2018-11-15T00:25:35-06:00 2017-12-31 346565596 ERNST & YOUNG US LLP 18101 VON KARMAN AVENUE SUITE 1700 IRVINE CA 92612 990 2017-01-01 272305304 SWEDISH EDMONDS SWED 4255253895 21601 76TH AVE W EDMONDS WA 98026 JO ANN ESCASA-HAIGH EVP/CFO - OPERATIONS 4255253895 2018-11-15 1 INAS RAOUF P01254678 9497942300 198.134.52.73 2018-11-15 00:17:56 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F9954457A230D2217538EB78B690AB1CFA3B7FEF 2017 2019-02-21 02:37:17Z MIKE BUTLER 1801 LIND AVE SW 9016 RENTON WA 98057 236818997 0 X www.swedish.org X 2010 WA SEE SCHEDULE OAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 13 13 1632 399 35728 9297 153627 576497 223463901 221694564 -87552 10067 15491528 14150107 239021504 236431235 0 0 0 0 95911141 94793557 0 0 0 100140394 94021465 196051535 188815022 42969969 47616213 169332712 185064368 96995375 92407118 72337337 92657250 X AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 1 1 160062275 0 232343917 SEE SCHEDULE OPROVIDENCE ST. JOSEPH HEALTH SYSTEMON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 50 HOSPITALS, 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE - A CHANGING HEALTH CARE ENVIRONMENT - WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE.PROVIDENCE HEALTH & SERVICESIN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON.ST. JOSEPH HEALTH SYSTEMIN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA.PROGRAM SERVICE ACCOMPLISHMENTS - ACUTE INPATIENT/OUTPATIENT - 10,937 ACUTE ADMISSIONS, 112,594 OUTPATIENT VISITS, AND 48,292 EMERGENCY ROOM VISITS IN 2017 WITH 47,450 PATIENT DAYS. SWEDISH EDMONDS (FORMERLY STEVENS HOSPITAL) HAS SERVED EDMONDS AND SURROUNDING COMMUNITIES FOR THE LAST 50 YEARS. TOGETHER WITH THE LARGER SWEDISH AND PROVIDENCE SYSTEMS, WE ARE CREATING AN INNOVATIVE, REGIONAL HEALTH-CARE DELIVERY NETWORK THAT WILL PROVIDE MORE LOCAL SERVICES, WHILE GIVING RESIDENTS GREATER ACCESS TO THE LATEST MEDICAL TREATMENTS AND THE COMPREHENSIVE SERVICES OF THE SWEDISH AND PROVIDENCE SYSTEMS. OUR CAMPUS INCLUDES 217 LICENSED BEDS, MORE THAN 450 MEDICAL STAFF PHYSICIANS, MORE THAN 1,400 STAFF AND A FULL SCOPE OF MEDICAL AND SURGICAL SERVICES, INCLUDING LEVEL IV TRAUMA EMERGENCY MEDICINE, DIAGNOSTIC, TREATMENT AND SUPPORT SERVICES. PATIENTS RECEIVING OUTPATIENT SERVICE ARE ELIGIBLE FOR THE SAME CHARITY CARE AS INPATIENTS AND CHARITY CARE DOLLARS ARE INCLUDED IN NUMBERS LISTED IN 4A ABOVE. IN ADDITION, OUR HOSPITAL PAYOR MIX IS APPROXIMATELY 60% MEDICARE AND MEDICAID- WE OFTEN HEAR THAT PATIENTS WITH THOSE INSURANCE TYPES HAVE TROUBLE FINDING PROVIDERS WHO WILL CARE FOR THEM. IN ADDITION TO OVER $10M IN COMMUNITY BENEFIT PROVIDED THROUGH CHARITY CARE AND OTHER COMMUNITY SERVICES, THROUGH OUR INNOVATIVE PARTNERSHIP WITH VERDANT (SNOHOMISH COUNTY PUBLIC HOSPITAL DISTRICT #2) WE PROVIDE MORE THAN $7M ANNUALLY IN FUNDS THAT CAN BE DIRECTLY CONTRIBUTED TO MEETING THE HEALTH NEEDS OF THE COMMUNITY. 1192507 0 1774016 SEE SCHEDULE OPRIMARY CARE - IN 2017, SWEDISH EDMONDS PROVIDED PRIMARY CARE IN SWEDISH INTERNAL MEDICINE (AN INTERNAL MEDICINE CLINIC). OTHER PRIMARY CARE SERVICES IN THE COMMUNITY ARE PROVIDED BY COMMUNITY PRACTICES AND THROUGH SWEDISH MEDICAL GROUP AND INCLUDE THE BIRTH AND FAMILY CLINIC (A FAMILY PRACTICE CLINIC THAT ALSO PROVIDES OBSTETRICAL CARE) AND SWEDISH CHILDREN'S CLINIC EDMONDS, A PEDIATRIC PRACTICE, AMONG OTHERS. 0 0 -234029 SEE SCHEDULE OHEALTHCARE JOINT VENTURES - SWEDISH/EDMONDS PARTNERS WITH RADIA TO PROVIDE IMAGING SERVICES IN AN OUTPATIENT SETTING AT OUR JOINT VENTURE, SWEDISH RADIA IMAGING CENTER, EDMONDS. SERVICES PROVIDED INCLUDE X-RAY, CT, MRI, AND ULTRASOUND. 161254782 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1632 1 1 1 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X JO ANN ESCASA-HAIGH 9493814000 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 DICK P ALLEN DIRECTOR 0.10 2.00 X 0 30360 0 RICHARD BLAIR CHAIR 0.10 4.60 X X 0 60360 0 ISIAAH CRAWFORD PHD DIRECTOR 0.10 4.10 X 0 30360 0 SISTER LUCILLE DEAN SP DIRECTOR 0.10 2.10 X 0 0 0 SR DIANE HEJNA CSJ RN DIRECTOR 0.10 1.90 X 0 0 0 MICHAEL HOLCOMB DIRECTOR 0.10 5.30 X 0 30360 0 SR PHYLLIS HUGHES RSM DRPH DIRECTOR 0.10 5.00 X 0 0 0 SALLYE LINER MSN RN DIRECTOR 0.10 4.70 X 0 25360 0 MARY LYONS PHD DIRECTOR 0.10 1.50 X 0 30360 0 WALTER NOCE JR DIRECTOR 0.10 2.00 X 0 30360 0 DAVE OLSEN VICE CHAIR 0.10 5.50 X X 0 30360 0 CAROLINA REYES MD DIRECTOR 0.10 4.60 X 0 30360 0 PHOEBE YANG DIRECTOR 0.10 2.00 X 0 25360 0 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 2.00 58.00 X 0 248186 20012 VENKAT BHAMIDIPATI EVP/TREASURER 2.00 58.00 X 0 638309 847978 MIKE BUTLER PRESIDENT 1.00 59.00 X 0 2529152 2095457 JO ANN ESCASA-HAIGH INTERIM CFO/TREASURER 1.00 59.00 X 0 1372090 667685 CINDY STRAUSS SECRETARY 1.00 59.00 X 0 1743082 1020214 TAMMY TEODOSIO ASSISTANT SECRETARY 2.00 48.00 X 0 117493 23110 JOHN WHIPPLE ASSISTANT SECRETARY 2.00 48.00 X 0 754800 485048 JENNIFER GRAVES CEO/SWEDISH EDMONDS 60.00 0.00 X 0 509281 8200 ANTHONY ARMADA EDUCATION CE/SWEDISH - THRU 2/17 1.00 64.00 X 0 2476654 32182 JEAN DOERGE NURSE EXECUTIVE 60.00 0.00 X 255428 0 36428 ELENA GEAMANU PHYSICIAN/ENDOCRINOLOGY 60.00 0.00 X 301762 0 48758 JORETTE RAMIREZ STAFF RN (ICU) 60.00 0.00 X 238942 0 41014 PETER RO PHYSICIAN/HYPERBARIC MEDICINE 60.00 0.00 X 396399 0 43953 SANDEEP SACHDEVA CMO 60.00 0.00 X 377511 0 35571 DAN HARRIS FORMER VP FINANCE/ WA & AK 0.00 50.00 X 0 1813187 10720 ROD F HOCHMAN MD FORMER PRESIDENT 0.00 50.00 X 0 5269095 6313965 TODD HOFHEINS FORMER EVP/CFO/TREAS. 0.00 60.00 X 0 2139115 45475 DAVID BROWN FORMER VP/STRATEGY & BUSINESS DEV. 0.00 55.00 X 0 700285 457360 DEBBIE BURTON FORMER SVP/ CHIEF NRSG. OFFICER 0.00 60.00 X 0 776449 387202 DEBRA CANALES FORMER EVP/CAO 0.00 60.00 X 0 1674402 1236264 MICHAEL C CARTER FORMER CAO 0.00 0.00 X 0 110380 27932 AMY COMPTON-PHILLIPS FORMER EVP / CHIEF CLINICAL OFFICER 0.00 55.00 X 0 1491216 1024801 MARY CRANSTOUN FORMER VP/TOTAL REWARDS 0.00 60.00 X 0 705405 482346 JOHN FLETCHER FORMER VP/OPERATIONS SUPPORT 0.00 0.00 X 0 103970 20386 MARK GARGETT FORMER VP/DIGITAL INTEGRATION 0.00 50.00 X 0 732000 324249 JOEL GILBERTSON FORMER SVP/COMMUNITY PARTNERSHIPS 0.00 60.00 X 0 856314 552384 OREST HOLUBEC FORMER SVP/CHIEF COMM./EXT. AFFAIRS OFFICER 0.00 55.00 X 0 788870 484008 AARON MARTIN FORMER SVP/STRATEGY & INNOVATION 0.00 70.00 X 0 900371 716019 TOM MCDONAGH FORMER VP/CHIEF INVESTMENT OFFICER 0.00 58.00 X 0 830621 546487 RHONDA MEDOWS MD FORMER EVP/POPULATION HEALTH 0.00 60.00 X 0 1582404 1126342 JANICE NEWELL FORMER SVP/CHIEF INFORMATION OFFICER 0.00 50.00 X 0 1396825 738630 HARVEY SMITH FORMER SVP/CHIEF CUSTOMER SVC. OFFICER 0.00 50.00 X 0 1048182 47496 TERRY SMITH FORMER SVP/MANAGEMENT SVCS 0.00 0.00 X 0 213516 18997 PAUL STODDART FORMER VP/MARKETING 0.00 0.00 X 0 175547 8264 GREG TILL FORMER VP/CHIEF TALENT OFFICER 0.00 61.00 X 0 713560 491592 SHARON TONCRAY FORMER SVP/CHIEF LABOR EMP. COUNSEL 0.00 60.00 X 0 766530 557321 LISA VANCE FORMER SVP/CLINICAL PROGRAM SERVICES 0.00 60.00 X 0 1691102 682325 MIKE WATERS FORMER VP,CAO/PHYSICIAN SERVICES 0.00 65.00 X 0 642910 463750 CRAIG WRIGHT MD FORMER SVP/PHYSICIAN SERVICES 0.00 0.00 X 0 245590 10916 1570042 38080493 22180841 225 1 1 0 SHIFTWISE INC PO BOX 70870 ST PAUL MN 551709705 STAFFING 2477850 SEIU LOCAL NO 1199 4710 196TH ST SW LYNNWOOD WA 980365517 UNION DUES 1475928 PATHOLOGY ASSOC MED LAB-PACLAB PO BOX 2670 SPOKANE MN 992202670 LAB SERVICES 1341536 SELLEN CONSTRUCTION CO PO BOX 9970 SEATTLE WA 98109 CONSTRUCTION 1183151 BLOODWORKS NORTHWEST 921 TERRY AVE SEATTLE WA 981041256 LAB SERVICES 956203 102 17057 559440 576497 ACUTE CARE/ IP & OP 621400 220367857 220367857 PRIMARY CARE 621110 1707182 1707182 PHARMACY 446110 -146446 -146446 JOINT VENTURES 900099 -234029 -234029 221694564 15571 15571 692354 0 692354 692354 692354 5504 -5504 -5504 -5504 954773 382258 572515 572515 PROVIDER TAX 900099 8463401 8463401 IAF REVENUE 900099 3501085 3501085 CAFETERIA 900099 415872 415872 504880 224854 35728 244298 12885238 236431235 233883904 35728 1935106 X 509477 509477 87183398 76071880 11111518 441359 344260 97099 6659323 5194272 1465051 1907 1907 17450205 11517135 5933070 1604 1251 353 6876161 5363406 1512755 105143 82012 23131 13843365 10797825 3045540 75744 59080 16664 150200 117156 33044 2143434 2143434 7881920 6147898 1734022 MEDICAL SUPPLIES 28329289 28329289 TAXES & LICENSES 9079068 7081673 1997395 BAD DEBT 7723358 7723358 RECRUITMENT/RELOCATION 220625 172088 48537 139442 108765 30677 188815022 161254782 27560240 0 X 2795848 2993980 36878270 88861346 2705756 2452810 786602 130815026 47127627 88745397 83687399 4767124 4335278 32653715 2733555 169332712 185064368 11538408 11182758 33523630 33693218 45880519 6052818 47531142 96995375 92407118 X 71418439 91669503 918898 987747 72337337 92657250 169332712 185064368 X 47616213 -27296300 X 0 1 X 1 0 X 72260946 7195480 65065466 57405262 39932147 17473115 1148818 1148818 83687399 FIN 47 - LT ASSET RETIREMENT OBLIGATION 1454143 DUE TO AFFILIATES 45880918 THIRD PARTY SETTLEMENTS 196081 47531142 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 633 4260522 4260522 0.02350 6507 43763392 31622957 12140435 0.06700 7140 48023914 31622957 16400957 0.09050 2815 2112 2112 0.00000 311171 311171 0.00170 2815 313283 313283 0.00170 9955 48337197 31622957 16714240 0.09220 1 7723358 83783689 108375515 -24591826 X 1 1 1 1 SWEDISH EDMONDS 21601 76TH AVENUE W EDMONDS WA 98026 WWW.SWEDISH.ORG/LOCATIONS/EDMONDS-CAMP HAC.FS.60183546 X X X SWEDISH EDMONDS 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X SEE PART V, PAGE 8 X HTTPS://VERDANTHEALTH.ORG/ X 1 16 1 SEE PART V, PAGE 8 0 1 X 300.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X WWW.SWEDISH.ORG/PATIENT-VISITOR-INFO/BILLING/FINANCIAL-ASSISTANCE X WWW.SWEDISH.ORG/PATIENT-VISITOR-INFO/BILLING/FINANCIAL-ASSISTANCE X WWW.SWEDISH.ORG/PATIENT-VISITOR-INFO/BILLING/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 1 SWEDISH EDMONDS Part V, Section B, Line 5: - SUICIDE FAMILY EDUCATION FROM PASTORAL CARE: DR JOHN SMOOT UNITY CHURCH- COMMUNITY OUTREACH TOWN HALL SESSION AT THE EDMONDS CHAMBER OF COMMERCE: SOLYNN MCGRADY - COMMUNITY HEALTH EDUCATION: SCOTT FORLAND, PROVIDENCE EVERETT - KOREAN COMMUNITY CENTER - COMMUNITY MEALS PROGRAM: MIA TUAN, DIRECTOR OF KOREAN CENTER- VERDANT HEALTH OF SNOHOMISH COUNTY ADVISOR FOR COMMUNITY HEALTH DATA: ROBIN FENN, COMMISSIONER OF VERDANT HEALTH SWEDISH EDMONDS Part V, Section B, Line 6a: SWEDISH CHERRY HILLSWEDISH FIRST HILLSWEDISH BALLARDSWEDISH ISSAQUAHSWEDISH CANCER INSTITUTE SWEDISH EDMONDS Part V, Section B, Line 6b: VERDANT HEALTH OF SNOHOMISH COUNTY SWEDISH EDMONDS Part V, Section B, Line 11: THE TOP HEALTH PRIORITIES FOR SWEDISH EDMONDS ARE HEART DISEASE, CANCER, YOUTH AND ADULT OBESITY, AND SUICIDE.HEART DISEASE AND CANCER:CANCER (168.5 PER 100,000) AND HEART DISEASE (154.6 PER 100,000) ARE TWO LEADING CAUSES OF DEATH IN SNOHOMISH COUNTY. CHRONIC DISEASES ARE THE PRIMARY CAUSE OF MORBIDITY AND MORTALITY IN SNOHOMISH COUNTY, WASHINGTON, AND THE UNITED STATES. THESE DISEASES ARE RESPONSIBLE FOR 70% OF DEATHS IN THE US, AND CAUSE 1 IN 10 AMERICANS TO BE LIMITED IN THEIR ACTIVITIES.OBESITY:OBESITY CONTRIBUTES TO NUMEROUS AND VARIED COMORBID CONDITIONS. COMPLICATIONS CAN OCCUR IN MANY ORGAN SYSTEMS, RANGING FROM CARDIOVASCULAR TO RESPIRATORY TO ORTHOPEDIC AND EVEN OPHTHALMOLOGIC.SUICIDE:SUICIDE WAS THE 9TH LEADING CAUSE OF DEATH IN SNOHOMISH COUNTY AND WAS RESPONSIBLE FOR 29% OF INJURY DEATHS. SUICIDE RATES INCREASED DRAMATICALLY WITH THE ECONOMIC DOWNTURN IN 2009. APPROXIMATELY 5% OF SNOHOMISH COUNTY ADULTS REPORT HAVING INADEQUATE EMOTIONAL SUPPORT. PEOPLE WITH INADEQUATE EMOTIONAL SUPPORT WERE MORE LIKELY THAN OTHERS TO SMOKE, BE DISABLED, AND BE DISSATISFIED WITH LIFE. NEARLY 30% OF SNOHOMISH COUNTY STUDENTS REPORTED BEING DEPRESSED. DEPRESSED YOUTH HAD POORER ACADEMIC PERFORMANCES THAN OTHERS AND WERE MORE LIKELY TO BE INVOLVED IN VIOLENCE. THEY WERE ALSO MORE LIKELY TO SMOKE, DRINK, AND USE ILLEGAL DRUGS. SWEDISH EDMONDS Part V, Section B, Line 24: FOR NON-MEDICALLY NECESSARY SERVICES, A PATIENT MAY BE CHARGED FULL BILLED CHARGES. Part V, Section B, Line 3I THE FOLLOWING ACTIONS WERE TAKEN TO ADDRESS SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN THE PRIOR CHNA: -45 COMMUNITY OUTREACH PROJECTS AND PROGRAMS TO INCREASED NUMBER OF INSURED PATIENTS WITH THE ACA INCREASE SIGN UP SESSION, INSURANCE LITERACY AND TRANSLATION SERVICES FOR OVER 450 INDIVIDUALS.-COMMUNITY PARTNERSHIP WITH 7 FQHC TO INCREASE REFERRALS TO PRIMARY CARE AND SPECIALTY CARE. INVOLVING CAREGIVERS WHO VOLUNTEERS 6500 HOURS TO PARTICIPATE IN OUTREACH PROGRAMS, SCREENING AND EDUCATION FOR THE UNDERINSURED AND UNDERSERVICES COMMUNITY, RESIDENTS, PATIENTS AND FAMILIES. Part V, Section B, Line 7A CHNA REPORT WEBSITEHTTP://WWW.SWEDISH.ORG/ABOUT/OVERVIEW/MISSION-OUTREACH/COMMUNITY-ENGAGEMENT/COMMUNITY-NEEDS-ASSESSMENT Part V, Section B, Line 10A HOSPITAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY WEBSITEHTTPS://WWW.SWEDISH.ORG/ABOUT/OVERVIEW/MISSION-OUTREACH/COMMUNITY-ENGAGEMENT/COMMUNITY-NEEDS-ASSESSMENT/ASSESSMENTS-SITE-LIST 33 1 - DIABETES EDUCATION AND NUTRITION - EDMON 21601 76TH AVE W EDMONDS WA 98026 EDUCATION 2 - MEDICAL IMAGING - EDMONDS 21601 76TH AVE W EDMONDS WA 98026 IMAGING CENTER 3 - CARDIAC DIAGNOSTIC IMAGING - EDMONDS 7320 216TH ST SW SUITE 110 EDMONDS WA 98026 IMAGING CENTER 4 - LABORATORY 21601 76TH AVE W EDMONDS WA 98026 LAB 5 - LAB PATIENT SERVICES CENTER AT STEVENS P 21616 76TH AVE W SUITE 208 EDMONDS WA 98026 LAB 6 - LAB PATIENT SERVICES CENTER AT 76 COMMON 21911 76TH AVE SUITE 207 EDMONDS WA 98026 LAB 7 - LAB PATIENT SERVICES CENTER AT EDMONDS M 7320 216TH ST SW SUITE 130 EDMONDS WA 98026 LAB 8 - EDMONDS PRIMARY CARE 7320 216TH ST SW EDMONDS MEDICAL PAVILI EDMONDS WA 98026 PRIMARY CARE 9 - OUTPATIENT REHABILITATION - EDMONDS 21601 76TH AVE W EDMONDS WA 98026 REHAB & PHYSICAL THERAPY 10 - EDMONDS URGENT CARE 21600 HIGHWAY 99 KRUGER BUILDING SUITE EDMONDS WA 98026 SPECIALTY CLINIC 11 - PEDIATRICS - EDMONDS 21600 HIGHWAY 99 KRUGER CLINIC BLDG SU EDMONDS WA 98026 SPECIALTY CLINIC 12 - WOUND HEALING & HYPERBARICS 21600 HIGHWAY 99 KRUGER CLINIC BUILDING EDMONDS WA 98026 SPECIALTY CLINIC 13 - MEDICAL ONCOLOGY - EDMONDS 21632 HIGHWAY 99 EDMONDS WA 98026 SPECIALTY CLINIC 14 - ONCOLOGY SOCIAL WORK - EDMONDS 21632 HIGHWAY 99 EDMONDS WA 98026 SPECIALTY CLINIC 15 - BIRTH & FAMILY CLINIC - EDMONDS 21911 76TH AVE W 76 COMMONS SUITE 11 EDMONDS WA 98026 SPECIALTY CLINIC 16 - HEART & VASCULAR - EDMONDS PROFESSIONAL 7315 212TH ST SW SUITE 205 EDMONDS WA 98026 SPECIALTY CLINIC 17 - HEART & VASCULAR - EDMONDS MEDICAL PAVIL 7320 216TH ST SW SUITE 210 EDMONDS WA 98026 SPECIALTY CLINIC 18 - BREAST CENTER - EDMONDS 7320 216TH ST SW SUITE 120 EDMONDS WA 98026 SPECIALTY CLINIC 19 - SLEEP MEDICINE - EDMONDS 7320 216TH ST SW SUITE 40 EDMONDS WA 98026 SPECIALTY CLINIC 20 - EDMONDS NEUROLOGY 7320 216TH ST SW SUITE 310 EDMONDS WA 98026 SPECIALTY CLINIC 21 - CARDIAC REHABILITATION - EDMONDS 21601 76TH AVE W EDMONDS WA 98026 SPECIALTY CLINIC 22 - COLON & RECTAL CLINIC - EDMONDS 21605 76TH AVE W STE 200 EDMONDS WA 98026 SPECIALTY CLINIC 23 - EDMONDS BIRTH CENTER 21601 76TH AVE W EDMONDS WA 98026 SPECIALTY CLINIC 24 - EDMONDS MENTAL HEALTH SERVICES 21601 76TH AVE W EDMONDS WA 98026 SPECIALTY CLINIC 25 - EDMONDS SPECIALTY CLINIC 21616 76TH AVE W STE 212 EDMONDS WA 98026 SPECIALTY CLINIC 26 - ENDOSCOPY CENTER - EDMONDS 21601 76TH AVE W EDMONDS WA 98026 SPECIALTY CLINIC 27 - INFECTIOUS DISEASE 21616 76TH AVE W EDMONDS WA 98026 SPECIALTY CLINIC 28 - NUTRITION CARE CLINIC - EDMONDS 21601 76TH AVE W EDMONDS WA 98026 SPECIALTY CLINIC 29 - OBGYN SPECIALISTS EDMONDS 21616 76TH AVE W STE 205 EDMONDS WA 98026 SPECIALTY CLINIC 30 - PALLIATIVE CARE CLINIC - EDMONDS 21616 76TH AVE W EDMONDS WA 98026 SPECIALTY CLINIC 31 - PULMONARY REHABILITATION - EDMONDS 21601 76TH AVE W EDMONDS WA 98026 SPECIALTY CLINIC 32 - RADIATION ONCOLOGY - EDMONDS 21605 76TH AVE W STE 100 EDMONDS WA 98026 SPECIALTY CLINIC 33 - VASCULAR SURGERY - EDMONDS PROFESSIONAL 7315 212TH ST SW STE 205 EDMONDS WA 98026 SPECIALTY CLINIC Part I, Line 3c: IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. Part I, Line 6a: IN ADDITION TO HAVING COMMUNITY BENEFIT INFORMATION INCLUDED IN THE CONSOLIDATED SWEDISH HEALTH SERVICES COMMUNITY BENEFIT REPORT, THIS INFORMATION IS ALSO INCLUDED IN THE PROVIDENCE HEALTH & SERVICES COMMUNITY BENEFIT REPORT. Part I, Line 7: COSTS FOR TABLE 7 ARE FROM ACTUAL EXPENSES INCURRED. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 7,723,358. Part I, Line 7, Column (g) NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. Part III, Line 2: THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. Part III, Line 4: THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. Part III, Line 8: THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. Part III, Line 9b: PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. Part VI, Line 2: NEEDS ASSESSMENTSWEDISH EDMONDS PUT TOGETHER A SMALL SUBGROUP OF EMPLOYEES TO DEVELOP THE CHNA. THEY PARTNERED WITH VERDANT HEALTH COMMISSION TO SOURCE DEMOGRAPHIC DATA OF ZIP CODES WITHIN THE PATIENT POPULATION HEALTH NEEDS AREA. SWEDISH EDMONDS SURVEYED 10 COMMUNITY BASED GROUPS TO IDENTIFY HEALTH RISK AND CHRONIC ILLNESS AND ISSUES IN THE COMMUNITY. TOGETHER WITH VERDANT HEALTH AND SWEDISH THEY ANALYSIS THE DATA TO DETERMINE SIGNIFICANT HEALTH INDICATORS. RECOMMENDATIONS WERE MADE TO SWEDISH EDMONDS LEADERSHIP USING THE ASSESSMENT TOOL FROM VERDANT AND EDMONDS WAS ABLE TO DETERMINE THE TOPIC HEALTH INDICATORS AND DEVELOP ITS REPORT. Part VI, Line 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCESWEDISH HOSPITALS ARE COMMITTED TO THE PROVISION OF HEALTHCARE SERVICES TO ALL PERSONS IN NEED OF MEDICAL ATTENTION REGARDLESS OF THEIR ABILITY TOPAY. EMPLOYEES ARE RESPONSIBLE FOR PROCESSING APPLICATIONS IN A RESPECTFUL AND COURTEOUS MANNER. PROCESSING SHOULD IN NO WAY DISCOURAGE PATIENTS FROM RECEIVING HEALTHCARE OR RESULT IN THE DELAYED PROVISION OF ESSENTIALHEALTHCARE SERVICES. CHARITY CARE/FINANCIAL ASSISTANCE ARE AVAILABLE TOANY ELIGIBLE PATIENT WITHOUT REGARD TO RACE, COLOR, SEX, RELIGION, AGE ORNATIONAL ORIGIN. ALL INTERACTIONS WITH PATIENTS MUST RESPECT THE INHERENTWORTH OF ALL PERSONS AND THEIR INDIVIDUAL DIGNITY.PUBLIC NOTICES:OUR FINANCIAL ASSISTANCE (CHARITY CARE) POLICY IS MADE AVAILABLE VIA WALLPOSTERS THAT ARE LOCATED IN REGISTRATION AREAS AND EMERGENCY DEPARTMENTS. LETTER SIZE POSTERS ARE ALSO AVAILABLE IN DEPARTMENTS AND HEALTH RESOURCE CENTERS.BROCHURES ARE AVAILABLE FOR DISSEMINATION OR UPON REQUEST AND ARE AVAILABLE IN SEVERAL LANGUAGES INCLUDING, BUT NOT LIMITED TO, ENGLISH,SPANISH, CHINESE, VIETNAMESE AND KOREAN. BROCHURES, APPLICATIONS AND THE SLIDING SCALE ARE AVAILABLE TO ANY PERSON REQUESTING THE INFORMATIONWHETHER IN PERSON, BY MAIL OR BY TELEPHONE.TIMING OF APPLICATION:PATIENTS MAY APPLY FOR CHARITY CARE PRIOR TO SERVICE, AT THE TIME OFSERVICE OR AT ANY POINT IN THE BILLING PROCESS UP TO THE RESOLUTION OF THEACCOUNT.IDENTIFICATION OF CHARITY CARE CANDIDATES:EVERY EFFORT IS MADE TO IDENTIFY PATIENTS WHO WOULD BENEFIT FROM CHARITYCARE AT THE EARLIEST POINT POSSIBLE. CARE FOR A PATIENT'S WELL-BEING IS ASIMPORTANT AS CARE FOR THEIR MEDICAL NEEDS. IT IS OUR GOAL TO DIMINISH APATIENT'S WORRY OVER HEALTHCARE BILLS. EMPLOYEES MUST BE ALERT TOINDICATIONS THAT THE PATIENT OR FAMILY HAS CONCERNS ABOUT THEIR ABILITY TOPAY HEALTHCARE BILLS, EVEN IF THE PATIENT DOES NOT SPECIFICALLY ASK ABOUTCHARITY CARE OR FINANCIAL ASSISTANCE.GENERAL APPLICATION PROCESS:ONCE A PATIENT IS IDENTIFIED AS A CHARITY CARE CANDIDATE, THE PATIENT WILLBE INTERVIEWED. INTERPRETERS WILL BE OFFERED AND ARRANGED AS APPROPRIATE. Part VI, Line 4: COMMUNITY INFORMATIONGEOGRAPHICALLY, SWEDISH EDMONDS IS LOCATED IN SNOHOMISH COUNTY, SITUATED BETWEEN NORTHERN PUGET SOUND TO THE WEST AND THE CREST LINE OF THE NORTH CASCADE RANGE TO THE EAST. IT SHARES ITS NORTHERN BORDER WITH RURAL SKAGIT COUNTY AND BORDERS KING COUNTY TO THE SOUTH.DUE TO ITS PROXIMITY TO AND SHARED LABOR MARKET WITH KING COUNTY, SNOHOMISH COUNTY IS INCORPORATED INTO THE SEATTLE, BELLEVUE, EVERETT METROPOLITAN STATISTICAL AREA, AS DESIGNATED BY THE BUREAU OF LABOR STATISTICS.THE GEOGRAPHICAL DISTRIBUTION OF POPULATION, ECONOMIC ACTIVITY AND LAND USE IN SNOHOMISH COUNTY IS DIVERS, WITH A MIX OF RURAL AND URBAN ZONES. FOR THE MOST PART, POPULATION CENTERS IN THE COUNTY ARE ORIENTED SOUTH IN PROXIMITY TO THE BORDER WITH KING COUNTY AND WEST ALONG INTERSTATE 5. BY CONTRAST, NORTH AND EAST SNOHOMISH COUNTY ARE CHARACTERIZED BY SMALLER CITIES, FARMS AND RESERVATIONS.SNOHOMISH COUNTY TOTAL POPULATION WAS APPROXIMATELY 713,335 PEOPLE IN 2010 WITH EDMONDS RANKED THE 3RD MOST POPULOUS CITY IN SNOHOMISH COUNTY AND THE 26TH MOST POPULOUS CITY IN WASHINGTON STATE. WITH A MEDIAN AGE OF 31, APPROXIMATELY 10% OF THE POPULATION IS AGE 65 OR OLDER AND TRENDING TO BE THE FASTEST GROWING AGE COHORT OVER THE NEXT FIVE YEARS. THE POPULATION WITHIN SNOHOMISH COUNTY HAS CONTINUED TO GROW STEADILY SINCE 2010: 730,500 IN 2013, 741,000 IN 2014, AND 757,600 IN 2015.THE RACIAL AND ETHNIC MAKEUP OF SNOHOMISH COUNTY SHOWS A RELATIVE UNDERPRESENTATION OF BALCK (3.1%) AND HISPANIC RESIDENTS (9.7%) COMPARED TO THE STATE AND A HIGHT REPRESENTATION OF ASIAN RESIDENTS (10.7%). SNOHOMISH COUNTY HAS, AND CONTINUES TO BE, HOME TO A NUMBER OF NATIVE AMERICAN TRIBES.IN 2015, THE TOTAL MALE POPULATION IN SNOHOMISH COUNTY IS ABOUT 234,872 AND FEMALE POPULATION IS 242,677. COMPARED TO WASHINGTON STATE AND THE US AS A WHOLE, SNOHOMISH COUNTY RESIDENTS AGE 25 AND ABOVE ARE MORE LIKELY TO HAVE GRADUATED FROM HIGH SCHOOL; 91.1% HAD A HIGH SCHOOL DIPLOMA.THE AVERAGE ANNUAL WAGE FOR ALL INDUSTRIES IN 2014 WAS $55,414. THE MEDIAN HOURLY WAGE WAS $25.03 IN 2013, COMPARED TO A STATEWIDE MEDIAN WAGE OF $22.09 PER HOUR. IN 2013, 11.3% OF THE RESIDENT POPULATION OF SNOHOMISH COUNTY WAS ESTIMATED TO BE LIVING BELOW POVERTY LEVEL.SNOHOMISH COUNTY'S 2014 LABOR FORCE AVERAGED 395,317 WITH AN UNEMPLOYMENT RATE OF 5.1%. Part VI, Line 5: PROMOTION OF COMMUNITY HEALTHSENIOR LEADERSHIP COMMUNITY BOARDS PARTICIPATION - AMERICAN RED CROSS, EDMONDS CHAMBER OF COMMERCE, EDMONDS COMMUNITY COLLEGECOMMUNITY HEALTH FAIRS - TASTE OF EDMONDS, FIRE SAFETY DAYS, TASTE OF LYNWOOD, REDMOND'S DAY, MUSIC IN THE PARK, EDMONDS HIGH SCHOOL MEAL PROGRAM - EDMONDS FOOD BANK, SNOHOMISH COUNTY FOOD PANTRY IN-KIND DONATIONS - MEDICAL EQUIPMENT AND SUPPLIES EMERGENCY PREPAREDNESS - LIFE SUPPORT, SCHOOLS AND COMMUNITY CENTERSCOMMUNITY EDUCATION - SUICIDE PREVENTION AND EDUCATION Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEMEFFECTIVE JULY 1, 2016, PROVIDENCE HEALTH & SERVICES AND ST. JOSEPH HEALTH CAME TOGETHER TO SERVE MORE PEOPLE IN A PARTNERSHIP THAT JOINS TWO REMARKABLE ORGANIZATIONS WITH RICH HERITAGES. WE ARE NOW CONNECTED BY A NEW PARENT ORGANIZATION, PROVIDENCE ST. JOSEPH HEALTH. TOGETHER, OVER 100,000 OF OUR CAREGIVERS (EMPLOYEES) NOW SERVE IN 50 HOSPITALS, OVER 800 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. ALL HOSPITALS AND OTHER MINISTRIES WILL MAINTAIN THEIR CURRENT NAMES AND IDENTITIES. THIS PARENT STRUCTURE ALLOWS OUR FAMILY OF DIVERSE ORGANIZATIONS TO WORK TOGETHER TO MEET THE NEEDS OF OUR COMMUNITIES BOTH TODAY AND INTO THE FUTURE. Part VI, Line 7, Reports Filed With States WA 1 1 0 0 0 0 0 0 0 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 0 192673 0 44659 0 10854 0 11200 0 8812 0 268198 0 0 VENKAT BHAMIDIPATI EVP/TREASURER 0 318745 0 300000 0 19564 0 832107 0 15871 0 1486287 0 0 MIKE BUTLER PRESIDENT 0 1294695 0 1189568 0 44889 0 2065833 0 29624 0 4624609 0 0 JO ANN ESCASA-HAIGH INTERIM CFO/TREASURER 0 623838 0 711543 0 36709 0 647363 0 20322 0 2039775 0 0 CINDY STRAUSS SECRETARY 0 697944 0 624379 0 420759 0 988958 0 31256 0 2763296 0 386962 JOHN WHIPPLE ASSISTANT SECRETARY 0 415579 0 303904 0 35317 0 459620 0 25428 0 1239848 0 0 JENNIFER GRAVES CEO/SWEDISH EDMONDS 0 12973 0 87666 0 408642 0 196 0 8004 0 517481 0 160830 ANTHONY ARMADA EDUCATION CE/SWEDISH - THRU 2/17 0 186452 0 768575 0 1521627 0 4050 0 28132 0 2508836 0 931602 JEAN DOERGE NURSE EXECUTIVE 213883 0 21993 0 19552 0 15855 0 20573 0 291856 0 0 0 ELENA GEAMANU PHYSICIAN/ENDOCRINOLOGY 210571 0 72839 0 18352 0 18900 0 29858 0 350520 0 0 0 JORETTE RAMIREZ STAFF RN (ICU) 236113 0 0 0 2829 0 13774 0 27240 0 279956 0 0 0 PETER RO PHYSICIAN/HYPERBARIC MEDICINE 377049 0 0 0 19350 0 18900 0 25053 0 440352 0 0 0 SANDEEP SACHDEVA CMO 292207 0 39608 0 45696 0 17666 0 17905 0 413082 0 0 0 DAN HARRIS FORMER VP FINANCE/ WA & AK 0 10131 0 161044 0 1642012 0 0 0 10720 0 1823907 0 1205017 ROD F HOCHMAN MD FORMER PRESIDENT 0 1974688 0 2203431 0 1090976 0 6285602 0 28363 0 11583060 0 1049676 TODD HOFHEINS FORMER EVP/CFO/TREAS. 0 15196 0 527139 0 1596780 0 10544 0 34931 0 2184590 0 777867 DAVID BROWN FORMER VP/STRATEGY & BUSINESS DEV. 0 373180 0 325150 0 1955 0 429702 0 27658 0 1157645 0 0 DEBBIE BURTON FORMER SVP/ CHIEF NRSG. OFFICER 0 353784 0 266872 0 155793 0 356594 0 30608 0 1163651 0 118981 DEBRA CANALES FORMER EVP/CAO 0 835135 0 795839 0 43428 0 1213992 0 22272 0 2910666 0 0 MICHAEL C CARTER FORMER CAO 0 109371 0 604 0 405 0 10092 0 17840 0 138312 0 0 AMY COMPTON-PHILLIPS FORMER EVP / CHIEF CLINICAL OFFICER 0 745415 0 499341 0 246460 0 992391 0 32410 0 2516017 0 0 MARY CRANSTOUN FORMER VP/TOTAL REWARDS 0 393699 0 291571 0 20135 0 454896 0 27450 0 1187751 0 0 JOHN FLETCHER FORMER VP/OPERATIONS SUPPORT 0 101601 0 0 0 2369 0 8415 0 11971 0 124356 0 0 MARK GARGETT FORMER VP/DIGITAL INTEGRATION 0 384503 0 158399 0 189098 0 303326 0 20923 0 1056249 0 148496 JOEL GILBERTSON FORMER SVP/COMMUNITY PARTNERSHIPS 0 470184 0 351171 0 34959 0 523643 0 28741 0 1408698 0 0 OREST HOLUBEC FORMER SVP/CHIEF COMM./EXT. AFFAIRS 0 415423 0 338118 0 35329 0 455947 0 28061 0 1272878 0 0 AARON MARTIN FORMER SVP/STRATEGY & INNOVATION 0 564005 0 316363 0 20003 0 707371 0 8648 0 1616390 0 0 TOM MCDONAGH FORMER VP/CHIEF INVESTMENT OFFICER 0 467734 0 324164 0 38723 0 516307 0 30180 0 1377108 0 0 RHONDA MEDOWS MD FORMER EVP/POPULATION HEALTH 0 858356 0 681403 0 42645 0 1101998 0 24344 0 2708746 0 0 JANICE NEWELL FORMER SVP/CHIEF INFORMATION OFFICER 0 599228 0 478973 0 318624 0 721041 0 17589 0 2135455 0 286030 HARVEY SMITH FORMER SVP/CHIEF CUSTOMER SVC. OFFIC 0 48492 0 372926 0 626764 0 34353 0 13143 0 1095678 0 86922 TERRY SMITH FORMER SVP/MANAGEMENT SVCS 0 187534 0 24001 0 1981 0 9657 0 9340 0 232513 0 0 PAUL STODDART FORMER VP/MARKETING 0 0 0 0 0 175547 0 0 0 8264 0 183811 0 0 GREG TILL FORMER VP/CHIEF TALENT OFFICER 0 396535 0 297987 0 19038 0 461102 0 30490 0 1205152 0 0 SHARON TONCRAY FORMER SVP/CHIEF LABOR EMP. COUNSEL 0 416606 0 321829 0 28095 0 526958 0 30363 0 1323851 0 0 LISA VANCE FORMER SVP/CLINICAL PROGRAM SERVICES 0 562680 0 510329 0 618093 0 654509 0 27816 0 2373427 0 579369 MIKE WATERS FORMER VP,CAO/PHYSICIAN SERVICES 0 431525 0 194089 0 17296 0 451441 0 12309 0 1106660 0 0 CRAIG WRIGHT MD FORMER SVP/PHYSICIAN SERVICES 0 0 0 0 0 245590 0 3661 0 7255 0 256506 0 100000 Part I, Line 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS RELATED ORGANIZATION, PROVIDENCE ST. JOSEPH HEALTH, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE ST. JOSEPH HEALTH. Part I, Lines 4a-b THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN 2017: ANTHONY ARMADA - $575,654 JENNIFER GRAVES - $246,483 DAN HARRIS - $432,694 TODD HOFHEINS - $739,260 HARVEY SMITH - $519,285 PAUL STODDART - $177,790 CRAIG WRIGHT MD - $144,200 BEGINNING IN JULY 2015, NEW EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PLAN PROVIDES FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND ARE SUBJECT TO A FIVE-YEAR OR AGE 65 VESTING SCHEDULE. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. THE AMOUNTS SHOWN IN COLUMN F OF PART II REFLECT CURRENT YEAR PAYOUTS FROM THESE PLANS. FORM 990, SCHEDULE J, PART II - EXECUTIVE INCENTIVE PROGRAM SWEDISH EXECUTIVES PARTICIPATE IN THE PROVIDENCE EXECUTIVE INCENTIVE PROGRAM WHICH PROVIDES A LUMP SUM AWARD ANNUALLY AS A PERCENT OF THE EXECUTIVE'S BASE PAY. PERCENT OPPORTUNITIES ARE ALIGNED WITH OUR TOTAL COMPENSATION PHILOSOPHY AS OUTLINED IN PART VI, SECTION B, LINE 15 (PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT, OFFICERS & KEY EMPLOYEES). THE PERFORMANCE AWARD IS BASED ON THE LEVEL OF ACCOMPLISHMENT OF ANNUAL SYSTEM AND FUNCTIONAL (OR REGIONAL) OBJECTIVES. IN 2017, 60 PERCENT OF THE PARTICIPANT AWARDS WERE BASED ON PRE-DETERMINED ORGANIZATIONAL GOALS CONSISTENT WITH PROVIDENCE'S STRATEGIC PRIORITIES. THE REMAINING 40% WAS BASED ON A ROBUST SET OF FUNCTION SPECIFIC GOALS DESIGNED TO ALIGN CRITICAL MISSION AND BUSINESS DRIVERS. IN 2017 THE PERCENT ALLOCATION FOR EACH OF THESE STRATEGIC PRIORITIES WAS AS OUTLINED BELOW: SYSTEM GOALS: FIRST-YEAR TURNOVER - 10% INPATIENT EXPERIENCE - 5% PATIENT EXPERIENCE - 5% MEDICAL GROUP PATIENT EXPERIENCE - 5% COMMUNITY BENEFIT - 10% CLINICAL EXCELLENCE - 15% FREE CASH FLOW - 10% Form 990, Part III, line 2 IN 2017, WE RELOCATED OUR DAY SURGERY UNIT IN ORDER TO RECLAIM SOME ADDITIONAL INPATIENT CAPACITY FOR GROWTH IN OUR WOMEN'S SERVICES PROGRAM. THIS UNIT ACCOMODATES BOTH POSTPARTUM PATIENTS AND CERTAIN FEMALE POST-SURGICAL PATIENTS. Form 990, Part III, line 3 IN 2017, WE CLOSED OUR EYE CENTER. WE HAD SEEN DECLINING VOLUMES AND WERE HEARING FROM PATIENTS THAT THIS SERVICE WAS NOT BEING COVERED BY INSURANCE IN A HOSPITAL SETTING SO THEY WERE CHOOSING TO HAVE THE SERVICE PERFORMED ELSEWHERE. WE HAVE PLANS TO USE THE SPACE OCCUPIED BY THIS AREA FOR OTHER MINOR PROCEDURES. Form 990, Part VI, Section A, line 6 WESTERN HEALTH CONNECT IS THE SOLE CORPORATE MEMBER OF SWEDISH EDMONDS. Form 990, Part VI, Section A, line 7a SWEDISH EDMONDS HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT DIRECTORS TO THE SWEDISH EDMONDS BOARD. Form 990, Part VI, Section A, line 7b THE FOLLOWING POWERS ARE RESERVED TO AND EXERCISED EXCLUSIVELY BY THE MEMBER: A) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS. B) TO APPROVE THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE, TRANSFER, ASSIGNMENT OR ENCUMBERING OF ASSETS. C) TO APPROVE THE DISSOLUTION, LIQUIDATION, CONSOLIDATION OR MERGER WITH ANOTHER CORPORATION OR ENTITY. D) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION ON A CONSOLIDATED REGION-WIDE BASIS AND RECOMMEND APPROVAL OF THE CORPORATION'S BUDGET. E) TO APPOINT CERTIFIED PUBLIC ACCOUNTANTS AFTER RECEIVING THE RECOMMENDATION OF THE BOARD OF DIRECTORS, AND TO RECEIVE THE ANNUAL AUDIT REPORT FROM SUCH ACCOUNTANTS. Form 990, Part VI, Section B, line 11b THE FORM 990 WAS PREPARED BY THE TAX DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AND WAS REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD. DURING THE AUDIT COMMITTEE MEETING, MANAGEMENT PRESENTED AND DISCUSSED CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE AUDIT COMMITTEE CHAIR THEN PROVIDED A SUMMARY AT THE FULL BOARD MEETING. Form 990, Part VI, Section B, line 12c BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY REAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PSJH COI POLICY AND IN CONNECTION WITH THAT INDIVIDUAL SATISFYING HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY AND/OR IF AT ANY TIME AN ACTUAL, REAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PSJH CHIEF LEGAL OFFICER AND/OR THE PSJH CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR CONSIDER MATTERS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER. PSJH CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING WHEN ACTION IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF COI DISCLOSURES IS RETAINED PER ORGANIZATION RETENTION POLICY. Form 990, Part VI, Section B, line 15 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS RELATED ORGANIZATION, PROVIDENCE ST. JOSEPH HEALTH, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE ST. JOSEPH HEALTH'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ST. JOSEPH HEALTH ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE ST. JOSEPH HEALTH HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE ST. JOSEPH HEALTH MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE ST. JOSEPH HEALTH'S LEGAL ENTITIES. PROVIDENCE ST. JOSEPH HEALTH ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE ST. JOSEPH HEALTH HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS OFFICERS, INCLUDING OUR SENIOR EXECUTIVES. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED BY THE PROVIDENCE ST. JOSEPH HEALTH COMMITTEE. THE BOARD RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE ST. JOSEPH HEALTH IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS WHOSE REVENUE IS SIMILAR TO THAT OF PROVIDENCE ST. JOSEPH HEALTH. ADDITIONALLY, PROVIDENCE ST. JOSEPH HEALTH'S LABOR MARKET CONTINUES TO SPREAD ACROSS HEALTH CARE AND INTO GENERAL INDUSTRY. BECAUSE OF THIS, PROVIDENCE ST. JOSEPH HEALTH ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY FOR-PROFIT MARKET DATA, WHERE APPLICABLE. BASE SALARIES FOR PROVIDENCE ST. JOSEPH HEALTH EXECUTIVES ARE GENERALLY TARGETED TO THE MEDIAN LEVEL OF THE MARKET, AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY ACHIEVE SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE ST. JOSEPH HEALTH OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS AND MIRRORS BEST PRACTICES. THE PROCESS TO REVIEW COMPENSATION WAS LAST COMPLETED IN MARCH 2018. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE PSJH COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PSJH INTERNET SITE. AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990. Form 990, Part IX, line 11g AGENCY/CONTRACT LABOR: Program service expenses 3,106,844. Management and general expenses 1,600,496. Fundraising expenses 0. Total expenses 4,707,340. MEDICAL DIR & MED PHYSICIAN FEES: Program service expenses 3,398,889. Management and general expenses 1,750,943. Fundraising expenses 0. Total expenses 5,149,832. REPAIRS & MAINTENANCE: Program service expenses 866,198. Management and general expenses 446,223. Fundraising expenses 0. Total expenses 1,312,421. OTHER PATIENT SERVICES: Program service expenses 2,145,903. Management and general expenses 1,105,465. Fundraising expenses 0. Total expenses 3,251,368. OTHER ADMINISTRATIVE SERVICES: Program service expenses 1,591,238. Management and general expenses 819,728. Fundraising expenses 0. Total expenses 2,410,966. GENERAL CONSULTING FEES: Program service expenses 408,063. Management and general expenses 210,215. Fundraising expenses 0. Total expenses 618,278. Form 990, Part X, Line 20 THE TAX-EXEMPT BOND LIABILITIES WERE TRANSFERRED FROM SWEDISH EDMONDS TO ITS TAX EXEMPT PARENT, PROVIDENCE ST. JOSEPH HEALTH, DURING THE YEAR ENDED 12/31/17. THE TAX-EXEMPT BOND LIABILITY IN PART X, LINE 20 HAS BEEN RECLASSED AS AN INTERCOMPANY LIABILITY FOR TAX-EXEMPT BONDS IN PART X, LINE 25. Form 990, Part XI, line 9: IAF TRANSFERS -27,279,246. IAF GRANT -17,057. ROUNDING 3. COVENANT ACO 3615 19TH STREET LUBBOCK TX 79410 611573313 HEALTHCARE TX 501(c)(3) 12,I CHS 1 COVENANT HEALTH NETWORK INC 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 461259908 HEALTHCARE CA 501(c)(3) 12,III SJHS 1 COVENANT HEALTH PARTNERS 3615 19TH STREET LUBBOCK TX 79410 463516417 HEALTHCARE TX 501(c)(3) 12,I CHS 1 COVENANT HEALTH SYSTEM 3615 19TH STREET LUBBOCK TX 79410 752765566 HEALTHCARE TX 501(c)(3) 3 SJHS 1 COVENANT HEALTH SYSTEM FOUNDATION 3623 22ND PLACE LUBBOCK TX 79410 752897026 HEALTHCARE TX 501(c)(3) 7 CHS 1 COVENANT MEDICAL GROUP 3420 22ND PLACE LUBBOCK TX 79410 752743883 HEALTHCARE TX 501(c)(3) 3 CHS 1 E WA & MT UNEMPLOYMENT COMPENSATION INSURANCE TRUST 1801 LIND AVENUE SW 9016 RENTON WA 980579016 911082119 UNEMPLOYMENT WA 501(c)(3) 12,I PHS WA 1 EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT WA 982065128 943264605 TRANS. 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