2024-05-07T15:58:25-05:00 2023-06-30 910189318 MOSS ADAMS LLP 225 S LAKE AVE SUITE 900 PASADENA CA 91101 990 2022-07-01 330011887 SADDLEBACK MEMORIAL FOUNDATION SADD 9494523680 24451 HEALTH CENTER DRIVE LAGUNA HILLS CA 92653 CHRISTY WARD PRESIDENT 9494523680 2024-05-07 1 CHRISTY WARD 999009999 1 LAUREN A HAVERLOCK P00545829 3104770450 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MEMORIALCARE SADDLEBACK MEDICAL CENTER FOUNDATION CHRISTY WARD 24451 HEALTH CENTER DRIVE LAGUNA HILLS CA 92653 31170224 0 X WWW.MEMORIALCARE.ORG X 1979 CA TO DEVELOP THE PHILANTHROPIC RESOURCES NECESSARY TO STRENGTHEN THE ABILITY OF SADDLEBACK MEMORIAL MEDICAL CENTER TO ENHANCE THE HEALTH AND WELL-BEING OF INDIVIDUALS, FAMILIES, AND OUR COMMUNITY. 24 19 11 20 0 0 3252423 7349053 0 0 9089614 4160259 12973129 -7444124 25315166 4065188 2272699 2713869 0 0 1660902 1947303 0 0 1741937 831685 698681 4765286 5359853 20549880 -1294665 165837734 175405493 5029595 4094625 160808139 171310868 X TO DEVELOP THE PHILANTHROPIC RESOURCES NECESSARY TO STRENGTHEN THE ABILITY OF SADDLEBACK MEMORIAL MEDICAL CENTER TO ENHANCE THE HEALTH AND WELL-BEING OF INDIVIDUALS, FAMILIES, AND OUR COMMUNITY. 0 0 817618 817618 0 PROVIDED GRANTS FOR SADDLEBACK MEMORIAL MEDICAL CENTER CAPITAL ITEMS (SEE SCHEDULE I). 309444 309444 PROVIDED GRANT FOR SADDLEBACK MEMORIAL MEDICAL CENTER'S SURGICAL SERVICES (SEE SCHEDULE I). 266000 266000 0 PROVIDED GRANT FOR SADDLEBACK MEMORIAL MEDICAL CENTER'S COMMISSION ON CANCER ACCREDITATION INITIATIVE (SEE SCHEDULE I). 1320807 1320807 0 OTHER PROGRAM SERVICES CONSIST OF GRANTS TO SADDLEBACK MEMORIAL MEDICAL CENTER AND MEMORIAL HEALTH SERVICES FOR THE FOLLOWING AMOUNTS AND RELATED PROGRAMS:NURSE NAVIGATOR (CANCER SERVICES-GENERAL ONCOLOGY) - $193,416NURSE NAVIGATOR (CARDIAC SERVICES) - $188,956NURSE NAVIGATOR (BREAST CENTER SERVICES) - $179,000NURSE NAVIGATOR (CANCER SERVICES-LUNG CANCER) - $143,233LICENSED SOCIAL WORKER FOR LAGUNA WOODS SENIOR PROGRAM - $117,000NURSE NAVIGATOR (SPINE-JOINT-REHAB SERVICES) - $97,795RADIATION/ONCOLOGY RESEARCH PROJECT - $81,052WOMEN'S SUPPORT GROUP COORDINATOR - $58,500NURSING SCHOLARSHIP AWARDS - $54,313HOSPICE PROGRAM - $50,000PHYSICIAN TRAINING (ONCOLOGY PROGRAM) - $30,000POSTPARTUM SUPPORT GROUP CLASSES (FOR NEW MOMS/BABIES) - $20,000CLINICAL STAFF MASSAGE CHAIRS (QTY 8) - $18,500HOSPITAL ELDER LIFE PROGRAM (H.E.L.P.) - $15,902CLINICIANS & STAFF KINDNESS INITIATIVES - $12,915STROKE PROGRAM ACCREDITATION - $12,400NURSING EDUCATION AND CERTIFICATION - $10,715INFANT SAFETY CPR CLASSES - $10,000POSTPARTUM SUPPORT GROUP PROGRAM FOR LDRP - $8,000PELVIC FLOOR PT/REHAB PROGRAM - $6,295VOLUNTEER LUNCHEON - $3,000NURSING STAFF APPRECIATION - $3,000ICU STAFF VESTS FOR BEACON AWARD - $2,520PHARMACY MEMBERSHIP AND CERTIFICATION - $1,795WOMEN'S HOSPITAL BEREAVEMENT PROGRAM - $1,500NICU DIARIES - $1,000 1320807 1320807 0 2713869 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 57 0 1 11 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 24 19 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X BRIAN KRAWIEC CFO 9494523680 24451 HEALTH CTR DR LAGUNA HILLS CA 92653 MARCIA MANKER BOARD MEMBER, CEO SMMC 1.00 59.00 X 0 2455914 682306 CHRISTY WARD PRESIDENT 60.00 0.00 X X 0 459001 33721 CATHY HAN MD BOARD CHAIR 1.00 0.00 X X 0 0 0 MATTHEW KIMMEL BOARD VICE CHAIR 1.00 0.00 X X 0 0 0 GUS ALVAREZ BOARD TREASURER 1.00 0.00 X X 0 0 0 HEIDI STOOPS BOARD SECRETARY 1.00 0.00 X X 0 0 0 SANDY BENSON BOARD MEMBER 1.00 0.00 X 0 0 0 GRETCHEN CONROY MD BOARD MEMBER 1.00 0.00 X 0 0 0 NAREN GOEL BOARD MEMBER 1.00 0.00 X 0 0 0 RHONDA LONGMORE-GRUND BOARD MEMBER 1.00 0.00 X 0 0 0 CANDACE HAYNES BOARD MEMBER 1.00 8.00 X 0 8299 0 PATTY JUAREZ BOARD MEMBER 1.00 0.00 X 0 0 0 DIANE LIBERTELLA THRU 9822 BOARD MEMBER 1.00 0.00 X 0 0 0 LAURIE LOUIE BOARD MEMBER 1.00 0.00 X 0 0 0 GAYLE LUCIANO BOARD MEMBER 1.00 0.00 X 0 0 0 JIM MCNULTY BOARD MEMBER 1.00 0.00 X 0 0 0 SARAH NEDERLANDER BOARD MEMBER 1.00 0.00 X 0 0 0 TOM ROGERS BOARD MEMBER 1.00 0.00 X 0 0 0 BEBE SHADDOCK BOARD MEMBER 1.00 0.00 X 0 0 0 KETAN SHAH MD BOARD MEMBER 1.00 0.00 X 0 0 0 WANG TENG MD BOARD MEMBER 1.00 40.00 X 0 33880 0 JESSIE VALENCIA BOARD MEMBER 1.00 0.00 X 0 0 0 SHARON CHEEVER BOARD MEMBER 1.00 0.00 X 0 0 0 TERESA EVANS BOARD MEMBER 1.00 0.00 X 0 0 0 BRIAN KRAWIEC CFO/EXECUTIVE DIRECTOR OF FINANCE 51.00 9.00 X 0 225799 29950 MELISSA CENTENO DIRECTOR, COMM & DONOR ENGAGEMENT 40.00 0.00 X 0 187757 31950 RAMONA LOPEZ DIRECTOR, PROSPECT MGT & RESEARCH 40.00 0.00 X 0 147016 19349 LYNN DICKINSON THRU 012923 DIRECTOR, PLANNED GIVING 40.00 0.00 X 0 143490 10040 COLLEEN O'CONNOR DIRECTOR, MAJOR GIFTS 40.00 0.00 X 0 138475 22906 GRACE TODD MANAGER, COMMUNICATIONS 40.00 0.00 X 0 102315 14160 0 3901946 844382 0 0 1 0 RUSSELL INVESTMENTS 1301 2ND AVENUE 18TH FLOOR SEATTLE WA 98101 INVESTMENT ADVISORY 168128 1 712011 32000 6605042 272411 7349053 2914035 2914035 27981525 26735301 1246224 1246224 1246224 144175 712011 369735 -225560 -225560 3850 0 3850 3850 K-1 PASSTHROUGH 901101 -7222414 -7222414 -7222414 4065188 0 0 -3283865 2713869 2713869 790719 347854 442865 806208 70901 735307 47115 11074 36041 201357 6714 194643 101904 21136 80768 50596 50536 60 213219 213219 117354 100000 17354 350 350 98101 29208 68893 56978 18385 38593 3044 3044 1011 71 940 55804 18411 37393 10457 6924 3533 BAD DEBT EXPENSE 54699 54699 RECOGNITION EVENTS 15413 15413 BUSINESS CULTIVATION 7939 7939 DUES AND SUBSCRIPTIONS 6963 649 6314 6753 5921 832 5359853 2713869 904047 1741937 16633247 15488615 100227 176548 509625 1975165 1282221 1282221 0 0 145525830 154454066 3068805 3311099 165837734 175405493 5029595 4094625 5029595 4094625 X 68971305 75668185 91836834 95642683 160808139 171310868 165837734 175405493 X -1294665 11694132 103262 X 0 1 X 1 0 X 2070612 6278679 3361945 3252423 7349053 22312712 2070612 6278679 3361945 3252423 7349053 22312712 5684471 16628241 1782435 3018470 2202236 2755561 2914035 12672737 8703 8703 84841 84841 35078993 0.47400 0.31080 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: K-1 PASSTHROUGH - 2020 AMOUNT: $ 84,841. 2021 AMOUNT: $ 0. 2022 AMOUNT: $ 0. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 72529746 1464207 4101338 3571249 238551 74285491 80136411 201567 -4240362 3386294 181576 72529746 67329242 13733 14579510 1638278 147796 80136411 68555554 78631 -826094 469143 9706 67329242 68735134 3082253 3253687 8146 68555554 0.01400 0.98600 0.00000 0 0 424567 424567 0 857654 857654 0 0 SPLIT INTEREST AGREEMENT LIABILITY 3646534 DUE TO RELATED PARTIES 448091 4094625 X 16019098 11694132 103262 11797394 4221704 213219 -369735 -156516 4065188 5516369 369735 369735 5146634 213219 213219 5359853 PART V, LINE 4: THE MAJORITY OF ENDOWMENT FUNDS ARE PERMANENTLY RESTRICTED (INCLUDED IN THE "WITH DONOR RESTRICTIONS" NET ASSET CLASSIFICATION). THE CUMULATIVE UNDISTRIBUTED ENDOWMENT INCOME IS HELD IN TEMPORARILY RESTRICTED (ALSO WITHIN "WITH DONOR RESTRICTIONS" NET ASSET CLASSIFICATION). THE PRINCIPAL, OR ORIGINAL GIFT AMOUNT, IS HELD IN PERPETUITY AND CANNOT BE USED, OR TRANSFERRED TO RELATED ORGANIZATIONS AS FUNDING OR GRANT REVENUE. ONLY THE NET INVESTMENT INCOME, WITHIN POLICY GUIDELINES AND THRESHOLDS, CAN BE USED TO SUPPORT SMMC. ADDITIONALLY, IN THE CURRENT REPORTING PERIOD, SMF'S BOARD ESTABLISHED A POLICY AND GUIDELINES THAT IMPOSE DESIGNATIONS ON CERTAIN NET ASSETS WITHOUT RESTRICTIONS. TO ENHANCE THE SUPPORT TO SMMC, FOR SPECIFIC ONCOLOGY RELATED PROGRAMS, AN AMOUNT TOTALING $1,000,000 WAS DESIGNATED FOR LONG-TERM INVESTMENT AS A BOARD DESIGNATED ENDOWMENT. ENDOWMENT FUNDS CREATED BY SMF'S BOARD ARE DESIGNATED FROM A PORTION OF NET ASSETS WITHOUT RESTRICTIONS TO BE INVESTED TO PROVIDE NET INVESTMENT INCOME FOR A LONG, BUT NOT NECESSARILY SPECIFIED PERIOD. THE DESIGNATED INVESTMENTS ARE HELD IN NET ASSETS WITHOUT RESTRICTIONS, AND THE NET INVESTMENT INCOME DERIVED FROM THE DESIGNATED ASSETS ARE RECORDED IN NET ASSETS WITHOUT RESTRICTIONS. THE NET INVESTMENT INCOME IS EXPENDABLE TO SUPPORT THE PURPOSE(S) AS DESIGNATED BY SMF'S BOARD FOR AS LONG AS DEEMED NECESSARY AND APPROPRIATE. THE DURATION OF THIS TYPE OF ENDOWMENT, AS DEFINED AND INTERPRETED BY RELEVANT LAW, STIPULATES THAT THE DESIGNATED ASSETS ARE NOT HELD IN PERPETUITY. UPON COMPLETION OR FULFILLMENT OF THE DESIGNATED PURPOSE(S), BY ORDER OF THE SMF'S BOARD, THE DESIGNATED ASSETS WILL EFFECTIVELY BECOME UNDESIGNATED, AND ALL NET INVESTMENT INCOME WILL AGAIN BE AVAILABLE FOR PURPOSES WITHOUT RESTRICTIONS. PART X, LINE 2: ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX PROVISION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DE-RECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY OR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED ON JUNE 30, 2023, AND 2022. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 103,262. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT EVENT EXPENSES -369,735. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT EVENT EXPENSES 369,735. GALA 680008 575108 104900 151762 75000 6000 89371 GOLF 79768 61018 18750 3109 9915 4500 1690 1 96410 75885 20525 20188 7500 700 856186 712011 144175 3109 181865 87000 6000 91761 369735 -225560 1 SADDLEBACK MEMORIAL MEDICAL CENTER 24451 HEALTH CENTER DRIVE LAGUNA HILLS CA 92653 952585792 501(C)(3) 2632367 0 SEE PART IV MEMORIAL HEALTH SERVICES 17360 BROOKHURST STREET FOUNTAIN VALLEY CA 92708 951643381 501(C)(3) 81502 0 SEE PART IV 2 0 PART I, LINE 2: FORM 990, SCHEDULE I, PART I, LINE 2: DEPARTMENTS WITHIN SADDLEBACK MEMORIAL MEDICAL CENTER (SMMC) REQUEST GRANTS FROM SADDLEBACK MEMORIAL FOUNDATION (SMF) BY SUBMITTING REQUEST FORMS TO SMMC ADMINISTRATION FOR REVIEW, EVALUATION, AND PRIORITIZATION. ADDITIONALLY, MEMORIAL HEALTH SERVICES RESEARCH ADMINISTRATION (MHS) MAY ALSO REQUEST GRANTS FROM SMF (FOR RESEARCH CONDUCTED AT SMMC). SMMC ADMINISTRATION INCLUDES SMMC'S CHIEF EXECUTIVE OFFICER (CEO), CHIEF OPERATING OFFICER (COO), CHIEF FINANCIAL OFFICER (CFO), AND CHIEF NURSING OFFICER (CNO). SMF'S PRESIDENT AND SMF'S CFO WORK CLOSELY WITH SMMC ADMINISTRATION TO ENSURE THE DONOR'S USE AND DESIGNATION OF PHILANTHROPIC FUNDS ARE MATCHED WITH THE NEEDS OF SMMC, THEREBY FULFILLING THE INTENT OF THE DONOR. THE GRANT REQUEST FORM IS COMPLETED BY THE INDIVIDUAL(S) AUTHORIZED TO INITIATE THE REQUEST AND MUST INCLUDE ALL SUPPORT DOCUMENTATION. ALL REQUESTS HAVE THE APPROVAL AND ENDORSEMENT OF THE DEPARTMENT'S EXECUTIVE DIRECTOR BEFORE BEING SUBMITTED TO SMMC ADMINISTRATION. DURING THE REVIEW, EVALUATION, AND PRIORITIZATION PROCESS, SMMC ADMINISTRATION CONSIDERS EACH GRANT SEPARATELY AND DETERMINES WHICH REQUESTS WOULD BE MOST EFFECTIVE IN PROVIDING ASSISTANCE TO ENHANCE CLINICAL OUTCOMES. CONSIDERATION IS GIVEN TO GRANT REQUESTS FOR CAPITAL ITEMS, PROJECTS, PROGRAM SERVICES, CLINICAL EDUCATION, AND RESEARCH. ONCE APPROVED, SMF'S CFO IS RESPONSIBLE FOR MONITORING, RECEIVING, PROCESSING, AND REPORTING ALL GRANT REQUESTS. ALL REQUESTS ARE REPORTED TO SMF'S BOARD ON A QUARTERLY BASIS. ADDITIONALLY, SMMC PROVIDES FEEDBACK/MONITORING TO SMF ON THE USE OF THE GRANTS, WHICH IS ALSO REPORTED BACK TO THE SMF BOARD. PURPOSE OF GRANTS OR ASSISTANCE FORM 990, SCHEDULE I, PART II: THE TOTAL CONSISTS OF THE FOLLOWING AMOUNTS: CAPITAL EQUIPMENT AND PROJECTS: CATH LAB RENOVATION - $506,999 FOUNDATION RENOVATION PROJECT - $268,923 BLUE LIGHT CYSTOSCOPY EQUIPMENT - $41,696 PROGRAM SERVICES: SURGICAL SERVICES - $309,444 COMMISSION ON CANCER ACCREDITATION - $266,000 NURSE NAVIGATOR (CANCER SERVICES-GENERAL ONCOLOGY) - $193,416 NURSE NAVIGATOR (CARDIAC SERVICES) - $188,956 NURSE NAVIGATOR (BREAST CENTER SERVICES) - $179,000 NURSE NAVIGATOR (CANCER SERVICES-LUNG CANCER) - $143,233 LICENSED SOCIAL WORKER FOR LAGUNA WOODS SENIOR PROGRAM - $117,000 NURSE NAVIGATOR (SPINE-JOINT-REHAB SERVICES) - $97,795 RADIATION/ONCOLOGY RESEARCH PROJECT - $81,052 WOMEN'S SUPPORT GROUP COORDINATOR - $58,500 NURSING SCHOLARSHIP AWARDS - $54,313 HOSPICE PROGRAM - $50,000 PHYSICIAN TRAINING (ONCOLOGY PROGRAM) - $30,000 POSTPARTUM SUPPORT GROUP CLASSES (FOR NEW MOMS/BABIES) - $20,000 CLINICAL STAFF MASSAGE CHAIRS (QTY 8) - $18,500 HOSPITAL ELDER LIFE PROGRAM (H.E.L.P.) - $15,902 CLINICIANS & STAFF KINDNESS INITIATIVES - $12,915 STROKE PROGRAM ACCREDITATION - $12,400 NURSING EDUCATION AND CERTIFICATION - $10,715 INFANT SAFETY CPR CLASSES - $10,000 POSTPARTUM SUPPORT GROUP PROGRAM FOR LDRP - $8,000 PELVIC FLOOR PT/REHAB PROGRAM - $6,295 VOLUNTEER LUNCHEON - $3,000 NURSING STAFF APPRECIATION - $3,000 ICU STAFF VESTS FOR BEACON AWARD - $2,520 PHARMACY MEMBERSHIP AND CERTIFICATION - $1,795 WOMEN'S HOSPITAL BEREAVEMENT PROGRAM - $1,500 NICU DIARIES - $1,000 0 1 0 0 0 0 0 0 0 MARCIA MANKER BOARD MEMBER, CEO SMMC 0 749295 0 458798 0 1247821 0 668382 0 13924 0 3138220 0 1250686 CHRISTY WARD PRESIDENT 0 408741 0 36000 0 14260 0 15250 0 18471 0 492722 0 0 BRIAN KRAWIEC CFO/EXECUTIVE DIRECTOR OF FINANCE 0 192832 0 23157 0 9810 0 22823 0 7127 0 255749 0 0 MELISSA CENTENO DIRECTOR, COMM & DONOR ENGAGEMENT 0 164352 0 18245 0 5160 0 13663 0 18287 0 219707 0 0 RAMONA LOPEZ DIRECTOR, PROSPECT MGT & RESEARCH 0 131514 0 14789 0 713 0 7715 0 11634 0 166365 0 0 COLLEEN O'CONNOR DIRECTOR, MAJOR GIFTS 0 138221 0 0 0 254 0 9907 0 12999 0 161381 0 0 LYNN DICKINSON THRU 012923 DIRECTOR, PLANNED GIVING 0 142747 0 0 0 743 0 3670 0 6370 0 153530 0 0 SCHEDULE J, PART I, LINE 3 THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT IS DETERMINED BY MEMORIAL HEALTH SERVICES (MHS), THE TAX-EXEMPT PARENT OF SADDLEBACK MEMORIAL MEDICAL CENTER. SEE SCHEDULE O FOR FORM 990, PART VI, LINES 15A AND 15B FOR THE PROCESS USED BY MHS TO DETERMINE COMPENSATION. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: THE ORGANIZATION MAINTAINS A DEFINED CONTRIBUTION PLAN WHERE EACH YEAR'S CONTRIBUTION VESTS AFTER THREE YEARS. DURING THE 2022 CALENDAR YEAR, THE ORGANIZATION MADE THE FOLLOWING CONTRIBUTIONS TO THE PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS, WHICH IS REPORTED AS "RETIREMENT AND DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C). CONTRIBUTIONS THAT ARE IMMEDIATELY VESTED UNDER THE CIRCUMSTANCES REFERENCED BELOW ARE REPORTED AS "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN (B)(III). MARCIA MANKER - $394,079 PARTICIPANTS WHO ATTAIN SPECIFIC AGE AND YEARS OF SERVICE REQUIREMENTS ARE FULLY VESTED IN THEIR PLAN BENEFIT AND EACH SUBSEQUENT CONTRIBUTION IS VESTED ON A QUARTERLY BASIS WHEN PAID. FOR THE 2022 CALENDAR YEAR, THE FOLLOWING INDIVIDUAL RECEIVED THE FOLLOWING VESTED CONTRIBUTIONS AND PAYMENTS, WHICH WERE INCLUDED ON THEIR 2022 W-2 AND WHICH ARE REPORTED AS "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN B(III): MARCIA MANKER - $801,317 SCHEDULE J, PART I, LINE 7 CERTAIN EXECUTIVES RECEIVE PART OF THEIR OVERALL COMPENSATION IN THE FORM OF AN ANNUAL INCENTIVE PAYMENT. SEVERAL FINANCIAL AND NON-FINANCIAL METRICS ARE UTILIZED IN THE FORMULA FOR THE INCENTIVE COMPENSATION, AND THESE METRICS AND THE FORMULA ARE REVIEWED AND APPROVED EACH YEAR IN ADVANCE BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF THE SOLE MEMBER OF EACH ORGANIZATION. PAYMENT OF ANY INCENTIVE COMPENSATION MUST BE APPROVED BY THE COMPENSATION COMMITTEE AFTER IT HAS REVIEWED THE METRICS TO DETERMINE WHETHER THEY HAVE BEEN MET, AND THE AMOUNT OF THE PAYMENTS (IF ANY), BASED ON THE APPROVED FORMULA. X 2 272411 FAIR MARKET VALUE 2 0 1 1 PART I, COLUMN (B): THE NUMBER OF CONTRIBUTORS REPORTED IN COLUMN B REPRESENTS THE NUMBER OF DONORS GIVING NONCASH ITEMS. PART I, LINE 32B: THE ORGANIZATION MAY HIRE THIRD PARTIES TO SELL NONCASH CONTRIBUTIONS (OTHER THAN SECURITIES) FOR ITEMS SUCH AS TANGIBLE ASSETS RECEIVED AS PART OF ESTATE GIFTS THAT ARE NOT READILY MARKETABLE. FORM 990, PART VI, SECTION A, LINE 1A THE SADDLEBACK MEMORIAL FOUNDATION (SMF) BOARD OF DIRECTORS (BOARD) HAS APPOINTED AN EXECUTIVE COMMITTEE TO CONDUCT THE BUSINESS OF SMF BETWEEN SCHEDULED MEETINGS OF THE BOARD. THE SMF BOARD HAS DELEGATED BROAD AUTHORITY TO THE EXECUTIVE COMMITTEE MEMBERS IN ORDER TO CONDUCT ALL NECESSARY BUSINESS OF SMF, INCLUDING FINANCIAL AND OPERATIONAL MATTERS THAT REQUIRE A VOTE. ALL EXECUTIVE COMMITTEE MEMBERS, WHO ARE ALSO BOARD MEMBERS WITH FULL VOTING PRIVILEGES, ARE APPOINTED BY THE BOARD. AT ALL TIMES THERE ARE TO BE NO LESS THAN FIVE (5) EXECUTIVE COMMITTEE MEMBERS APPOINTED. THE EXECUTIVE COMMITTEE IS CHAIRED BY THE CHAIRMAN OF THE SMF BOARD, AND ALSO INCLUDES THE SMF PRESIDENT AS AN EX-OFFICIO MEMBER. FORM 990, PART VI, SECTION A, LINE 6 SADDLEBACK MEMORIAL MEDICAL CENTER (SMMC), A RELATED TAX-EXEMPT ORGANIZATION IS THE SOLE CORPORATE MEMBER OF SADDLEBACK MEMORIAL FOUNDATION (SMF). FORM 990, PART VI, SECTION A, LINE 7A SADDLEBACK MEMORIAL MEDICAL CENTER (SMMC), A RELATED TAX-EXEMPT ORGANIZATION IS THE SOLE CORPORATE MEMBER OF SADDLEBACK MEMORIAL FOUNDATION (SMF). THE SMMC BOARD APPOINTS THE MEMBERS OF THE SMF BOARD. FORM 990, PART VI, SECTION A, LINE 7B SADDLEBACK MEMORIAL MEDICAL CENTER (SMMC), A RELATED TAX-EXEMPT ORGANIZATION IS THE SOLE CORPORATE MEMBER OF SADDLEBACK MEMORIAL FOUNDATION (SMF). THE SMMC BOARD APPOINTS THE MEMBERS OF THE SMF BOARD. THE SMMC BOARD HAS THE POWER TO VOTE ON THE NOMINATION OF ANY CANDIDATE OF SMF'S BOARD, ANY AMENDMENTS TO SMF'S BYLAWS, AND, IN CONJUNCTION WITH A MAJORITY VOTE OF SMF'S BOARD, MAY SET RESTRICTIONS ON THE USE OF SMF'S ASSETS, OR DISTRIBUTION OF ASSETS IN THE EVENT OF SMF'S DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S CFO REVIEWS THE FORM 990 TO ENSURE THE ACCURACY OF THE FOLLOWING INFORMATION: ALL FINANCIAL DATA FOR THE REPORTING PERIOD, ANSWERS TO TAX COMPLIANCE QUESTIONS, ANSWERS TO POLICY AND GOVERNANCE QUESTIONS, ALL SCHEDULES, AND ALL REQUIRED NARRATIVES. FURTHER REVIEW OF THE FORM 990 IS CONDUCTED BY THE ORGANIZATION'S EXECUTIVE COMMITTEE, PRIOR TO THE FULL BOARD REVIEW. THE EXECUTIVE COMMITTEE INCLUDES ALL OFFICERS OF THE ORGANIZATION'S BOARD. LASTLY, THE ORGANIZATION'S FORM 990 IS REVIEWED BY THE BOARD (A COPY MADE AVAILABLE TO EACH MEMBER) PRIOR TO FILING WITH THE IRS. QUESTIONS AND COMMENTS FROM THE GOVERNING BOARD ARE ADDRESSED BEFORE THE FINAL VERSION IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE GENERAL COUNSEL'S OFFICE ANNUALLY SURVEYS EACH DIRECTOR AND OFFICER AND REQUIRES AFFIRMATION THAT THE CONFLICT OF INTEREST POLICY HAS BEEN READ AND UNDERSTOOD. THE RESULTS OF THE SURVEY ARE REPORTED TO THE GOVERNANCE COMMITTEE OF THE SADDLEBACK MEMORIAL MEDICAL CENTER, THE PARENT ORGANIZATION, WHICH IS RESPONSIBLE FOR GOVERNANCE, OVERSIGHT, AND NOMINATIONS. CONFLICTS ARE EVALUATED FOR BEING OCCASIONAL OR DISABLING IN NATURE. THE GENERAL COUNSEL MAKES THE INITIAL EVALUATION AND ADVISES THE GOVERNANCE COMMITTEE IN ITS DELIBERATIONS. IF AN OCCASIONAL CONFLICT IS IDENTIFIED, THE GENERAL COUNSEL ADVISES THE SUBJECT DIRECTOR OR OFFICER AND GOVERNANCE COMMITTEE IN A "REBUTTABLE PRESUMPTION" TYPE PROCESS. SHOULD A DISABLING CONFLICT BE IDENTIFIED, THE DIRECTOR OR OFFICER RESIGNS OR IS REMOVED UPON THE RECOMMENDATION OF THE GENERAL COUNSEL, GOVERNANCE COMMITTEE, AND BOARD OF DIRECTORS. IN ADDITION, AN ANNUAL NOTICE IS SENT BY EMAIL (TO EACH EMPLOYEE WITH ACCESS TO EMAIL) REGARDING THE ACCEPTANCE OF GIFTS AND CORRESPONDING POLICIES. FORM 990, PART VI, SECTION B, LINE 15 THE CEO OF THE ORGANIZATION IS NOT COMPENSATED BY THE FILING ORGANIZATION, BUT RATHER BY THE TAX-EXEMPT PARENT, MEMORIAL HEALTH SERVICES (MHS). SADDLEBACK MEMORIAL FOUNDATION (SMF) REIMBURSES MHS FOR THESE EXPENSES. THE FOLLOWING IS THE PROCESS THAT THE PARENT ORGANIZATION UNDERTAKES TO APPROVE THE CEO'S COMPENSATION. WITHIN THE ORGANIZATION, THE COMPENSATION OF VICE PRESIDENTS AND ABOVE IS REVIEWED BY AN EXTERNAL CONSULTANT WITH FINAL REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE MHS BOARD OF DIRECTORS AND THEIR OUTSIDE COUNSEL. ALL MARKET DATA IS OBTAINED FROM THIRD PARTY SURVEY SOURCES. MARKET DATA REVIEWS ARE COMPLETED CONSISTENTLY ON AN ANNUAL BASIS IN ORDER TO DETERMINE APPROPRIATE COMPENSATION. FOR THE CURRENT REPORTING PERIOD, THE COMPENSATION DETERMINATION PROCESS WAS COMPLETED IN CALENDAR YEAR 2022. THE PROCESS OF DETERMINING THE COMPENSATION IS DOCUMENTED IN THE MINUTES OF THE MHS BOARD. FORM 990, PART VI, SECTION C, LINE 19 CURRENTLY, THE ORGANIZATION DOES NOT MAKE THE GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION, BYLAWS, AND CONFLICT OF INTEREST POLICY) AVAILABLE TO THE GENERAL PUBLIC. HOWEVER, THE ARTICLES OF INCORPORATION ARE AVAILABLE FROM THE CALIFORNIA SECRETARY OF STATE'S OFFICE VIA WRITTEN REQUEST. AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC WHEN REQUESTS ARE MADE IN PERSON OR IN WRITING. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS 103,262. MEMORIALCARE SELECT HEALTH PLAN 2801 ATLANTIC AVENUE LONG BEACH CA 90806 461870181 MEDICAL SERVICES CA 501(C)(4) MHS 0 MEMORIAL MEDICAL CENTER FOUNDATION 2801 ATLANTIC AVENUE LONG BEACH CA 90806 956105984 PHILANTHROPIC FOUNDATION CA 501(C)(3) LINE 7 LBMMC 0 MEMORIALCARE HOME HEALTH LLC 23521 PASEO DE VALENCIA STE 100 LAGUNA HILLS CA 92653 463056446 HEALTHCARE CA N/A 0 0 BEACH SURGICAL HOLDINGS LLC 3000 RIVERCHASE GALLERIA STE 500 BIRMINGHAM AL 35244 371708521 HEALTHCARE CA N/A 0 0 MEMORIALCARE INNOVATION FUND LP 320 GOLDEN SHORE AVENUE STE 120 LONG BEACH CA 90802 460791893 HEALTHCARE CA N/A 0 0 BEACH SURGICAL HOLDINGS II LLC 17360 BROOKHURST ST FOUNTAIN VALLEY CA 92708 472083076 HEALTHCARE CA N/A 0 0 SUMMATION HEALTH VENTURES 320 GOLDEN SHORE AVENUE STE 120 LONG BEACH CA 90802 465252681 INVESTMENTS DE N/A 0 0 MC FV MOB I LLC 17360 BROOKHURST ST FOUNTAIN VALLEY CA 92708 464578097 OWN, OPERATE, LEASE, MAINTAIN THE MEDICAL OFFICE BUILDING PROPERTY CA N/A 0 0 RMV MOB I LLC 17360 BROOKHURST ST FOUNTAIN VALLEY CA 92708 301013230 OWN, OPERATE, LEASE, MAINTAIN THE MEDICAL OFFICE BUILDING PROPERTY CA N/A 0 0 BRISTOL PARK INVESTMENT GROUP I LP 17360 BROOKHURST ST FOUNTAIN VALLEY CA 92708 330180494 OWN, LEASE, PROVIDE MANAGEMENT SERVICES FOR MEDICAL OFFICE BUILDING CA N/A 0 0 BRISTOL PARK INVESTMENT GROUP II LP 17360 BROOKHURST ST FOUNTAIN VALLEY CA 92708 330180495 OWN, LEASE, PROVIDE MANAGEMENT SERVICES FOR MEDICAL OFFICE BUILDING CA N/A 0 0 BRISTOL PARK INVESTMENT GROUP III LP 17360 BROOKHURST ST FOUNTAIN VALLEY CA 92708 330226684 OWN, LEASE, PROVIDE MANAGEMENT SERVICES FOR MEDICAL OFFICE BUILDING CA N/A 0 0 BRISTOL PARK INVESTMENT GROUP V LP 17360 BROOKHURST ST FOUNTAIN VALLEY CA 92708 330975781 OWN, LEASE, PROVIDE MANAGEMENT SERVICES FOR MEDICAL OFFICE BUILDING CA N/A 0 0 PS CENTER LLC 569 BROOKWOOD VILLAGE STE 901 BIRMINGHAM AL 35209 900876656 HEALTHCARE CA N/A 0 0 CHARITABLE REMAINDER UNITRUST (8) SUPPORT CA SMF T 1 CHARITABLE REMAINDER ANNUITY TRUST (1) SUPPORT CA SMF T 1 NATIONAL HEALTHCARE SERVICES 330 GOLDEN SHORE AVENUE LONG BEACH CA 90802 953496341 MEDICAL SERVICES CA N/A C 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 SCHEDULE R, PART II SADDLEBACK MEMORIAL FOUNDATION (SMF) IS RELATED TO THE CENTRAL ORGANIZATION AND SUBORDINATE ORGANIZATIONS IN THE MEMORIAL HEALTH SERVICES GROUP EXEMPTION. SMF AND THE SUBORDINATES ARE BOTH CONTROLLED BY THE CENTRAL ORGANIZATION, MEMORIAL HEALTH SERVICES (MHS). THE CENTRAL ORGANIZATION AND OTHER SUBORDINATE ORGANIZATIONS OF THE MHS GROUP EXEMPTION HAVE NOT BEEN INCLUDED IN SCHEDULE R, PART II, IN ACCORDANCE WITH THE IRS INSTRUCTIONS.