ST JOSEPH HOME CARE NETWORK: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- ST JOSEPH HOME CARE NETWORK (EIN 68-0331084)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-04
- IRS object ID
- 202023099349302752
- Schema version
- 2019v5.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-04T16:40:00-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | 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 | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680331084 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOSEPH HOME CARE NETWORK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STJO | BusinessNameControlTxt |
| Phone | 7072069124 | 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 | MARK PROVAN | PersonNm |
| Person Title | EXECUTIVE DIR. | PersonTitleTxt |
| Phone | 7072069124 | PhoneNum |
| Signature | 2020-11-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AERRIAL ORR | PreparerPersonNm |
| PTIN | P01598400 | PTIN |
| Phone | 4158948000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 173.69.35.40 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-04 | IPDt |
| IP Tm | 16:27:20 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | C1D173E94BF8F437F31B2A2A0842E69A37E5B0FF | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | MARK PROVAN | 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 | $37,141,406 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STJOSEPHHOMECARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 338 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $517,862 | PYContributionsGrantsAmt |
| CY Contributions Grants | $900,037 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $29,168,700 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $35,371,146 | CYProgramServiceRevenueAmt |
| PY Investment Income | $58,405 | PYInvestmentIncomeAmt |
| CY Investment Income | $36,073 | CYInvestmentIncomeAmt |
| PY Other Revenue | $611,393 | PYOtherRevenueAmt |
| CY Other Revenue | $806,083 | CYOtherRevenueAmt |
| PY Total Revenue | $30,356,360 | PYTotalRevenueAmt |
| CY Total Revenue | $37,113,339 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,023 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $22,431,972 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,286,542 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $187,375 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,402,043 | PYOtherExpensesAmt |
| CY Other Expenses | $12,741,804 | CYOtherExpensesAmt |
| PY Total Expenses | $31,837,038 | PYTotalExpensesAmt |
| CY Total Expenses | $37,028,346 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,480,678 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $84,993 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,397,456 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,800,486 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $27,433,904 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $25,448,202 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$10,036,448 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$13,647,716 | 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 | $31,262,590 | ExpenseAmt |
| Revenue | $35,371,146 | RevenueAmt |
| Desc | SEE SCHEDULE OPROVIDENCE ST. JOSEPH HEALTH SYSTEMON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH 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.PROGRAM SERVICE ACCOMPLISHMENTS THE PRIMARY SERVICE PROVIDED BY THE AGENCY IS HOME CARE SERVICES IN THE FORM OF NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, SOCIAL WORK, AID SERVICES, AND HOSPICE SERVICES. FOR MORE INFORMATION ABOUT ST. JOSEPH HOME CARE NETWORK, PLEASE VISIT WWW.STJOSEPHHOMECARE.ORG FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORG. FOR MORE INFORMATION ABOUT PROVIDENCE ST. JOSEPH HEALTH, PLEASE VISIT WWW.PSJHEALTH.ORG | Desc |
| Total Program Service Expenses | $31,262,590 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | 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 | 0 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 338 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | 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 | 0 | InvestmentInJointVentureInd |
| 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 | LYDIA THANGAYIAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7147127130 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 W CENTER ST PROMENADE SUITE 200 | AddressLine1Txt |
| City | ANAHEIM | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92805 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| KEVIN KLOCKENGA | ||||||||
| REGIONAL CHIEF EXECUTIVE - NO CA | 4.00 | 46.00 | Yes (X) | Yes (X) | $0 | $1,144,038 | $231,217 | |
| ROBERTA LUSKIN-HAWK MD | ||||||||
| TRUSTEE | 2.00 | 48.00 | Yes (X) | $0 | $673,993 | $181,655 | ||
| LARRY COOMES | ||||||||
| TRUSTEE | 2.00 | 52.00 | Yes (X) | $0 | $648,340 | $199,798 | ||
| ROBERT JUST III | ||||||||
| TRUSTEE | 2.00 | 50.00 | Yes (X) | $0 | $530,604 | $147,002 | ||
| OLUYEMI ADEYANJU ESQ | ||||||||
| SECRETARY | 2.00 | 48.00 | Yes (X) | $0 | $544,043 | $101,971 | ||
| CARMELO MOCERI | ||||||||
| TRUSTEE | 2.00 | 48.00 | Yes (X) | $0 | $465,044 | $79,712 | ||
| TYLER HEDDEN | ||||||||
| CEO-CHIEF EXEC OFFICER-SONOMA | 42.00 | 8.00 | Yes (X) | Yes (X) | $0 | $479,748 | $45,798 | |
| MARK PROVAN | ||||||||
| CHIEF OPS/WORKFORCE INT OFF | 25.00 | 25.00 | Yes (X) | Yes (X) | $0 | $421,096 | $56,415 | |
| AMY MASSEY | ||||||||
| MGR, HOME HEALTH/HOSPICE MRKTNG | 50.00 | 0.00 | $266,274 | $0 | $20,403 | Yes (X) | ||
| JILL LAMB | ||||||||
| CLINICAL PHARMACIST | 50.00 | 0.00 | $250,195 | $0 | $28,394 | Yes (X) | ||
| MICHAEL ROBINSON | ||||||||
| CHIEF HOME HEALTH | 50.00 | 0.00 | $251,032 | $0 | $20,317 | Yes (X) | ||
| JEAN MEHLSACK | ||||||||
| DIRECTOR, HOME HEALTH | 50.00 | 0.00 | $241,045 | $0 | $25,115 | Yes (X) | ||
| DANIEL DWYER | ||||||||
| TRUSTEE | 2.00 | 48.00 | Yes (X) | $0 | $238,297 | $25,206 | ||
| DANA CODRON | ||||||||
| TRUSTEE | 2.00 | 50.00 | Yes (X) | $0 | $209,800 | $37,970 | ||
| JEFFREY PATAJO | ||||||||
| PHYSICAL THERAPIST | 50.00 | 0.00 | $216,667 | $0 | $23,321 | Yes (X) | ||
| MAUREEN DISBOT | ||||||||
| TRUSTEE | 2.00 | 48.00 | Yes (X) | $0 | $209,786 | $13,920 | ||
| VINCENT CASTALDO | ||||||||
| CHIEF FINANCIAL OFFICER | 25.00 | 25.00 | Yes (X) | $0 | $49,761 | $2,706 | ||
| DAN JANICAK | ||||||||
| TRUSTEE/INTERIM CFO | 42.00 | 8.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOHN PETERS | ||||||||
| TRUSTEE | 2.00 | 48.00 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,225,213 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,614,550 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,240,920 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | 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 |
|---|---|---|---|---|---|
| HOSPICE PHARMACY SOLUTIONS | |||||
| PO BOX 161583 | ATLANTA | GA | 30321 | PHARMACY | $1,491,940 |
| SCOTT EBERLE MD | |||||
| 611 N FAIR ST | PETALUMA | CA | 94952 | MEDICAL SERVICES | $696,713 |
| ANDREW WAGNER MD | |||||
| 819 LONGWOOD LN | SEBASTOPOL | CA | 95472 | MEDICAL SERVICES | $600,906 |
| EMPRES POST ACUTE REHABILITATION | |||||
| PO BOX 650823 | DALLAS | TX | 75265 | MEDICAL SERVICES | $385,023 |
| VINEYARD POST ACUTE | |||||
| 101 MONROE | PETALUMA | CA | 94954 | MEDICAL SERVICES | $298,323 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $20,000 | FundraisingAmt |
| All Other Contributions | $880,037 | AllOtherContributionsAmt |
| Total Contributions | $900,037 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 621610 | BusinessCd |
| Total Revenue Column | $35,371,146 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,371,146 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $35,371,146 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,073 | TotalRevenueColumnAmt |
| Exclusion | $36,073 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $48,920 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $20,000 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $28,067 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,853 | TotalRevenueColumnAmt |
| Exclusion | $20,853 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $785,230 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $785,230 | TotalRevenueColumnAmt |
| Exclusion | $785,230 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,113,339 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $35,371,146 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $842,156 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,609,445 | TotalAmt |
| Program Services | $18,862,654 | ProgramServicesAmt |
| Management And General | $2,584,720 | ManagementAndGeneralAmt |
| Fundraising | $162,071 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $940,465 | TotalAmt |
| Program Services | $836,135 | ProgramServicesAmt |
| Management And General | $104,330 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,338 | TotalAmt |
| Program Services | $9,030 | ProgramServicesAmt |
| Management And General | $23,308 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,704,294 | TotalAmt |
| Program Services | $1,545,810 | ProgramServicesAmt |
| Management And General | $145,702 | ManagementAndGeneralAmt |
| Fundraising | $12,782 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,566 | TotalAmt |
| Program Services | $16,566 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,104,880 | TotalAmt |
| Program Services | $4,721,103 | ProgramServicesAmt |
| Management And General | $1,383,777 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,495 | TotalAmt |
| Program Services | $65,495 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,082,837 | TotalAmt |
| Program Services | $738,187 | ProgramServicesAmt |
| Management And General | $344,650 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $653,638 | TotalAmt |
| Program Services | $653,638 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $599,321 | TotalAmt |
| Program Services | $455,748 | ProgramServicesAmt |
| Management And General | $143,573 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,905 | TotalAmt |
| Program Services | $11,530 | ProgramServicesAmt |
| Management And General | $375 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $344,405 | TotalAmt |
| Program Services | $344,405 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,792 | TotalAmt |
| Program Services | $47,792 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SYSTEM COST ALLOCATION | $2,474,490 | $2,089,182 | $372,786 | $12,522 |
| MEDICAL SUPPLIES | $1,206,295 | $731,828 | $474,467 | |
| DUES & SUBSCRIPTIONS | $43,700 | $43,700 | ||
| REPAIRS & MAINTENANCE | $28,014 | $28,014 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,466 | TotalAmt |
| Program Services | $61,773 | ProgramServicesAmt |
| Management And General | $693 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,028,346 | TotalAmt |
| Program Services | $31,262,590 | ProgramServicesAmt |
| Management And General | $5,578,381 | ManagementAndGeneralAmt |
| Fundraising | $187,375 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $884,319 | BOYAmt |
| EOY | $1,529,693 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,628,066 | BOYAmt |
| EOY | $1,472,284 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,591,934 | BOYAmt |
| EOY | $8,559,380 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,703 | BOYAmt |
| EOY | $54,869 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,892,902 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,708,642 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,883 | BOYAmt |
| EOY | $184,260 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,551 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,397,456 | BOYAmt |
| EOY | $11,800,486 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,285,670 | BOYAmt |
| EOY | $7,970,051 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $858,262 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,148,234 | BOYAmt |
| EOY | $16,619,889 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,433,904 | BOYAmt |
| EOY | $25,448,202 | 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 | -$10,036,448 | BOYAmt |
| EOY | -$13,835,864 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $188,148 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$10,036,448 | BOYAmt |
| EOY | -$13,647,716 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,397,456 | BOYAmt |
| EOY | $11,800,486 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $84,993 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$3,696,261 | 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,034 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,506 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,094 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $517,862 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $900,037 | CurrentTaxYearAmt |
| Total | $1,457,533 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,782,738 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,909,622 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,133,409 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,843,189 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $36,205,296 | CurrentTaxYearAmt |
| Total | $96,874,254 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,810,772 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,915,128 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,139,503 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $30,361,051 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,105,333 | CurrentTaxYearAmt |
| Total | $98,331,787 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $98,331,787 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $58,405 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $36,073 | CurrentTaxYearAmt |
| Total | $94,478 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $58,405 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $36,073 | CurrentTaxYearAmt |
| Total | $94,478 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,765 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $85,840 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,246 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,662 | CurrentTaxYearMinus1YearAmt |
| Total | $122,513 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,812,537 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,000,968 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,171,749 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $30,422,118 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,141,406 | CurrentTaxYearAmt |
| Total | $98,548,778 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99780 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99750 | PublicSupportPY509Pct |
| Investment Income CY | 0.00100 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00080 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $259,558 | OtherCostOrOtherBasisAmt |
| Depreciation | $219,244 | DepreciationAmt |
| Book Value | $40,314 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,574,704 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,489,398 | DepreciationAmt |
| Book Value | $85,306 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $58,640 | OtherCostOrOtherBasisAmt |
| Book Value | $58,640 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $184,260 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $16,619,889 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,619,889 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | HOSPICE GOLF | Event1Nm |
| Gross Receipts Event1 | $68,920 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $20,000 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $48,920 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $1,000 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $27,067 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $68,920 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $20,000 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $48,920 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $1,000 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $27,067 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $28,067 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $20,853 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | 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 (16 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN KLOCKENGA | ||||||||||||||
| REGIONAL CHIEF EXECUTIVE - NO CA | $0 | $696,204 | $0 | $440,231 | $0 | $7,603 | $0 | $195,574 | $0 | $35,643 | $0 | $1,375,255 | $0 | $0 |
| ROBERTA LUSKIN-HAWK MD | ||||||||||||||
| TRUSTEE | $0 | $451,632 | $0 | $171,999 | $0 | $50,362 | $0 | $150,331 | $0 | $31,324 | $0 | $855,648 | $0 | $33,339 |
| LARRY COOMES | ||||||||||||||
| TRUSTEE | $0 | $434,385 | $0 | $207,928 | $0 | $6,027 | $0 | $148,141 | $0 | $51,657 | $0 | $848,138 | $0 | $0 |
| ROBERT JUST III | ||||||||||||||
| TRUSTEE | $0 | $379,432 | $0 | $146,304 | $0 | $4,868 | $0 | $102,360 | $0 | $44,642 | $0 | $677,606 | $0 | $0 |
| OLUYEMI ADEYANJU ESQ | ||||||||||||||
| SECRETARY | $0 | $352,516 | $0 | $187,551 | $0 | $3,976 | $0 | $88,287 | $0 | $13,684 | $0 | $646,014 | $0 | $0 |
| CARMELO MOCERI | ||||||||||||||
| TRUSTEE | $0 | $336,743 | $0 | $87,086 | $0 | $41,215 | $0 | $38,570 | $0 | $41,142 | $0 | $544,756 | $0 | $0 |
| TYLER HEDDEN | ||||||||||||||
| CEO-CHIEF EXEC OFFICER-SONOMA | $0 | $383,463 | $0 | $92,056 | $0 | $4,229 | $0 | $11,200 | $0 | $34,598 | $0 | $525,546 | $0 | $0 |
| MARK PROVAN | ||||||||||||||
| CHIEF OPS/WORKFORCE INT OFF | $0 | $300,843 | $0 | $115,907 | $0 | $4,346 | $0 | $52,493 | $0 | $3,922 | $0 | $477,511 | $0 | $0 |
| AMY MASSEY | ||||||||||||||
| MGR, HOME HEALTH/HOSPICE MRKTNG | $108,474 | $0 | $156,950 | $0 | $850 | $0 | $17,644 | $0 | $2,759 | $0 | $286,677 | $0 | $0 | $0 |
| JILL LAMB | ||||||||||||||
| CLINICAL PHARMACIST | $248,532 | $0 | $813 | $0 | $850 | $0 | $25,000 | $0 | $3,394 | $0 | $278,589 | $0 | $0 | $0 |
| MICHAEL ROBINSON | ||||||||||||||
| CHIEF HOME HEALTH | $226,914 | $0 | $15,880 | $0 | $8,238 | $0 | $16,883 | $0 | $3,434 | $0 | $271,349 | $0 | $0 | $0 |
| JEAN MEHLSACK | ||||||||||||||
| DIRECTOR, HOME HEALTH | $58,388 | $0 | $182,022 | $0 | $635 | $0 | $25,000 | $0 | $115 | $0 | $266,160 | $0 | $0 | $0 |
| DANIEL DWYER | ||||||||||||||
| TRUSTEE | $0 | $190,934 | $0 | $40,532 | $0 | $6,831 | $0 | $8,090 | $0 | $17,116 | $0 | $263,503 | $0 | $0 |
| DANA CODRON | ||||||||||||||
| TRUSTEE | $0 | $188,380 | $0 | $18,207 | $0 | $3,213 | $0 | $17,314 | $0 | $20,656 | $0 | $247,770 | $0 | $0 |
| JEFFREY PATAJO | ||||||||||||||
| PHYSICAL THERAPIST | $209,588 | $0 | $6,229 | $0 | $850 | $0 | $19,000 | $0 | $4,321 | $0 | $239,988 | $0 | $0 | $0 |
| MAUREEN DISBOT | ||||||||||||||
| TRUSTEE | $0 | $119,853 | $0 | $87,200 | $0 | $2,733 | $0 | $4,854 | $0 | $9,066 | $0 | $223,706 | $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. 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. REIMBURSEMENT OF THESE EXPENSES IS LIMITED AND MAY BE CONSIDERED A TAXABLE BENEFIT BY THE IRS AND IF SO, ARE INCLUDED ON THE EMPLOYEE'S FORM W-2. LARRY COOMES - $2,565 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. 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 ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX-EXEMPT PARENT, SANTA ROSA MEMORIAL HOSPITAL, 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, LINE 4B | 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 INDIVIDUAL RECEIVED A PAYOUT DURING THE CURRENT YEAR: ROBERTA LUSKIN-HAWK, M.D. - $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. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 4 & FORM 990, PART VI, SECTION A, LINE 1B | BOARD MEMBER INDEPENDENCE PER THE BYLAWS OF ST. JOSEPH HOME CARE NETWORK, TRUSTEES ARE EMPLOYEES OF EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION. AS THEY RECEIVE COMPENSATION FOR THEIR EMPLOYMENT, THEY ARE NOT CONSIDERED TO BE INDEPENDENT. |
| FORM 990, PART V, LINE 1 | ST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR ST. JOSEPH HOME CARE NETWORK 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 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 ORGANIZATIONS SECTION 4960 TAX ANALYSIS AND REPORTING. |
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HOSPITAL OF EUREKA, REDWOOD MEMORIAL HOSPITAL, QUEEN OF THE VALLEY MEDICAL CENTER, AND SANTA ROSA MEMORIAL HOSPITAL ARE THE SOLE CORPORATE MEMBERS OF ST. JOSEPH HOME CARE NETWORK |
| FORM 990, PART VI, SECTION A, LINE 7A | CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ST. JOSEPH HOME CARE NETWORK HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE ST. JOSEPH HOME CARE NETWORK BOARD. ALL TRUSTEE NOMINATIONS THAT COME FROM THE ST. JOSEPH HOME CARE NETWORK BOARD AS NOMINATIONS MUST BE APPROVED BY ST. JOSEPH HOSPITAL OF EUREKA, REDWOOD MEMORIAL HOSPITAL, QUEEN OF THE VALLEY MEDICAL CENTER, AND SANTA ROSA MEMORIAL HOSPITAL, AS THE CORPORATE MEMBERS. |
| 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 ST. JOSEPH HOSPITAL OF EUREKA, REDWOOD MEMORIAL HOSPITAL, QUEEN OF THE VALLEY MEDICAL CENTER, AND SANTA ROSA MEMORIAL HOSPITAL MEMBERS 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 ST. JOSEPH HOSPITAL OF EUREKA, REDWOOD MEMORIAL HOSPITAL, QUEEN OF THE VALLEY MEDICAL CENTER, AND SANTA ROSA MEMORIAL HOSPITAL RESERVE 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 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 EXECUTIVE DIRECTOR IS PAID BY ITS TAX-EXEMPT PARENT, SANTA ROSA MEMORIAL HOSPITAL, 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 1,401,385. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,401,385. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 2,820,035. MANAGEMENT AND GENERAL EXPENSES 801,064. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,621,099. MEDICAL DIRECTOR & MED PHUSICIAN FEES: PROGRAM SERVICE EXPENSES 434,278. MANAGEMENT AND GENERAL EXPENSES 582,713. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,016,991. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 65,405. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,405. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFERS BETWEEN RELATED ORGANIZATIONS -3,696,261. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (116 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 AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 611573313 | HEALTHCARE | TX | 501(C)(3) | 12,I | CHS | Yes (1) | |
| COVENANT HEALTH NETWORK INC | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 461259908 | HEALTHCARE | CA | 501(C)(3) | 12,III | SJHS | Yes (1) | |
| COVENANT HEALTH PARTNERS | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 463516417 | HEALTHCARE | TX | 501(C)(3) | 12,I | CHS | Yes (1) | |
| COVENANT HEALTH SYSTEM | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752765566 | HEALTHCARE | TX | 501(C)(3) | 3 | SJHS | Yes (1) | |
| COVENANT HEALTH SYSTEM FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752897026 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (1) | |
| COVENANT HOSPITAL HOBBS | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844273963 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| COVENANT MEDICAL CENTER | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 822913146 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| COVENANT MEDICAL GROUP | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752743883 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| E WA & MT UNEMPLOYMENT COMPENSATION INSURANCE TRUST | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911082119 | UNEMPLOYMENT | WA | 501(C)(3) | 12,I | PHS WA | Yes (1) | |
| EVERETT TRANSITIONAL CARE SERVICES | |||||||||||
| PO BOX 5128 | EVERETT | WA | 982065128 | 943264605 | TRANS. CARE | WA | 501(C)(3) | 10 | 0 | N/A | |
| FACEY MEDICAL FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 954322584 | SUPPORT | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (1) | |
| GAMELIN WASHINGTON ASSOCIATION | |||||||||||
| 1801 LIND AVE 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 AVE 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 BOX 6100 | 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 AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752133781 | HEALTHCARE | TX | 501(C)(3) | 10 | CHS | Yes (1) | |
| INLAND NORTHWEST HEALTH SERVICES | |||||||||||
| 1801 LIND AVE 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 AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814260130 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS SJHS | Yes (1) | |
| INSTITUTE FOR SYSTEMS BIOLOGY | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 912003593 | HEALTHCARE | WA | 501(C)(3) | 7 | WHC | Yes (1) | |
| JOHN WAYNE CANCER INSTITUTE | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 954291515 | HEALTHCARE | CA | 501(C)(3) | 4 | PSJHC | Yes (1) | |
| KADLEC AUXILIARY INC | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 916033089 | SUPPORT | WA | 501(C)(3) | 12,III | KRMC | Yes (1) | |
| KADLEC FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 237005501 | SUPPORT | WA | 501(C)(3) | 7 | KRMC | Yes (1) | |
| KADLEC REGIONAL MEDICAL CENTER | |||||||||||
| 1801 LIND AVE 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 AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330844408 | IMAGING SVCS | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (1) | |
| LUBBOCK HERITAGE HOSPITAL LLC | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 264021016 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| LUBBOCK METHODIST HOSPITAL FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752220963 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (1) | |
| LUNDBERG ASSOCIATION | |||||||||||
| 1801 LIND AVE 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 AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 912054035 | RESEARCH | WA | 501(C)(3) | 7 | SHS | Yes (1) | |
| METHODIST CHILDREN'S HOSPITAL | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752428911 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| METHODIST HOSPITAL LEVELLAND | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752246348 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| METHODIST HOSPITAL PLAINVIEW | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752426010 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| MISSION HOSPITAL REGIONAL MEDICAL CTR | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643360 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| NORTHWEST HOPE & HEALING FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 200799737 | SUPPORT | WA | 501(C)(3) | 12,I | SHS | Yes (1) | |
| PACMED CLINICS | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 562290878 | HEALTHCARE | WA | 501(C)(3) | 10 | WHC | Yes (1) | |
| PH&S FOUNDATIONSFVSA & SCVSA | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 953544877 | HEALTHCARE | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (1) | |
| PROVIDENCE ALASKA FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 920093565 | HEALTHCARE | AK | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911940286 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE BLANCHET ASSOCIATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911789266 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE CHILDREN'S HEALTH FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 930800140 | SUPPORT | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE COMMUNITY HEALTH FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 930692907 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE DETHMAN HOUSE | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 473385506 | SUPPORT | WA | 501(C)(3) | 7 | 0 | N/A | |
| PROVIDENCE GAMELIN HOUSE ASSOCIATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 311744654 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911549796 | HEALTHCARE | WA | 501(C)(3) | 12,II | PSJH | 0 | |
| PROVIDENCE HEALTH & SERVICES - MONTANA | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810231793 | HEALTHCARE | MT | 501(C)(3) | 3 | PHS WA | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES - OREGON | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 510216587 | HEALTHCARE | OR | 501(C)(3) | 3 | PHS | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES - WASHINGTON | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 510216586 | HEALTHCARE | WA | 501(C)(3) | 3 | PHS | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911303277 | HEALTHCARE | WA | 501(C)(3) | 3 | PMWHC | Yes (1) | |
| PROVIDENCE HEALTH ASSURANCE | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 550828701 | MEDICAID | OR | 501(C)(4) | N/A | PHP | Yes (1) | |
| PROVIDENCE HEALTH CARE FOUNDATION - EASTERN WASHINGTON | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 320014330 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE HEALTH CARE FOUNDATION (CENTRALIA) | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911433382 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE HEALTH PLAN | |||||||||||
| 1801 LIND AVE 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 AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 510216589 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS | Yes (1) | |
| PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 930921990 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE HOSPICE AND HOME CARE FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 272552749 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE HOSPICE OF SEATTLE FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 912077378 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 510224944 | HEALTHCARE | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (1) | |
| PROVIDENCE MARIANWOOD FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 931554288 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE MEDICAL INSTITUTE | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330283773 | HEALTHCARE | CA | 501(C)(3) | 12,I | PHS SOCAL | Yes (1) | |
| PROVIDENCE MILWAUKIE FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 943079515 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE MINISTRIES | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | RELIGIOUS ORG | WA | 501(C)(3) | 1 | 0 | N/A | ||
| PROVIDENCE MOUNT ST VINCENT FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911188119 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE NEWBERG HEALTH FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 930889144 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE PETER CLAVER ASSOCIATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 311629656 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE PLAN PARTNERS | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911861964 | HEALTHCARE | WA | 501(C)(4) | N/A | PHS OR | Yes (1) | |
| PROVIDENCE PORTLAND MEDICAL FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 931231494 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE ROSSI ASSOCIATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 311584166 | SUPPORT | WA | 501(C)(3) | 10 | PHS WA | Yes (1) | |
| PROVIDENCE SAINT JOHN'S HEALTH CENTER | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951684082 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS SOCAL | Yes (1) | |
| PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814542216 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS SOCAL | Yes (1) | |
| PROVIDENCE SEASIDE HOSPITAL FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 930927320 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE ST ELIZABETH HOUSE ASSOCIATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 912171539 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST FRANCIS ASSOCIATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 943244854 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST JOSEPH HEALTH | |||||||||||
| 1801 LIND AVE 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 ATTN TAX DEPT | RENTON | WA | 98057 | 943078543 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST JOSEPH MEDICAL CENTER | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810463482 | HEALTHCARE | MT | 501(C)(3) | 3 | PHS WA | Yes (1) | |
| PROVIDENCE ST MARY FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 452841492 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST PETER FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911097056 | SUPPORT | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE ST VINCENT MEDICAL FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 930575982 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE TRINITYCARE HOSPICE | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 953264139 | HEALTHCARE | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (1) | |
| PROVIDENCE TRINITYCARE HOSPICE FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330261016 | HEALTHCARE | CA | 501(C)(3) | 7 | PTCH | Yes (1) | |
| PROVIDENCE WILLAMETTE FALLS MEDICAL FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 931003750 | HEALTHCARE | OR | 501(C)(3) | 12, I | PHS OR | Yes (1) | |
| QUEEN OF THE VALLEY MEDICAL CENTER | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 941243669 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (1) | |
| REDWOOD MEMORIAL FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 942779313 | HEALTHCARE | CA | 501(C)(3) | 7 | RMH | Yes (1) | |
| REDWOOD MEMORIAL HOSPITAL | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 941384665 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (1) | |
| SAINT JOHN'S HOSPITALHEALTH CENTER FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 956100079 | SUPPORT | CA | 501(C)(3) | 7 | PSJHC | Yes (1) | |
| SANTA ROSA MEMORIAL HOSPITAL | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 941231005 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (1) | |
| SEATTLE SCIENCE FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 611502822 | PHYSN COLLAB | WA | 501(C)(3) | 7 | WHC | Yes (1) | |
| SISTERS OF PROVIDENCE OF MONTANA CORPORATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 262612415 | SHELL CORP | MT | 501(C)(3) | 1 | PHS WA | 0 | |
| SISTERS OF ST JOSEPH OF ORANGE | |||||||||||
| 1801 LIND AVE 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 AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 680395200 | HEALTHCARE | CA | 501(C)(3) | 3 | SRMH | Yes (1) | |
| ST JOSEPH HEALTH MINISTRY | |||||||||||
| 1801 LIND AVE 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 AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814791043 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (1) | |
| ST JOSEPH HEALTH SYSTEM | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 953589356 | HEALTHCARE | CA | 501(C)(3) | 12,I | PSJH | 0 | |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330143024 | HEALTHCARE | CA | 501(C)(3) | 10 | SJHS | Yes (1) | |
| ST JOSEPH HERITAGE HEALTHCARE | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330185031 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (1) | |
| ST JOSEPH HOSPITAL OF EUREKA | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 941156596 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (1) | |
| ST JOSEPH HOSPITAL OF ORANGE | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643359 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| ST JUDE HOSPITAL INC | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643324 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| ST LUKE ASSOCIATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 943176618 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| ST MARY MEDICAL CENTER | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951914489 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| ST MARY OF THE PLAINS HOSPITAL FDN | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 751653181 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (1) | |
| ST PATRICK HOSPITAL FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 237056976 | HEALTHCARE | MT | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| ST THOMAS CHILD AND FAMILY CENTER | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810233495 | EDUCATION | MT | 501(C)(3) | 10 | PHS WA | Yes (1) | |
| SWEDISH EDMONDS | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 272305304 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (1) | |
| SWEDISH HEALTH SERVICES | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 910433740 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (1) | |
| SWEDISH MEDICAL CENTER FOUNDATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 910983214 | HEALTHCARE | WA | 501(C)(3) | 7 | SHS | Yes (1) | |
| SWEDISH MJM HOLDINGS | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 273139262 | HOLDING CO | WA | 501(C)(3) | 12,I | SHS | Yes (1) | |
| TARZANA MEDICAL CENTER LLC | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 833972614 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS SOCAL | Yes (1) | |
| THE GAMELIN ASSOCIATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911180824 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| THE GAMELIN CALIFORNIA ASSOCIATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911293869 | SUPPORT | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (1) | |
| THE GAMELIN OREGON ASSOCIATION | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911214491 | SUPPORT | OR | 501(C)(3) | 10 | PHS OR | Yes (1) | |
| UNIVERSITY OF PROVIDENCE | |||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810231777 | EDUCATION | MT | 501(C)(3) | 2 | PHS | Yes (1) | |
| WESTERN HEALTHCONNECT | |||||||||||
| 1801 LIND AVE 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 |
|---|---|---|---|---|---|---|---|
| 20TH STREET SURGERY LLC | |||||||
| 1301 20TH STREET STE 140 | SANTA MONICA | CA | 90404 | 731735618 | AMBULATORY SURG | CA | N/A |
| BROADWAY IMAGING LLC | |||||||
| 500 W BROADWAY | MISSOULA | MT | 59802 | 522405971 | MEDICAL IMAGING | MT | N/A |
| CENTER FOR MATERNAL NEWBORN AND CHILD | |||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 813526875 | HEALTHCARE | CA | N/A |
| CLACKAMAS RADIATION ONCOLOGY CENTER LLC | |||||||
| 4400 NE HALSEY ST BLDG II 495 | PORTLAND | OR | 97213 | 260381897 | RADIATION ONCOL | OR | N/A |
| COASTAL ASC HOLDINGS LLC | |||||||
| ONE HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92663 | 810986844 | HEALTHCARE | CA | N/A |
| COVENANT LONG-TERM CARE LP | |||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 205033419 | HEALTHCARE | TX | N/A |
| BRIDGEPORT MEDICAL IMAGING (BMI) | |||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260796953 | IMAGING DIAG. | OR | N/A |
| CENTER FOR MEDICAL IMAGING (CMI) | |||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 200477972 | IMAGING DIAG. | OR | N/A |
| FULLERTON SURGICAL CENTER LP | |||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 470927394 | AMBULATORY SURG | CA | N/A |
| GREATER VALLEY MEDICAL BUILDING LP | |||||||
| 501 S BUENA VISTA ST | BURBANK | CA | 91505 | 954570858 | REAL ESTATE - MOB | CA | N/A |
| HCSA PROPERTIES LLC | |||||||
| 1600 M STREET NW | AUBURN | WA | 98001 | 460620892 | REAL ESTATE RENT | WA | N/A |
| HERITAGE INVESTMENT GROUP I LLC | |||||||
| 500 S MAIN STREET STE 1000 | ORANGE | CA | 92868 | 271000061 | INVESTMENTS | CA | N/A |
| HOAG ORTHOPEDIC INSTITUTE | |||||||
| ONE HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 611588294 | HEALTHCARE | CA | N/A |
| IMAGING ASSOCIATES LLC | |||||||
| 3650 PIPER STREET STE A | ANCHORAGE | AK | 99508 | 203906048 | MEDICAL IMAGING | AK | N/A |
| INLAND IMAGING LLC | |||||||
| 801 S STEVENS ST | SPOKANE | WA | 99204 | 911855796 | MEDICAL IMAGING | WA | N/A |
| LSC REAL PROPERTY LLC | |||||||
| 2301 QUAKER AVENUE | LUBBOCK | TX | 79410 | 474646059 | REAL ESTATE | TX | N/A |
| METHODIST DIAGNOSTIC IMAGING | |||||||
| 4005 24TH STREET | LUBBOCK | TX | 79410 | 752343261 | HEALTHCARE | TX | N/A |
| NEWPORT IMAGING CENTER | |||||||
| 360 SAN MIGUEL | NEWPORT BEACH | CA | 92660 | 330191776 | HEALTHCARE | CA | N/A |
| NEWPORT SURGICAL PARTNERS LLC | |||||||
| 27271 LAS RAMBLAS 350 | MISSION VIEJO | CA | 92691 | 392060266 | HEALTHCARE | CA | N/A |
| OREGON ADVANCED IMAGING LLC | |||||||
| 881 OHARE PARKWAY | MEDFORD | OR | 97504 | 450471748 | MEDICAL IMAGING | OR | N/A |
| OREGON OUTPATIENT SURGERY CENTER | |||||||
| 7300 SW CHILDS RD | TIGARD | OR | 97224 | 223883387 | AMBULATORY SURG | OR | N/A |
| PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC | |||||||
| 1221 MADISON STREET | SEATTLE | WA | 98104 | 203132044 | MEDICAL IMAGING | WA | N/A |
| PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO | |||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 812701056 | INVESTMENTS | WA | N/A |
| PROV RADIATION ONCOLOGY DEVELOP ASSN | |||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260682491 | REAL ESTATE - MOB | OR | N/A |
| PROVIDENCE CHILDREN'S NEONATAL SERVICES | |||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 470918549 | NEONATAL CARE | WA | N/A |
| PROVIDENCE HOUSE HEARING HEALTH CENTERS LLC | |||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | HEALTHCARE | CA | N/A | |
| PROVIDENCE IMAGING CENTER JOINT VENTURE | |||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 920118807 | MEDICAL IMAGING | AK | N/A |
| PROVIDENCE ST JOSEPH HEALTH LONG TERM PORTFOLIO | |||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 823190634 | INVESTMENTS | WA | N/A |
| PROVIDENCE SURGERY CENTER LLC | |||||||
| 902 N ORANGE ST | MISSOULA | MT | 59802 | 841401625 | AMBULATORY SURG | MT | N/A |
| PROVIDENCESILVERTON REHAB LLC | |||||||
| 4400 NE HALSEY 425 | PORTLAND | OR | 97213 | 481287267 | REHAB SERVICES | OR | N/A |
| PROVIDENCE UCLA USP SURGERY CENTER JV | |||||||
| 15305 DALLAS PKWY STE 1600 LB 28 | ADDISON | TX | 75001 | 320503030 | AMBULATORY SURG | CA | N/A |
| PROVIDENCEUSP SOUTH BAY SURGERY CENTERS | |||||||
| 15305 DALLAS PKWY STE 1600 LB 28 | ADDISON | TX | 75001 | 475064486 | AMBULATORY SURG | CA | N/A |
| PROVIDENCEUSP SURGERY CENTERS LLC | |||||||
| 11550 INDIAN HILLS ROAD 160 | MISSION HILLS | CA | 91345 | 200684116 | AMBULATORY SURG | CA | N/A |
| RADIATION THERAPY INNOVATIONS LLC | |||||||
| 1221 MADISON STREET 1ST FL | SEATTLE | WA | 98104 | 300553035 | HEALTHCARE | WA | N/A |
| REDMOND AMBULATORY SURGERY CENTER LLC | |||||||
| 805 MADISON ST STE 901 | SEATTLE | WA | 98104 | 813558711 | AMBULATORY SURG | WA | N/A |
| SANTA ANA MOB LLC | |||||||
| 1800 QUAIL STREET STE 100 | NEWPORT BEACH | CA | 92660 | 753205306 | REAL ESTATE - MOB | CA | N/A |
| SHA LLC | |||||||
| 12940 NORTH HIGHWAY 183 | AUSTIN | TX | 78750 | 752569094 | HEALTHCARE | TX | N/A |
| SJO ASC HOLDINGS LLC | |||||||
| 1140 W LA VETA AVE | ORANGE | CA | 92868 | 821655501 | HEALTHCARE | CA | N/A |
| ST JOSEPH PHYSICIAN VENTURES I LLC | |||||||
| 1100 WEST STEWART DRIVE | ORANGE | CA | 92868 | 454521884 | REAL ESTATE | CA | N/A |
| ST JOSEPHSATELLITE DIALYSIS CENTERS LLC | |||||||
| 300 SANTANA ROW STE 300 | SAN JOSE | CA | 95128 | 814657391 | HEALTHCARE | CA | N/A |
| ST JUDE SURGICAL CENTERS LLC | |||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 823352570 | AMBULATORY SURG | CA | N/A |
| SURGERY CENTER AT TANASBOURNE LLC | |||||||
| 11221 ROE AVE STE 300 | LEAWOOD | KS | 66211 | 208187971 | AMBULATORY SURG | KS | N/A |
| TARZANA PEDIATRIC VENTURES LLC | |||||||
| 18321 CLARK ST | TARZANA | CA | 91356 | 821308306 | HEALTHCARE | CA | N/A |
| THE MADISON SPOKANE INN LLC | |||||||
| 15 WEST ROCKWOOD BLVD | SPOKANE | WA | 99204 | 841606484 | HOTEL SERVICES | WA | N/A |
| YELM MEDICAL OFFICE BUILDING | |||||||
| 2840 CRITES ST SW STE 104 | TUMATER | WA | 98512 | 263685020 | REAL ESTATE - MOB | WA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (35 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' ASSOC. | WA | N/A | C | 0 | |||
| AMERICAN UNITY GROUP LTD | ||||||||||||
| CAPTIVE INSURANCE | N/A | C | 0 | 90 PITTS BAY ROAD PEMBROKE | BD | BD | ||||||
| AYIN HEALTH SOLUTIONS INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 833037172 | HEALTHCARE | DE | N/A | C | 0 | |||
| BLUETREE NETWORK INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 900872936 | HEALTHCARE | WI | N/A | C | 0 | |||
| BOURGET HEALTH SERVICES INC | ||||||||||||
| 101 W 8TH AVE TAF C-9 | SPOKANE | WA | 99220 | 911354431 | CLIN/MED LAB | WA | N/A | C | 0 | |||
| CARON HEALTH CORPORATION | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810486082 | MED PHYS SVCS | 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 AND SUBSIDIARIES | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 463070062 | IT SVCS | DE | N/A | C | 0 | |||
| ENGAGE IT SERVICES INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844058573 | IT SVCS | DE | 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 ACQUISITION CO INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 833881097 | HEALTHCARE | WA | N/A | C | 0 | |||
| MISSION VIEJO MEDICAL VENTURES | ||||||||||||
| 27800 MEDICAL CENTER RD | 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 | |||
| MEDIREVV INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 208783763 | HEALTHCARE | DE | N/A | C | 0 | |||
| PHN HOLDINGS | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 461814184 | STRAT PLAN SVCS | CA | N/A | C | 0 | |||
| PIONEER INNOVATIONS INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 364818191 | HEALTH INNOVATNS | 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 HEALTH CARE VENTURES INC | ||||||||||||
| 101 W 8TH AVE TAF C-9 | SPOKANE | WA | 99220 | 900155714 | CLIN/MED LAB | WA | N/A | C | 0 | |||
| PROVIDENCE HEALTH NETWORK | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 800886966 | PREPAID HEALTH | 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 | 99220 | 911216033 | HEALTHCARE | WA | N/A | C | 0 | |||
| PROVIDENCE RCM GROUP | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844686520 | HOLDING COMPANY | DE | N/A | C | 0 | |||
| PROVIDENCE SERVICES GROUP INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844704409 | HOLDING COMPANY | DE | 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 | |||
| VINSERRA INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 953943315 | INVESTMENTS | CA | N/A | C | 0 | |||
| WESTERN HEALTHCONNECT VENTURES INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 800953654 | INVESTMENTS | WA | 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 | |||
| GRADY BLOCKER LLC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 842092143 | HOLDING COMPANY | DE | N/A | C | 0 | |||
| PROVIDENCE ST JOSEPH HEALTH NETWORK | ||||||||||||
| 20555 EARL ST | TORRANCE | CA | 90503 | 823771547 | HEALTHCARE | CA | 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 | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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