efile Public Visual Render
ObjectId: 202321309349306057 - Submission: 2023-05-10
TIN: 95-3804495
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
21
Open to Public Inspection
Name of the organization
LOMA LINDA UNIVERSITY HEALTH
Employer identification number
95-3804495
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
(1)
N3EIGHT LLC
11219 ANDERSON ST
LOMA LINDA
,
CA
92354
83-1880972
MEDICAL RESEARCH
CA
LOMA LINDA UNIVERSITY HEALTH
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)
LLUH PROFESSIONALGENERAL LIABILITY TRUST
RISK MANAGEMENT 101 E REDLANDS BLVD
SAN BERNARDINO
,
CA
92408
36-6821892
INSURANCE
IL
501(C)(3)
12A
LOMA LINDA UNIVERSITY HEALTH
Yes
(2)
LOMA LINDA UNIVERSITY HEALTH CARE
11175 CAMPUS STREET
LOMA LINDA
,
CA
92354
33-0364239
HEALTHCARE MANAGEMENT SERVICE ORGANIZATIONS
CA
501(C)(3)
12C
LOMA LINDA UNIVERSITY HEALTH
Yes
(3)
FACULTY MEDICAL GROUP OF LLU SCHOOL OF MEDICINE
11175 CAMPUS STREET 11120
LOMA LINDA
,
CA
92350
33-0672914
PHYSICIAN PRACTICE GROUP
CA
501(C)(3)
3
LOMA LINDA UNIVERSITY HEALTH
Yes
(4)
LOMA LINDA FACULTY MEDICAL GROUP
11175 CAMPUS STREET 11120
LOMA LINDA
,
CA
92350
33-0672915
PHYSICIAN PRACTICE GROUP
CA
501(C)(3)
3
LOMA LINDA UNIVERSITY HEALTH
Yes
(5)
GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS
12501 OLD COLUMBIA PIKE
SILVER SPRINGS
,
MD
20904
52-0643036
CHURCH
MD
501(C)(3)
1
N/A
No
(6)
LOMA LINDA UNIVERSITY SHARED SERVICES
11175 CAMPUS STREET
LOMA LINDA
,
CA
92354
81-0661056
SERVICE ORGANIZATION
CA
501(C)(3)
1
LOMA LINDA UNIVERSITY HEALTH
Yes
(7)
LOMA LINDA MERCANTILE
11234 ANDERSON STREET
LOMA LINDA
,
CA
92354
95-3858272
PURCHASING COMPANY
CA
501(C)(3)
1
LOMA LIND UNIVERSITY MEDICAL CENTER
No
(8)
LOMA LINDA UNIVERSITY
11145 ANDERSON STREET
LOMA LINDA
,
CA
92350
95-1816009
UNIVERSITY
CA
501(C)(3)
2
LOMA LINDA UNIVERSITY HEALTH
Yes
(9)
LOMA LINDA UNIVERSITY BEHAVIORAL MEDICINE CENTER
1710 BARTON ROAD
REDLANDS
,
CA
92373
33-0245579
PSYCHIATRIC HOSPITAL
CA
501(C)(3)
3
LOMA LINDA UNIVERSITY HEALTH
No
(10)
LOMA LINDA UNIVERSITY MEDICAL CENTER
11234 ANDERSON STREET
LOMA LINDA
,
CA
92354
95-3522679
HOSPITAL
CA
501(C)(3)
3
LOMA LINDA UNIVERSITY HEALTH
Yes
(11)
LOMA LINDA UNIVERSITY MEDICAL ENTERPRISES
11234 ANDERSON STREET
LOMA LINDA
,
CA
92354
33-0873998
OUTPATIENT PHARMACY
CA
501(C)(3)
12A
LOMA LIND UNIVERSITY MEDICAL CENTER
No
(12)
LOMA LINDA UNIVERSITY UNEMPLOYMENT COMPENSATION AND WORKERS' COMPENSATION S
BANK OF AMERICAATTNENGRACIA M RODRI
PROVIDENCE
,
RI
029019972
95-3458265
INSURANCE
CA
501(C)(3)
12A
LOMA LINDA UNIVERSITY HEALTH
Yes
(13)
UNIVERSITY INSURANCE COMPANY OF VERMONT
40 MAIN STREET STE 500
BURLINGTON
,
VT
05402
03-0311174
INSURANCE UNDERWRITING
VT
501(C)(3)
1
LOMA LINDA UNIVERSITY HEALTH
Yes
(14)
LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL FOUNDATION
PO BOX 2000
LOMA LINDA
,
CA
92354
33-0565591
FOUNDATION
CA
501(C)(3)
12C
LOMA LIND UNIVERSITY MEDICAL CENTER
No
(15)
LOMA LINDA UNIVERSITY FACULTY PHARMACY
11234 ANDERSON ST
LOMA LINDA
,
CA
92354
20-2834636
OUTPATIENT PHARMACY
CA
501(C)(3)
12A
LOMA LIND UNIVERSITY MEDICAL CENTER
No
(16)
LOMA LINDA - INLAND EMPIRE CONSORTIUM FOR HEALTHCARE EDUCATION
11175 CAMPUS STREET
LOMA LINDA
,
CA
92354
46-1612773
GRADUATE MEDICAL EDUCATION
CA
501(C)(3)
10
LOMA LINDA UNIVERSITY HEALTH
Yes
(17)
LOMA LINDA UNIVERSITY MEDICAL CENTER-MURRIETA
28062 BAXTER ROAD
MURRIETA
,
CA
92653
37-1705906
HOSPITAL
CA
501(C)(3)
3
LOMA LINDA UNIVERSITY HEALTH
No
(18)
LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL
11234 ANDERSON ST
LOMA LINDA
,
CA
92354
46-3214504
HOSPITAL
CA
501(C)(3)
3
LOMA LINDA UNIVERSITY HEALTH
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Page 2
Schedule R (Form 990) 2021
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
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
Schedule R (Form 990) 2021
Page 3
Schedule R (Form 990) 2021
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
No
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
No
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
Yes
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
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
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)
LOMA LINDA MERCANTILE
P
21,820,283
(2)
LLU MEDICAL CENTER
L
9,321,914
(3)
LOMA LINDA UNIVERSITY
L
4,306,833
(4)
LLU CHILDREN'S HOSPITAL
L
3,402,869
(5)
LL UNIVERSITY MEDICAL CENTER-MURRIETA
L
2,470,275
(6)
LLU BEHAVIORAL MEDICINE CENTER
L
897,711
(7)
FACULTY PHYSICIANS AND SURGEONS OF LLUSM
L
147,367
(8)
LLU HEALTH CARE
L
51,953
Schedule R (Form 990) 2021
Page 4
Schedule R (Form 990) 2021
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) 2021
Page 5
Schedule R (Form 990) 2021
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) 2021
Additional Data
Software ID:
Software Version: