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ObjectId: 202430459349300823 - Submission: 2024-02-14
TIN: 84-2278120
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
AUDUBON RETIREMENT VILLAGE INC
Employer identification number
84-2278120
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)
LOUISIANA CHILDRENS MEDICAL CENTER
1100 POYDRAS STREET 2500 ENERGY CEN
NEW ORLEANS
,
LA
70119
94-3480131
HEALTH SERVICES
LA
501(C)(3)
LINE 3
No
(2)
CHILDREN'S HOSPITAL
200 HENRY CLAY AVENUE
NEW ORLEANS
,
LA
70118
72-0467503
PEDIATRIC HOSPITAL
LA
501(C)(3)
LINE 3
LOUISIANA CHILDREN'S MEDICAL CENTER
No
(3)
TOURO INFIRMARY
1401 FOUCHER STREET
NEW ORLEANS
,
LA
70115
72-0423659
FULL-SERVICE COMMUNITY HOSPITAL
LA
501(C)(3)
LINE 3
LOUISIANA CHILDREN'S MEDICAL CENTER
No
(4)
UNIVERSITY MEDICAL CENTER MANAGEMENT
2021 PERDIDO STREET
NEW ORLEANS
,
LA
70112
25-1925187
FULL-SERVICE COMMUNITY & TEACHING HOSPITAL
LA
501(C)(3)
LINE 3
LOUISIANA CHILDREN'S MEDICAL CENTER
No
(5)
CHILDRENS HOSPITAL ANESTHESIA CORPORATION
1100 POYDRAS STREET 2500 ENERGY CEN
NEW ORLEANS
,
LA
70119
06-1587311
PEDIATRIC HOSPITAL ANESTHESIA SERVICES
LA
501(C)(3)
LINE 10
LOUISIANA CHILDREN'S MEDICAL CENTER
No
(6)
LCMC HEALTH HOLDINGS INC
4200 HOUMA BLVD
METAIRIE
,
LA
70006
84-3390470
FULL-SERVICE COMMUNITY HOSPITAL
LA
501(C)(3)
LINE 3
LOUISIANA CHILDREN'S MEDICAL CENTER
No
(7)
NEW ORLEANS PHYSICIAN SERVICES
1101 MEDICAL CENTER BLVD
MARRERO
,
LA
70072
46-4568405
HEALTHCARE SERVICES
LA
501(C)(3)
LINE 10
WEST JEFFERSON HOLDINGS LLC
No
(8)
WOLDENBERG VILLAGE
3701 BEHRMAN PLACE
NEW ORLEANS
,
LA
70114
72-0540671
HEALTHCARE SERVICES
LA
501(C)(3)
LINE 10
TOURO INFIRMARY
No
(9)
CHILDREN'S HOSPITAL MEDICAL PRACTICE
200 HENRY CLAY AVE
NEW ORLEANS
,
LA
70118
72-1318421
PEDIATRIC PRIMARY CARE PHYSICIAN SERVICE
LA
501(C)(3)
LINE 10
CHILDREN'S HOSPITAL
No
(10)
METAIRIE PHYSICIAN SERVICES INC
1101 MEDICAL CENTER BLVD
METAIRIE
,
LA
70006
46-1434300
HEALTHCARE DELIVERY
LA
501(C)(3)
LINE 10
LCMC HEALTH HOLDINGS
No
(11)
TOURO INFIRMARY FOUNDATION
1401 FOUCHER STREET
NEW ORLEANS
,
LA
70115
72-1169939
HEALTHCARE SUPPORT
LA
501(C)(3)
LINE 12A, I
TOURO INFIRMARY
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)
TIJV LLC
1401 FOUCHER ST
NEW ORLEANS
,
LA
70115
26-1378361
IMAGING CENTER RENTAL
LA
N/A
No
No
(2)
CRESCENT CITY RESEARCH CONSORTIUM LLC
1111 MEDICAL CENTER BLVD STE N701
MARRERO
,
LA
70072
38-3880814
SCIENTIFIC RESEARCH
LA
N/A
No
No
(3)
COMMUNITY SERVICES COLLABORATIVE
1101 MEDICAL CENTER BLVD STE N-201
MARRERO
,
LA
70072
36-4819943
MEDICAL COLLABORATION
LA
N/A
No
No
(4)
EAST JEFFERSON SURGERY CENTER LLC
4320 HOUMA BLVD 5TH FLOOR
METAIRIE
,
LA
70006
20-1425074
OUTPATIENT SURGERY
LA
N/A
No
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
(1)
CRESCENT CITY PHYSICIANS INC
3600 PRYTANIA STREET SUITE 72
NEW ORLEANS
,
LA
70115
72-1269878
HEALTHCARE
LA
N/A
C
No
(2)
BUCKMAN MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION
1401 FOUCHER STREET
NEW ORLEANS
,
LA
70115
72-1226687
REAL ESTATE
LA
N/A
C
No
(3)
PRYTANIA MEDICAL COMPLEX OWNERS ASSOCIATION
650 POYDRAS STREET SUITE 1200
NEW ORLEANS
,
LA
70130
72-0866121
REAL ESTATE
LA
N/A
C
No
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
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
Yes
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
Yes
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
No
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
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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