SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
PROVIDENCE HOSPICE OF SEATTLE FOUNDATION
 
Employer identification number

91-2077378
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)COVENANT ACO
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
61-1573313
HEALTHCARE TX 501(C)(3) 12,I CHS
 
Yes
 
(2)COVENANT HEALTH NETWORK INC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
46-1259908
HEALTHCARE CA 501(C)(3) 12, III SJHS
 
Yes
 
(3)COVENANT HEALTH PARTNERS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
46-3516417
HEALTHCARE TX 501(C)(3) 12, I CHS
 
Yes
 
(4)COVENANT HEALTH SYSTEM
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2765566
HEALTHCARE TX 501(C)(3) 3 SJHS
 
Yes
 
(5)COVENANT HEALTH SYSTEM FOUNDATION
3623 22ND PLACE

LUBBOCK,TX79410
75-2897026
HEALTHCARE TX 501(C)(3) 7 CHS
 
Yes
 
(6)COVENANT HOSPITAL HOBBS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
84-4273963
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(7)COVENANT MEDICAL CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
82-2913146
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(8)COVENANT MEDICAL GROUP
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2743883
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(9)EVERETT TRANSITIONAL CARE SERVICES
PO BOX 5128

EVERETT,WA982065128
94-3264605
TRANSITIONAL CARE WA 501(C)(3) 10 N/A
 
No
(10)GAMELIN WASHINGTON ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
20-1910170
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(11)GLOBAL TO LOCAL HEALTH INITIATIVE
2800 SOUTH 192ND ST 104

SEATAC,WA98188
27-3133200
HEALTHCARE WA 501(C)(3) 7 SHS
 
Yes
 
(12)GRACE CLINIC OF LUBBOCK
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
20-3856995
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(13)HMTS INC
1 HOAG DRIVE

NEWPORT BEACH,CA92658
45-3583707
HEALTHCARE CA 501(C)(3) 12, I HMHP
 
Yes
 
(14)HOAG CHARITY SPORTS
2081 BUSINESS CENTER DR STE 195

NEWPORT BEACH,CA92663
45-2982422
SUPPORT CA 501(C)(3) 7 HHF
 
Yes
 
(15)HOAG CLINIC
1 HOAG DRIVE

NEWPORT BEACH,CA92658
33-0676831
HEALTHCARE CA 501(C)(3) 10 HMHP
 
Yes
 
(16)HOAG HOSPITAL FOUNDATION
330 PLACENTIA AVE

NEWPORT BEACH,CA92663
95-3222343
FUNDRAISING CA 501(C)(3) 7 HMHP
 
Yes
 
(17)HOAG MEMORIAL HOSPITAL PRESBYTERIAN
1 HOAG ROAD BOX 6100

NEWPORT BEACH,CA92663
95-1643327
HEALTHCARE CA 501(C)(3) 3 CHN
 
Yes
 
(18)HOSPICE OF LUBBOCK
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2133781
HEALTHCARE TX 501(C)(3) 10 CHS
 
Yes
 
(19)INLAND NORTHWEST HEALTH SERVICES
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1307555
HEALTHCARE WA 501(C)(3) 3 PHS WA
 
Yes
 
(20)INSTITUTE FOR MENTAL HEALTH & WELLNESS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-4260130
HEALTHCARE WA 501(C)(3) 7 PHS SJHS
 
Yes
 
(21)INSTITUTE FOR SYSTEMS BIOLOGY
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-2003593
HEALTHCARE WA 501(C)(3) 7 WHC
 
Yes
 
(22)KADLEC AUXILIARY INC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-6033089
SUPPORT WA 501(C)(3) 12, III KRMC
 
Yes
 
(23)KADLEC FOUNDATION
888 SWIFT BLVD

RICHLAND,WA99352
23-7005501
SUPPORT WA 501(C)(3) 7 KRMC
 
Yes
 
(24)KADLEC REGIONAL MEDICAL CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-0655392
HEALTHCARE WA 501(C)(3) 3 WHC
 
Yes
 
(25)LITTLE COMPANY OF MARY ANCILLARY SERVICES CORPORATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
33-0844408
IMAGING SERVICES CA 501(C)(3) 10 PHS SOCAL
 
Yes
 
(26)LUBBOCK HERITAGE HOSPITAL LLC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
26-4021016
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(27)LUNDBERG ASSOCIATION PROVIDENCE HOUSE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1562797
SUPPORT OR 501(C)(3) 7 PHS OR
 
Yes
 
(28)MARSHA RIVKIN CENTER FOR OVARIAN CANCER RESEARCH
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-2054035
RESEARCH WA 501(C)(3) 7 SHS
 
Yes
 
(29)METHODIST CHILDREN'S HOSPITAL
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2428911
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(30)METHODIST HOSPITAL LEVELLAND
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2246348
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(31)METHODIST HOSPITAL PLAINVIEW
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2426010
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(32)MISSION HOSPITAL REGIONAL MEDICAL CTR
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1643360
HEALTHCARE CA 501(C)(3) 3 CHN
 
Yes
 
(33)NORTHWEST HOPE & HEALING FOUNDATION
PO BOX 16069

SEATTLE,WA98116
20-0799737
SUPPORT WA 501(C)(3) 12, I SHS
 
Yes
 
(34)PACMED CLINICS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
56-2290878
HEALTHCARE WA 501(C)(3) 10 WHC
 
Yes
 
(35)PH&S FOUNDATIONSFVSA & SCVSA
501 SOUTH BUENA VISTA STREET

BURBANK,CA915054809
95-3544877
HEALTHCARE CA 501(C)(3) 7 PHS SOCAL
 
Yes
 
(36)PROVIDENCE ALASKA FOUNDATION
3760 PIPER STREET SUITE 2021

ANCHORAGE,AK99508
92-0093565
HEALTHCARE AK 501(C)(3) 7 PHS WA
 
Yes
 
(37)PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION
540 SOUTH MAIN ST

MT ANGEL,OR97362
91-1940286
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(38)PROVIDENCE BLANCHET ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1789266
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(39)PROVIDENCE CHILDREN'S HEALTH FOUNDATION
4805 NE GLISAN ST STE 2N35

PORTLAND,OR97213
93-0800140
SUPPORT OR 501(C)(3) 7 PHS OR
 
Yes
 
(40)PROVIDENCE COMMUNITY HEALTH FOUNDATION
940 ROYAL AVE SUITE 410

MEDFORD,OR97504
93-0692907
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(41)PROVIDENCE DETHMAN HOUSE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
47-3385506
SUPPORT WA 501(C)(3) 7 N/A
 
No
(42)PROVIDENCE FACEY MEDICAL FOUNDATION (FKA FACEY MEDICAL FDN)
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-4322584
SUPPORT CA 501(C)(3) 7 PHS SOCAL
 
Yes
 
(43)PROVIDENCE GAMELIN HOUSE ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
31-1744654
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(44)PROVIDENCE HEALTH & SERVICES
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1549796
HEALTHCARE WA 501(C)(3) 12, II PSJH
 
 
No
(45)PROVIDENCE HEALTH & SERVICES - MONTANA
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-0231793
HEALTHCARE MT 501(C)(3) 3 PHS WA
 
Yes
 
(46)PROVIDENCE HEALTH & SERVICES - OREGON
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
51-0216587
HEALTHCARE OR 501(C)(3) 3 PHS
 
Yes
 
(47)PROVIDENCE HEALTH & SERVICES - WASHINGTON
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
51-0216586
HEALTHCARE WA 501(C)(3) 3 PHS
 
Yes
 
(48)PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1303277
HEALTHCARE WA 501(C)(3) 3 PMWHC
 
Yes
 
(49)PROVIDENCE HEALTH ASSURANCE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
55-0828701
MEDICAID HEALTHCARE PROVIDER OR 501(C)(4) N/A PHP
 
Yes
 
(50)PROVIDENCE HEALTH CARE FOUNDATION - EASTERN WASHINGTON
101 W 8TH AVE

SPOKANE,WA99204
32-0014330
HEALTHCARE WA 501(C)(3) 7 PHS WA
 
Yes
 
(51)PROVIDENCE HEALTH CARE FOUNDATION (CENTRALIA)
413 LILLY ROAD NE

OLYMPIA,WA985065166
91-1433382
HEALTHCARE WA 501(C)(3) 7 PHS W WA
 
Yes
 
(52)PROVIDENCE HEALTH PLAN
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
93-0863097
HEALTHCARE OR 501(C)(4) N/A PPP
 
Yes
 
(53)PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
51-0216589
HEALTHCARE CA 501(C)(3) 3 PHS
 
Yes
 
(54)PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION INC
810 12TH STREET PO BOX 149

HOOD RIVER,OR97031
93-0921990
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(55)PROVIDENCE HOSPICE AND HOME CARE FOUNDATION
2731 WETMORE AVE STE 500

EVERETT,WA98201
27-2552749
HEALTHCARE WA 501(C)(3) 7 PHS W WA
 
Yes
 
(56)PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION
4101 TORRANCE BLVD

TORRANCE,CA90503
51-0224944
HEALTHCARE CA 501(C)(3) 7 PHS SOCAL
 
Yes
 
(57)PROVIDENCE MARIANWOOD FOUNDATION
3725 PROVIDENCE POINT DRIVE SE

ISSAQUAH,WA980297219
93-1554288
HEALTHCARE WA 501(C)(3) 7 PHS W WA
 
Yes
 
(58)PROVIDENCE MEDICAL FDN (FKA ST JOSEPH HERITAGE HEALTHCARE)
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
33-0185031
HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(59)PROVIDENCE MEDICAL INSTITUTE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
33-0283773
HEALTHCARE CA 501(C)(3) 12, I PHS SOCAL
 
Yes
 
(60)PROVIDENCE MILWAUKIE FOUNDATION
10150 SE 32ND AVE

MILWAUKIE,OR97222
94-3079515
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(61)PROVIDENCE MINISTRIES
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
RELIGIOUS ORG WA 501(C)(3) 1 N/A
 
No
(62)PROVIDENCE MOUNT ST VINCENT FOUNDATION
4831 35TH AVE SW

SEATTLE,WA981262799
91-1188119
HEALTHCARE WA 501(C)(3) 7 PHS WA
 
Yes
 
(63)PROVIDENCE NEWBERG HEALTH FOUNDATION
1001 PROVIDENCE DRIVE

NEWBERG,OR97132
93-0889144
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(64)PROVIDENCE PETER CLAVER ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
31-1629656
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(65)PROVIDENCE PLAN PARTNERS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1861964
HEALTHCARE WA 501(C)(4) N/A PHS OR
 
Yes
 
(66)PROVIDENCE PORTLAND MEDICAL FOUNDATION
4805 NE GLISAN ST

PORTLAND,OR972132967
93-1231494
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(67)PROVIDENCE ROSSI ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
31-1584166
SUPPORT WA 501(C)(3) 10 PHS WA
 
Yes
 
(68)PROVIDENCE SAINT JOHN'S HEALTH CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1684082
HEALTHCARE CA 501(C)(3) 3 PHS SOCAL
 
Yes
 
(69)PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-4542216
HEALTHCARE CA 501(C)(3) 3 PHS SOCAL
 
Yes
 
(70)PROVIDENCE SEASIDE HOSPITAL FOUNDATION
725 S WAHANNA ROAD

SEASIDE,OR97138
93-0927320
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(71)PROVIDENCE SW WASHINGTON FOUNDATION (FKA PROV ST PETER FDN)
413 LILLY ROAD NE

OLYMPIA,WA985065166
91-1097056
SUPPORT WA 501(C)(3) 7 PHS W WA
 
Yes
 
(72)PROVIDENCE ST ELIZABETH HOUSE ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-2171539
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(73)PROVIDENCE ST FRANCIS ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
94-3244854
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(74)PROVIDENCE ST JOSEPH HEALTH
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-1244422
HEALTHCARE WA 501(C)(3) 12, III N/A
 
No
(75)PROVIDENCE ST JOSEPH HEALTH FOUNDATION
1801 LIND AVE SW

RENTON,WA980579016
94-3078543
HEALTHCARE WA 501(C)(3) 7 PHS WA
 
Yes
 
(76)PROVIDENCE ST JOSEPH MEDICAL CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-0463482
HEALTHCARE MT 501(C)(3) 3 PHS WA
 
Yes
 
(77)PROVIDENCE ST MARY FOUNDATION
1025 S 2ND AVENUE

WALLA WALLA,WA99362
45-2841492
HEALTHCARE WA 501(C)(3) 7 PHS WA
 
Yes
 
(78)PROVIDENCE ST VINCENT MEDICAL FOUNDATION
9205 SW BARNES ROAD STE MT2111

PORTLAND,OR97225
93-0575982
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(79)PROVIDENCE TRINITYCARE HOSPICE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-3264139
HEALTHCARE CA 501(C)(3) 10 PHS SOCAL
 
Yes
 
(80)PROVIDENCE TRINITYCARE HOSPICE FOUNDATION
5315 TORRANCE BLVD NO B-1

TORRANCE,CA90503
33-0261016
HEALTHCARE CA 501(C)(3) 7 PTCH
 
Yes
 
(81)PROVIDENCE WILLAMETTE FALLS MEDICAL FOUNDATION
1500 DIVISION STREET

OREGON CITY,OR97045
93-1003750
HEALTHCARE OR 501(C)(3) 12, I PHS OR
 
Yes
 
(82)REDWOOD MEMORIAL FOUNDATION
2700 DOBEER STREET

EUREKA,CA95501
94-2779313
HEALTHCARE CA 501(C)(3) 7 RMH
 
Yes
 
(83)SAINT JOHN'S CANCER INSTITUTE (FKA JOHN WAYNE CANCER INST)
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-4291515
HEALTHCARE CA 501(C)(3) 4 PSJHC
 
Yes
 
(84)SAINT JOHN'S HOSPITALHEALTH CENTER FOUNDATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-6100079
SUPPORT SAINT JOHN HEALTH CENTER & JWCI CA 501(C)(3) 7 PSJHC
 
Yes
 
(85)SEATTLE SCIENCE FOUNDATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
61-1502822
PHYSICIAN COLLABORATION WA 501(C)(3) 7 WHC
 
Yes
 
(86)SISTERS OF PROVIDENCE OF MONTANA CORPORATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
26-2612415
SHELL CORPORATION MT 501(C)(3) 1 PHS WA
 
 
No
(87)SISTERS OF ST JOSEPH OF ORANGE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1643383
RELIGIOUS ORG CA 501(C)(3) 1 N/A
 
No
(88)SRM ALLIANCE HOSPITAL SERVICES (PVH)
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
68-0395200
HEALTHCARE CA 501(C)(3) 3 SRMH
 
Yes
 
(89)ST JOSEPH HEALTH MINISTRY
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
27-1666576
RELIGIOUS ORG CA 501(C)(3) 1 SSJO
 
 
No
(90)ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-4791043
HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(91)ST JOSEPH HEALTH SYSTEM
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-3589356
HEALTHCARE CA 501(C)(3) 12, I PSJH
 
 
No
(92)ST JOSEPH HEALTH SYSTEM FOUNDATION
3345 MICHELSON DRIVE SUITE 100

IRVINE,CA92612
33-0143024
HEALTHCARE CA 501(C)(3) 10 SJHS
 
Yes
 
(93)ST JOSEPH HOME CARE NETWORK
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
68-0331084
HEALTHCARE CA 501(C)(3) 10 SJHS
 
Yes
 
(94)ST JOSEPH HOSPITAL OF ORANGE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1643359
HEALTHCARE CA 501(C)(3) 3 CHN
 
Yes
 
(95)ST JUDE HOSPITAL INC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1643325
HEALTHCARE CA 501(C)(3) 3 CHN
 
Yes
 
(96)ST LUKE ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
94-3176618
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(97)ST MARY MEDICAL CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1914489
HEALTHCARE CA 501(C)(3) 3 CHN
 
Yes
 
(98)ST PATRICK HOSPITAL FOUNDATION
502 W SPRUCE STREET

MISSOULA,MT59802
23-7056976
HEALTHCARE MT 501(C)(3) 7 PHS WA
 
Yes
 
(99)ST THOMAS CHILD AND FAMILY CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-0233495
EDUCATION MT 501(C)(3) 10 PHS WA
 
Yes
 
(100)SWEDISH EDMONDS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
27-2305304
HEALTHCARE WA 501(C)(3) 3 WHC
 
Yes
 
(101)SWEDISH HEALTH SERVICES
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-0433740
HEALTHCARE WA 501(C)(3) 3 WHC
 
Yes
 
(102)SWEDISH MEDICAL CENTER FOUNDATION
747 BROADWAY

SEATTLE,WA98122
91-0983214
HEALTHCARE WA 501(C)(3) 7 SHS
 
Yes
 
(103)SWEDISH MJM HOLDINGS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
27-3139262
HOLDING COMPANY WA 501(C)(3) 12, I SHS
 
Yes
 
(104)TARZANA MEDICAL CENTER LLC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
83-3972614
HEALTHCARE CA 501(C)(3) 3 PHS SOCAL
 
Yes
 
(105)THE GAMELIN ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1180824
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(106)THE GAMELIN CALIFORNIA ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1293869
SUPPORT CA 501(C)(3) 10 PHS SOCAL
 
Yes
 
(107)THE GAMELIN OREGON ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1214491
SUPPORT OR 501(C)(3) 10 PHS OR
 
Yes
 
(108)TRI-CITIES CANCER CENTER
1802 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1594526
HEALTHCARE WA 501(C)(3) 3 KADLEC
 
Yes
 
(109)TRI-CITIES CANCER CENTER FOUNDATION
7350 W DESCHUTES AVE BUILDING A

KENNEWICK,WA99336
91-1739024
SUPPORT WA 501(C)(3) 12, I KADLEC
 
Yes
 
(110)UNIVERSITY OF PROVIDENCE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-0231777
EDUCATION MT 501(C)(3) 2 PHS
 
Yes
 
(111)WESTERN HEALTHCONNECT
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
45-4171900
SHELL CORPORATION WA 501(C)(3) 12, II PHS W WA
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Page 2
Schedule R (Form 990) 2020
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) 20TH STREET SURGERY LLC

1301 20TH STREET STE 140
SANTA MONICA,CA90404
73-1735618
AMBULATORY SURGERY CENTER CA N/A
        No     No  
(2) BRIDGEPORT MEDICAL IMAGING (BMI)

4400 NE HALSEY 495
PORTLAND,OR97213
26-0796953
IMAGING - DIAGNOSTICS OR N/A
        No     No  
(3) BROADWAY IMAGING LLC

500 W BROADWAY
MISSOULA,MT59802
52-2405971
MEDICAL IMAGING MT N/A
        No     No  
(4) CENTER FOR MATERNAL NEWBORN AND CHILD

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
81-3526875
HEALTHCARE CA N/A
        No     No  
(5) CENTER FOR MEDICAL IMAGING (CMI)

4400 NE HALSEY 495
PORTLAND,OR97213
20-0477972
IMAGING - DIAGNOSTICS OR N/A
        No     No  
(6) CLACKAMAS RADIATION ONCOLOGY CENTER LLC

4400 NE HALSEY 495
PORTLAND,OR97213
26-0381897
RADIATION ONCOLOGY OR N/A
        No     No  
(7) COASTAL ASC HOLDINGS LLC

ONE HOAG DRIVE BOX 6100
NEWPORT BEACH,CA92663
81-0986844
HEALTHCARE CA N/A
        No   Yes    
(8) COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY

ONE CITY BLVD W STE 1100
ORANGE,CA92868
26-4591502
HEALTHCARE CA N/A
        No   Yes    
(9) COVENANT LONG-TERM CARE LP

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
20-5033419
HEALTHCARE TX N/A
        No     No  
(10) FULLERTON SURGICAL CENTER LP

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
47-0927394
AMBULATORY SURGERY CENTER CA N/A
        No   Yes    
(11) GREATER VALLEY MEDICAL BUILDING LP

501 S BUENA VISTA ST
BURBANK,CA91505
95-4570858
REAL ESTATE - MOB CA N/A
        No     No  
(12) HCSA PROPERTIES LLC

1600 M STREET NW
AUBURN,WA98001
46-0620892
REAL ESTATE RENTAL WA N/A
        No     No  
(13) HERITAGE INVESTMENT GROUP I LLC

500 S MAIN STREET STE 1000
ORANGE,CA92868
27-1000061
INVESTMENTS CA N/A
        No     No  
(14) HOAG ORTHOPEDIC INSTITUTE

1 HOAG DRIVE BOX 6100
NEWPORT BEACH,CA92658
61-1588294
HEALTHCARE CA N/A
        No   Yes    
(15) IMAGING ASSOCIATES LLC

3650 PIPER STREET STE A
ANCHORAGE,AK99508
20-3906048
MEDICAL IMAGING AK N/A
        No   Yes    
(16) INLAND IMAGING LLC

801 S STEVENS ST
SPOKANE,WA99204
91-1855796
MEDICAL IMAGING WA N/A
        No   Yes    
(17) LSC REAL PROPERTY LLC

2301 QUAKER AVENUE
LUBBOCK,TX79410
47-4646059
REAL ESTATE TX N/A
        No     No  
(18) METHODIST DIAGNOSTIC IMAGING

4005 24TH STREET
LUBBOCK,TX79410
75-2343261
HEALTHCARE TX N/A
        No     No  
(19) MISSION VIEJO PARTNERS II LLC

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
82-3943675
REAL ESTATE - MOB CA N/A
        No   Yes    
(20) NEWPORT IMAGING CENTER

360 SN MIGUEL
NEWPORT BEACH,CA92660
33-0191776
HEALTHCARE CA N/A
        No   Yes    
(21) NEWPORT SURGICAL PARTNERS LLC

27271 LAS RAMBLAS 350
MISSION VIEJO,CA92691
39-2060266
HEALTHCARE CA N/A
        No   Yes    
(22) OREGON ADVANCED IMAGING LLC

881 OHARE PARKWAY
MEDFORD,OR97504
45-0471748
MEDICAL IMAGING OR N/A
        No     No  
(23) OREGON OUTPATIENT SURGERY CENTER

7300 SW CHILDS RD
TIGARD,OR97224
22-3883387
AMBULATORY SURGERY CENTER OR N/A
        No     No  
(24) PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC

1221 MADISON STREET
SEATTLE,WA98104
20-3132044
MEDICAL IMAGING WA N/A
        No     No  
(25) PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
81-2701056
INVESTMENTS WA N/A
        No     No  
(26) PROV RADIATION ONCOLOGY DEVELOP ASSN LLC

4400 NE HALSEY 495
PORTLAND,OR97213
26-0682491
REAL ESTATE - MOB OR N/A
        No     No  
(27) PROVIDENCE CHILDREN'S NEONATAL SVCS

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
47-0918549
NEONATAL CARE WA N/A
        No     No  
(28) PROVIDENCE IMAGING CENTER JOINT VENTURE

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
92-0118807
MEDICAL IMAGING AK N/A
        No     No  
(29) PROVIDENCE ST JOSEPH HEALTH LONG TERM PORTFOLIO

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
82-3190634
INVESTMENTS WA PHS WA
 
EXCLUDED 100,291 1,381,077   No -2   No 0.030 %
(30) PROVIDENCE SURGERY CENTER LLC

902 N ORANGE ST
MISSOULA,MT59802
84-1401625
AMBULATORY SURGERY CENTER MT N/A
        No     No  
(31) PROVIDENCE UCLA USP SURGERY CENTER JV

14201 DALLAS PARKWAY
DALLAS,TX75254
32-0503030
AMBULATORY SURGERY CENTER CA N/A
        No     No  
(32) PROVIDENCESILVERTON REHAB LLC

4400 NE HALSEY 425
PORTLAND,OR97213
48-1287267
REHAB SERVICES OR N/A
        No     No  
(33) PROVIDENCEUSP SOUTH BAY SURGERY CENTERS

15305 DALLAS PKWY STE 1600 LB 28
ADDISON,TX75001
47-5064486
AMBULATORY SURGERY CENTER CA N/A
        No     No  
(34) PROVIDENCEUSP SURGERY CTRS LLC

11550 INDIAN HILLS ROAD 160
MISSION HILLS,CA91345
20-0684116
AMBULATORY SURGERY CENTER CA N/A
        No     No  
(35) RADIATION THERAPY INNOVATIONS LLC

1221 MADISON ST 1ST FL
SEATTLE,WA98104
30-0553035
HEALTHCARE WA N/A
        No   Yes    
(36) REDMOND AMBULATORY SURGERY CENTER LLC

805 MADISON ST STE 901
SEATTLE,WA98104
81-3558711
AMBULATORY SURGERY CENTER WA N/A
        No   Yes    
(37) SANTA ANA MOB LLC

1800 QUAIL STREET STE 100
NEWPORT BEACH,CA92660
75-3205306
REAL ESTATE - MOB CA N/A
        No   Yes    
(38) SJO ASC HOLDINGS LLC

1140 W LA VETA AVE
ORANGE,CA92868
82-1655501
HEALTHCARE CA N/A
        No     No  
(39) ST JOSEPH PHYSICIAN VENTURES I LLC

1100 WEST STEWART DRIVE
ORANGE,CA92868
45-4521884
REAL ESTATE CA N/A
        No   Yes    
(40) ST JOSEPHSATELLITE DIALYSIS CENTERS LLC

300 SANTANA ROW SUITE 300
SAN JOSE,CA95128
81-4657391
HEALTHCARE CA N/A
        No     No  
(41) ST JUDE SURGICAL CENTERS LLC

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
82-3352570
AMBULATORY SURGERY CENTER CA N/A
        No   Yes    
(42) SURGERY CENTER AT TANASBOURNE LLC

11221 ROE AVE STE 300
LEAWOOD,KS66211
20-8187971
AMBULATORY SURGERY CENTER KS N/A
        No     No  
(43) TARZANA PEDIATRIC VENTURES LLC

18321 CLARK ST
TARZANA,CA91356
82-1308306
HEALTHCARE CA N/A
        No     No  
(44) THE MADISON SPOKANE INN LLC

15 WEST ROCKWOOD BLVD
SPOKANE,WA99204
84-1606484
HOTEL SERVICES WA N/A
        No   Yes    
(45) YELM MEDICAL OFFICE BUILDING

2840 CRITES ST SW STE 104
TUMATER,WA98512
26-3685020
REAL ESTATE - MOB WA N/A
        No   Yes    
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) 1221 MADISON STREET OWNERS ASSOC

747 BROADWAY
SEATTLE,WA98122
20-1954319
OWNERS' ASSOCIATION WA N/A
C         No
(2) ACCLARA SOLUTIONS INTERMEDIATE LLC

10713 W SAM HOUSTON PKWY N 500
HOUSTON,TX77064
37-1783298
HEALTHCARE FINANCIAL SERVICES TX N/A
C         No
(3) AMERICAN UNITY GROUP LTD

90 PITTS BAY ROAD HM08 PEMBROKE
BD
CAPTIVE INSURANCE BD N/A
C         No
(4) AYIN HEALTH SOLUTIONS INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
83-3037172
HEALTHCARE DE N/A
C         No
(5) BOURGET HEALTH SERVICES INC

101 W 8TH AVE TAF C-9
SPOKANE,WA99204
91-1354431
CLINICAL/MEDICAL LAB WA N/A
C         No
(6) CARON CORPORATION

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
81-0486082
MEDICAL PHYSICIAN SERVICE MT N/A
C         No
(7) COMMUNITY TECHNOLOGIES INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
84-4722399
IT SVCS DE N/A
C         No
(8) DATU HEALTH INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
46-3070062
IT SVCS DE N/A
C         No
(9) ENDOSCOPY CENTER OF SOUTHERN CALIFORNIA

1301 20TH ST STE 280
SANTA MONICA,CA90404
95-2880495
HEALTHCARE CA N/A
S         No
(10) ENGAGE IT SERVICES INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
84-4058573
IT SVCS DE N/A
C         No
(11) HMR WEIGHT MANAGEMENT SERVICES CORP

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
46-3598718
HEALTHCARE WA N/A
C         No
(12) HOAG MANAGEMENT SERVICES INC

1 HOAG DRIVE BOX 6100
NEWPORT BEACH,CA92658
33-0731587
HEALTHCARE CA N/A
C         No
(13) HOAG PHYSICIAN PARTNERS

16148 SAND CANYON AVE
IRVINE,CA92618
83-4276044
HEALTHCARE CA N/A
C         No
(14) LUBBOCK METHODIST HOSP PRACTICE MGMT

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
75-2578995
INACTIVE TX N/A
C         No
(15) LUBBOCK METHODIST HOSPITAL SVCS

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
75-2118585
HEALTHCARE TX N/A
C         No
(16) LUMEDIC INC (FKA LUMEDIC ACQ CO INC)

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
83-3881097
HEALTHCARE WA N/A
C         No
(17) MEDICAL SPECIALTIES MANAGERS INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
33-0406218
HEALTHCARE WA N/A
C         No
(18) MEDIREVV INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
20-8783763
HEALTHCARE DE N/A
C         No
(19) MISSION VIEJO MEDICAL VENTURES

27800 MEDICAL CENTER RD 354
MISSION VIEJO,CA92691
33-0212905
HEALTHCARE CA N/A
C         No
(20) PERFORMANCE HEALTH TECHNOLOGY LTD

3993 FAIRVIEW INDUSTRIAL DR SE
SALEM,OR97302
93-1211733
HEALTHCARE OR N/A
C         No
(21) PHN HOLDINGS

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
46-1814184
STRATEGIC PLANNING SERVICES CA N/A
C         No
(22) PIONEER INNOVATIONS INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
36-4818191
HEALTHCARE INNOVATIONS WA N/A
C         No
(23) PROVIDENCE ASSURANCE INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
20-8194071
CAPTIVE INSURANCE AZ N/A
C         No
(24) PROVIDENCE GLOBAL CENTER LLP

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
98-1516461
IT SVCS IN N/A
C         No
(25) PROVIDENCE HCC HOLDINGS INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
HOLDING COMPANY CA N/A
C         No
(26) PROVIDENCE HEALTH CARE VENTURES INC

101 W 8TH AVE TAF C-9
SPOKANE,WA99204
90-0155714
CLINICAL/MEDICAL LAB WA N/A
C         No
(27) PROVIDENCE HEALTH NETWORK

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
80-0886966
PREPAID HEALTHCARE CA N/A
C         No
(28) PROVIDENCE HEALTH VENTURES INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
33-0122216
INVESTMENT CA N/A
C         No
(29) PROVIDENCE PHYSICIAN SERVICES CO

101 W 8TH AVE TAF C-9
SPOKANE,WA99204
91-1216033
HEALTHCARE WA N/A
C         No
(30) PROVIDENCE ST JOSEPH HEALTH NETWORK

20555 EARL ST
TORRANCE,CA90503
82-3771547
HEALTHCARE CA N/A
C         No
(31) QUIVIQ INC

1400-112TH AVENUE ST SUITE 100
BELLEVUE,WA98004
83-3879444
HEALTHCARE ANALYTICS WA N/A
C         No
(32) ST JOSEPH HEALTH

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
46-2340232
HOLDING COMPANY CA N/A
C         No
(33) ST JOSEPH HEALTH SOURCE INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
46-1900168
HEALTHCARE CA N/A
C         No
(34) ST JOSEPH PROF SVCS ENTERPRSES INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
33-0155323
HEALTHCARE CA N/A
C         No
(35) TEGRIA HOLDINGS LLC (FKA GRADY BLOCKER LLC)

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
84-2092143
HOLDING COMPANY DE N/A
C         No
(36) TEGRIA RCM GROUP INC (FKA PROV RCM GROUP INC)

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
84-4686520
HOLDING COMPANY DE N/A
C         No
(37) TEGRIA SERVICES GROUP INC (FKA PROVIDENCE SERVICES GROUP)

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
84-4704409
HOLDING COMPANY DE N/A
C         No
(38) TEGRIA SERVICES GROUP-US INC (FKA BLUETREE NETWORK INC)

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
90-0872936
HEALTHCARE WI N/A
C         No
(39) VINSERRA INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
95-3943315
INVESTMENT CA N/A
C         No
(40) WESTERN HEALTHCONNECT VENTURES INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
80-0953654
INVESTMENT WA N/A
C         No
Schedule R (Form 990) 2020
Page 3
Schedule R (Form 990) 2020
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) PROVIDENCE HEALTH & SERVICES - WASHINGTON

C 229,000 FMV
(2) PROVIDENCE HEALTH & SERVICES - WASHINGTON

B 1,099,020 FMV




Schedule R (Form 990) 2020
Page 4
Schedule R (Form 990) 2020
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2020
Page 5
Schedule R (Form 990) 2020
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2020

Additional Data


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