PROVIDENCE SAINT JOHNS HEALTH CENTER: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PROVIDENCE SAINT JOHNS HEALTH CENTER (EIN 95-1684082)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-14
- IRS object ID
- 202113189349300806
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-14T07:49:50-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 346565596 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 IVAN ALLEN JR BLVD SUITE 1000 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30308 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 951684082 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE SAINT JOHN'S HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROV | BusinessNameControlTxt |
| Phone | 3108295511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 LIND AVE SW ATTN TAX DEPT | AddressLine1Txt |
| City | RENTON | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98057 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JO ANN ESCASA-HAIGH | PersonNm |
| Person Title | EVP/ASSISTANT TREASURER | PersonTitleTxt |
| Phone | 4255253985 | PhoneNum |
| Signature | 2021-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JO | PersonFirstNm |
| Person Last | ANN ESCASA-HAIGH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AERRIAL ORR | PreparerPersonNm |
| PTIN | P01598400 | PTIN |
| Phone | 4048748300 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GREG HOFFMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 LIND AVE SW ATTN TAX DEPT | AddressLine1Txt |
| City | RENTON | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98057 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $410,592,381 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CALIFORNIA.PROVIDENCE.ORG/SAINT-JOHNS/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1942 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE OAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1804 | TotalEmployeeCnt |
| Total Volunteers | 255 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,766,029 | PYContributionsGrantsAmt |
| CY Contributions Grants | $32,521,276 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $397,043,517 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $373,828,122 | CYProgramServiceRevenueAmt |
| PY Investment Income | $273,282 | PYInvestmentIncomeAmt |
| CY Investment Income | $179,393 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,523,861 | PYOtherRevenueAmt |
| CY Other Revenue | $3,889,967 | CYOtherRevenueAmt |
| PY Total Revenue | $410,606,689 | PYTotalRevenueAmt |
| CY Total Revenue | $410,418,758 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,340,991 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,948,207 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $135,029,366 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $138,457,601 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $343,341,702 | PYOtherExpensesAmt |
| CY Other Expenses | $360,397,490 | CYOtherExpensesAmt |
| PY Total Expenses | $479,712,059 | PYTotalExpensesAmt |
| CY Total Expenses | $500,803,298 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$69,105,370 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$90,384,540 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $592,838,390 | TotalAssetsBOYAmt |
| Total Assets EOY | $594,443,833 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $192,008,906 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $258,654,781 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $400,829,484 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $335,789,052 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $430,855,913 | ExpenseAmt |
| Grant | $1,948,207 | GrantAmt |
| Revenue | $376,302,985 | RevenueAmt |
| Desc | SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE PURSUE INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA2020 - AN UNPRECEDENTED YEAROVER THE PAST YEAR, OUR COMMUNITIES HAVE FACED EXTRAORDINARY CHALLENGES. BUT EVEN DURING THE MOST DIFFICULT PUBLIC HEALTH CRISIS OF OUR TIME, COMMUNITIES HAVE ALSO SHOWN REMARKABLE STRENGTH AND RESOLVE. THERE IS SO MUCH GOOD THAT CAN BE ACCOMPLISHED AT THE COMMUNITY LEVEL, ESPECIALLY WHEN LIKE-MINDED ORGANIZATIONS WORK TOGETHER. IN SERVICE TO OUR MISSION, PROVIDENCE PARTNERS WITH COMMUNITY-BASED ORGANIZATIONS TO IDENTIFY URGENT HEALTH NEEDS AND ENVIRONMENTAL FACTORS THAT ARE IMPACTING THE WELL-BEING OF OUR COMMUNITIES. WE ACT TO PROVIDE SHORT-TERM SOLUTIONS AND ENVISION LONG-TERM RESULTS BY WISELY INVESTING IN OUR COMMUNITIES TO HELP BUILD A MORE EQUITABLE AND SUSTAINABLE FUTURE. IN 2020, WE INVESTED $1.7 BILLION IN COMMUNITY BENEFIT ACROSS SEVEN REGIONS, TO SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT CREATE LASTING CHANGE AT THE COMMUNITY LEVEL. THESE EFFORTS SEEK TO MITIGATE IMMEDIATE CHALLENGES WHILE FINDING SOLUTIONS TO DEEP-ROOTED PROBLEMS, IMPROVE ACCESS TO HEALTH CARE, AND ADVANCE INNOVATIVE CARE MODELS TO MEET THE EVOLVING NEEDS OF OUR COMMUNITIES.CARING FOR OUR COMMUNITIES HAS NEVER BEEN MORE IMPORTANT. TO ACHIEVE OUR VISION OF HEALTH FOR A BETTER WORLD, OUR PROVIDENCE FAMILY OF ORGANIZATIONS FOCUSED ON FOUR COMMUNITY INITIATIVES IN 2020:1 - FOUNDATIONS OF HEALTH;2 - REMOVING BARRIERS TO CARE;3 - COMMUNITY RESILIENCE; AND4 - INNOVATING FOR THE FUTURE.WE CHOSE THESE FOCUS AREAS BECAUSE THEY ARE ALL FOUNDATIONAL TO HEALTH AND WELL-BEING, REPRESENTING IDENTIFIED NEEDS THAT ARE INTEGRAL TO IMPROVING QUALITY OF LIFE. 2020 PROGRAM SERVICE ACCOMPLISHMENTSFOR SEVENTY-FIVE YEARS, SAINT JOHN'S HEALTH CENTER HAS OFFERED A RANGE OF HEALTH CARE PROGRAMS AND SERVICES UNPARALLELED ON THE WESTSIDE OF LOS ANGELES. DURING CALENDAR YEAR 2020, PROVIDENCE SAINT JOHN'S HEALTH CENTER AFFILIATION FUND PROVIDED $948,000 IN SEPARATE GRANT FUNDING TO LOCAL NON-PROFIT AGENCIES HEALTH CARE SERVICES AND ACCESS THERETO, INCLUDING WELLNESS PROGRAMS, HEALTH RESEARCH, AND HEALTH EDUCATION, PUBLIC/PRIVATE PARTNERSHIPS FORMED TO IMPROVE HEALTH, DIRECTLY AND THROUGH GRANT MAKING, TO THE RESIDENTS IN SAINT JOHN'S HEALTH CENTER'S SERVICE AREAIN ADDITION PROVIDENCE SAINT JOHN'S MADE PROGRESS TOWARD FOUR KEY INITIATIVES.INITIATIVE 1: STRENGTHEN INFRASTRUCTURE OF CONTINUUM OF CARE FOR PATIENTS EXPERIENCING HOMELESSNESS AS A HOSPITAL THAT SEES A SIGNIFICANT NUMBER OF PATIENTS EXPERIENCING HOMELESSNESS THAT COME IN THROUGH OUR EMERGENCY DEPARTMENTS FOR CARE.2020 ACCOMPLISHMENTS:- 353 PATIENTS SCREENED FOR HOMELESSNESS - 21 PATIENTS LINKED TO HOMELESS SERVICE PROVIDERS - 63 PATIENTS DISCHARGED TO TEMPORARY/PERMANENT HOUSING- $150,000 IN GRANTS AWARDED BY PSJHC TO LOCAL HOMELESS SERVICE PROVIDERS - $307,000 IN GRANTS AWARDED BY SAINT JOHN'S HEALTH CENTER FOUNDATION TO LOCAL HOMELESS SERVICE PROVIDERINITIATIVE 2: IMPROVE ACCESS TO HEALTH CARE SERVICES WE WILL CONTINUE TO PROVIDE FINANCIAL AND IN-KIND SUPPORT TO COMMUNITY CLINICS AND NONPROFIT ORGANIZATIONS THAT IMPROVE HEALTH CARE ACCESS TO UNDERSERVED AND VULNERABLE POPULATIONS. 2020 ACCOMPLISHMENTS:- $275,000 IN GRANTS AWARDED FROM PSJHC TO LOCAL ORGANIZATIONS FOR ACCESS TO CARE - $108,503 OF IN-KIND LAB AND DIAGNOSTIC SERVICES PROVIDED TO LOCAL FQHCS - $75,000 IN GRANTS AWARDED FROM SAINT JOHN'S HEALTH CENTER FOUNDATION TO LOCAL ORGANIZATIONS FOR ACCESS TO CARE- WITH THE DEVELOPMENT AND FDA EMERGENCY USE AUTHORIZATION OF MULTIPLE COVID-19 VACCINES BEGINNING IN DECEMBER 2020, PSJHC WILL MODIFY ACCESS TO CARE STRATEGIES BEGINNING IN 2021 TO FOCUS ON INCREASING ACCESS TO THE COVID-19 VACCINE, ESPECIALLY IN HARD TO REACH POPULATIONS.INITIATIVE 3: IMPROVE ACCESS TO BEHAVIORAL HEALTH AND REDUCE STIGMA PSJHC HAS HAD A LONGSTANDING COMMITMENT TO IMPROVING ACCESS TO BEHAVIORAL HEALTH THROUGH THE CHILD AND FAMILY DEVELOPMENT CENTER (CFDC).DUE TO THE PANDEMIC, STAFFING AND SERVICES FOR WOMEN'S HEALTH HAD TO BE MODIFIED FOR SOCIAL DISTANCING AND TO RESPOND TO COVID-19 SURGES IN THE COMMUNITY, WHICH HINDERED OUR ABILITY TO START UP THESE SUPPORT SERVICE PROGRAMS FOR NEW MOTHERS AND THEIR FAMILIES. RESOURCES FOR THESE PROGRAMS SHIFTED TO RESPOND TO ECONOMIC IMPACT OF COVID-19 AS MORE EFFORT AND TIME WENT INTO DELIVERING BASIC NEEDS SUCH AS FOOD, DIAPERS AND WIPES, AND HELPING FAMILIES TO ACCESS FOOD PANTRIES.CHILD AND FAMILY DEVELOPMENT CENTER: CAPACITY BUILDING FOR LOCAL ORGANIZATIONS THROUGH TRAUMA INFORMED TRAININGS- 14 IN SERVICE TRAININGS TO SCHOOL STAFF - 4 IN SERVICE TRAININGS TO AFTER SCHOOL STAFFINITIATIVE 4: TRAIN AND DEPLOY A WORKFORCE OF COMMUNITY HEALTH WORKERS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH IN UNDERSERVED POPULATIONS PROVIDENCE HAS A LONG HISTORY IN EMPLOYING COMMUNITY HEALTH WORKERS (CHWS) IN A DIVERSE BREADTH OF ROLES IN PROGRAMS THAT ADDRESS SOCIAL DETERMINANTS OF HEALTH. CHW ACADEMY: IN COLLABORATION WITH CHARLES DREW UNIVERSITY, DEVELOP AN ACADEMY FOR COMMUNITY HEALTH WORKERS THAT FOCUS ON INTEGRATION INTO HEALTH CARE ORGANIZATIONS.RECRUITMENT AND CURRICULUM DESIGN FOR CHW ACADEMY WAS COMPLETED IN 2020. GO-LIVE OF THE FIRST COHORTS TRAINING WAS POSTPONED TO JANUARY OF 2021 AS ADAPTATIONS WERE NEEDED TO TEACH THE COURSE ONLINE. FIRST COHORT IN 2021 HAS 13 COMMUNITY HEALTH WORKERS ENROLLED.FOR MORE INFORMATION BY NEED AREA GO TO PG 17 OF OUR CB ANNUAL REPORT LOCATED AT: HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/SAINT-JOHNS-HEALTH-CENTER/ABOUT/COMMUNITY-HEALTH-INVESTMENT | Desc |
| Total Program Service Expenses | $430,855,913 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 211 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1804 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JO ANN ESCASA-HAIGH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9493814000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3345 MICHELSON DRIVE SUITE 100 | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92612 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (43 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ROD F HOCHMAN MD | ||||||||||
| FORMER PRESIDENT/CEO | 0.00 | 60.00 | Yes (X) | $0 | $9,299,594 | $813,801 | ||||
| MIKE BUTLER | ||||||||||
| PRESIDENT - THRU 9/20 | 1.00 | 59.00 | $0 | $8,708,237 | $56,431 | Yes (X) | ||||
| DEBRA CANALES | ||||||||||
| FORMER EVP CAO PSJH | 0.00 | 60.00 | Yes (X) | $0 | $2,003,884 | $691,108 | ||||
| ERIK WEXLER | ||||||||||
| FORMER EVP CHIEF EXEC PSJH SO CA | 0.00 | 65.00 | Yes (X) | $0 | $1,864,281 | $448,015 | ||||
| AMY COMPTON-PHILLIPS MD | ||||||||||
| FORMER EVP CHIEF CLINICAL OFC PSJH | 0.00 | 55.00 | Yes (X) | $0 | $1,709,011 | $533,089 | ||||
| RHONDA MEDOWS MD | ||||||||||
| FORMER PRESIDENT POP HEALTH / AYIN | 0.00 | 60.00 | Yes (X) | $0 | $1,814,460 | $328,861 | ||||
| VENKAT BHAMIDIPATI | ||||||||||
| EVP/TREASURER - THRU 9/20 | 1.00 | 59.00 | $0 | $2,084,131 | $22,680 | Yes (X) | ||||
| CINDY STRAUSS | ||||||||||
| SECRETARY - THRU 12/20 | 1.00 | 59.00 | $0 | $1,745,541 | $358,093 | Yes (X) | ||||
| LISA VANCE | ||||||||||
| FORMER EVP REGIONAL CE OR | 0.00 | 60.00 | Yes (X) | $0 | $1,529,706 | $411,248 | ||||
| JO ANN ESCASA-HAIGH | ||||||||||
| TREASURER/CFO/VP | 1.00 | 59.00 | $0 | $1,311,654 | $434,938 | Yes (X) | ||||
| GREG TILL | ||||||||||
| FORMER CHIEF PEOPLE OFFICER | 0.00 | 65.00 | Yes (X) | $0 | $1,304,460 | $341,650 | ||||
| AARON MARTIN | ||||||||||
| FORMER EVP CHIEF MKT/DIGITAL INNO OF | 0.00 | 70.00 | Yes (X) | $0 | $1,307,753 | $272,343 | ||||
| MIKE WATERS | ||||||||||
| FORMER EVP AMBULATORY CARE NETWORK | 0.00 | 65.00 | Yes (X) | $0 | $1,120,486 | $223,207 | ||||
| JOEL GILBERTSON | ||||||||||
| FORMER EVP COMMUNITY PARTNERSHIPS | 0.00 | 60.00 | Yes (X) | $0 | $1,107,594 | $226,050 | ||||
| MICHAEL RICKS | ||||||||||
| CHIEF EXEC ST JOHNS HEALTH CNT | 20.00 | 20.00 | $0 | $1,019,703 | $189,473 | Yes (X) | ||||
| OREST HOLUBEC | ||||||||||
| FORMER SVP CHIEF COMMUNICATION OFCR | 0.00 | 55.00 | Yes (X) | $0 | $939,380 | $203,274 | ||||
| JOHN WHIPPLE | ||||||||||
| SECRETARY | 1.00 | 59.00 | $0 | $963,651 | $176,306 | Yes (X) | ||||
| MARY CRANSTOUN | ||||||||||
| FORMER SVP TOTAL REWARDS TALENT ACQ | 0.00 | 60.00 | Yes (X) | $0 | $833,682 | $188,693 | ||||
| MARCEL LOH | ||||||||||
| FORMER CE ST JOHNS HEALTH CNT | 0.00 | 55.00 | Yes (X) | $0 | $1,005,785 | $3,763 | ||||
| DAVID BROWN | ||||||||||
| FORMER SVP CAO AMBULATORY CARE | 0.00 | 55.00 | Yes (X) | $0 | $708,463 | $156,898 | ||||
| JIM WATSON ESQ | ||||||||||
| FORMER SECRETARY | 0.00 | 60.00 | Yes (X) | $0 | $744,481 | $120,056 | ||||
| ROBERT KLEIN | ||||||||||
| PRESIDENT/CEO FOUNDATION | 1.00 | 40.00 | $736,203 | $0 | $84,514 | Yes (X) | ||||
| GREG HOFFMAN | ||||||||||
| PRESIDENT/CEO (PART YEAR) | 1.00 | 59.00 | $0 | $675,947 | $122,495 | Yes (X) | ||||
| DEBBIE BURTON | ||||||||||
| FORMER SVP CHIEF NURSING OFFICER | 0.00 | 60.00 | Yes (X) | $0 | $651,863 | $39,206 | ||||
| TOM MCDONAGH | ||||||||||
| FORMER VP/CHIEF INVESTMENT OFFICER | 0.00 | 58.00 | Yes (X) | $0 | $485,249 | $30,532 | ||||
| STELLA NICHOLS | ||||||||||
| CFO & COO FOUNDATION | 1.00 | 40.00 | $405,395 | $0 | $45,910 | Yes (X) | ||||
| SHARON TONCRAY | ||||||||||
| FORMER SVP/CHIEF LABOR EE COUNSEL | 0.00 | 60.00 | Yes (X) | $0 | $361,654 | $27,461 | ||||
| GIANCARLO LYLE-EDROSOLO | ||||||||||
| CHIEF NURSING OFFICER | 40.00 | 0.00 | $350,241 | $0 | $21,249 | Yes (X) | ||||
| PAUL NATTERSON | ||||||||||
| CHIEF MEDICAL OFFICER - THRU 10/20 | 40.00 | 0.00 | $366,922 | $0 | $4,243 | Yes (X) | ||||
| NAHID NOORI | ||||||||||
| ULTRASOUND TECHNICIAN GF | 40.00 | 0.00 | $313,431 | $0 | $13,758 | Yes (X) | ||||
| DONALD ANDERSON JR | ||||||||||
| FORMER ASSISTANT SECRETARY FOR ENROLLMENT | 1.00 | 59.00 | Yes (X) | $0 | $228,473 | $22,814 | ||||
| RANDALL ROISMAN | ||||||||||
| CFO ST JOHNS HEALTH CNT - THRU 3/20 | 40.00 | 0.00 | $0 | $182,161 | $7,050 | Yes (X) | ||||
| TAMMY TEODOSIO | ||||||||||
| FORMER ASSISTANT SECRETARY | 1.00 | 59.00 | Yes (X) | $0 | $105,105 | $17,660 | ||||
| DAVE OLSEN | ||||||||||
| BOARD CHAIR | 0.10 | 7.00 | $0 | $65,770 | $0 | Yes (X) | ||||
| MARY LYONS PHD | ||||||||||
| DIRECTOR | 0.10 | 4.60 | $0 | $62,020 | $0 | Yes (X) | ||||
| RICHARD BLAIR | ||||||||||
| DIRECTOR | 0.10 | 7.70 | $0 | $60,270 | $0 | Yes (X) | ||||
| ISIAAH CRAWFORD PHD | ||||||||||
| DIRECTOR | 0.10 | 7.00 | $0 | $55,830 | $0 | Yes (X) | ||||
| KATHARIN DYER | ||||||||||
| DIRECTOR | 0.10 | 5.00 | $0 | $40,945 | $0 | Yes (X) | ||||
| MICHAEL MURPHY | ||||||||||
| DIRECTOR | 0.10 | 5.00 | $0 | $40,770 | $0 | Yes (X) | ||||
| CHARLES SORENSON MD | ||||||||||
| DIRECTOR | 0.10 | 5.00 | $0 | $40,000 | $0 | Yes (X) | ||||
| SISTER DIANE HEJNA CSJ RN | ||||||||||
| DIRECTOR | 0.10 | 5.30 | $0 | $0 | $0 | Yes (X) | ||||
| SISTER LUCILLE DEAN SP | ||||||||||
| DIRECTOR | 0.10 | 5.50 | $0 | $0 | $0 | Yes (X) | ||||
| SISTER PHYLLIS HUGHES RSM DRPH | ||||||||||
| DIRECTOR | 0.10 | 5.00 | $0 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,172,192 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $46,181,994 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $6,636,869 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 499 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ARAMARK RECEIVABLES LLC | |||||
| 2121 SANTA MONICA BLVD | SANTA MONICA | CA | 904042303 | CATERING SERVICES | $5,999,693 |
| SPECIALTYCARE CARDIOVASCULA | |||||
| DEPT 1614 PO BOX 11407 | BIRMINGHAM | AL | 35246 | MEDICAL SERVICES | $5,927,251 |
| CROTHALL SERVICES GROUP | |||||
| 13028 COLLECTION CTR DR | CHICAGO | IL | 60693 | MEDICAL SERVICES | $5,332,337 |
| DEB CONSTRUCTION INC | |||||
| 2230 E WINSTON RD | ANAHEIM | CA | 928065536 | CONSTRUCTION SERVICES | $2,879,746 |
| CALIFORNIA REHAB SVCS INC | |||||
| 333 E GLENOAKS BLVD STE 204 | GLENDALE | CA | 912072098 | MEDICAL SERVICES | $1,754,338 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 87 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $3,222,214 | RelatedOrganizationsAmt |
| Government Grants | $28,211,467 | GovernmentGrantsAmt |
| All Other Contributions | $1,087,595 | AllOtherContributionsAmt |
| Total Contributions | $32,521,276 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621110 | $369,018,090 | $369,018,090 |
| HOSPITAL FEE | 621110 | $4,810,032 | $4,810,032 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $373,828,122 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $179,393 | TotalRevenueColumnAmt |
| Exclusion | $179,393 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,280,100 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,280,100 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,280,100 | TotalRevenueColumnAmt |
| Exclusion | $1,280,100 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $308,627 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $173,623 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $135,004 | TotalRevenueColumnAmt |
| Exclusion | $135,004 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722514 | $798,901 | $798,901 |
| PARKING REVENUE | 812930 | $376,888 | $376,888 |
| INTERAFFILIATE REVENUE | 900099 | $79,540 | $79,540 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,219,534 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,219,534 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,474,863 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $410,418,758 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $376,302,985 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,594,497 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,948,207 | TotalAmt |
| Program Services | $1,948,207 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,355,707 | TotalAmt |
| Program Services | $116,784,734 | ProgramServicesAmt |
| Management And General | $10,570,973 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,221,463 | TotalAmt |
| Program Services | $1,060,243 | ProgramServicesAmt |
| Management And General | $161,220 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,784 | TotalAmt |
| Program Services | $111,220 | ProgramServicesAmt |
| Management And General | $143,564 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,625,647 | TotalAmt |
| Program Services | $8,476,054 | ProgramServicesAmt |
| Management And General | $1,149,593 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,580,774 | TotalAmt |
| Program Services | $124,091 | ProgramServicesAmt |
| Management And General | $1,456,683 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,600,262 | TotalAmt |
| Program Services | $55,887,358 | ProgramServicesAmt |
| Management And General | $19,712,904 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,838 | TotalAmt |
| Management And General | $5,838 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,270,063 | TotalAmt |
| Program Services | $4,095,224 | ProgramServicesAmt |
| Management And General | $2,174,839 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,062 | TotalAmt |
| Program Services | $69,134 | ProgramServicesAmt |
| Management And General | $36,928 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,299,507 | TotalAmt |
| Program Services | $2,367,774 | ProgramServicesAmt |
| Management And General | $4,931,733 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,762 | TotalAmt |
| Program Services | $23,956 | ProgramServicesAmt |
| Management And General | $19,806 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,490 | TotalAmt |
| Program Services | $45,504 | ProgramServicesAmt |
| Management And General | $48,986 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,465,247 | TotalAmt |
| Management And General | $4,465,247 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,320,491 | TotalAmt |
| Program Services | $7,174,311 | ProgramServicesAmt |
| Management And General | $3,146,180 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,629 | TotalAmt |
| Program Services | $99,629 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SYSTEM COST ALLOCATION | $138,123,541 | $119,892,689 | $18,230,852 |
| MEDICAL SUPPLIES | $84,272,521 | $83,406,042 | $866,479 |
| HOSPITAL FEE | $27,951,046 | $27,951,046 | |
| LICENSES AND TAXES | $743,323 | $111,080 | $632,243 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,420,934 | TotalAmt |
| Program Services | $1,227,617 | ProgramServicesAmt |
| Management And General | $2,193,317 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500,803,298 | TotalAmt |
| Program Services | $430,855,913 | ProgramServicesAmt |
| Management And General | $69,947,385 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$20,296 | BOYAmt |
| EOY | $132,827 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$5,589,233 | BOYAmt |
| EOY | -$5,592,638 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,983 | BOYAmt |
| EOY | $215,451 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,005,456 | BOYAmt |
| EOY | $45,563,236 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,596,198 | BOYAmt |
| EOY | $7,788,625 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $282,677 | BOYAmt |
| EOY | $1,115,588 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $367,797,616 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $69,736,373 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $295,808,093 | BOYAmt |
| EOY | $298,061,243 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,610,610 | BOYAmt |
| EOY | $228,274,910 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,055,902 | BOYAmt |
| EOY | $18,883,591 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $592,838,390 | BOYAmt |
| EOY | $594,443,833 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,925,037 | BOYAmt |
| EOY | $49,019,455 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $274,361 | BOYAmt |
| EOY | $1,307,362 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,809,508 | BOYAmt |
| EOY | $208,327,964 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $192,008,906 | BOYAmt |
| EOY | $258,654,781 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $283,281,234 | BOYAmt |
| EOY | $190,451,402 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,548,250 | BOYAmt |
| EOY | $145,337,650 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400,829,484 | BOYAmt |
| EOY | $335,789,052 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $592,838,390 | BOYAmt |
| EOY | $594,443,833 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$90,384,540 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $25,344,108 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $40,589 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $40,589 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE LOBBYING EXPENDITURES REPORTED REPRESENT THE PORTION OF DUES PAID TO ALLIANCE OF CATHOLIC HEALTH CARE, AMERICAN HOSPITAL ASSOCIATION AND CALIFORNIA HOSPITAL ASSOCIATION FOR LOBBYING SERVICES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $150,000,000 | OtherCostOrOtherBasisAmt |
| Book Value | $150,000,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,553,457 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,842,362 | DepreciationAmt |
| Book Value | $90,711,095 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,569,829 | OtherCostOrOtherBasisAmt |
| Depreciation | $770,364 | DepreciationAmt |
| Book Value | $799,465 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $75,250,267 | OtherCostOrOtherBasisAmt |
| Depreciation | $48,324,448 | DepreciationAmt |
| Book Value | $26,925,819 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,424,063 | OtherCostOrOtherBasisAmt |
| Depreciation | $799,199 | DepreciationAmt |
| Book Value | $29,624,864 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $298,061,243 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BENEFICIAL INTEREST IN FOUNDATION | Desc |
| Book Value | $228,274,910 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $228,274,910 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| CAPITAL LEASE OBLIGATIONS | $5,207,988 |
| DUE TO THIRD PARTY | $20,552,806 |
| FEDERAL INCOME TAXES | $120,000 |
| OTHER LIABILITIES | $58,487,304 |
| I/C - TAX-EXEMPT BOND LIABILITIES | $118,740,000 |
| DUE TO AFFILIATES | $5,219,866 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $208,327,964 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 280 | PersonsServedCnt |
| Total Community Benefit Expns | $2,563,863 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,563,863 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4499 | PersonsServedCnt |
| Total Community Benefit Expns | $41,211,242 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $527,933 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $40,683,309 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08120 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4779 | PersonsServedCnt |
| Total Community Benefit Expns | $43,775,105 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $527,933 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $43,247,172 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08630 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 1471 | PersonsServedCnt |
| Total Community Benefit Expns | $1,038,777 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $348,807 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $689,970 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 149 | PersonsServedCnt |
| Total Community Benefit Expns | $578,500 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $578,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 13570 | PersonsServedCnt |
| Total Community Benefit Expns | $10,393,379 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,068,695 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,324,684 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01060 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $425,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $425,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 15190 | PersonsServedCnt |
| Total Community Benefit Expns | $12,435,656 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,417,502 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,018,154 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01400 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 19969 | PersonsServedCnt |
| Total Community Benefit Expns | $56,210,761 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,945,435 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $50,265,326 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10030 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 299 | PersonsServedCnt |
| Total Community Benefit Expns | $1,321,753 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $370,733 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $951,020 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 299 | PersonsServedCnt |
| Total Community Benefit Expns | $1,321,753 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $370,733 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $951,020 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Reimbursed By Medicare | $140,542,656 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $224,261,614 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$83,718,958 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 SM WILSHIRE IMAGING | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | OUTPATIENT IMAGING CENTER | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.50000 | OrgProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.50000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAINT JOHN'S HEALTH CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2121 SANTA MONICA BLVD | AddressLine1Txt |
| City | SANTA MONICA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90404 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | CALIFORNIA.PROVIDENCE.ORG/SAINT-JOHNS/ | WebsiteAddressTxt |
| State License | 930000158 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAINT JOHN'S HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE LINE 10A URL BELOW | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B, LINE 3E: | THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY:THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE PRIORITIZED BASED ON THE METHODOLOGY DESCRIBED IN THE MOST RECENT CHNA SECTION ON SIGNIFICANT HEALTH NEEDS. |
| PART V, SECTION B, LINE 5: | PROVIDENCE CONDUCTED KEY INFORMANT INTERVIEWS, IN COLLABORATION WITH KAISER PERMANENTE WEST LOS ANGELES, UCLA HEALTH, AND CEDARS SINAI MEDICAL CENTER, WITH INDIVIDUALS WHO REPRESENT A VARIETY OF LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS THROUGHOUT THE HOSPITAL'S SERVICE AREA. EACH MEDICAL CENTER USED A COMMON SET OF QUESTIONS DEVELOPED BY THE LA PARTNERSHIP, A COLLABORATIVE OF HOSPITALS ACROSS LOS ANGELES COUNTY, AND SHARED THE DATA WITH EACH OTHER. (SEE BELOW FOR LIST OF ORGANIZATIONS SERVING THE SAINT JOHN'S SERVICE AREA): - BOYS AND GIRLS CLUBS OF SANTA MONICA (COMMUNITY BASED ORGANIZATION, YOUTH PROGRAMMING)- CALIFORNIA COMMUNITY FOUNDATION (COMMUNITY BASED ORGANIZATION, SOCIAL JUSTICE AND ADVOCACY)- CATHOLIC CHARITIES OF LA (NATIONAL ORGANIZATION, HOMELESS SERVICES)- COMMUNITY CLINIC ASSOCIATION OF LOS ANGELES COUNTY (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- DIDI HIRSCH MENTAL HEALTH SERVICES (COMMUNITY BASED ORGANIZATION, BEHAVIORAL HEALTH)- JEWISH FAMILY SERVICES OF LOS ANGELES (NATIONAL ORGANIZATION, SOCIAL SERVICES)- L.A. CARE HEALTH PLAN (COMMUNITY BASED ORGANIZATION, HEALTH CARE COVERAGE)- LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH (GOVERNMENT, BEHAVIORAL HEALTH)- LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH (GOVERNMENT, PUBLIC HEALTH)- LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH (GOVERNMENT, PUBLIC HEALTH)- PUBLIC HEALTH, MENTAL HEALTH AND HEALTH SERVICES (GOVERNMENT, PUBLIC HEALTH)- LOS ANGELES LGBT CENTER (COMMUNITY BASED ORGANIZATION, SOCIAL SERVICES, HEALTH, AND ADVOCACY)- LOS ANGELES UNIFIED SCHOOL DISTRICT (SCHOOL DISTRICT, EDUCATION)- MATERNAL MENTAL HEALTH NOW (COMMUNITY BASED ORGANIZATION, BEHAVIORAL HEALTH)- MEALS ON WHEELS WEST (NATIONAL ORGANIZATION, FOOD SECURITY)- SABAN COMMUNITY CLINIC (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- SAFE PLACE FOR YOUTH (COMMUNITY BASED ORGANIZATION, HOMELESSNESS)- SANTA MONICA COLLEGE (COLLEGE, EDUCATION)- SANTA MONICA- MALIBU UNIFIED SCHOOL DISTRICT (SCHOOL DISTRICT, EDUCATION)- ST. JOSEPH CENTER (COMMUNITY BASED ORGANIZATION, HOMELESSNESS)- THE ACHIEVABLE FOUNDATION (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- THE L.A. TRUST FOR CHILDREN'S HEALTH (COMMUNITY BASED ORGANIZATION, HEALTH CARE AND ADVOCACY)- THE PEOPLE CONCERN (COMMUNITY BASED ORGANIZATION, SOCIAL SERVICES)- UCLA BICYCLE ACADEMY (GROUP, TRANSPORTATION)- UCLA DAVID GEFFEN SCHOOL OF MEDICINE (UNIVERSITY, HEALTH CARE)- UCLA/ VA VETERAN FAMILY WELLNESS CENTER (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- UNIHEALTH FOUNDATION (COMMUNITY BASED ORGANIZATION, HEALTH GRANTMAKING)- VENICE FAMILY CLINIC (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- WISE & HEALTHY AGING (COMMUNITY BASED ORGANIZATION, SENIOR SERVICES)- WORKFORCE DEVELOPMENT, AGING AND COMMUNITY SERVICES (COMMUNITY BASED ORGANIZATION, WORKFORCE DEVELOPMENT)PROVIDENCE SAINT JOHN'S HEALTH CENTER CONDUCTED LISTENING SESSIONS BETWEEN APRIL AND JULY 2019 WITH COMMUNITY MEMBERS AND INTERVIEWS WITH COMMUNITY STAKEHOLDERS, INCLUDING LA COUNTY DEPARTMENT OF PUBLIC HEALTH, AS PART OF THEIR COLLECTION OF PRIMARY DATA. IN ADDITION TO CONDUCTING KEY INFORMANT INTERVIEWS AS PART OF ITS PRIMARY DATA COLLECTION, PROVIDENCE ALSO INCLUDED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY AS PART OF ITS CHNA OVERSIGHT COMMITTEE.THE CHNA OVERSIGHT COMMITTEE, AUTHORIZED BY THE GOVERNING BOARD, MET IN AUGUST 2019 AND SEPTEMBER 2019 TO PRIORITIZE AND RECOMMEND THE TOP IDENTIFIED HEALTH NEEDS TO BE ADDRESSED OVER THE NEXT THREE YEARS. THE EXTERNAL REPRESENTATIVES INCLUDED THE PERSPECTIVE OF A FQHC, HOMELESS SERVICES PROVIDER, PUBLIC SCHOOLS, THE MANAGER OF THE HUMAN SERVICES DIVISION FOR THE CITY OF SANTA MONICA AND THE AREA HEALTH OFFICER FOR SPA 5 AND SPA 6 FROM THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH. THE GROUP PARTICIPATED IN TWO MEETINGS TO REVIEW THE ASSEMBLED PRIMARY AND SECONDARY DATA FOR EACH IDENTIFIED HEALTH NEED. THE FIRST MEETING INCLUDED DISCUSSIONS ON HOW EACH ISSUE AFFECTED THE COMMUNITIES IN THE REGION, USING THE IDENTIFIED NEEDS OF FOOD INSECURITY AND HOMELESSNESS AND HOUSING INSTABILITY TO FAMILIARIZE AND PREPARE THE PARTICIPANTS FOR CRITERIA THAT WOULD BE APPLIED DURING THE PRIORITIZATION MEETING. IN THE SECOND MEETING COMMITTEE PARTICIPANTS RECEIVED A QUESTIONNAIRE AT THE START OF THE MEETING AND ASKED TO RATE THE SEVERITY OF EACH IDENTIFIED HEALTH NEED USING THREE CRITERIA: (1) THE CHANGE OVER TIME, (2) THE AVAILABILITY OF COMMUNITY RESOURCES/ASSETS TO ADDRESS THE HEALTH NEED, AND (3) THE COMMUNITY READINESS TO IMPLEMENT/SUPPORT PROGRAMS TO ADDRESS THE HEALTH NEED. OVERSIGHT COMMITTEE MEMBERS WERE THEN ASKED TO CONSIDER THE THREE QUESTIONS BELOW AND GIVEN THREE DOTS, OR "VOTES," TO ASSIGN TO THE IDENTIFIED HEALTH NEEDS, RESULTING IN A LIST OF PRIORITIZED NEEDS.- HOW DOES THIS NEED IMPACT THE WORK OF YOUR ORGANIZATION AND THE CLIENTS YOU SERVE?- WHAT OTHER SERVICE GAPS CURRENTLY EXIST?- WHAT ROLE CAN PROVIDENCE PLAY IN ADDRESSING THIS NEED? |
| PART V, SECTION B, LINE 6A: | THE 2019 PROVIDENCE SAINT JOHN'S HEALTH CENTER COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) KEY INFORMANT INTERVIEW DATA COLLECTION PROCESS WAS CONDUCTED BY SAINT JOHN'S COMMUNITY HEALTH INVESTMENT STAFF IN COLLABORATION WITH THE CEDARS SINAI MEDICAL CENTER (LOS ANGELES, CA), KAISER PERMANENTE MEDICAL CENTER (WEST LOS ANGELES, CA), AND UCLA HEALTH SYSTEM (WESTWOOD, CA). |
| PART V, SECTION B, LINE 6B: | THE CHNA WAS CONDUCTED IN PARTNERSHIP WITH THE CENTER FOR NONPROFIT MANAGEMENT (CNM) - LOS ANGELES, CA |
| PART V, SECTION B, LINE 11: | IN DEVELOPING THE LIST OF PRIORITY NEEDS, PROVIDENCE LOOKED AT BRINGING ITS EXPERTISE AND RESOURCES TO THOSE ISSUES WHERE IT CAN MAKE POSITIVE CHANGE. IN OUR LATEST CHNA, THE BOARD COMMITTEE ON COMMUNITY BENEFITS IDENTIFIED THE FOLLOWING AS THE HIGHEST PRIORITY NEEDS WITHIN OUR COMMUNITIES:1. HOMELESSNESS AND HOUSING INSTABILITY2. BEHAVIORAL HEALTH3. ECONOMIC INSECURITY4. ACCESS TO HEALTH CARETHE FOUR PRIORITIZED HEALTH NEEDS ARE BEING ADDRESSED WITHIN THE CONTEXT OF FOUR INITIATIVES THAT MAKE UP THE THREE-YEAR IMPLEMENTATION STRATEGY:1) STRENGTHEN INFRASTRUCTURE OF CONTINUUM OF CARE FOR PATIENTS EXPERIENCING HOMELESSNESS- SCREENED OVER 300 ER PATIENTS FOR HOMELESSNESS.- PARTICIPATED IN UNIHEALTH FOUNDATION'S RECUPERATIVE CARE ADVISORY GROUP TO DEVELOP RECOMMENDATIONS FOR STRENGTHENING THE INFRASTRUCTURE OF RECUPERATIVE CARE IN LA COUNTY.2) INITIATIVE #2: IMPROVE ACCESS TO HEALTH CARE SERVICESOUR GOAL IS TO IMPROVE ACCESS TO QUALITY HEALTH CARE SERVICES FOR VULNERABLE POPULATIONS BY:- $275,000 IN GRANTS AWARDED FROM PSJHC TO LOCAL ORGANIZATIONS FOR ACCESS TO CARE.3) INITIATIVE #3: IMPROVE ACCESS TO BEHAVIORAL HEALTH AND REDUCE STIGMAOUR GOAL IS TO:- PROVIDED 14 TRAUMA-INFORMED TRAININGS TO SCHOOL STAFF.- CONDUCTED 7 PARENT SUPPORT GROUPS AND 3 MENTAL HEALTH EDUCATION EVENTS AT LOCAL LIBRARIES.4) INITIATIVE #4: TRAIN AND DEPLOY A WORKFORCE OF COMMUNITY HEALTH WORKERS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH IN UNDERSERVED POPULATIONS- ESTABLISHED OUR FEAST PROGRAM TO PROVIDE NUTRITION EDUCATION FOR COMMUNITY MEMBERS.- RECRUITED COMMUNITY MEMBERS FOR OUR CHW ACADEMY TO TRAIN COMMUNITY HEALTH WORKERS FROM WITHIN OUR LOCAL COMMUNITY.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE CHNA WILL NOT BE ADDRESS AND AN EXPLANATION IS PROVIDED BELOW: ORAL HEALTH: THIS WAS IDENTIFIED AS THE LOWEST PRIORITY NEED IN THE 2019 CHNA. FURTHERMORE, OUR HEALTH FACILITIES DO NOT PROVIDE ORAL HEALTH CARE, AND IT IS NOT OUR AREA OF EXPERTISE WITHIN THE PROVIDENCE HEALTH SYSTEM IN THE LOS ANGELES REGION. HOWEVER, THERE ARE A NUMBER OF COMMUNITY PARTNERS INCLUDING LOCAL FEDERALLY QUALIFIED HEALTH CLINICS WHO ARE FOCUSING ON INCREASING ACCESS TO ORAL HEALTH CARE ESPECIALLY FOR THE MEDI-CAL POPULATION. FOR COMMUNITY MEMBERS IN NEED OF THESE SERVICES WE REFER THEM TO THESE PROVIDERS OF LOW-COST DENTAL CARE. |
| PART V, LINE 16A, FAP WEBSITE: | HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE |
| PART V, LINE 16B, FAP APPLICATION WEBSITE: | HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/FINANCIAL-ASSISTANCE-APPLICATION |
| PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: | HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/PLAIN-LANGUAGE-SUMMARY |
| PART V, SECTION B, LINE 16J: | THE FAP SIGNAGE AND INFORMATION ARE INCLUDED ON BILLING STATEMENTS. |
| PART V, SECTION B, LINE 24: | IF THE SERVICES WERE NOT MEDICALLY NECESSARY OR WERE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY, THEY WERE BILLED AT THE GROSS CHARGE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 13 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - SANTA MONICA WILSHIRE IMAGING | ||||
| 2200-2202 WILSHIRE BLVD | SANTA MONICA | CA | 90404 | OUTPATIENT/IMAGING CTR |
| 2 - FAMILY AND OBESITY MEDICINE | ||||
| 12304 SANTA MONICA BLVD SUITE 101 | LOS ANGELES | CA | 90025 | PRIMARY CARE |
| 3 - PEDIATRICS KIDDOX | ||||
| 1245 16TH ST SUITE 305 | SANTA MONICA | CA | 90404 | PRIMARY CARE |
| 4 - FAMILY MEDICINE | ||||
| 1811 WILSHIRE BLVD SUITE 201 | SANTA MONICA | CA | 90403 | PRIMARY CARE |
| 5 - FAMILY MEDICINE | ||||
| 1821 WILSHIRE BLVD SUITE 301 | SANTA MONICA | CA | 90403 | PRIMARY CARE |
| 6 - PEDIATRICS | ||||
| 2021 SANTA MONICA BLVD SUITE 245E | SANTA MONICA | CA | 90404 | PRIMARY CARE |
| 7 - PEDIATRICS | ||||
| 2021 SANTA MONICA BLVD SUITE 421E | SANTA MONICA | CA | 90404 | PRIMARY CARE |
| 8 - FAMILY MEDICINE PEAK | ||||
| 2143 S SEPULVEDA BL 300 | LOS ANGELES | CA | 90025 | PRIMARY CARE |
| 9 - INTERNAL MEDICINE | ||||
| 1301 20TH ST SUITE 110 | SANTA MONICA | CA | 90404 | SPECIALTY CLINIC |
| 10 - NEPHROLOGY & INTERNAL MEDICINE | ||||
| 1301 20TH ST SUITE 290 | SANTA MONICA | CA | 90404 | SPECIALTY CLINIC |
| 11 - RHEUMATOLOGY | ||||
| 2021 SANTA MONICA BLVD SUITE 335E | SANTA MONICA | CA | 90404 | SPECIALTY CLINIC |
| 12 - HOSPITAL MEDICINE | ||||
| 2121 SANTA MONICA BLVD | SANTA MONICA | CA | 90404 | SPECIALTY CLINIC |
| 13 - RHEUMATOLOGY | ||||
| 2336 SANTA MONICA BL 207 | SANTA MONICA | CA | 90404 | SPECIALTY CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. |
| PART I, LINE 6A: | PROVIDENCE SAINT JOHN'S HEALTH CENTER PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.PSJHEALTH.ORG/COMMUNITY-BENEFIT/SOUTHERN-CALIFORNIA/. |
| PART I, LINE 7: | THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING A COST-TO-CHARGE RATIO AND GENERAL LEDGER. |
| PART I, LINE 7G: | NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | PROVIDENCE SAINT JOHN'S EXTENDS CARE BEYOND THE HOSPITAL'S WALLS TO IMPROVE THE HEALTH OF THE COMMUNITY. THROUGH COMMUNITY BUILDING ACTIVITIES THE ORGANIZATION FOCUSES ON ISSUES SUCH AS HOMELESSNESS, POVERTY, ENVIRONMENTAL STEWARDSHIP AND IMPROVEMENTS IN EDUCATION.PROVIDENCE SAINT JOHN'S LEADERS SERVE ON THE BOARDS OF LOCAL NONPROFIT ORGANIZATIONS SUCH AS MEALS ON WHEELS WEST AND WISE AND HEALTHY AGING. MANY OF THE EMPLOYEES AT THE HOSPITAL DONATE THEIR TIME THROUGH VOLUNTEER ACTIVITIES WITH NONPROFITS IN THE AREA. |
| PART III, LINE 4: | AS A RESULT OF ADOPTING ASU 2014-09 , THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2019. |
| PART III, LINE 8: | THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. |
| PART III, LINE 9B: | PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. |
| PART VI, LINE 2: | NEEDS ASSESSMENT:IN ADDITION TO COMPLETING A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT, PROVIDENCE SAINT JOHN'S SEEKS FEEDBACK ON EMERGING NEEDS AND ISSUES IN THE COMMUNITY. THIS IS ACCOMPLISHED THROUGH A NUMBER OF WAYS:-THE HOSPITAL PARTICIPATES ON A WESTSIDE HEALTH ACCESS: ED WORKGROUP, WHICH FOCUSES ON IMPROVING COORDINATION OF CARE FOR FREQUENT USERS OF THE AREA HOSPITALS' EMERGENCY DEPARTMENTS, ESPECIALLY FOR THOSE WHO ARE HOMELESS.-PROVIDENCE SAINT JOHN'S MAINTAINS ONGOING COMMUNICATION WITH KEY COLLABORATORS IN THE COMMUNITY TO IDENTIFY KEY NEEDS AND ISSUES FACING THE AREA. THESE ORGANIZATIONS INCLUDE VENICE FAMILY CLINIC, THE PEOPLE CONCERN, SAFE PLACE FOR YOUTH, CITY OF SANTA MONICA, ST. MONICA CHURCH, KAISER PERMANENTE WEST LOS ANGELES, UCLA MEDICAL CENTER, CEDARS SINAI MEDICAL CENTER AND WISE AND HEALTHY AGING.-PROVIDENCE SAINT JOHN'S HOLDS AN ANNUAL MEETING WITH LOCAL RESIDENTS TO SEEK THEIR INPUT ON ISSUES THEY FEEL ARE FACING THE COMMUNITY. |
| PART VI, LINE 3: | COMMUNICATION TO THE PUBLIC:PROVIDENCE HOSPITALS POST NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME UNINSURED PATIENTS. THESE NOTICES ARE POSTED IN VISIBLE LOCATIONS THROUGHOUT THE HOSPITAL SUCH AS ADMITTING/REGISTRATION, BILLING OFFICE, EMERGENCY DEPARTMENT AND OTHER OUTPATIENT SETTINGS.EVERY POSTED NOTICE REGARDING FINANCIAL ASSISTANCE POLICIES CONTAINS BRIEF INSTRUCTIONS ON HOW TO APPLY FOR FINANCIAL ASSISTANCE OR A DISCOUNTED PAYMENT. THE NOTICES ALSO INCLUDE A CONTACT TELEPHONE NUMBER THAT A PATIENT OR FAMILY MEMBER CAN CALL TO OBTAIN MORE INFORMATION.PROVIDENCE ENSURES THAT APPROPRIATE STAFF MEMBERS ARE KNOWLEDGEABLE ABOUT THE EXISTENCE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICIES. TRAINING IS PROVIDED TO STAFF MEMBERS (I.E., BILLING OFFICE, FINANCIAL DEPARTMENT, ETC.) WHO DIRECTLY INTERACT WITH PATIENTS REGARDING THEIR HOSPITAL BILLS.WHEN COMMUNICATING TO PATIENTS REGARDING THEIR FINANCIAL ASSISTANCE POLICIES, PROVIDENCE ATTEMPTS TO DO SO IN THE PRIMARY LANGUAGE OF THE PATIENT, OR HIS/HER FAMILY, IF REASONABLY POSSIBLE, AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.PROVIDENCE SHARES THEIR FINANCIAL ASSISTANCE POLICIES WITH APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST SUCH PATIENTS. |
| PART VI, LINE 4: | THE SERVICE AREA DEFINED FOR THE PROVIDENCE SAINT JOHN'S HEALTH CENTER (PSJHC) COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INCLUDES THE ZIP CODES LOCATED WITHIN SERVICE PLANNING AREA (SPA) 5 OF LOS ANGELES COUNTY. THE PLANNING AREA INCLUDES THE COMMUNITIES LOCATED ON THE WEST SIDE OF THE COUNTY (REFERRED TO AS "THE WESTSIDE" LOCALLY, AND IN THE CHNA REPORT), AND REPRESENTS THE AREA WHERE A SIGNIFICANT PORTION (OVER70%) OF THE PATIENTS SERVED BY THE HOSPITAL RESIDES. THE AREA INCLUDES 20 DISTINCT COMMUNITIES AND 30 ZIP CODES. THE TOTAL POPULATION OF THE PSJHC SERVICE AREA IN 2019 IS 682,449 PERSONS. A BREAKDOWN OF DEMOGRAPHICS SHOWS:- AGE: A MAJORITY OF RESIDENTS IN THE SERVICE AREA ARE BETWEEN 20 AND 39 YEARS OLD. CHILDREN UNDER THE AGE OF 19 COMPRISE 17.6% OF THE POPULATION. ADULTS 60 YEARS OF AGE AND OLDER MAKE UP 20.5% OF THE TOTAL SERVICE AREA POPULATION- RACE/ETHNICITY: 66.8% WERE WHITE, 14.5% WERE ASIAN/PACIFIC ISLANDER/HAWAIIAN, 0.4% WERE ALASKA NATIVE OR AMERICAN INDIAN, 6.0% WERE AFRICAN AMERICAN OR BLACK, AND 5.7% WERE OF TWO OR MORE RACES- INCOME: IN 2019, THE MEDIAN HOUSEHOLD INCOME OF THE AREA VARIED SIGNIFICANTLY FROM A LOW OF $65,417 IN PALMS TO $200,001 IN BEL AIR. ALTHOUGH THE WESTSIDE CONTAINS MANY AFFLUENT COMMUNITIES, THERE ARE AREAS WITHIN SPA 5 WITH A HIGHER PORTION OF LOW-INCOME HOUSEHOLDS. APPROXIMATELY 23.0 % OF THE POPULATION HAS ANNUAL INCOMES BELOW 200% OF THE FEDERAL POVERTY LEVEL.- EDUCATION: THE VAST MAJORITY (94.4 %) OF ADULTS AGE 25+ LIVING IN THE PSJHC SERVICE AREA HAVE AT LEAST GRADUATED FROM HIGH SCHOOL.- LANGUAGE: WITHIN THE PSJHC SERVICE AREA, APPROXIMATELY 10.8% OF THE GENERAL POPULATION AGE 5 AND OLDER HAS LIMITED ENGLISH PROFICIENCYHEALTH PROFESSIONS SHORTAGE AREA AND MEDICALLY UNDERSERVED POPULATIONSTHE PSJHC SERVICE AREA HAS A LARGE SUPPLY OF PHYSICIANS DUE IN PART THAT THERE IS A LARGE MEDICAL SCHOOL AND ACADEMIC MEDICAL CENTER IN THE VICINITY. HOWEVER, THE PROVIDERS IN THE AREA ARE NOT EQUALLY ACCESSIBLE TO ALL RESIDENTS. THE HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA) DEFINES A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AS A SHORTAGE OF PRIMARY CARE, DENTAL CARE OR MENTAL HEALTH PROVIDERS BY GEOGRAPHIES OR POPULATIONS. SIX OF THE EIGHTEEN HIGH-NEED CENSUS TRACTS (SEE THE HEALTHY PLACES INDEX MAP ON PAGE 8 OF THIS REPORT) FALL WITHIN A PRIMARY CARE SHORTAGE AREA. DURING COMMUNITY STAKEHOLDER INTERVIEWS, MANY PARTICIPANTS ECHOED THE NEED FOR MORE PROVIDERS WHO ACCEPT MEDI-CAL IN THEIR AREAS AND THAT TRANSPORTATION IS A BARRIER TO ACCESSING CARE. A LARGE PORTION OF SANTA MONICA HAS A SHORTAGE OF PRIMARY CARE PROVIDERS.THE OTHER HOSPITALS IN SANTA MONICA INCLUDE UCLA SANTA MONICA MEDICAL CENTER. |
| PART VI, LINE 5: | PROVIDENCE SAINT JOHN'S HEALTH CENTER PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. PROVIDENCE SAINT JOHN'S HEALTH CENTER IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: 1) OPEN MEDICAL STAFF 2) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS. |
| PART VI, LINE 6: | AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE HEALTH CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:- PROVIDENCE ACROSS FIVE WESTERN STATES- COVENANT HEALTH IN WEST TEXAS- PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA.- HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA.- KADLEC IN SOUTHEAST WASHINGTON- PACIFIC MEDICAL CENTERS IN SEATTLE, WA.- SWEDISH HEALTH SERVICES IN SEATTLE, WA. 2020 AN UNPRECEDENTED YEAROVER THE PAST YEAR, OUR COMMUNITIES HAVE FACED EXTRAORDINARY CHALLENGES. BUT EVEN DURING THE MOST DIFFICULT PUBLIC HEALTH CRISIS OF OUR TIME, COMMUNITIES HAVE ALSO SHOWN REMARKABLE STRENGTH AND RESOLVE. THERE IS SO MUCH GOOD THAT CAN BE ACCOMPLISHED AT THE COMMUNITY LEVEL, ESPECIALLY WHEN LIKE-MINDED ORGANIZATIONS WORK TOGETHER. IN SERVICE TO OUR MISSION, PROVIDENCE PARTNERS WITH COMMUNITY BASED ORGANIZATIONS TO IDENTIFY URGENT HEALTH NEEDS AND ENVIRONMENTAL FACTORS THAT ARE IMPACTING THE WELL-BEING OF OUR COMMUNITIES. WE ACT TO PROVIDE SHORT-TERM SOLUTIONS AND ENVISION LONG-TERM RESULTS BY WISELY INVESTING IN OUR COMMUNITIES TO HELP BUILD A MORE EQUITABLE AND SUSTAINABLE FUTURE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | CA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| VENICE FAMILY CLINIC | |||||||
| 604 ROSE AVENUE | VENICE | CA | 90291 | 952769432 | 501(C)(3) | $175,000 | OPERATIONAL SUPPORT |
| THE PEOPLE CONCERN - OCEAN PARK COMMUNITY | |||||||
| 2116 ARLINGTON AVE NO 100 | LOS ANGELES | CA | 90018 | 956143865 | 501(C)(3) | $150,000 | COMMUNITY BENEFIT RESTRICTED GRANT |
| ROMAN CATHOLIC ARCHBISHOP OF LOS ANGELES A CORPORATION SOLE | |||||||
| 2015 COLORADO AVENUE | STA MONICA | CA | 90404 | 951690538 | 501(C)(3) | $50,000 | COMMUNITY BENEFIT RESTRICTED GRANT |
| WESTSIDE FAMILY HEALTH CENTER | |||||||
| 1711 OCEAN PARK BLVD | SANTA MONICA | CA | 90405 | 952931931 | 501(C)(3) | $50,000 | COMMUNITY BENEFIT RESTRICTED GRANT |
| PALISADES WILL ROGERS 5 & 10K RUN FOUNDATION | |||||||
| 552 ALMAR AVE | PACIFIC PALISADES | CA | 90272 | 463944524 | 501(C)(3) | $35,000 | SPONSORSHIP |
| BEAUTY BUS FOUNDATION | |||||||
| 2716 OCEAN PARK BLVD STE 1062 | SANTA MONICA | CA | 90405 | 263075655 | 501(C)(3) | $20,000 | SPONSORSHIP |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT ALONG WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (33 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROD F HOCHMAN MD | ||||||||||||||
| FORMER PRESIDENT/CEO | $0 | $1,773,896 | $0 | $6,709,440 | $0 | $816,258 | $0 | $782,925 | $0 | $30,876 | $0 | $10,113,395 | $0 | $751,800 |
| MIKE BUTLER | ||||||||||||||
| PRESIDENT - THRU 9/20 | $0 | $965,819 | $0 | $3,330,902 | $0 | $4,411,516 | $0 | $34,515 | $0 | $21,916 | $0 | $8,764,668 | $0 | $2,150,861 |
| DEBRA CANALES | ||||||||||||||
| FORMER EVP CAO PSJH | $0 | $895,727 | $0 | $575,002 | $0 | $533,155 | $0 | $673,455 | $0 | $17,653 | $0 | $2,694,992 | $0 | $487,270 |
| ERIK WEXLER | ||||||||||||||
| FORMER EVP CHIEF EXEC PSJH SO CA | $0 | $964,730 | $0 | $573,824 | $0 | $325,727 | $0 | $425,498 | $0 | $22,517 | $0 | $2,312,296 | $0 | $310,110 |
| AMY COMPTON-PHILLIPS MD | ||||||||||||||
| FORMER EVP CHIEF CLINICAL OFC PSJH | $0 | $760,456 | $0 | $519,149 | $0 | $429,406 | $0 | $500,905 | $0 | $32,184 | $0 | $2,242,100 | $0 | $384,671 |
| RHONDA MEDOWS MD | ||||||||||||||
| FORMER PRESIDENT POP HEALTH / AYIN | $0 | $897,985 | $0 | $523,880 | $0 | $392,595 | $0 | $308,771 | $0 | $20,090 | $0 | $2,143,321 | $0 | $346,425 |
| VENKAT BHAMIDIPATI | ||||||||||||||
| EVP/TREASURER - THRU 9/20 | $0 | $713,471 | $0 | $400,000 | $0 | $970,660 | $0 | $4,275 | $0 | $18,405 | $0 | $2,106,811 | $0 | $184,910 |
| CINDY STRAUSS | ||||||||||||||
| SECRETARY - THRU 12/20 | $0 | $801,070 | $0 | $601,420 | $0 | $343,051 | $0 | $331,005 | $0 | $27,088 | $0 | $2,103,634 | $0 | $299,545 |
| LISA VANCE | ||||||||||||||
| FORMER EVP REGIONAL CE OR | $0 | $771,527 | $0 | $511,879 | $0 | $246,300 | $0 | $384,714 | $0 | $26,534 | $0 | $1,940,954 | $0 | $203,441 |
| JO ANN ESCASA-HAIGH | ||||||||||||||
| TREASURER/CFO/VP | $0 | $682,465 | $0 | $370,006 | $0 | $259,183 | $0 | $403,809 | $0 | $31,129 | $0 | $1,746,592 | $0 | $218,804 |
| GREG TILL | ||||||||||||||
| FORMER CHIEF PEOPLE OFFICER | $0 | $601,238 | $0 | $514,002 | $0 | $189,220 | $0 | $308,738 | $0 | $32,912 | $0 | $1,646,110 | $0 | $152,175 |
| AARON MARTIN | ||||||||||||||
| FORMER EVP CHIEF MKT/DIGITAL INNO OF | $0 | $644,818 | $0 | $390,425 | $0 | $272,510 | $0 | $266,627 | $0 | $5,716 | $0 | $1,580,096 | $0 | $249,267 |
| MIKE WATERS | ||||||||||||||
| FORMER EVP AMBULATORY CARE NETWORK | $0 | $513,014 | $0 | $313,206 | $0 | $294,266 | $0 | $207,159 | $0 | $16,048 | $0 | $1,343,693 | $0 | $161,221 |
| JOEL GILBERTSON | ||||||||||||||
| FORMER EVP COMMUNITY PARTNERSHIPS | $0 | $578,919 | $0 | $305,000 | $0 | $223,675 | $0 | $195,488 | $0 | $30,562 | $0 | $1,333,644 | $0 | $186,629 |
| MICHAEL RICKS | ||||||||||||||
| CHIEF EXEC ST JOHNS HEALTH CNT | $0 | $548,798 | $0 | $201,749 | $0 | $269,156 | $0 | $160,832 | $0 | $28,641 | $0 | $1,209,176 | $0 | $0 |
| OREST HOLUBEC | ||||||||||||||
| FORMER SVP CHIEF COMMUNICATION OFCR | $0 | $472,607 | $0 | $259,999 | $0 | $206,774 | $0 | $173,676 | $0 | $29,598 | $0 | $1,142,654 | $0 | $169,616 |
| JOHN WHIPPLE | ||||||||||||||
| SECRETARY | $0 | $448,628 | $0 | $316,136 | $0 | $198,887 | $0 | $148,450 | $0 | $27,856 | $0 | $1,139,957 | $0 | $169,265 |
| MARY CRANSTOUN | ||||||||||||||
| FORMER SVP TOTAL REWARDS TALENT ACQ | $0 | $450,242 | $0 | $204,417 | $0 | $179,023 | $0 | $163,934 | $0 | $24,759 | $0 | $1,022,375 | $0 | $145,103 |
| MARCEL LOH | ||||||||||||||
| FORMER CE ST JOHNS HEALTH CNT | $0 | $17,730 | $0 | $0 | $0 | $988,055 | $0 | $0 | $0 | $3,763 | $0 | $1,009,548 | $0 | $304,488 |
| DAVID BROWN | ||||||||||||||
| FORMER SVP CAO AMBULATORY CARE | $0 | $381,205 | $0 | $143,506 | $0 | $183,752 | $0 | $127,676 | $0 | $29,222 | $0 | $865,361 | $0 | $161,988 |
| JIM WATSON ESQ | ||||||||||||||
| FORMER SECRETARY | $0 | $437,006 | $0 | $301,877 | $0 | $5,598 | $0 | $84,307 | $0 | $35,749 | $0 | $864,537 | $0 | $0 |
| ROBERT KLEIN | ||||||||||||||
| PRESIDENT/CEO FOUNDATION | $437,064 | $0 | $227,250 | $0 | $71,889 | $0 | $64,476 | $0 | $20,038 | $0 | $820,717 | $0 | $38,779 | $0 |
| GREG HOFFMAN | ||||||||||||||
| PRESIDENT/CEO (PART YEAR) | $0 | $436,362 | $0 | $98,549 | $0 | $141,036 | $0 | $93,123 | $0 | $29,372 | $0 | $798,442 | $0 | $69,769 |
| DEBBIE BURTON | ||||||||||||||
| FORMER SVP CHIEF NURSING OFFICER | $0 | $377,566 | $0 | $135,000 | $0 | $139,297 | $0 | $8,252 | $0 | $30,954 | $0 | $691,069 | $0 | $107,362 |
| TOM MCDONAGH | ||||||||||||||
| FORMER VP/CHIEF INVESTMENT OFFICER | $0 | $0 | $0 | $0 | $0 | $485,249 | $0 | $6,415 | $0 | $24,117 | $0 | $515,781 | $0 | $0 |
| STELLA NICHOLS | ||||||||||||||
| CFO & COO FOUNDATION | $316,715 | $0 | $77,501 | $0 | $11,179 | $0 | $35,688 | $0 | $10,222 | $0 | $451,305 | $0 | $6,561 | $0 |
| SHARON TONCRAY | ||||||||||||||
| FORMER SVP/CHIEF LABOR EE COUNSEL | $0 | $0 | $0 | $0 | $0 | $361,654 | $0 | $3,685 | $0 | $23,776 | $0 | $389,115 | $0 | $0 |
| GIANCARLO LYLE-EDROSOLO | ||||||||||||||
| CHIEF NURSING OFFICER | $287,013 | $0 | $62,644 | $0 | $584 | $0 | $4,275 | $0 | $16,974 | $0 | $371,490 | $0 | $0 | $0 |
| PAUL NATTERSON | ||||||||||||||
| CHIEF MEDICAL OFFICER - THRU 10/20 | $310,773 | $0 | $50,000 | $0 | $6,149 | $0 | $2,323 | $0 | $1,920 | $0 | $371,165 | $0 | $0 | $0 |
| NAHID NOORI | ||||||||||||||
| ULTRASOUND TECHNICIAN GF | $311,508 | $0 | $0 | $0 | $1,923 | $0 | $5,594 | $0 | $8,164 | $0 | $327,189 | $0 | $1,369 | $0 |
| DONALD ANDERSON JR | ||||||||||||||
| FORMER ASSISTANT SECRETARY FOR ENROL | $0 | $204,368 | $0 | $23,098 | $0 | $1,007 | $0 | $11,841 | $0 | $10,973 | $0 | $251,287 | $0 | $0 |
| RANDALL ROISMAN | ||||||||||||||
| CFO ST JOHNS HEALTH CNT - THRU 3/20 | $0 | $54,553 | $0 | $0 | $0 | $127,608 | $0 | $779 | $0 | $6,271 | $0 | $189,211 | $0 | $0 |
| TAMMY TEODOSIO | ||||||||||||||
| FORMER ASSISTANT SECRETARY | $0 | $95,587 | $0 | $7,996 | $0 | $1,522 | $0 | $4,335 | $0 | $13,325 | $0 | $122,765 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | PROVIDENCE EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: FIRST CLASS TRAVEL OR CHARTER TRAVEL AIR TRAVEL IS GENERALLY REIMBURSABLE AT THE LEAST EXPENSIVE AIRFARE WHICH PERMITS DEPARTURES AND ARRIVALS AT REASONABLE TIMES AND REASONABLE DISTANCE TRAVELED. EMPLOYEES ARE ENCOURAGED TO PLAN IN ADVANCE TO GET AVAILABLE DISCOUNTS. AIRLINE FREQUENT FLYER UPGRADES WILL NEVER BE REIMBURSED. IN LIMITED SITUATIONS FIRST CLASS TICKETS AND CHARTER MAY BE REIMBURSED WHEN APPROVED BY A SENIOR LEVEL SUPERVISOR. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - RELOCATION PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO RELOCATION EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THE RELOCATION EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THE RELOCATION BENEFITS, SO THAT A PORTION OF THE REIMBURSEMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - FINANCIAL/RETIREMENT PLANNING PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO FINANCIAL AND RETIREMENT PLANNING EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THESE OTHER EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THIS BENEFIT, SO THAT A PORTION OF THE PAYMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE PROVIDENCE PROVIDES HOUSING ALLOWANCES ONLY FOR PURPOSES OF RELOCATION ASSISTANCE TO A NEWLY HIRED EMPLOYEE. PROVIDENCE MAY PAY TEMPORARY LIVING EXPENSES FOR THE NEWLY HIRED EMPLOYEE UP TO A MAXIMUM OF 90 CALENDAR DAYS. COVERED EXPENSES ARE RENT (EXCLUDING "RENT" WHICH MAY BE PAID IN ORDER TO OCCUPY A NEW PERMANENT RESIDENCE UNTIL THE TITLE CLEARS) AND UTILITIES, INCLUDING HEAT, ELECTRICITY, GAS, WATER, LOCAL INTERNET AND LOCAL TELEPHONE AND GARBAGE SERVICES. THE EXECUTIVE VICE PRESIDENT, CHIEF ADMINISTRATIVE OFFICER OF PROVIDENCE MAY APPROVE TEMPORARY HOUSING ASSISTANCE FOR UP TO SIX MONTHS WHEN FAMILY RELOCATION IS DELAYED TO ACCOMMODATE THE SCHOOL YEAR OR EQUIVALENT CIRCUMSTANCES. ONLY IN EXTENUATING CIRCUMSTANCES IS HOUSING EXTENDED BEYOND THIS SIX-MONTH PERIOD. THE AMOUNTS REPORTED FOR THESE RELOCATION/HOUSING PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE. |
| PART I, LINE 3 | DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX EXEMPT RELATED ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE. |
| PART I, LINES 4A-B | THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS DURING THE YEAR: VENKAT BHAMIDIPATI - $750,000 MIKE BUTLER - $507,235 TOM MCDONAGH - $485,032 MARCEL LOH - $459,186 SHARON TONCRAY - $367,774 RANDALL ROISMAN - $114,233 ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(III) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR: MIKE BUTLER - $2,150,861 ROD F. HOCHMAN, MD - $751,800 DEBRA CANALES - $487,270 AMY COMPTON-PHILLIPS, MD - $384,671 RHONDA MEDOWS, MD - $346,425 ERIK WEXLER - $310,110 MARCEL LOH - $304,488 CINDY STRAUSS - $299,545 AARON MARTIN - $249,267 JO ANN ESCASA-HAIGH - $218,804 LISA VANCE - $203,441 JOEL GILBERTSON - $186,629 VENKAT BHAMIDIPATI - $184,910 OREST HOLUBEC - $169,616 JOHN WHIPPLE - $169,265 DAVID BROWN - $161,988 MIKE WATERS - $161,221 GREG TILL - $152,175 MARY CRANSTOUN - $145,103 DEBBIE BURTON - $107,362 GREG HOFFMAN - $69,769 ROBERT KLEIN - $38,779 STELLA NICHOLS - $6,551 NAHID NOORI - $1,369 |
| PART I, LINE 7 | NON-FIXED PAYMENTS THE PROVIDENCE EXECUTIVE COMPENSATION COMMITTEE (OF THE BOARD) HAS APPROVED AN EXECUTIVE COMPENSATION PHILOSOPHY THAT CLOSELY TIES AN EXECUTIVE'S COMPENSATION TO PERFORMANCE BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE EXECUTIVE. THERE IS NO GUARANTEE THAT THIS PART OF A LEADER'S COMPENSATION WILL BE PAID IF THE PERFORMANCE OF THE ORGANIZATION OR OF THE INDIVIDUAL DOES NOT MEET THE PERFORMANCE STANDARDS FOR PAYMENT, NO PERFORMANCE-BASED PAYMENT IS MADE. THIS APPROACH IS REFLECTED IN PROVIDENCE'S LEADERSHIP ANNUAL INCENTIVE PLAN, WHICH IS A PERFORMANCE-BASED ANNUAL INCENTIVE PLAN THAT AFFORDS PARTICIPATING EXECUTIVES THE OPPORTUNITY TO EARN "AT RISK" COMPENSATION THROUGH PERFORMANCE AGAINST VERY CHALLENGING GOALS. PAYOUTS WILL BE AWARDED BASED ON GOALS RELATED TO STRATEGIC OBJECTIVES, FISCAL STEWARDSHIP AND QUALITY OF CARE THESE GOALS ARE SET BEFORE THE YEAR BEGINS AND ARE VERY CHALLENGING. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S PERFORMANCE GOALS TO MAKE SURE THEY ARE SUFFICIENTLY CHALLENGING, AND TO MAKE SURE THE GOALS ARE DESIGNED TO HELP PROVIDENCE MEET ITS MISSION AND STRATEGIC PURPOSES. EACH YEAR THE PSJH BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE INCENTIVE PERFORMANCE AND MUST CERTIFY THE ACHIEVEMENT OF PERFORMANCE GOALS BEFORE ANY AWARDS ARE PAID OUT. WHEN REVIEWING AND APPROVING TOTAL COMPENSATION FOR EXECUTIVES, THE EXECUTIVE COMPENSATION COMMITTEE INCLUDES INCENTIVE AWARDS, TO MAKE SURE THAT COMPENSATION IS REASONABLE AND WELL-SUPPORTED BY MARKET DATA. THE COMMITTEE CONSISTS ONLY OF DIRECTORS WHO ARE FREE OF CONFLICTS OF INTEREST, AND THE COMMITTEE RELIES ON MARKET SURVEY DATA GATHERED BY AN INDEPENDENT CONSULTANT. THE COMMITTEE CONDUCTS THIS REVIEW AND APPROVAL PROCESS IN A MANNER THAT IS IN ACCORDANCE WITH IRS REQUIREMENTS FOR COMPENSATION OF TAX-EXEMPT ORGANIZATION LEADERS, AND IN ACCORDANCE WITH THE BEST GOVERNANCE PRACTICES IN THE INDUSTRY. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART V, LINE 15 | INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF THE RELATED ORGANIZATION. IT IS THE INTENTION OF PROVIDENCE AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE EMPLOYEES OF A RELATED ORGANIZATION WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. THE RELATED ORGANIZATION COMMON LAW EMPLOYEES ARE INCLUDED IN THE RELATED ORGANIZATION'S SECTION 4960 TAX ANALYSIS AND REPORTING. |
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA IS THE SOLE CORPORATE MEMBER OF PROVIDENCE SAINT JOHN'S HEALTH CENTER. |
| FORM 990, PART VI, SECTION A, LINE 7A | CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PROVIDENCE SAINT JOHN'S HEALTH CENTER HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT DIRECTORS TO THE PROVIDENCE SAINT JOHN'S HEALTH CENTER BOARD. ALL DIRECTOR NOMINATIONS THAT COME FROM THE PROVIDENCE SAINT JOHN'S HEALTH CENTER BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA, AS THE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE FOLLOWING POWERS RESIDE WITH THE CORPORATE MEMBER: 1) TO ADOPT OR CHANGE THE MISSION, PHILOSOPHY, AND VALUES, INCLUDING THE STRATEGIC PLAN AND MISSION STATEMENT. 2) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS. 3) TO APPROVE THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE TRANSFER, ASSIGNMENT OR ENCUMBERING OF ASSETS EXCEEDING A SPECIFIED THRESHOLD, OR THE SALE OR TRANSFER OF ANY PROPERTY WHICH MAY HAVE HISTORICAL OR RELIGIOUS SIGNIFICANCE. 4) TO APPROVE THE DISSOLUTION OR LIQUIDATION. 5) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS. 6) TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANTS. 7) TO APPROVE THE CLOSURE OF ANY INSTITUTION OR MAJOR ENTITY OR WORK OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW FORM 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE REGULARLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE ST. JOSEPH HEALTH, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE'S LEGAL ENTITIES. PROVIDENCE ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS SENIOR EXECUTIVES, INCLUDING ALL OFFICERS. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED AT LEAST ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS A COMMITTEE OF THE PROVIDENCE BOARD CONSISTING ONLY OF OUTSIDE, INDEPENDENT DIRECTORS. THE COMMITTEE MAKES SURE, AT EACH OF ITS MEETINGS, THAT NO MEMBER OF THE COMMITTEE HAS A CONFLICT OF INTEREST AS TO ANY EXECUTIVE WHOSE COMPENSATION IS REVIEWED BY THE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS THAT ARE SUBSTANTIALLY SIMILAR TO PROVIDENCE IN SIZE AND COMPLEXITY (SUCH AS HAVING A SIMILAR AMOUNT OF ANNUAL NET REVENUE). ADDITIONALLY, BECAUSE PROVIDENCE OFTEN LOOKS TO GENERAL INDUSTRY FOR LEADERS IN CERTAIN FUNCTIONAL AREAS, PROVIDENCE ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY MARKET DATA IN THESE SPECIAL SITUATIONS. BASE SALARIES FOR PROVIDENCE EXECUTIVES ARE GENERALLY TARGETED TO THE "MEDIAN" LEVEL OF THE MARKET DATA (WHERE HALF THE SALARIES IN THE DATA ARE LOWER AND HALF THE SALARIES IN THE DATA ARE HIGHER), AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. TOTAL COMPENSATION IS TIED CLOSELY TO PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY HELP LEAD PROVIDENCE IN ACHIEVING SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE'S OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR SETTING, REVIEWING AND APPROVING EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS (TO ASSURE THAT ALL COMPENSATION IS CONSIDERED REASONABLE) AND REFLECTS BEST GOVERNANCE PRACTICES IN THE INDUSTRY. THE PROCESS WAS LAST COMPLETED IN 2020. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE PROVIDENCE COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, CONSOLIDATED AUDITED FINANCIAL STATEMENTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PROVIDENCE INTERNET SITE. |
| FORM 990, PART IX, LINE 11G | AGENCY & CONTRACT LABOR: PROGRAM SERVICE EXPENSES 17,510,466. MANAGEMENT AND GENERAL EXPENSES 1,186,735. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18,697,201. BILLING AND COLLECTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 133,104. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 133,104. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 234,862. MANAGEMENT AND GENERAL EXPENSES 2,503,624. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,738,486. MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 10,120,292. MANAGEMENT AND GENERAL EXPENSES 3,476,761. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,597,053. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 21,796,472. MANAGEMENT AND GENERAL EXPENSES 8,642,144. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,438,616. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 6,225,266. MANAGEMENT AND GENERAL EXPENSES 3,770,536. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,995,802. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS -13,320,192. OTHER 27,789,400. FAS 136 - RECIPIENT ORGANIZATION ADJUSTMENT 10,874,900. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (111 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COVENANT ACO | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 611573313 | HEALTHCARE | TX | 501(C)(3) | 12,I | CHS | Yes (1) | |
| COVENANT HEALTH NETWORK INC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 461259908 | HEALTHCARE | CA | 501(C)(3) | 12, III | SJHS | Yes (1) | |
| COVENANT HEALTH PARTNERS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 463516417 | HEALTHCARE | TX | 501(C)(3) | 12, I | CHS | Yes (1) | |
| COVENANT HEALTH SYSTEM | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752765566 | HEALTHCARE | TX | 501(C)(3) | 3 | SJHS | Yes (1) | |
| COVENANT HEALTH SYSTEM FOUNDATION | |||||||||||
| 3623 22ND PLACE | LUBBOCK | TX | 79410 | 752897026 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (1) | |
| COVENANT HOSPITAL HOBBS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844273963 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| COVENANT MEDICAL CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 822913146 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| COVENANT MEDICAL GROUP | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752743883 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| EVERETT TRANSITIONAL CARE SERVICES | |||||||||||
| PO BOX 5128 | EVERETT | WA | 982065128 | 943264605 | TRANSITIONAL CARE | WA | 501(C)(3) | 10 | 0 | N/A | |
| GAMELIN WASHINGTON ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 201910170 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| GLOBAL TO LOCAL HEALTH INITIATIVE | |||||||||||
| 2800 SOUTH 192ND ST 104 | SEATAC | WA | 98188 | 273133200 | HEALTHCARE | WA | 501(C)(3) | 7 | SHS | Yes (1) | |
| GRACE CLINIC OF LUBBOCK | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 203856995 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| HMTS INC | |||||||||||
| 1 HOAG DRIVE | NEWPORT BEACH | CA | 92658 | 453583707 | HEALTHCARE | CA | 501(C)(3) | 12, I | HMHP | Yes (1) | |
| HOAG CHARITY SPORTS | |||||||||||
| 2081 BUSINESS CENTER DR STE 195 | NEWPORT BEACH | CA | 92663 | 452982422 | SUPPORT | CA | 501(C)(3) | 7 | HHF | Yes (1) | |
| HOAG CLINIC | |||||||||||
| 1 HOAG DRIVE | NEWPORT BEACH | CA | 92658 | 330676831 | HEALTHCARE | CA | 501(C)(3) | 10 | HMHP | Yes (1) | |
| HOAG HOSPITAL FOUNDATION | |||||||||||
| 330 PLACENTIA AVE | NEWPORT BEACH | CA | 92663 | 953222343 | FUNDRAISING | CA | 501(C)(3) | 7 | HMHP | Yes (1) | |
| HOAG MEMORIAL HOSPITAL PRESBYTERIAN | |||||||||||
| 1 HOAG ROAD BOX 6100 | NEWPORT BEACH | CA | 92663 | 951643327 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| HOSPICE OF LUBBOCK | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752133781 | HEALTHCARE | TX | 501(C)(3) | 10 | CHS | Yes (1) | |
| INLAND NORTHWEST HEALTH SERVICES | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911307555 | HEALTHCARE | WA | 501(C)(3) | 3 | PHS WA | Yes (1) | |
| INSTITUTE FOR MENTAL HEALTH & WELLNESS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814260130 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS SJHS | Yes (1) | |
| INSTITUTE FOR SYSTEMS BIOLOGY | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 912003593 | HEALTHCARE | WA | 501(C)(3) | 7 | WHC | Yes (1) | |
| KADLEC AUXILIARY INC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 916033089 | SUPPORT | WA | 501(C)(3) | 12, III | KRMC | Yes (1) | |
| KADLEC FOUNDATION | |||||||||||
| 888 SWIFT BLVD | RICHLAND | WA | 99352 | 237005501 | SUPPORT | WA | 501(C)(3) | 7 | KRMC | Yes (1) | |
| KADLEC REGIONAL MEDICAL CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 910655392 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (1) | |
| LITTLE COMPANY OF MARY ANCILLARY SERVICES CORPORATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330844408 | IMAGING SERVICES | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (1) | |
| LUBBOCK HERITAGE HOSPITAL LLC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 264021016 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| LUNDBERG ASSOCIATION PROVIDENCE HOUSE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911562797 | SUPPORT | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| MARSHA RIVKIN CENTER FOR OVARIAN CANCER RESEARCH | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 912054035 | RESEARCH | WA | 501(C)(3) | 7 | SHS | Yes (1) | |
| METHODIST CHILDREN'S HOSPITAL | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752428911 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| METHODIST HOSPITAL LEVELLAND | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752246348 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| METHODIST HOSPITAL PLAINVIEW | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752426010 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| MISSION HOSPITAL REGIONAL MEDICAL CTR | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643360 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| NORTHWEST HOPE & HEALING FOUNDATION | |||||||||||
| PO BOX 16069 | SEATTLE | WA | 98116 | 200799737 | SUPPORT | WA | 501(C)(3) | 12, I | SHS | Yes (1) | |
| PACMED CLINICS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 562290878 | HEALTHCARE | WA | 501(C)(3) | 10 | WHC | Yes (1) | |
| PH&S FOUNDATIONSFVSA & SCVSA | |||||||||||
| 501 SOUTH BUENA VISTA STREET | BURBANK | CA | 915054809 | 953544877 | HEALTHCARE | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (1) | |
| PROVIDENCE ALASKA FOUNDATION | |||||||||||
| 3760 PIPER STREET SUITE 2021 | ANCHORAGE | AK | 99508 | 920093565 | HEALTHCARE | AK | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION | |||||||||||
| 540 SOUTH MAIN ST | MT ANGEL | OR | 97362 | 911940286 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE BLANCHET ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911789266 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE CHILDREN'S HEALTH FOUNDATION | |||||||||||
| 4805 NE GLISAN ST STE 2N35 | PORTLAND | OR | 97213 | 930800140 | SUPPORT | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE COMMUNITY HEALTH FOUNDATION | |||||||||||
| 940 ROYAL AVE SUITE 410 | MEDFORD | OR | 97504 | 930692907 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE DETHMAN HOUSE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 473385506 | SUPPORT | WA | 501(C)(3) | 7 | 0 | N/A | |
| PROVIDENCE FACEY MEDICAL FOUNDATION (FKA FACEY MEDICAL FDN) | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 954322584 | SUPPORT | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (1) | |
| PROVIDENCE GAMELIN HOUSE ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 311744654 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911549796 | HEALTHCARE | WA | 501(C)(3) | 12, II | PSJH | 0 | |
| PROVIDENCE HEALTH & SERVICES - MONTANA | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810231793 | HEALTHCARE | MT | 501(C)(3) | 3 | PHS WA | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES - OREGON | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 510216587 | HEALTHCARE | OR | 501(C)(3) | 3 | PHS | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES - WASHINGTON | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 510216586 | HEALTHCARE | WA | 501(C)(3) | 3 | PHS | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911303277 | HEALTHCARE | WA | 501(C)(3) | 3 | PMWHC | Yes (1) | |
| PROVIDENCE HEALTH ASSURANCE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 550828701 | MEDICAID HEALTHCARE PROVIDER | OR | 501(C)(4) | N/A | PHP | Yes (1) | |
| PROVIDENCE HEALTH CARE FOUNDATION - EASTERN WASHINGTON | |||||||||||
| 101 W 8TH AVE | SPOKANE | WA | 99204 | 320014330 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE HEALTH CARE FOUNDATION (CENTRALIA) | |||||||||||
| 413 LILLY ROAD NE | OLYMPIA | WA | 985065166 | 911433382 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE HEALTH PLAN | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 930863097 | HEALTHCARE | OR | 501(C)(4) | N/A | PPP | Yes (1) | |
| PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 510216589 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS | Yes (1) | |
| PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 810 12TH STREET PO BOX 149 | HOOD RIVER | OR | 97031 | 930921990 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE HOSPICE AND HOME CARE FOUNDATION | |||||||||||
| 2731 WETMORE AVE STE 500 | EVERETT | WA | 98201 | 272552749 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE HOSPICE OF SEATTLE FOUNDATION | |||||||||||
| 2811 SOUTH 102ND NO 220 | TUKWILA | WA | 98168 | 912077378 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION | |||||||||||
| 4101 TORRANCE BLVD | TORRANCE | CA | 90503 | 510224944 | HEALTHCARE | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (1) | |
| PROVIDENCE MARIANWOOD FOUNDATION | |||||||||||
| 3725 PROVIDENCE POINT DRIVE SE | ISSAQUAH | WA | 980297219 | 931554288 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE MEDICAL FDN (FKA ST JOSEPH HERITAGE HEALTHCARE) | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330185031 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (1) | |
| PROVIDENCE MEDICAL INSTITUTE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330283773 | HEALTHCARE | CA | 501(C)(3) | 12, I | PHS SOCAL | Yes (1) | |
| PROVIDENCE MILWAUKIE FOUNDATION | |||||||||||
| 10150 SE 32ND AVE | MILWAUKIE | OR | 97222 | 943079515 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE MINISTRIES | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | RELIGIOUS ORG | WA | 501(C)(3) | 1 | 0 | N/A | ||
| PROVIDENCE MOUNT ST VINCENT FOUNDATION | |||||||||||
| 4831 35TH AVE SW | SEATTLE | WA | 981262799 | 911188119 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE NEWBERG HEALTH FOUNDATION | |||||||||||
| 1001 PROVIDENCE DRIVE | NEWBERG | OR | 97132 | 930889144 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE PETER CLAVER ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 311629656 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE PLAN PARTNERS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911861964 | HEALTHCARE | WA | 501(C)(4) | N/A | PHS OR | Yes (1) | |
| PROVIDENCE PORTLAND MEDICAL FOUNDATION | |||||||||||
| 4805 NE GLISAN ST | PORTLAND | OR | 972132967 | 931231494 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE ROSSI ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 311584166 | SUPPORT | WA | 501(C)(3) | 10 | PHS WA | Yes (1) | |
| PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814542216 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS SOCAL | Yes (1) | |
| PROVIDENCE SEASIDE HOSPITAL FOUNDATION | |||||||||||
| 725 S WAHANNA ROAD | SEASIDE | OR | 97138 | 930927320 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE SW WASHINGTON FOUNDATION (FKA PROV ST PETER FDN) | |||||||||||
| 413 LILLY ROAD NE | OLYMPIA | WA | 985065166 | 911097056 | SUPPORT | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE ST ELIZABETH HOUSE ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 912171539 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST FRANCIS ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 943244854 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST JOSEPH HEALTH | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 811244422 | HEALTHCARE | WA | 501(C)(3) | 12, III | 0 | N/A | |
| PROVIDENCE ST JOSEPH HEALTH FOUNDATION | |||||||||||
| 1801 LIND AVE SW | RENTON | WA | 980579016 | 943078543 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST JOSEPH MEDICAL CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810463482 | HEALTHCARE | MT | 501(C)(3) | 3 | PHS WA | Yes (1) | |
| PROVIDENCE ST MARY FOUNDATION | |||||||||||
| 1025 S 2ND AVENUE | WALLA WALLA | WA | 99362 | 452841492 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST VINCENT MEDICAL FOUNDATION | |||||||||||
| 9205 SW BARNES ROAD STE MT2111 | PORTLAND | OR | 97225 | 930575982 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE TRINITYCARE HOSPICE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 953264139 | HEALTHCARE | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (1) | |
| PROVIDENCE TRINITYCARE HOSPICE FOUNDATION | |||||||||||
| 5315 TORRANCE BLVD NO B-1 | TORRANCE | CA | 90503 | 330261016 | HEALTHCARE | CA | 501(C)(3) | 7 | PTCH | Yes (1) | |
| PROVIDENCE WILLAMETTE FALLS MEDICAL FOUNDATION | |||||||||||
| 1500 DIVISION STREET | OREGON CITY | OR | 97045 | 931003750 | HEALTHCARE | OR | 501(C)(3) | 12, I | PHS OR | Yes (1) | |
| REDWOOD MEMORIAL FOUNDATION | |||||||||||
| 2700 DOBEER STREET | EUREKA | CA | 95501 | 942779313 | HEALTHCARE | CA | 501(C)(3) | 7 | RMH | Yes (1) | |
| SAINT JOHN'S CANCER INSTITUTE (FKA JOHN WAYNE CANCER INST) | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 954291515 | HEALTHCARE | CA | 501(C)(3) | 4 | PSJHC | Yes (1) | |
| SAINT JOHN'S HOSPITALHEALTH CENTER FOUNDATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 956100079 | SUPPORT SAINT JOHN HEALTH CENTER & JWCI | CA | 501(C)(3) | 7 | PSJHC | Yes (1) | |
| SEATTLE SCIENCE FOUNDATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 611502822 | PHYSICIAN COLLABORATION | WA | 501(C)(3) | 7 | WHC | Yes (1) | |
| SISTERS OF PROVIDENCE OF MONTANA CORPORATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 262612415 | SHELL CORPORATION | MT | 501(C)(3) | 1 | PHS WA | 0 | |
| SISTERS OF ST JOSEPH OF ORANGE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643383 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | 0 | N/A | |
| SRM ALLIANCE HOSPITAL SERVICES (PVH) | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 680395200 | HEALTHCARE | CA | 501(C)(3) | 3 | SRMH | Yes (1) | |
| ST JOSEPH HEALTH MINISTRY | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 271666576 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | SSJO | 0 | |
| ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814791043 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (1) | |
| ST JOSEPH HEALTH SYSTEM | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 953589356 | HEALTHCARE | CA | 501(C)(3) | 12, I | PSJH | 0 | |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | |||||||||||
| 3345 MICHELSON DRIVE SUITE 100 | IRVINE | CA | 92612 | 330143024 | HEALTHCARE | CA | 501(C)(3) | 10 | SJHS | Yes (1) | |
| ST JOSEPH HOME CARE NETWORK | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 680331084 | HEALTHCARE | CA | 501(C)(3) | 10 | SJHS | Yes (1) | |
| ST JOSEPH HOSPITAL OF ORANGE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643359 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| ST JUDE HOSPITAL INC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643325 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| ST LUKE ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 943176618 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| ST MARY MEDICAL CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951914489 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| ST PATRICK HOSPITAL FOUNDATION | |||||||||||
| 502 W SPRUCE STREET | MISSOULA | MT | 59802 | 237056976 | HEALTHCARE | MT | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| ST THOMAS CHILD AND FAMILY CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810233495 | EDUCATION | MT | 501(C)(3) | 10 | PHS WA | Yes (1) | |
| SWEDISH EDMONDS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 272305304 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (1) | |
| SWEDISH HEALTH SERVICES | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 910433740 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (1) | |
| SWEDISH MEDICAL CENTER FOUNDATION | |||||||||||
| 747 BROADWAY | SEATTLE | WA | 98122 | 910983214 | HEALTHCARE | WA | 501(C)(3) | 7 | SHS | Yes (1) | |
| SWEDISH MJM HOLDINGS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 273139262 | HOLDING COMPANY | WA | 501(C)(3) | 12, I | SHS | Yes (1) | |
| TARZANA MEDICAL CENTER LLC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 833972614 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS SOCAL | Yes (1) | |
| THE GAMELIN ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911180824 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| THE GAMELIN CALIFORNIA ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911293869 | SUPPORT | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (1) | |
| THE GAMELIN OREGON ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911214491 | SUPPORT | OR | 501(C)(3) | 10 | PHS OR | Yes (1) | |
| TRI-CITIES CANCER CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911594526 | HEALTHCARE | WA | 501(C)(3) | 3 | KADLEC | Yes (1) | |
| TRI-CITIES CANCER CENTER FOUNDATION | |||||||||||
| 7350 W DESCHUTES AVE BUILDING A | KENNEWICK | WA | 99336 | 911739024 | SUPPORT | WA | 501(C)(3) | 12, I | KADLEC | Yes (1) | |
| UNIVERSITY OF PROVIDENCE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810231777 | EDUCATION | MT | 501(C)(3) | 2 | PHS | Yes (1) | |
| WESTERN HEALTHCONNECT | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 454171900 | SHELL CORPORATION | WA | 501(C)(3) | 12, II | PHS W WA | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (45 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| 20TH STREET SURGERY LLC | |||||||||
| 1301 20TH STREET STE 140 | SANTA MONICA | CA | 90404 | 731735618 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | 0 |
| BRIDGEPORT MEDICAL IMAGING (BMI) | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260796953 | IMAGING - DIAGNOSTICS | OR | N/A | 0 | 0 |
| BROADWAY IMAGING LLC | |||||||||
| 500 W BROADWAY | MISSOULA | MT | 59802 | 522405971 | MEDICAL IMAGING | MT | N/A | 0 | 0 |
| CENTER FOR MATERNAL NEWBORN AND CHILD | |||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 813526875 | HEALTHCARE | CA | N/A | 0 | 0 |
| CENTER FOR MEDICAL IMAGING (CMI) | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 200477972 | IMAGING - DIAGNOSTICS | OR | N/A | 0 | 0 |
| CLACKAMAS RADIATION ONCOLOGY CENTER LLC | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260381897 | RADIATION ONCOLOGY | OR | N/A | 0 | 0 |
| COASTAL ASC HOLDINGS LLC | |||||||||
| ONE HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92663 | 810986844 | HEALTHCARE | CA | N/A | 0 | Yes (1) |
| COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY | |||||||||
| ONE CITY BLVD W STE 1100 | ORANGE | CA | 92868 | 264591502 | HEALTHCARE | CA | N/A | 0 | Yes (1) |
| COVENANT LONG-TERM CARE LP | |||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 205033419 | HEALTHCARE | TX | N/A | 0 | 0 |
| FULLERTON SURGICAL CENTER LP | |||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 470927394 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | Yes (1) |
| GREATER VALLEY MEDICAL BUILDING LP | |||||||||
| 501 S BUENA VISTA ST | BURBANK | CA | 91505 | 954570858 | REAL ESTATE - MOB | CA | N/A | 0 | 0 |
| HCSA PROPERTIES LLC | |||||||||
| 1600 M STREET NW | AUBURN | WA | 98001 | 460620892 | REAL ESTATE RENTAL | WA | N/A | 0 | 0 |
| HERITAGE INVESTMENT GROUP I LLC | |||||||||
| 500 S MAIN STREET STE 1000 | ORANGE | CA | 92868 | 271000061 | INVESTMENTS | CA | N/A | 0 | 0 |
| HOAG ORTHOPEDIC INSTITUTE | |||||||||
| 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 611588294 | HEALTHCARE | CA | N/A | 0 | Yes (1) |
| IMAGING ASSOCIATES LLC | |||||||||
| 3650 PIPER STREET STE A | ANCHORAGE | AK | 99508 | 203906048 | MEDICAL IMAGING | AK | N/A | 0 | Yes (1) |
| INLAND IMAGING LLC | |||||||||
| 801 S STEVENS ST | SPOKANE | WA | 99204 | 911855796 | MEDICAL IMAGING | WA | N/A | 0 | Yes (1) |
| LSC REAL PROPERTY LLC | |||||||||
| 2301 QUAKER AVENUE | LUBBOCK | TX | 79410 | 474646059 | REAL ESTATE | TX | N/A | 0 | 0 |
| METHODIST DIAGNOSTIC IMAGING | |||||||||
| 4005 24TH STREET | LUBBOCK | TX | 79410 | 752343261 | HEALTHCARE | TX | N/A | 0 | 0 |
| MISSION VIEJO PARTNERS II LLC | |||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 823943675 | REAL ESTATE - MOB | CA | N/A | 0 | Yes (1) |
| NEWPORT IMAGING CENTER | |||||||||
| 360 SN MIGUEL | NEWPORT BEACH | CA | 92660 | 330191776 | HEALTHCARE | CA | N/A | 0 | Yes (1) |
| NEWPORT SURGICAL PARTNERS LLC | |||||||||
| 27271 LAS RAMBLAS 350 | MISSION VIEJO | CA | 92691 | 392060266 | HEALTHCARE | CA | N/A | 0 | Yes (1) |
| OREGON ADVANCED IMAGING LLC | |||||||||
| 881 OHARE PARKWAY | MEDFORD | OR | 97504 | 450471748 | MEDICAL IMAGING | OR | N/A | 0 | 0 |
| OREGON OUTPATIENT SURGERY CENTER | |||||||||
| 7300 SW CHILDS RD | TIGARD | OR | 97224 | 223883387 | AMBULATORY SURGERY CENTER | OR | N/A | 0 | 0 |
| PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC | |||||||||
| 1221 MADISON STREET | SEATTLE | WA | 98104 | 203132044 | MEDICAL IMAGING | WA | N/A | 0 | 0 |
| PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO | |||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 812701056 | INVESTMENTS | WA | N/A | 0 | 0 |
| PROV RADIATION ONCOLOGY DEVELOP ASSN LLC | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260682491 | REAL ESTATE - MOB | OR | N/A | 0 | 0 |
| PROVIDENCE CHILDREN'S NEONATAL SVCS | |||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 470918549 | NEONATAL CARE | WA | N/A | 0 | 0 |
| PROVIDENCE IMAGING CENTER JOINT VENTURE | |||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 920118807 | MEDICAL IMAGING | AK | N/A | 0 | 0 |
| PROVIDENCE ST JOSEPH HEALTH LONG TERM PORTFOLIO | |||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 823190634 | INVESTMENTS | WA | N/A | 0 | 0 |
| PROVIDENCE SURGERY CENTER LLC | |||||||||
| 902 N ORANGE ST | MISSOULA | MT | 59802 | 841401625 | AMBULATORY SURGERY CENTER | MT | N/A | 0 | 0 |
| PROVIDENCE UCLA USP SURGERY CENTER JV | |||||||||
| 14201 DALLAS PARKWAY | DALLAS | TX | 75254 | 320503030 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | 0 |
| PROVIDENCESILVERTON REHAB LLC | |||||||||
| 4400 NE HALSEY 425 | PORTLAND | OR | 97213 | 481287267 | REHAB SERVICES | OR | N/A | 0 | 0 |
| PROVIDENCEUSP SOUTH BAY SURGERY CENTERS | |||||||||
| 15305 DALLAS PKWY STE 1600 LB 28 | ADDISON | TX | 75001 | 475064486 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | 0 |
| PROVIDENCEUSP SURGERY CTRS LLC | |||||||||
| 11550 INDIAN HILLS ROAD 160 | MISSION HILLS | CA | 91345 | 200684116 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | 0 |
| RADIATION THERAPY INNOVATIONS LLC | |||||||||
| 1221 MADISON ST 1ST FL | SEATTLE | WA | 98104 | 300553035 | HEALTHCARE | WA | N/A | 0 | Yes (1) |
| REDMOND AMBULATORY SURGERY CENTER LLC | |||||||||
| 805 MADISON ST STE 901 | SEATTLE | WA | 98104 | 813558711 | AMBULATORY SURGERY CENTER | WA | N/A | 0 | Yes (1) |
| SANTA ANA MOB LLC | |||||||||
| 1800 QUAIL STREET STE 100 | NEWPORT BEACH | CA | 92660 | 753205306 | REAL ESTATE - MOB | CA | N/A | 0 | Yes (1) |
| SJO ASC HOLDINGS LLC | |||||||||
| 1140 W LA VETA AVE | ORANGE | CA | 92868 | 821655501 | HEALTHCARE | CA | N/A | 0 | 0 |
| ST JOSEPH PHYSICIAN VENTURES I LLC | |||||||||
| 1100 WEST STEWART DRIVE | ORANGE | CA | 92868 | 454521884 | REAL ESTATE | CA | N/A | 0 | Yes (1) |
| ST JOSEPHSATELLITE DIALYSIS CENTERS LLC | |||||||||
| 300 SANTANA ROW SUITE 300 | SAN JOSE | CA | 95128 | 814657391 | HEALTHCARE | CA | N/A | 0 | 0 |
| ST JUDE SURGICAL CENTERS LLC | |||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 823352570 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | Yes (1) |
| SURGERY CENTER AT TANASBOURNE LLC | |||||||||
| 11221 ROE AVE STE 300 | LEAWOOD | KS | 66211 | 208187971 | AMBULATORY SURGERY CENTER | KS | N/A | 0 | 0 |
| TARZANA PEDIATRIC VENTURES LLC | |||||||||
| 18321 CLARK ST | TARZANA | CA | 91356 | 821308306 | HEALTHCARE | CA | N/A | 0 | 0 |
| THE MADISON SPOKANE INN LLC | |||||||||
| 15 WEST ROCKWOOD BLVD | SPOKANE | WA | 99204 | 841606484 | HOTEL SERVICES | WA | N/A | 0 | Yes (1) |
| YELM MEDICAL OFFICE BUILDING | |||||||||
| 2840 CRITES ST SW STE 104 | TUMATER | WA | 98512 | 263685020 | REAL ESTATE - MOB | WA | N/A | 0 | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (40 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1221 MADISON STREET OWNERS ASSOC | ||||||||||||
| 747 BROADWAY | SEATTLE | WA | 98122 | 201954319 | OWNERS' ASSOCIATION | WA | N/A | C | 0 | |||
| ACCLARA SOLUTIONS INTERMEDIATE LLC | ||||||||||||
| 10713 W SAM HOUSTON PKWY N 500 | HOUSTON | TX | 77064 | 371783298 | HEALTHCARE FINANCIAL SERVICES | TX | N/A | C | 0 | |||
| AMERICAN UNITY GROUP LTD | ||||||||||||
| CAPTIVE INSURANCE | N/A | C | 0 | 90 PITTS BAY ROAD HM08 PEMBROKE | BD | BD | ||||||
| AYIN HEALTH SOLUTIONS INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 833037172 | HEALTHCARE | DE | N/A | C | 0 | |||
| BOURGET HEALTH SERVICES INC | ||||||||||||
| 101 W 8TH AVE TAF C-9 | SPOKANE | WA | 99204 | 911354431 | CLINICAL/MEDICAL LAB | WA | N/A | C | 0 | |||
| CARON CORPORATION | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810486082 | MEDICAL PHYSICIAN SERVICE | MT | N/A | C | 0 | |||
| COMMUNITY TECHNOLOGIES INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844722399 | IT SVCS | DE | N/A | C | 0 | |||
| DATU HEALTH INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 463070062 | IT SVCS | DE | N/A | C | 0 | |||
| ENDOSCOPY CENTER OF SOUTHERN CALIFORNIA | ||||||||||||
| 1301 20TH ST STE 280 | SANTA MONICA | CA | 90404 | 952880495 | HEALTHCARE | CA | N/A | S | 0 | |||
| ENGAGE IT SERVICES INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844058573 | IT SVCS | DE | N/A | C | 0 | |||
| HMR WEIGHT MANAGEMENT SERVICES CORP | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 463598718 | HEALTHCARE | WA | N/A | C | 0 | |||
| HOAG MANAGEMENT SERVICES INC | ||||||||||||
| 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 330731587 | HEALTHCARE | CA | N/A | C | 0 | |||
| HOAG PHYSICIAN PARTNERS | ||||||||||||
| 16148 SAND CANYON AVE | IRVINE | CA | 92618 | 834276044 | HEALTHCARE | CA | N/A | C | 0 | |||
| LUBBOCK METHODIST HOSP PRACTICE MGMT | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752578995 | INACTIVE | TX | N/A | C | 0 | |||
| LUBBOCK METHODIST HOSPITAL SVCS | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752118585 | HEALTHCARE | TX | N/A | C | 0 | |||
| LUMEDIC INC (FKA LUMEDIC ACQ CO INC) | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 833881097 | HEALTHCARE | WA | N/A | C | 0 | |||
| MEDICAL SPECIALTIES MANAGERS INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330406218 | HEALTHCARE | WA | N/A | C | 0 | |||
| MEDIREVV INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 208783763 | HEALTHCARE | DE | N/A | C | 0 | |||
| MISSION VIEJO MEDICAL VENTURES | ||||||||||||
| 27800 MEDICAL CENTER RD 354 | MISSION VIEJO | CA | 92691 | 330212905 | HEALTHCARE | CA | N/A | C | 0 | |||
| PERFORMANCE HEALTH TECHNOLOGY LTD | ||||||||||||
| 3993 FAIRVIEW INDUSTRIAL DR SE | SALEM | OR | 97302 | 931211733 | HEALTHCARE | OR | N/A | C | 0 | |||
| PHN HOLDINGS | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 461814184 | STRATEGIC PLANNING SERVICES | CA | N/A | C | 0 | |||
| PIONEER INNOVATIONS INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 364818191 | HEALTHCARE INNOVATIONS | WA | N/A | C | 0 | |||
| PROVIDENCE ASSURANCE INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 208194071 | CAPTIVE INSURANCE | AZ | N/A | C | 0 | |||
| PROVIDENCE GLOBAL CENTER LLP | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 981516461 | IT SVCS | N/A | C | 0 | IN | |||
| PROVIDENCE HCC HOLDINGS INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | HOLDING COMPANY | CA | N/A | C | 0 | ||||
| PROVIDENCE HEALTH CARE VENTURES INC | ||||||||||||
| 101 W 8TH AVE TAF C-9 | SPOKANE | WA | 99204 | 900155714 | CLINICAL/MEDICAL LAB | WA | N/A | C | 0 | |||
| PROVIDENCE HEALTH NETWORK | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 800886966 | PREPAID HEALTHCARE | CA | N/A | C | 0 | |||
| PROVIDENCE HEALTH VENTURES INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330122216 | INVESTMENT | CA | N/A | C | 0 | |||
| PROVIDENCE PHYSICIAN SERVICES CO | ||||||||||||
| 101 W 8TH AVE TAF C-9 | SPOKANE | WA | 99204 | 911216033 | HEALTHCARE | WA | N/A | C | 0 | |||
| PROVIDENCE ST JOSEPH HEALTH NETWORK | ||||||||||||
| 20555 EARL ST | TORRANCE | CA | 90503 | 823771547 | HEALTHCARE | CA | N/A | C | 0 | |||
| QUIVIQ INC | ||||||||||||
| 1400-112TH AVENUE ST SUITE 100 | BELLEVUE | WA | 98004 | 833879444 | HEALTHCARE ANALYTICS | WA | N/A | C | 0 | |||
| ST JOSEPH HEALTH | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 462340232 | HOLDING COMPANY | CA | N/A | C | 0 | |||
| ST JOSEPH HEALTH SOURCE INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 461900168 | HEALTHCARE | CA | N/A | C | 0 | |||
| ST JOSEPH PROF SVCS ENTERPRSES INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330155323 | HEALTHCARE | CA | N/A | C | 0 | |||
| TEGRIA HOLDINGS LLC (FKA GRADY BLOCKER LLC) | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 842092143 | HOLDING COMPANY | DE | N/A | C | 0 | |||
| TEGRIA RCM GROUP INC (FKA PROV RCM GROUP INC) | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844686520 | HOLDING COMPANY | DE | N/A | C | 0 | |||
| TEGRIA SERVICES GROUP INC (FKA PROVIDENCE SERVICES GROUP) | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844704409 | HOLDING COMPANY | DE | N/A | C | 0 | |||
| TEGRIA SERVICES GROUP-US INC (FKA BLUETREE NETWORK INC) | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 900872936 | HEALTHCARE | WI | N/A | C | 0 | |||
| VINSERRA INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 953943315 | INVESTMENT | CA | N/A | C | 0 | |||
| WESTERN HEALTHCONNECT VENTURES INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 800953654 | INVESTMENT | WA | N/A | C | 0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PROVIDENCE HEALTH & SERVICES WASHINGTON | ||
| R | $12,631,595 | COST |
| PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA | ||
| R | $308,047,486 | COST |
| PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION | ||
| R | $419,329 | COST |
| PROVIDENCE HEALTH SYSTEM SOUTHERN CALIFORNIA | ||
| R | $98,886 | COST |
| PROVIDENCE MEDICAL INSTITUTE | ||
| C | $83,946 | COST |
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