2019-11-13T19:10:16-06:00 2018-12-31 346565596 ERNST & YOUNG US LLP 560 MISSION STREET SUITE 1600 SAN FRANCISCO CA 94105 990 2018-01-01 810231793 PROVIDENCE HEALTH & SERVICES - MONTANA PROV 4255253985 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 JO ANN ESCASA-HAIGH EVP/ASSISTANT TREASURER 4255253985 2019-11-13 1 EVA NITTA P01286320 4158948000 104.187.159.70 2019-11-13 19:09:54 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 03333E4B0684ADD489F38648AD786F05819FFCF0 2018 2020-03-31 21:24:44Z X PROVIDENCE ST PATRICK HOSPITAL MIKE BUTLER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 434833471 0 0928 X HTTP://MONTANA.PROVIDENCE.ORG X 1991 MT SEE SCHEDULE O.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. 13 13 2447 208 0 85691 1884099 736036 407121025 390852329 3519858 1966436 5418024 21369340 417943006 414924141 1550785 1985072 0 0 139330614 146645035 0 0 0 241910053 234534772 382791452 383164879 35151554 31759262 269125990 276978099 97789258 103044025 171336732 173934074 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 243404775 0 344073402 SEE SCHEDULE O.PROVIDENCE 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, 829 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. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON.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.ACUTE CARE - INPATIENT & OUTPATIENTTOTAL ADMISSIONS: 10,688TOTAL PATIENT DAYS: 47,489TOTAL OUTPATIENT VISITS: 283,973HIGHLIGHTS/ACHIEVEMENTS:IN 2015 ST. PATRICK HOSPITAL OPENED A FAMILY MATERNITY CENTER AND STARTED DELIVERING BABIES FOR THE FIRST TIME IN OVER 40 YEARS. * MOUNTAIN-PACIFIC QUALITY HEALTH PRESENTED PROVIDENCE ST. PATRICK HOSPITAL WITH THE 2016 HOSPITAL COMMITMENT TO QUALITY AWARD. MOUNTAIN-PACIFIC QUALITY HEALTH'S QUALITY AWARDS REFLECT CONTINUED EXPECTATIONS OF ENGAGING PATIENTS AND FAMILIES IN IMPROVING CARE AS WELL AS TOP PERFORMANCE ON QUALITY INDICATORS AND SYSTEM CHANGES, AS PROMOTED BY TODAY'S HEALTH CARE INDUSTRY. STRONG LEADERSHIP SUPPORT IS CONSIDERED, SINCE IT IS VITAL FOR ACHIEVING AND SUSTAINING EXCELLENT PATIENT SAFETY AND IMPROVEMENTS IN PATIENT CARE. IN ADDITION, ST. PAT'S EARNED MOUNTAIN PACIFIC'S NEW AWARD CALLED CHASING ZERO, FOR DEMONSTRATING SUSTAINED PERIODS OF ZERO INFECTIONS FOR SPECIFIC HOSPITAL-ACQUIRED INFECTIONS. * PROVIDENCE ST. PATRICK HOSPITAL WAS NAMED ONE OF THE NATION'S 50 TOP CARDIOVASCULAR HOSPITALS BY TRUVEN HEALTH ANALYTICS. THIS IS THE NINTH TIME PROVIDENCE ST. PATRICK HOSPITAL HAS BEEN RECOGNIZED WITH THIS HONOR. THE 50 TOP CARDIOVASCULAR HOSPITALS STUDY EVALUATES PERFORMANCE IN KEY AREAS: RISK-ADJUSTED MORTALITY, RISK-ADJUSTED COMPLICATIONS, CORE MEASURES (A GROUP OF MEASURES THAT ASSESS PROCESS OF CARE), PERCENTAGE OF CORONARY BYPASS PATIENTS WITH INTERNAL MAMMARY ARTERY USE, 30-DAY MORTALITY RATES, 30-DAY READMISSION RATES, SEVERITY-ADJUSTED AVERAGE LENGTH OF STAY, AND WAGE- AND SEVERITY-ADJUSTED AVERAGE COST.* ST. PATRICK HOSPITAL'S EMERGENCY DEPARTMENT AND CATHETERIZATION LABORATORY RECEIVED THE 2016 MISSION: LIFELINE RECEIVING CENTER GOLD RECOGNITION AWARD MISSION FROM THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION FOR OUR QUALITY OF HEART ATTACK CARE AS DEMONSTRATED THROUGH THE 2015 ACTION REGISTRY -GWTG DATA. THIS AWARD RECOGNIZES SUCCESS IN IMPLEMENTING A HIGH QUALITY CARE PROGRAM, ENSURING THAT OUR ST-ELEVATION MYOCARDIAL INFARCTION (STEMI) PROGRAM TREATS PATIENTS ACCORDING TO NATIONALLY ACCEPTED GUIDELINES. STEMI IS A SERIOUS HEART ATTACK DURING WHICH ONE OF THE HEART'S MAJOR ARTERIES IS BLOCKED, AND MUST BE TREATED QUICKLY AND APPROPRIATELY FOR THE PATIENT TO SURVIVE. * PROVIDENCE ST. PATRICK HOSPITAL WAS ONE OF 844 HOSPITALS TO RECEIVE AN "A" RANKING AMONG THE SAFEST HOSPITALS IN THE UNITED STATES ACCORDING TO LEAPFROG HOSPITAL SAFETY GRADES, A NATIONAL PATIENT SAFETY WATCHDOG. LEAPFROG SAFETY GRADES ASSIGN A, B, C, D AND F LETTER GRADES TO HOSPITALS NATIONWIDE AND PROVIDE THE MOST COMPLETE PICTURE OF PATIENT SAFETY IN THE U.S. * ST. PATRICK HOSPITAL RECEIVED RECOGNITION FROM US NEWS AND WORLD REPORT FOR BEING A TOP 50 HOSPITAL FOR UROLOGY CARE IN 2016. HOSPITALS ARE SCORED ON VOLUME OF HIGH-RISK PATIENTS, NURSE STAFFING AND PATIENT SURVIVAL. SPECIFIC CRITERIA THAT CONTRIBUTED TO THE RANKING INCLUDED OUR PATIENT'S 30-DAY SURVIVAL RATE (SCORE 10/10), THE USE OF ADVANCED TECHNOLOGIES (SCORE 6/6), PATIENT SERVICES (SCORE 8/9), MAGNET RECOGNITION, SERVING AS A LEVEL II TRAUMA CENTER AND HAVING AN INTENSIVIST PROGRAM. IN ADDITION, ST. PAT'S WAS RECOGNIZED AS "HIGH PERFORMING" IN AORTIC VALVE SURGERY, HEART BYPASS SURGERY AND PULMONOLOGY.* PROVIDENCE ST. PATRICK HOSPITAL WAS AWARDED THE PARTNER FOR CHANGE AWARD FROM PRACTICE GREENHEALTH FOR IMPLEMENTATION OF A SIGNIFICANT NUMBER OF ENVIRONMENTAL STEWARDSHIP PROGRAMS AND BEST PRACTICES, AND CONTINUOUSLY IMPROVING AND EXPANDING UPON THESE PROGRAMS ON THE PATH TO SUSTAINABILITY.* PROVIDENCE ST. PATRICK HOSPITAL WAS GIVEN THE WOMEN'S CHOICE AWARD FOR ONE OF AMERICA'S 100 BEST HOSPITALS FOR PATIENT EXPERIENCE IN MONTANA. THE HOSPITALS ARE HIGHLY RATED BY WOMEN FOR CREATING AN EXTRAORDINARY PATIENT EXPERIENCE FOR WOMEN AND THEIR FAMILIES. THE PROCESS BEGINS WITH SCORES DERIVED FOR EACH HOSPITAL IN THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) DATABASE. THE SCORE TAKES A SUBSET OF THE QUESTIONS HCAHPS USES THAT RESEARCH AND EXPERIENCE SHOWS ARE MORE IMPORTANT TO WOMEN THAN TO MEN. WOMENCERTIFIED APPLIES WEIGHT TO EACH OF THOSE QUESTIONS TO ADJUST FOR RELATIVE IMPORTANCE TO ARRIVE AT A NUMERICAL SCORE. THE SCORING IS OBJECTIVE AND UNIFORM. THE 100 BEST SCORES IN EACH OF THE FOUR CATEGORIES DETERMINE THE AMERICA'S 100 BEST HOSPITALS FOR OUTSTANDING PATIENT EXPERIENCE BY WOMENCERTIFIED AWARD WINNERS.HEALTHCARE JOINT VENTURESTHROUGH PARNERSHIPS, ST. PATRICK'S IS ABLE TO PROVIDE ADDITIONAL HEALTHCARE SERVICES TO THE COMMUNITY. 45372635 0 62965506 SEE SCHEDULE O.PRIMARY CARETOTAL VISITS: 305,767* NINE WESTERN MONTANA PROVIDENCE MEDICAL GROUP MEDICAL CLINICS RECEIVED NATIONAL RECOGNITION AS LEVEL 3 PATIENT-CENTERED MEDICAL HOMES, THE HIGHEST ACCREDITATION POSSIBLE, BY THE NATIONAL COMMITTEE OF QUALITY ASSURANCE (NCQA). LEVEL 3 STATUS INVOLVES MEETING AND DOCUMENTING REQUISITE ELEMENTS IN SIX CATEGORIES, SUCH AS TRACKING AND COORDINATING PATIENT CARE, EASING ACCESS TO PROVIDERS THROUGH IMPROVED HOURS AND SCHEDULING, AND MEASURING AND IMPROVING CLINIC/PROVIDER PERFORMANCE. NCQA RECOGNITION ENSURES THAT THESE CLINICS USE EVIDENCE-BASED, PATIENT-CENTERED PROCESSES THAT FOCUS ON HIGHLY COORDINATED CARE AND LONG?TERM INTERACTIVE RELATIONSHIPS BETWEEN THE CARE TEAMS AND THE PATIENT. A PATIENT-CENTERED MEDICAL HOME IS A MODEL OF PRIMARY CARE THAT COMBINES TEAMWORK AND INFORMATION TECHNOLOGY TO IMPROVE CARE, IMPROVE THE PATIENT'S CARE EXPERIENCE, AND REDUCE COSTS. MEDICAL HOMES FOSTER ONGOING PARTNERSHIPS BETWEEN PATIENTS AND THEIR CLINICIANS USING MULTI-DISCIPLINARY CARE TEAMS TO COORDINATE TREATMENT, FOLLOW-UP AND SUPPORT. RESEARCH CONFIRMS THAT MEDICAL HOMES ADVANCE THE "TRIPLE AIM" OF HIGHER QUALITY, BETTER PATIENT EXPERIENCE AND COST CONTAINMENT.IN MISSOULA, THE PMG CLINICS INCLUDE: * BROADWAY INTERNAL MEDICINE* GRANT CREEK FAMILY MEDICINE* MONTANA INTERNAL MEDICINE* WOMEN'S CARE & FAMILY WELLNESS * MISSOULA FAMILY MEDICALPMG CLINICS OUTSIDE OF MISSOULA INCLUDE:* FLORENCE FAMILY MEDICINE IN FLORENCE* LIFESPAN FAMILY MEDICINE IN STEVENSVILLE* ST. JOSEPH MEDICAL CLINIC IN POLSON * ST. JOSEPH MEDICAL CLINIC IN RONAN* WITH A GRANT FROM THE MONTANA HEALTH FOUNDATION, GRANT CREEK FAMILY PRACTICE, A PATIENT-CENTERED MEDICAL HOME, BEGAN TO INTEGRATE BEHAVIORAL HEALTH INTO THE PRIMARY CARE SETTING. THE PRACTICE HIRED A LICENSED CLINICAL SOCIAL WORKER, WITH THE GOAL OF PROVIDING PATIENTS SEAMLESS, EFFECTIVE, MENTAL HEALTH CARE. FOLLOWING GRANT CREEK'S LEAD, THIS SERVICE WILL BE IMPLEMENTED INTO THE EIGHT OTHER WESTERN MONTANA PROVIDENCE PATIENT-CENTERED MEDICAL HOMES, WITH SPECIALTY SUPPORT FROM PROVIDENCE WESTERN MONTANA PSYCHIATRIC SERVICES. 1985072 1985072 0 GRANTS AND ALLOCATIONS.SEE SCHEDULE I. 0 0 0 OTHER PROGRAM SUPPORT - CAPITATION REVENUE 0 0 0 290762482 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 2447 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 MT X JO ANN ESCASA-HAIGH 9493814000 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 DICK P ALLEN DIRECTOR 0.10 2.00 X 0 30360 0 RICHARD BLAIR BOARD CHAIR 0.10 4.60 X X 0 60360 0 ISIAAH CRAWFORD PHD DIRECTOR 0.10 4.10 X 0 30360 0 SR LUCILLE DEAN SP DIRECTOR 0.10 2.10 X 0 0 0 SR DIANE HEJNA CSJ RN DIRECTOR 0.10 1.90 X 0 0 0 MICHAEL HOLCOMB DIRECTOR 0.10 5.30 X 0 30360 0 SR PHYLLIS HUGHES RSM DRPH DIRECTOR 0.10 5.00 X 0 0 0 SALLYE LINER MSN RN DIRECTOR 0.10 4.70 X 0 25360 0 MARY LYONS PHD DIRECTOR 0.10 1.50 X 0 30360 0 WALTER NOCE JR DIRECTOR 0.10 2.00 X 0 30360 0 DAVE OLSEN BOARD VICE CHAIR 0.10 5.50 X X 0 30360 0 CAROLINA REYES MD DIRECTOR 0.10 4.60 X 0 30360 0 PHOEBE YANG DIRECTOR 0.10 2.00 X 0 25360 0 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 1.00 49.00 X 0 210649 37871 VENKAT BHAMIDIPATI EVP/TREASURER 1.00 49.00 X 0 1227009 673841 MIKE BUTLER PRESIDENT 1.00 59.00 X 0 4583366 968461 JO ANN ESCASA-HAIGH EVP/ASSISTANT TREASURER 1.00 49.00 X 0 1110835 527424 CINDY STRAUSS SECRETARY 1.00 59.00 X 0 1884790 690548 JIM WATSON ESQ ASSISTANT SECRETARY 1.00 59.00 X 0 576188 65143 JOHN WHIPPLE ASSISTANT SECRETARY 1.00 49.00 X 0 1029547 345689 KIRK BODLOVIC CFO/ST. PATRICK HOSPITAL 50.00 0.00 X 0 268906 100872 ROBERT HELLRIGEL SVP-CE/SENIOR & COMM. SERVICES 1.00 54.00 X 0 1077407 312063 CARTER BECK MD PHYSICIAN 50.00 0.00 X 1294971 0 105619 STEWART LONG III PHYSICIAN 50.00 0.00 X 1403344 0 134964 JAMES MADDUX PHYSICIAN 50.00 0.00 X 1337192 0 113335 SIMONE MUSCO MD PHYSICIAN 50.00 0.00 X 1263707 0 118158 JOSEPH SCHMOKER PHYSICIAN 50.00 0.00 X 1229079 0 100755 ROD F HOCHMAN MD FORMER PRESIDENT/CEO 0.00 60.00 X 0 6569155 4266266 TODD HOFHEINS FORMER EVP/CFO/TREAS. 0.00 60.00 X 0 820571 35946 TAMMY TEODOSIO FORMER ASSISTANT SECRETARY 1.00 49.00 X 0 122692 24264 DAVID BROWN FORMER VP/STRATEGY & BUSINESS DEV 0.00 55.00 X 0 1450101 280369 DEBBIE BURTON FORMER SVP/CHIEF NRSG. OFFICER 0.00 60.00 X 0 752349 219917 DEBRA CANALES FORMER EVP/CAO 0.00 60.00 X 0 2732103 724111 AMY COMPTON-PHILLIPS FORMER EVP/CHIEF CLINICAL OFFICER 0.00 55.00 X 0 1654073 667254 MARY CRANSTOUN FORMER VP/TOTAL REWARDS 0.00 60.00 X 0 874811 290673 JEFFREY FEE FORMER CE/WESTERN MT. REGION 0.00 0.00 X 0 204938 16504 MARK GARGETT FORMER VP/DIGITAL INTEGRATION 0.00 50.00 X 0 389747 17140 JOEL GILBERTSON FORMER SVP/COMMUNITY PARTNERSHIPS 0.00 60.00 X 0 1606496 361983 OREST HOLUBEC FORMER SVP/CHIEF COMM/EXT AFF OFF 0.00 55.00 X 0 1111242 274690 AARON MARTIN FORMER SVP/STRATEGY & INNOVATION 0.00 70.00 X 0 1196074 435284 TOM MCDONAGH FORMER VP/CHIEF INVESTMENT OFFICER 0.00 58.00 X 0 1103684 122850 RHONDA MEDOWS MD FORMER EVP/POPULATION HEALTH 0.00 60.00 X 0 2024470 605869 JACK MUDD FORMER SVP/MISSION LEADERSHIP 0.00 29.00 X 0 477056 124468 JANICE NEWELL FORMER SVP/CHIEF INFORMATION OFFCR 0.00 60.00 X 0 1512913 154123 HARVEY SMITH FORMER SVP/CHIEF COSTUMER SVC. OFF 0.00 0.00 X 0 583049 16156 TERRY SMITH FORMER SVP/MANAGEMENT SVCS 0.00 0.00 X 0 232094 21187 GREG TILL FORMER VP/CHIEF TALENT OFFICER 0.00 65.00 X 0 963974 295508 SHARON TONCRAY FORMER SVP/CHIEF LABOR EE COUNSEL 0.00 60.00 X 0 1423352 178439 LISA VANCE FORMER SVP/CLINICAL PROGRAM SRVCS 0.00 60.00 X 0 1375835 351382 MIKE WATERS FORMER VP, CAO/PHYSICIAN SERVICES 0.00 65.00 X 0 863546 295528 6528293 42336622 14074654 232 1 1 0 0 650436 85600 736036 ACUTE CARE 621110 322184391 322184391 PRIMARY CARE 621110 60377026 60377026 HEALTHCARE JVS 900099 8076343 8076343 PHARMACY 900099 204029 204029 LABORATORY 621500 10540 10540 390852329 1197433 1197433 1487578 2284578 -797000 -797000 -797000 18318173 17549170 769003 769003 769003 137467 75582 61885 61885 PROVIDER TAX 900099 13901978 13901978 BIC OUTSIDE SERVICES 900099 2000272 2000272 CMMI TRIAL TEST REV. 900099 1248107 1248107 4954098 284329 4669769 22104455 414924141 407038908 0 7149197 X 1763877 1763877 221195 221195 134885845 119946106 14939739 2568600 2286054 282546 261847 231409 30438 8928743 7946580 982163 26120 26120 2150 2150 10138 10138 150540 150540 58698824 56192528 2506296 635969 635969 4192909 2534147 1658762 272156 186553 85603 5009031 3704537 1304494 749014 509773 239241 322912 229367 93545 1630644 1630644 66789405 66789405 8822029 7600184 1221845 MEDICAL SUPPLIES 80821026 80821026 BAD DEBTS 3167831 3167831 DUES & SUBSCRIPTIONS 553921 279435 274486 RECRUITMENT & RELOC. 450640 401070 49570 2229513 474197 1755316 383164879 290762482 92402397 0 170492 513 1240686 1240522 41897264 42860916 9345052 8933597 4921253 4875546 83273 93365 250466146 181954738 73180672 68511408 40624887 40251975 22101641 23441439 75560770 86768818 269125990 276978099 23693557 30559073 194716 226586 73900985 72258366 97789258 103044025 X 162972889 165690545 6529610 6290534 1834233 1952995 171336732 173934074 269125990 276978099 X 31759262 -2100950 -27060970 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 138 1 10000 0 0 10138 0 Part II-B, Line 1: THE PORTION OF MONTHLY DUES PAID TO THE MONTANA HOSPITAL ASSOCIATION DESIGNATED FOR LOBBYING. INITIATIVE SUPPORT. COSTS ASSOCIATED WITH THE DIRECT CONTACT WITH LEGISLATORS. 8487614 8487614 112920327 72896207 40024120 2663371 2350929 312442 124128973 106707602 17421371 2265861 2265861 68511408 BENEFICIAL INTEREST IN FOUNDATION 11016668 C INVEST IN PARTNERS IN HEALTH CARE 5871840 C INVEST IN BROADWAY IMAGING, LLC 3816825 C INVEST IN PROV. SURGERY CENTER, LLC 2730578 C INVEST IN N. ROCKIES HEALTH ASSOC. 5528 C 23441439 DUE FROM AFFILIATES 77856705 THIRD PARTY SETTLEMENTS 7922192 OTHER RECEIVABLES 989921 86768818 DUE TO AFFILIATES 30719430 TAX EXEMPT BOND LIABILITIES 35550779 CAPITALIZED LEASE OBLIGATION 4522500 THIRD PARTY SETTLEMENTS 1465657 72258366 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 1473 5198848 0 5198848 0.01360 14738 51926080 48219665 3706415 0.00970 3 11216 9541 1675 0.00000 16214 57136144 48229206 8906938 0.02330 2718 305854 0 305854 0.00080 240 7953130 4556946 3396184 0.00890 19371 29950289 14675167 15275122 0.03990 0 0 0 0 85100 0 85100 0.00020 22329 38294373 19232113 19062260 0.04980 38543 95430517 67461319 27969198 0.07310 189 130000 130000 0.00030 288 123500 123500 0.00030 100 4714 4714 0.00000 37 37000 37000 0.00010 614 295214 295214 0.00070 1 3167831 162890704 197448924 -34558220 X 1 1 1 PROVIDENCE SURGERY CENTER SAME DAY SURGERY, NON-EMERGENT CARE 0.76500 0.23500 1 1 PROVIDENCE ST PATRICK HOSPITAL 500 WEST BROADWAY MISSOULA MT 59802 montana.providence.org/hospitals/ 13200 X X X X REHAB AND PSYCH PROVIDENCE ST PATRICK HOSPITAL 1 0 0 1 X X X X X X X X X 17 1 1 1 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X 1 18 1 SEE PART V, SECTION C 0 1 X 300.000000000000 350.000000000000 X X X X 1 1 X X X 1 X WWW2.PROVIDENCE.ORG/OBP/DOCS/MT-CHARITY-CARE-POLICY.PDF X WWW2.PROVIDENCE.ORG/OBP/DOCS/FINANCIALASSISTANCEREQUEST(ENGLISH).PDF X WWW.PROVIDENCE.ORG/OBP/PLAIN-LANGUAGE-SUMMARY X X X X X X X 1 X 0 X X X X X 1 X 0 1 PROVIDENCE ST. PATRICK HOSPITAL Part V, Section B, Line 5: THE FOLLOWING PEOPLE DEVOTED TIME AND ENERGY TO THE CREATING THIS REPORT. THE WORK GROUP MET THROUGHOUT 2017, COLLECTING AND TALKING ABOUT DATA SO THAT WE CAN BETTER UNDERSTAND HEALTH STATUS, COMMUNITY ASSETS AND RESOURCES, AND CHALLENGES IN MISSOULA COUNTY.AGRICULTURAL WORKERS HEALTH & SERVICES - AARON JOHNSON, ILEANA AREZIAAMERICAN CANCER SOCIETY - EMILY COYLECATCH, ST. PATRICK HOSPITAL - LISA TIMSCITY OF MISSOULA DEVELOPMENT SERVICES - LAVAL MEANSCITY OF MISSOULA HOUSING & COMMUNITY DEVELOPMENT - WILL SEBERNCITY OF MISSOULA PARKS & RECREATION - RYAN YEAROUS CLIMATE SMART MISSOULA - AMY CILIMBURGCOMMUNITY MEDICAL CENTER - SUE ENGLERT, DON MILLERDISABILITY ADVOCATE - LEEANNE BEERSEAT SMART COALITION, MCCHD - REBECCA MORLEYFAMILY MEDICAL RESIDENCY PROGRAM, UNIVERSITY OF MONTANA - ROB STENGERJOB SERVICE - KELLY DENIGERMISSOULA AGING SERVICES - JORDAN LYONSMISSOULA CITY-COUNTY HEALTH DEPARTMENT - CINDY FARR, ELLEN LEAHY, KATE DEVINO, LISA BECZKIEWICZMISSOULA COALITION ON AGING & DISABILITY - PATTI HOLKUPMISSOULA COUNTY COMMUNITY & PLANNING SERVICES - KAREN HUGHESMISSOULA FORUM FOR CHILDREN & YOUTH - ANNA SEMPLE, BRANDEE TYREEMISSOULA HOUSING AUTHORITY - JIM MCGRATH, LORI DAVIDSONMISSOULA URBAN INDIAN HEALTH CENTER - DANA KINGFISHER, TROY WILSON, TRILANDA NORUNNERMONTANA DENTAL HYGIENISTS ASSOCIATION - HEIDI HALVERSONNEIGHBORWORKS MONTANA - KAIA PETERSONPARTNERSHIP HEALTH CENTER - ELIZABETH ROLLEPLANNED PARENTHOOD OF MONTANA - CHRISTOPHER COBURN, MACKENZIE FORBISPOVERELLO CENTER - MELISSA BROOKSPROVIDENCE ST. PATRICK HOSPITAL - HOLLIE TIMMONS, KAREN MYERS, MERRY HUTTONRURAL INSTITUTE FOR INCLUSIVE COMMUNITIES, UNIVERSITY OF MONTANA - HELEN RUSSETTESALVATION ARMY - JULIE CLARKSCHOOL OF PUBLIC & COMMUNITY HEALTH, UNIVERSITY OF MONTANA - TONY WARD, KARI HARRISUNITED WAY OF MISSOULA COUNTY - KRISTIN STRATFORDVOCATIONAL REHABILITATION - BROOK HODGEWESTERN MONTANA MENTAL HEALTH CENTER - KATHERINE ISAACSON PROVIDENCE ST. PATRICK HOSPITAL Part V, Section B, Line 6a: COMMUNITY MEDICAL CENTER PROVIDENCE ST. PATRICK HOSPITAL Part V, Section B, Line 6b: MISSOULA CITY-COUNTY HEALTH DEPARTMENT, GRANT CREEK FAMILY MEDICINE, MISSOULA AGING SERVICES, MISSOULA FORUM FOR CHILDREN & YOUTH, MISSOULA INDIAN CENTER, PARTNERSHIP HEALTH CENTER, UNITED WAY OF MISSOULA COUNTY. PROVIDENCE ST. PATRICK HOSPITAL Part V, Section B, Line 11: IN DETERMINING THE PRIORITIES ASSOCIATED WITHTHE 2017 COMMUNITY HEALTH NEEDS ASSESSMENT, WE BEGAN WITH THE PRIORITIESIDENTIFIED IN THE 2014 MISSOULA COUNTY ASSESSMENT: (1) IMPROVE ACCESS TOMENTAL HEALTH CARE AND PRIMARY CARE, (2) PREVENT OBESITY AND (3) IMPROVEFOOD SECURITY IN THE COMMUNITY. PROVIDENCE THEN LISTENED CLOSELY TO OURCOMMUNITIES AND PARTNERS, USING RESULTS FROM THE 2017 SURVEYS AND DATAFROM THE HEALTH DISTRICT TO ESTABLISH CURRENT COMMUNITY NEEDS. PROVIDENCEST. PATRICK HOSPITAL CREATED PRIORITIES FOR THE HOSPITAL AFTER EVALUATINGSCALE AND SCOPE, GAPS IN SERVICE, COMMUNITY RECOGNITION OF NEED, ANDALIGNMENT OF OUR MISSION AND ABILITIES TO IMPROVE THE MOST PRESSINGCOMMUNITY HEALTH NEEDS.THE IDENTIFIED PRIORITIZED NEEDS ST. PATRICK HOSPITAL WILL ADDRESS:SOCIAL DETERMINANTS OF HEALTH AND WELL-BEING- AFFORDABLE HOUSING- CLIMATE CHANGE/WILDFIRE IMPACT- HOMELESSNESS- FOOD INSECURITY- OBESITY PREVENTION (YOUTH AND ADULT) MENTAL HEALTHMENTAL HEALTH- SUICIDE PREVENTION- ACCESS TO MENTAL HEALTH SERVICES FOR YOUTH AND ADULTS ACCESS TO CAREACCESS TO CARE- PRIMARY CARE- TRAUMA/ADVERSE EXPERIENCE PREVENTION SUBSTANCE ABUSESUBSTANCE ABUSE- SUBSTANCE ABUSE TREATMENT- PREVENTION PROVIDENCE ST. PATRICK HOSPITAL Part V, Section B, Line 16j: BROCHURES AND CARDS ARE AVAILABLE IN ALL ACCESS POINTS AT OUR FACILITIES TELLING A PATIENT HOW TO GAIN INFORMATION AND APPLY. ALSO OUR STATEMENTS PROVIDE INFORMATION ON HOW TO APPLY BY MAKING CONTACT WITH OUR BUSINESS OFFICE. PROVIDENCE ST. PATRICK HOSPITAL Part V, Section B, Line 20e: FINANCIAL ASSISTANCE INFORMATION ALONG WITH PAYMENT OPTIONS ARE GIVEN ON EACH BILLING STATEMENT TO THE PATIENT. PROVIDENCE ST. PATRICK HOSPITAL Part V, Section B, Line 24: FOR NON MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES. Part V, Section B, Line 3e THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. Part V, Section B, Line 7a HTTP://WWW.PSJHEALTH.ORG/-/MEDIA/FILES/PROVIDENCE-ST-JOSEPH-HEALTH/COMMUNITY-BENEFIT/MT/2017MTSTPATRICKCHNACHIP.PDF?LA=EN Part V, Section B, Line 7b HTTPS://WWW.MISSOULACOUNTY.US/HOME/SHOWDOCUMENT?ID=27015 Part V, Section B, Line 10a HTTPS://OREGON.PROVIDENCE.ORG/~/MEDIA/FILES/CBR/CHNAS/2017/MT/2017MTSTPATRICKCHNACHIP.PDF 22 1 - Florence Family Medicine 5549 Old Highway 93 Florence MT 59833 Outpatient Services 2 - Montana Spine and Pain Center 1103 Westwood Drive Suite 200 Hamilton MT 59840 Outpatient Services 3 - Bariatric Services 500 West Broadway 5th Floor Missoula MT 59802 Outpatient Services 4 - Broadway Internal Medicine 500 W Broadway Broadway Bldg 4th Fl Missoula MT 59802 Outpatient Services 5 - Endocrinology Diabetes and Nutrition 900 N Orange St Suite 304 Missoula MT 59802 Outpatient Services 6 - Grant Creek Family Medicine 3075 N Reserve Street Suite Q Missoula MT 59808 Outpatient Services 7 - Infectious Disease 902 N Orange Street Missoula MT 59802 Outpatient Services 8 - Long Term Mobility Care 500 W Broadway Missoula MT 59802 Outpatient Services 9 - Missoula Family Medical 900 N Orange Street Suite 303 Missoula MT 59802 Outpatient Services 10 - Missoula Midwives 601 W Spruce Street Suite D Missoula MT 59802 Outpatient Services 11 - Montana Internal Medicine 2819 Great Northern Loop Suite 200 Missoula MT 59808 Outpatient Services 12 - Montana Nephrology 500 W Broadway Broadway Bldg 4th Fl Missoula MT 59802 Outpatient Services 13 - Montana Neurosurgical Specialists 500 W Broadway Suite 310 Missoula MT 59802 Outpatient Services 14 - Montana Spine and Pain Center 500 W Broadway 3rd Fl Missoula MT 59802 Outpatient Services 15 - Occupational Health 3055 N Reserve Street Suite D Missoula MT 59808 Outpatient Services 16 - Providence Neurology Specialists 601 W Spruce Street Suite J Missoula MT 59802 Outpatient Services 17 - Providence Palliative Care 900 N Orange Street Suite 205 Missoula MT 59802 Outpatient Services 18 - Providence Psychiatry 900 N Orange Street Suite 202 Missoula MT 59802 Outpatient Services 19 - Urgent Mental Health Clinic 900 N Orange Street Suite 102 Missoula MT 59802 Outpatient Services 20 - Women's Care and Family Wellness 1211 S Reserve Street Suite 101 Missoula MT 59801 Outpatient Services 21 - Wound Care Center 902 N Orange Street Missoula MT 59802 Outpatient Services 22 - Lifespan Family Medicine 715 South Main Street Suite A Stevensville MT 59870 Outpatient Services Part I, Line 3c: IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. Part I, Line 6a: PROVIDENCE HEALTH & SERVICES - MONTANA PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTPS://MONTANA.PROVIDENCE.ORG/LOCATIONS-DIRECTORY/S/ST-PATRICK-HOSPITAL/COMMUNITY-SUPPORT Part I, Line 7: THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS. Part I, Line 7g: NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. Part II, Community Building Activities: UNITED WAYUNITED WAY OF MISSOULA COUNTY BUILDS A BETTER COMMUNITY FOR ALL, SPECIFICALLY IN THE AREAS OF EDUCATION, INCOME, AND HEALTH. PROVIDENCE ST. PATRICK HOSPITAL FINANCIALLY CONTRIBUTED TO UNITED WAY IN ITS SUPPORT OF ITS PROGRAMS FOR SUICIDE PREVENTION, THE ZERO TO FIVE EARLY CHILDHOOD INITIATIVE AND ENDING HOMELESSNESS IN MISSOULA. ZERO FAREMISSOULA'S THREE-YEAR DEMONSTRATION PROJECT FOR ZERO-FARE FOR MOUNTAIN LINE'S PUBLIC TRANSPORTATION ENDED IN 2017, AND DEMONSTRATED INCREDIBLE SUCCESS, WITH RIDERSHIP INCREASING BY 70% . COMMUNITY PARTNERS, INCLUDING PROVIDENCE ST. PATRICK HOSPITAL, HAVE COMMITTED TO EXTENDING THE PROJECT THROUGH 2019. THE GROWING LIST OF PARTNERS INCLUDE THE UNIVERSITY OF MONTANA, ASSOCIATED STUDENTS OF THE UNIVERSITY OF MONTANA, CITY OF MISSOULA, COUNTY OF MISSOULA, THE MISSOULA METROPOLITAN PLANNING ORGANIZATION, COMMUNITY MEDICAL CENTER, MISSOULA COUNTY PUBLIC SCHOOLS, MISSOULA AGING SERVICES, MISSOULA DOWNTOWN ASSOCIATION, MISSOULA PARKING COMMISSION, MISSOULIAN, SOUTHGATE MALL, DESTINATION MISSOULA AND HOMEWORD, INC. IN ADDITION TO INCREASED RIDERSHIP AND DECREASED TRAFFIC CONGESTION, MOUNTAIN LINE RECEIVED FEDERAL GRANT FUNDING TO ADD SIX ELECTRIC BUSES TO ITS FLEET AND TO UPGRADE ITS TRANSIT FACILITY.POVERELLO CENTER MEDICAL RESPITE PROGRAMPROVIDENCE ST. PATRICK HOSPITAL AND THE POVERELLO CENTER CONTINUE CLOSE COLLABORATION IN SUPPORT OF THE MEDICAL RESPITE PROGRAM. THIS PROGRAM PROVIDES CARE COORDINATION BETWEEN THE HOSPITAL AND PEOPLE WHO ARE HOMELESS AND DISCHARGED TO A MEDICAL RESPITE BED FROM THE HOSPITAL.CHILDHOOD OBESITYCATCH ( COORDINATED APPROACH TO CHILD HEALTH) UNITES MULTIPLE ORGANIZATIONS IN A CHILD'S LIFE TO CREATE A COMMUNITY OF HEALTH. PROVIDENCE ST. PATRICK HOSPITAL HAS SUPPORTED MISSOULA'S CATCH PROGRAM FOR OVER A DECADE. CATCH'S EVIDENCE-BASED PROGRAM PREVENTS AND DECREASES THE RATES OF CHILDHOOD OBESITY. THE PROGRAM FOCUSES ON THE MESSAGING A CHILD RECEIVES IN PHYSICAL EDUCATION, THE LUNCHROOM, THE CLASSROOM, AND AT HOME, TO INFLUENCE A CHILD'S CHOICES NOT ONLY IN SCHOOL, BUT LIFELONG.LET'S MOVE! MISSOULA (LM!M) IS A LOCAL INITIATIVE THAT IS PART OF THE NATIONAL LET'S MOVE! CAMPAIGN TO COMBAT THE EPIDEMIC OF CHILDHOOD OBESITY. NATIONALLY, THE VISION OF LET'S MOVE! IS TO RAISE A HEALTHIER GENERATION OF KIDS. LOCALLY, MANY COMMUNITY PARTNERS TAKE PART IN LM!M. THE MISSION OF LM!M IS TO MOBILIZE PROJECTS AND PARTNERSHIPS THAT BUILD HEALTHY KIDS AND RESIDENTS OF ALL AGES - NO MATTER WHERE THEY LIVE, WORK, PLAY, OR GO TO SCHOOL. PROJECTS FOCUS ON IMPROVING PHYSICAL ACTIVITY OPPORTUNITIES, NUTRITION, AND ACCESS TO HEALTHY FOODS.COMMUNITY HEALTH IMPROVEMENT: ENVIRONMENTAL STEWARDSHIPGREEN 4 GOOD (G4G) IS AN INITIATIVE AT ST. PATRICK HOSPITAL TO DECREASE THE ENVIRONMENTAL IMPACTS OF OUR DAILY HEALTHCARE WORK. THROUGH G4G, ST. PATRICK HOSPITAL WORKS TO REDUCE IMPACTS TO THE NATURAL ENVIRONMENT, IN TURN CREATING A HEALTHIER ENVIRONMENT FOR PATIENTS, STAFF MEMBERS, AND COMMUNITIES. G4G EARNED FOR ST. PATRICK HOSPITAL AWARDS FROM PRACTICE GREENHEALTH, INCLUDING THE EMERALD AWARD, CIRCLE OF EXCELLENCE FOR ENERGY AND THE GREENING THE OR RECOGNITION AWARD.IN 2018, ST. PATRICK HOSPITAL BEGAN FOOD COMPOSTING BY PARTNERING WITH MISSOULA COMPOST COLLECTION, AND CONTRIBUTED OVER 65 THOUSAND POUNDS FOR COMPOSTING. FOR THE FIRST TIME, OVER HALF OF THE HOSPITAL'S WASTE WAS DIVERTED FROM THE LANDFILL. THE PROVIDENCE CENTER GARDEN DONATED OVER 900 POUNDS OF FOOD TO THE PRESCRIPTION PRODUCE PROGRAM AND TO THE MISSOULA FOOD BANK. Part III, Line 2: THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. Part III, Line 3: THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. Part III, Line 4: THE HEALTH SYSTEM PROVIDES FOR AN ALLOWANCE AGAINST PATIENT ACCOUNTS RECEIVABLE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE. THE HEALTH SYSTEM ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR, AND OTHER RELEVANT FACTORS. THERE ARE VARIOUS FACTORS THAT CAN IMPACT THE COLLECTION TRENDS, SUCH AS CHANGES IN THE ECONOMY, WHICH IN TURN HAVE AN IMPACT ON UNEMPLOYMENT RATES AND THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE INCREASED BURDEN OF COPAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE COVERAGE AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS USED BY THE HEALTH SYSTEM. THE HEALTH SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICES ON THE BASIS OF PAST EXPERIENCE, WHICH HAS HISTORICALLY INDICATED THAT MANY PATIENTS ARE UNRESPONSIVE OR ARE OTHERWISE UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. Part III, Line 8: THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. Part III, Line 9b: PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. Part VI, Line 2: WE RECOGNIZE THAT CARING FOR THE POOR AND VULNERABLE IS NOT A TASK WE CAN DO ON OUR OWN. ON A ROUTINE BASIS WE CONDUCT A FORMAL COMMUNITY ASSESSMENT TO DETERMINE WHO IN OUR COMMUNITIES IS EXPERIENCING THE GREATEST NEED. THIS OUTREACH CONNECTS US TO MANY NOT-FOR-PROFITS AND SOCIAL SERVICE AGENCIES AS WELL AS CARE PROVIDERS AND THEIR CLIENTS IN THE COMMUNITIES. TO ENSURE THAT WE CONDUCT A COMPREHENSIVE ASSESSMENT, OUR PROCESS INCLUDES RESEARCH, MEETINGS, INTERVIEWS, FOCUS GROUPS AND SURVEYS.ADDITIONALLY, PROVIDENCE MINISTRIES HAVE COMMUNITY AND FOUNDATION BOARDS. THE CIVIC LEADERS THAT SERVE ON PROVIDENCE BOARDS CONNECT OUR MISSION WITH A LOCAL PERSPECTIVE ON COMMUNITY NEEDS.OUR ASSESSMENT FINDINGS ARE ASSEMBLED TO MAKE CERTAIN WE UNDERSTAND AND RESPOND TO LOCAL AND REGIONAL NEEDS, WHICH OFTEN VARY FROM ONE CITY OR COUNTY TO ANOTHER. IDENTIFIED AREAS OF NEED NOT ONLY GUIDE OUR COMMUNITY BENEFIT GIVING, BUT ALSO GUIDE OUR STRATEGIC PLANNING. WE BELIEVE MEANINGFUL COMMUNITY NEEDS ASSESSMENT PROVIDES INSIGHT INTO THE COMPLETE COMMUNITY BENEFIT THAT IS REQUIRED, BEYOND JUST FREE AND DISCOUNTED CARE.THE MISSOULA COUNTY 'COMMUNITY HEALTH ASSESSMENT COMMITTEE' WITH INPUT FROM THE PROVIDENCE ST. PATRICK HOSPITAL BOARD'S MISSION AND COMMUNITY NEEDS COMMITTEE MET OVER 12 MONTHS TO DISCUSS THE MOST PRESSING HEALTH CONCERNS AS WELL AS TO GATHER AND REVIEW DATA TO IDENTIFY THE GREATEST COMMUNITY NEEDS. Part VI, Line 3: PROVIDENCE HOSPITALS POST NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME UNINSURED PATIENTS. THESE NOTICES ARE POSTED IN VISIBLE LOCATIONS THROUGHOUT THE HOSPITAL SUCH AS ADMITTING/REGISTRATION, BILLING OFFICE, EMERGENCY DEPARTMENT AND OTHER OUTPATIENT SETTINGS.EVERY POSTED NOTICE REGARDING FINANCIAL ASSISTANCE POLICIES CONTAINS BRIEF INSTRUCTIONS ON HOW TO APPLY FOR FINANCIAL ASSISTANCE OR A DISCOUNTED PAYMENT. THE NOTICES ALSO INCLUDE A CONTACT TELEPHONE NUMBER THAT A PATIENT OR FAMILY MEMBER CAN CALL TO OBTAIN MORE INFORMATION.PROVIDENCE ENSURES THAT APPROPRIATE STAFF MEMBERS ARE KNOWLEDGEABLE ABOUT THE EXISTENCE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICIES. TRAINING IS PROVIDED TO STAFF MEMBERS (I.E., BILLING OFFICE, FINANCIAL DEPARTMENT, ETC.) WHO DIRECTLY INTERACT WITH PATIENTS REGARDING THEIR HOSPITAL BILLS. THE FINANCIAL COUNSELORS ARE AVAILABLE TO MEET WITH PATIENTS OR FAMILIES IF THEY HAVE A QUESTION ABOUT THEIR BILL OR THOSE NEEDING ASSISTANCE IN FILLING OUT APPLICATIONS FOR COVERAGE FOR A VARIETY OF PROGRAMS SUCH AS MEDICAID, CHIP OR ACA-MARKET PLACE PLANS. THE FINANCIAL COUNSELORS ARE AVAILABLE EVERY DAY OF THE WEEK.WHEN COMMUNICATING TO PATIENTS REGARDING THEIR FINANCIAL ASSISTANCE POLICIES, PROVIDENCE ATTEMPTS TO DO SO IN THE PRIMARY LANGUAGE OF THE PATIENT, OR HIS/HER FAMILY, IF REASONABLY POSSIBLE, AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS.PROVIDENCE SHARES THEIR FINANCIAL ASSISTANCE POLICIES WITH APPROPRIATE COMMUNITY HEALTH AND HUMAN SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST SUCH PATIENTS. Part VI, Line 4: MISSOULA COUNTY COVERS AN AREA OF ROUGHLY 2,600 SQUARE MILES IN WESTERN MONTANA. THE COUNTY IS MOUNTAINOUS, WITH MORE THAN 1,975 MILES OF RIVERS AND STREAMS AND FIVE VALLEYS THAT SIT ABOUT 3,200 FEET ABOVE SEA LEVEL. THE AREA IS HOME TO ABUNDANT WILDLIFE. THE FIRST INHABITANTS OF THE MISSOULA AREA WERE AMERICAN INDIANS FROM THE SALISH TRIBE. THE FIRST WHITE SETTLEMENT WAS ESTABLISHED IN 1860. (MISSOULA COUNTY COMMUNITY AND PLANNING SERVICES).THE SOCIO-CULTURAL ENVIRONMENT OF MISSOULA COUNTY IS PREDOMINANTLY WHITE ANGLO-SAXON WITH REPRESENTATION OF AMERICAN INDIAN, EASTERN EUROPEAN, AND HMONG CULTURES. MISSOULA COUNTY DOES INCLUDE A SMALL AREA OF THE FLATHEAD RESERVATION, HOME OF THE CONFEDERATED SALISH AND KOOTENAI TRIBES. HOWEVER, THAT AREA IS SPARSELY POPULATED, AND THE COUNTY'S AMERICAN INDIAN POPULATION IS PRIMARILY URBAN AND LIVING IN OR NEAR THE CITY OF MISSOULA. THE URBAN INDIAN POPULATION IS MADE UP OF MANY TRIBES, MOST OF WHOM ARE STILL CONNECTED WITH THEIR HOME RESERVATIONS. THE HMONG COMMUNITY SETTLED IN THE COUNTY IN ONE MAIN WAVE OF IMMIGRATION IN THE 1970S. THE EASTERN EUROPEAN COMMUNITY COMES PRIMARILY FROM IMMIGRANTS FROM BELARUS, WHO ARRIVED IN THE 1980S. BOTH IMMIGRANT GROUPS MAINTAIN THEIR LANGUAGE AND CULTURAL TRADITIONS. (MISSOULA COUNTY RURAL INITIATIVES)THE PRESENCE OF THE UNIVERSITY OF MONTANA, AS AN EDUCATIONAL INSTITUTION AND AS AN EMPLOYER, MEANS THAT THE CITY OF MISSOULA IN PARTICULAR IS FOCUSED ON EDUCATION. THE UNIVERSITY OF MONTANA IS A FOUR-YEAR, MOSTLY NON-RESIDENTIAL UNIVERSITY WITH GRADUATE PROGRAMS. IN SPRING 2017 ENROLLMENT STOOD AT 11,615. MISSOULA IS ALSO HOME TO MISSOULA COLLEGE, WHICH OFFERS 40 TECHNICAL AND OCCUPATIONAL PROGRAMS; ENROLLMENT IN MISSOULA COLLEGE IS 1,609 STUDENTS.POPULATION AND AGE DEMOGRAPHICSTOTAL POPULATION OF MISSOULA COUNTY IS 116,130, WITH AN ANNUAL GROWTH RATE OF ABOUT 1.88 PERCENT IN 2016. THE AMERICAN COMMUNITY SURVEY 2011-2015 FIVE-YEAR ESTIMATES OF THE POPULATION COMPRISED:- 20% PERCENT YOUTH (0-17 YEARS)- 30% PERCENT YOUNG ADULTS (18-34 YEARS)- 37% PERCENT OLDER ADULTS (35-64 YEARS)- 13% PERCENT SENIORS (65 YEARS AND OLDER)ETHNICITYAMONG MISSOULA RESIDENTS IN THE ACS FIVE-YEAR ESTIMATES, 92% WERE WHITE, 1.25% ASIAN, 3% WERE HISPANIC OR LATINO, 3% WERE ALASKA NATIVE OR AMERICAN INDIAN, <1% WERE AFRICAN AMERICAN OR BLACK, <1% WERE NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER, AND 3% WERE OF TWO OR MORE RACES. INCOME LEVELS AND HOUSINGIN THE 2011-2015 ACS FIVE-YEAR ESTIMATES, THE MEDIAN HOUSEHOLD INCOME FOR MISSOULA COUNTY WAS $65,463, AND THE UNEMPLOYMENT RATE WAS 3.8% . MISSOULA COUNTY'S MEDIAN HOUSEHOLD INCOME IS 6.6% HIGHER THAN MONTANA'S MEDIAN HOUSEHOLD INCOME, AND LESS THAN 1% LOWER THAN THE NATIONAL MEDIAN HOUSEHOLD INCOME. Part VI, Line 5: PROMOTION OF COMMUNITY HEALTH:PROVIDENCE HEALTH & SERVICES - MONTANA PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. PROVIDENCE HEALTH & SERVICES - MONTANA IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: 1) OPEN MEDICAL STAFF 2) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS. Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEM:ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (LEGACY PHS) AND ST. JOSEPH HEALTH SYSTEM (LEGACY 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 AND OVER 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. Part VI, Line 7, Reports Filed With States MT 1 ST PATRICK HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 237056976 501 (C)(3) 795350 CONTRIBUTION FOR OPERATIONAL SUPPORT DEPARTMENT OF PUBLIC HEALTH & HUMAN SERVICES PO BOX 4210 HELENA MT 59620 810302402 GOVT 534200 HOSPITAL COMMUNITY BENEFIT ASSESSMENT GENERAL FUND THE POVELLO CENTER PO BOX 7644 535 RYMAN MISSOULA MT 59807 237439391 501 (C)(3) 70000 SUPPORT FOR MEDICAL RESPITE PROGRAM YWCA MISSOULA 1130 W BROADWAY MISSOULA MT 59802 810245851 501 (C)(3) 70000 CAPITAL CAMPAIGN MISSOULA FAMILY YMCA 3000 S RUSSEL ST MISSOULA MT 59801 810300829 501 (C)(3) 50000 IMPROVE HEALTH OUTCOMES FOR FAMILIES AND INDIVIDUALS IN MISSOULA MONTANA HOME OWNERSHIP NETWORK INC 509 1ST AVE S GREAT FALLS MT 59401 810543240 501 (C)(3) 40000 OPERATIONAL SUPPORT MISSOULA COUNTY UNITED WAY 412 W ALDER ST MISSOULA MT 59807 810287854 501 (C)(3) 28500 SUPPORT HEALTHCARE IN COMMUNITY MISSOULA COUNTY PUBLIC SCHOOLS 215 SOUTH 6TH WEST MISSOULA MT 59801 810504312 GOVT 25000 SPONSOR HEALTH SCIENCE ACADEMY AT BIG SKY HIGH SCHOOL AMERICAN HEART ASSOC PO BOX 50085 PRESCOTT AZ 86304 135613797 501 (C)(3) 25000 GO RED FOR WOMEN MISSOULA URBAN TRANSPORTATION 121 SHAKESPEAR STREET MISSOULA MT 59802 810370921 GOVT 25000 ZERO FARE PARTNER MISSOULA AGING SERVICES 337 STEPHENS AVE MISSOULA MT 59801 810379543 501 (C)(3) 20000 OPERATIONAL SUPPORT NORTH AMERICA RESCUE 35 TEDWELL COURT GREER SC 29650 271030140 18996 STOP THE BLEED PROGRAM GARDEN CITY HARVEST PO BOX 205 MISSOULA MT 59806 810510580 501 (C)(3) 18000 SUPPORT OF YOUTH DEVELOPMENT PROGRAM WESTERN MONTANA MENTAL HEALTH CENTER 1325 WYOMING ST MISSOULA MT 59801 810307814 501 (C)(3) 6000 SUPPORT OF FALL AND SPRING AFTER SCHOOL PROGRAM 13 1 TUITION ASSISTANCE 51 221195 COST TUITION FOR NURSING PROGRAM STUDENTS AT UGF Part I, Line 2: IN THE APPLICATION FOR SUPPORT, WE REQUEST A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA. IF THE APPLICATION FOR SUPPORT IS APPROVED, WE SEND A LETTER 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 SINCE 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. 1 1 0 0 0 0 0 0 0 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 0 195960 0 14071 0 618 0 29366 0 8505 0 248520 0 0 VENKAT BHAMIDIPATI EVP/TREASURER 0 903927 0 282772 0 40310 0 649292 0 24549 0 1900850 0 0 MIKE BUTLER PRESIDENT 0 1320076 0 2525154 0 738136 0 942095 0 26366 0 5551827 0 692718 JO ANN ESCASA-HAIGH EVP/ASSISTANT TREASURER 0 676469 0 396611 0 37755 0 503453 0 23971 0 1638259 0 0 CINDY STRAUSS SECRETARY 0 769625 0 724144 0 391021 0 664452 0 26096 0 2575338 0 356681 JIM WATSON ESQ ASSISTANT SECRETARY 0 449476 0 64532 0 62180 0 24750 0 40393 0 641331 0 0 JOHN WHIPPLE ASSISTANT SECRETARY 0 420678 0 357576 0 251293 0 321644 0 24045 0 1375236 0 218336 KIRK BODLOVIC CFO/ST. PATRICK HOSPITAL 0 247433 0 15618 0 5855 0 76664 0 24208 0 369778 0 0 ROBERT HELLRIGEL SVP-CE/SENIOR & COMM. SERVICES 0 431949 0 212824 0 432634 0 285075 0 26988 0 1389470 0 430367 CARTER BECK MD PHYSICIAN 1157129 0 85000 0 52842 0 85277 0 20342 0 1400590 0 0 0 STEWART LONG III PHYSICIAN 977750 0 81250 0 344344 0 109122 0 25842 0 1538308 0 324084 0 JAMES MADDUX PHYSICIAN 770614 0 65952 0 500626 0 87643 0 25692 0 1450527 0 480366 0 SIMONE MUSCO MD PHYSICIAN 941902 0 0 0 321805 0 92466 0 25692 0 1381865 0 301545 0 JOSEPH SCHMOKER PHYSICIAN 1156224 0 0 0 72855 0 80648 0 20107 0 1329834 0 0 0 ROD F HOCHMAN MD FORMER PRESIDENT/CEO 0 2026331 0 3370808 0 1172016 0 4239838 0 26428 0 10835421 0 1130152 TODD HOFHEINS FORMER EVP/CFO/TREAS. 0 0 0 0 0 820571 0 4960 0 30986 0 856517 0 0 TAMMY TEODOSIO FORMER ASSISTANT SECRETARY 0 113095 0 8184 0 1413 0 12754 0 11510 0 146956 0 0 DAVID BROWN FORMER VP/STRATEGY & BUSINESS DEV 0 378024 0 330500 0 741577 0 253902 0 26467 0 1730470 0 739590 DEBBIE BURTON FORMER SVP/CHIEF NRSG. OFFICER 0 355841 0 311439 0 85069 0 190913 0 29004 0 972266 0 60891 DEBRA CANALES FORMER EVP/CAO 0 857075 0 881587 0 993441 0 706123 0 17988 0 3456214 0 949253 AMY COMPTON-PHILLIPS FORMER EVP/CHIEF CLINICAL OFFICER 0 775101 0 744687 0 134285 0 638301 0 28953 0 2321327 0 90925 MARY CRANSTOUN FORMER VP/TOTAL REWARDS 0 403975 0 354347 0 116489 0 262286 0 28387 0 1165484 0 79913 JEFFREY FEE FORMER CE/WESTERN MT. REGION 0 0 0 0 0 204938 0 1400 0 15104 0 221442 0 0 MARK GARGETT FORMER VP/DIGITAL INTEGRATION 0 13877 0 151632 0 224238 0 10620 0 6520 0 406887 0 39641 JOEL GILBERTSON FORMER SVP/COMMUNITY PARTNERSHIPS 0 482510 0 421153 0 702833 0 334483 0 27500 0 1968479 0 666795 OREST HOLUBEC FORMER SVP/CHIEF COMM/EXT AFF OFF 0 414903 0 376200 0 320139 0 248009 0 26681 0 1385932 0 284306 AARON MARTIN FORMER SVP/STRATEGY & INNOVATION 0 619482 0 299538 0 277054 0 429276 0 6008 0 1631358 0 256355 TOM MCDONAGH FORMER VP/CHIEF INVESTMENT OFFICER 0 479100 0 424836 0 199748 0 94395 0 28455 0 1226534 0 160512 RHONDA MEDOWS MD FORMER EVP/POPULATION HEALTH 0 892539 0 881144 0 250787 0 585104 0 20765 0 2630339 0 207264 JACK MUDD FORMER SVP/MISSION LEADERSHIP 0 181444 0 246198 0 49414 0 110334 0 14134 0 601524 0 25651 JANICE NEWELL FORMER SVP/CHIEF INFORMATION OFFCR 0 605657 0 593967 0 313289 0 140906 0 13217 0 1667036 0 280351 HARVEY SMITH FORMER SVP/CHIEF COSTUMER SVC. OFF 0 0 0 0 0 583049 0 0 0 16156 0 599205 0 0 TERRY SMITH FORMER SVP/MANAGEMENT SVCS 0 199733 0 21000 0 11361 0 11820 0 9367 0 253281 0 0 GREG TILL FORMER VP/CHIEF TALENT OFFICER 0 413001 0 366609 0 184364 0 266034 0 29474 0 1259482 0 149031 SHARON TONCRAY FORMER SVP/CHIEF LABOR EE COUNSEL 0 415487 0 390622 0 617243 0 148032 0 30407 0 1601791 0 578583 LISA VANCE FORMER SVP/CLINICAL PROGRAM SRVCS 0 620962 0 612077 0 142796 0 327116 0 24266 0 1727217 0 100938 MIKE WATERS FORMER VP, CAO/PHYSICIAN SERVICES 0 449557 0 227731 0 186258 0 284611 0 10917 0 1159074 0 150340 Part I, Line 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE HEALTH & SERVICES, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE HEALTH & SERVICES. Part I, Lines 4a-b THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS THIS YEAR: - HARVEY SMITH: $ 587,018 - JEFFREY FEE: $ 206,815 - TODD HOFHEINS: $ 824,990 ENTITIES WITHIN THE PSJH 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. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLMENTAL EXECUTIVE RETIRMENT PLAN PROVIDED BY A RELATED ENTITY. THE AMOUNTS SHOWN IN COLUMN F OF PART II REFLECT CURRENT YEAR PAYOUTS FROM THESE PLANS. FORM 990, SCHEDULE J, PART II - EXECUTIVE INCENTIVE PROGRAM THE PROVIDENCE EXECUTIVE INCENTIVE PROGRAM PROVIDES A LUMP SUM AWARD ANNUALLY AS A PERCENT OF THE EXECUTIVE'S BASE PAY. PERCENT OPPORTUNITIES ARE ALIGNED WITH OUR TOTAL COMPENSATION PHILOSOPHY AS OUTLINED IN PART VI, SECTION B, LINE 15 (PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT, OFFICERS & KEY EMPLOYEES). FOR PROVIDENCE LEADERS, THE PERFORMANCE AWARD IS BASED ON THE LEVEL OF ACCOMPLISHMENT OF ANNUAL SYSTEM AND FUNCTIONAL (OR MARKET) OBJECTIVES. IN 2018, 60 PERCENT OF THE PARTICIPANT AWARDS WERE BASED ON PRE-DETERMINED ORGANIZATIONAL GOALS CONSISTENT WITH PROVIDENCE'S STRATEGIC PRIORITIES. IN 2018 THE PERCENT ALLOCATION FOR EACH OF THESE STRATEGIC PRIORITIES WAS AS OUTLINED BELOW: SYSTEM GOALS: FIRST-YEAR TURNOVER - 10% INPATIENT EXPERIENCE - 5% PATIENT EXPERIENCE - 5% MEDICAL GROUP PATIENT EXPERIENCE - 5% COMMUNITY BENEFIT - 10% CLINICAL EXCELLENCE - 15% FREE CASH FLOW - 10% THE REMAINING 40% WAS BASED ON A ROBUST SET OF FUNCTION SPECIFIC GOALS DESIGNED TO ALIGN CRITICAL MISSION AND BUSINESS DRIVERS. PATIENT EXPERIENCE - 5% MEDICAL GROUP PATIENT EXPERIENCE - 5% COMMUNITY BENEFIT - 10% CLINICAL EXCELLENCE - 15% FREE CASH FLOW - 10% THE REMAINING 40% WAS BASED ON A ROBUST SET OF FUNCTION SPECIFIC GOALS DESIGNED TO ALIGN CRITICAL MISSION AND BUSINESS DRIVERS. Form 990, Part V, Line 1a - Issuance of Form 1099: ISSUANCE OF FORM 1099 ALL 1099S FOR 2018 WERE ISSUED BY PROVIDENCE HEALTH & SERVICES - WASHINGTON #51-0216586. THEREFORE, NONE ARE SHOWN FOR THE REPORTING ORGANIZATION. Form 990, Part VI, Section A, line 6 PROVIDENCE HEALTH & SERVICES IS THE SOLE CORPORATE MEMBER OF PROVIDENCE HEALTH & SERVICES - MONTANA. Form 990, Part VI, Section A, line 7a DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PROVIDENCE HEALTH & SERVICES - MONTANA HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT DIRECTORS TO THE PROVIDENCE HEALTH & SERVICES - MONTANA BOARD. ALL TRUSTEE NOMINATIONS THAT COME FROM THE PROVIDENCE HEALTH & SERVICES - MONTANA BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE HEALTH & SERVICES, AS THE CORPORATE MEMBER. Form 990, Part VI, Section A, line 7b 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 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 BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY REAL OR POTENTIAL CONFLICT OF INTEREST (COI) IN ACCORDANCE WITH THE PSJH COI POLICY AND IN CONNECTION WITH THAT INDIVIDUAL SATISFYING HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY AND/OR IF AT ANY TIME AN ACTUAL, REAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PSJH CHIEF LEGAL OFFICER AND/OR THE PSJH CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR CONSIDER MATTERS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER. PSJH CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE 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 WHEN ACTION IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF COI DISCLOSURES IS RETAINED PER ORGANIZATION RETENTION POLICY. Form 990, Part VI, Section B, line 15 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE HEALTH & SERVICES, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE ST. JOSEPH HEALTH'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ST. JOSEPH HEALTH 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 ST. JOSEPH HEALTH HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE ST. JOSEPH HEALTH MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE ST. JOSEPH HEALTH'S LEGAL ENTITIES. PROVIDENCE ST. JOSEPH HEALTH ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE ST. JOSEPH HEALTH HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS OFFICERS, INCLUDING OUR SENIOR EXECUTIVES. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED BY THE PROVIDENCE ST. JOSEPH HEALTH COMMITTEE. THE BOARD 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 ST. JOSEPH HEALTH 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 WHOSE REVENUE IS SIMILAR TO THAT OF PROVIDENCE ST. JOSEPH HEALTH. ADDITIONALLY, PROVIDENCE ST. JOSEPH HEALTH'S LABOR MARKET CONTINUES TO SPREAD ACROSS HEALTH CARE AND INTO GENERAL INDUSTRY. BECAUSE OF THIS, PROVIDENCE ST. JOSEPH HEALTH ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY FOR-PROFIT MARKET DATA, WHERE APPLICABLE. BASE SALARIES FOR PROVIDENCE ST. JOSEPH HEALTH EXECUTIVES ARE GENERALLY TARGETED TO THE MEDIAN LEVEL OF THE MARKET, 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. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY ACHIEVE SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE ST. JOSEPH HEALTH 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 EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS AND MIRRORS BEST PRACTICES. THE PROCESS TO REVIEW COMPENSATION WAS LAST COMPLETED MARCH 5, 2019. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE PSJH COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PSJH INTERNET SITE. AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990. Form 990, Part IX, line 11g AGENCY/CONTRACT LABOR: Program service expenses 389,697. Management and general expenses 252. Fundraising expenses 0. Total expenses 389,949. MEDICAL DIRECTOR & MED PHYSICIAN FEES: Program service expenses 20,441,278. Management and general expenses 11,575. Fundraising expenses 0. Total expenses 20,452,853. REPAIRS & MAINTENANCE: Program service expenses 2,939,449. Management and general expenses 258,528. Fundraising expenses 0. Total expenses 3,197,977. BILLING & COLLECTIONS: Program service expenses 0. Management and general expenses 761. Fundraising expenses 0. Total expenses 761. TRANSCRIPTION & TRANSLATION SERVICES: Program service expenses 6,444. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,444. DIETARY: Program service expenses 12,034. Management and general expenses 0. Fundraising expenses 0. Total expenses 12,034. OTHER PATIENT SERVICES: Program service expenses 29,554,928. Management and general expenses 0. Fundraising expenses 0. Total expenses 29,554,928. OTHER ADMINISTRATIVE SERVICES: Program service expenses 0. Management and general expenses 1,623,323. Fundraising expenses 0. Total expenses 1,623,323. GENERAL CONSULTING FEES: Program service expenses 2,848,698. Management and general expenses 611,857. Fundraising expenses 0. Total expenses 3,460,555. Form 990, Part XI, line 9: PR FAS 136 118,762. NET ASSET TRANSFER IN LIEU 66,785,854. INTERAFFILIATE TRANSFER -95,210,088. INTERDIVISION TRANSFERS 353,468. TEMPORARILY RESTRICTED FAS 136 -239,075. UNRESTRICTED FAS 136 1,130,107. ROUNDING 2. COVENANT ACO 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 611573313 HEALTHCARE TX 501(c)(3) 12,I CHS 1 COVENANT HEALTH NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 461259908 HEALTHCARE CA 501(c)(3) 12,III SJHS 1 COVENANT HEALTH PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 463516417 HEALTHCARE TX 501(c)(3) 12,I CHS 1 COVENANT HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752765566 HEALTHCARE TX 501(c)(3) 3 SJHS 1 COVENANT HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752897026 HEALTHCARE TX 501(c)(3) 7 CHS 1 COVENANT MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 822913146 HEALTHCARE TX 501(c)(3) 3 CHS 1 COVENANT MEDICAL GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 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 980579016 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 980579016 954322584 SUPPORT CA 501(c)(3) 7 PHS SOCAL 1 GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 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 HMTS INC 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH CA 926586100 453583707 HEALTHCARE CA 501(c)(3) 12,I HMHP 1 HOAG CHARITY SPORTS 2081 BUSINESS CENTER DR STE 195 IRVINE CA 92612 452982422 SUPPORT CA 501(c)(3) 7 HHF 1 HOAG CLINIC 1 HOAG DRIVE PO BOX 6100 NEWPORT BEACH CA 926586100 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 DRIVE PO BOX 6100 NEWPORT BEACH CA 926586100 951643327 HEALTHCARE CA 501(c)(3) 3 CHN 1 HOSPICE OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752133781 HEALTHCARE TX 501(c)(3) 10 CHS 1 INLAND NORTHWEST HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911307555 HEALTHCARE WA 501(c)(3) 3 PHS WA 1 INSTITUTE FOR MENTAL HEALTH & WELLNESS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 814260130 HEALTHCARE WA 501(c)(3) 7 PHS SJHS 1 INSTITUTE FOR SYSTEMS BIOLOGY 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 912003593 HEALTHCARE WA 501(c)(3) 7 WHC 1 JOHN WAYNE CANCER INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 954291515 HEALTHCARE CA 501(c)(3) 4 PSJHC 1 KADLEC AUXILIARY INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 916033089 SUPPORT WA 501(c)(3) 12,III KRMC 1 KADLEC FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 237005501 SUPPORT WA 501(c)(3) 12,I KRMC 1 KADLEC REGIONAL MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 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 980579016 330844408 IMAGING SVCS CA 501(c)(3) 10 PHS SOCAL 1 LUBBOCK METHODIST HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752220963 HEALTHCARE TX 501(c)(3) 7 CHS 1 LUNDBERG ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 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 980579016 912054035 RESEARCH WA 501(c)(3) 7 SHS 1 METHODIST CHILDREN'S HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752428911 HEALTHCARE TX 501(c)(3) 3 CHS 1 METHODIST HOSPITAL LEVELLAND 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752246348 HEALTHCARE TX 501(c)(3) 3 CHS 1 METHODIST HOSPITAL PLAINVIEW 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752426010 HEALTHCARE TX 501(c)(3) 3 CHS 1 MISSION HOSPITAL REGIONAL MEDICAL CTR 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 951643360 HEALTHCARE CA 501(c)(3) 3 CHN 1 NORTHWEST HOPE & HEALING FOUNDATION PO BOX 16069 SEATTLE WA 98116 200799737 SUPPORT WA 501(c)(3) 12,I SHS 1 PACMED CLINICS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 562290878 HEALTHCARE WA 501(c)(3) 10 WHC 1 PH&S FOUNDATIONSFVSA & SCVSA 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 953544877 HEALTHCARE CA 501(c)(3) 7 PHS SOCAL 1 PROVIDENCE ALASKA FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 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 980579016 911940286 HEALTHCARE OR 501(c)(3) 7 PHS OR 1 PROVIDENCE BLANCHET ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911789266 SUPPORT WA 501(c)(3) 7 PHS WA 1 PROVIDENCE CHILDREN'S HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 930800140 SUPPORT OR 501(c)(3) 7 PHS OR 1 PROVIDENCE COMMUNITY HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 930692907 HEALTHCARE OR 501(c)(3) 7 PHS OR 1 PROVIDENCE DETHMAN HOUSE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 473385506 SUPPORT WA 501(c)(3) 7 N/A 0 PROVIDENCE GAMELIN HOUSE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 311744654 SUPPORT WA 501(c)(3) 7 PHS WA 1 PROVIDENCE HEALTH & SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911549796 HEALTHCARE WA 501(c)(3) 12,II PSJH 0 PROVIDENCE HEALTH & SERVICES - OREGON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 510216587 HEALTHCARE OR 501(c)(3) 3 PHS 1 PROVIDENCE HEALTH & SERVICES - WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 510216586 HEALTHCARE WA 501(c)(3) 3 PHS 1 PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911303277 HEALTHCARE WA 501(c)(3) 3 PMWHC 1 PROVIDENCE HEALTH ASSURANCE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 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 980579016 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