PROVIDENCE HOSPITAL: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
PROVIDENCE HOSPITAL (EIN 63-0288861)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-11
IRS object ID
201931319349300808
Schema version
2017v2.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2019-05-11T10:31:54-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN630288861EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Providence HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPROVBusinessNameControlTxt
Phone3147338000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16801 Airport BoulevardAddressLine1Txt
CityMobileCityNm
State AbbreviationALStateAbbreviationCd
ZIP36608ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTonya MershonPersonNm
Person TitleTax OfficerPersonTitleTxt
Signature2019-05-11SignatureDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1JASON P ALEXANDERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16801 Airport BoulevardAddressLine1Txt
CityMobileCityNm
State AbbreviationALStateAbbreviationCd
ZIP36608ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$210,877,876GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttps://healthcare.ascension.org/Locations/Alabama/ALMOB/Mobile-Providence-HospitalWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1958FormationYr
Legal Domicile StateALLegalDomicileStateCd
Activity Or MissionTo improve the health and well-being of all people in the communities we serve.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee1854TotalEmployeeCnt
Total Volunteers267TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$438,930PYContributionsGrantsAmt
CY Contributions Grants$390,316CYContributionsGrantsAmt
PY Program Service Revenue$220,074,911PYProgramServiceRevenueAmt
CY Program Service Revenue$208,119,849CYProgramServiceRevenueAmt
PY Investment Income$392,856PYInvestmentIncomeAmt
CY Investment Income$277,766CYInvestmentIncomeAmt
PY Other Revenue$2,879,632PYOtherRevenueAmt
CY Other Revenue$1,859,234CYOtherRevenueAmt
PY Total Revenue$223,786,329PYTotalRevenueAmt
CY Total Revenue$210,647,165CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$3,581,187CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$77,427,989PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$78,661,575CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$135,714,192PYOtherExpensesAmt
CY Other Expenses$131,916,139CYOtherExpensesAmt
PY Total Expenses$213,142,181PYTotalExpensesAmt
CY Total Expenses$214,158,901CYTotalExpensesAmt
PY Revenues Less Expenses$10,644,148PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,511,736CYRevenuesLessExpensesAmt
Total Assets BOY$183,960,108TotalAssetsBOYAmt
Total Assets EOY$151,386,366TotalAssetsEOYAmt
Total Liabilities BOY$121,524,230TotalLiabilitiesBOYAmt
Total Liabilities EOY$106,395,662TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$62,435,878NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$44,990,704NetAssetsOrFundBalancesEOYAmt
MissionOur Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$149,125,973ExpenseAmt
Grant$3,581,187GrantAmt
Revenue$208,129,968RevenueAmt
DescPROVIDENCE HOSPITAL is a 302-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2018, PROVIDENCE HOSPITAL treated 14,147 adults and children for a total of 68,429 patient days of service. The hospital also provided services for 143,076 outpatient visits, which included 8,382 outpatient surgeries and 50,949 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions.Desc
Total Program Service Expenses$149,125,973TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (true)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document143IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1854EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OfYes (true)Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SARA OBRIENBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3147338070PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111775 BORMAN DRIVEAddressLine1Txt
CityMARYLAND HEIGHTSCityNm
State AbbreviationMOStateAbbreviationCd
ZIP63146ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
CHRISTOPHER H BROWN MD
VICE CHAIR1.01.0Yes (X)Yes (X)$0$0$0
LAWRENCE RUSS G FORD JR
CHAIR (START 8/2017)1.00Yes (X)Yes (X)$0$0$0
G TIMOTHY GASTON
CHAIR (END 8/2017)1.00Yes (X)Yes (X)$0$0$0
TODD S KENNEDY
PRESIDENT46.04.0Yes (X)Yes (X)$609,435$0$37,548
WINDY TAYLOR
ASSISTANT SECRETARY1.00Yes (X)Yes (X)$0$0$0
ADINE B WADDELL
ASSISTANT SECRETARY (END 9/2017)1.059.0Yes (X)Yes (X)$0$217,668$28,263
RICHARD WILKINS
SECRETARY1.00Yes (X)Yes (X)$0$0$0
TYRONE FENDERSON JR
MEMBER1.00Yes (X)$0$0$0
R MICHAEL HUDDLE MD
MEMBER40.00Yes (X)$128,130$0$19,080
CONNIE L HUDSON RN
MEMBER1.00Yes (X)$0$0$0
HENRY J KOCH MD
MEMBER1.00Yes (X)$0$0$0
RICHARD OYLER
MEMBER1.00Yes (X)$0$0$0
JOSHUA TANNER
MEMBER1.00Yes (X)$0$0$0
JASON P ALEXANDER FACHE
CEO, MINISTRY MARKET0.050.0Yes (X)$0$472,184$27,767
C SUSAN CORNEJO
CFO (END 6/2018)7.043.0Yes (X)$666,356$37,316$37,265
BRANDON M WILLIAMS
CFO, MINISTRY MARKET (START 8/2017)10.044.0Yes (X)$0$152,113$9,142
KATRINA R BROWN
CNO/COO50.00$191,896$0$35,996Yes (X)
IJAZ IQBAL
CMO50.00$363,078$0$38,632Yes (X)
DON E KING
COO (START 1/2018)7.043.0$0$782,385$41,936Yes (X)
ASTON GAMALIE ARCHIBALD MD
PHYSICIAN50.00$417,647$0$38,080Yes (X)
DAVID CHRISTOPHER BRASWELL MD
PHYSICIAN50.00$421,409$0$37,703Yes (X)
WILFRED JOSEPH FONTENOT MD
PHYSICIAN50.00$416,721$0$38,157Yes (X)
DANIEL CURTIS HARRISON MD
PHYSICIAN50.00$420,565$0$37,970Yes (X)
PRESTON TODD SPEAKMAN MD
PHYSICIAN50.00$445,359$0$38,730Yes (X)
WILLIAM M LIGHTFOOT MD
FORMER KEY EMPLOYEE (END 12/2016)0.050.0$0$573,442$35,741Yes (X)
JOHN E STONE JR MD
FORMER KEY EMPLOYEE (END 12/2016)0.00$268,307$0$23,580Yes (X)
CLARK P CHRISTIANSON
FORMER OFFICER (END 9/2015)0.00.0$323,392$0$2,660Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,672,295TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,235,108TotReportableCompRltdOrgAmt
Total Other Compensation$528,250TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K85IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HOLMES HEALTHCARE INC
20 MILL CREEK RDWARRIORAL351805100Medical Services$1,023,107
MOBILE BAY LITHOTRIPSY LLC
300 TOWNPARK DR NW STE 260KENNESAWGA30144Medical Services$611,250
BIO-MEDICAL APPLICATIONS OF ALABAMA INC
16343 COLLECTION CENTER DRCHICAGOIL606930163Medical Services$446,070
ARUP LABORATORIES
500 S CHIPETA WAYSALT LAKE CITYUT841081221Lab Services$331,873
MICHAEL HOUSTON
1298 N MCKENZIE STFOLEYAL36535Physician Services$185,502
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Related Organizations$174,477RelatedOrganizationsAmt
Government Grants$37,619GovernmentGrantsAmt
All Other Contributions$178,220AllOtherContributionsAmt
Noncash Contributions$19,089NoncashContributionsAmt
Total Contributions$390,316TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Service Revenue621990$205,850,622$205,850,622
Services to Affiliates561000$2,268,692$2,268,692
Lab Services621500$500$500
Management Fees561000$35$35

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$208,119,849TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column-$54,798TotalRevenueColumnAmt
Exclusion-$54,798ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$246,708RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$246,708RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$246,708TotalRevenueColumnAmt
Exclusion$246,708ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$563,276OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$230,711OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$332,565OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$332,564TotalRevenueColumnAmt
Exclusion$332,564ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
Cafeteria/Vending Revenue722514$1,228,063$1,228,063
Medical Staff Dues900099$25,250$25,250
Escheatment Revenue900099$15,535$15,535

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$343,678TotalRevenueColumnAmt
Related Or Exempt Func Income$10,119RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$333,559ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,612,526OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$210,647,165TotalRevenueColumnAmt
Related Or Exempt Func Income$208,129,968RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,126,881ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$3,581,187TotalAmt
Program Services$3,581,187ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,124,841TotalAmt
Program Services$1,912,356ProgramServicesAmt
Management And General$212,485ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$60,143,537TotalAmt
Program Services$54,125,452ProgramServicesAmt
Management And General$6,018,085ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$3,479,813TotalAmt
Program Services$3,131,619ProgramServicesAmt
Management And General$348,194ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,489,712TotalAmt
Program Services$7,640,224ProgramServicesAmt
Management And General$849,488ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,423,672TotalAmt
Program Services$3,981,039ProgramServicesAmt
Management And General$442,633ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$435,107TotalAmt
Program Services$752ProgramServicesAmt
Management And General$434,355ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total-$38,317TotalAmt
Management And General-$38,317ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$25,186TotalAmt
Management And General$25,186ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,456,225TotalAmt
Program Services$825,972ProgramServicesAmt
Management And General$630,253ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$33,441TotalAmt
Program Services$20,911ProgramServicesAmt
Management And General$12,530ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$602,010TotalAmt
Program Services$278,339ProgramServicesAmt
Management And General$323,671ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$40,048TotalAmt
Program Services$12,022ProgramServicesAmt
Management And General$28,026ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,407,703TotalAmt
Program Services$771,061ProgramServicesAmt
Management And General$2,636,642ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$158,281TotalAmt
Program Services$51,757ProgramServicesAmt
Management And General$106,524ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$73,911TotalAmt
Program Services$18,057ProgramServicesAmt
Management And General$55,854ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,426,117TotalAmt
Management And General$2,426,117ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$9,700,196TotalAmt
Program Services$4,294,394ProgramServicesAmt
Management And General$5,405,802ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,822,897TotalAmt
Management And General$3,822,897ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$43,234,471$43,401,681-$167,210
Purchased Services$26,579,089$4,737,684$21,841,405
Management Fee to Affiliate$19,236,540$19,236,540
Provider Tax$10,913,666$10,913,666

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$9,809,568TotalAmt
Program Services$9,427,800ProgramServicesAmt
Management And General$381,768ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$214,158,901TotalAmt
Program Services$149,125,973ProgramServicesAmt
Management And General$65,032,928ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,655,044BOYAmt
EOY$15,695EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$31,414EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$30,156,832BOYAmt
EOY$25,930,083EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$5,039,117BOYAmt
EOY$4,966,546EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$566,905BOYAmt
EOY$553,985EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$218,914,557LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$169,052,051LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$52,525,250BOYAmt
EOY$49,862,506EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$10,000,000BOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$15,010,057BOYAmt
EOY$18,088,212EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$66,006,903BOYAmt
EOY$51,937,925EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$183,960,108BOYAmt
EOY$151,386,366EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$13,196,363BOYAmt
EOY$12,295,358EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$20,500BOYAmt
EOY$32,881EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$108,307,367BOYAmt
EOY$94,067,423EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$121,524,230BOYAmt
EOY$106,395,662EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$61,823,843BOYAmt
EOY$44,435,134EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$612,035BOYAmt
EOY$555,570EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$62,435,878BOYAmt
EOY$44,990,704EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$183,960,108BOYAmt
EOY$151,386,366EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,511,736ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$41,485NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$13,891,953OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$25,186OtherActivitiesAmt
Total Lobbying Expenditures$25,186TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYLobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Providence Hospital does not participate in or intervene in (including the publishing or distributing or statements), any political campaign on behalf of (or in opposition to) any candidate for public office.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITYLobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Providence Hospital does not participate in or intervene in (including the publishing or distributing or statements), any political campaign on behalf of (or in opposition to) any candidate for public office.

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,297,513OtherCostOrOtherBasisAmt
Book Value$8,297,513BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$99,890,798OtherCostOrOtherBasisAmt
Depreciation$81,677,004DepreciationAmt
Book Value$18,213,794BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$166,093OtherCostOrOtherBasisAmt
Depreciation$166,093DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$94,598,822OtherCostOrOtherBasisAmt
Depreciation$81,565,847DepreciationAmt
Book Value$13,032,975BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,961,331OtherCostOrOtherBasisAmt
Depreciation$5,643,107DepreciationAmt
Book Value$10,318,224BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$49,862,506TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (6 entries)

DescDescBook ValueBookValueAmt
Restricted Funds$215,959
Other Assets-$8,329
Due from Affiliates$50,715,461
Other Receivables$555,393
Deferred Compensation/Retirement/Pension Asset
Estimated 3rd Party Payor Settlements$459,441
FieldValueIRS element (for citing)
Total Book Value Other Assets$51,937,925TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (9 entries)

DescDescAmtAmt
OTHER MISC LIABILITIES
RECEIVABLES SOLD WITH RECOURSE$464,995
VALUATION ALLOWANCE$271,752
Due to Affiliates$25,413,069
Deferred Compensation/Retirement/Pension Liability
Savings Plan Liability
Estimated 3rd Party Payor Settlement$528,408
Recovery Tail Liability$831,691
Debt with Ascension Health Alliance$66,557,508
FieldValueIRS element (for citing)
Total Liability$94,067,423TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteFormAndLineReferenceDesc
ExplanationTHE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2018.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,703,659TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,703,659NetCommunityBenefitExpnsAmt
Total Expense0.0546TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,268,609TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,456,731DirectOffsettingRevenueAmt
Net Community Benefit Expns$811,878NetCommunityBenefitExpnsAmt
Total Expense0.0038TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$37,972,268TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,456,731DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,515,537NetCommunityBenefitExpnsAmt
Total Expense0.0584TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs6ActivitiesOrProgramsCnt
Persons Served6863PersonsServedCnt
Total Community Benefit Expns$298,337TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$59,833DirectOffsettingRevenueAmt
Net Community Benefit Expns$238,504NetCommunityBenefitExpnsAmt
Total Expense0.0011TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs10ActivitiesOrProgramsCnt
Persons Served167PersonsServedCnt
Total Community Benefit Expns$24,634TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$24,634NetCommunityBenefitExpnsAmt
Total Expense0.0001TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs16ActivitiesOrProgramsCnt
Persons Served7030PersonsServedCnt
Total Community Benefit Expns$322,971TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$59,833DirectOffsettingRevenueAmt
Net Community Benefit Expns$263,138NetCommunityBenefitExpnsAmt
Total Expense0.0012TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs16ActivitiesOrProgramsCnt
Persons Served7030PersonsServedCnt
Total Community Benefit Expns$38,295,239TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,516,564DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,778,675NetCommunityBenefitExpnsAmt
Total Expense0.0597TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served9PersonsServedCnt
Total Community Benefit Expns$37,924TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$37,924NetCommunityBenefitExpnsAmt
Total Expense0.0002TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.0TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served9PersonsServedCnt
Total Community Benefit Expns$37,924TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$37,924NetCommunityBenefitExpnsAmt
Total Expense0.0002TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$2,343,758BadDebtExpenseAmt
Bad Debt Expense Attributable$232,720BadDebtExpenseAttributableAmt
Reimbursed By Medicare$104,927,658ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$107,201,108CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$2,273,450MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16801 AIRPORT BLVDAddressLine1Txt
CityMOBILECityNm
State AbbreviationALStateAbbreviationCd
ZIP36608ZIPCd
FieldValueIRS element (for citing)
Website Addresshttps://healthcare.ascension.org/Locations/Alabama/ALMOB/Mobile-Providence-HospitalWebsiteAddressTxt
State LicenseH4905StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLhttps://healthcare.ascension.org/Locations/Alabama/ALMOB/Mobile-Providence-HospitalOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttps://healthcare.ascension.org/Locations/Alabama/ALMOB/Mobile-Providence-HospitalStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.0FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.0FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Pt VIFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Pt VIFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Pt VIFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3ETo better target community resources on the service area's most pressing health needs, the hospital participated in a group discussion with organizational decision makers and community leaders to prioritize the significant community health needs while considering several criteria: alignment with Ascension Health strategies of healthcare that leaves no one behind; care for the poor and vulnerable; opportunities for partnership; availability of existing programs and resources; addressing disparities of subgroups; availability of evidence-based practices; and community input. The significant health needs are a prioritized description of the significant health needs of the community as identified through the CHNA. See Schedule H, Part V, Line 7 for the link to the CHNA and Schedule H, Part V, Line 11 for how those needs are being addressed.
Schedule H, Part V, Section B, Line 5 Facility , 1Facility , 1 - Providence Hospital. From September 2015 through March 2016, Providence Hospital ("Providence"), in collaboration with other community organizations and agencies, conducted a community health needs assessment ("assessment") for Mobile County. This needs assessment is for Mobile County, Alabama, the county of residence for approximately 83 percent of Providence inpatients. Input from the community included persons with a broad knowledge of the community, health and human services providers, stakeholders and representatives of the public. This assessment was led by Providence Hospital, with active participation by the following community organizations and public and private agencies: American Cancer Society, American Diabetes Association, American Heart Association, Bayou Clinic, Big Brothers Big Sisters, Feeding America, Grand Bay Senior Center, Guadalupe Center, Infirmary Health, Live Better Mobile, March of Dimes, Mobile Area Chamber of Commerce, Mobile County Health Department, North Baldwin Chamber of Commerce, Providence Hospital Senior Center, Rotary Rehab, USA Center for Health Communities, USA College of Nursing, and USA Health System. Special attention was given to obtaining input from the medically underserved and vulnerable populations. Key informants included individuals with public health expertise, state and local officials, community leaders and healthcare consumers. Quantitative data were obtained from county, state, and national sources in order to develop a social, economic, and health assessment of Mobile County. The indicators included public health surveillance data, such as deaths and births. Sixty-six health indicators for Mobile County were compared and contrasted to those for the state and surrounding counties. In addition, local data were compared to previous years' data from Mobile County, highlighting improvements and statistical trends. To identify the issues of greatest priority for the community, the indicator results were evaluated using the County Health Rankings Model created by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation. The model emphasizes factors that, when improved, can help improve the overall health of a community. This model has three major components: Health Outcomes, Health Factors, Programs and Policies. Of the 66 health status indicators, Mobile County was worse than the state average on 44 indicators. Prioritization of the community health issues was a multi-step process that included: Review and discussion of all of the top health concerns and associated indicator data. Identification and discussion of consequences of not addressing the issue. Consideration of key criteria for impacting change. Through the assessment process described in further detail in this report, the top priority health issues identified for Mobile County are: Access to Care Weight Mental Health and Substance Abuse
Schedule H, Part V, Section B, Line 11 Facility , 1Facility , 1 - Providence Hospital. THE PROVIDENCE HOSPITAL FY2015-2016 IMPLEMENTATION STRATEGY SPECIFICALLY ADDRESSES THE FOLLOWING THREE SYSTEM WIDE HEALTH IMPROVEMENT PRIORITIES: FROM THE MOST RECENT CHNA (2015-2016), THE TOP ISSUES CONSIDERED TO BE OF GREATEST NEED IN THE COMMUNITY WERE AS FOLLOWS: 1. ACCESS TO CARE 2. WEIGHT 3. MENTAL HEALTH/SUBSTANCE ABUSE. STRATEGIES HAVE BEEN ADOPTED TO ADDRESS THESE NEEDS. RESOURCES IN MOBILE COUNTY AVAILABLE TO ADDRESS THE ACCESS TO CARE PRIORITY ISSUE INCLUDE: BAYOU CLINIC, FRANKLIN PRIMARY HEALTH CENTERS, MOBILE COUNTY HEALTH DEPARTMENT, MOSTELLAR CLINIC, STANTON ROAD CLINIC, VA OUTPATIENT CLINIC, VICTORY HEALTH PARTNERS, PROVIDENCE HOSPITAL OUTREACH IN SOUTH MOBILE COUNTY, PROVIDENCE HOSPITAL CARE PROGRAM, OZANAM CHARITABLE PHARMACY, MERCY LIFE AND AREA AGENCY ON AGING. SPECIFICALLY, THE BAYOU CLINIC FOCUSED REDUCING LANGUAGE AND CULTURAL BARRIERS TO SELF -MAINTENANCE OF HEALTH WITH A SPECIFIC DIABETES SELF-MANAGEMENT EDUCATION (DSME) FOR VIETNAMESE, CAMBODIAN, AND LAOTIAN PATIENTS COMING TO THE CLINIC. THE EDUCATION ADDRESSES HEALTH DISPARITIES AND BARRIERS TO CARE BY PROVIDING CULTURALLY SPECIFIC EDUCATION AND MONITORING A1CS. PARTICIPANTS ARE DEFINED AS CLIENT/PATIENT COMPLETING DSME CLASS AND RECEIVING A BLOOD GLUCOSE MONITOR/TEST SUPPLIES. IT WAS ANTICIPATED THAT BY JUNE 2018 THAT THE NUMBER OF DIABETES RELATED ED VISITS AMONG ASIAN RESIDENTS IN SOUTH MOBILE COUNTY WOULD DECREASE BY 20 PERCENT. INITIAL DATA SHOWED INACCURATE CLASSIFICATION BY NATIONALITY AT REGISTRATION AND UNABLE TO MEASURE ASIAN POPULATION ALONE. PROGRAM DEVELOPED TO SCREEN ALL RESIDENTS REGARDLESS OF NATIONALITY WHEN REGISTERED AS INPATIENT OR ED VISITS. 100% SCREENED AS OF JUNE 2018 AND PROGRAM ONGOING. RESOURCES IDENTIFIED TO ADDRESS HEALTHY WEIGHT INCLUDE: PROVIDENCE HOSPITAL DIABETES CENTER, FEEDING THE GULF COAST NUTRITION PROGRAMS, JUNIOR LEAGUE OF MOBILE, CITY OF MOBILE, MOBILE COUNTY PUBLIC SCHOOLS, PROVIDENCE FARMERS MARKET, PROVIDENCE COMMUNITY GARDEN, AND LIVE BETTER MOBILE/MOBILE UNITED. THE DIABETES CENTER FOCUSED ON PROVIDING A CLASS FOR HEALTHY EATING FOR UNINSURED OBESE/OVERWEIGHT PATIENTS. THE PROGRAM OFFERED A SINGLE DAY CLASS THAT COMBINED DIABETES SELF MANAGEMENT AND KEY ELEMENTS OF THE COOKING MATTERS PROGRAM. THE REGISTERED PROGRAM WHICH WAS A 6-8 WEEK CLASS WAS MODIFIED AND TAUGHT IN ONE DAY. THE PROGRAM WAS COMPLETED IN 2017. RESOURCES THAT HAVE BEEN IDENTIFIED TO HELP WITH THE MENTAL HEALTH/SUBSTANCE ABUSE ISSUE INCLUDE: PROVIDENCE HOSPITAL ED SOCIAL WORKER AND FAITH AND COMMUNITY NURSES. COMMUNITY PARTNERS INCLUDE ALABAMA MEDICAID REGIONAL CARE ORGANIZATION (AMRCO), ALTA POINTE, HEALTHY GULF COAST TRANSITION IHGCCT) AND NATIONAL ASSOCIATION OF MENTAL ILLNESS (NAMI). THE CAMPAIGN ASSESSED BARRIERS TO MENTAL HEALTH TREATMENT BY TRACKING THE NUMBER OF PATIENTS WHO WERE UNABLE TO ACCESS CARE DUE TO LACK OF INSURANCE OR INABILITY TO PAY. PROVIDENCE HOSPITAL ACUTE CARE VOLUME FOR FY 16 REFLECTED 116 OF THE 277 ACUTE CARE SERVICES FOR MENTAL HEALTH DIAGNOSES WERE UNINSURED OR MEDICAID RECIPIENTS. 20% WERE READMITTED WITHIN 90 DAYS. MORE THAN 60% OF THE ACUTE CARE CONDITIONS RELATED TO SUBSTANCE ABUSE. THE STRATEGIES INCLUDED DEVELOPING A METHOD OF ASSESSING AND DOCUMENTING ED PATIENTS EXPERIENCES RELATED TO BARRIERS IN ADDRESSING THEIR MENTAL HEALTH ISSUES. A NETWORK WAS ESTABLISHED WITH PROVIDENCE AND AMG PRIMARY CARE PROVIDERS TO ADVANCE POLICIES FOR ASSESSMENTS AND TREATMENTS/REFERRAL FOR PATIENTS WITH MENTAL HEALTH ISSUES. A MENTAL HEALTH RESOURCE GUIDE WAS PRODUCED FOR PROVIDENCE STAFF AND FAITH COMMUNITY NURSES (FCN). FCN DOCUMENTED THE NUMBER OF CHURCH MEMBERS REQUIRING ASSISTANCE WITH MENTAL HEALTH/SUBSTANCE ABUSE ISSUES. A TRACKING TOOL WAS COMPLETED BY FCN. COLLECTED DATA WAS SHARED WITH LOCAL MENTAL HEALTH PROVIDERS AND OTHER PARTICIPATING ORGANIZATIONS. THE DATA WAS REVIEWED AND ANALYZED AS TO BARRIER DATA FOR PROCEDURAL/POLICY FOR PROVIDENCE HEALTH. PROVIDENCE HOSPITAL STRATEGY FOR IMPROVING ACCESS TO MENTAL HEALTH BY RESHAPING THE CASE MANAGEMENT MODEL IN THE EMERGENCY DEPARTMENT ALONG WITH THE INTEGRATION OF NEW TELE-PSYCHIATRY SERVICES. A COLLABORATIVE TEAM OF CASE MANAGERS, ED PROVIDERS AND MENTAL HEALTH PROVIDERS DEVELOPED THE PATHWAY FOR ACCESSING TELE-PSYCHIATRY SERVICES. ACCESS TO PSYCHIATRIC INPATIENT SERVICES FOR THE UNDERSERVED IMPROVED BY 71%. IN 2017 IT WAS LESS THAN 40%. NEEDS THAT WILL NOT BE ADDRESSED: THE HOSPITAL WILL BE ADDRESSING ALL NEEDS THAT WERE IDENTIFIED.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Guadalupe CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13810 Wulff Road EAddressLine1Txt
CitySemmesCityNm
State AbbreviationALStateAbbreviationCd
ZIP365755256ZIPCd
FieldValueIRS element (for citing)
FacilityMedical ClinicFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (19 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 6a Community Benefit ReportThis report illustrates the significant degree to which Providence Hospital contributes to the positive health status of the people and communities it serves. As a member of Ascension Health, the nation's largest Catholic healthcare system, Providence Hospital continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of Providence Hospital is to perpetuate the healing mission of the Church. Providence Hospital advances this goal through the delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community, and medical research. Our concern for all human life and the dignity of each person leads the organization to provide medical and social services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay. Providence Hospital has engaged in many activities to ensure that our mission is accomplished some of which are highlighted in this report. Unreimbursed Services Provided to the Elderly and the Poor: Providence Hospital provides a large portion of its services to the elderly and poor. During the fiscal year ending June 30, 2017, approximately 53% of admissions were elderly patients enrolled in the Medicare program, and approximately $18 million in services were provided to persons who were poor or vulnerable under state, county, or Providence Hospital guidelines. In the spirit of principles adopted by Ascension Health, Providence Hospital has taken proactive steps to address those issues that will affect accessibility, the financing and the delivery of healthcare to all persons, especially the uninsured, underinsured, and the under served. Patient Services: During the fiscal year ending June 30, 2017, Providence Hospital treated 14,964 inpatient adults and children in the community for a total of 75,954 patient days of service. Our health ministry also provided services for 340,610 outpatient visits, including 9,654 outpatient surgery visits, and 49,183 emergency department visits. For over 160 years the Daughters of Charity and Providence Hospital have cared for the medically needy in Mobile and the surrounding area. Over time, the needs of our community and the way we meet those needs have changed, but our compassion for those in need has never wavered. We remain committed to sharing our mission, our vision, our values and our gifts with our community. As caregivers we see the devastating impact acute and chronic illnesses have on our patients, our family members and our community. Coordinating and participating in local and national fundraisers is one of the ways we contribute towards research and financial assistance for those suffering from these illnesses. In the past year Providence has supported the ALS "Ice Bucket Challenge, the Kidney Foundation Walk, the American Cancer Society Vintage Affair, Colors for a Cause, Ozanam Charitable Pharmacy and others. Our Diabetes Center staff collaborated with Bay Area Food Bank to offer the "Diabesity Conference" to patients and professionals in addition to providing free screenings and education classes on an ongoing basis. They are also offering a "Living Well" series to help community members learn to live with Diabetes. Our Vision: We envision a strong, vibrant Catholic health ministry in the United States which will lead to the transformation of healthcare. We will ensure service that is committed to health and well-being for our communities and that responds to the needs of individuals throughout the life cycle. We will expand the role of laity, in both leadership and sponsorship, to ensure a Catholic health ministry of the future. Our Values: - Service of the Poor: Generosity of spirit, especially for persons most in need - Reverence: Respect and compassion for the dignity and diversity of life - Integrity: Inspiring trust through personal leadership - Wisdom: Integrating excellence and stewardship - Creativity: Courageous innovation - Dedication: Affirming the hope and joy of our ministry Our People & Our Gifts: Providence Hospital, like the Daughters of Charity, is committed to serving the needs of the poor and vulnerable in our community. The Guadalupe Center and the Senior Center continue to serve the needs of low income Hispanics and seniors and we have expanded our outreach program in south Mobile County to include a full-time client navigator who assists residents with both social and health related needs. Staff members from the USDA, Gulf Coast PPO, Franklin Clinic, and a local disability attorney use the office free of charge so that clients in this rural area can better access their services. The Pastoral Care Department collaborated with Goodwill Easter Seals to offer clothes to patients in need through the Sister Mary Louise Clothes Closet. When Providence employees donate to Goodwill, the resulting credit allows the Pastoral Care staff to purchase clothes for the closet. This program also allows the hospital to give vouchers to needy patients and clients who use these vouchers to obtain clothes and household items. Assessment of Community Needs: Providence Hospital is in the process of conducting an assessment of the health needs of our community. Community leaders from the Mobile County Health Department, area hospitals, and local civic and social service organizations were invited to participate in the process as were staff members, participants in local health screenings, and other community residents. As it was in 2013, the information collected will be presented to the Providence Hospital Board for their review and for the development of future goals and implementation strategies. The top five issues considered to be of greatest need in the community were as follows: 1. Good Nutrition/Obesity Prevention 2. Diabetes Education and Support 3. Free/Subsidized Healthcare Services 4. Cardiac Health Education and Support 5. Mental Health Access and Support Strategies adopted to address these needs included the establishment of a community garden; the development of a disease management program for indigent, diabetic clients; the development of the CARE program to assist individuals with accessing and enrolling in healthcare coverage; support for cardiac health education services; and increased support and education related to mental illness. We believe that healing is ultimately the work of God and that our involvement in health care is a participation in the healing ministry of Christ, a mission that we share with all those who assist in this work.
Schedule H, Part V, Section B, Line 16a FAPhttps://healthcare.ascension.org/error?aspxerrorpath=/Locations/Alabama/ALMOB/Mobile-Providence-Hospital/Financial-Assistance
Schedule H, Part V, Section B, Line 16b FAP Applicationhttps://healthcare.ascension.org/error?aspxerrorpath=/Locations/Alabama/ALMOB/Mobile-Providence-Hospital/Financial-Assistance
Schedule H, Part V, Section B, Line 16c FAP Plain Language Summaryhttps://healthcare.ascension.org/error?aspxerrorpath=/Locations/Alabama/ALMOB/Mobile-Providence-Hospital/Financial-Assistance
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistanceThe cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied.
Schedule H, Part II Community Building ActivitiesPROVIDENCE HOSPITAL PARTICIPATES IN SUMMER SCRUBS, A FREE, THREE-DAY CAREER EXPLORATION OPPORTUNITY FOR CURRENT 11TH GRADE STUDENTS IN MOBILE AND BALDWIN COUNTIES WHO WANT TO EXPLORE CAREERS IN HEALTHCARE. PARTICIPANTS SPEND EACH DAY AT A DIFFERENT HEALTHCARE SITES AND INTERACT WITH AND OBSERVE HEALTH PROFESSIONALS ON THE JOB IN A "REAL-WORLD" ENVIRONMENT. PROVIDENCE HOSPITAL PARTICIPATES IN THE PROJECT SEARCH HIGH SCHOOL TRANSITION PROGRAM. THIS IS A UNIQUE ONE-YEAR SCHOOL-TO-WORK PROGRAM THAT TAKES PLACE ENTIRELY AT THE BUSINESS. INTERNS PARTICIPATE IN EMPLOYMENT-RELATED INSTRUCTION AND ARE ASSIGNED INTERNSHIPS WITHIN EITHER MOBILE INFIRMARY OR PROVIDENCE HOSPITAL. THE PROGRAM PROVIDES REAL-LIFE WORK EXPERIENCE COMBINED WITH TRAINING IN EMPLOYABILITY AND INDEPENDENT LIVING SKILLS. PROJECT SEARCH HELPS YOUNG ADULTS WITH DISABILITIES MAKE SUCCESSFUL TRANSITIONS FROM SCHOOL TO PRODUCTIVE ADULT LIFE. THE GOAL FOR EACH INTERN IS COMPETITIVE EMPLOYMENT.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amountAfter satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2018 was $9,765,659 at charges, ($2,343,758 at cost).
Schedule H, Part III, Line 3 Bad Debt Expense MethodologyThe provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnoteThe organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 21.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costsA cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistanceTHE ORGANIZATION HAS A WRITTEN DEBT COLLECTION POLICY THAT ALSO INCLUDES A PROVISION ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE CERTAIN COLLECTION PRACTICES DO NOT APPLY.
Schedule H, Part V, Section B, Line 16a FAP website- PROVIDENCE HOSPITAL: Line 16a URL: See Pt VI;
Schedule H, Part V, Section B, Line 16b FAP Application website- PROVIDENCE HOSPITAL: Line 16b URL: See Pt VI;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website- PROVIDENCE HOSPITAL: Line 16c URL: See Pt VI;
Schedule H, Part VI, Line 2 Needs assessmentThe staff in our outreach programs are constantly assessing community needs by working with individuals in the community and participating in multi-agency meetings. This includes the seniors, the Hispanic community, and the residents of south Mobile County. The Vice President of Population Health, Director of Case Management and the Outreach and Advocacy Manager are also part of a state-wide collaboration with AQAF and area health care providers to assess and meet the health related needs of residents.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistancePATIENTS OR PERSONS WHO MAY BE BILLED FOR PATIENT CARE ARE INFORMED AND EDUCATED ABOUT THEIR POTENTIAL ELIGIBILITY FOR FEDERAL STATE LOCAL OR HOSPITAL ASSISTANCE IN THE FOLLOWING MANNER: - AN EXPLANATION OF THE HOSPITAL'S BILLING PROCESS AND CONTACT INFORMATION FOR FINANCIAL COUNSELORS IS POSTED ON THE HOSPITAL'S WEB SITE AND IN ALL INPATIENT AND OUTPATIENT REGISTRATION AREAS. A SUMMARY OF THE HOSPITAL'S BILLING AND PAYMENT PHILOSOPHY IS INCLUDED IN EVERY PATIENT'S REGISTRATION PACKET. THE INFORMATION IS PROVIDED IN ENGLISH AND SPANISH AND INTERPRETER SERVICES FOR OTHER LANGUAGES ARE AVAILABLE AS NEEDED. - FINANCIAL COUNSELORS VISIT EVERY UNINSURED PATIENT ON THE DAY AFTER THEIR ADMISSION TO EXPLAIN AVAILABLE RESOURCES AND WHEN APPROPRIATE, INITIATE THE APPLICATION PROCESS FOR ASSISTANCE. FINANCIAL COUNSELORS HAVE COMPLETED SPECIFIC TRAINING FOR MEDICAID, CHIPS, SOBRA, AND ALL-KIDS AND WILL RECEIVE ADDITIONAL TRAINING AS THE NEED IS IDENTIFIED. IF THE FINANCIAL COUNSELORS IDENTIFY ADDITIONAL FINANCIAL OR SOCIAL NEEDS THEY WILL REFER THE PATIENT TO A HOSPITAL SOCIAL WORKER. - A LISTING OF COMMUNITY RESOURCES IS INCLUDED IN EACH PATIENT'S DISCHARGE MATERIALS. - WITHIN 24 HOURS OF ADMISSION THE CASE MANAGEMENT DEPARTMENT CONDUCTS A SCREENING FOR POTENTIAL DISCHARGE NEEDS ON EVERY PATIENT. THOSE PATIENTS IDENTIFIED AS NEEDING ASSISTANCE WITH THEIR HOSPITAL BILL OR APPLYING FOR STATE AND FEDERAL ASSISTANCE ARE REFERRED TO THE FINANCIAL COUNSELORS BY THE HOSPITAL SOCIAL WORKERS.
Schedule H, Part VI, Line 4 Community informationMOBILE COUNTY IS LOCATED ON THE ALABAMA GULF COAST AND BORDERED BY MISSISSIPPI TO THE WEST AND FLORIDA TO THE EAST. ECONOMIC GROWTH, MILD CLIMATE AND COASTAL APPEAL ENTICE RESIDENTS TO LIVE IN THIS COMMUNITY. IN SUMMER 2013, CONSTRUCTION BEGAN ON A $350 MILLION JETLINER ASSEMBLY PLANT WHICH WILL BRING THOUSANDS OF JOBS TO THE AREA. THE LAND AREA OF THE COUNTY IS 1,233.09 (75%) SQUARE MILES WITH 410.93 (25%) SQUARE MILES OF WATER. ACCORDING TO THE US CENSUS 2010 RESULTS THE POPULATION OF MOBILE COUNTY IS APPROXIMATELY 412,992 PEOPLE FROM 2000 TO 2010, THE MOBILE COUNTY POPULATION GROWTH PERCENTAGE WAS 3.3%. THE COUNTY SHOWS A SLIGHTLY HIGHER PERCENTAGE OF WOMEN AS OPPOSED TO MEN; THIS IS CONSISTENT WITH STATE AND NATIONAL DATA. THE PERCENTAGE OF PERSONS 65 YEAR AND OLDER IS 13.0%, SLIGHTLY LOWER THAN THE STATE'S 14%. THE DOMINANT LANGUAGE IS ENGLISH, WITH 4.8% SPEAKING ANOTHER LANGUAGE IN THE HOME. IN MOBILE, THERE ARE 35,538 VETERANS THE COMMUNITY. THE, POPULATION OF COUNTY IS 60.8% WHITE, 34.9% BLACK, AND 2.9% OTHER WITH 1.4% REPORTING TWO OR MORE RACES. PROVIDENCE HOSPITAL COMMUNITY IS DEFINED BY THE ZIP CODE OF 75% OF THE HOSPITAL'S DISCHARGES AND INCLUDES THE FOLLOWING: 36522 36575 36606 36618 36541 36582 36608 36619 36544 36587 36609 36693 36571 36605 36613 36695 39452.
Schedule H, Part VI, Line 5 Promotion of community healthPROVIDENCE HOSPITAL IS LOCATED AT 6801 AIRPORT BLVD MOBILE, AL 36608. SINCE ITS FOUNDING IN 1854 PROVIDENCE HAS BEEN, HOSPITAL SERVING, CARING FOR AND HEALING THE PEOPLE OF MOBILE COUNTY AND SURROUNDING AREAS. SPONSORED BY ASCENSION HEALTH THE NATION'S LARGEST CATHOLIC NOT FOR PROFIT HEALTHCARE SYSTEM, THE HOSPITAL'S MISSION IS TO EXTEND THE HEALING MINISTRY OF JESUS CHRIST TO SOUTH ALABAMA AND SOUTHEAST MISSISSIPPI, WITH A SPECIAL CONCERN FOR PERSONS WHO ARE POOR AND VULNERABLE. PROVIDENCE PROVIDES MANY COMMUNITY BENEFITS SUCH AS SOCIAL SERVICES, PASTORAL CARE, COMMUNITY MEETING SPACE, AND HEALTH EDUCATION, ALL AT NO CHARGE. THE HOSPITAL'S 500-PLUS MEMBER MEDICAL STAFF INCLUDES REPRESENTATIVES FROM EVERY MAJOR MEDICAL SPECIALTY. A MAJORITY OF THE PROVIDENCE HOSPITAL BOARD IS COMPRISED OF PERSONS WHO RESIDE IN THE COUNTY WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. PROVIDENCE HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA.
Schedule H, Part VI, Line 6 Affiliated health care systemPROVIDENCE HOSPITAL IS A MEMBER OF ASCENSION HEALTH ALLIANCE ("THE SYSTEM"). ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 STATES AND THE DISTRICT OF COLUMBIA. ASCENSION HEALTH ALLIANCE SERVES AS THE MEMBER OR SHAREHOLDER OF VARIOUS SUBSIDIARIES. ASCENSION HEALTH ALLIANCE AND ITS MEMBER ORGANIZATIONS ARE HEREAFTER REFERRED TO COLLECTIVELY AS THE SYSTEM. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. PROVIDENCE HOSPITAL, LOCATED IN MOBILE ALABAMA IS A NONPROFIT ACUTE CARE HOSPITAL. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR THE RESIDENTS OF MOBILE. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. THE HOSPITAL IS RELATED TO ASCENSION HEALTH'S OTHER SPONSORED ORGANIZATIONS THROUGH COMMON CONTROL. THE ENTITIES COMPRISING THE HEALTH MINISTRY ARE UNDER COMMON MANAGEMENT AND CONTROL BY ASCENSION HEALTH AND SERVE THE SAME COMMUNITY. THE COMBINED FINANCIAL STATEMENTS INCLUDE THE ACCOUNTS OF THE HOSPITAL, PROVIDENCE AND PROVIDENCE'S MEMBER ENTITIES. ALL SIGNIFICANT INTERCOMPANY ACCOUNTS HAVE BEEN ELIMINATED. MEMBER ENTITIES OF PROVIDENCE INCLUDE: - PROVIDENCE FOUNDATION OF MOBILE (THE FOUNDATION) - ESTABLISHED TO RECEIVE MAINTAIN AND ADMINISTER FUNDS TO BE USED FOR THE DEVELOPMENT AND EXPANSION OF THE HOSPITAL OR ITS RELATED ORGANIZATIONS AND TO SUPPORT THE CORPORATE PURPOSES OF ASCENSION HEALTH. THE FOUNDATION IS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. - PROVIDENCE BUILDING CORPORATION OF MOBILE - ESTABLISHED TO HOLD TITLE TO PROPERTY AND TO COLLECT INCOME THEREFROM AND TO SUPPORT THE CORPORATE PURPOSES OF ASCENSION HEALTH. PROVIDENCE BUILDING CORPORATION OF MOBILE IS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(2) OF THE INTERNAL REVENUE CODE. - PROVIDENCE HEALTHCARE SERVICES OF MOBILE - ESTABLISHED TO OPERATE AND SUPPORT HEALTHCARE INSTITUTIONS WHICH ARE SPONSORED BY OR AFFILIATED WITH ASCENSION HEALTH. PROVIDENCE HEALTHCARE SERVICES OF MOBILE IS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. - PROVIDENCE PARK, INC. - ESTABLISHED TO MAINTAIN AND DEVELOP PROPERTY ADJACENT TO THE HOSPITAL FOR PURPOSES OF ASCENSION HEALTH. PROVIDENCE PARK INC. IS TAXABLE UNDER THE INTERNAL REVENUE CODE. - SETON MEDICAL MANAGEMENT - ESTABLISHED TO OWN AND OPERATE PHYSICIAN PRACTICES. SETON MEDICAL MANAGEMENT IS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. - ANESTHESIA SOLUTIONS - ESTABLISHED TO PROVIDE ANESTHESIA SERVICES FOR THE HOSPITAL ANESTHESIA SOLUTIONS IS A TAXABLE ORGANIZATION THE INTERNAL REVENUE CODE. - ALABAMA PROVIDENCE HEALTHCARE SERVICES HAS BEEN FORMED TO EMPLOY PHYSICIANS, MID-LEVEL PROVIDERS, AND PHYSICIAN PRACTICE STAFF AND TO COORDINATE THE PROVISION OF INPATIENT AND OUTPATIENT PHYSICIAN AND RELATED MEDICAL CARE FOR THE PATIENTS AND COMMUNITY MEMBERS SERVED BY ORGANIZATIONS AFFILIATED WITH PROVIDENCE HEALTH SYSTEM IN ALABAMA. THE ENTITY'S APPLICATION FOR TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE IS PENDING. - MISSISSIPPI PROVIDENCE HEALTHCARE SERVICES HAS BEEN FORMED TO EMPLOY PHYSICIANS, MID-LEVEL PROVIDERS, AND PHYSICIAN PRACTICE STAFF AND TO COORDINATE THE PROVISION OF INPATIENT AND OUTPATIENT PHYSICIAN AND RELATED MEDICAL CARE FOR THE PATIENTS AND COMMUNITY MEMBERS SERVED BY ORGANIZATIONS AFFILIATED WITH PROVIDENCE HEALTH SYSTEM IN MISSISSIPPI. MISSION THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING, AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE WHICH SUSTAINS AND IMPROVES THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. IN ACCORDANCE WITH THE SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS, EACH HEALTH MINISTRY ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES UTILIZED FOR THE CARE OF PERSONS LIVING IN POVERTY AND COMMUNITY BENEFIT PROGRAMS: - TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTHCARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. - UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE, REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS. - COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE PERSONS LIVING IN POVERTY AND OTHER VULNERABLE PERSONS OF THE COMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME. - COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR THE PERSONS LIVING IN POVERTY, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, AND MEDICAL RESEARCH. DISCOUNTS ARE PROVIDED TO ALL UNINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE OF PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF EACH ENTITY'S TOTAL OPERATING EXPENSES TO THE ENTITY'S BILLED CHARGES FOR PATIENT CARE.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxt
PROVIDENCE FOUNDATION
6801 AIRPORT BLVDMOBILEAL36608630915493501(C)(3)$1,300,113$86,671FMVEQUIPMENTOPERATING/CAPITAL SUPPORT
MISSISSIPPI PROVIDENCE HEALTHCARE SERVICES INC
6801 AIRPORT BLVDMOBILEAL36608461130426$2,194,403OPERATING SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule I, Part I, Line 2 Procedures for monitoring use of grant funds.FormAndLineReferenceDesc
ExplanationPROVIDENCE HOSPITAL PROVIDED SUPPORT TO RELATED ENTITIES WHOSE OPERATIONS ARE CLOSELY MONITORED THROUGH SHARED LEADERSHIP AND GOVERNANCE TO ENSURE SUPPORT GIVEN IS USED AS INTENDED.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
TODD S KENNEDY
PRESIDENT$330,401$0$228,379$0$50,655$0$16,200$0$21,348$0$646,983$0$0$0
ADINE B WADDELL
ASSISTANT SECRETARY (END 9/2017)$0$122,356$0$43,943$0$51,368$0$9,867$0$18,396$0$245,931$0$0
CLARK P CHRISTIANSON
FORMER OFFICER (END 9/2015)$0$0$0$0$323,392$0$0$0$2,660$0$326,052$0$17,423$0
JASON P ALEXANDER FACHE
CEO, MINISTRY MARKET$0$414,474$0$0$0$57,710$0$11,406$0$16,361$0$499,951$0$0
C SUSAN CORNEJO
CFO (END 6/2018)$365,157$36,565$248,229$0$52,971$750$15,629$571$19,061$2,004$701,047$39,891$0$0
BRANDON M WILLIAMS
CFO, MINISTRY MARKET (START 8/2017)$0$119,738$0$30,000$0$2,376$0$3,231$0$5,911$0$161,255$0$0
WILLIAM M LIGHTFOOT MD
FORMER KEY EMPLOYEE (END 12/2016)$0$519,708$0$32,948$0$20,786$0$15,380$0$20,361$0$609,184$0$0
JOHN E STONE JR MD
FORMER KEY EMPLOYEE (END 12/2016)$203,676$0$44,300$0$20,331$0$13,334$0$10,246$0$291,887$0$0$0
KATRINA R BROWN
CNO/COO$164,563$0$22,420$0$4,912$0$12,484$0$23,512$0$227,891$0$0$0
IJAZ IQBAL
CMO$332,377$0$29,147$0$1,553$0$14,850$0$23,782$0$401,710$0$0$0
DON E KING
COO (START 1/2018)$0$456,783$0$276,549$0$49,054$0$14,850$0$27,086$0$824,321$0$0
ASTON GAMALIE ARCHIBALD MD
PHYSICIAN$392,903$0$20,617$0$4,127$0$13,500$0$24,580$0$455,727$0$0$0
DAVID CHRISTOPHER BRASWELL MD
PHYSICIAN$387,586$0$29,617$0$4,206$0$13,500$0$24,203$0$459,112$0$0$0
WILFRED JOSEPH FONTENOT MD
PHYSICIAN$385,998$0$26,617$0$4,106$0$13,500$0$24,657$0$454,878$0$0$0
DANIEL CURTIS HARRISON MD
PHYSICIAN$392,822$0$23,617$0$4,127$0$13,500$0$24,470$0$458,535$0$0$0
PRESTON TODD SPEAKMAN MD
PHYSICIAN$417,478$0$23,617$0$4,264$0$13,500$0$25,230$0$484,089$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensationASCENSION HEALTH, A RELATED ORGANIZATION OF PROVIDENCE HOSPITAL, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO: - COMPENSATION COMMITTEE, - INDEPENDENT COMPENSATION CONSULTANT, - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4a Severance or change-of-control paymentThe following individual(s) received severance payments from the organization or a related organization: Clark P Christianson - $301,344
Schedule J, Part I, Line 4b Supplemental nonqualified retirement planELIGIBLE EXECUTIVES PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. The following individuals received current year distributions during calendar year 2017: CLARK P CHRISTIANSON - $17,423

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part IV, Line 20b Explanation of Financial StatementsTHE ACTIVITY OF PROVIDENCE HOSPITAL IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF PROVIDENCE HOSPITAL IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF PROVIDENCE HOSPITAL.
Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICALIn determining the compensation of the Organization's President, the process performed by Ascension Health, a related organization of Providence Hospital, included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the President was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the Committee minutes. The individual was not present when his compensation was decided.
Form 990, Part VI, Line 15b Process to establish compensation of other officers or key employeesIN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, THE PROCESS PERFORMED BY GULF COAST HEALTH SYSTEM, INC., A RELATED ORGANIZATION OF PROVIDENCE HOSPITAL, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE GULF COAST HEALTH SYSTEM, INC. EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED.
Form 990, Part VI, Line 6 Classes of members or stockholdersPROVIDENCE HOSPITAL HAS A SINGLE CORPORATE MEMBER, Gulf Coast Health System, Inc.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing bodyPROVIDENCE HOSPITAL HAS A SINGLE CORPORATE MEMBER, Gulf Coast Health System, Inc., WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF PROVIDENCE HOSPITAL
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholdersAscension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations and major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic and financial plans; assets; system policies and procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyDURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD.
Form 990, Part VI, Line 12c Conflict of interest policyThe organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
Form 990, Part VI, Line 19 Required documents available to the publicTHE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST.
Form 990, Part VII, Section A Related EntitiesThe organization utilizes an affiliate as the common pay agent. Employees reported in Part VII may have duties that impact multiple related entities. Total average hours worked and compensation and benefits paid are reported. In doing so, if available, a common law employer analysis is used to determine whether the hours and compensation/benefits are reportable as attributable directly to the filing organization or another entity; otherwise, the best available information has been used as the basis for allocations utilized in the reporting.
Form 990, Part VIII, Line 11d Other Miscellaneous RevenueCommunity Services - Total Revenue: 7864, Related or Exempt Function Revenue: 7864, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Education Revenue - Total Revenue: 2255, Related or Exempt Function Revenue: 2255, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Medical Records Fees - Total Revenue: 11131, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 11131; Miscellaneous Revenue - Total Revenue: 322428, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 322428;
Form 990, Part XI, Line 9 Other changes in net assets or fund balancesTransfers with Alpha Fund - -13891953;
Form 990, Part XII, Line 2c oversight of audit or selection of independent accountantProvidence Hospital is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
ASCENSION HEALTH ALLIANCE
PO BOX 45998ST LOUISMO63145453358926NATIONAL HEALTH SYSTEMMO501(c)(3)Type INAfalse
ASCENSION HEALTH
PO BOX 45998ST LOUISMO63145311662309NATIONAL HEALTH SYSTEMMO501(c)(3)Type IASCENSION HEALTH ALLIANCEfalse
GULF COAST HEALTH SYSTEM
6801 AIRPORT BLVDMOBILEAL36608630934712HEALTH SYSTEMAL501(c)(3)Type III-FIASCENSION HEALTHfalse
PROVIDENCE FOUNDATION
6801 AIRPORT BLVDMOBILEAL36608630915493SUPPORT PROVIDENCE HOSPITALAL501(c)(3)7GULF COAST HEALTH SYSTEMYes (true)
SETON MEDICAL MANAGEMENT
6801 AIRPORT BLVDMOBILEAL36608630937704SUPPORT PROVIDENCE HOSPITALAL501(c)(3)Type IIGULF COAST HEALTH SYSTEMYes (true)
PROVIDENCE BUILDING CORPORATION
6801 AIRPORT BLVDMOBILEAL36608630914564SUPPORT PROVIDENCE HOSPITALAL501(c)(2)GULF COAST HEALTH SYSTEMYes (true)
SACRED HEART HEALTH SYSTEM INC
5151 N 9TH AVENUEPENSACOLAFL32504590634434HOSPITAL - HEALTHCAREFL501(c)(3)3GULF COAST HEALTH SYSTEMYes (true)
HAVEN OF OUR LADY OF PEACE INC
5151 N 9TH AVENUEPENSACOLAFL32504593620346NURSING HOMEFL501(c)(3)10SACRED HEART HEALTH SYSTEMYes (true)
SACRED HEART HEALTH VENTURES INC
5151 N 9TH AVENUEPENSACOLAFL32504571183283INVESTMENTFL501(c)(3)Type ISACRED HEART HEALTH SYSTEMYes (true)
SACRED HEART FOUNDATION INC
5151 N 9TH AVENUEPENSACOLAFL32504592436597FOUNDATIONFL501(c)(3)7SACRED HEART HEALTH SYSTEMYes (true)
ALABAMA PROVIDENCE HEALTHCARE SERVICES
6801 AIRPORT BLVDMOBILEAL36608462847744SUPPORT PROVIDENCE HOSPITALAL501(c)(3)10GULF COAST HEALTH SYSTEMYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
INTERVENTIONAL REHABILITATION CENTER LLC
1549 AIRPORT BOULEVARD STE 420PENSACOLAFL32503593673361MEDICAL SERVICESFLNAN/A
PET LLC
5149 NORTH 9TH AVENUE SUITE 124PENSACOLAFL32504593788701MEDICAL SERVICESFLNAN/A
ENDOSCOPY GROUP LLC
4810 NORTH DAVIS HIGHWAYPENSACOLAFL32503593519881MEDICAL SERVICESFLNAN/A
SOUTH COAST REAL ESTATE VENTURE LLC
5907 HIGHWAY 90MOSS POINTMS39563455599047OWN REAL ESTATE FOR A PHYSICIAN OFFICE BUILDINGMSNAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
PROVIDENCE PARK Inc
PO BOX 850429MOBILEAL36685630886846REAL ESTATEALNAC CorporationYes (true)
MISSISSIPPI PROVIDENCE HEALTHCARE SERVICES INC
6801 AIRPORT BLVDMOBILEAL36608461130426HEALTHCARE SERVICESMSNAC CorporationYes (true)
GULF COAST DIVERSIFIED INC
5154 NORTH 9TH AVENUEPENSACOLAFL32507592432798INVESTMENTFLNAC CorporationYes (true)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (22 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
ALABAMA PROVIDENCE HEALTHCARE SERVICES
L$6,830,074FAIR MARKET VALUE
ALABAMA PROVIDENCE HEALTHCARE SERVICES
M$5,188,112FAIR MARKET VALUE
ALABAMA PROVIDENCE HEALTHCARE SERVICES
O$95,065FAIR MARKET VALUE
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Q$886,898FAIR MARKET VALUE
ALABAMA PROVIDENCE HEALTHCARE SERVICES
S$541,719FAIR MARKET VALUE
PROVIDENCE BUILDING CORPORATION
K$620,063FAIR MARKET VALUE
PROVIDENCE BUILDING CORPORATION
M$235,333FAIR MARKET VALUE
PROVIDENCE PARK INC
O$2,002,607FAIR MARKET VALUE
PROVIDENCE PARK INC
P$49,122,773FAIR MARKET VALUE
SETON MEDICAL MANAGEMENT INC
L$217,726FAIR MARKET VALUE
SETON MEDICAL MANAGEMENT INC
M$686,438FAIR MARKET VALUE
SETON MEDICAL MANAGEMENT INC
S$4,129,528FAIR MARKET VALUE
SOUTH COAST REAL ESTATE VENTURE LLC
L$162,501FAIR MARKET VALUE
SOUTH COAST REAL ESTATE VENTURE LLC
P$312,916FAIR MARKET VALUE
MISSISSIPPI PROVIDENCE HEALTHCARE SERVICES INC
M$328,235FAIR MARKET VALUE
MISSISSIPPI PROVIDENCE HEALTHCARE SERVICES INC
P$129,375FAIR MARKET VALUE
MISSISSIPPI PROVIDENCE HEALTHCARE SERVICES INC
Q$229,996FAIR MARKET VALUE
MISSISSIPPI PROVIDENCE HEALTHCARE SERVICES INC
R$2,194,403FAIR MARKET VALUE
MISSISSIPPI PROVIDENCE HEALTHCARE SERVICES INC
S$121,516FAIR MARKET VALUE
PROVIDENCE FOUNDATION
M$53,094FAIR MARKET VALUE
PROVIDENCE FOUNDATION
R$1,386,784FAIR MARKET VALUE
PROVIDENCE FOUNDATION
S$535,785FAIR MARKET VALUE

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