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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
2022
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) NEIGHBORHOOD WELLNESS FNDT
7648 MARINA COVE DR
SACRAMENTO,CA95831 		47-4874487 501(c)(3) 810,754       Program Support
(2) LEUKEMIA AND LYMPHOMA SOCIETY
10409 FOX BOROUGH CT
OAKDALE,CA95361 		13-5644916 501(c)(3) 150,000       Program Support
(3) CRISTO REY HIGH SCHOOL SACRAMENTO
8475 JACKSON RD
SACRAMENTO,CA95826 		04-3832927 501(c)(3) 143,500       Program Support
(4) Anamatangi Polynesian Voices
152 Daphne Way
EAST PALO ALTO,CA94303 		84-3568185 501(c)(3)   136,657 fmv Medical Supplies PROGRAM SUPPORT
(5) GREATER SACRAMENTO AREA ECONOMIC COUNCIL
400 CPTL ML BLVD 2520
SACRAMENTO,CA95814 		46-5517841 501(c)(3) 100,000       PROGRAM SUPPORT
(6) AMBULATORY SURGERY ACCESS COALITION
353 KEARNY ST 201
SAN FRANCISCO,CA94108 		94-3180356 501(c)(3) 100,000       PROGRAM SUPPORT
(7) CA LATINO LEGISLATIVE CAUCUS FNDT
777 S FGRA ST 4050
LOS ANGELES,CA90017 		20-1993440 501(c)(3) 50,000       PROGRAM SUPPORT
(8) COALITION FOR COMPASSIONATE CARE OF CA
2530 RVR PLAZA DR 110
SACRAMENTO,CA95833 		27-0419836 501(c)(3) 50,000       PROGRAM SUPPORT
(9) Healthy Davis Together
1632 Da Vinci CT
DAVIS,CA95618 		68-0526185 501(c)(3)   49,134 fmv MEDICAL SUPPLIES PROGRAM SUPPORT
(10) PCOE Placer County Office Of Education
360 Nevada St
AUBURN,CA95618 		95-6000527 GOVT   37,411 fmv MEDICAL SUPPLIES PROGRAM SUPPORT
(11) Clinica Del Valle
45 Nielson ST
WATSONVILLE,CA95076 		94-3096772 501(c)(3)   35,493 fmv MEDICAL SUPPLIES PROGRAM SUPPORT
(12) AMERICAN NATIONAL RED CROSS
431 18TH ST NW
WASHINGTON DC,DC20006 		53-0196605 501(c)(3) 35,000       PROGRAM SUPPORT
(13) SECOND HARVEST FOOD BANK
750 CURTNER AVE
SAN JOSE,CA95125 		94-2614101 501(c)(3) 33,500       PROGRAM SUPPORT
(14) SALVATION ARMY DEL ORO DIV YUBA SUTTER CORPS
30840 HTH BLVD
RANCHO PALOS VERDE,CA90275 		94-1156347 501(c)(3) 28,930       PROGRAM SUPPORT
(15) UNITED STATES OF CARE CAMPAIGN
2776 S ALTN ML DR 504
ARLINGTON,VA22206 		82-2860302 501(c)(3) 25,000       PROGRAM SUPPORT
(16) CALIFORNIA LEGISLATIVE LGBT FOUNDATION
5445 MADISON AVE
Sacramento,CA95841 		30-0805115 501(c)(3) 25,000       PROGRAM SUPPORT
(17) CALIFORNIA LEGISLATIVE BLACK CAUCUS INST
777 S FGRA ST 4050
Los Angeles,CA90017 		26-3911734 501(c)(3) 25,000       PROGRAM SUPPORT
(18) FISHER HOUSE FOUNDATION INC
111 RKVL PIKE 420
ROCKVILLE,MD20850 		11-3158401 501(c)(3) 25,000       PROGRAM SUPPORT
(19) SAN FRANCISCO FOOD BANK
900 PENN AVE
SAN FRANCISCO,CA94107 		94-3041517 501(c)(3) 22,500       PROGRAM SUPPORT
(20) ALAMEDA COUNTY COMMUNITY FOOD BANK
PO BOX 2599
OAKLAND,CA94614 		94-2960297 501(c)(3) 20,000       PROGRAM SUPPORT
(21) MIGA (MATTER)
7005 Oxford ST
SAINT LUIS PARK,MN55426 		37-1441658 501(c)(3)   18,931 fmv MEDICAL SUPPLIES PROGRAM SUPPORT
(22) SECOND HARVEST OF THE GREATER VALLEY
704 E INDUSTRIAL PARK DR
MANTECA,CA95337 		68-0376587 501(c)(3) 18,215       PROGRAM SUPPORT
(23) RIVER CITY COMMUNITY SERVICES
3311 E CURTIS DR
SACRAMENTO,CA95818 		91-1851398 501(c)(3) 18,215       PROGRAM SUPPORT
(24) SECOND HARVEST FOOD BANK OF SANTA CRUZ CNTY
800 OHLONE PKWY
WATSONVILLE,CA95076 		77-0326685 501(c)(3) 16,500       PROGRAM SUPPORT
(25) DAVIS STREET COMMUNITY CENTER
3081 TEAGARDEN ST
SAN LEANDRO,CA94577 		94-3121699 501(c)(3) 15,000       PROGRAM SUPPORT
(26) CALIFORNIA ISSUES FORUM
1121 L ST STE 211
SACRAMENTO,CA95814 		01-0595129 501(c)(3) 15,000       PROGRAM SUPPORT
(27) FOOD BANK OF CONTRA COSTA AND SOLANO
4010 NELSON AVE
CONCORD,CA94520 		94-2418054 501(c)(3) 14,215        
(28) TRACY INTERFAITH MINISTRIES
311 W GRANT LINE RD
TRACY,CA95376 		94-3150638 501(c)(3) 13,215       PROGRAM SUPPORT
(29) PLACER FOOD BANK
8284 INDUSTRIAL AVE
ROSEVILLE,CA95678 		94-1740316 501(c)(3) 12,215       PROGRAM SUPPORT
(30) Sutter Valley Hospitals
2200 River Plaza Drive
SACRAMENTO,CA95833 		94-1156621 501(c)(3) 11,000       PROGRAM SUPPORT
(31) Sutter Valley Medical Foundation
2200 River Plaza Drive
SACRAMENTO,CA95833 		68-0273974 501(c)(3) 10,000        
(32) MEALS ON WHEELS OF ALAMEDA COUNTY
1721 BROADWAY STE 201
OAKLAND,CA94612 		94-2651065 501(c)(3) 10,000       PROGRAM SUPPORT
(33) Sutter Bay Hospitals
2200 River Plaza Drive
SACRAMENTO,CA95833 		94-0562680 501(c)(3) 10,000        
(34) ELK GROVE COMMUNITY FOOD BANK SERVICES
PO BOX 1447
ELK GROVE,CA95759 		38-3664737 501(c)(3) 9,215       PROGRAM SUPPORT
(35) YOLO FOOD BANK
233 HARTER AVE
WOODLAND,CA95776 		23-7111782 501(c)(3) 9,215       PROGRAM SUPPORT
(36) INTERFAITH COUNCIL OF AMADOR
12181 AIRPORT RD
JACKSON,CA95642 		68-0363653 501(c)(3) 6,715       PROGRAM SUPPORT
(37) Malta Clinic Of Northern California
2121 Harrison ST 120
OAKLAND,CA94612 		20-5969389 501(c)(3)   6,465 fmv MEDICAL SUPPLIES PROGRAM SUPPORT
(38) CERES COMMUNITY PROJECT
PO BOX 1562
SEBASTOPOL,CA95473 		26-2250997 501(c)(3) 6,250       PROGRAM SUPPORT
(39) REDWOOD EMPIRE FOOD BANK
3990 BRICKWAY BLVD
SANTA ROSA,CA95403 		68-0121855 501(c)(3) 6,250       PROGRAM SUPPORT
(40) SALVATION ARMY
PO BOX 340699
SACRAMENTO,CA95834 		94-1170408 501(c)(3) 5,715       PROGRAM SUPPORT
(41) UNITED METHODIST CHURCH OF LOS BANOS
1031 IOWA AVE
LOS BANOS,CA93635 		77-0384534 501(c)(3) 5,715        
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
41
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2022
Page 2

Schedule I (Form 990) 2022
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) Patient Assistance 19120   117,266 fmv Patient Clothing
(2) STUDENT SCHOLARSHIP 20 800      
(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 the appropriate reporting period, community benefit analyzes data to ensure community partners have 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. We also rely on the governance practices of the recipient organization to monitor the use of the funds.
Schedule I (Form 990) 2022



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