2020-11-10T16:20:34-06:00 2019-12-31 346565596 ERNST & YOUNG US LLP 560 MISSION STREET SUITE 1600 SAN FRANCISCO CA 94105 990 2019-01-01 911861964 PROVIDENCE PLAN PARTNERS PROV 5035747500 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 MICHAEL G WHITE CFO/TREASURER 5035747500 2020-11-10 1 EVA NITTA P01286320 4158948000 104.187.159.70 2020-11-10 16:17:14 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 03333E4B0684ADD489F38648AD786F05819FFCF0 2019 2022-01-07 14:23:13Z X MICHAEL L COTTON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 249283676 0 X N/A X 1997 WA SEE SCHEDULE OAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 6 3 0 0 0 0 1563542 1633986 249808436 247649690 0 0 0 0 251371978 249283676 1563561 1710191 0 0 113546578 123807618 0 0 0 135430314 120978551 250540453 246496360 831525 2787316 59754393 95783417 45577411 28819119 14176982 66964298 X AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 205206268 1710191 247649690 SEE SCHEDULE OPROVIDENCEON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT TO FORM PROVIDENCE ST. JOSEPH HEALTH (PROVIDENCE). BY COMING TOGETHER, PROVIDENCE SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 1,085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE A CHANGING HEALTH CARE ENVIRONMENT WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE.PROVIDENCE HEALTH & SERVICESIN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. ST. JOSEPH HEALTH SYSTEMIN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK, TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA.PROVIDENCE PLAN PARTNERS (PPP) FULFILLS ITS SOCIAL WELFARE PURPOSES BY FURTHERING THE HEALTHCARE SERVICES PROVIDED BY ITS AFFILIATES PROVIDENCE HEALTH PLAN (PHP) AND PROVIDENCE HEALTH ASSURANCE (PHA). BOTH ARE REGULATED HEALTH PLANS WITH ACTIVITY IN OREGON AND WASHINGTON, AND ARE RECOGNIZED AS EXEMPT UNDER IRC SEC. 501 (C)(4). PPP OPERATES AS AN INTEGRAL PART OF PHP AND PHA, PROVIDING OPERATIONAL OVERSIGHT, LEADERSHIP, POLICYMAKING, MANAGEMENT AND SUPPORT SERVICES, AND STRATEGIC PLANNING. WITHOUT PPP, PHP AND PHA WOULD NEED TO PERFORM THESE SERVICES FOR THEMSELVES. THEREFORE, BY PROVIDING THESE OPERATIONAL SERVICES, PPP ALLOWS PHP AND PHA TO FREE UP AND RE-ALLOCATE RESOURCES IN ORDER TO IMPROVE QUALITY AND BREADTH OF HEALTHCARE SERVICES TO THE SURROUNDING COMMUNITY. IN ADDITION, BECAUSE OF PPP'S PRESENCE, PHP AND PHA CAN PERFORM INITIATIVES THAT LEAD TO THE IMPROVEMENT OF HEALTHCARE THROUGH THE STUDY, TREATMENT, AND REMEDY OF HUMAN DISEASES AND DISORDERS.BRINGING A WIDE NETWORK OF HEALTHCARE PROVIDERS TO BEAR IN A MANAGED CARE PROGRAM THAT IS SUBJECT TO THE CONTROL OF A NON-PROFIT HEALTH SYSTEM CREATES AN INTEGRATED NON-PROFIT HEALTHCARE DELIVERY ORGANIZATION. IN PARTICULAR, THIS STRUCTURE AFFORDS THE PROGRAM AND ITS PARTICIPANTS SIGNIFICANT BENEFITS FROM COST EFFICIENCIES, IMPROVED COORDINATION OF CARE AND MANAGEMENT, AND GREATER ACCESS TO SPECIALIZED SERVICES NOT USUALLY FOUND IN RURAL AREAS. THE PROGRAMS WILL ALSO FOSTER STRENGTHENED MANAGEMENT AND IMPROVED ACCESS TO SOPHISTICATED SERVICES AVAILABLE THROUGH THE SYSTEM AND ITS AFFILIATED CLINICIANS.PPP PROVIDES PHP AND PHA WITH OPERATIONAL OVERSIGHT, INCLUDING PROVIDING EMPLOYEES TO BOTH ENTITIES. PPP EMPLOYS APPROXIMATELY 1164 THROUGH A LEASED EMPLOYEE AGREEMENT WITH ITS AFFILIATE PARENT PROVIDENCE HEALTH & SERVICES - OREGON, IN ORDER TO SUPPORT PHP AND PHA. THESE EMPLOYEES PERFORM ADMINISTRATIVE AND OPERATIONAL SERVICES IN ORDER TO ALLOW PHP AND PHA TO PROVIDE IMPROVED HEALTHCARE SERVICES AND ACCESS, BENEFITING THE SURROUNDING COMMUNITY. PPP CHARGES THESE ADMINISTRATIVE EXPENSES TO PHP AND PHA BASED ON TIME NECESSARY TO PERFORM THE SUPPORT SERVICES. PPP PAYS ALL ADMINISTRATIVE AND PAYROLL COSTS ON BEHALF OF PHP AND PHA, WHICH ARE LATER REIMBURSED TO PPP.PROVIDENCE PREFERRED PROVIDER PROGRAM (THE PROGRAM), AS PART OF PROVIDENCE PLAN PARTNERS (PPP), IS A NETWORK OF MEDICAL PRACTITIONERS, HOSPITALS AND ANCILLARY MEDICAL PROVIDERS THROUGHOUT OREGON AND SOUTHWEST WASHINGTON DESIGNED TO MANAGE THE COST, DELIVERY, AND QUALITY OF HEALTHCARE IN THESE COMMUNITIES. THE PROGRAM OFFERS EMPLOYERS, SELF-INSURED EMPLOYERS, HEALTH AND WELFARE TRUSTS AND OTHER HEALTHCARE PURCHASERS A PROGRAM FOR REDUCING THE COST OF HEALTHCARE SERVICES, WHILE MAINTAINING THE QUALITY OF MEDICAL CARE TO ENROLLEES. THE PROGRAM ACTS AS A LIAISON BETWEEN HOSPITALS AND PAYORS BY INFORMING PAYORS AND ENROLLEES OF THE AGREEMENTS ENTERED ON THEIR BEHALF BY THE PROGRAM. THE PROGRAM NEITHER ASSUMES RISK OR RESPONSIBILITY FOR PAYMENT TO HOSPITALS OR PROVIDERS NOR GUARANTEES PAYMENT BY PAYORS OR PERFORMANCE BY HOSPITALS OR PROVIDERS OF ANY OF THE TERMS OF CONDITIONS SET FORTH IN ANY PAYOR AGREEMENTS.PROVIDENCE MANAGED CARE ORGANIZATION PROGRAM (MCO), AS PART OF PROVIDENCE PLAN PARTNERS (PPP), IS AN OREGON CERTIFIED WORKERS' COMPENSATION PROGRAM DESIGNED TO COMPLEMENT THE CLAIMS MANAGEMENT PROGRAM OF EMPLOYERS. AS SUCH, THE PROGRAM AIMS TO PROVIDE COORDINATED, HIGH QUALITY MEDICAL CARE TO WORKERS WHO SUFFER WORK-RELATED INJURIES OR ILLNESSES AND FOCUSES ON EARLY RETURN-TO-WORK STRATEGIES THAT KEEP EMPLOYEES PRODUCTIVE DURING RECOVERY. THE PROGRAM IS FUNCTIONALLY AND STRUCTURALLY SIMILAR TO PREFERRED PROVIDER PROGRAM (PPO), ALTHOUGH FOCUSED ON WORKERS' COMPENSATION ONLY. DURING 2019, THERE WERE 377,495 INDIVIDUALS THAT WERE ELIGIBLE TO USE THE PROVIDENCE MCO PROGRAM. 205206268 0 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 X 15 0 1 0 0 0 0 0 1 1 0 0 0 X 6 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OR X MICHAEL G WHITE 5035747500 4400 NE HALSEY BLDG 2 PORTLAND OR 97213 DEBRA CANALES DIRECTOR 0.10 59.90 X 0 2204087 353537 RHONDA MEDOWS MD CHAIR 10.00 50.00 X X 0 1888838 274454 CINDY STRAUSS FORMER SECRETARY 0.00 60.00 X 0 1735009 347233 MICHAEL L COTTON PRESIDENT/CEO 5.00 55.00 X X 0 1512186 250848 ROBERT A GLUCKMAN CHIEF MEDICAL OFFICER 5.00 45.00 X 0 825716 191667 MICHAEL G WHITE CFO/TREASURER 5.00 55.00 X 0 819423 164182 GREG ZAMUDIO SECRETARY 5.00 45.00 X 0 378199 71750 BRAD GARRIGUES CHIEF MARKETING OFFICER 5.00 45.00 X 0 377183 61326 LAUREL C SOOT MEDICAL DIRECTOR 2.00 38.00 X 0 368973 43602 STEPHANIE C DREYFUSS DIR. NETWORK DEVELOP. 5.00 45.00 X 0 338413 33819 ASHA N CHESNUTT MD MEDICAL DIRECTOR 2.00 38.00 X 0 303657 26494 MARK JENSEN CHIEF SERVICES OFFICER 5.00 45.00 X 0 258547 52996 ANDREW D TARAB VP INFORMATICS 5.00 45.00 X 0 278193 21876 AARON BALS CHIEF COMP. OFC. - EFF. 6/19 5.00 45.00 X 0 272118 24623 JON MCANNIS CHIEF INFO. OFFICER - THRU 9/19 5.00 45.00 X 0 258196 17109 CARESSE SAKAGAWA AVP, PRODUCT MARKETING 5.00 45.00 X 0 246650 25863 ISIAAH CRAWFORD PHD DIRECTOR 1.00 4.00 X 0 46550 0 JOSEPH BLANKENSHIP DIRECTOR 1.00 4.00 X 0 5000 0 HEATH SCHIESSER DIRECTOR 1.00 4.00 X 0 0 0 0 12116938 1961379 0 1 1 0 DELOITTE CONSULTING LLP 925 FOURTH AVE STE 3300 SEATTLE WA 981041106 CONSULTING SERVICES 3921795 OLSON MARKETING GROUP LLC 435 2ND ST LAKE OSWEGO OR 970343126 CONSULTING SERVICES 2978321 CHANGE HEALTHCARE LLC 5995 WINDWARD PKWY ALPHARETTA GA 30005 CONSULTING SERVICES 1197426 THE SOURCING GROUP LLC 77 WATER ST STE 902 NEW YORK NY 100054415 CONSULTING SERVICES 1103002 HIGHPOINT SOLUTIONS LLC 301 E GERMANTOWN PIKE NORRISTOWN PA 194016517 CONSULTING SERVICES 928898 14 1633986 1633986 MGMT FEE - REL. EXEMPT 561000 241088584 241088584 MSO ADMIN FEES 900099 3239057 3239057 PREF. PROVIDER PROGRAM 900099 2687015 2687015 MCO ADMIN FEES 900099 635034 635034 247649690 249283676 247649690 0 0 X 1710191 1710191 868378 782055 86323 95750805 86232449 9518356 27188435 22122172 5066263 348827 278313 70514 210191 210191 33909043 25346064 8562979 5715393 5540103 175290 12513390 8299634 4213756 18374670 13012170 5362500 9639470 6778367 2861103 643130 570991 72139 736869 504820 232049 4285662 4285662 53077 53077 PREMIUM TAX 18864287 18864287 COVER OREGON TAX 13448270 13448270 INSURANCE COMMISSIONER 848902 848902 ELECTRONIC CLAIMS 756504 681245 75259 630866 186235 444631 246496360 205206268 41290092 0 39677921 1723 0 58549218 827428 999872 2323487 7130145 0 6209311 16925557 22893148 59754393 95783417 7170251 9478481 220766 1059924 38186394 18280714 45577411 28819119 X 9729010 59729010 586411 586411 3861561 6648877 14176982 66964298 59754393 95783417 X 2787316 50000000 X X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 INVESTMENTS - OTHER SECURITIES 6209311 F 6209311 DUE FROM AFFILIATES 22893148 22893148 OTHER LIABILITIES 415231 DUE TO AFFILIATES 17865483 18280714 0 ST FRANCIS OF ASSISI CATHOLIC CHURCH 2450 NE 27TH ST BEND OR 97701 562302037 501 (C) (3) 11239 SEE PART IV ROSE HAVEN PO BOX 10405 PORTLAND OR 97296 205922682 501 (C) (3) 35000 SEE PART IV PROVIDENCE PORTLAND MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 931231494 501 (C) (3) 100000 SEE PART IV MICHELLE'S LOVE PO BOX 544 SCAPPOOSE OR 97056 454218268 501 (C) (3) 12536 SEE PART IV OREGON COMMUNITY PROGRAMS 1170 PEARL ST EUGENE OR 97401 931208532 501 (C) (3) 12536 SEE PART IV OREGON COMMUNITY FOUNDATION 1221 SW YAMHILL STREET SUITE 100 PORTLAND OR 97205 237315673 501 (C) (3) 1000000 SEE PART IV WASHINGTON STATE HEALTH INSURANCE POOL (WHIP) 2015 16TH STREET GREAT BEND KS 67530 470720973 501 (C) (3) 96895 SEE PART IV STAND FOR CHILDREN 2121 SW BROADWAY SUITE 111 PORTLAND OR 97201 521957214 501 (C) (3) 25000 SEE PART IV CATHOLIC CHARITIES 2740 SE POWELL BOULEVARD PORTLAND OR 97202 930386801 501 (C) (3) 225032 SEE PART IV LINES FOR LIFE 5100 SW MACADAM AVENUE PORTLAND OR 97239 930725294 501 (C) (3) 12536 SEE PART IV NEIGHBORHOOD HEALTH CENTER 6420 SW MACADAM SUITE 300 PORTLAND OR 97239 273524752 501 (C) (3) 60000 SEE PART IV NORTH BY NORTHEAST COMMUNITY HEALTH CENTER 714 NE ALBERTA STREET PORTLAND OR 97211 721618287 501 (C) (3) 10000 SEE PART IV FOOD FOR LANE COUNTY 770 BAILEY HILL RD EUGENE OR 97402 930888347 501 (C) (3) 11000 SEE PART IV BOYS AND GIRLS CLUB 8203 SE 7TH AVENUE SUITE 100 PORTLAND OR 97202 930474800 501 (C) (3) 25000 SEE PART IV NORTHWEST CHILDREN'S OUTREACH PO BOX 1604 LAKE OSWEGO OR 97035 931315508 501 (C) (3) 10000 SEE PART IV MEALS ON WHEELS PEOPLE PO BOX 19477 PORTLAND OR 972800477 930584318 501 (C) (3) 10000 SEE PART IV ST VINCENT DE PAUL SOCIETY-PORTLAND COUNCIL PO BOX 42157 PORTLAND OR 97242 930831082 501 (C) (3) 53417 SEE PART IV 17 PART I, LINE 2: DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT ALONG WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION. PART II, LINE 1, COLUMN (H): NAME OF ORGANIZATION OR GOVERNMENT: OREGON COMMUNITY FOUNDATION (H) PURPOSE OF GRANT OR ASSISTANCE: GRANTS TO BE MADE IN SUPPORT OF ACCESS TO CARE, BEHAVIOR HEALTH, AND SOCIAL DETERMINANTS OF HEALTH AND WELL-BEING. NAME OF ORGANIZATION OR GOVERNMENT: NORTHWEST CHILDREN'S OUTREACH (H) PURPOSE OF GRANT OR ASSISTANCE: PROVIDING INFANT CARE PRODUCTS TO THE POOR AND VULNERABLE TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. NAME OF ORGANIZATION OR GOVERNMENT: CATHOLIC CHARITIES (H) PURPOSE OF GRANT OR ASSISTANCE: DONATION TO HELP PROVIDE RESOURCES AND ADVOCACY TO THE POOR, VULNERABLE AND UNINSURED REGARDLESS OF RACE, FAITH OR ANY CONDITION IN LIFE. NAME OF ORGANIZATION OR GOVERNMENT: NORTH BY NORTHEAST COMMUNITY HEALTH CENTER (H) PURPOSE OF GRANT OR ASSISTANCE: SUPPORT GROWTH OF OUTREACH PROGRAM TO PROVIDE PRIMARY CARE SERVICES TO MEDICAID AND MEDICARE POPULATIONS WITH CHRONIC CONDITIONS. NAME OF ORGANIZATION OR GOVERNMENT: ST. VINCENT DE PAUL SOCIETY-PORTLAND COUNCIL (H) PURPOSE OF GRANT OR ASSISTANCE: PROVIDING RENT AND UTILITY ASSISTANCE TO LOW-INCOME INDIVIDUALS. NAME OF ORGANIZATION OR GOVERNMENT: STAND FOR CHILDREN (H) PURPOSE OF GRANT OR ASSISTANCE: IMPROVING ACCESS TO QUALITY EDUCATION FOR POOR AND VULNERABLE CHILDREN THROUGHOUT OREGON. NAME OF ORGANIZATION OR GOVERNMENT: BOYS AND GIRLS CLUB (H) PURPOSE OF GRANT OR ASSISTANCE: SUPPORTING TRAUMA SERVICES AND HEALTHY LIFESTYLES PROGRAM PROMOTING OVERALL HEALTH, AND EMPOWERING THE CHILDREN THEY SERVE. NAME OF ORGANIZATION OR GOVERNMENT: NEIGHBORHOOD HEALTH CENTER (H) PURPOSE OF GRANT OR ASSISTANCE: PROVIDING DENTAL CARE TO LOW-INCOME, UNISURED, AND UNDER-INSURED INDIVIDUALS. NAME OF ORGANIZATION OR GOVERNMENT: FOOD FOR LANE COUNTY (H) PURPOSE OF GRANT OR ASSISTANCE: SERVING THE POOR AND VULNERABLE, LOW INCOME AND UNINSURED POPULATION OF LANE COUNTY. NAME OF ORGANIZATION OR GOVERNMENT: LINES FOR LIFE (H) PURPOSE OF GRANT OR ASSISTANCE: PROVIDING DIRECT SERVICE TO THE COMMUNITY ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND WELL BEING AND BEHAVIORAL HEALTH TO THE POOR AND VULNERABLE SERVING ALL OF OREGON. NAME OF ORGANIZATION OR GOVERNMENT: OREGON COMMUNITY PROGRAMS (H) PURPOSE OF GRANT OR ASSISTANCE: 2019 CHARITY AUCTION DONATION/MATCH TOTAL DONATION OF $25,072 IN SUPPORT OF PROVIDING AFFORDABLE HOUSING, HEALTHY FOOD ACCESS, PROVIDING DIRECT SERVICES TO THE COMMUNITY WHILE PROMOTING OVERALL POPULATION HEALTH AND SOCIAL DETERMINANTS OF HEALTH AND WELL BEING TO SUPPORT THE HOMELESS, POOR AND VULNABLE FAMILIES IN THE PORTLAND METRO AREA. NAME OF ORGANIZATION OR GOVERNMENT: OREGON COMMUNITY PROGRAMS (H) PURPOSE OF GRANT OR ASSISTANCE: PROVIDING SAFE, HEALTHY AND PROSOCIAL EXTRACURRICULAR ACTIVITIES FOR CHILDREN AND PROVIDING DIRECT SERVICE TO THE COMMUNITY ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND WELL BEING AND BEHAVIORAL HEALTH TO THE POOR AND VULNERABLE SERVING LANE COUNTY AND OTHER OREGON COUNTIES. NAME OF ORGANIZATION OR GOVERNMENT: PATIENT ASSISTANCE FUND-MONTHLY SUPPORT (H) PURPOSE OF GRANT OR ASSISTANCE: TO PROVIDE FINANCIAL ASSISTANCE TO PATIENTS BEING SERVED AT PHS WHO MEET ELGIBILITY REQUIREMENTS. THE BIGGEST PART OF THIS PROGRAM IS FOR MEDICATION ASSISTANCE. NAME OF ORGANIZATION OR GOVERNMENT: ROSE HAVEN (H) PURPOSE OF GRANT OR ASSISTANCE: IN SUPPORT OF THE ADVOCACY PROGRAM PROVIDING PERSONAL GUIDANCE AND DIRECT SERVICE ALLOCATIONS ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND WELL BEING TO THE POOR AND VULNERABLE FAMILIES THE PORTLAND METRO AREA. NAME OF ORGANIZATION OR GOVERNMENT: ST. FRANCIS OF ASSISI CATHOLIC CHURCH (H) PURPOSE OF GRANT OR ASSISTANCE: TO FUND A NEW STOVE AND INSTALLATION FOR THE SAFETY OF THE FACILITY TO HELP SERVE THE POOR AND VULNERABLE POPULATION. SOCIAL DETERMINANTS OF HEALTH AND WELL BEING. NAME OF ORGANIZATION OR GOVERNMENT: WASHINGTON STATE HEALTH INSURANCE POOL (WHIP) (H) PURPOSE OF GRANT OR ASSISTANCE: TO COVER ADULTS AND CHILDREN WHO ARE UNABLE TO OBTAIN MEDICAL INSURANCE BECAUSE OF HEALTH CONDITIONS. NAME OF ORGANIZATION OR GOVERNMENT: MEALS ON WHEELS PEOPLE (H) PURPOSE OF GRANT OR ASSISTANCE: PROVIDE MEALS TO THE FRAIL & ELDERLY TO REDUCE MALNUTRITION IN ELDERLY PEOPLE TO HELP REDUCE: LOSS OF MUSCLE MASS, WEAKNESS & FATIGUE, INFECTION & WITHOUT NUTRITION, DEATH. 0 1 0 0 0 0 0 1 0 DEBRA CANALES DIRECTOR 0 893126 0 651636 0 659325 0 336204 0 17333 0 2557624 0 929511 RHONDA MEDOWS MD CHAIR 0 941139 0 618340 0 329359 0 254421 0 20033 0 2163292 0 577152 CINDY STRAUSS FORMER SECRETARY 0 823797 0 528043 0 383169 0 321803 0 25430 0 2082242 0 640817 MICHAEL L COTTON PRESIDENT/CEO 0 836268 0 453858 0 222060 0 227707 0 23141 0 1763034 0 387548 ROBERT A GLUCKMAN CHIEF MEDICAL OFFICER 0 440193 0 211382 0 174141 0 161590 0 30077 0 1017383 0 248094 MICHAEL G WHITE CFO/TREASURER 0 395999 0 284256 0 139168 0 141511 0 22671 0 983605 0 216536 GREG ZAMUDIO SECRETARY 0 252343 0 88106 0 37750 0 50896 0 20854 0 449949 0 125013 BRAD GARRIGUES CHIEF MARKETING OFFICER 0 255583 0 101666 0 19934 0 40310 0 21016 0 438509 0 0 LAUREL C SOOT MEDICAL DIRECTOR 0 307273 0 19367 0 42333 0 18188 0 25414 0 412575 0 0 STEPHANIE C DREYFUSS DIR. NETWORK DEVELOP. 0 264698 0 51550 0 22165 0 17621 0 16198 0 372232 0 54715 ASHA N CHESNUTT MD MEDICAL DIRECTOR 0 264667 0 13598 0 25392 0 13715 0 12779 0 330151 0 0 MARK JENSEN CHIEF SERVICES OFFICER 0 207095 0 40335 0 11117 0 26808 0 26188 0 311543 0 40335 ANDREW D TARAB VP INFORMATICS 0 245302 0 26475 0 6416 0 13161 0 8715 0 300069 0 25694 AARON BALS CHIEF COMP. OFC. - EFF. 6/19 0 233512 0 38202 0 404 0 12491 0 12132 0 296741 0 20702 JON MCANNIS CHIEF INFO. OFFICER - THRU 9/19 0 208176 0 48943 0 1077 0 1761 0 15348 0 275305 0 48943 CARESSE SAKAGAWA AVP, PRODUCT MARKETING 0 207973 0 24010 0 14667 0 12943 0 12920 0 272513 0 24010 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, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE. PART I, 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 INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR: DEBRA CANALES - $613,775 CINDY STRAUSS - $344,018 RHONDA MEDOWS, MD - $283,794 MICHAEL L. COTTON - $182,323 ROBERT A. GLUCKMAN - $130,796 MICHAEL G. WHITE - $116,110 GREG ZAMUDIO - $36,907 STEPHANIE C. DREYFUSS - $3,165 PART I, LINE 7 NON-FIXED PAYMENTS THE PROVIDENCE EXECUTIVE COMPENSATION COMMITTEE (OF THE BOARD) HAS APPROVED AN EXECUTIVE COMPENSATION PHILOSOPHY THAT CLOSELY TIES AN EXECUTIVE'S COMPENSATION TO PERFORMANCE BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE EXECUTIVE. THERE IS NO GUARANTEE THAT THIS PART OF A LEADER'S COMPENSATION WILL BE PAID IF THE PERFORMANCE OF THE ORGANIZATION OR OF THE INDIVIDUAL DOES NOT MEET THE PERFORMANCE STANDARDS FOR PAYMENT, NO PERFORMANCE-BASED PAYMENT IS MADE. THIS APPROACH IS REFLECTED IN PROVIDENCE'S LEADERSHIP ANNUAL INCENTIVE PLAN, WHICH IS A PERFORMANCE-BASED ANNUAL INCENTIVE PLAN THAT AFFORDS PARTICIPATING EXECUTIVES THE OPPORTUNITY TO EARN "AT RISK" COMPENSATION THROUGH PERFORMANCE AGAINST VERY CHALLENGING GOALS. PAYOUTS WILL BE AWARDED BASED ON GOALS RELATED TO STRATEGIC OBJECTIVES, FISCAL STEWARDSHIP AND QUALITY OF CARE THESE GOALS ARE SET BEFORE THE YEAR BEGINS AND ARE VERY CHALLENGING. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S PERFORMANCE GOALS TO MAKE SURE THEY ARE SUFFICIENTLY CHALLENGING, AND TO MAKE SURE THE GOALS ARE DESIGNED TO HELP PROVIDENCE MEET ITS MISSION AND STRATEGIC PURPOSES. EACH YEAR THE PSJH BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE INCENTIVE PERFORMANCE AND MUST CERTIFY THE ACHIEVEMENT OF PERFORMANCE GOALS BEFORE ANY AWARDS ARE PAID OUT. WHEN REVIEWING AND APPROVING TOTAL COMPENSATION FOR EXECUTIVES, THE EXECUTIVE COMPENSATION COMMITTEE INCLUDES INCENTIVE AWARDS, TO MAKE SURE THAT COMPENSATION IS REASONABLE AND WELL-SUPPORTED BY MARKET DATA. THE COMMITTEE CONSISTS ONLY OF DIRECTORS WHO ARE FREE OF CONFLICTS OF INTEREST, AND THE COMMITTEE RELIES ON MARKET SURVEY DATA GATHERED BY AN INDEPENDENT CONSULTANT. THE COMMITTEE CONDUCTS THIS REVIEW AND APPROVAL PROCESS IN A MANNER THAT IS IN ACCORDANCE WITH IRS REQUIREMENTS FOR COMPENSATION OF TAX-EXEMPT ORGANIZATION LEADERS, AND IN ACCORDANCE WITH THE BEST GOVERNANCE PRACTICES IN THE INDUSTRY. FORM 990, PART V, LINE 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 PROVIDENCE HEALTH & SERVICES - OREGON IS THE SOLE CORPORATE MEMBER OF PROVIDENCE PLAN PARTNERS. FORM 990, PART VI, SECTION A, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PROVIDENCE PLAN PARTNERS HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBER RESERVES THE RIGHT TO APPOINT DIRECTORS TO THE PROVIDENCE PLAN PARTNERS BOARD. ALL DIRECTOR NOMINATIONS THAT COME FROM THE PROVIDENCE PLAN PARTNERS BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE HEALTH & SERVICES - OREGON, AS THE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL AND TYPE OF VOTING RIGHTS THE FOLLOWING POWERS RESIDE WITH THE CORPORATE MEMBER: 1) TO ADOPT OR CHANGE THE MISSION, PHILOSOPHY, AND VALUES, INCLUDING THE STRATEGIC PLAN AND MISSION STATEMENT. 2) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS. 3) TO APPROVE THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE TRANSFER, ASSIGNMENT OR ENCUMBERING OF ASSETS EXCEEDING A SPECIFIED THRESHOLD, OR THE SALE OR TRANSFER OF ANY PROPERTY WHICH MAY HAVE HISTORICAL OR RELIGIOUS SIGNIFICANCE. 4) TO APPROVE THE DISSOLUTION OR LIQUIDATION. 5) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS. 6) TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANTS. 7) TO APPROVE THE CLOSURE OF ANY INSTITUTION OR MAJOR ENTITY OR WORK OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE REGULARLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX-EXEMPT PARENT, PROVIDENCE HEALTH & SERVICES - WASHINGTON, 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 PURCHASED SERVICES - OTHER: PROGRAM SERVICE EXPENSES 11,924,445. MANAGEMENT AND GENERAL EXPENSES 917,006. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,841,451. PROFESSIONAL FEES - CONSULTING: PROGRAM SERVICE EXPENSES 7,615,923. MANAGEMENT AND GENERAL EXPENSES 7,645,604. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,261,527. PHARMACY ADMIN FEES: PROGRAM SERVICE EXPENSES 2,922,969. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,922,969. NETWORK FEES: PROGRAM SERVICE EXPENSES 1,385,022. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,385,022. ACTUARIAL FEES: PROGRAM SERVICE EXPENSES 886,814. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 886,814. ELECTRONIC DATA INTERCHANGE: PROGRAM SERVICE EXPENSES 351,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 351,500. ID CARDS: PROGRAM SERVICE EXPENSES 255,936. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 255,936. RECORDS MANAGEMENT: PROGRAM SERVICE EXPENSES 3,455. MANAGEMENT AND GENERAL EXPENSES 369. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,824. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS 50,000,000. COVENANT ACO 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 611573313 HEALTHCARE TX 501(C)(3) 12,I CHS 1 COVENANT HEALTH NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 461259908 HEALTHCARE CA 501(C)(3) 12,III SJHS 1 COVENANT HEALTH PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 463516417 HEALTHCARE TX 501(C)(3) 12,I CHS 1 COVENANT HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS 1 COVENANT HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752897026 HEALTHCARE TX 501(C)(3) 7 CHS 1 COVENANT HOSPITAL HOBBS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 844273963 HEALTHCARE TX 501(C)(3) 3 CHS 1 COVENANT MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 822913146 HEALTHCARE TX 501(C)(3) 3 CHS 1 COVENANT MEDICAL GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752743883 HEALTHCARE TX 501(C)(3) 3 CHS 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 1 EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT WA 982065128 943264605 TRANS. CARE WA 501(C)(3) 10 N/A 0 FACEY MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 954322584 SUPPORT CA 501(C)(3) 7 PHS SOCAL 1 GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 201910170 SUPPORT WA 501(C)(3) 7 PHS WA 1 GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC WA 98188 273133200 HEALTHCARE WA 501(C)(3) 7 SHS 1 GRACE CLINIC OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 844273963 HEALTHCARE TX 501(C)(3) 3 CHS 1 HMTS INC 1 HOAG DRIVE NEWPORT BEACH CA 92658 453583707 HEALTHCARE CA 501(C)(3) 12,I HMHP 1 HOAG CHARITY SPORTS 2081 BUSINESS CENTER DR STE 195 NEWPORT BEACH CA 92663 452982422 SUPPORT CA 501(C)(3) 7 HHF 1 HOAG CLINIC 1 HOAG DRIVE BOX 6100 NEWPORT BEACH CA 92658 330676831 HEALTHCARE CA 501(C)(3) 10 HMHP 1 HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH CA 92663 953222343 FUNDRAISING CA 501(C)(3) 7 HMHP 1 HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG ROAD BOX 6100 NEWPORT BEACH CA 92663 951643327 HEALTHCARE CA 501(C)(3) 3 CHN 1 HOSPICE OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752133781 HEALTHCARE TX 501(C)(3) 10 CHS 1 INLAND NORTHWEST HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911307555 HEALTHCARE WA 501(C)(3) 3 PHS WA 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 1 INSTITUTE FOR SYSTEMS BIOLOGY 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 912003593 HEALTHCARE WA 501(C)(3) 7 WHC 1 JOHN WAYNE CANCER INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 954291515 HEALTHCARE CA 501(C)(3) 4 PSJHC 1 KADLEC AUXILIARY INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 916033089 SUPPORT WA 501(C)(3) 12,III KRMC 1 KADLEC FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 237005501 SUPPORT WA 501(C)(3) 12,I KRMC 1 KADLEC REGIONAL MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 910655392 HEALTHCARE WA 501(C)(3) 3 WHC 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 1 LUBBOCK HERITAGE HOSPITAL LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 264021016 HEALTHCARE TX 501(C)(3) 3 CHS 1 LUBBOCK METHODIST HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752220963 HEALTHCARE TX 501(C)(3) 7 CHS 1 LUNDBERG ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911562797 SUPPORT OR 501(C)(3) 7 PHS OR 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 1 METHODIST CHILDREN'S HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752428911 HEALTHCARE TX 501(C)(3) 3 CHS 1 METHODIST HOSPITAL LEVELLAND 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752246348 HEALTHCARE TX 501(C)(3) 3 CHS 1 METHODIST HOSPITAL PLAINVIEW 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752426010 HEALTHCARE TX 501(C)(3) 3 CHS 1 MISSION HOSPITAL REGIONAL MEDICAL CTR 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 951643360 HEALTHCARE CA 501(C)(3) 3 CHN 1 NORTHWEST HOPE & HEALING FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 200799737 SUPPORT WA 501(C)(3) 12,I SHS 1 PACMED CLINICS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 562290878 HEALTHCARE WA 501(C)(3) 10 WHC 1 PH&S FOUNDATIONSFVSA & SCVSA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 953544877 HEALTHCARE CA 501(C)(3) 7 PHS SOCAL 1 PROVIDENCE ALASKA FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 920093565 HEALTHCARE AK 501(C)(3) 12,I PHS WA 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 1 PROVIDENCE BLANCHET ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911789266 SUPPORT WA 501(C)(3) 7 PHS WA 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 1 PROVIDENCE COMMUNITY HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 930692907 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE DETHMAN HOUSE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 473385506 SUPPORT WA 501(C)(3) 7 N/A 0 PROVIDENCE GAMELIN HOUSE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 311744654 SUPPORT WA 501(C)(3) 7 PHS WA 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 1 PROVIDENCE HEALTH & SERVICES - OREGON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 510216587 HEALTHCARE OR 501(C)(3) 3 PHS 1 PROVIDENCE HEALTH & SERVICES - WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 510216586 HEALTHCARE WA 501(C)(3) 3 PHS 1 PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911303277 HEALTHCARE WA 501(C)(3) 3 PMWHC 1 PROVIDENCE HEALTH ASSURANCE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 550828701 MEDICAID OR 501(C)(4) N/A PHP 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 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 1 PROVIDENCE HEALTH PLAN 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 930863097 HEALTHCARE OR 501(C)(4) N/A PPP 1 PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 510216589 HEALTHCARE CA 501(C)(3) 3 PHS 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 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 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 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 1 PROVIDENCE MARIANWOOD FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 931554288 HEALTHCARE WA 501(C)(3) 12,I PHS W WA 1 PROVIDENCE MEDICAL INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 330283773 HEALTHCARE CA 501(C)(3) 12,I PHS SOCAL 1 PROVIDENCE MILWAUKIE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 943079515 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE MINISTRIES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 RELIGIOUS ORG WA 501(C)(3) 1 N/A 0 PROVIDENCE MOUNT ST VINCENT FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911188119 HEALTHCARE WA 501(C)(3) 7 PHS WA 1 PROVIDENCE NEWBERG HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 930889144 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE PETER CLAVER ASSOCIATION 1801 LIND 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