QUEEN OF THE VALLEY MEDICAL CENTER: Form 990EZ, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: QUEEN OF THE VALLEY MEDICAL CENTER (EIN 94-1243669)
Tax period: 2019-01-01 to 2019-12-31
Filed: 2020-11-05
IRS object ID: 202033109349202103
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
Form 990-EZ
Schedule A
Schedule N
Schedule O
Transfer Prsnl Bnft Contracts Decl

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-11-05T21:04:11-06:00	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	4365 EXECUTIVE DRIVE SUITE 1600	AddressLine1Txt
City	SAN DIEGO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92121	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990EZ	ReturnTypeCd
Tax Period Begin	2019-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	941243669	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	QUEEN OF THE VALLEY MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	QUEE	BusinessNameControlTxt
Phone	7072524411	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	PATTI PILGRIM	PersonNm
Person Title	REGIONAL CFO	PersonTitleTxt
Phone	7072524411	PhoneNum
Signature	2020-11-05	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	ANDY JAMESON	PreparerPersonNm
PTIN	P01894820	PTIN
Phone	8585357200	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	99.132.79.23	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-11-05	IPDt
IP Tm	20:14:34	IPTm
IP Timezone	PS	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	DA39A3EE5E6B4B0D3255BFEF95601890AFD80709	AtSubmissionCreationDeviceId
At Submission Filing Device Id	C03E818AF5564214394D8BCBF65FFCB8F048BD21	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990-EZ IRS990EZ

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd
Final Return	Yes (X)	FinalReturnInd
Group Exemption	0928	GroupExemptionNum
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Schedule B Not Required	Yes (X)	ScheduleBNotRequiredInd
Website Address	WWW.THEQUEEN.ORG	WebsiteAddressTxt
Organization501c3	Yes (X)	Organization501c3Ind
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Gross Receipts	$0	GrossReceiptsAmt
Contributions Gifts Grants Etc	$0	ContributionsGiftsGrantsEtcAmt
Total Revenue	$0	TotalRevenueAmt
Salaries Other Comp Empl Bnft	$0	SalariesOtherCompEmplBnftAmt
Total Expenses	$0	TotalExpensesAmt
Excess Or Deficit For Year	$0	ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY	$0	NetAssetsOrFundBalancesBOYAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Net Assets Or Fund Balances EOY	$0	NetAssetsOrFundBalancesEOYAmt

Form990 Total Assets Form990TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Primary Exempt Purpose	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.	PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

Field	Value	IRS element (for citing)
Description Program Srvc Accom	SEE SCHEDULE O	DescriptionProgramSrvcAccomTxt
Grants And Allocations	$0	GrantsAndAllocationsAmt
Program Service Expenses	$0	ProgramServiceExpensesAmt

Field	Value	IRS element (for citing)
Total Program Service Expenses	$0	TotalProgramServiceExpensesAmt
Info In Schedule O Part IV	Yes (X)	InfoInScheduleOPartIVInd

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (12 entries)

TitleTitleTxt	Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt	CompensationCompensationAmt	Employee Benefit ProgramEmployeeBenefitProgramAmt	Expense Account Other AllwncExpenseAccountOtherAllwncAmt
LARRY COOMES
CHIEF EXEC QVMC	50.00	$648,340	$199,798	$0
OLUYEMI ADEYANJU ESQ
SECRETARY	0.00	$544,043	$101,971	$0
ROSARIO PEREZ
BOARD MEMBER	2.00	$455,555	$85,807	$0
TIM HERMAN
BOARD VICE CHAIRPERSON	5.00	$0	$0	$0
ED FARVER
BOARD CHAIRPERSON	5.00	$0	$0	$0
BR VICTOR KENNETH FSC
BOARD MEMBER	2.00	$0	$0	$0
CON HEWITT
BOARD MEMBER	2.00	$0	$0	$0
DENNIS PEDISICH
BOARD MEMBER	2.00	$0	$0	$0
FRANCIS HEALY MD
BOARD MEMBER	2.00	$0	$0	$0
GENI BENNETTS MD
BOARD MEMBER	2.00	$0	$0	$0
GREG BENNETT
BOARD MEMBER	2.00	$0	$0	$0
MICHAEL MERWIN MD
BOARD MEMBER	2.00	$0	$0	$0

Field	Value	IRS element (for citing)
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
Activities Not Previously Rpt	0	ActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not Rpt	0	ChgMadeToOrgnzngDocNotRptInd
Organization Had UBI	0	OrganizationHadUBIInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Organization Dissolved Etc	Yes (1)	OrganizationDissolvedEtcInd
Direct Indirect Pltcl Expend	$0	DirectIndirectPltclExpendAmt
Made Loans To From Officers	0	MadeLoansToFromOfficersInd
Tax Imposed Under IRC4911	$0	TaxImposedUnderIRC4911Amt
Tax Imposed Under IRC4912	$0	TaxImposedUnderIRC4912Amt
Tax Imposed Under IRC4955	$0	TaxImposedUnderIRC4955Amt
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
Tax Imposed On Organization Mgr	$0	TaxImposedOnOrganizationMgrAmt
Tax Reimbursed By Organization	$0	TaxReimbursedByOrganizationAmt
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JONI MURPHY	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1000 TRANCAS STREET	AddressLine1Txt
City	NAPA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94558	ZIPCd

Field	Value	IRS element (for citing)
Phone	7075255300	PhoneNum

Field	Value	IRS element (for citing)
Foreign Financial Account	0	ForeignFinancialAccountInd
Foreign Office	0	ForeignOfficeInd
Donor Advised Fnds	0	DonorAdvisedFndsInd
Operate Hospital	0	OperateHospitalInd
Tanning Services Provided	0	TanningServicesProvidedInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
School Operating	0	SchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Part VI Of Comp Of Hghst Pd Empl	NONE	PartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof Srvc	NONE	PartVIHghstPdCntrctProfSrvcTxt
Filed Schedule A	Yes (1)	FiledScheduleAInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE A, PART I, LINE 3	FormAndLineReferenceDesc
Explanation	QUEEN OF THE VALLEY MEDICAL CENTER (QVMC) IS IDENTIFIED AS A HOSPITAL OR COOPERATIVE HOSPITAL SERVICE ORGANIZATION UNDER SECTION 170(B)(A)(III) IN SCHEDULE A. HOWEVER, QVMC WAS DISSOLVED ON MARCH 31, 2018, AND THEREFORE DOES NOT FILE A SCHEDULE H WITH THIS 990-EZ. QVMC MAINTAINS GOOD-STANDING AS A LICENSED HOSPITAL, AND REPORTS ALL RELATED FILING REQUIREMENTS ON FORM 990, SCHEDULE H, FOR ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC (EIN: 81-4790143).	ExplanationTxt

Schedule N IRS990ScheduleN

Liquidation Of Assets Table LiquidationOfAssetsTableGrp

Liquidation Of Assets Detail LiquidationOfAssetsDetail

Field	Value	IRS element (for citing)
Assets Distri Or Expnss Paid	NO ASSETS WERE DISTRIBUTED	AssetsDistriOrExpnssPaidDesc
Distribution	2018-03-31	DistributionDt
EIN	814794013	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SJHNC LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1801 LIND AVE SW	AddressLine1Txt
City	RENTON	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	98057	ZIPCd

Field	Value	IRS element (for citing)
IRC Section	501(C)(3)	IRCSectionTxt

Field	Value	IRS element (for citing)
Director Of Successor	Yes (1)	DirectorOfSuccessorInd
Employee Of Successor	Yes (1)	EmployeeOfSuccessorInd
Owner Of Successor	0	OwnerOfSuccessorInd
Receive Compensation	0	ReceiveCompensationInd
Assets Distributed	Yes (1)	AssetsDistributedInd
Required To Notify AG	Yes (1)	RequiredToNotifyAGInd
Attorney General Notified	Yes (1)	AttorneyGeneralNotifiedInd
Liabilities Paid	Yes (1)	LiabilitiesPaidInd
Bonds Outstanding	0	BondsOutstandingInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2E:	FormAndLineReferenceDesc
Explanation	EXPLANATION OF INVOLVEMENT: THE FOLLOWING INDIVIDUALS BECAME AN OFFICER OR TRUSTEE OF THE TRANSFEREEORGANIZATION:OLUYEMI ADEYANJU - OFFICER OF ST. JOSEPH HEALTH NORTHERN CA. LLCCON HEWITT - TRUSTEE OF ST. JOSEPH HEALTH NORTHERN CA. LLCALL EMPLOYEES OF QUEEN OF THE VALLEY MEDICAL CENTER TRANSFERRED TO ST.JOSEPH HEALTH NORTHERN CALIFORNIA, LLC ON 1/1/2019.ON MARCH 31, 2018, QUEEN OF THE VALLEY MEDICAL CENTER, ALONG WITH SANTAROSA MEMORIAL HOSPITAL, REDWOOD MEMORIAL HOSPITAL, AND ST. JOSEPHHOSPITAL OF EUREKA, COLLECTIVELY THE "HOSPITALS", TRANSFERRED ALL OFTHEIR NET ASSETS TO ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, A RELATED501(C)(3) ORGANIZATION. ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC WASCREATED TO CONSOLIDATE AND SIMPLIFY THE CURRENT STRUCTURE BY MOVING THEOPERATIONS OF THE HOSPITALS INTO A SINGLE LEGAL ENTITY. THE OPERATION OFTHE HOSPITALS WILL REMAIN THE SAME.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990-EZ, PART III, LINE 28	FormAndLineReferenceDesc
Explanation	PROVIDENCE ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 1,085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE A CHANGING HEALTH CARE ENVIRONMENT WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE. PROVIDENCE HEALTH & SERVICES IN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON. ST. JOSEPH HEALTH SYSTEM IN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA. PROVIDENCE ST. JOSEPH HEALTH IS THE CORPORATE MEMBER OF ST. JOSEPH HEALTH SYSTEM (SJHS). SJHS IS THE SOLE MEMBER OF QUEEN OF THE VALLEY MEDICAL CENTER (QVMC) AND IS RECOGNIZED AS INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) ORGANIZATION AND IS COMPLYING WITH IRC SECTION 501(R). SJHS HAS CONSOLIDATED AND SIMPLIFIED ITS STRUCTURE BY MOVING THE OPERATIONS OF QVMC AND THREE OTHER HOSPITAL ORGANIZATIONS INTO A SINGLE LEGAL ENTITY, ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, ON MARCH 31, 2018.	ExplanationTxt

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

Field	Value	IRS element (for citing)
Declaration	THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.	DeclarationDesc

QUEEN OF THE VALLEY MEDICAL CENTER: Form 990EZ, tax year 2019

Return header ReturnHeader

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Preparer US Address PreparerUSAddress

Filer Filer

Business Name BusinessName

US Address USAddress

Business Officer BusinessOfficerGrp

Preparer Person PreparerPersonGrp

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Form 990-EZ IRS990EZ

Form990 Total Assets Form990TotalAssetsGrp

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (12 entries)

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

US Address USAddress

Schedule A IRS990ScheduleA

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

Schedule N IRS990ScheduleN

Liquidation Of Assets Table LiquidationOfAssetsTableGrp

Liquidation Of Assets Detail LiquidationOfAssetsDetail

Business Name BusinessName

US Address USAddress

Supplemental Information Detail SupplementalInformationDetail

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

Comments