2020-11-05T21:04:11-06:00 2019-12-31 346565596 ERNST & YOUNG US LLP 4365 EXECUTIVE DRIVE SUITE 1600 SAN DIEGO CA 92121 990EZ 2019-01-01 941156596 ST JOSEPH HOSPITAL OF EUREKA STJO 7074458121 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 PATTI PILGRIM REGIONAL CFO 7074458121 2020-11-05 1 ANDY JAMESON P01894820 8585357200 99.132.79.23 2020-11-05 20:31:16 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 C03E818AF5564214394D8BCBF65FFCB8F048BD21 2019 2021-01-29 14:40:06Z X X 0928 X X HTTPS://WWW.STJOEHUMBOLDT.ORG/ X X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 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. PROVIDENCEON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT TO FORM PROVIDENCE ST. JOSEPH HEALTH (PROVIDENCE). BY COMING TOGETHER, PROVIDENCE SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 1,085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE A CHANGING HEALTH CARE ENVIRONMENT WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE. PROVIDENCE HEALTH & SERVICESIN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. ST. JOSEPH HEALTH SYSTEMIN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK, TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA. PROVIDENCE ST. JOSEPH HEALTH IS THE CORPORATE MEMBER OF ST. JOSEPH HEALTH SYSTEM (SJHS). SJHS IS THE SOLE MEMBER OF ST. JOSEPH HOSPITAL OF EURKEA (SJHE) AND IS RECOGNIZED AS INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) ORGANIZATION AND IS COMPLYING WITH IRC SECTION 501(R). SJHS HAS CONSOLIDATED AND SIMPLIFIED ITS STRUCTURE BY MOVING THE OPERATIONS OF SJHE AND THREE OTHER HOSPITAL ORGANIZATIONS INTO A SINGLE LEGAL ENTITY, ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, ON MARCH 31, 2018. 0 0 0 X ROBERTA LUSKIN-HAWK MD CHIEF EXEC EUREKA 2.00 673993 181655 33339 OLUYEMI ADEYANJU ESQ SECRETARY 0.00 544043 101971 0 PAUL OHTA BOARD MEMBER 2.00 448588 92535 0 DAVID SOUTHERLAND INTERIM COO NO CA 7.00 385146 13572 0 JULIE MALVEY VP, MISSION INTEGRATION 2.00 291747 43568 32418 ELLEN MAHONEY MD BOARD MEMBER 2.00 65867 0 0 PETER GOLDBERG MD BOARD MEMBER/CHIEF OF STAFF 2.00 0 0 0 DENNIS LEONARDI BOARD CHAIRPERSON 4.00 0 0 0 RON JONES MD BOARD VICE CHAIR 4.00 0 0 0 BECKY GIACOMINI BOARD MEMBER 2.00 0 0 0 DAVID WELLS BOARD MEMBER 2.00 0 0 0 DONALD WHEELER MD BOARD MEMBER 2.00 0 0 0 X 0 0 0 0 1 0 0 0 0 0 0 0 0 0 CA JONI MURPHY 1165 MONTGOMERY DRIVE SANTA ROSA CA 95405 7075255300 0 0 0 0 0 0 0 0 0 0 NONE NONE 1 X SCHEDULE A, PART I, LINE 3 ST. JOSEPH HOSPITAL OF EUREKA (SJHE) IS IDENTIFIED AS A HOSPITAL OR COOPERATIVE HOSPITAL SERVICE ORGANIZATION UNDER SECTION 170(B)(A)(III) IN SCHEDULE A. HOWEVER, SJHE WAS DISSOLVED ON MARCH 31, 2018, AND THEREFORE DOES NOT FILE A SCHEDULE H WITH THIS 990-EZ. SJHE MAINTAINS GOOD-STANDING AS A LICENSED HOSPITAL, AND REPORTS ALL RELATED FILING REQUIREMENTS ON FORM 990, SCHEDULE H, FOR ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC (EIN: 81-4790143). NO ASSETS WERE DISTRIBUTED 2018-03-31 814794013 SJHNC LLC 1801 LIND AVE SW RENTON WA 98057 501(C)(3) 1 1 0 0 1 1 1 1 0 PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: THE FOLLOWING INDIVIDUALS BECAME AN OFFICER OR TRUSTEE OF THE TRANSFEREEORGANIZATION:OLUYEMI ADEYANJU - OFFICER OF ST. JOSEPH HEALTH NORTHERN CA. LLCKEVIN KLOCKENGA - OFFICER OF ST. JOSEPH HEALTH NORTHERN CA. LLCALL EMPLOYEES OF ST. JOSEPH HOSPITAL OF EUREKA TRANSFERRED TO ST.JOSEPH HEALTH NORTHERN CALIFORNIA, LLC ON 1/1/2019.ON MARCH 31, 2018, ST. JOSEPH HOSPITAL OF EUREKA, ALONG WITH SANTA ROSAMEMORIAL HOSPITAL, REDWOOD MEMORIAL HOSPITAL, AND QUEEN OF THE VALLEYMEDICAL CENTER, COLLECTIVELY THE "HOSPITALS", TRANSFERRED ALL OF THEIRNET ASSETS TO ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, A RELATED501(C)(3) ORGANIZATION. ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC WASCREATED TO CONSOLIDATE AND SIMPLIFY THE CURRENT STRUCTURE BY MOVING THEOPERATIONS OF THE HOSPITALS INTO A SINGLE LEGAL ENTITY. THE OPERATION OFTHE HOSPITALS WILL REMAIN THE SAME. FORM 990-EZ, PART III, LINE 28 PROVIDENCE ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 1,085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE A CHANGING HEALTH CARE ENVIRONMENT WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE. PROVIDENCE HEALTH & SERVICES IN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON. ST. JOSEPH HEALTH SYSTEM IN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA. PROVIDENCE ST. JOSEPH HEALTH IS THE CORPORATE MEMBER OF ST. JOSEPH HEALTH SYSTEM (SJHS). SJHS IS THE SOLE MEMBER OF ST. JOSEPH HOSPITAL OF EURKEA (SJHE) AND IS RECOGNIZED AS INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) ORGANIZATION AND IS COMPLYING WITH IRC SECTION 501(R). SJHS HAS CONSOLIDATED AND SIMPLIFIED ITS STRUCTURE BY MOVING THE OPERATIONS OF SJHE AND THREE OTHER HOSPITAL ORGANIZATIONS INTO A SINGLE LEGAL ENTITY, ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, ON MARCH 31, 2018. THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.