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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
ST TAMMANY HOSPITAL FOUNDATION
 
Employer identification number
37-1458857
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #1

 
  		72-0478620 SECTION 115 675,202       TO SUPPORT, DEVELOP, AND EXPAND ITS SERVICES, FUNCTIONS, PURPOSE, AND MISSION OF PROVIDING QUALITY COMMUNITY HEALTHCARE TO WESTERN ST. TAMMANY PARISH. THE FOLLOWING STPH DEPARTMENTS RECEIVED GRANTS AND DISBURSEMENTS FROM THE FOUNDATION'S FUNDS: CARDIOLOGY, EMPLOYEE BENEVOLENT FUND, HEALING ARTS INITIATIVE, HOME HEALTH, HOSPICE, MARY BIRD PERKINS AT ST. TAMMANY PARISH HOSPITAL, NEW FAMILY CENTER, ONCOLOGY, THE PARENTING CENTER, PEDIATRICS, ST. TAMMANY PARISH HOSPITAL, ST. TAMMANY PARISH HOSPITAL EMPLOYEES, ST. TAMMANY CANCER CENTER, STPH GIFT SHOP, EDUCATION, 2EAST, AND PLANT OPERATIONS, CARDIAC REHAB, DISCHARGE CLINIC, ED, FOOD SERVICES, EVS, LABORATORY, OUTPATIENT PAVILION, REGAB SERVICES, PHARMACY, MANDEVILLE ED, NURSING ADMIN, PRE-ACCESS CLINIC, PULMONARY REHAB, RESPIRATORY, SLEEP CENTER, ULTRASOUND, AND UTILIZATION MANAGEMENT.
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
 
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019
Page 2

Schedule I (Form 990) 2019
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1) EMPLOYEE FUNDED AND DISTRIBUTED GRANTS 4 6,960   FMV NEEDS BASED FINANCIAL ASSISTANCE TO EMPLOYEES OF STPH. EMPLOYEES REQUEST FUNDS THROUGH AN EBF REQUEST FORM THAT IS REVIEWED BY A COMMITTEE MADE UP ON FELLOW STPH EMPLOYEES. FUNDS ARE DISTRIBUTED DIRECTLY TO THE SOURCE (IE: UTILITIES, VENDORS, ETC ) AND NOT TO THE INDIVIDUAL.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: IN ORDER TO RECEIVE DESIGNATED FUNDS FROM THE FOUNDATION, A REQUEST FOR FUNDS DISBURSEMENT MUST BE SUBMITTED IN WRITING TO THE FOUNDATION. THE REQUEST IS SUBMITTED BY THE MANAGER/DEPARTMENT HEAD AND MUST BE SIGNED BY THE APPROPRIATE SR. VP. PROPER DOCUMENTATION OF HOW THE FUNDS ARE BEING SPENT IS SUBMITTED WITH THE FORM. WHEN THE FORM ARRIVES IN THE FOUNDATION, IT IS REVIEWED AND APPROVED BY THE CHAIR OF THE STHF GRANTS REVIEW COMMITTEE. THEN, REVIEWED AND APPROVED BY THE EXECUTIVE DIRECTOR OF THE FOUNDATION. FINALLY, WHEN THE ACTUAL TRANSFER IS MADE FROM THE FOUNDATION TO THE APPROPRIATE COST CENTER AT THE HOSPITAL, THE CONTROLLER OF THE HOSPITAL ACKNOWLEDGES BY SIGNING THAT THE TRANSFER HAS BEEN MADE FROM STHF TO STPH.
Schedule I (Form 990) 2019



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