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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
SUTTER HEALTH
 
Employer identification number
94-2788907
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) REGENTS OF THE UNIV OF CA
1995 UNIV AVE 3RD FLR
BERKELEY,CA94720 		94-6002123 GOVT 474,386       Program Support
(2) MEDSHARE INTERNATIONAL
3240 CLIFTON SPRINGS RD
DECATUR,GA30034 		58-2433968 501(c)(3) 211,250       Program Support
(3) MARCH OF DIMES INC
1550 CRYSTAL DR 1300
ARLINGTON,VA22202 		13-1846366 501(c)(3) 145,000       Program Support
(4) AMBULATORY SURGERY ACCESS
1119 MARKET ST 400
SAN FRANCISCO,CA94103 		94-3180356 501(c)(3) 105,000       Program Support
(5) CHILDRENS HEALTH INITIATIVE FUND OF CFSC
120 STONY PT RD 220
SANTA ROSA,CA95401 		68-0003212 501(c)(3) 50,000       Program Support
(6) COALITION FOR COMPASSIONATE CARE OF CA
2530 RIVER PL DR 110
SACRAMENTO,CA95833 		27-0419836 501(c)(3) 45,000       Program Support
(7) AMERICAN NATIONAL RED CROSS
431 18TH ST NW
WASHINGTON,DC20006 		53-0196605 501(c)(3) 35,000       Program Support
(8) SEC HARVEST FB OF SNTC SAN MATEO COUNTIES
750 CURTNER AVE
SAN JOSE,CA95125 		94-2614101 501(c)(3) 33,500       Program Support
(9) SAN FRANCISCO FOOD BANK
900 PENNSYLVANIA AVE
SAN FRANCISCO,CA94107 		94-3041517 501(c)(3) 32,500       Program Support
(10) FISHER HOUSE FOUNDATION INC
111 ROCKVILLE PIKE 420
ROCKVILLE,MD20850 		11-3158401 501(c)(3) 25,000       Program Support
(11) LEUKEMIA AND LYMPHOMA SOCIETY INC
3 INTERNATIONAL DR 200
RYE BROOK,NY10573 		13-5644916 501(c)(3) 25,000       Program Support
(12) OKIZU FOUNDATION
16 DIGITAL DR STE 130
NOVATO,CA94949 		68-0291178 501(c)(3) 25,000       Program Support
(13) SALVATION ARMY
180 E OCEAN BLVD LONG BEACH
LONG BEACH,CA90802 		94-1156347 501(c)(3) 25,000       Program Support
(14) FOOD BANK OF CONTRA COSTA AND SOLANO
4010 NELSON AVE CONCORD
CONCORD,CA91520 		94-2418054 501(c)(3) 23,500       Program Support
(15) ALAMEDA COUNTY COMMUNITY FOOD BANK
PO BOX 2599
OAKLAND,CA94614 		94-2960297 501(c)(3) 17,500       Program Support
(16) SEC HARV FB OF SANTA CRUZ & SAN BENITY CNTY
800 OHLONE PKWY
WATSONVILLE,CA95076 		77-0326685 501(c)(3) 16,500       Program Support
(17) RIVER CITY COMMUNITY SERVICES
3311 E CURTIS DR
SACRAMENTO,CA95818 		91-1851398 501(c)(3) 15,000       Program Support
(18) SEC HARV FB OF SAN JOAQUIN & STANISLAUS CO
704 E INDUSTRIAL PARK DR
MANTECA,CA95337 		68-0376587 501(c)(3) 15,000       Program Support
(19) DAVIS STREET COMMUNITY CENTER
3081 TEAGARDEN ST
SAN LEANDRO,CA94577 		94-3121699 501(c)(3) 10,000       Program Support
(20) KELSEYVILLE PRESBYTERIAN CHURCH
PO BOX 310
KELSEYVILLE,CA95451 		94-1219120   10,000       Program Support
(21) TRACY INTERFAITH MINISTRIES
311 W GRANT LINE RD
TRACY,CA95376 		94-3150638 501(c)(3) 10,000       Program Support
(22) WELLSPACE HEALTH
777 12TH ST STE 250
SACRAMENTO,CA95814 		94-1713704 501(c)(3) 9,200       Program Support
(23) PLACER FOOD BANK
8284 INDUSTRIAL AVE
ROSEVILLE,CA95678 		94-1740316 501(c)(3) 9,000       Program Support
(24) NORTH COAST OPPORTUNITIES INC
413 NO STATE ST
UKIAH,CA95482 		94-1671958 501(c)(3) 8,000       Program Support
(25) CERES COMMUNITY PROJECT
PO BOX 1562
SEBASTOPOL,CA95473 		26-2250997 501(c)(3) 6,250       Program Support
(26) REDWOOD EMPIRE FOOD BANK
3320 INDUSTRIAL DR
SANTA ROSA,CA95403 		68-0121855 501(c)(3) 6,250       Program Support
(27) ELK GROVE COMMUNITY FOOD BANK SERVICES
PO BOX 1447
ELK GROVE,CA95759 		38-3664737 501(c)(3) 6,000       Program Support
(28) FOOD BANK OF YOLO COUNTY
1244 FORTNA AVE
WOODLAND,CA95776 		23-7111782 501(c)(3) 6,000       Program Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
27
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
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) Nursing Student Excellence Award 17 8,500      
(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
SCHEDULE I, PART I, LINE 2 In order to closely monitor efficiency and effectiveness, the Community Benefit function outlines measurable reporting (quarterly, six-month and/or year-end), program and funding requirements in a Memorandum of Understanding (MOU), Business Services Agreement (BSA), or Joint Venture Agreement for each investment made with a community partner. Where it is determined necessary, additional efforts are made to monitor effectiveness and efficiency of investments, which could include: - Quarterly meetings with community partners - E-mail and telephonic communications with community partners - Continued dialogue with involved hospital staff and community partners throughout duration of program - Site visits with community partners - Bi-annual "outcomes" survey (6-month and/or year-end outcomes) - Review of hospital usage and patient level data - Collection of patient stories and narratives - Collaborative discussions around ad-hoc successes and challenges that arise - Reporting to include year-end financial summary that compares actual expenditures to the funded project's budget, indicating any unused amount of grant funds. At the end of each year/reporting period, Community Benefit analyzes full-year data to ensure community partners met the objectives outlined in the MOU or BSA. If the community partners did not reach the anticipated outcomes, Community Benefit works to understand what circumstances prevented the organization from meeting the goals to help identify ways to improve or perhaps re-evaluate what success of this program looks like, and makes the determination to continue or terminate funding.
SCHEDULE I, PART III, LINE 1 SUTTER HEALTH SUPPORTS SEVERAL LOCAL AREA NURSING EDUCATION PROGRAMS. IN 2019, CERTAIN NURSING STUDENT GRADUATES RECEIVED A $500 MONETARY AWARD FOR COMPLETING THE PROGRAM.
Schedule I (Form 990) 2019



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