Instrumentl eFile Render
Object ID: 202103199349314865 - Rendered 2024-05-06
TIN: 94-1105628
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
20
Open to Public Inspection
Name of the organization
KAISER FOUNDATION HOSPITALS
Employer identification number
94-1105628
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)
MAUI HEALTH SYSTEM A KAISER FOUNDATION
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
81-1559375
HEALTH CARE
HI
347,631,112
179,828,362
KFH
(2)
KAISER PERMANENTE VENTURES LLC SERIES A
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
27-2252521
INVESTMENT
DE
3,028,452
103,088,628
KFH
(3)
KAISER PERMANENTE VENTURES LLC SERIES C
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
47-2924619
INVESTMENT
DE
4,529,061
43,405,178
KFH
(4)
KAISER PERMANENTE VENTURES LLC SERIES E
ONE KAISER PLAZA 15L
Oakland
,
CA
94612
84-2190194
INVESTMENT
DE
0
22,528,429
KFH
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)
KAISER FOUNDATION HEALTH PLAN INC
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
94-1340523
HEALTH CARE
CA
501(C)(3)
10
NA
No
(2)
KAISER FOUNDATION HEALTH PLAN OF CO
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
84-0591617
HEALTH CARE
CO
501(c)(3)
10
KFHP INC
Yes
(3)
KAISER FOUNDATION HEALTH PLAN OF GA INC
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
58-1592076
HEALTH CARE
GA
501(c)(3)
10
KFHP INC
Yes
(4)
KAISER FOUNDATION HEALTH PLAN OF THE MAS
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
52-0954463
HEALTH CARE
MD
501(c)(3)
10
KFHP INC
Yes
(5)
KAISER FOUNDATION HEALTH PLAN OF THE NW
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
93-0798039
HEALTH CARE
OR
501(c)(3)
10
KFHP INC
Yes
(6)
KAISER FDN HEALTH PLAN OF WASHINGTON
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
91-0511770
HEALTH CARE
WA
501(c)(3)
3
KFHPW HLDING
Yes
(7)
KAISER HOSPITAL ASSET MANAGEMENT INC
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
94-3299125
ASSET MGT
CA
501(c)(3)
12-I
KFH
Yes
(8)
KAISER HEALTH PLAN ASSET MANAGEMENTINC
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
94-3299124
ASSET MGT
CA
501(c)(3)
12-I
KFHP INC
Yes
(9)
CAMP BOWIE SERVICE CENTER
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
94-3299123
ADMIN
CA
501(c)(3)
12-I
KFHP INC
Yes
(10)
LOKAHI ASSURANCE LTD
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
91-2171891
WC PLACEMENT
HI
501(c)(3)
12-I
KFHP INC
Yes
(11)
1800 HARRISON FOUNDATION
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
94-3317484
FINANCING
CA
501(c)(3)
12-I
KFHP INC
Yes
(12)
KAISER HOSPITAL ASSISTANCE CORPORATION
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
31-1779500
FINANCING
CA
501(c)(3)
12-I
KFH
Yes
(13)
KAISER HEALTH ALTERNATIVES
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
93-0954562
HEALTH CARE
OR
501(C)(3)
10
KFHP INC
Yes
(14)
KP BERNARD J TYSON SCHOOL OF MEDICINE
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
81-4053028
MEDICAL EDU
CA
501(C)(3)
2
KFH
Yes
(15)
KFHPW HOLDINGS
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
93-0480268
HEALTH CARE
WA
501(C)(3)
12-I
KFHP INC
Yes
(16)
GROUP HEALTH NORTHWEST
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
91-1216856
INACTIVE
WA
501(C)(3)
12-I
KFHP OF WA
Yes
(17)
GROUP HEALTH OF WASHINGTON
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
91-1314907
inactive
WA
501(C)(3)
12-I
KFHP OF WA
Yes
(18)
KAISER FDN FOR THE ADV OF INTEGRATED HC
ONE KAISER PLAZA 15L
oakland
,
CA
94612
82-3819611
ADVOCACY
CA
501(C)(4)
N/A
KFHP INC
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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)
AG KFHDL FUND LP
245 Park avenue 28th Floor
New York
,
NY
10167
47-3496708
INVESTMENT
NY
KFH
EXCL. UNDER SEC 512
846,109
25,807,287
No
0
No
99.980 %
(2)
AG DIRECT LENDING FUND II LP
245 PARK AVE 26TH FLOOR
NEW YORK
,
NY
10167
37-1830579
INVESTMENT
NY
KFH
EXCL. UNDER SEC 512
7,217,163
130,650,160
No
258,796
No
97.828 %
(3)
AHVF (TE AIV) LP
ONE MANHATTANVILLE ROAD STE 201
PURCHASE
,
NY
10577
84-3957403
INVESTMENT
NY
KFH
EXCL. UNDER SEC 512
0
2,005,657
No
0
No
60.606 %
(4)
AHVF (CAYMAN TE AIV) LP
27 HOSPITAL ROAD
GEORGE TOWN
,
GRAND CAYMAN
KY-9008
CJ
98-1548144
INVESTMENT
CJ
KFH
EXCL. UNDER SEC 512
235,873
6,092,104
No
0
No
60.606 %
(5)
AHVF (TE FC AIV) LP
27 HOSPITAL ROAD
GEORGE TOWN
,
GRAND CAYMAN
KY-9008
CJ
98-1519129
INVESTMENT
CJ
KFH
EXCL. UNDER SEC 512
1,151,954
26,889,499
No
0
No
60.606 %
(6)
FORTRESS REAL ESTATE OPPORTUNITIES FUND
PO BOX 5098
NEW YORK
,
NY
10185
61-1796658
INVESTMENT
NY
KFH
EXCL. UNDER SEC 512
-86,513
17,156,380
No
24,499
No
57.683 %
(7)
HO FUND B LP
30 HUDSON STREET 38TH FLOOR
JERSEY CITY
,
NJ
07302
46-4966204
INVESTMENT
NJ
KFH
EXCL. UNDER SEC 512
10,339,753
980,888,713
No
8,479,315
No
99.483 %
(8)
GV-KF FUND PH AIV LLC
30 HUDSON STREET 38TH FLOOR
JERSEY CITY
,
NJ
07302
85-0667010
INVESTMENT
NJ
KFH
EXCL. UNDER SEC 512
-31,824
56,548,320
No
109
No
99.512 %
(9)
GV-KF FUND VNT AIV LLC
30 HUDSON STREET 38TH FLOOR
JERSEY CITY
,
NJ
07302
84-4866583
INVESTMENT
NJ
KFH
EXCL. UNDER SEC 512
-29,582,715
36,779,200
No
-29,448,460
No
100.000 %
(10)
HOUSING FOR HEALTH FUND LLP
11000 BROKEN LAND PARKWAY STE 700
COLUMBIA
,
MD
21044
37-1913493
INVESTMENT
MD
KFH
EXCL. UNDER SEC 512
-1,030,521
35,505,963
No
0
No
99.990 %
(11)
KFH ABSOLUTE LP
875 THIRD AVENUE
NEW YORK
,
NY
10022
82-5076948
INVESTMENT
NY
KFH
EXCL. UNDER SEC 512
10,789,051
481,962,586
No
-1,251,401
No
100.000 %
(12)
KFH STRATEGIC PRIVATE INVESTMENTS LP
600 MONTGOMERY STREET
SAN FRANCISCO
,
CA
94111
81-1186461
INVESTMENT
CA
KFH
EXCL. UNDER SEC 512
3,925,867
302,991,123
No
220,226
No
100.000 %
(13)
LAZARD KP EM SOLUTIONS FUND LLC
30 ROCKEFELLER PLAZA 55TH FLOOR
NEW YORK
,
NY
10112
82-4364389
INVESTMENT
NY
KFH
EXCL. UNDER SEC 512
-19,423,103
510,087,832
No
0
No
99.996 %
(14)
NXT CAPITAL SENIOR LOAN FUND ILLC
191 N Wacker Dr 30TH FLOOR
CHICAGO
,
IL
60606
37-1651297
INVESTMENT
DE
KFH
EXCL. UNDER SEC 512
19,754,090
398,749,530
No
0
No
98.106 %
(15)
PANTHEON GLOBAL HO FUND LP
600 MONTGOMERY ST 23RD FL
SAN FRANCISCO
,
CA
94111
80-0948707
INVESTMENT
DE
KFH
EXCL. UNDER SEC 512
24,597,433
704,336,970
No
739,331
No
100.000 %
(16)
PANTHEON GLOBAL REAL ASSETS HO FUND LP
600 MONTGOMERY ST 23RD FL
SAN FRANCISCO
,
CA
94111
47-4226360
INVESTMENT
DE
KFH
EXCL. UNDER SEC 512
-21,944,576
365,980,054
No
-1,449,554
No
100.000 %
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)
OAK TREE ASSURANCE LTD
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
03-0329760
INSURANCE
VT
NA
C CORP
0
0
Yes
(2)
KAISER PERMANENTE INSURANCE COMPANY
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
94-3203402
INSURANCE
CA
NA
C CORP
0
0
Yes
(3)
KAISER PERMANENTE INTERNATIONAL
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
94-3245176
CONSULTING
CA
NA
C CORP
-384,907
385,683
100.000 %
Yes
(4)
GROUP HEALTH SERVICES INC
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
91-1392222
INACTIVE
WA
NA
C CORP
0
0
Yes
(5)
KFHP OF WASHINGTON OPTIONS INC
ONE KAISER PLAZA 15L
OAKLAND
,
CA
94612
91-1467158
INSURANCE
WA
NA
C CORP
0
0
Yes
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
Yes
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
Yes
h
Purchase of assets from related organization(s)
............................
1h
Yes
i
Exchange of assets with related organization(s)
............................
1i
Yes
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
Yes
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
Yes
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
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
Yes
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)
KAISER FOUNDATION HEALTH PLAN INC
I
55,576
PER AGREEMENT
(2)
KAISER FOUNDATION HEALTH PLAN INC
L
22,291,392,031
PER AGREEMENT
(3)
KAISER FOUNDATION HEALTH PLAN INC
M
4,055,282,574
PER AGREEMENT
(4)
KAISER FOUNDATION HEALTH PLAN INC
P
12,256,070,404
PER AGREEMENT
(5)
KAISER FOUNDATION HEALTH PLAN INC
Q
6,145,433,441
PER AGREEMENT
(6)
KAISER FOUNDATION HEALTH PLAN INC
R
55,611,812
PER AGREEMENT
(7)
KAISER FOUNDATION HEALTH PLAN INC
S
815,058,661
PER AGREEMENT
(8)
KAISER FDN HEALTH PLAN OF COLORADO
A
2,112,658
PER AGREEMENT
(9)
KAISER FDN HEALTH PLAN OF COLORADO
D
50,000,000
PER AGREEMENT
(10)
KAISER FDN HEALTH PLAN OF COLORADO
J
7,443,456
PER AGREEMENT
(11)
KAISER FDN HEALTH PLAN OF COLORADO
L
206,313,517
PER AGREEMENT
(12)
KAISER FDN HEALTH PLAN OF COLORADO
P
11,486,489
PER AGREEMENT
(13)
KAISER FDN HEALTH PLAN OF COLORADO
Q
9,027,650
PER AGREEMENT
(14)
KAISER FDN HEALTH PLAN OF GEORGIA INC
A
38,374,645
PER AGREEMENT
(15)
KAISER FDN HEALTH PLAN OF GEORGIA INC
B
73,908
PER AGREEMENT
(16)
KAISER FDN HEALTH PLAN OF GEORGIA INC
D
125,000,000
PER AGREEMENT
(17)
KAISER FDN HEALTH PLAN OF GEORGIA INC
L
99,088,474
PER AGREEMENT
(18)
KAISER FDN HEALTH PLAN OF GEORGIA INC
P
137,620,429
PER AGREEMENT
(19)
KAISER FDN HEALTH PLAN OF GEORGIA INC
Q
2,598,013
PER AGREEMENT
(20)
KFHP OF THE MID-ATLANTIC STATES INC
A
27,494,873
PER AGREEMENT
(21)
KFHP OF THE MID-ATLANTIC STATES INC
D
150,000,000
PER AGREEMENT
(22)
KFHP OF THE MID-ATLANTIC STATES INC
L
235,757,173
PER AGREEMENT
(23)
KFHP OF THE MID-ATLANTIC STATES INC
M
6,635,621
PER AGREEMENT
(24)
KFHP OF THE MID-ATLANTIC STATES INC
P
7,456,535
PER AGREEMENT
(25)
KFHP OF THE MID-ATLANTIC STATES INC
Q
13,042,196
PER AGREEMENT
(26)
KAISER FDN HEALTH PLAN OF THE NORTHWEST
I
5,298,670
PER AGREEMENT
(27)
KAISER FDN HEALTH PLAN OF THE NORTHWEST
K
1,427,107
PER AGREEMENT
(28)
KAISER FDN HEALTH PLAN OF THE NORTHWEST
L
237,724,828
PER AGREEMENT
(29)
KAISER FDN HEALTH PLAN OF THE NORTHWEST
P
1,291,805
PER AGREEMENT
(30)
KAISER FDN HEALTH PLAN OF THE NORTHWEST
Q
6,543,308
PER AGREEMENT
(31)
KFHPW HOLDINGS
A
609,072
PER AGREEMENT
(32)
KAISER FDN HEALTH PLAN OF WASHINGTON
A
2,711,744
PER AGREEMENT
(33)
KAISER FDN HEALTH PLAN OF WASHINGTON
L
12,055,191
PER AGREEMENT
(34)
KAISER FDN HEALTH PLAN OF WASHINGTON
P
7,721,296
PER AGREEMENT
(35)
KAISER FDN HEALTH PLAN OF WASHINGTON
Q
488,992,294
PER AGREEMENT
(36)
CAMP BOWIE SERVICE CENTER
P
24,681,960
PER AGREEMENT
(37)
KAISER PERMANENTE INSURANCE COMPANY
L
56,254
PER AGREEMENT
(38)
KAISER PERMANENTE INSURANCE COMPANY
M
22,418,322
PER AGREEMENT
(39)
KAISER PERMANENTE INSURANCE COMPANY
P
100,160
PER AGREEMENT
(40)
KAISER PERMANENTE INSURANCE COMPANY
Q
164,836
PER AGREEMENT
(41)
LOKAHI ASSURANCE LTD
A
46,175,404
PER AGREEMENT
(42)
LOKAHI ASSURANCE LTD
B
53,670,374
PER AGREEMENT
(43)
LOKAHI ASSURANCE LTD
L
28,362,805
PER AGREEMENT
(44)
LOKAHI ASSURANCE LTD
M
198,999,593
PER AGREEMENT
(45)
LOKAHI ASSURANCE LTD
Q
125,341,871
PER AGREEMENT
(46)
LOKAHI ASSURANCE LTD
R
210,328,480
PER AGREEMENT
(47)
KAISER HOSPITAL ASSET MANAGEMENT INC
H
7,022,211
PER AGREEMENT
(48)
KAISER HOSPITAL ASSET MANAGEMENT INC
K
183,310,795
PER AGREEMENT
(49)
KAISER HOSPITAL ASSET MANAGEMENT INC
R
5,071,935
PER AGREEMENT
(50)
KAISER HOSPITAL ASSET MANAGEMENT INC
S
501,095
PER AGREEMENT
(51)
KAISER HEALTH PLAN ASSET MANAGEMENT INC
A
1,177,476
PER AGREEMENT
(52)
OAK TREE ASSURANCE LTD
L
263,000
PER AGREEMENT
(53)
OAK TREE ASSURANCE LTD
M
268,000
PER AGREEMENT
(54)
KP BERNARD J TYSON SCHOOL OF MEDICINE INC
A
101,855
PER AGREEMENT
(55)
KP BERNARD J TYSON SCHOOL OF MEDICINE INC
B
68,654,053
PER AGREEMENT
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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) 2020
Schedule R (Form 990) 2020
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) 2020
Additional Data
Software ID:
Software Version: