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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
St Charles Health System Inc
 
Employer identification number
93-0602940
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) CASA OF CENTRAL OR
1029 NW 14TH ST STE 100
BEND,OR97703
93-1062982 501(C)(3) 9,500 0     YOUTH FOSTER CARE
(2) CO COMMUNITY COLLEGE
2600 NW COLLEGE WAY
BEND,OR97701
93-0505827 MUNI CORP 7,500 0     COLLEGE NURSING PROGRAM
(3) CO COUNCIL ON AGING
373 NE Greenwood Ave
BEND,OR97701
93-0661229 501(C)(3) 15,000 0     MEALS ON WHEELS PROGRAM
(4) CO VETERANS RANCH
65920 61st St
BEND,OR97703
37-1755279 501(C)(3) 20,000 0     IMPROVE QUALITY OF LIFE FOR VETS
(5) FAMILY ACCESS NETWORK
2125 NE DAGGETT LN
BEND,OR97701
20-3534560 501(C)(3) 8,500 0     Access to basic needs for children
(6) FAMILY KITCHEN
469 NW WALL ST
BEND,OR97701
93-0427371 501(C)(3) 10,000 0     FREE COMMUNITY MEALS
(7) GIVING PLATE
61445 S HWY 97 S
BEND,OR97702
80-0553186 501(C)(3) 10,000 0     COMMUNITY FOOD BANK
(8) J BAR J YOUTH SERVICES
62895 Hamby Rd
BEND,OR97701
93-0677650 501(C)(3) 10,000 0     FACILITY SERVING YOUTH OFFENDERS
(9) JEFFERSON CNTY FAITH BASED
278 Southeast 8th Street
MADRAS,OR97741
46-1018517 501(C)(3) 10,000 0     COMMUNITY IMPROVEMENT
(10) KIDS CLUB JEFFERSON COUNTY
410 SW 4TH ST
MADRAS,OR97741
46-1018517 501(C)(3) 10,000 0     KIDS OPPORTUNITIES AND ACTIVITIES
(11) LA PINE COMMUNITY KITCHEN
16480 FINLEY BUTTE RD
LA PINE,OR97739
20-2087631 501(C)(3) 6,900 0     Provide food & clothing
(12) LEADERSHIP BEND FOUNDATION
777 nw Wall St STE 200
BEND,OR97701
93-1224982 501(C)(3) 11,500 0     Community leadership development
(13) MADRAS AQUATIC CENTER SPECIAL
1195 SE Kemper Way
MADRAS,OR97441
20-5757201 SPECIAL DISTRICT 28,790 0     After school and summer programs
(14) PRINEVILLE SNR CENTER TRUST
180 NE BLEKNAP ST
PRINEVILLE,OR97754
93-1326625 501(C)(3) 7,000 0     SERVICES FOR SENIORS
(15) REDMOND OASIS VILLAGE PROJECT
PO BOX 553
PRINEVILLE,OR97754
93-1326625 501(C)(3) 8,475 0     Alcohol Misuse Prevention
(16) RONALD MCDONALD HOUSE
1700 NE PURCELL BLVD
BEND,OR97701
93-1125838 501(C)(3) 9,000 0     LODGING FOR FAMILIES
(17) SAMARA LEARNING CENTER
230 NE 9TH ST
BEND,OR97701
46-5701194 501(C)(3) 7,000 0     DIVERSITY TRAINING
(18) SAVING GRACE
1004 NW MILWAUKEE AVE 100
BEND,OR97701
93-0797194 501(C)(3) 10,000 0     Family Violence Abuse & Services
(19) SERENITY LANE
PO BOX 8549
COBURG,OR97408
93-0606316 501(C)(3) 10,500 0     ALCOHOL MISUSE PREVENTION
(20) SHEPHERDS HOUSE
PO Box 5484
BEND,OR97708
75-3207723 501(C)(3) 10,550 0     Homeless shelter and services
(21) SISTERS COLD WEATHER SHELTER
PO BOX 1782
SISTERS,OR97759
93-0716745 501(C)(3) 7,500 0     BASIC NEEDS
(22) SISTERS RODEO ASSN
67637 HWY 220
SISTERS,OR97759
93-0716745 501(c)(4) 6,000 0     Community Event Sponsorship
(23) ST CHARLES FOUNDATION
2500 NE Neff Rd
BEND,OR97701
94-3076293 501(c)(3) 15,695 0     To support fundraising activities
(24) STOKE AWARENESS OREGON
695 SW Mill View Way
BEND,OR97701
82-4216575 501(C)(3) 5,750 0     Support for Seniors in the Communit
(25) TOUR DES CHUTES
70 SW Century Dr STE 100-273
BEND,OR97702
20-2006038 501(C)(3) 10,000 0     SUPPORTS CANCER CARE
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
24
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) 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)
(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 (Form 990) 2022



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