130000000 true false true true false false false false true 0.00000 0.00000 0.00000 true false false false false true 0.00000 0.00000 0.00000 true false true false false false true false false false false false true Schedule K, Part I The tax exempt bond liabilities were issued for the purpose of borrowing funds to (1) acquire property, plant, and equipment of certain acute health care hospitals owned by Daughters of Charity Health System or its affiliates, (2) fund certain routine capital expenditures of the members, and (3) pay the cost of insuring the bonds. Schedule K, Part I, Part I, Column E The difference in the issue price reported in Part I, column E and total proceeds reported in Part II, line 3 relates to investment earnings on net proceeds and proceeds released from reserve funds. ROBERT ISSAI HOME PURCHASE X 912000 182838 false true true LORRAINE AUERBACH HOME PURCHASE X 500000 388750 false true true JAMES DOVER HOME PURCHASE X 250000 158333 false true true 729921 Form 990 Part IV, Line 12A, and Part XII, Line 2b and 2c The financial statements of the organization are consolidated by the Daughters of Charity Health System and include each of the affiliated Local Health Ministries, their related fundraising Foundations and other related organizations (as listed on form 990 Schedule R) in accordance with GAAP and audited by an independent public accounting firm. The Daughters of Charity Health System's Board and Audit Committee of the Board have responsibility for oversight of the audit of the consolidated financial statements and selection of the independent public accounting firm. Form 990 Part VI, Line 6 The Daughters of Charity Health System has only one member, the Daughters of Charity Ministry Services Corporation, a California nonprofit religious corporation. Form 990 Part VI, Line 7a The Member's Board of Directors may appoint the organization's directors and officers. Form 990 Part VI, Line 7b The sole member has broad powers including the power to amend the Bylaws and Articles of Incorporation, and approve, interpret and change any statement of mission, philosophy, role or purpose of Daughters of Charity Health System. The member has the right to approve any merger, dissolution, consolidation or reorganization of Daughters of Charity Health System. In addition, the member has the right to approve capital and operating budgets, approve debt incurred or guaranteed, approve the disposition of the assets, and establish policy concerning quality of care, finance and resources. Finally, the member has such other powers and rights as provided by the California Nonprofit Corporation Law. Form 990, Part VI, Line 11b Grant Thornton LLP and the System's finance staff work together to gather the required tax information necessary to complete the tax returns. The initial draft return is reviewed by Grant Thornton and the System's finance staff, and the Chief Financial Officer. After the return is discussed and reviewed, recommended changes are reflected on the return and a draft tax return is prepared. The return is then reviewed by the Audit, Risk and Compliance Committee of the Board. The full Board of Directors of the organization receives the final version of the draft return prior to the return being filed. Form 990, Part VI, Line 12c The Daughters of Charity Health System ("DCHS") has a Conflict of Interest Policy that covers DCHS 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 Presidents/CEOs of the Local Health Ministries report the conflict of interest findings and resolutions to their respective Board of Directors. This policy is reviewed annually for compliance by the DCHS's Corporate Responsibility Officer. Form 990, Part VI, Line 15a and 15b The Daughters of Charity Health System ("DCHS") compensation programs cover DCHS and all of its affiliated Local Health Ministries. The CEO of each Local Health Ministry is employed by DCHS. The DCHS compensation programs are designed to recruit, retain, and motivate qualified executives. The programs are designed for positions that have a significant impact on the high-level strategic and policy direction of the Daughters of Charity Health System and its affiliated Local Health Ministries. All of the Local Health Ministry CEOs are paid directly by the Daughters of Charity Health System and covered by the Daughters of Charity Health System compensation programs. Market data analyses are made of comparable organizations within the industry and within the region. Total compensation is established for all executive positions to target similar total compensation of comparable organization market compensation. Base pay is established for all executive positions to target the median range of comparable organization market compensation. The Daughters of Charity Health System utilizes a benefits committee to review compensation and benefits. The Daughters of Charity Health System Board of Directors reviews and approves compensation recommended by the benefits committee, and documents its conclusion that the proposed compensation is reasonable. In evaluating and finalizing its determination of base pay and total compensation for comparable positions at comparable organizations in comparable markets, DCHS utilizes available market data analyses including the DCHS benefits committee, independent compensation consultant, Form 990 of other organizations, written employment contracts, compensation survey or study, recommendation of the benefits committee and approval by the DCHS Board of Directors. Form 990, Part VI, Line 19 The Daughters of Charity Health System makes its Form 990 available upon request. Form 990, Part XI, Line 5 The other changes in net assets or fund balance consists of the following: Change in Unrealized Gain on Investments $2,186,006 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Sr. Marion Bill, D.C. TITLE:VICE CHAIRPERSON HOURS:11 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Robert Issai TITLE:PRESIDENT AND CEO HOURS:13 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Mike Stuart TITLE:CFO HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Richard Hutsell TITLE:VP OF IT AND CIO HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Gerry Kozai TITLE:PRESIDENT AND CEO, SFMC HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Lorraine Auerbach TITLE:PRESIDENT AND CEO, SMC HOURS:44 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Margaret Catherine Fickes TITLE:PRESIDENT AND CEO, SVMC HOURS:45 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:James Dover TITLE:PRESIDENT AND CEO, OCH HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Joanne Evelyn Allen TITLE:PRESIDENT AND CEO, SLRH HOURS:40 SEE PART VII SEE PART VII SEE PART VII SEE PART VII false true true false false false false false false false false false true true false true false true Caritas Business Services P 2957647 O'Connor Hospital n 60156 O'Connor Hospital p 16707765 Saint Louise Regional Hospital p 6606264 Seton Medical Center p 20533055 St Francis Medical Center p 30435409 Saint Vincent Medical Center p 16988361 Marillac Insurance Company b 15774950 Marillac Insurance Company r 6000000 De Paul Ventures LLC b 1170250 Robert F Kennedy Medical Center b 606561 Robert F Kennedy Medical Center Foundation c 1609507 St Francis Medical Center c 1679631 ROBERT F KENNEDY MEDICAL CENTER C 317626 Schedule R, Part I De Paul Ventures, LLC 26000 Altamont Road Los Altos Hills, CA 94022-4317 EIN: 27-3340398 Col (B): Primary Activity - To support the mission of the System by providing for the multiple needs of the poor, particularly for housing, health and social services. Col (C): Legal Domicile - CA Col (D): Total Income - $0 Col (E): End-of-year assets - $1,568,121 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System De Paul Ventures-San Jose ASC, LLC 26000 Altamont Road Los Altos Hills, CA 94022-4317 EIN: 27-3340453 Col (B): Primary Activity - To support the mission of the System by providing for the multiple needs of the poor, particularly for housing, health and social services. Col (C): Legal Domicile - CA Col (D): Total Income - $0 Col (E): End-of-year assets - $1,568,121 Col (F): Direct Controlling Entity Name - DePaul Ventures, LLC Schedule R, Part II The following organizations listed below are related to the filing organization including the organization itself: Daughters of Charity Ministry Services Corporation 3663 Martin Luther King Jr. Blvd. Lynwood, CA 90262 EIN: 77-0482943 Col (B): Primary Activity - Managerial and consulting services in the areas of finance, administration and facilities to the Daughters of Charity of St. Vincent de Paul Province of the West ministries. Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501 (c)(3) Col (E): Public Charity Status - 1 Col (F): Direct Controlling Entity Name - Daughters of Charity of St. Vincent de Paul Province of the West Daughters of Charity Health System 26000 Altamont Road Los Altos Hills, CA 94022-4317 EIN: 91-2145484 Col (B): Primary Activity - Health System leadership and support to health ministries. Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11b Col (F): Direct Controlling Entity Name - Daughters of Charity Ministry Services Corporation Caritas Business Services 203 Redwood Shores Parkway, Suite 800 Redwood City, CA 94065 EIN: 51-0659139 Col (B): Primary Activity - Promote and support the activities of the Daughters of Charity Health System and its local health ministries by performing accounting, budgeting and patient financial services on a centralized basis, all of which must be provided internally by each hospital for its exempt operations if not provided by Caritas Business Services. Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Director Controlling Entity Name - Daughters of Charity Health System Hotel Dieu, Inc. 3663 Martin Luther King Blvd. Lynwood, California 90262 EIN: 95-475156 Col (B): Primary Activity - Low-Income residence for fragile senior citizens Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 9 Col (F): Director Controlling Entity Name - Daughters of Charity Ministry Services Corporation O'Connor Hospital 2105 Forest Avenue San Jose, CA 95128 EIN: 91-2154436 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System O'Connor Hospital Foundation 2105 Forest Avenue San Jose, CA 95128 EIN: 77-0006295 Col (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - O'Connor Hospital Robert F. Kennedy Medical Center 26000 Altamont Road Los Altos Hills, CA 94022 EIN: 91-2154440 Col (B): Primary Activity - Hospital - Inactive Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System Robert F. Kennedy Medical Center Foundation 26000 Altamont Road Los Altos Hills, CA 94022 EIN: 95-3745227 Line (B): Primary Activity - Fundraising - Inactive Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - Robert F. Kennedy Medical Center St. Francis Medical Center 3630 East Imperial Highway Lynwood, CA 90262 EIN: 91-2154439 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System St. Francis Medical Center of Lynwood Foundation 3630 East Imperial Highway Lynwood, CA 90262-2636 EIN: 95-3190773 Col (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - St. Francis Medical Center Saint Louise Regional Hospital 9400 No Name Uno Gilroy, CA 95020 EIN: 91-2154437 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System Saint Louise Regional Hospital Foundation 18550 De Paul Drive Morgan Hill, CA 95037 EIN: 56-2384735 Col (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - Saint Louise Regional Hospital St. Vincent Medical Center 2131 West 3rd Street Los Angeles, CA 90057 EIN: 91-2154438 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System St. Vincent de Paul Ethics Corporation 3630 East Imperial Hwy Lynwood, Ca 90262 EIN: 95-4426405 Col (B): Primary Activity - Supports DCHS Ministries Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501 (c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - St. Francis Medical Center St. Vincent Dialysis Center 2131 West 3rd Street Los Angeles, CA 90057 EIN: 95-3749293 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - St. Vincent Medical Center St. Vincent Foundation 2131 West 3rd Street Los Angeles, CA 90057 EIN: 95-3922511 Col (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - St. Vincent Medical Center St. Vincent Senior Center Nutrition Program, Inc. 2131 West 3rd Street Los Angeles, Ca 90057-1901 EIN: 95-3696693 Col (B): Primary Activity - Nutrition Program Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 9 Col (F): Direct Controlling Entity Name - Daughters of Charity Ministry Services Corporation Seton Medical Center 1900 Sullivan Avenue Daly City, CA 94015 EIN: 91-2154441 Col (B): Primary Activity - Hospital Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 3 Col (F): Direct Controlling Entity Name - Daughters of Charity Health System Seton Medical Center Foundation 1900 Sullivan Avenue Daly City, CA 94015 EIN: 94-2824033 Col (B): Primary Activity - Fundraising Col (C): Legal Domicile - CA Col (D): Exempt Code Section - 501(c)(3) Col (E): Public Charity Status - 11a Col (F): Direct Controlling Entity Name - Seton Medical Center Schedule R, Part III O'Connor Health Center 1, A California Limited Partnership 1960 The Alameda, Suite 20 San Jose, CA 95126 EIN: 77-0419045 Col (B): Primary Activity - Development and Rental Col (C): Legal Domicile - CA Col (D): Direct Controlling Entity Name - O'Connor Hospital Col (E): Predominant Income - Investment or other income excluded from tax under section 512, 513, or 514 Col (F): Share of Total Income - $523,745 Col (G): Share of end-of-year assets - $3,856,536 Col (H): Disproportionate Allocations - No Col (I): Code V - UBI Amount in Box 20 of Schedule K-1 (Form 1065) -$0 Col (J): General or Managing Partner - No Col (K): Percentage of Ownership - 75% Campbell-Gateway Square, A California Limited Partnership 1960 The Alameda, Suite 20 San Jose, CA 95126 EIN 77-0313494 Col (B): Primary Activity - Development and Rental Col (C): Legal Domicile - CA Col (D): Direct Controlling Entity Name - O'Connor Hospital Col (E): Predominant Income - Unrelated Business Income Col (F): Share of Total Income - $733,880 Col (G): Share of end-of-year assets - $6,055,051 Col (H): Disproportionate Allocations - No Col (I): Code V - UBI Amount in Box 20 of Schedule K-1 (Form 1065) -$0 Col (J): General or Managing Partner - No Col (K): Percentage of Ownership - 65% Schedule R, Part IV Marillac Insurance Company, Ltd. c/o Aon Insurance Managers (Cayman), Ltd. P.O. Box 69GT, B.W.I., Cayman Islands EIN: 98-0417930 Col (B): Primary Activity - Insurance Col (C): Legal Domicile - CJ Col (D): Direct Controlling Entity Name - Daughters of Charity Health System Col (E): Type of Entity - C Corporation Col (F): Share of Total Income - $10,484,306 Col (G): Share of end-of-year assets - $67,958,395 Col (H): Percentage ownership - 100%