2020-11-04T14:49:45-06:00 2019-12-31 346565596 ERNST & YOUNG US LLP 4365 EXECUTIVE DRIVE SUITE 1600 SAN DIEGO CA 92121 990 2019-01-01 953589356 ST JOSEPH HEALTH SYSTEM STJO 9493814000 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 JO ANN ESCASA-HAIGH EVP/ASSISTANT TREASURER 9493814000 2020-11-04 1 RYAN MAYOR P01650740 8585357200 24.1.248.215 2020-11-04 14:48:43 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 3B0AEB4C10782F86AB23190FF1A36115670650D6 2019 2021-01-29 14:40:06Z X MIKE BUTLER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 547491234 0 0928 X HTTPS://WWW.PROVIDENCE.ORG/ X 1981 CA 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. 15 15 1211 60 0 0 550620 1191555 494210912 522859254 6165586 7048777 17649444 16391648 518576562 547491234 2468820 8848277 0 0 300597076 256023281 0 0 0 256522052 294968144 559587948 559839702 -41011386 -12348468 2607554873 2690773867 2629258814 2728161106 -21703941 -37387239 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. 0 0 268718649 8848277 539250902 SEE SCHEDULE OPROVIDENCEON 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.COMMUNITY BENEFIT OPERATIONSTHE SYSTEM OFFICE ALSO PROVIDES KEY COMMUNITY BENEFIT STRATEGIC SUPPORT TO LOCAL MINISTRIES ON COMMUNITY BENEFIT PLANNING, COMMUNITY HEALTH NEEDS ASSESSMENTS, AND INTERNAL AND EXTERNAL REPORTING. THIS WORK IS ACCOMPLISHED IN PARTNERSHIP WITH VARIOUS KEY SYSTEM OFFICE DEPARTMENTSINCLUDING ADVOCACY, COMMUNITY OUTREACH, LEGAL AND STRATEGIC SERVICES. 268718649 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 X 2503 0 1 1211 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 CA X JO ANN ESCASA-HAIGH 9493814000 3345 MICHELSON DRIVE STE 100 IRVINE CA 92612 MIKE BUTLER PRESIDENT, OPERATIONS 25.00 35.00 X 0 3421103 597820 ERIK WEXLER FORMER EVP CHIEF EXEC PSJH SO CA 0.00 65.00 X 0 2323821 283835 CINDY STRAUSS SECRETARY 7.00 53.00 X 0 1735009 347233 VENKAT BHAMIDIPATI EVP/TREASURER 7.00 53.00 X 0 1615492 304802 RICHARD PARKS REG CE - WEST TX/EASTERN NM 0.00 52.00 X 1263188 0 247209 KEVIN MANEMANN EVP & CE, PHYSICIAN ENTERPRISE 0.00 50.00 X 1180128 0 256025 JO ANN ESCASA-HAIGH EVP, ASSISTANT TREASURER 25.00 35.00 X 0 1188910 217824 KEVIN KLOCKENGA REGIONAL CHIEF EXECUTIVE - NO CA 0.00 50.00 X 1144038 0 231217 ROBERT BRAITHWAITE CHIEF EXECUTIVE, HOAG 0.00 50.00 X 1178924 0 182385 JOHN WHIPPLE ASSISTANT SECRETARY 7.00 53.00 X 0 905646 235831 JIM WATSON ESQ ASSISTANT SECRETARY 50.00 10.00 X 843494 0 137810 BRIAN LEE HELLELAND CHIEF EXECUTIVE - ST. JUDE 0.00 50.00 X 779439 0 196852 MICHAEL MARINO DO CHIEF MED. INFO OFFICER, PSJH 48.00 2.00 X 742870 0 204686 JEREMY ZOCH CHIEF EXECUTIVE - SJO 0.00 50.00 X 682075 0 181203 ROBERTA LUSKIN-HAWK MD CHIEF EXECUTIVE - EUREKA 0.00 50.00 X 673993 0 181655 LARRY COOMES CHIEF EXEC QVMC 0.00 54.00 X 648340 0 199798 RICHARD AFABLE MD FORMER REG EVP, SOUTHERN CA 25.00 25.00 X 0 829005 0 WALTER CATHEY FORMER CHIEF EXECUTIVE, COVENANT 0.00 60.00 X 0 666644 121311 JACK L COX MD SVP, CHIEF MEDICAL OFFICER 48.00 2.00 X 678215 0 55947 MICHELLE WOODLEY CHIEF NURSING INFORMATICS OFFICER 0.00 50.00 X 602523 0 106666 SHANNON DWYER ESQ FORMER EVP, GEN. COUNSEL/SECRETARY 25.00 25.00 X 0 569160 24211 SETH TEIGEN CHIEF EXECUTIVE, MHRMC 0.00 50.00 X 494559 0 51585 TODD SALNAS CEO-SONOMA (PT YR) 0.00 50.00 X 290102 0 42415 TAREK SALAWAY CHIEF EXECUTIVE, MHRMC (PT YR) 0.00 50.00 X 229410 0 21150 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 7.00 53.00 X 0 222743 19991 TAMMY TEODOSIO FORMER ASSISTANT SECRETARY 7.00 53.00 X 0 133465 24894 DAVE OLSEN BOARD VICE CHAIR 2.00 5.10 X 0 65360 0 RICHARD BLAIR PAST CHAIR 2.00 5.80 X 0 50360 0 ISIAAH CRAWFORD PHD BOARD TRUSTEE/COMMITTEE CHAIR 1.00 3.20 X 0 46550 0 DICK P ALLEN BOARD TRUSTEE/COMMITTEE CHAIR 1.00 4.10 X 0 40789 0 MICHAEL HOLCOMB BOARD TRUSTEE/COMMITTEE CHAIR 1.00 4.60 X 0 40391 0 CAROLINA REYES MD BOARD TRUSTEE/COMMITTEE CHAIR 2.00 4.10 X 0 40360 0 MARY LYONS PHD BOARD TRUSTEE/COMMITTEE CHAIR 1.00 3.70 X 0 40360 0 CHARLES SORENSON MD BOARD TRUSTEE 0.10 5.00 X 0 30360 0 PHOEBE YANG BOARD TRUSTEE 2.00 3.60 X 0 30360 0 LYDIA MARSHALL BOARD TRUSTEE 0.10 5.00 X 0 22860 0 KATHARIN DYER BOARD TRUSTEE 0.10 5.00 X 0 0 0 MICHAEL MURPHY BOARD TRUSTEE 0.10 5.00 X 0 0 0 SISTER DIANE HEJNA CSJ RN BOARD TRUSTEE 1.00 4.40 X 0 0 0 SISTER LUCILLE DEAN SP BOARD TRUSTEE 1.00 4.60 X 0 0 0 SISTER PHYLLIS HUGHES RSM DRPH BOARD TRUSTEE 1.00 4.10 X 0 0 0 11431298 14018748 4474355 485 1 1 0 COVENANT MEDICAL GROUP 2215 NASHVILLE AVE LUBBOCK TX 79410 MEDICAL SERVICES 10643877 DAVIS WRIGHT TREMAINE LLP 920 5TH AVE STE 3300 SEATTLE WA 98104 LEGAL SERVICES 9136208 NORTHSTAR ANESTHESIA PA 6225 N STATE HIGHWAY 161 STE 200 IRVING TX 75038 MEDICAL SERVICES 9091825 UNIVERSITY OF CALIFORNIA SAN FRANCISCO PO BOX 39000 SAN FRANCISCO CA 94139 RESEARCH/LAB SERVICES 8152887 INPATIENT SERVICES OF CALIFORNIA INC 7032 COLLECTION CENTER DR CHICAGO IL 60693 MEDICAL SERVICES 7693674 406 977880 213675 1191555 SUPPORT & SERVICE REV 561110 420309991 420309991 HOME HEALTH SERVICES 621110 102549263 102549263 522859254 7048777 7048777 REBATE/REFUND 561110 15686981 15686981 RESEARCH 541715 479667 479667 SETTLEMENT/REIMB. 561110 225000 225000 16391648 547491234 539250902 0 7048777 X 8848277 8848277 17125133 8562567 8562566 213270881 155799315 57471566 8669590 5571189 3098401 489367 352344 137023 16468310 11875383 4592927 2290325 1832140 458185 19397177 492482 18904695 462795 185600 277195 205914 205914 93708109 47951293 45756816 130898 16183 114715 9912908 4604254 5308654 7635829 1347652 6288177 7213796 4947048 2266748 360194 217124 143070 9490483 234428 9256055 63652883 405985 63246898 OTHER DIRECT EXPENSES 66186167 2182450 64003717 MEDICAL SUPPLIES 11402584 11402584 DUES AND SUBSCRIPTIONS 1828228 1600729 227499 LICENSES & TAXES 558757 194103 364654 531097 95519 435578 559839702 268718649 291121053 0 135717358 59646134 24450399 25027427 0 15408396 431154 515113 23125054 92062058 491850884 328422916 198447525 163427968 207255885 126772054 21751986 65596080 35892001 36173333 1960483511 2106145304 2607554873 2690773867 238727860 124791194 0 1130764 106806358 0 2283724596 2602239148 2629258814 2728161106 X -19572969 -37660820 -2130972 273581 -21703941 -37387239 2607554873 2690773867 X -12348468 12308469 -15643299 X 0 1 X 1 0 X X 2 ST JOSEPH HEALTH MINISTRY 271666576 1 1 0 0 PROVIDENCE MINISTRIES 000000000 1 1 0 0 2 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 SCHEDULE A, PART I, LINE 12G, COLUMN VI ST. JOSEPH HEALTH SYSTEM (SJHS) GOVERNS AND MANAGES A HEALTH CARE SYSTEM COMPRISED OF CHARITABLE HOSPITALS AND OTHER CHARITABLE HEALTH PROGRAMS TO CARRY OUT THE MISSION AND PHILOSOPHY OF HEALTH CARE OF ITS FOUNDING SPONSOR, THE SISTERS OF ST. JOSEPH OF ORANGE, IN ACCORDANCE WITH THE SUPPORTED ORGANIZATIONS, ST. JOSEPH HEALTH MINISTRY (SJHM) AND PROVIDENCE MINISTRIES, AND THE ETHICAL PRINCIPLES OF THE ROMAN CATHOLIC CHURCH. SJHS PROVIDES GUIDANCE, CONSULTATION AND, IN SOME CASES, CENTRAL MANAGEMENT AND ADMINISTRATIVE STAFF SERVICES TO EACH HOSPITAL WITHIN THE HEALTH CARE SYSTEM. SCHEDULE A, PART IV, SECTION A, LINE 2 ST. JOSEPH HEALTH MINISTRY (SJHM) IS AN INTEGRATED AUXILIARY OF THE SISTERS OF ST. JOSEPH OF ORANGE, A RELIGIOUS ORDER OF THE ROMAN CATHOLIC CHURCH, WITH ITS MOTHERHOUSE IN ORANGE, CALIFORNIA. THE PURPOSE OF THIS ORGANIZATION IS TO: A. CARRY OUT THE HEALING MINISTRY OF JESUS CHRIST IN THE CHURCH THROUGH THE OWNERSHIP, MANAGEMENT AND GOVERNANCE OF HEALTH CARE FACILITIES, PROGRAMS AND SERVICES INTENDED TO IMPROVE THE HEALTH OF INDIVIDUALS AND THE COMMUNITIES SERVED; B. CONDUCT ITS ACTIVITIES IN A MANNER CONSISTENT WITH THE TEACHINGS AND LAWS OF THE ROMAN CATHOLIC CHURCH; C. ADHERE TO THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES AS APPROVED BY THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS, AS APPLIED BY THE DIOCESAN BISHOP AND AS AMENDED FROM TIME TO TIME, AS WELL AS BY ANY GUIDING PRINCIPLES WHICH MAY BE GIVEN BY THE CORPORATE MEMBERS; AND D. SEEK OPPORTUNITIES FOR CO-MINISTRY WITH OTHER RELIGIOUS ORGANIZATIONS WHICH HAVE A LIKE PURPOSE OF ESTABLISHING HEALTH CARE SYSTEMS WITH A CHRISTIAN DIMENSION. SJHM AND PROVIDENCE MINISTRIES ARE INCLUDED IN THE GROUP RULING ISSUED TO THE UNITED STATES CONFERENCE OF CATHOLIC BISHOPS BY THE IRS (GROUP EXEMPTION NUMBER 0928), WHICH EXEMPTS THE FOLLOWING FROM INCOME TAX UNDER IRC SECTION 501(C)(3): THE AGENCIES AND INSTRUMENTALITIES AND THE EDUCATIONAL, CHARITABLE, AND RELIGIOUS INSTITUTIONS OPERATED, SUPERVISED OR CONTROLLED BY OR IN CONNECTION WITH THE ROMAN CATHOLIC CHURCH IN THE UNITED STATES, ITS TERRITORIES OR POSSESSIONS APPEARING IN THE OFFICIAL CATHOLIC DIRECTORY. SJHM AND PROVIDENCE MINISTRIES ARE LISTED IN THE OFFICIAL CATHOLIC DIRECTORY AND ARE THEREBY EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). AS A RESULT OF THE GROUP RULING, SJHM AND PROVIDENCE MINISTRIES DO NOT HAVE A DETERMINATION LETTER FROM THE IRS. SCHEDULE A, PART IV, SECTION A, LINE 6 THE MISSION, AND PRIMARY ACTIVITIES, OF ST. JOSEPH HEALTH SYSTEM (SJHS) IS TO GOVERN AND MANAGE A HEALTH CARE SYSTEM COMPRISED OF CHARITABLE HOSPITALS AND OTHER CHARITABLE HEALTH PROGRAMS TO CARRY OUT THE MISSION AND PHILOSOPHY OF HEALTH CARE OF ITS FOUNDING SPONSOR, THE SISTERS OF ST. JOSEPH OF ORANGE, IN ACCORDANCE WITH ITS SUPPORTED ORGANIZATIONS, ST. JOSEPH HEALTH MINISTRY (SJHM) AND PROVIDENCE MINISTRIES, AND THE ETHICAL PRINCIPLES OF THE ROMAN CATHOLIC CHURCH. SEE ADDITIONAL INFORMATION IN SCHEDULE A, PART IV, SECTION B, QUESTION 2 REGARDING HOW SJHS CARRIED OUT THE PURPOSES OF ITS SUPPORTED ORGANIZATION BY PROVIDING SUPPORT TO ALL OF THE HEALTH MINISTRIES WITHIN ST. JOSEPH HEALTH. ST. JOSEPH HEALTH RECOGNIZES THAT THE HEALTH OF ANY COMMUNITY DEPENDS ON THE MAINTENANCE AND CREATION OF STRONG STRUCTURES, BOTH PHYSICAL AND SOCIAL, WHICH CONTRIBUTE TO THE LONG-TERM WELL-BEING OF PEOPLE. THAT PHILOSOPHY INSPIRED THE INITIATION OF THE COMMUNITY INVESTMENT FUND (THE CIF), AN EFFORT TO SUPPORT ORGANIZATIONS THAT PROMOTE THE COMMON GOOD. THERE WERE TWENTY LOW-INCOME ACTIVE INVESTMENTS MANAGED BY THE PROVIDENCE TREASURY DEPARTMENT. INVESTMENTS INCLUDE LOW INTEREST LOANS, LINES OF CREDIT AND CD COLLATERAL. SOME OF THE PROGRAMS SUPPORTED THROUGH THE CIF INCLUDE: AFFORDABLE HOUSING, ECONOMIC DEVELOPMENT INITIATIVES, SOCIAL SERVICES, JOB EXPANSION, AND SCHOOL AND EDUCATIONAL PROGRAMS. SCHEDULE A, PART IV, SECTION B, LINE 2 THE MISSION OF ST. JOSEPH HEALTH SYSTEM (SJHS) IS TO GOVERN AND MANAGE A HEALTH CARE SYSTEM COMPRISED OF CHARITABLE HOSPITALS AND OTHER CHARITABLE HEALTH PROGRAMS TO CARRY OUT THE MISSION AND PHILOSOPHY OF HEALTH CARE OF ITS FOUNDING SPONSOR, THE SISTERS OF ST. JOSEPH OF ORANGE, IN ACCORDANCE WITH ITS SUPPORTED ORGANIZATIONS, ST. JOSEPH HEALTH MINISTRY (SJHM) AND PROVIDENCE MINISTRIES, AND THE ETHICAL PRINCIPLES OF THE ROMAN CATHOLIC CHURCH. SJHS ALSO ASSURES THE CONTINUED DEVELOPMENT AND QUALITY OF EACH HOSPITAL AND OF EACH HEALTH PROGRAM WITHIN THE HEALTH CARE SYSTEM BY PROVIDING GUIDANCE, CONSULTATION AND, IN SOME CASES, CENTRAL MANAGEMENT AND ADMINISTRATIVE STAFF SERVICES. THE HOSPITAL MINISTRIES ARE ESTABLISHED FOR THE PURPOSES OF DELIVERING HEALTH SERVICES TO THE PEOPLE IN THE COMMUNITIES WE SERVE (NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, WEST TEXAS AND EAST NEW MEXICO). THESE SERVICES INCLUDE INPATIENT AND OUTPATIENT CARE, EDUCATIONAL PROGRAMS, RESEARCH ACTIVITIES AND PARTICIPATION IN OTHER ACTIVITIES DESIGNED TO PROMOTE THE GENERAL HEALTH, REHABIITATION AND SOCIAL NEEDS OF THE COMMUNITY. PROVIDING SUCH BENEFIT TO THE HOSPITAL MINISTRIES ALSO CARRIES OUT THE PURPOSE OF SJHS'S SUPPORTED ORGANIZATIONS, SJHM AND PROVIDENCE MINISTRIES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 192180 192180 0 PART II-B, LINE 1: THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO ST. JOSEPH HEALTH SYSTEM. 11230000 11230000 17648542 9417625 8230917 25187773 14749398 10438375 52004370 49549956 2454414 385780199 254705937 131074262 163427968 I/C - TAX-EXEMPT BOND ASSETS 2024195574 DUE FROM AFFILIATES 47848164 SJHS ROU ASSET OPER LEASE BLDG 18679050 SJHS SWAP MARK TO MARKET 15422516 2106145304 I/C - TAX-EXEMPT BOND LIABILITIES 2289615232 SJHS INVESTMENT PENDING TRADES-SYS POOLED NT 142696463 SWAP MARKET VALUATION 116680602 SJHS LT OPER LEASE LIAB BUILDINGS 23442047 ACCRUED RETIREMENT COMPENSATION 19262763 SJHS CP OF LT OP LEASE LIAB BLDG 6332356 ASBESTOS LIABILITY 3140653 CAPITAL LEASE OBLIGATIONS 1069032 2602239148 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 PROGRAM SERVICE EXPENSE SEE PART IV 263101 0 0 0 0 0 0 263101 0 263101 0 0 1 1 1 0 PART III ACCOUNTING METHOD: PART I, LINE 3, COLUMN (E): ST. JOSEPH HEALTH SYSTEM MEMBERS OF THE BOARD AND EXECUTIVE MANAGEMENT TEAM ARE SELECTED TO PARTICIPATE IN AN ANNUAL PILGRIMAGE TO LE PUY, FRANCE, WHERE THE SISTERS' FIRST CONGREGATION WAS FORMED. THE PURPOSE OF THE PILGRIMAGE IS FOR THE ORGANIZATION'S LEADERS TO DEVELOP A DEEPER UNDERSTANDING OF THE ROOTS AND HERITAGE OF THE ORGANIZATION IN ORDER TO CARRY OUT THE MISSION. PART I, LINE 3, COLUMN (F): ACCOUNTING METHOD THE ACCRUAL METHOD WAS USED TO DETERMINE THE AMOUNTS IN COLUMN (F). 1 SISTERS OF ST JOSEPH OF ORANGE 480 S BATAVIA ORANGE CA 92868 951643383 501(C)(3) 8733525 PROGRAM SUPPORT AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 50000 PROGRAM SUPPORT THE ORANGE CATHOLIC FOUNDATION 13280 CHAPMAN AVENUE SUITE 430 GARDEN GROVE CA 92840 330934571 501(C)(3) 30000 PROGRAM SUPPORT TALLER SAN JOSE HOPE BUILDERS FIX 801 N BROADWAY SANTA ANA CA 92701 593816355 501(C)(3) 10000 PROGRAM SUPPORT 4 PART I, LINE 2: 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. X X X X X X 1 1 1 1 0 0 0 0 0 1 0 MIKE BUTLER PRESIDENT, OPERATIONS 0 1445448 0 1133982 0 841673 0 571275 0 26545 0 4018923 0 1472737 ERIK WEXLER FORMER EVP CHIEF EXEC PSJH SO CA 0 977457 0 874244 0 472120 0 263235 0 20600 0 2607656 0 710614 CINDY STRAUSS SECRETARY 0 823797 0 528043 0 383169 0 321803 0 25430 0 2082242 0 640817 VENKAT BHAMIDIPATI EVP/TREASURER 0 1050394 0 523975 0 41123 0 280148 0 24654 0 1920294 0 319593 RICHARD PARKS REG CE - WEST TX/EASTERN NM 797406 0 453878 0 11904 0 216500 0 30709 0 1510397 0 0 0 KEVIN MANEMANN EVP & CE, PHYSICIAN ENTERPRISE 715863 0 355580 0 108685 0 222792 0 33233 0 1436153 0 0 0 JO ANN ESCASA-HAIGH EVP, ASSISTANT TREASURER 0 722963 0 270658 0 195289 0 209155 0 8669 0 1406734 0 427495 KEVIN KLOCKENGA REGIONAL CHIEF EXECUTIVE - NO CA 696204 0 440231 0 7603 0 195574 0 35643 0 1375255 0 0 0 ROBERT BRAITHWAITE CHIEF EXECUTIVE, HOAG 800010 0 374912 0 4002 0 166222 0 16163 0 1361309 0 0 0 JOHN WHIPPLE ASSISTANT SECRETARY 0 470433 0 259537 0 175676 0 210397 0 25434 0 1141477 0 300654 JIM WATSON ESQ ASSISTANT SECRETARY 467350 0 370314 0 5830 0 103753 0 34057 0 981304 0 0 0 BRIAN LEE HELLELAND CHIEF EXECUTIVE - ST. JUDE 586346 0 185872 0 7221 0 167488 0 29364 0 976291 0 0 0 MICHAEL MARINO DO CHIEF MED. INFO OFFICER, PSJH 570324 0 163263 0 9283 0 173876 0 30810 0 947556 0 0 0 JEREMY ZOCH CHIEF EXECUTIVE - SJO 517878 0 158339 0 5858 0 146054 0 35149 0 863278 0 0 0 ROBERTA LUSKIN-HAWK MD CHIEF EXECUTIVE - EUREKA 451632 0 171999 0 50362 0 150331 0 31324 0 855648 0 33339 0 LARRY COOMES CHIEF EXEC QVMC 434385 0 207928 0 6027 0 148141 0 51657 0 848138 0 0 0 RICHARD AFABLE MD FORMER REG EVP, SOUTHERN CA 0 0 0 0 0 829005 0 0 0 0 0 829005 0 0 WALTER CATHEY FORMER CHIEF EXECUTIVE, COVENANT 0 434511 0 227279 0 4854 0 89286 0 32025 0 787955 0 0 JACK L COX MD SVP, CHIEF MEDICAL OFFICER 169710 0 130985 0 377520 0 48593 0 7354 0 734162 0 0 0 MICHELLE WOODLEY CHIEF NURSING INFORMATICS OFFICER 351392 0 240052 0 11079 0 81947 0 24719 0 709189 0 0 0 SHANNON DWYER ESQ FORMER EVP, GEN. COUNSEL/SECRETARY 0 0 0 0 0 569160 0 0 0 24211 0 593371 0 0 SETH TEIGEN CHIEF EXECUTIVE, MHRMC 197936 0 100000 0 196623 0 37789 0 13796 0 546144 0 0 0 TODD SALNAS CEO-SONOMA (PT YR) 106882 0 181835 0 1385 0 32452 0 9963 0 332517 0 0 0 TAREK SALAWAY CHIEF EXECUTIVE, MHRMC (PT YR) 64458 0 163501 0 1451 0 18816 0 2334 0 250560 0 0 0 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 0 200073 0 22110 0 560 0 10673 0 9318 0 242734 0 22110 TAMMY TEODOSIO FORMER ASSISTANT SECRETARY 0 115500 0 0 0 17965 0 12772 0 12122 0 158359 0 0 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. TRAVEL FOR COMPANIONS SPOUSE OR COMPANION TRAVEL. TRAVEL EXPENSES INCURRED BY A PROVIDENCE EMPLOYEE'S SPOUSE OR COMPANION WILL NOT BE REIMBURSED BY PROVIDENCE UNLESS THE SPOUSE OR COMPANION IS REQUIRED TO, OR INVITED TO ATTEND A PROVIDENCE SYSTEM-SPONSORED MEETING, OR FOR TRAVEL RELATED TO RELOCATION. RELOCATION-RELATED VISITS SHOULD NOT EXCEED TWO RELOCATION-RELATED VISITS, UNLESS APPROVED BY THE EXECUTIVE VICE PRESIDENT, CHIEF ADMINISTRATIVE OFFICER OF PROVIDENCE. THESE EXPENSES MAY BE CONSIDERED A TAXABLE BENEFIT BY THE IRS AND IF SO, ARE INCLUDED ON THE EMPLOYEE'S FORM W-2. ROBERTA LUSKIN-HAWK - $2,565 LARRY COOMES - $2,565 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 SUPPLEMENTAL COMPENSATION INFORMATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX-EXEMPT PARENT, PROVIDENCE, 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 INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE YEAR: SHANNON DWYER, ESQ. - $ 573,310 RICHARD AFABLE, M.D. - $ 829,005 NONQUALIFIED RETIREMENT PLAN 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 - $795,755 ERIK WEXLER - $364,484 CINDY STRAUSS - $344,018 JO ANN ESCASA-HAIGH - $156,837 ROBERT BRAITHWAITE - $148,022 JOHN WHIPPLE - $146,592 ROBERTA LUSKIN-HAWK - $33,339 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. FORM 990, PART V, LINE 1A ST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR SJHS ENTITIES FROM ITS SHARED SERVICES. SJHS ISSUES FORM 1099-MISC UNDER ITS TAX ID NUMBER AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS PROVIDENCE ST. JOSEPH HEALTH IS THE SOLE CORPORATE MEMBER OF ST. JOSEPH HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ST. JOSEPH HEALTH SYSTEM HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE ST. JOSEPH HEALTH SYSTEM BOARD. ALL TRUSTEE NOMINATIONS THAT COME FROM THE ST. JOSEPH HEALTH SYSTEM BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE, AS THE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE PROVIDENCE MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, EXEMPT PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE CORPORATE MEMBER, PROVIDENCE ST. JOSEPH HEALTH, RESERVES THE RIGHT TO APPROVE THE PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW 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. MANAGEMENT PRESENTED THE RETURNS TO THE AUDIT COMMITTEE, AND DISCUSSED KEY DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. IN ADDITION, A COPY OF THE FORM 990 WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING. 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. 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 15B PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX-EXEMPT PARENT, PROVIDENCE, 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 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS 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 GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 36,331,909. MANAGEMENT AND GENERAL EXPENSES 33,776,337. TOTAL EXPENSES 70,108,246. AGENCY & CONTRACT LABOR: PROGRAM SERVICE EXPENSES 9,348,963. MANAGEMENT AND GENERAL EXPENSES 5,183,536. TOTAL EXPENSES 14,532,499. MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,162,385. MANAGEMENT AND GENERAL EXPENSES 750. TOTAL EXPENSES 1,163,135. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 1,004,050. MANAGEMENT AND GENERAL EXPENSES 6,602,491. TOTAL EXPENSES 7,606,541. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 103,986. MANAGEMENT AND GENERAL EXPENSES 134,824. TOTAL EXPENSES 238,810. OTHER PATIENT SERVICES: MANAGEMENT AND GENERAL EXPENSES 58,878. TOTAL EXPENSES 58,878. FORM 990, PART XI, LINE 9: CHANGE IN FMV OF SWAP AGREEMENT -32,706,701. EQUITY TRANSFERS 17,063,402. 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