2019-11-13T18:39:53-06:00 2018-12-31 346565596 ERNST & YOUNG US LLP 560 MISSION STREET SUITE 1600 SAN FRANCISCO CA 94105 990 2018-01-01 911861964 PROVIDENCE PLAN PARTNERS PROV 5035747500 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 MICHAEL G WHITE CFO/TREASURER 5035747500 2019-11-13 1 EVA NITTA P01286320 4158948000 104.187.159.70 2019-11-13 18:38:26 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 03333E4B0684ADD489F38648AD786F05819FFCF0 2018 2020-03-31 21:24:44Z X MICHAEL L COTTON 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 251371978 0 X N/A X 1997 WA SEE SCHEDULE OAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 6 3 0 0 0 0 0 1563542 3755611 249808436 0 0 0 0 3755611 251371978 0 1563561 0 0 2385385 113546578 0 0 0 341373 135430314 2726758 250540453 1028853 831525 46132848 59754393 32787391 45577411 13345457 14176982 X AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 207976894 1563561 246432924 SEE SCHEDULE OPROVIDENCE PLAN PARTNERS (PPP) FULFILLS ITS SOCIAL WELFARE PURPOSES BY FURTHERING THE HEALTHCARE SERVICES PROVIDED BY ITS AFFILIATES PROVIDENCE HEALTH PLAN (PHP) AND PROVIDENCE HEALTH ASSURANCE (PHA). BOTH ARE REGULATED HEALTH PLANS WITH ACTIVITY IN OREGON AND WASHINGTON, AND ARE RECOGNIZED AS EXEMPT UNDER IRC SEC. 501 (C)(4). PPP OPERATES AS AN INTEGRAL PART OF PHP AND PHA, PROVIDING OPERATIONAL OVERSIGHT, LEADERSHIP, POLICYMAKING, MANAGEMENT AND SUPPORT SERVICES, AND STRATEGIC PLANNING. WITHOUT PPP, PHP AND PHA WOULD NEED TO PERFORM THESE SERVICES FOR THEMSELVES. THEREFORE, BY PROVIDING THESE OPERATIONAL SERVICES, PPP ALLOWS PHP AND PHA TO FREE UP AND RE-ALLOCATE RESOURCES IN ORDER TO IMPROVE QUALITY AND BREADTH OF HEALTHCARE SERVICES TO THE SURROUNDING COMMUNITY. IN ADDITION, BECAUSE OF PPP'S PRESENCE, PHP AND PHA CAN PERFORM INITIATIVES THAT LEAD TO THE IMPROVEMENT OF HEALTHCARE THROUGH THE STUDY, TREATMENT, AND REMEDY OF HUMAN DISEASES AND DISORDERS.BRINGING A WIDE NETWORK OF HEALTHCARE PROVIDERS TO BEAR IN A MANAGED CARE PROGRAM THAT IS SUBJECT TO THE CONTROL OF A NON-PROFIT HEALTH SYSTEM CREATES AN INTEGRATED NON-PROFIT HEALTHCARE DELIVERY ORGANIZATION. IN PARTICULAR, THIS STRUCTURE AFFORDS THE PROGRAM AND ITS PARTICIPANTS SIGNIFICANT BENEFITS FROM COST EFFICIENCIES, IMPROVED COORDINATION OF CARE AND MANAGEMENT, AND GREATER ACCESS TO SPECIALIZED SERVICES NOT USUALLY FOUND IN RURAL AREAS. THE PROGRAMS WILL ALSO FOSTER STRENGTHENED MANAGEMENT AND IMPROVED ACCESS TO SOPHISTICATED SERVICES AVAILABLE THROUGH THE SYSTEM AND ITS AFFILIATED CLINICIANS.PPP PROVIDES PHP AND PHA WITH OPERATIONAL OVERSIGHT, INCLUDING PROVIDING EMPLOYEES TO BOTH ENTITIES. PPP EMPLOYS APPROXIMATELY 1164 THROUGH A LEASED EMPLOYEE AGREEMENT WITH ITS AFFILIATE PARENT PROVIDENCE HEALTH & SERVICES - OREGON, IN ORDER TO SUPPORT PHP AND PHA. THESE EMPLOYEES PERFORM ADMINISTRATIVE AND OPERATIONAL SERVICES IN ORDER TO ALLOW PHP AND PHA TO PROVIDE IMPROVED HEALTHCARE SERVICES AND ACCESS, BENEFITING THE SURROUNDING COMMUNITY. PPP CHARGES THESE ADMINISTRATIVE EXPENSES TO PHP AND PHA BASED ON TIME NECESSARY TO PERFORM THE SUPPORT SERVICES. PPP PAYS ALL ADMINISTRATIVE AND PAYROLL COSTS ON BEHALF OF PHP AND PHA, WHICH ARE LATER REIMBURSED TO PPP. 1108446 0 2551243 SEE SCHEDULE OPROVIDENCE PREFERRED PROVIDER PROGRAM (THE PROGRAM), AS PART OF PROVIDENCE PLAN PARTNERS (PPP), IS A NETWORK OF MEDICAL PRACTITIONERS, HOSPITALS AND ANCILLARY MEDICAL PROVIDERS THROUGHOUT OREGON AND SOUTHWEST WASHINGTON DESIGNED TO MANAGE THE COST, DELIVERY, AND QUALITY OF HEALTHCARE IN THESE COMMUNITIES. THE PROGRAM OFFERS EMPLOYERS, SELF-INSURED EMPLOYERS, HEALTH AND WELFARE TRUSTS AND OTHER HEALTHCARE PURCHASERS A PROGRAM FOR REDUCING THE COST OF HEALTHCARE SERVICES, WHILE MAINTAINING THE QUALITY OF MEDICAL CARE TO ENROLLEES. THE PROGRAM ACTS AS A LIAISON BETWEEN HOSPITALS AND PAYORS BY INFORMING PAYORS AND ENROLLEES OF THE AGREEMENTS ENTERED ON THEIR BEHALF BY THE PROGRAM. THE PROGRAM NEITHER ASSUMES RISK OR RESPONSIBILITY FOR PAYMENT TO HOSPITALS OR PROVIDERS NOR GUARANTEES PAYMENT BY PAYORS OR PERFORMANCE BY HOSPITALS OR PROVIDERS OF ANY OF THE TERMS OF CONDITIONS SET FORTH IN ANY PAYOR AGREEMENTS. 1128749 0 824269 PROVIDENCE MANAGED CARE ORGANIZATION PROGRAM (MCO), AS PART OF PROVIDENCE PLAN PARTNERS (PPP), IS AN OREGON CERTIFIED WORKERS' COMPENSATION PROGRAM DESIGNED TO COMPLEMENT THE CLAIMS MANAGEMENT PROGRAM OF EMPLOYERS. AS SUCH, THE PROGRAM AIMS TO PROVIDE COORDINATED, HIGH QUALITY MEDICAL CARE TO WORKERS WHO SUFFER WORK-RELATED INJURIES OR ILLNESSES AND FOCUSES ON EARLY RETURN-TO-WORK STRATEGIES THAT KEEP EMPLOYEES PRODUCTIVE DURING RECOVERY. THE PROGRAM IS FUNCTIONALLY AND STRUCTURALLY SIMILAR TO PREFERRED PROVIDER PROGRAM (PPO), ALTHOUGH FOCUSED ON WORKERS' COMPENSATION ONLY. DURING 2018, THERE WERE 377,495 INDIVIDUALS THAT WERE ELIGIBLE TO USE THE PROVIDENCE MCO PROGRAM. 210214089 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 51 0 1 0 0 0 0 0 1 1 0 0 0 X 6 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OR X MICHAEL G WHITE 5035747500 4400 NE HALSEY BLDG 2 PORTLAND OR 97213 JOSEPH BLANKENSHIP DIRECTOR - EFF. 3/18 0.50 4.50 X 0 3750 0 DEBRA CANALES DIRECTOR 0.10 59.90 X 0 2732103 724111 MICHAEL L COTTON PRESIDENT / CEO 0.50 49.50 X X 0 1140991 481682 ISIAAH CRAWFORD PHD DIRECTOR 0.10 4.10 X 0 30360 0 RHONDA MEDOWS MD CHAIR 0.25 59.75 X X 0 2024470 605869 GILBERT RODRIGUES MD DIRECTOR - THRU 4/18 0.50 4.50 X 0 0 0 HEATH SCHIESSER DIRECTOR 0.50 4.50 X 0 0 0 MICHAEL G WHITE CFO/TREASURER 0.50 49.50 X 0 653774 242337 GREG ZAMUDIO SECRETARY 1.00 49.00 X 0 297156 166311 AARON BALS INT. CHIEF COMP. OFC. - EFF. 10/18 0.50 49.50 X 0 195381 46077 STEPHANIE C DREYFUSS DIR. NETWORK DEVELOP. 0.40 39.60 X 0 319711 84688 BRAD GARRIGUES CHIEF MARKETING OFFICER 0.50 49.50 X 0 390240 61709 ROBERT A GLUCKMAN CHIEF MEDICAL OFFICER 0.50 49.50 X 0 745900 314526 MARK JENSEN CHIEF SERVICES OFFICER 0.50 49.50 X 0 245398 91735 JON MCANNIS CHIEF INFO. OFFICER 0.50 49.50 X 0 304676 80694 CARRIE L SMITH CHIEF COMPLIANCE OFFICER - THRU 9/18 0.50 49.50 X 0 276644 35085 SUSAN CAMPBELL DIRECTOR - SALES ACCT. SVCS. 0.40 39.60 X 0 240595 46137 ASHA N CHESNUTT MD MEDICAL DIRECTOR 0.40 39.60 X 0 284587 40294 CARESSE SAKAGAWA AVP, PRODUCT MARKETING 0.40 39.60 X 0 242330 49564 LAUREL C SOOT MEDICAL DIRECTOR 0.40 39.60 X 0 304928 41229 ANDREW D TARAB AVP INFORMATICS 0.40 39.60 X 0 264933 47537 CINDY STRAUSS FORMER SECRETARY 0.00 60.00 X 0 1884790 690548 ALISON S SCHRUPP FORMER CHIEF ADMIN. OFF. 0.00 0.00 X 0 157276 0 0 12739993 3850133 0 1 1 0 MULTIPLAN INC 535 E DIEHL RD STE 100 NAPERVILLE IL 60563 CLAIMS PROCESSING 8420049 COGNIZANT TRIZETTO SOFTWARE 3300 RIDER TRAIL S 6TH FL EARTH CITY MO 63045 CLAIMS PROCESSING 6896975 CHANGE HEALTHCARE SOLUTIONS 3055 LEBANON PIKE STE 1000 NASHVILLE TN 37214 CLAIMS PROCESSING 4147751 DST PHARMACY SOLUTIONS INC 333 W 11TH ST KANSAS CITY MO 64105 CLAIMS PROCESSING 2262722 COGNIZANT TECHNOLOGY SOLUTI 500 FRANK W BURR BLVD TEANECK NJ 07666 CONSULTANT 2101997 63 1563542 1563542 MGMT FEE - REL. EXEMPT 561000 246432924 246432924 PREF. PROVIDER PROGRAM 900099 2551243 2551243 MCO ADMIN FEES 900099 824269 824269 249808436 251371978 249808436 0 0 X 1563561 1563561 3851448 3426775 424673 84250391 74960677 9289714 25444739 20001906 5442833 297975 194816 103159 300000 300000 34025647 28984108 5041539 6228753 6214015 14738 12523225 7806041 4717184 15025656 10593570 4432086 9352852 6119171 3233681 562000 483726 78274 846831 583180 263651 4160837 4160837 52221 52221 PREMIUM TAX 20812586 20812586 ACA TAX 12667286 12667286 COVER OREGON TAX 12124282 12124282 ELECTRONIC CLAIMS 820196 820196 5629967 2858193 2771774 250540453 210214089 40326364 0 26346596 39677921 475794 827428 4500 0 2909667 2323487 16396291 16925557 46132848 59754393 2586200 7170251 202028 220766 29999163 38186394 32787391 45577411 X 9729010 9729010 -14413589 586411 18030036 3861561 13345457 14176982 46132848 59754393 831525 0 X X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE FROM AFFILIATES 16925557 16925557 DUE TO AFFILIATES 31568479 OTHER PAYABLES 6617915 38186394 0 OREGON COMMUNITY FOUNDATION 1221 SW YAMHILL STREET SUITE 100 PORTLAND OR 97205 237315673 501 (c) (3) 1000000 SEE PART IV PROVIDENCE PORTLAND MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 931231494 501 (c) (3) 100000 SEE PART IV NORTHWEST CHILDREN'S OUTREACH PO BOX 1604 LAKE OSWEGO OR 97035 931315508 501 (c) (3) 25000 SEE PART IV SAVING GRACE 1004 NW MILWAKEE STE 100 BEND OR 97703 930797194 501 (c) (3) 17093 SEE PART IV HOMEPLATE YOUTH SERVICES 12520 SW 3RD STREET BEAVERTON OR 97005 261666325 501 (c) (3) 17093 SEE PART IV CATHOLIC CHARITIES 2740 SE POWELL BOULEVARD PORTLAND OR 97202 930386801 501 (c) (3) 204263 SEE PART IV NORTH BY NORTHEAST 714 NE ALBERTA STREET PORTLAND OR 97211 721618287 501 (c) (3) 30000 SEE PART IV SOCIETY OF ST VINCENT DEPAUL PO BOX 42157 PORTLAND OR 97242 930831082 501 (c) (3) 28625 SEE PART IV STAND FOR CHILDREN 2121 SW BROADWAY SUITE 111 PORTLAND OR 97201 521957214 501 (c) (3) 25000 SEE PART IV BOYS AND GIRLS CLUB 8203 SE 7TH AVENUE SUITE 100 PORTLAND OR 97202 930474800 501 (c) (3) 25000 SEE PART IV CENTRAL CITY CONCERN 232 NW SIXTH AVENUE PORTLAND OR 97209 930728816 501 (c) (3) 25000 SEE PART IV NEIGHBORHOOD HEALTH CENTER 6420 SW MACADAM SUITE 300 PORTLAND OR 97239 273524752 501 (c) (3) 25000 SEE PART IV PROJECT ACCESS NOW PO BOX 10953 PORTLAND OR 97296 208928388 501 (c) (3) 25000 SEE PART IV 13 0 Part I, Line 2: PROVIDENCE PLAN PARTNERS REQUESTS AND CONDITIONS UPON EACH OF THE FOLLOWING: 1) THE PROGRAM SUMMARY AND BUDGET; 2) VERIFICATION OF MALPRACTICE AND LIABILITY COVERAGE; 3) UPDATES PROVIDED EVERY SIX MONTHS; 4) DOCUMENTATION EVIDENCING TAX-EXEMPT OR MUNICIPAL STATUS; 5) DOCUMENTATION SHOWING THE SERVICE OF LOW INCOME AND UNINSURED REGARDLESS OF ABILITY TO PAY FOR SERVICES; 6) UPON REQUEST, FINANCIAL REPORTING OF THE BUDGETED USE OF GRANT FUNDS. Part II, line 1, Column (h): Name of Organization or Government: OREGON COMMUNITY FOUNDATION (h) Purpose of Grant or Assistance: GRANTS TO BE MADE IN SUPPORT OF ACCESS TO CARE, BEHAVIOR HEALTH, AND SOCIAL DETERMINANTS OF HEALTH AND WELL-BEING. Name of Organization or Government: PROVIDENCE PORTLAND MEDICAL FOUNDATION (h) Purpose of Grant or Assistance: ASSIST WITH MEDICAL BILLS FOR THE NEEDY. Name of Organization or Government: NORTHWEST CHILDREN'S OUTREACH (h) Purpose of Grant or Assistance: PROVIDING INFANT CARE PRODUCTS TO THE POOR AND VULNERABLE TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. Name of Organization or Government: SAVING GRACE (h) Purpose of Grant or Assistance: PROVIDING BEHAVORIAL HEALTH, SHELTER, AND EMERGENCY AND ADVOCACY SERVICES FOR SURVIVORS OF DOMESTIC VIOLENCE IN CENTRAL OREGON. Name of Organization or Government: HOMEPLATE YOUTH SERVICES (h) Purpose of Grant or Assistance: PROVIDING EDUCATION, ACCESS TO SERVICES, AND EMPOWERMENT TO YOUTH EXPERIENCING HOMELESSNESS OR HOUSING INSTABILITY. Name of Organization or Government: CATHOLIC CHARITIES (h) Purpose of Grant or Assistance: CREATING INNOVATIVE SOLUTIONS TO HOMELESSNESS, AND SUPPORTING CURRENT PROJECTS TO ADDRESS HOMELESSNESS. Name of Organization or Government: NORTH BY NORTHEAST (h) Purpose of Grant or Assistance: SUPPORT GROWTH OF OUTREACH PROGRAM TO PROVIDE PRIMARY CARE SERVICES TO MEDICAID AND MEDICARE POPULATIONS WITH CHRONIC CONDITIONS. Name of Organization or Government: SOCIETY OF ST. VINCENT DEPAUL (h) Purpose of Grant or Assistance: PROVIDING RENT AND UTILITY ASSISTANCE TO LOW-INCOME INDIVIDUALS. Name of Organization or Government: STAND FOR CHILDREN (h) Purpose of Grant or Assistance: IMPROVING ACCESS TO QUALITY EDUCATION FOR POOR AND VULNERABLE CHILDREN THROUGHOUT OREGON. Name of Organization or Government: BOYS AND GIRLS CLUB (h) Purpose of Grant or Assistance: SUPPORTING TRAUMA SERVICES AND HEALTHY LIFESTYLES PROGRAM PROMOTING OVERALL HEALTH, AND EMPOWERING THE CHILDREN THEY SERVE. Name of Organization or Government: CENTRAL CITY CONCERN (h) Purpose of Grant or Assistance: PROVIDING TRANSITIONAL HOUSING AND OUTREACH TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. Name of Organization or Government: NEIGHBORHOOD HEALTH CENTER (h) Purpose of Grant or Assistance: PROVIDING DENTAL CARE TO LOW-INCOME, UNISURED, AND UNDER-INSURED INDIVIDUALS. Name of Organization or Government: PROJECT ACCESS NOW (h) Purpose of Grant or Assistance: PROVIDING ACCESS TO CARE TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. 0 1 0 0 0 0 0 0 0 DEBRA CANALES DIRECTOR 0 857075 0 881587 0 993441 0 706123 0 17988 0 3456214 0 949253 MICHAEL L COTTON PRESIDENT / CEO 0 666873 0 373963 0 100155 0 459870 0 21812 0 1622673 0 66806 RHONDA MEDOWS MD CHAIR 0 892539 0 881144 0 250787 0 585104 0 20765 0 2630339 0 207264 MICHAEL G WHITE CFO/TREASURER 0 324374 0 176389 0 153011 0 237609 0 4728 0 896111 0 131229 GREG ZAMUDIO SECRETARY 0 234135 0 56783 0 6238 0 144770 0 21541 0 463467 0 5474 AARON BALS INT. CHIEF COMP. OFC. - EFF. 10/18 0 172610 0 22443 0 328 0 30566 0 15511 0 241458 0 0 STEPHANIE C DREYFUSS DIR. NETWORK DEVELOP. 0 260885 0 38152 0 20674 0 69960 0 14728 0 404399 0 2174 BRAD GARRIGUES CHIEF MARKETING OFFICER 0 253162 0 117667 0 19411 0 42086 0 19623 0 451949 0 0 ROBERT A GLUCKMAN CHIEF MEDICAL OFFICER 0 402025 0 180326 0 163549 0 285098 0 29428 0 1060426 0 138634 MARK JENSEN CHIEF SERVICES OFFICER 0 207376 0 29792 0 8230 0 66031 0 25704 0 337133 0 0 JON MCANNIS CHIEF INFO. OFFICER 0 267237 0 36095 0 1344 0 61265 0 19429 0 385370 0 0 CARRIE L SMITH CHIEF COMPLIANCE OFFICER - THRU 9/18 0 194606 0 47278 0 34760 0 23724 0 11361 0 311729 0 8315 SUSAN CAMPBELL DIRECTOR - SALES ACCT. SVCS. 0 157965 0 66855 0 15775 0 34647 0 11490 0 286732 0 0 ASHA N CHESNUTT MD MEDICAL DIRECTOR 0 275408 0 6507 0 2672 0 13785 0 26509 0 324881 0 0 CARESSE SAKAGAWA AVP, PRODUCT MARKETING 0 216595 0 22836 0 2899 0 36771 0 12793 0 291894 0 0 LAUREL C SOOT MEDICAL DIRECTOR 0 296843 0 6538 0 1547 0 15159 0 26070 0 346157 0 0 ANDREW D TARAB AVP INFORMATICS 0 229808 0 29068 0 6057 0 39062 0 8475 0 312470 0 0 CINDY STRAUSS FORMER SECRETARY 0 769625 0 724144 0 391021 0 664452 0 26096 0 2575338 0 356681 ALISON S SCHRUPP FORMER CHIEF ADMIN. OFF. 0 0 0 0 0 157276 0 0 0 0 0 157276 0 23101 Part I, Line 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS RELATED ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE HEALTH & SERVICES - WASHINGTON. Part I, Line 4b ENTITIES WITHIN THE PSJH SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. THE AMOUNTS SHOWN IN COLUMN F OF PART II REFLECT CURRENT YEAR PAYOUTS FROM THESE PLANS. Part II - Executive Incentive Program THE PROVIDENCE EXECUTIVE INCENTIVE PROGRAM PROVIDES A LUMP SUM AWARD ANNUALLY AS A PERCENT OF THE EXECUTIVE'S BASE PAY. PERCENT OPPORTUNITIES ARE ALIGNED WITH OUR TOTAL COMPENSATION PHILOSOPHY AS OUTLINED IN PART VI, SECTION B, LINE 15 (PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT, OFFICERS & KEY EMPLOYEES). FOR PROVIDENCE LEADERS, THE PERFORMANCE AWARD IS BASED ON THE LEVEL OF ACCOMPLISHMENT OF ANNUAL SYSTEM AND FUNCTIONAL (OR MARKET) OBJECTIVES. IN 2018, 60 PERCENT OF THE PARTICIPANT AWARDS WERE BASED ON PRE-DETERMINED ORGANIZATIONAL GOALS CONSISTENT WITH PROVIDENCE'S STRATEGIC PRIORITIES. IN 2018 THE PERCENT ALLOCATION FOR EACH OF THESE STRATEGIC PRIORITIES WAS AS OUTLINED BELOW: SYSTEM GOALS: FIRST-YEAR TURNOVER - 10% INPATIENT EXPERIENCE - 5% PATIENT EXPERIENCE - 5% MEDICAL GROUP PATIENT EXPERIENCE - 5% COMMUNITY BENEFIT - 10% CLINICAL EXCELLENCE - 15% FREE CASH FLOW - 10% THE REMAINING 40% WAS BASED ON A ROBUST SET OF FUNCTION SPECIFIC GOALS DESIGNED TO ALIGN CRITICAL MISSION AND BUSINESS DRIVERS. Form 990, Part VI, Section A, line 6 CLASSES OF MEMBERS OR STOCKHOLDERS PROVIDENCE HEALTH & SERVICES - OREGON IS THE SOLE CORPORATE MEMBER OF PROVIDENCE PLAN PARTNERS. Form 990, Part VI, Section A, line 7a CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PROVIDENCE PLAN PARTNERS HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBER RESERVES THE RIGHT TO APPOINT DIRECTORS TO THE PROVIDENCE PLAN PARTNERS BOARD. ALL DIRECTOR NOMINATIONS THAT COME FROM THE PROVIDENCE PLAN PARTNERS BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE HEALTH & SERVICES - OREGON, AS THE CORPORATE MEMBER. Form 990, Part VI, Section A, line 7b CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL AND TYPE OF VOTING RIGHTS THE FOLLOWING POWERS RESIDE WITH THE MEMBER: 1) TO ADOPT OR CHANGE THE MISSION, PHILOSOPHY, AND VALUES, INCLUDING THE STRATEGIC PLAN AND MISSION STATEMENT. 2) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS. 3) TO APPROVE THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE, TRANSFER, ASSIGNMENT OR ENCUMBERING OF ASSETS EXCEEDING A SPECIFIED THRESHOLD, OR THE SALE OR TRANSFER OF ANY PROPERTY WHICH MAY HAVE HISTORICAL OR RELIGIOUS SIGNIFICANCE. 4) TO APPROVE THE DISSOLUTION AND/OR THE CONSOLIDATION OR MERGER OF THE CORPORATION. 5) TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANTS. 6) TO APPROVE, ACCORDING TO ESTABLISHED GUIDELINES, ANY JOINT VENTURE OF CORPORATE AFFILIATION. 7) TO APPROVE LENDING OF CORPORATE FUNDS. 8) TO APPROVE THE CLOSURE OF ANY INSTITUTION OR MAJOR MINISTRY OR WORK OF THE CORPORATION. Form 990, Part VI, Section B, line 11b PROCESS TO REVIEW 990 THE FORM 990 WAS PREPARED BY THE TAX DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AND WAS REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD. DURING THE FINANCE AND AUDIT COMMITTEE MEETING, MANAGEMENT PRESENTED AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE FINANCE AND AUDIT COMMITTEE CHAIR THEN PROVIDED A SUMMARY AT THE FULL BOARD MEETING. Form 990, Part VI, Section B, 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 IN ACCORDANCE WITH THE PSJH COI POLICY AND IN CONNECTION WITH THAT INDIVIDUAL SATISFYING HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY AND/OR IF AT ANY TIME AN ACTUAL, REAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PSJH CHIEF LEGAL OFFICER AND/OR THE PSJH CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR CONSIDER MATTERS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER. PSJH CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING WHEN ACTION IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF COI DISCLOSURES IS RETAINED PER ORGANIZATION RETENTION POLICY. Form 990, Part VI, Section B, line 15 PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE ST. JOSEPH HEALTH'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ST. JOSEPH HEALTH ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE ST. JOSEPH HEALTH HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE ST. JOSEPH HEALTH MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE ST. JOSEPH HEALTH'S LEGAL ENTITIES. PROVIDENCE ST. JOSEPH HEALTH ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE ST. JOSEPH HEALTH HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS OFFICERS, INCLUDING OUR SENIOR EXECUTIVES. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED BY THE PROVIDENCE ST. JOSEPH HEALTH COMMITTEE. THE BOARD RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE ST. JOSEPH HEALTH IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS WHOSE REVENUE IS SIMILAR TO THAT OF PROVIDENCE ST. JOSEPH HEALTH. ADDITIONALLY, PROVIDENCE ST. JOSEPH HEALTH'S LABOR MARKET CONTINUES TO SPREAD ACROSS HEALTH CARE AND INTO GENERAL INDUSTRY. BECAUSE OF THIS, PROVIDENCE ST. JOSEPH HEALTH ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY FOR-PROFIT MARKET DATA, WHERE APPLICABLE. BASE SALARIES FOR PROVIDENCE ST. JOSEPH HEALTH EXECUTIVES ARE GENERALLY TARGETED TO THE MEDIAN LEVEL OF THE MARKET, AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY ACHIEVE SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE ST. JOSEPH HEALTH OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS AND MIRRORS BEST PRACTICES. THE PROCESS TO REVIEW COMPENSATION WAS LAST COMPLETED MARCH 5, 2019. Form 990, Part VI, Section C, line 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND 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. Form 990, Part IX, line 11g NETWORK FEES: Program service expenses 8,222,583. Total expenses 8,222,583. PURCHASED SERVICES - CONSULTING: Program service expenses 7,389,720. Management and general expenses 4,263,568. Total expenses 11,653,288. PHARMACY ADMIN FEES: Program service expenses 2,617,985. Total expenses 2,617,985. ACTUARIAL FEES: Program service expenses 884,053. Total expenses 884,053. PURCHASED SERVICES - OTHER: Program service expenses 9,869,767. Management and general expenses 777,971. Total expenses 10,647,738. SUPPLEMENTAL SCHEDULE O NARRATIVE 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. COVENANT ACO 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 611573313 HEALTHCARE TX 501(c)(3) 12,I CHS 1 COVENANT HEALTH NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 461259908 HEALTHCARE CA 501(c)(3) 12,III SJHS 1 COVENANT HEALTH PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 463516417 HEALTHCARE TX 501(c)(3) 12,I CHS 1 COVENANT HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752765566 HEALTHCARE TX 501(c)(3) 3 SJHS 1 COVENANT HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752897026 HEALTHCARE TX 501(c)(3) 7 CHS 1 COVENANT MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 822913146 HEALTHCARE TX 501(c)(3) 3 CHS 1 COVENANT MEDICAL GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 752743883 HEALTHCARE TX 501(c)(3) 3 CHS 1 E WA & MT UNEMPLOYMENT COMPENSATION INSURANCE TRUST 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 980579016 911082119 UNEMPLOYMENT WA 501(c)(3) 12,I PHS WA 1 EVERETT TRANSITIONAL CARE SERVICES PO Box 5128 EVERETT WA 982065128 943264605 TRANS. 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