efile Public Visual Render
ObjectId: 202411369349309961 - Submission: 2024-05-15
TIN: 95-3407027
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
22
Open to Public Inspection
Name of the organization
USC ARCADIA HOSPITAL FOUNDATION
Employer identification number
95-3407027
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)
UNIVERSITY OF SOUTHERN CALIFORNIA
UNIVERSITY GARDENS - UGB203
LOS ANGELES
,
CA
90089
95-1642394
EDUCATION
CA
501(C)(3)
2
NA
No
(2)
ICT PRODUCTIONS INC
C/O USC UGB 203
LOS ANGELES
,
CA
90089
95-4843260
EDUC. MEDIA
CA
501(C)(3)
12A
USC
Yes
(3)
DAVID X MARKS FOUNDATION
C/O USC UGB 203
LOS ANGELES
,
CA
90089
95-6034304
USC SUPPORT
CA
501(C)(3)
12A
USC
Yes
(4)
SURVIVORS OF SHOAH VISUAL HISTORY FDN
C/O USC 650 W 35TH ST
LOS ANGELES
,
CA
90089
95-4474965
EDUC. MEDIA
CA
501(C)(3)
7
USC
Yes
(5)
USC Verdugo Hills Hospital Foundation
1812 VERDUGO BLVD
GLENDALE
,
CA
91208
95-3247823
USC SUPPORT
CA
501(C)(3)
12A
VHH
Yes
(6)
ALBEDO INSURANCE COMPANY IC
UNIVERSITY GARDENS UGB203
LOS ANGELES
,
CA
90089
85-1454978
USC SUPPORT
VT
501(C)(3)
12A
USC
Yes
(7)
USC CAPTIVE INSURANCE COMPANY
UNIVERSITY GARDENS UGB203
LOS ANGELES
,
CA
90089
85-1454519
USC SUPPORT
VT
501(C)(3)
12A
USC
Yes
(8)
USC CARE MEDICAL GROUP INC
1510 SAN PABLO ST 649
LOS ANGELES
,
CA
90033
95-4540991
MANAGED CARE
CA
501(C)(3)
12A
USC HEALTH
Yes
(9)
USC HEALTH SYSTEM
1510 SAN PABLO STREET
LOS ANGELES
,
CA
90089
85-0666499
USC SUPPORT
CA
501(C)(3)
12B
USC
Yes
(10)
KECK MEDICAL CENTER OF USC
1510 SAN PABLO STREET
LOS ANGELES
,
CA
90033
85-1644866
HOSPITAL
CA
501(C)(3)
3
USC HEALTH
Yes
(11)
USC VERDUGO HILLS HOSPITAL
1812 VERDUGO BOULEVARD
GLENDALE
,
CA
91208
85-1634852
HOSPITAL
CA
501(C)(3)
3
USC HEALTH
Yes
(12)
USC ARCADIA HOSPITAL
300 WEST HUNTINGTON DRIVE
ARCADIA
,
CA
91007
95-1643336
HOSPITAL
CA
501(C)(3)
3
USC HEALTH
Yes
(13)
GENERAL LIABILITY DEFENSE IC
UNIVERSITY GARDENS UGB203
LOS ANGELES
,
CA
90089
85-1472543
USC SUPPORT
VT
501(C)(3)
12A
USC
Yes
(14)
NAT'L HLTHCRE RESEARCH & EDUC FINANCE CO
1445 ROSS AVENUE STE 3800
DALLA
,
TX
75202
31-1707979
USC SUPPORT
TX
501(C)(3)
12C
NA
No
(15)
THE ASC TRUST AT USC
C/O R FOX 1500 MARKET STREET
PHILADELPHIA
,
PA
19102
77-6216147
USC SUPPORT
PA
501(C)(3)
12D
NA
No
(16)
PACIFIC-12 CONFERENCE
1350 TREAT BOULEVARD
WALNUT CREEK
,
CA
94597
94-1459048
USC SUPPORT
CA
501(C)(3)
12A
NA
No
(17)
ALDERSGATE MEDICAL SERVICES
300 WEST HUNTINGTON DRIVE
ARCADIA
,
CA
91007
95-3702057
SUPPORT ORG
CA
501(C)(3)
12A
USCAH
Yes
(18)
WOMEN'S AUXILIARY OF METHODIST HOSPITAL
300 WEST HUNTINGTON DRIVE
ARCADIA
,
CA
91007
95-4123357
HEALTHCARE
CA
501(C)(3)
12D
NA
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2022
Page 2
Schedule R (Form 990) 2022
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)
USCSCA SURGICAL HOLDINGS LLC
1510 SAN PABLO STREET
LOS ANGELES
,
CA
02210
HOLDING COMPA
CA
NA
(2)
SUMMERTIME APARTMENTS
3990 RUFFIN ROAD SUITE 100
SAN DIEGO
,
CA
92123
33-0167146
HOUSING
CA
USC
(3)
HM FUND II LP
150 EAST 58TH STREET 33RD FL
NEW YORK
,
NY
10155
87-1030738
INVESTMENTS
NY
USC
(4)
STRIPES V MEADOWS CO-INVEST LP
40 10TH AVE 5TH FLOOR
NEW YORK
,
NY
10014
86-2543648
INVESTMENTS
NY
USC
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)
MAY ROBERTS DEWRIGHT TRUST
UNIVERSITY GARDENS - UGB203
LOS ANGELES
,
CA
900898003
95-6284845
USC SUPPORT
CA
NA
T
Yes
(2)
INTEGRATED DIGITAL ASSET CORPORATION
UNIVERSITY GARDENS - UGB203
LOS ANGELES
,
CA
900898003
95-4680904
3RD PARTY CON
CA
NA
C
Yes
(3)
CHARITABLE REMAINDER TRUSTS (353)
FUNDRAISING
CA
NA
T
Yes
(4)
POOLED INCOME FUND (1)
FUNDRAISING
CA
NA
T
Yes
(5)
CHARITABLE REMAINDER TRUST
952 FALLEN LEAF ROAD
ARCADIA
,
CA
91006
20-7419078
INVESTMENT
CA
USCAHF
T
12,377
141,829
100.000 %
Yes
Schedule R (Form 990) 2022
Page 3
Schedule R (Form 990) 2022
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
Yes
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
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
Yes
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)
CHARITABLE REMAINDER TRUST
A
5,896
ACTUAL VALUE
Schedule R (Form 990) 2022
Page 4
Schedule R (Form 990) 2022
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) 2022
Page 5
Schedule R (Form 990) 2022
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) 2022
Additional Data
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