QUEEN OF THE VALLEY MEDICAL CENTER: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- QUEEN OF THE VALLEY MEDICAL CENTER (EIN 94-1243669)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-15
- IRS object ID
- 201923199349314567
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule H
- Schedule I
- Schedule J
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-15T15:37:29-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4365 EXECUTIVE DR STE 1600 | AddressLine1Txt |
| City | SAN DIEGO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92121 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941243669 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUEEN OF THE VALLEY MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % John Peters | InCareOfNm |
| Business Name Control | QUEE | BusinessNameControlTxt |
| Phone | 7072524411 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 LIND AVE SW ATTN TAX DEPT | AddressLine1Txt |
| City | RENTON | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 980579016 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN PETERS | PersonNm |
| Person Title | INTERIM REGIONAL CFO | PersonTitleTxt |
| Phone | 7072524411 | PhoneNum |
| Signature | 2019-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RYAN MAYOR | PreparerPersonNm |
| PTIN | P01650740 | PTIN |
| Phone | 8585357200 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 164.57.159.254 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 33577420193195000086 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-11-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | C8EB7D7F4A43AD7C11A3CC780D94EAED606DA475 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | CBBDC42840D8014E8353DD16D453BA683ED30307 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | Larry Coomes | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 Trancas Street | AddressLine1Txt |
| City | Napa | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94558 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $174,207,765 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.thequeen.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1953 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 1387 | TotalEmployeeCnt |
| Total Volunteers | 170 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,194,910 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,023,982 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $132,029,591 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $69,186,607 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,166,646 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,379,620 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,521,746 | PYOtherRevenueAmt |
| CY Other Revenue | $100,617,556 | CYOtherRevenueAmt |
| PY Total Revenue | $137,912,893 | PYTotalRevenueAmt |
| CY Total Revenue | $174,207,765 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,045,017 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,073,974 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $62,529,231 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $132,774,049 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,934,088 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $76,548,633 | PYOtherExpensesAmt |
| CY Other Expenses | $34,159,833 | CYOtherExpensesAmt |
| PY Total Expenses | $140,122,881 | PYTotalExpensesAmt |
| CY Total Expenses | $168,007,856 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,209,988 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,199,909 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $420,632,413 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $212,036,556 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $208,595,857 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $154,105,353 | ExpenseAmt |
| Grant | $1,073,974 | GrantAmt |
| Revenue | $169,804,163 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $154,105,353 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | Yes (true) | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1387 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John Peters | PersonNm |
| Phone | 7072524411 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 Trancas Street | AddressLine1Txt |
| City | Napa | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94558 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (36 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| GREG BENNETT | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| GENI BENNETTS MD | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| LARRY COOMES | ||||||||||
| BOARD MEMBER/CEO | 50.0 | 0.0 | Yes (X) | $0 | $541,337 | $57,989 | Yes (X) | |||
| ED FARVER | ||||||||||
| BOARD CHAIR | 5.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| FRANCIS HEALY MD | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| TIM HERMAN | ||||||||||
| BOARD VICE CHAIR | 5.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| CON HEWITT | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| SR MARYANNE HUEPPER CSJ | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| BR VICTOR KENNETH FSC | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| PAM KINDIG | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| SR NADINE MCGUINNESS CSJ | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL MERWIN MD | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| VINCENT MORGESE MD | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| DENNIS PEDISICH | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| ROSARIO PEREZ | ||||||||||
| BD MBR/SVP MISSION INTEG. | 2.0 | 0.0 | Yes (X) | $0 | $378,436 | $38,714 | ||||
| RON PROFILI | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| SR CHRISTINE SCHLEICH CSJ | ||||||||||
| BOARD MEMBER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| OLUYEMI ADEYANJU | ||||||||||
| SECRETARY | 50.0 | 4.0 | $0 | $408,366 | $22,535 | Yes (X) | ||||
| RAJU IYER | ||||||||||
| REGIONAL CFO, TREASURER | 0.0 | 50.0 | $0 | $363,872 | $33,831 | Yes (X) | ||||
| JOHN PETERS | ||||||||||
| INTERIM REGIONAL CFO | 0.0 | 5.0 | $0 | $0 | $0 | Yes (X) | ||||
| JOHN BIBBY | ||||||||||
| REGIONAL VP HR N. CA | 0.0 | 50.0 | $0 | $364,111 | $47,710 | Yes (X) | ||||
| KIM BROWN SIMS | ||||||||||
| CHIEF NURSING OFFICER | 50.0 | 0.0 | $307,912 | $0 | $31,923 | Yes (X) | ||||
| MAUREEN DISBOT | ||||||||||
| REG VP, QUALITY & SAFETY-N. CA | 0.0 | 50.0 | $0 | $327,756 | $35,927 | Yes (X) | ||||
| AMY HEROLD | ||||||||||
| VP, CHIEF MEDICAL OFFICER | 50.0 | 0.0 | $345,342 | $0 | $26,221 | Yes (X) | ||||
| ELAINE JOHN | ||||||||||
| Ministry Chief, Philant. Ofcr | 50.0 | 0.0 | $288,782 | $0 | $43,557 | Yes (X) | ||||
| CAROL KOEBLE | ||||||||||
| CHIEF MEDICAL OFFICER - NCAL | 0.0 | 50.0 | $0 | $437,819 | $13,007 | Yes (X) | ||||
| CARMELO MOCERI | ||||||||||
| CHIEF STRATEGY OFFICER - NCAL | 0.0 | 50.0 | $0 | $333,404 | $37,125 | Yes (X) | ||||
| MARK PROVAN | ||||||||||
| N.CA REG VP-POST ACUTE CARE | 0.0 | 50.0 | $0 | $326,802 | $47,033 | Yes (X) | ||||
| ANGELA BURR | ||||||||||
| LEAD RADIOLOGY NURSE | 40.0 | 0.0 | $265,621 | $0 | $61,716 | Yes (X) | ||||
| PAUL DEUS | ||||||||||
| RNFA II | 40.0 | 0.0 | $274,848 | $0 | $65,151 | Yes (X) | ||||
| MARYAM MOHSENZADEH | ||||||||||
| SR. MANAGER DENTAL DDS | 40.0 | 0.0 | $244,224 | $0 | $47,287 | Yes (X) | ||||
| MARYANN NELSON | ||||||||||
| NURSE, STAFF III | 40.0 | 0.0 | $273,077 | $0 | $57,747 | Yes (X) | ||||
| JACK COX | ||||||||||
| BD MBR/SVP CMHO SJH (FMR OFCR) | 0.0 | 50.0 | $0 | $901,815 | $33,238 | Yes (X) | ||||
| WALTER MICKENS | ||||||||||
| CEO (FORMER OFFICER) | 0.0 | 0.0 | $0 | $485,608 | $0 | Yes (X) | ||||
| DANIEL DWYER | ||||||||||
| Reg VP Miss Integ (Fmr KE) | 0.0 | 50.0 | $0 | $290,678 | $37,333 | Yes (X) | ||||
| MICHEL RICCIONI | ||||||||||
| CFO-N. CAL REGION (FMR OFCR) | 0.0 | 50.0 | $0 | $151,400 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,999,806 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,311,404 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $738,044 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 389 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| INPATIENT CONSULTANTS OF CALIFORNIA | |||||
| PO BOX 844929 | LOS ANGELES | CA | 90084 | CONSULTING SERVICES | $463,197 |
| PULMONARY MEDICINE ASSOCIATES | |||||
| 1300 ETHAN WAY 600 | SACRAMENTO | CA | 95825 | MEDICAL SERVICES | $437,967 |
| CALIFORNIA IMAGING SERVICES | |||||
| 499 C EDISON CT | FAIRFIELD | CA | 94534 | MEDICAL SERVICES | $426,238 |
| ANESTHESIA AND ANALGESIA MEDICAL GR | |||||
| 2455 BENNETT VALLEY RD SUITE C219 | SANTA ROSA | CA | 95404 | MEDICAL SERVICES | $316,803 |
| RADIOLOGY MEDICAL GROUP OF NAPA | |||||
| PO BOX 348120 | SACRAMENTO | CA | 95834 | MEDICAL SERVICES | $267,692 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $934,287 | RelatedOrganizationsAmt |
| Government Grants | $65,673 | GovernmentGrantsAmt |
| All Other Contributions | $24,022 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $1,023,982 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| NET PATIENT REVENUE | 622110 | $67,370,060 | $67,370,060 | $0 | $0 |
| SYNERGY WELLNESS CENTER REVENUE | 713940 | $960,491 | $960,491 | $0 | $0 |
| MEDICAL OFFICE BUILDING REVENUE | 531120 | $195,610 | $195,610 | $0 | $0 |
| 340B DRUG DISCOUNT PROGRAM REVENUE | 622210 | $179,385 | $179,385 | $0 | $0 |
| CAFETERIA REVENUE | 722514 | $103,872 | $103,872 | $0 | $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $377,189 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $377,189 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $69,186,607 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,379,620 | TotalRevenueColumnAmt |
| Exclusion | $3,379,620 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EMPLOYEE LEASE REIMBURSEMENT-SJHNC LLC | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $100,617,556 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $100,617,556 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $100,617,556 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $174,207,765 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $169,804,163 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,379,620 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,073,974 | TotalAmt |
| Program Services | $1,073,974 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,657,483 | TotalAmt |
| Program Services | $368,581 | ProgramServicesAmt |
| Management And General | $1,288,902 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,624,719 | TotalAmt |
| Program Services | $84,996,397 | ProgramServicesAmt |
| Management And General | $5,294,405 | ManagementAndGeneralAmt |
| Fundraising | $1,333,917 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,381,896 | TotalAmt |
| Program Services | $4,894,537 | ProgramServicesAmt |
| Management And General | $401,889 | ManagementAndGeneralAmt |
| Fundraising | $85,470 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,980,685 | TotalAmt |
| Program Services | $25,189,012 | ProgramServicesAmt |
| Management And General | $1,479,442 | ManagementAndGeneralAmt |
| Fundraising | $312,231 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,129,266 | TotalAmt |
| Program Services | $6,572,942 | ProgramServicesAmt |
| Management And General | $452,481 | ManagementAndGeneralAmt |
| Fundraising | $103,843 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,000,492 | TotalAmt |
| Program Services | $4,100,893 | ProgramServicesAmt |
| Management And General | $899,599 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $372,181 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $372,181 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,559 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $10,559 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,555 | TotalAmt |
| Program Services | $5,555 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $273,895 | TotalAmt |
| Management And General | $273,895 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,266,794 | TotalAmt |
| Program Services | $11,189,498 | ProgramServicesAmt |
| Management And General | $1,017,650 | ManagementAndGeneralAmt |
| Fundraising | $59,646 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,986 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $6,314 | ManagementAndGeneralAmt |
| Fundraising | $10,672 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,060 | TotalAmt |
| Program Services | $208,780 | ProgramServicesAmt |
| Management And General | $59,762 | ManagementAndGeneralAmt |
| Fundraising | $1,518 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,586 | TotalAmt |
| Program Services | $138,986 | ProgramServicesAmt |
| Management And General | $20,065 | ManagementAndGeneralAmt |
| Fundraising | $3,535 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $994,812 | TotalAmt |
| Program Services | $978,123 | ProgramServicesAmt |
| Management And General | $16,624 | ManagementAndGeneralAmt |
| Fundraising | $65 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,439 | TotalAmt |
| Program Services | $34,535 | ProgramServicesAmt |
| Management And General | $71,988 | ManagementAndGeneralAmt |
| Fundraising | $7,916 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,852 | TotalAmt |
| Program Services | $19,803 | ProgramServicesAmt |
| Management And General | $6,970 | ManagementAndGeneralAmt |
| Fundraising | $79 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,257,136 | TotalAmt |
| Program Services | $1,251,756 | ProgramServicesAmt |
| Management And General | $5,380 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,343,721 | TotalAmt |
| Program Services | $3,230,859 | ProgramServicesAmt |
| Management And General | $112,862 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,111 | TotalAmt |
| Program Services | $224,544 | ProgramServicesAmt |
| Management And General | $142,686 | ManagementAndGeneralAmt |
| Fundraising | $3,881 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies | $9,062,218 | $9,062,218 | $0 | $0 |
| Licenses | $186,943 | $146,268 | $40,675 | $0 |
| Dues and Subscriptions | $157,550 | $152,149 | $4,645 | $756 |
| ALL OTHER EXPENSES | $265,943 | $265,943 | $0 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,007,856 | TotalAmt |
| Program Services | $154,105,353 | ProgramServicesAmt |
| Management And General | $11,968,415 | ManagementAndGeneralAmt |
| Fundraising | $1,934,088 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,063,048 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,282,489 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,166,360 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,143,174 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $386,655 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $203,032,680 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $163,203,789 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,354,218 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $420,632,413 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,561,183 | BOYAmt |
| EOY | $0 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,050,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,425,373 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $212,036,556 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,595,857 | BOYAmt |
| EOY | $0 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,595,857 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $420,632,413 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,199,909 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,804,502 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$211,991,264 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Media Advertisements | $0 | MediaAdvertisementsAmt |
| Mailings Members | false | MailingsMembersInd |
| Mailings Members | $0 | MailingsMembersAmt |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Publications Or Broadcast | $0 | PublicationsOrBroadcastAmt |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $0 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Direct Contact Legislators | $0 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Rallies Demonstrations | $0 | RalliesDemonstrationsAmt |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $5,555 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,555 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | LOBBYING ACTIVITIES THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO QUEEN OF THE VALLEY MEDICAL CENTER. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 500. | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $583,514 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $583,514 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,986,984 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,408,876 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $578,108 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00340 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,092,672 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,743,920 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,348,752 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00800 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,663,170 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,152,796 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,510,374 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01490 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,228,955 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $211,375 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,017,580 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00610 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $184,251 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $173,972 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,279 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $482,991 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $64,610 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $418,381 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,896,197 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $449,957 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,446,240 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00870 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,559,367 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,602,753 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,956,614 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02360 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $896,518 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $16,162,081 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $26,369,054 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$10,206,973 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | Yes (X) | CostAccountingSystemInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUEEN OF THE VALLEY MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 TRANCAS STREET | AddressLine1Txt |
| City | NAPA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94558 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.thequeen.org | WebsiteAddressTxt |
| State License | 110000060 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUEEN OF THE VALLEY MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 500. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, 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. SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUT THE PROCESS OF COLLECTING QUALITATIVE COMMUNITY INPUT TOOK THREE MAIN FORMS: COMMUNITY RESIDENT FOCUS GROUP, A NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, AND A COMMUNITY FORUM. EACH GROUP WAS DESIGNED TO CAPTURE THE COLLECTED KNOWLEDGE AND OPINIONS OF PEOPLE WHO LIVE AND WORK IN THE COMMUNITIES SERVED BY QUEEN OF THE VALLEY MEDICAL CENTER. WE DEVELOPED A PROTOCOL (NOTED IN APPENDIX 3B OF THE CHNA) FOR EACH GROUP TO ENSURE CONSISTENCY ACROSS INDIVIDUAL FOCUS GROUPS, ALTHOUGH THE FACILITATORS HAD SOME DISCRETION ON ASKING FOLLOW-UP QUESTIONS OR PROBES AS THEY SAW FIT. INVITATION AND RECRUITMENT PROCEDURES VARIED FOR EACH TYPE OF GROUP. APPENDIX 3 OF THE CHNA INCLUDES A FULL REPORT OF THE COMMUNITY INPUT PROCESS AND FINDINGS ALONG WITH DESCRIPTIONS OF THE PARTICIPANTS. RESIDENT FOCUS GROUPS FOR COMMUNITY RESIDENT GROUPS, COMMUNITY BENEFIT STAFF, IN COLLABORATION WITH THEIR COMMITTEES AND THE SYSTEM OFFICE, IDENTIFIED GEOGRAPHIC AREAS WHERE DATA SUGGESTED THERE WERE SIGNIFICANT HEALTH, PHYSICAL ENVIRONMENT, AND SOCIOECONOMIC CONCERNS. THIS PROCESS ALSO IDENTIFIED THE LANGUAGE NEEDS OF THE COMMUNITY, WHICH DETERMINED THE LANGUAGE IN WHICH EACH FOCUS GROUP WAS CONDUCTED. COMMUNITY BENEFIT STAFF THEN PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS THAT SERVE THOSE AREAS TO RECRUIT FOR AND HOST THE FOCUS GROUPS. THE COMMUNITY BASED ORGANIZATION DEVELOPED AN INVITATION LIST USING THEIR CONTACTS AND KNOWLEDGE OF THE AREA, AND PARTICIPANTS WERE PROMISED A SMALL INCENTIVE FOR THEIR TIME. TWO CONSULTANTS STAFFED EACH FOCUS GROUP, SERVING AS FACILITATORS AND NOTE TAKERS. THESE CONSULTANTS WERE NOT DIRECTLY AFFILIATED WITH THE MINISTRY TO ENSURE CANDOR FROM THE PARTICIPANTS. TWO RESIDENT FOCUS GROUPS WERE CONDUCTED, ONE CONDUCTED ON 3/16/17 IN THE CITY OF SONOMA IN SPANISH WITH 20 PARTICIPANTS AND THE OTHER CONDUCTED ON 3/22/17 IN THE CITY OF AMERICAN CANYON WITH 16 PARTICIPANTS. THE COMMUNITY RESIDENT FOCUS GROUP ATTENDEES WERE 83% FEMALE AND 17% MALE. 70% OF ATTENDEES IDENTIFIED AS HISPANIC/LATINO, 13% AS NON-LATINO WHITE, 10% AS FILIPINO, AND 7% AS BLACK/AFRICAN-AMERICAN. OF THOSE WHO RESPONDED, 45% SAID THEY EARNED LESS THAN $35,000 ANNUALLY; THE AMERICAN CANYON GROUP WAS CONSIDERABLY MORE AFFLUENT THAN THE GROUP IN SONOMA. MORE DETAILED DEMOGRAPHIC INFORMATION IS LISTED IN APPENDIX 3A OF THE CHNA. NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP FOR THE NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, COMMUNITY BENEFIT STAFF DEVELOPED A LIST OF LEADERS FROM ORGANIZATIONS THAT SERVE DIVERSE CONSTITUENCIES WITHIN THE HOSPITAL'S SERVICE AREA. MINISTRY STAFF SOUGHT TO INVITE ORGANIZATIONS WITH WHICH THEY HAD EXISTING RELATIONSHIPS, BUT ALSO USED THE FOCUS GROUP AS AN OPPORTUNITY TO BUILD NEW RELATIONSHIPS WITH STAKEHOLDERS. THE GROUP WAS CONDUCTED ON 3/23/17. PARTICIPANTS WERE NOT GIVEN A MONETARY INCENTIVE FOR ATTENDANCE. AS WITH THE RESIDENT FOCUS GROUPS, THIS GROUP WAS FACILITATED BY OUTSIDE CONSULTANTS WITHOUT A DIRECT LINK TO ST. JOSEPH HEALTH. THE GROUP INCLUDED 21 PARTICIPANTS REPRESENTING DIVERSE POPULATIONS INCLUDING LOW INCOME, CHRONICALLY ILL, MEDICALLY UNDERSERVED, LATINO AND FILIPINO POPULATIONS. A FULL LIST OF PARTICIPANTS AND ORGANIZATIONS IS IN APPENDIX 3B OF THE CHNA. RESIDENT COMMUNITY FORUM RECRUITMENT FOR THE COMMUNITY RESIDENT FORUM WAS MUCH BROADER TO ENCOURAGE AS MANY PEOPLE AS POSSIBLE TO ATTEND THE SESSION. COMMUNITY BENEFIT STAFF PUBLICIZED THE EVENT THROUGH FLYERS AND EMAILS USING THEIR EXISTING OUTREACH NETWORKS, AND ALSO ASKED THEIR PARTNER ORGANIZATIONS TO INVITE AND RECRUIT PARTICIPANTS. NO FORMAL INVITATION LIST WAS USED FOR THE FORUM AND ANYONE WHO WISHED TO ATTEND WAS WELCOMED. THE FORUM WAS CONDUCTED ON 3/27/17 BY AN OUTSIDE CONSULTANT IN ENGLISH, WITH SIMULTANEOUS SPANISH LANGUAGE TRANSLATION FOR ANYONE WHO REQUESTED IT. WHILE THE FOCUS GROUPS FOLLOWED A SIMILAR PROTOCOL TO EACH OTHER IN WHICH FIVE TO SIX QUESTIONS WERE ASKED OF THE GROUP, THE FORUM FOLLOWED A DIFFERENT PROCESS. THE LEAD FACILITATOR SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR AND ASKED THE PARTICIPANTS TO COMMENT ON THEM AND ADD ANY OTHER CONCERNS. ONCE THE DISCUSSION WAS COMPLETE, THE PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS PROCESS, THE FORUM SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT PROCESS. |
| SCHEDULE H, PART V, SECTION B, LINE 7A | HTTPS://WWW.THEQUEEN.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ |
| SCHEDULE H, PART V, SECTION B, LINE 10A | HTTPS://WWW.THEQUEEN.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ |
| SCHEDULE H, PART V, SECTION B, LINE 11 | QUEEN OF THE VALLEY IS WORKING BOTH INTERNALLY AND WITH COMMUNITY PARTNERS TO ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFIED BY THE FY17 COMMUNITY HEALTH NEEDS ASSESSMENT. QUEEN OF THE VALLEY'S FY18-FY20 COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORT FOCUSES ON THREE BROAD CATEGORIES OF HEALTH NEEDS: MENTAL HEALTH, SUBSTANCE ABUSE, AND SOCIAL DETERMINANTS OF HEALTH WHICH INCLUDE HOUSING, ECONOMIC ISSUES AND ACCESS TO HEALTH CARE. MENTAL HEALTH: THIS INITIATIVE IS FOCUSED ON IMPROVING MENTAL HEALTH AND WELLBEING OF 200 VULNERABLE LOW-INCOME OLDER ADULTS, INDIVIDUALS WITH ACUTE MEDICAL CONDITIONS AND PREGNANT AND POSTPARTUM WOMEN ANNUALLY. ACCESS TO MENTAL HEALTH SERVICES FOR LOW-INCOME INDIVIDUALS IS LIMITED. OLDER ADULTS, POSTPARTUM WOMEN AND THOSE WITH COMPLEX MEDICAL CONDITIONS ARE MORE LIKELY TO SUFFER FROM DEPRESSION THAT CAN CONTRIBUTE TO POOR QUALITY OF LIFE AND PLACE THEM AT HIGHER RISK FOR SUICIDE. GOAL: REDUCE DEPRESSION AND IMPROVE QUALITY OF LIFE AMONG 200 LOW-INCOME OLDER ADULTS, INDIVIDUALS WITH ACUTE MEDICAL CONDITIONS AND PREGNANT AND POSTPARTUM WOMEN ANNUALLY. THE OUTCOME MEASURE IS PERCENTAGE OF CLIENTS THAT IMPROVE DEPRESSION INDICTORS AS MEASURED THROUGH VALIDATED TOOLS (PHQ9). SUBSTANCE ABUSE: PERINATAL SUBSTANCE USE HAS SERIOUS CONSEQUENCES FOR BOTH MOTHER AND CHILD. OBSTETRICAL COMPLICATIONS FROM SUBSTANCE USE INCLUDE AN INCREASED RISK OF MISCARRIAGE, INTRAUTERINE GROWTH RESTRICTION, PREMATURE LABOR, AND EVEN FETAL DEMISE. RISKS EXTEND BEYOND PREGNANCY TO THE NEWBORN. ALCOHOL USE CAN LEAD TO FETAL ALCOHOL SPECTRUM DISORDER (FASD) ASSOCIATED WITH NUMEROUS DISABILITIES. OPIOID USE IS ASSOCIATED WITH NEONATAL WITHDRAWAL SYNDROME (NAS). RECENT ESTIMATES IDENTIFIED AN INCREASE IN THE RATE OF NEONATAL INTENSIVE CARE UNIT (NICU) ADMISSIONS IN THE UNITED STATES FOR NAS FROM 7 CASES TO 27 CASES PER 1000 ADMISSIONS LEADING TO AN INCREASE FROM 0.6% TO 4% OF ALL NICU DAYS BEING ATTRIBUTED TO NAS. INTERVENING WITH HIGH RISK WOMEN CAN ALSO PREVENT CHILDHOOD TRAUMA ASSOCIATED WITH PARENTAL SUBSTANCE ABUSE. IN NAPA, A SCREENING PILOT CONDUCTED FROM OCTOBER 2015-MAY 2017 USING THE VALIDATED 4PS PLUS TOOL TO ASSESS USE OF ALCOHOL, TOBACCO AND OTHER DRUGS BY PREGNANT WOMEN IN NAPA HAD THE FOLLOWING RESULTS: WITH A TOTAL OF 1,094 WOMEN SCREENED, THERE WERE A TOTAL OF 369 POSITIVE SCREENS FOR SUBSTANCE USE, OR ABOUT 33.7% OF THE TOTAL NUMBER OF SCREENS. GOAL: PREVENT ADVERSE CHILDHOOD EXPERIENCES THROUGH A COMPREHENSIVE SET OF ACTIVITIES TO REDUCE PERINATAL SUBSTANCE USE AND ABUSE SERVING APPROXIMATELY 500 WOMEN ANNUALLY. OUTCOME MEASURE: TO BE DEVELOPED BASED ON PLANNING COALITION RESEARCH OF APPROPRIATE MEASURES. ACTIVITIES INCLUDE DEVELOPING A BROAD BASED COALITION OF COMMUNITY AND PUBLIC AGENCY PARTNERS TO ADDRESS ISSUES OF PERINATAL SUBSTANCE USE AND ABUSE, EDUCATION PROFESSIONALS AND THE PUBLIC ON PERINATAL SUBSTANCE ABUSE IMPACTS AND SERVICES AVAILABLE, IMPLEMENT INTEGRATED PATIENT EDUCATION, SCREENING AND INTERVENTION TO CHANGE PATIENT SUBSTANCE ABUSE BEHAVIORS. SOCIAL DETERMINANTS OF HEALTH: THIS INITIATIVE ADDRESSES THE GAP IN HOUSING THAT IS AVAILABLE AND AFFORDABLE FOR CHRONICALLY HOMELESS AND LOW INCOME COMMUNITY MEMBERS, IMPROVING ECONOMIC STABILITY FOR LOW INCOME VULNERABLE ADULTS, AND ENSURING ACCESS TO QUALITY ORAL HEALTH CARE FOR LOW INCOME CHILDREN. GOALS INCLUDE SUPPORTING SUSTAINABLE, COLLECTIVE EFFORTS TO REDUCE HOMELESSNESS AND IMPROVE AVAILABILITY AND ACCESSIBILITY OF HOUSING THAT IS AFFORDABLE FOR LOW INCOME AND OTHER VULNERABLE POPULATIONS, ENSURE ACCESS TO BASIC NEEDS AND HEALTH MANAGEMENT OF LOW INCOME VULNERABLE ADULTS WITH COMPLEX MEDICAL AND SOCIO-ECONOMIC CONDITIONS INCLUDING HOMELESSNESS AND LACK OF ACCESS TO ESSENTIAL MEDICAL AND SOCIAL SERVICE RESOURCES, AND TO REDUCE THE ECONOMIC BURDEN ON FAMILIES AND IMPROVE ORAL HEALTH STATUS OF CHILDREN 6 MONTHS TO 26 YEARS OF AGE WHO ARE UNINSURED OR UNDERINSURED. OUTCOME MEASURES FOR THE SOCIAL DETERMINANTS OF HEALTH INITIATIVE INCLUDE COMMUNITY-WIDE COLLABORATIVE EFFORTS EXPANDING NUMBER OF INDIVIDUALS (TBD) HOUSED WHO WERE HOMELESS OR PRECARIOUSLY HOUSED, PERCENTAGE IMPROVEMENT IN QUALITY OF LIFE MEASURES ON VALIDATED SF12 SURVEY FROM ENROLLMENT TO DISCHARGE OF LOW INCOME, VULNERABLE CLIENTS, AND PERCENTAGE OF LOW INCOME PATIENTS WHO DEMONSTRATE ORAL HEALTH STATUS IMPROVEMENT AT RECALL VISIT BASED ON A SET OF CLINICAL CRITERIA. FOR MORE INFORMATION ON THE KEY STRATEGIES FOR ADDRESSING THESE HEALTH NEEDS GO TO THE QUEEN OF THE VALLEY MEDICAL CENTER FY18-FY20 CB PLAN LOCATED AVAILABLE ONLINE AT HTTPS://WWW.THEQUEEN.ORG/FOR-COMMUNITY/ NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH QUEEN OF THE VALLEY AND BY FUNDING OTHER NON-PROFITS THROUGH OUR CARE FOR THE POOR PROGRAM MANAGED BY THE QUEEN OF THE VALLEY. FURTHERMORE, QUEEN OF THE VALLEY WILL ENDORSE LOCAL NON-PROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT QUEEN OF THE VALLEY SERVICE AREAS. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED WITH THE FOLLOWING EXPLANATION: SJH QUEEN OF THE VALLEY DOES NOT DIRECTLY ADDRESS IMMIGRATION STATUS. HOWEVER, COMMUNITY BENEFIT SERVICES ARE PROVIDED WITHOUT CONSIDERATION OF IMMIGRATION STATUS AND THE MEDICAL CENTER PROVIDES CHARITY MEDICAL CARE. IN ADDITION, QUEEN OF THE VALLEY MEDICAL CENTER AND COMMUNITY BENEFIT PROGRAMS PARTNERS WITH MULTIPLE COMMUNITY-BASED ORGANIZATIONS TO ADDRESS THE NEEDS OF THE UNDOCUMENTED. WHILE CANCER, HEART DISEASE, DIABETES AND ASTHMA ARE NOT A PRIMARY FOCUS OF THE PLAN, THE SERVICE AREA INCLUDES QUEEN OF THE VALLEY MEDICAL CENTER, ST. HELENA HOSPITAL, KAISER CLINIC AND OLE HEALTH THAT PROVIDE MEDICAL SERVICES TO INDIVIDUALS WITH THESE CONDITIONS. ALSO, QUEEN OF THE VALLEY'S CARE NETWORK PROVIDES CARE COORDINATION AND CARE MANAGEMENT FOR LOW INCOME PERSONS WITH COMPLEX MEDICAL CONDITIONS INCLUDING CHRONIC DISEASES SUCH AS THESE. SJH QUEEN OF THE VALLEY DOES NOT DIRECTLY ADDRESS ISSUES OF TRANSPORTATION AND TRAFFIC. AS A PARTNER IN LIVE HEALTHY NAPA COUNTY, QUEEN OF THE VALLEY PARTNERS WITH THE COMMUNITY TO IMPROVE CONDITIONS THROUGH ADVOCACY AND PARTNERSHIPS. IN ADDITION, TRANSPORTATION SUPPORT IS PROVIDED TO QUEEN OF THE VALLEY CARE NETWORK CLIENTS. WHILE ACCESS TO FOOD IS NOT A PRIMARY FOCUS OF THE IMPLEMENTATION STRATEGY, SJH QUEEN OF THE VALLEY COMMUNITY BENEFIT PROVIDES FUNDING SUPPORT TO LOCAL SAFETY FOOD NET ORGANIZATIONS, WORKS DIRECTLY WITH COMMUNITY PARTNERS SUCH AS THE FOOD BANK AND LIVE HEALTHY NAPA COUNTY TO EXPAND ACCESS, AND DIRECTLY ASSISTS LOW-INCOME CHRONICALLY ILL CARE NETWORK CLIENTS WITH FOOD ACCESS. IN ADDITION, QUEEN OF THE VALLEY WILL COLLABORATE WITH PUBLIC AGENCIES AND COMMUNITY-BASED ORGANIZATIONS THAT ADDRESS LANGUAGE BARRIERS AND AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL AND ADDRESS THESE UNMET NEEDS. |
| SCHEDULE H, PART V, SECTION B, LINE 13H | BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS 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 USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. |
| SCHEDULE H, PART V, SECTION B, LINE 16A | FINANCIAL ASSISTANCE POLICY HTTPS://WWW.THEQUEEN.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL- ASSISTANCE/ |
| SCHEDULE H, PART V, SECTION B, LINE 16B | FINANCIAL ASSISTANCE APPLICATION HTTPS://WWW.THEQUEEN.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL- ASSISTANCE/ |
| SCHEDULE H, PART V, SECTION B, LINE 16C | PLAIN LANGUAGE SUMMARY HTTPS://WWW.THEQUEEN.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL- ASSISTANCE/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| OUTPATIENT SURGERY AND PROCEDURAL CENTER | ||||
| 1000 TRANCAS STREET | NAPA | CA | 94558 | OUTPATIENT SERVICES |
| PROFILI IMAGING CENTER | ||||
| 1000 TRANCAS STREET | NAPA | CA | 94558 | OUTPATIENT SERVICES |
| QVMC URGENT CARE CENTER | ||||
| 1621 W IMOLA AVE | NAPA | CA | 94559 | OUTPATIENT SERVICES |
| LAB DRAW STATION | ||||
| 980 TRANCAS STREET | NAPA | CA | 94558 | OUTPATIENT SERVICES |
| MOBILE DENTAL VAN | ||||
| 1000 TRANCAS STREET | NAPA | CA | 94558 | OUTPATIENT SERVICES |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, 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. |
| SCHEDULE H, PART I, LINE 6A | QUEEN OF THE VALLEY MEDICAL CENTER PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.THEQUEEN.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ |
| SCHEDULE H, PART I, LINE 7A-7I | THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS. |
| SCHEDULE H, PART I, LINE 7G | NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. |
| SCHEDULE H, PART III, SECTION A, LINE 2 | METHODOLOGY FOR CALCULATING BAD DEBT 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. |
| SCHEDULE H, PART III, SECTION A, 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 IDENTICY AND QUALICY 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. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | FINANCIAL STATEMENT FOOTNOTE DESCRIBING BAD DEBT FOOTNOTE FROM THE PROVIDENCE ST. JOSEPH HEALTH COMBINED FINANCIAL STATEMENTS FOR THE YEAR ENDED 12/31/2018 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. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | COMMUNITY BENEFITS THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | COLLECTION ACTIVITY 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 IDENTICY 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. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT IN ADDITION TO THE CHNA, ADDITIONAL COMMUNITY NEEDS EMERGE OVER TIME. TO ENSURE A CONTINUOUS CONNECTION TO EMERGING COMMUNITY NEEDS, QUEEN OF THE VALLEY COMMUNITY BENEFIT STAFF ARE MEMBERS OF LIVE HEALTHY NAPA COUNTY (LHNC). NAPA COUNTY PUBLIC HEALTH SERVES AS THE BACKBONE ORGANIZATION OF LHNC, AND THIS THE PUBLIC PRIVATE SECTOR COLLABORATIVE CONSISTS OF OVER 40 AGENCIES. LHNC MEETS REGULARLY, HAS A WEB SITE AND SENDS ELECTRONIC NEWSLETTERS AND UPDATES FOR ANY URGENT COMMUNITY NEEDS THAT ARISE BETWEEN MEETINGS. IN ADDITION TO LHNC, QUEEN OF THE VALLEY STRATEGIC SERVICES CONDUCT ANALYSIS AND REPORT ON COMMUNITY NEEDS AND TRENDS. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE. IN ADDITION TO ON SITE FINANCIAL COUNSELORS WITHIN THE HOSPITAL, COMMUNITY OUTREACH ALSO OFFERS INFORMATION AND APPLICATION ASSISTANCE THROUGH THE CARE NETWORK DEPARTMENT AND COMMUNITY SOCIAL SERVICES. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION QUEEN OF THE VALLEY MEDICAL CENTER'S TOTAL HOSPITAL SERVICE AREA (TSA) INCLUDES APPROXIMATELY 167,000 PEOPLE AND PORTIONS OF NAPA AND SONOMA COUNTIES. THE PRIMARY SERVICE AREA (PSA) CONSISTS OF THE ZIP CODES FOR THE CITIES OF NAPA AND YOUNTVILLE, AND THE SECONDARY SERVICE AREA CONSISTS OF THE CITIES OF AMERICAN CANYON, ST. HELENA, AND BOYES HOT SPRINGS IN SONOMA. OVER 75% OF THE POPULATION OF THE TSA IS IN NAPA COUNTY, AND APPROXIMATELY 90% OF NAPA COUNTY'S POPULATION IS WITHIN THE TSA. A PREMIUM WINE PRODUCING REGION, THERE IS A LARGE AGRICULTURE AND HOSPITALITY INDUSTRY. ALTHOUGH OFTEN VIEWED AS A COMMUNITY OF WEALTH, THE LARGE NUMBER OF LOW WAGE EARNERS IN THESE INDUSTRIES COMBINED WITH THE HIGH COST OF LIVING LEND TO POCKETS OF POVERTY AND INDIVIDUALS AND FAMILIES HAVING DIFFICULTY MEETING BASIC NEEDS. ETHNIC DIVERSITY OF THE TSA INCLUDE 33.5% LATINO, 54.8% NON-LATINO WHITE WITH 7.2% ASIAN/PACIFIC ISLANDER AND 1.7% BLACK. 16.2% OF THE TSA DO NOT SPEAK ENGLISH "VERY WELL". THE MEDIAN HOUSEHOLD INCOME IS $68,468 WITH 22.1% HOUSEOLDS BELOW 200% OF THE FPL AND 7.6% LIVING BELOW 100% FPL. 15.4% OF CHILDREN AND 7.1% OF OLDER ADULTS LIVE 100% BELOW FPL. QUEEN OF THE VALLEY'S TSA HAS A HIGHER PERCENTAGE OF OLDER ADULTS (18.5%) THAN THE MEDICAL UNDERSERVED AREA/MEDICAL PROFESSIONAL SHORTAGE AREA MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MEDICALLY UNDERSERVED AREAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREA'S LEVEL OF MEDICAL "UNDER SERVICE". MEDICALLY UNDERSERVED POPULATIONS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. QUEEN OF THE VALLEY, ALONG WITH THE MAJORITY OF THE TSA IS LOCATED IN A MEDICALLY UNDERSERVED POPULATIONS AREA, SIGNIFYING THE IMPORTANCE OF THE MEDICAL CENTER TO THE COMMUNITY IT SERVES STATE. THERE IS ONE OTHER HOSPITAL IN THE COMMUNITY: ST. HELENA HOSPITAL. HEALTH PROFESSIONS SHORTAGE AREA - MENTAL, DENTAL, OTHER THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS).ALTHOUGH QUEEN OF THE VALLEY IS NOT LOCATED IN A HEALTH PROFESSIONS SHORTAGE AREA, LARGE PORTIONS OF THE SERVICE AREA TO THE WEST AND NORTH ARE DESIGNATED SHORTAGE AREAS. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH QUEEN OF THE VALLEY MEDICAL CENTER PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. QUEEN OF THE VALLEY IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS: 1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES. 2) OPEN MEDICAL STAFF. 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM ON 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 AND 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| CATHOLIC CHARITIES | |||||||
| 465 A ST | SANTA ROSA | CA | 95401 | 942479393 | 501(c)(3) | $200,000 | ACCESS TO HEALTHCARE |
| EXODUS FOUNDATION | |||||||
| 9808 Venice Blvd 700 | Culver City | CA | 90232 | 880279721 | 501(c)(3) | $100,000 | PROGRAM SUPPORT |
| HABITAT FOR HUMANITY | |||||||
| 5130 FULTON DR STE R | FAIRFIELD | CA | 94534 | 680252525 | 501(c)(3) | $30,000 | LOW-INCOME SUPPORT |
| VIA HEART PROJECT | |||||||
| 1725 CLAY ST 100 | SAN FRANCISCO | CA | 94109 | 271530938 | 501(c)(3) | $20,000 | COMMUNITY AED PROGRAM |
| MENTIS | |||||||
| 709 FRANKLIN ST | NAPA | CA | 94559 | 941236934 | 501(c)(3) | $17,000 | NIGHTENGALE HOUSE |
| St Joseph Health System Foundation | |||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 330143024 | 501(C)(3) | $631,600 | CARE FOR THE POOR |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 6 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | DESCR OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS COMMUNITY BENEFIT CHARITABLE DONATIONS ARE CONDITIONED AND RESTRICTED TOWARDS MEETING A SPECIFIC IDENTIFIED COMMUNITY NEED. IN ADDITION THE RECIPIENT AGENCY MUST REMAIN A NON-PROFIT, TAX EXEMPT ORGANIZATION AND IS REQUIRED TO REPORT AN ACCOUNTING METHOD RELATIVE TO EXPENDITURE OF THE DONATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LARRY COOMES | ||||||||||||||
| BOARD MEMBER/CEO | $0 | $378,419 | $0 | $158,534 | $0 | $4,384 | $0 | $10,913 | $0 | $47,076 | $0 | $599,326 | $0 | $0 |
| ROSARIO PEREZ | ||||||||||||||
| BD MBR/SVP MISSION INTEG. | $0 | $333,666 | $0 | $39,415 | $0 | $5,355 | $0 | $11,000 | $0 | $27,714 | $0 | $417,150 | $0 | $0 |
| OLUYEMI ADEYANJU | ||||||||||||||
| SECRETARY | $0 | $340,587 | $0 | $37,485 | $0 | $30,294 | $0 | $10,939 | $0 | $11,596 | $0 | $430,901 | $0 | $0 |
| RAJU IYER | ||||||||||||||
| REGIONAL CFO, TREASURER | $0 | $309,613 | $0 | $50,000 | $0 | $4,259 | $0 | $1,096 | $0 | $32,735 | $0 | $397,703 | $0 | $0 |
| JOHN BIBBY | ||||||||||||||
| REGIONAL VP HR N. CA | $0 | $275,109 | $0 | $85,403 | $0 | $3,599 | $0 | $11,000 | $0 | $36,710 | $0 | $411,821 | $0 | $0 |
| KIM BROWN SIMS | ||||||||||||||
| CHIEF NURSING OFFICER | $277,384 | $0 | $25,634 | $0 | $4,894 | $0 | $4,450 | $0 | $27,473 | $0 | $339,835 | $0 | $0 | $0 |
| MAUREEN DISBOT | ||||||||||||||
| REG VP, QUALITY & SAFETY-N. CA | $0 | $268,284 | $0 | $33,182 | $0 | $26,290 | $0 | $9,747 | $0 | $26,180 | $0 | $363,683 | $0 | $0 |
| AMY HEROLD | ||||||||||||||
| VP, CHIEF MEDICAL OFFICER | $299,276 | $0 | $41,975 | $0 | $4,091 | $0 | $9,869 | $0 | $16,352 | $0 | $371,563 | $0 | $0 | $0 |
| ELAINE JOHN | ||||||||||||||
| Ministry Chief, Philant. Ofcr | $219,483 | $0 | $39,377 | $0 | $29,922 | $0 | $11,380 | $0 | $32,177 | $0 | $332,339 | $0 | $0 | $0 |
| CAROL KOEBLE | ||||||||||||||
| CHIEF MEDICAL OFFICER - NCAL | $0 | $391,704 | $0 | $35,833 | $0 | $10,282 | $0 | $1,102 | $0 | $11,905 | $0 | $450,826 | $0 | $0 |
| CARMELO MOCERI | ||||||||||||||
| CHIEF STRATEGY OFFICER - NCAL | $0 | $310,325 | $0 | $17,198 | $0 | $5,881 | $0 | $0 | $0 | $37,125 | $0 | $370,529 | $0 | $0 |
| MARK PROVAN | ||||||||||||||
| N.CA REG VP-POST ACUTE CARE | $0 | $260,288 | $0 | $62,285 | $0 | $4,229 | $0 | $10,500 | $0 | $36,533 | $0 | $373,835 | $0 | $0 |
| ANGELA BURR | ||||||||||||||
| LEAD RADIOLOGY NURSE | $263,964 | $0 | $0 | $0 | $1,657 | $0 | $20,781 | $0 | $40,935 | $0 | $327,337 | $0 | $0 | $0 |
| PAUL DEUS | ||||||||||||||
| RNFA II | $273,936 | $0 | $0 | $0 | $912 | $0 | $24,111 | $0 | $41,040 | $0 | $339,999 | $0 | $0 | $0 |
| MARYAM MOHSENZADEH | ||||||||||||||
| SR. MANAGER DENTAL DDS | $232,750 | $0 | $7,603 | $0 | $3,871 | $0 | $16,546 | $0 | $30,741 | $0 | $291,511 | $0 | $0 | $0 |
| MARYANN NELSON | ||||||||||||||
| NURSE, STAFF III | $272,013 | $0 | $0 | $0 | $1,064 | $0 | $21,076 | $0 | $36,671 | $0 | $330,824 | $0 | $0 | $0 |
| DANIEL DWYER | ||||||||||||||
| Reg VP Miss Integ (Fmr KE) | $0 | $251,431 | $0 | $28,638 | $0 | $10,609 | $0 | $10,313 | $0 | $27,020 | $0 | $328,011 | $0 | $0 |
| MICHEL RICCIONI | ||||||||||||||
| CFO-N. CAL REGION (FMR OFCR) | $0 | $0 | $0 | $0 | $0 | $151,400 | $0 | $0 | $0 | $0 | $0 | $151,400 | $0 | $0 |
| JACK COX | ||||||||||||||
| BD MBR/SVP CMHO SJH (FMR OFCR) | $0 | $512,129 | $0 | $299,564 | $0 | $90,122 | $0 | $11,000 | $0 | $22,238 | $0 | $935,053 | $0 | $0 |
| WALTER MICKENS | ||||||||||||||
| CEO (FORMER OFFICER) | $0 | $0 | $0 | $0 | $0 | $485,608 | $0 | $0 | $0 | $0 | $0 | $485,608 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3 | THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY ST. JOSEPH HEALTH SYSTEM. |
| SCHEDULE J, PART I, LINE 4A | THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT DURING THE YEAR: MICHEL RICCIONI - $151,400 WALTER MICKENS - $485,608 |
| SCHEDULE J, PART I, LINE 4B | NONQUALIFIED RETIREMENT PLAN 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 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. BEGINNING IN 2015, THE SEVP AND CHIEF QUALITY OFFICER OF PROVIDENCE ST JOSEPH HEALTH, PARTICIPATED IN A NONQUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PLAN PROVIDES FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY IN ADDITION TO THE STANDARD NONQUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. |
| SCHEDULE J, PART I, LINE 7 | A PORTION OF EXECUTIVE SALARIES ARE PLACED AT-RISK AND ARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE STRATEGIC OBJECTIVES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY. |
Schedule N IRS990ScheduleN
| Field | Value | IRS element (for citing) |
|---|---|---|
| Liquidation Of Assets Table | LiquidationOfAssetsTableGrp |
Disposition Of Assets Detail DispositionOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | TOTAL NET ASSETS | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2018-03-31 | DistributionDt |
| Fair Market Value Of Asset | $228,467,497 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | BOOK VALUE | MethodOfFMVDeterminationTxt |
| EIN | 814791043 | EIN |
| Person | ST JOSEPH HEALTH NORTHERN CALIFORNI | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3345 MICHELSON DR | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 926120693 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501(c)(3) | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | Yes (true) | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | Yes (true) | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | false | OwnerOfSuccessor2Ind |
| Receive Compensation2 | false | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE N, PART II, LINE 2A | THE FOLLOWING INDIVIDUALS BECAME AN OFFICER OR TRUSTEE OF THE TRANSFEREE ORGANIZATION: OLUYEMI ADEYANJU OFFICER OF ST.JOSEPH HEALTH NORTHERN CA. LLC CON HEWITT TRUSTEE OF ST.JOSEPH HEALTH NORTHERN CA. LLC RAJU IYER OFFICER OF ST.JOSEPH HEALTH NORTHERN CA. LLC |
| SCHEDULE N, PART II, LINE 2B | ALL EMPLOYEES OF QUEEN OF THE VALLEY MEDICAL CENTER WILL TRANSFER TO ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC ON 1/1/2019. ON MARCH 31, 2018, QUEEN OF THE VALLEY MEDICAL CENTER, ALONG WITH SANTA ROSA MEMORIAL HOSPITAL, REDWOOD MEMORIAL HOSPITAL, AND ST. JOSEPH HOSPITAL OF EUREKA, COLLECTIVELY THE "HOSPITALS", TRANSFERRED ALL OF THEIR NET ASSETS TO ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, A RELATED 501(C)(3) ORGANIZATION. ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC WAS CREATED TO CONSOLIDATE AND SIMPLIFY THE CURRENT STRUCTURE BY MOVING THE OPERATIONS OF THE HOSPITALS INTO A SINGLE LEGAL ENTITY. THE OPERATION OF THE HOSPITALS WILL REMAIN THE SAME. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | PROVIDENCE ST. JOSEPH HEALTH SYSTEM ON 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 & SERVICES IN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON. ST. JOSEPH HEALTH SYSTEM IN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA. REALIZING OUR MISSION QUEEN OF THE VALLEY MEDICAL CENTER (QUEEN OF THE VALLEY) HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE LOCAL COMMUNITY FOR NEARLY 60 YEARS. SERVING THE COMMUNITIES OF NAPA, YOUNTVILLE, AMERICAN CANYON, ST HELENA AND SONOMA, QUEEN OF THE VALLEY IS AN ACUTE CARE HOSPITAL OFFERING AN ARRAY OF ADVANCED TECHNOLOGIES AND TREATMENTS RARELY FOUND IN A SMALL COMMUNITY. SERVICES INCLUDE THE COUNTY'S ONLY LEVEL III TRAUMA CENTER AND NEONATAL INTENSIVE CARE UNIT IN ADDITION TO STATE OF THE ART ROBOTIC SURGERY, DIAGNOSTIC IMAGING INCLUDING 3-D MAMMOGRAPHY, ACCREDITED CANCER CARE, A REGIONAL HEART CENTER, NEUROSCIENCES, ORTHOPEDICS, CRITICAL CARE AND OBSTETRICS. COMMUNITY BASED SERVICES INCLUDE A CANCER WELLNESS PROGRAM, A MEDICAL FITNESS CENTER, ROBUST REHABILITATION AND INTEGRATIVE MEDICINE SERVICES, A MOBILE DENTAL CLINIC, URGENT CARE AND HEALTH EDUCATION. WITH OVER 1,300 EMPLOYEES COMMITTED TO REALIZING THE MISSION, QUEEN OF THE VALLEY IS ONE OF THE LARGEST EMPLOYERS IN THE NAPA REGION. AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM, QUEEN OF THE VALLEY IS COMMITTED TO EXTEND THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. 2018 PROGRAM SERVICE ACCOMPLISHMENTS: ON MARCH 31, 2018, QUEEN OF THE VALLEY MEDICAL CENTER, ALONG WITH SANTA ROSA MEMORIAL HOSPITAL, REDWOOD MEMORIAL HOSPITAL, AND ST. JOSEPH HOSPITAL OF EUREKA, COLLECTIVELY THE "HOSPITALS", TRANSFERRED ALL OF THEIR NET ASSETS TO ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, A RELATED 501(C)(3) ORGANIZATION. ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC WAS CREATED TO CONSOLIDATE AND SIMPLIFY THE CURRENT STRUCTURE BY MOVING THE OPERATIONS OF THE HOSPITALS INTO A SINGLE LEGAL ENTITY. THE OPERATION OF THE HOSPITALS WILL REMAIN THE SAME. CARE (CARE MANAGEMENT, ADVOCACY, RESOURCES, AND EDUCATION) NETWORK IS A NATIONALLY RECOGNIZED, AWARD WINNING COMMUNITY BASED PROGRAM THAT PROMOTES CHRONIC DISEASE SELF-MANAGEMENT UTILIZING AN INTERDISCIPLINARY RN, SOCIAL WORK, BEHAVIORAL AND SPIRITUAL APPROACH. SERVICES ARE PROVIDED IN THE CLIENTS' HOME OR AS NEEDED IN A HEALTH PROVIDER OFFICE OR OTHER COMMUNITY SERVICE LOCATION. THE PROGRAM IS AIMED AT CARE COORDINATION AND IMPROVING DISEASE MANAGEMENT AND QUALITY OF LIFE WHILE REDUCING OVERALL GOVERNMENT BURDEN OF HEALTHCARE COSTS. CARE NETWORK SERVED 490 CLIENTS, OF THOSE 191 WERE NEWLY ENROLLED. FOR THOSE NEWLY ENROLLED CLIENTS, EMERGENCY ROOM VISITS DECREASED BY 78% AND HOSPITALIZATIONS DECREASED BY 47% AS COMPARED TO ONE YEAR PRIOR TO ENROLLMENT. CARE NETWORK EXPANDED TO IMBED A COMMUNITY HEALTH WORKER IN THE EMERGENCY DEPARTMENT (ED) SERVING 75 HOMELESS AND OTHERWISE VULNERABLE PERSONS WHO DISCHARGED FROM OUR ED. CHILDRENS MOBILE DENTAL CLINIC WAS LAUNCED IN 2005 BASED ON AN IDENTIFIED COMMUNITY NEED. CURRENTLY AS ONE OF ONLY TWO PROVIDERS OF DENTAL CARE FOR LOW INCOME OR MEDI-CAL ELIGIBLE CHILDREN IN NAPA COUNTY, QUEEN OF THE VALLEY STRIVES TO MEET THIS CONTINUED COMMUNITY NEED. THIS YEAR OUR MOBILE DENTAL CLINIC SPANNED 9 LOCATIONS ACROSS NAPA COUNTY PROVIDING 1421 CLINIC VISITS. COMMUNTY HEALTH EDUCATION INCLUDES A VARIETY OF COMPREHENSIVE AND COLLABORATIVE PROGRAMMING INCLUDING PRE AND POST NATAL HEALTH EDUCATION, INFANT CARE, CAR SEAT SAFETY AND INSTALLATION, GENERAL NUTRITION, EXERCISE AND HEALTHY LIFESTYLES AND EDUCATION FOR LOW INCOME SPANISH SPEAKING PARENTS (NAPA VALLEY PARENT UNIVERSITY). PERINATAL EDUCATION: QUEEN OF THE VALLEY COMMUNITY BENEFIT OFFERS A WIDE VARIETY OF PERINATAL CLASSES TO ALL IN OUR COMMUNITY, REGARDLESS OF INCOME OR AREA HOSPITAL BIRTHING CHOICE. THIS QUARTER 37 CLASSES WERE PRESENTED IN ENGLISH AND 4 CLASSES WERE PRESENTED IN SPANISH WITH 326 CLASS PARTICIPANTS (DUPLICATED). FREE PERINATAL EXERCISE CLASSES AT QUEEN OF THE VALLEY'S MEDICAL FITNESS CENTER ARE OFFERED TO LOW INCOME WOMEN. THIS YEAR PERINATAL EXERCISE CLASSES INCLUDING AQUA AND YOGA WERE PROVIDED TO 26 LOW INCOME WOMEN. NAPA VALLEY PARENT UNIVERSITY OFFERED 100 DIFFERENT CLASS TOPICS AT 6 ELEMENTARY SCHOOL SITES INCLUDING 3 NAPA VALLEY EARLY LEARNING INITIATIVE LOCATIONS WITH OVER 602 UNDUPLICATED PARENT PARTICIPANTS. ALTOGETHER 112 CLASSES WERE OFFERED WITH OVER 2465 PARENT PARTICIPANTS (PARENTS TAKE MULTIPLE CLASSES). CLASS TOPICS INCLUDE: BECOMING AN EFFECTIVE SCHOOL CONSUMER, HELPING CHILDREN WITH HOMEWORK, COMPUTER LITERACY, BECOMING A SCHOOL AND COMMUNITY LEADER, BECOMING AN EFFECTIVE VOLUNTEER IN THE SCHOOL, RAISING A HEALTHY CHILD AND ACCESSING HEALTH SERVICES. FOR MORE INFORMATION ABOUT QUEEN OF THE VALLEY MEDICAL CENTER PLEASE VISIT WWW.THEQUEEN.ORG. FOR MORE INFORMATION ABOUT PROVIDENCE ST. JOSEPH HEALTH, PLEASE VISIT HTTPS://WWW.PSJHEALTH.ORG FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORG |
| FORM 990, PART V, LINE 1 | ST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR SJH ENTITIES UNDER SJH AP SHARED SERVICES. THEREFORE, SJHS ISSUES FORM 1099-MISC UNDER ITS TAX ID NUMBER AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. |
| FORM 990, PART VI, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF QUEEN OF THE VALLEY MEDICAL CENTER. |
| FORM 990, PART VI, LINE 7A | CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS QUEEN OF THE VALLEY MEDICAL CENTER (QVMC) HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE QVMC BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE QUEEN OF THE VALLEY MEDICAL CENTER BOARD AS NOMINATIONS MUST BE APPROVED BY THE ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER. |
| FORM 990, PART VI, LINE 7B | CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, EXEMPT PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE CORPORATE MEMBER, ST. JOSEPH HEALTH SYSTEM, RESERVES THE RIGHT TO APPROVE THE PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. |
| FORM 990, PART VI, LINE 11B | PROCESS TO REVIEW 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSELS 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, LINE 12C | PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST 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, LINE 15A & 15B | PROCESS FOR DETERMINING COMPENSATION 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 HEALTHS 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, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS 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 XI, LINE 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCES EQUITY TRANSFER FROM PROVIDENCE FOR QAF $19,432,705 RELEASED FROM RESTRICTED FUNDS FOR CAPITAL $1,074,707 NET ASSET DIST. TO ST. JOSEPH HEALTH NORTERN CA, LLC ($228,467,497) EQUITY TRANSFER TO ST. JOSEPH HERITAGE HEALTHCARE ($2,293,451) EQUITY TRANSFER TO SJHS FOR IT PROJECT BILLINGS ($1,737,728) -------------- TOTAL ($211,991,264) |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (112 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| COVENANT ACO | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 611573313 | HEALTHCARE | TX | 501(C)(3) | 12, I | CHS | Yes (true) |
| COVENANT HEALTH NETWORK INC | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 461259908 | HEALTHCARE | CA | 501(C)(3) | 12, III | SJHS | Yes (true) |
| COVENANT HEALTH PARTNERS | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 463516417 | HEALTHCARE | TX | 501(C)(3) | 12, I | CHS | Yes (true) |
| COVENANT HEALTH SYSTEM | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 752765566 | HEALTHCARE | TX | 501(C)(3) | 3 | SJHS | Yes (true) |
| COVENANT HEALTH SYSTEM FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 752897026 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| COVENANT MEDICAL CENTER | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 822913146 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| COVENANT MEDICAL GROUP | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 752743883 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| E WA & MT UNEMPLOYMENT COMP INSR TRUST | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911082119 | UNEMPLOYMENT | WA | 501(C)(3) | 12, I | PHS WA | Yes (true) |
| EVERETT TRANSITIONAL CARE SERVICES | ||||||||||
| PO BOX 5128 | EVERETT | WA | 982065128 | 943264605 | TRANS. CARE | WA | 501(C)(3) | 10 | NA | false |
| FACEY MEDICAL FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 954322584 | SUPPORT | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (true) |
| GAMELIN WASHINGTON ASSOCIATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 201910170 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| GLOBAL TO LOCAL HEALTH INITIATIVE | ||||||||||
| 2800 SOUTH 192ND ST 104 | SEATAC | WA | 98188 | 273133200 | HEALTHCARE | WA | 501(C)(3) | 7 | SHS | Yes (true) |
| HMTS INC | ||||||||||
| 1 HOAG DRIVE PO BOX 6100 | NEWPORT BEACH | CA | 92658 | 453583707 | HEALTHCARE | CA | 501(C)(3) | 12, I | HMHP | Yes (true) |
| HOAG CHARITY SPORTS | ||||||||||
| 2081 BUSINESS CTR DR STE 195 | IRVINE | CA | 92612 | 452982422 | SUPPORT | CA | 501(C)(3) | 7 | HHF | Yes (true) |
| HOAG CLINIC (FKA COASTAL MGMT SVCS ORG) | ||||||||||
| 1 HOAG DRIVE PO BOX 6100 | NEWPORT BEACH | CA | 92658 | 330676831 | HEALTHCARE | CA | 501(C)(3) | 10 | HMHP | Yes (true) |
| HOAG HOSPITAL FOUNDATION | ||||||||||
| 330 PLACENTIA AVE | NEWPORT BEACH | CA | 92663 | 953222343 | FUNDRAISING | CA | 501(C)(3) | 7 | HMHP | Yes (true) |
| HOAG MEMORIAL HOSPITAL PRESBYTERIAN | ||||||||||
| 1 HOAG DRIVE PO BOX 6100 | NEWPORT BEACH | CA | 92658 | 951643327 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| HOSPICE OF LUBBOCK | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 752133781 | HEALTHCARE | TX | 501(C)(3) | 10 | CHS | Yes (true) |
| INLAND NORTHWEST HEALTH SERVICES | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911307555 | HEALTHCARE | WA | 501(C)(3) | 3 | PHS WA | Yes (true) |
| INSTITUTE FOR MENTAL HEALTH & WELLNESS | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 814260130 | HEALTHCARE | WA | 501(C)(3) | 7 | PHSSJHS | Yes (true) |
| INSTITUTE FOR SYSTEMS BIOLOGY | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 912003593 | HEALTHCARE | WA | 501(C)(3) | 7 | WHC | Yes (true) |
| JOHN WAYNE CANCER INSTITUTE | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 954291515 | HEALTHCARE | CA | 501(C)(3) | 4 | PSJHC | Yes (true) |
| KADLEC AUXILIARY INC | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 916033089 | SUPPORT | WA | 501(C)(3) | 12, III | KRMC | Yes (true) |
| KADLEC FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 237005501 | SUPPORT | WA | 501(C)(3) | 12, I | KRMC | Yes (true) |
| KADLEC REGIONAL MEDICAL CENTER | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 910655392 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (true) |
| LITTLE COMPANY OF MARY ANCILLARY SVCS CO | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 330844408 | IMAGING SVCS | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (true) |
| LUBBOCK METHODIST HOSPITAL FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 752220963 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| LUNDBERG ASSOCIATIONPROVIDENCE HOUSE | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911562797 | SUPPORT | OR | 501(C)(3) | 7 | PHS OR | Yes (true) |
| MARSHA RIVKIN CTR FOR OVARIAN CANCER | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 912054035 | RESEARCH | WA | 501(C)(3) | 7 | SHS | Yes (true) |
| METHODIST CHILDREN'S HOSPITAL | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 752428911 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| METHODIST HOSPITAL LEVELLAND | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 752246348 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| METHODIST HOSPITAL PLAINVIEW | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 752426010 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| MISSION HOSPITAL REGIONAL MEDICAL CTR | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 951643360 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| NORTHWEST HOPE & HEALING FOUNDATION | ||||||||||
| PO BOX 16069 | SEATTLE | WA | 98116 | 200799737 | SUPPORT | WA | 501(C)(3) | 12,I | SHS | Yes (true) |
| PACMED CLINICS | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 562290878 | HEALTHCARE | WA | 501(C)(3) | 10 | WHC | Yes (true) |
| PH&S FOUNDATIONSFVSA & SCVSA | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 953544877 | HEALTHCARE | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (true) |
| PROVIDENCE ALASKA FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 920093565 | HEALTHCARE | AK | 501(C)(3) | 12, I | PHS WA | Yes (true) |
| PROVIDENCE BENEDICTINE NURSING CTR FNDN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911940286 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (true) |
| PROVIDENCE BLANCHET ASSOCIATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911789266 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| PROVIDENCE CHILDREN'S HEALTH FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 930800140 | SUPPORT | OR | 501(C)(3) | 7 | PHS OR | Yes (true) |
| PROVIDENCE COMMUNITY HEALTH FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 930692907 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (true) |
| PROVIDENCE DETHMAN HOUSE | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 473385506 | SUPPORT | WA | 501(C)(3) | 7 | NA | false |
| PROVIDENCE GAMELIN HOUSE ASSOCIATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 311744654 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| PROVIDENCE HEALTH & SERVICES | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911549796 | HEALTHCARE | WA | 501(C)(3) | 12, II | PSJH | false |
| PROVIDENCE HEALTH & SERVICES - MONTANA | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 810231793 | HEALTHCARE | MT | 501(C)(3) | 3 | PHS WA | Yes (true) |
| PROVIDENCE HEALTH & SERVICES - OREGON | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 510216587 | HEALTHCARE | OR | 501(C)(3) | 3 | PHS | Yes (true) |
| PROVIDENCE HEALTH & SERVICES - WA | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 510216586 | HEALTHCARE | WA | 501(C)(3) | 3 | PHS | Yes (true) |
| PROVIDENCE HEALTH & SERVICES - WEST WA | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911303277 | HEALTHCARE | WA | 501(C)(3) | 3 | PMWHC | Yes (true) |
| PROVIDENCE HEALTH ASSURANCE | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 550828701 | MEDICAID | OR | 501(C)(4) | N/A | PHP | Yes (true) |
| PROVIDENCE HEALTH CARE FNDN - E WA | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 320014330 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| PROVIDENCE HEALTH CARE FNDN (CENTRALIA) | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911433382 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (true) |
| PROVIDENCE HEALTH PLAN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 930863097 | HEALTHCARE | OR | 501(C)(4) | N/A | PPP | Yes (true) |
| PROVIDENCE HEALTH SYSTEM - SO CAL | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 510216589 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS | Yes (true) |
| PROVIDENCE HOOD RIVER MEM HOSP FNDN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 930921990 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (true) |
| PROVIDENCE HOSPICE AND HOME CARE FNDN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 272552749 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (true) |
| PROVIDENCE HOSPICE OF SEATTLE FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 912077378 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (true) |
| PROVIDENCE LITTLE COMPANY OF MARY FNDN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 510224944 | HEALTHCARE | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (true) |
| PROVIDENCE MARIANWOOD FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 931554288 | HEALTHCARE | WA | 501(C)(3) | 12, I | PHS W WA | Yes (true) |
| PROVIDENCE MEDICAL INSTITUTE | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 330283773 | HEALTHCARE | CA | 501(C)(3) | 12, I | PHS SOCAL | Yes (true) |
| PROVIDENCE MILWAUKIE FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 943079515 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (true) |
| PROVIDENCE MINISTRIES | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | RELIGIOUS ORG | WA | 501(C)(3) | 1 | NA | false | |
| PROVIDENCE MOUNT ST VINCENT FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911188119 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| PROVIDENCE NEWBERG HEALTH FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 930889144 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (true) |
| PROVIDENCE PETER CLAVER ASSOCIATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 311629656 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| PROVIDENCE PLAN PARTNERS | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911861964 | HEALTHCARE | WA | 501(C)(4) | N/A | PHS OR | Yes (true) |
| PROVIDENCE PORTLAND MEDICAL FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 931231494 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (true) |
| PROVIDENCE ROSSI ASSOCIATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 311584166 | SUPPORT | WA | 501(C)(3) | 10 | PHS WA | Yes (true) |
| PROVIDENCE SAINT JOHN'S HEALTH CENTER | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 951684082 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS SOCAL | Yes (true) |
| PROVIDENCE SAINT JOHN'S MEDICAL FNDN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 814542216 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS SOCAL | Yes (true) |
| PROVIDENCE SEASIDE HOSPITAL FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 930927320 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (true) |
| PROVIDENCE ST ELIZABETH HOUSE ASSOC | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 912171539 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| PROVIDENCE ST FRANCIS ASSOCIATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 943244854 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| PROVIDENCE ST JOSEPH HEALTH | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 811244422 | HEALTHCARE | WA | 501(C)(3) | 12, III | NA | false |
| PROVIDENCE ST JOSEPH HEALTH FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 943078543 | HEALTHCARE | WA | 501(C)(3) | 12, I | PHS WA | Yes (true) |
| PROVIDENCE ST JOSEPH MEDICAL CENTER | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 810463482 | HEALTHCARE | MT | 501(C)(3) | 3 | PHS WA | Yes (true) |
| PROVIDENCE ST MARY FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 452841492 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| PROVIDENCE ST PETER FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911097056 | SUPPORT | WA | 501(C)(3) | 7 | PHS W WA | Yes (true) |
| PROVIDENCE ST VINCENT MEDICAL FNDN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 930575982 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (true) |
| PROVIDENCE TRINITYCARE HOSPICE | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 953264139 | HEALTHCARE | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (true) |
| PROVIDENCE TRINITYCARE HOSPICE FNDN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 330261016 | HEALTHCARE | CA | 501(C)(3) | 7 | PTCH | Yes (true) |
| PROVIDENCE WILLAMETTE FALLS MEDICAL FNDN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 931003750 | HEALTHCARE | OR | 501(C)(3) | 12, I | PHS OR | Yes (true) |
| REDWOOD MEMORIAL FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 942779313 | HEALTHCARE | CA | 501(C)(3) | 7 | RMH | Yes (true) |
| REDWOOD MEMORIAL HOSPITAL | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 941384665 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| SAINT JOHN'S HOSPITALHEALTH CENTER FNDN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 956100079 | SUPPORT | CA | 501(C)(3) | 7 | PSJHC | Yes (true) |
| SANTA ROSA MEMORIAL HOSPITAL | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 941231005 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| SEATTLE SCIENCE FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 611502822 | PHYSN COLLAB | WA | 501(C)(3) | 7 | WHC | Yes (true) |
| SISTERS OF PROVIDENCE OF MONTANA CORP | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 262612415 | SHELL CORP | MT | 501(C)(3) | 1 | PHS WA | false |
| SISTERS OF ST JOSEPH OF ORANGE | ||||||||||
| 480 S BATAVIA | ORANGE | CA | 92868 | 951643383 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | NA | false |
| SRM ALLIANCE HOSPITAL SERVICES (PVH) | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 680395200 | HEALTHCARE | CA | 501(C)(3) | 3 | SRMH | Yes (true) |
| ST JOSEPH HEALTH MINISTRY | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 271666576 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | SSJO | false |
| ST JOSEPH HEALTH N CALIFORNIA LLC | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 814791043 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| ST JOSEPH HEALTH SYSTEM | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 953589356 | HEALTHCARE | CA | 501(C)(3) | 12, I | PSJH | false |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 330143024 | HEALTHCARE | CA | 501(C)(3) | 7 | SJHS | Yes (true) |
| ST JOSEPH HERITAGE HEALTHCARE | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 330185031 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| ST JOSEPH HOME CARE NETWORK | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 680331084 | HEALTHCARE | CA | 501(C)(3) | 10 | SJHS | Yes (true) |
| ST JOSEPH HOSPITAL OF EUREKA | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 941156596 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| ST JOSEPH HOSPITAL OF ORANGE | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 951643359 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST JUDE HOSPITAL INC | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 951643324 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST LUKE ASSOCIATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 943176618 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| ST MARY MEDICAL CENTER | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 951914489 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST MARY OF THE PLAINS HOSPITAL FDN | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 751653181 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| ST PATRICK HOSPITAL FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 237056976 | HEALTHCARE | MT | 501(C)(3) | 7 | PHS WA | Yes (true) |
| ST THOMAS CHILD AND FAMILY CENTER | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 810233495 | EDUCATION | MT | 501(C)(3) | 10 | PHS WA | Yes (true) |
| SWEDISH EDMONDS | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 272305304 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (true) |
| SWEDISH HEALTH SERVICES | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 910433740 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (true) |
| SWEDISH MEDICAL CENTER FOUNDATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 910983214 | HEALTHCARE | WA | 501(C)(3) | 7 | SHS | Yes (true) |
| SWEDISH MJM HOLDINGS | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 273139262 | HOLDING CO | WA | 501(C)(3) | 12, I | SHS | Yes (true) |
| THE GAMELIN ASSOCIATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911180824 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (true) |
| THE GAMELIN CALIFORNIA ASSOCIATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911293869 | SUPPORT | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (true) |
| THE GAMELIN OREGON ASSOCIATION | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 911214491 | SUPPORT | OR | 501(C)(3) | 10 | PHS OR | Yes (true) |
| UNIVERSITY OF PROVIDENCE | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 810231777 | EDUCATION | MT | 501(C)(3) | 2 | PHS | Yes (true) |
| WESTERN HEALTHCONNECT | ||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 454171900 | SHELL CORP | WA | 501(C)(3) | 12, II | PHS W WA | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (62 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd |
|---|---|---|---|---|---|---|---|---|---|
| 20TH STREET SURGERY LLC | |||||||||
| 1301 20TH STREET STE 140 | SANTA MONICA | CA | 90404 | 731735618 | AMBULATORY SURG | CA | NA | N/A | false |
| BROADWAY IMAGING LLC | |||||||||
| 500 W BROADWAY | MISSOULA | MT | 59802 | 522405971 | MEDICAL IMAGING | MT | NA | N/A | false |
| CENTER FOR SPECIALTY SURGERY LLC | |||||||||
| 11782 SW BARNES RD | PORTLAND | OR | 97225 | 263638838 | AMBULATORY SURG | OR | NA | N/A | |
| CLACKAMAS RADIATION ONCOLOGY CENTER LLC | |||||||||
| 4400 NE HALSEY ST BLDG II 495 | PORTLAND | OR | 97213 | 260381897 | RADIATION ONCOL | OR | NA | N/A | false |
| COASTAL ASC HOLDINGS LLC | |||||||||
| ONE HOAG DRIVE PO BOX 6100 | NEWPORT BEACH | CA | 926586100 | 810986844 | HEALTHCARE | CA | NA | N/A | false |
| COVENANT LONG-TERM CARE LP | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 205033419 | HEALTHCARE | TX | NA | N/A | false |
| CTR FOR MED IMAGING-BRIDGEPORT LLC | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260796953 | IMAGING DIAG. | OR | NA | N/A | false |
| CTR FOR MED IMAGING-TANASBOURNE LLC | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 200477972 | IMAGING DIAG. | OR | NA | N/A | false |
| FULLERTON SURGICAL CENTER LP | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 470927394 | AMBULATORY SURG | CA | NA | N/A | false |
| GREATER VALLEY MEDICAL BUILDING LP | |||||||||
| 501 S BUENA VISTA ST | BURBANK | CA | 91505 | 954570858 | REAL ESTATE - MOB | CA | NA | N/A | false |
| HCSA PROPERTIES LLC | |||||||||
| 1600 M STREET NW | AUBURN | WA | 98001 | 460620892 | REAL ESTATE RENT | WA | NA | N/A | false |
| HERITAGE INVESTMENT GROUP I LLC | |||||||||
| 500 S MAIN STREET STE 1000 | ORANGE | CA | 92868 | 271000061 | INVESTMENTS | CA | NA | N/A | false |
| HOAG ORTHOPEDIC INSTITUTE | |||||||||
| ONE HOAG DRIVE PO BOX 6100 | NEWPORT BEACH | CA | 926586100 | 611588294 | HEALTHCARE | CA | NA | N/A | false |
| HOAG OUTPATIENT CENTERS LLC | |||||||||
| 27271 LAS RAMBLAS 350 | MISSION VIEJO | CA | 92691 | 453587572 | HEALTHCARE | CA | NA | N/A | false |
| INLAND IMAGING LLC | |||||||||
| 801 S STEVENS ST | SPOKANE | WA | 99204 | 911855796 | MEDICAL IMAGING | WA | NA | N/A | false |
| LSC REAL PROPERTY LLC | |||||||||
| 2301 QUAKER AVENUE | LUBBOCK | TX | 79410 | 474646059 | REAL ESTATE | TX | NA | N/A | false |
| METHODIST DIAGNOSTIC IMAGING | |||||||||
| 4005 24TH STREET | LUBBOCK | TX | 79410 | 752343261 | HEALTHCARE | TX | NA | N/A | false |
| NEWPORT BAY SURGERY CENTER LLC | |||||||||
| 3333 W PACIFIC COAST HWY 100 | NEWPORT BEACH | CA | 92663 | 562518360 | HEALTHCARE | CA | NA | N/A | false |
| NEWPORT BEACH ENDOSCOPY CENTER LLC | |||||||||
| 27271 LAS RAMBLAS 350 | MISSION VIEJO | CA | 92691 | 770368744 | HEALTHCARE | CA | NA | N/A | false |
| NEWPORT IMAGING CENTER | |||||||||
| 360 SN MIGUEL | NEWPORT BEACH | CA | 92660 | 330191776 | HEALTHCARE | CA | NA | N/A | false |
| NEWPORT SURGICAL PARTNERS LLC | |||||||||
| 27271 LAS RAMBLAS 350 | MISSION VIEJO | CA | 92691 | 392060266 | HEALTHCARE | CA | NA | N/A | false |
| NORTH BAY ENDOSCOPY CENTER | |||||||||
| 1383 N MCDOWELL BLVD STE 110 | PETALUMA | CA | 94954 | 611559876 | HEALTHCARE | CA | NA | N/A | false |
| OREGON ADVANCED IMAGING LLC | |||||||||
| 881 OHARE PARKWAY | MEDFORD | OR | 97504 | 450471748 | MEDICAL IMAGING | OR | NA | N/A | false |
| OREGON OUTPATIENT SURGERY CENTER | |||||||||
| 7300 SW CHILDS RD | TIGARD | OR | 97224 | 223883387 | AMBULATORY SURG | OR | NA | N/A | false |
| PETCT IMAGING AT SWEDISH CANCER INSTITU | |||||||||
| 1221 MADISON STREET | SEATTLE | WA | 98104 | 203132044 | MEDICAL IMAGING | WA | NA | N/A | false |
| PHS INVESTMENT TRANSITION PORTFOLIO | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472279711 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST 2015 PRIVATE ASSETS | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 473393740 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST 2016 PRIVATE ASSETS | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 811532735 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST 2016 PRIVATE REAL E | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 812960145 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST BANK LOANS PORTFOLI | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472357735 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST COMMODITIES PORTFOL | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472269004 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST HEDGE FUND PORTFOLI | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472293255 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST LDI PORTFOLIO | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472392060 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST LONG TREASURIES POR | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472385238 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST MLP PORTFOLIO | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472367538 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST PUBLIC DEBT PORTFOL | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472353569 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST PUBLIC EQUITY PORTF | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472283974 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST RELATIVE VALUE PORT | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472314743 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST RISK PARITY PORTFOL | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472336377 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST SHORT TERM INVESTME | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 812701056 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST TACTICAL TRADING PO | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472327491 | INVESTMENTS | WA | NA | N/A | false |
| PHS INVESTMENT TRUST TIPS PORTFOLIO | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 472402609 | INVESTMENTS | WA | NA | N/A | false |
| PORTLAND MEDICAL IMAGING LLC | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 201054971 | IMAGING DIAG. | OR | NA | N/A | false |
| PROV RADIATION ONCOLOGY DEVELOP ASSN | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260682491 | REAL ESTATE - MOB | OR | NA | N/A | false |
| PROVIDENCE CHILDREN'S NEONATAL SERVICES | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 470918549 | NEONATAL CARE | WA | NA | N/A | false |
| PROVIDENCE IMAGING CENTER JOINT VENTURE | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 920118807 | MEDICAL IMAGING | AK | NA | N/A | false |
| PROVIDENCE PARTNERS FOR HEALTH LLC | |||||||||
| 501 S BUENA VISTA ST | BURBANK | CA | 91505 | 454041798 | CLIN QUALITY/INT | CA | NA | N/A | false |
| PROVIDENCE ST JOSEPH HEALTH LONG TERM P | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 823190634 | INVESTMENTS | WA | NA | N/A | false |
| PROVIDENCE SURGERY CENTER LLC | |||||||||
| 902 N ORANGE ST | MISSOULA | MT | 59802 | 841401625 | AMBULATORY SURG | MT | NA | N/A | false |
| PROVIDENCESILVERTON REHAB LLC | |||||||||
| 4400 NE HALSEY 425 | PORTLAND | OR | 97213 | 481287267 | REHAB SERVICES | OR | NA | N/A | false |
| PROVIDENCEUSP SANTA CLARITA GP LLC | |||||||||
| 11550 INDIAN HILLS ROAD 160 | MISSION HILLS | CA | 91345 | 202829660 | AMBULATORY SURG | CA | NA | N/A | false |
| PROVIDENCEUSP SURGERY CTRS LLC | |||||||||
| 11550 INDIAN HILLS ROAD 160 | MISSION HILLS | CA | 91345 | 200905938 | AMBULATORY SURG | CA | NA | N/A | false |
| SHA LLC | |||||||||
| 12940 NORTH HIGHWAY 183 | AUSTIN | TX | 78750 | 752569094 | HEALTHCARE | TX | NA | N/A | false |
| SJO ASC HOLDINGS LLC | |||||||||
| 1140 W LA VETA AVE | ORANGE | CA | 92868 | 821655501 | HEALTHCARE | CA | NA | N/A | false |
| ST JOSEPH PHYSICIAN VENTURES I LLC | |||||||||
| 1100 WEST STEWART DRIVE | ORANGE | CA | 92868 | 454521884 | REAL ESTATE | CA | NA | N/A | false |
| ST JOSEPHSATELLITE DIALYSIS CENTERS L | |||||||||
| 300 SANTANA ROW SUITE 300 | SAN JOSE | CA | 95128 | 814657391 | HEALTHCARE | CA | NA | N/A | |
| ST JUDE SURGICAL CENTERS LLC | |||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 823352570 | AMBULATORY SURG | CA | NA | N/A | |
| SURGERY CENTER AT TANASBOURNE LLC | |||||||||
| 11221 ROE AVE STE 300 | LEAWOOD | KS | 66211 | 208187971 | AMBULATORY SURG | KS | NA | N/A | |
| TARZANA PEDIATRIC VENTURES LLC | |||||||||
| 18321 CLARK ST TARZANA CA 91356 | TARZANA | CA | 91356 | 821308306 | HEALTHCARE | CA | NA | N/A | |
| THE MADISON SPOKANE INN LLC | |||||||||
| 15 WEST ROCKWOOD BLVD | SPOKANE | WA | 99204 | 841606484 | HOTEL SERVICES | WA | NA | N/A | |
| TARZANA PEDIATRIC VENTURES LLC | |||||||||
| 18321 CLARK ST TARZANA CA 91356 | TARZANA | CA | 91356 | 821308306 | HEALTHCARE | CA | NA | N/A | |
| THE MADISON SPOKANE INN LLC | |||||||||
| 15 WEST ROCKWOOD BLVD | SPOKANE | WA | 99204 | 841606484 | HOTEL SERVICES | WA | NA | N/A | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (26 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMERICAN UNITY GROUP LTD | |||||||||||||
| 90 PITTS BAY ROAD | PEMBROKE | BD | HM08 | CAPTIVE INSURANCE | BD | NA | C-CORP | ||||||
| 1221 MADISON STREET OWNERS ASSOC | |||||||||||||
| OWNERS' ASSOC. | NA | C-CORP | 747 BROADWAY | SEATTLE | WA | 98122 | 201954319 | WA | |||||
| AYIN HEALTH SOLUTIONS INC | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 833037172 | DE | |||||
| BOURGET HEALTH SERVICES INC | |||||||||||||
| CLIN/MED LAB | NA | C-CORP | PO BOX 2687 | SPOKANE | WA | 99220 | 911354431 | WA | |||||
| CARON HEALTH CORPORATION | |||||||||||||
| MED PHYS SVCS | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 810486082 | MT | |||||
| DATU HEALTH INC AND SUBSIDIARIES | |||||||||||||
| IT SVCS | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 463070062 | DE | |||||
| GRACE CLINIC OF LUBBOCK | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 203856995 | TX | |||||
| GRACE CLINIC SERVICES INC | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 203857067 | TX | |||||
| HOAG CLINIC (FKA COASTAL MGM SVS ORG) | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1 HOAG DRIVE PO BOX 6100 | NEWPORT BEACH | CA | 926586100 | 330676831 | CA | |||||
| HOAG MANAGEMENT SERVICES INC | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1 HOAG DRIVE PO BOX 6100 | NEWPORT BEACH | CA | 926586100 | 330731587 | CA | |||||
| LUBBOCK METHODIST HOSP PRACTICE MGMT | |||||||||||||
| INACTIVE | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 752578995 | TX | |||||
| LUBBOCK METHODIST HOSPITAL SVCS | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 752118585 | TX | |||||
| LUMEDIC ACQUISITION CO INC | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 833881097 | WA | |||||
| MISSION VIEJO MEDICAL VENTURES | |||||||||||||
| HEALTHCARE | NA | C-CORP | 27800 MEDICAL CENTER RD 354 | MISSION VIEJO | CA | 92691 | 330212905 | CA | |||||
| PHN HOLDINGS | |||||||||||||
| STRAT PLAN SVCS | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 461814184 | CA | |||||
| PIONEER INNOVATIONS INC | |||||||||||||
| HEALTH INNOVATNS | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 364818191 | WA | |||||
| PROVIDENCE ASSURANCE INC | |||||||||||||
| CAPTIVE INSURANCE | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 208194071 | AZ | |||||
| PROVIDENCE HEALTH CARE VENTURES INC | |||||||||||||
| CLIN/MED LAB | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 900155714 | WA | |||||
| PROVIDENCE HEALTH NETWORK | |||||||||||||
| PREPAID HEALTH | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 800886966 | CA | |||||
| PROVIDENCE HEALTH VENTURES INC | |||||||||||||
| INVESTMENT | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 330122216 | CA | |||||
| ST JOSEPH HEALTH | |||||||||||||
| HOLDING COMPANY | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 462340232 | CA | |||||
| ST JOSEPH HEALTH SOURCE INC | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 461900168 | CA | |||||
| ST JOSEPH PROF SVCS ENTERPRSES INC | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 330155323 | CA | |||||
| VINSERRA INC | |||||||||||||
| INVESTMENT | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 953943315 | CA | |||||
| WESTERN HEALTHCONNECT VENTURES INC | |||||||||||||
| INVESTMENT | NA | C-CORP | 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 980579016 | 800953654 | WA | |||||
| YAKIMA MEDICAL ARTS INC | |||||||||||||
| RENT REAL ESTATE | NA | C-CORP | 611 N PERRY 100 | SPOKANE | WA | 99202 | 910787963 | WA | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ST JOSEPH HEALTH SYSTEM | ||
| p | $70,902,039 | ACCRUAL |
| ST JOSEPH HEALTH SYSTEM | ||
| r | $224,544 | ACCRUAL |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||
| b | $631,600 | ACCRUAL |
| SANTA ROSA MEMORIAL HOSPITAL | ||
| p | $1,635,491 | ACCRUAL |
| SANTA ROSA MEMORIAL HOSPITAL | ||
| q | $411,416 | ACCRUAL |
| ST JOSEPH HERITAGE HEALTHCARE | ||
| b | $2,293,451 | ACCRUAL |
| QUEEN OF THE VALLEY MEDICAL CENTER FOUNDATION | ||
| c | $896,787 | ACCRUAL |
| ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | ||
| r | $228,467,497 | ACCRUAL |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART III | FormAndLineReferenceDesc |
| Explanation | IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP 20TH STREET SURGERY LLC EIN: 73-1735618 ADDRESS: 1301 20TH STREET, STE 140, SANTA MONICA, CA 90404 BROADWAY IMAGING, LLC EIN: 52-2405971 ADDRESS: 500 W. BROADWAY MISSOULA, MT 59802 CENTER FOR SPECIALTY SURGERY, LLC EIN: 26-3638838 ADDRESS: 11782 SW BARNES RD. PORTLAND, OR 97225 CLACKAMAS RADIATION ONCOLOGY CENTER, LLC EIN: 26-0381897 ADDRESS: 4400 NE HALSEY ST., BLDG. II, #495 PORTLAND, OR 97213 COASTAL ASC HOLDINGS LLC EIN: 81-0986844 ADDRESS: ONE HOAG DRIVE, PO BOX 6100, NEWPORT BEACH, CA 92658 COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 CTR. FOR MED. IMAGING-BRIDGEPORT, LLC EIN: 26-0796953 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 CTR. FOR MED. IMAGING-TANASBOURNE, LLC EIN: 20-0477972 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 FULLERTON SURGICAL CENTER LP EIN: 47-0927394 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 GREATER VALLEY MEDICAL BUILDING, L.P. EIN: 95-4570858 ADDRESS: 501 S. BUENA VISTA ST. BURBANK, CA 91505 HCSA PROPERTIES LLC EIN: 46-0620892 ADDRESS: 1600 M STREET NW AUBURN, WA 98001 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 500 S. MAIN STREET, STE 1000, ORANGE, CA 92868 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, PO BOX 6100, NEWPORT BEACH, CA 92658 HOAG OUTPATIENT CENTERS, LLC EIN: 45-3587572 ADDRESS: 27271 LAS RAMBLAS #350, MISSION VIEJO, CA 92691 INLAND IMAGING, LLC EIN: 91-1855796 ADDRESS: 801 S. STEVENS ST., SPOKANE, WA 99204 LSC REAL PROPERTY, LLC EIN: 47-4646059 ADDRESS: 2301 QUAKER AVENUE, LUBBOCK, TX, 79410 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 NEWPORT BAY SURGERY CENTER, LLC EIN: 56-2518360 ADDRESS: 3333 W. PACIFIC COAST HWY, #100 NEWPORT BEACH, CA 92663 NEWPORT BEACH ENDOSCOPY CENTER, LLC EIN: 77-0368744 ADDRESS: 27271 LAS RAMBLAS #350 MISSION VIEJO, CA 92691 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SN MIGUEL, NEWPORT BEACH, CA 92660 NEWPORT SURGICAL PARTNERS, LLC EIN: 39-2060266 ADDRESS: 27271 LAS RAMBLAS #350 MISSION VIEJO, CA 92691 NORTH BAY ENDOSCOPY CENTER EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD, SUITE 110, PETALUMA, CA 94954 OREGON ADVANCED IMAGING, LLC EIN: 45-0471748 ADDRESS: 881 O'HARE PARKWAY, MEDFORD, OR 97504 OREGON OUTPATIENT SURGERY CENTER EIN: 22-3883387 ADDRESS: 7300 SW CHILDS ROAD, TIGARD, OR 97224 PET/CT IMAGING AT SWEDISH CANCER INSTITUTE, LLC EIN: 20-3132044 ADDRESS: 1221 MADISON STREET SEATTLE, WA 98104 PHS INVESTMENT TRANSITION PORTFOLIO EIN: 47-2279711 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST 2015 PRIVATE ASSETS PORTFOLIO EIN: 47-3393740 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST 2016 PRIVATE ASSETS PORTFOLIO EIN: 81-1532735 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST 2016 PRIVATE REAL ESTATE PORTFOLIO EIN: 81-2960145 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST BANK LOANS PORTFOLIO EIN: 47-2357735 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST COMMODITIES PORTFOLIO EIN: 47-2269004 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST HEDGE FUND PORTFOLIO EIN: 47-2293255 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST LDI PORTFOLIO EIN: 47-2392060 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST LONG TREASURIES PORTFOLIO EIN: 47-2385238 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST MLP PORTFOLIO EIN: 47-2367538 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST PUBLIC DEBT PORTFOLIO EIN: 47-2353569 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST PUBLIC EQUITY PORTFOLIO EIN: 47-2283974 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST RELATIVE VALUE PORTFOLIO EIN: 47-2314743 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST RISK PARITY PORTFOLIO EIN: 47-2336377 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO EIN: 81-2701056 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST TACTICAL TRADING PORTFOLIO EIN: 47-2327491 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST TIPS PORTFOLIO EIN: 47-2402609 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PORTLAND MEDICAL IMAGING, LLC EIN: 20-1054971 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 PROV. RADIATION ONCOLOGY DEVELOP. ASSN., LLC EIN: 26-0682491 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 PROVIDENCE CHILDREN'S NEONATAL SERVICES EIN: 47-0918549 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE IMAGING CENTER JOINT VENTURE EIN: 92-0118807 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE PARTNERS FOR HEALTH, LLC EIN: 45-4041798 ADDRESS: 501 S. BUENA VISTA ST. BURBANK, CA 91505 PROVIDENCE ST. JOSEPH HEALTH LONG TERM PORTFOLIO EIN: 82-3190634 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE SURGERY CENTER, LLC EIN: 84-1401625 ADDRESS: 902 N. ORANGE ST MISSOULA, MT 59802 PROVIDENCE/SILVERTON REHAB, LLC EIN: 48-1287267 ADDRESS: 4400 NE HALSEY #425, PORTLAND, OR 97213 PROVIDENCE/USP SANTA CLARITA GP, LLC EIN: 20-2829660 ADDRESS: 11550 INDIAN HILLS ROAD #160, MISSION HILLS, CA 91345 PROVIDENCE/USP SURGERY CENTERS, LLC EIN: 20-0905938 ADDRESS: 11550 INDIAN HILLS ROAD #160, MISSION HILLS, CA 91345 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 SJO ASC HOLDINGS LLC EIN: 82-1655501 ADDRESS: 1140 W. LA VETA AVE ORANGE, CA 92868 ST JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 ST. JOSEPH/SATELLITE DIALYSIS CENTERS, LLC EIN: 81-4657391 ADDRESS: 300 SANTANA ROW, SUITE 300 SAN JOSE, CA 95128 ST. JUDE SURGICAL CENTERS, LLC EIN: 82-3352570 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 SURGERY CENTER AT TANASBOURNE, LLC EIN: 20-8187971 ADDRESS: 11221 ROE AVE., STE 300, LEAWOOD, KS 66211 TARZANA PEDIATRIC VENTURES LLC EIN: 82-1308306 ADDRESS: 18321 CLARK ST, TARZANA, CA 91356 THE MADISON SPOKANE INN, LLC EIN: 84-1606484 ADDRESS: 15 WEST ROCKWOOD BLVD. SPOKANE, WA 99204 | ExplanationTxt |
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