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 930863097 PROVIDENCE HEALTH PLAN PROV 5035747500 4400 NE HALSEY BLDG 2 PORTLAND OR 97213 MICHAEL G WHITE CFO/TREASURER 5035747500 2018-11-14 1 INAS RAOUF P01254678 9497942300 198.134.52.73 2018-11-14 23:57:42 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 F9954457A230D2217538EB78B690AB1CFA3B7FEF 2017 2019-02-21 02:37:17Z MICHAEL L COTTON 4400 NE HALSEY BLDG 2 PORTLAND OR 97213 2389476155 0 X HEALTHPLANS.PROVIDENCE.ORG/INDIVIDUALS-FAMILIES/ X 1998 OR SEE SCHEDULE OAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 6 3 0 0 0 0 0 0 1194307321 1381189199 11727901 8524990 965842 1112957 1207001064 1390827146 420247 443265 0 0 82787888 82494502 0 0 0 1153448545 1292819308 1236656680 1375757075 -29655616 15070071 739167042 792530930 247813674 263222450 491353368 529308480 X AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 1291775179 0 1294627843 SEE SCHEDULE OPROVIDENCE HEALTH PLANS (PHP) OFFERS VARIOUS COMMERCIAL GROUP AND INDIVIDUAL AND FAMILY PLANS, THROUGHOUT OREGON AND WASHINGTON. COMMERCIAL GROUP COVERAGE IS OFFERED TO EMPLOYERS WHO PROVIDE ACCESS TO HEALTH COVERAGE TO THEIR EMPLOYEES, WHILE INDIVIDUAL AND FAMILY PLANS ARE OFFERED BOTH ON AND OFF OF THE PUBLIC EXCHANGES. TO DELIVER TRUE HEALTH TO OUR MEMBERS, PHP FOCUSES ON INNOVATION, PERSONALIZED MEDICINE, COLLABORATION AMONG DIVERSE PARTNERS, AND STABILITY. PHP ALSO PARTICIPATES IN HEALTH MEASUREMENT PROGRAMS, INCLUDING HEALTHCARE EFFECTIVENESS DATA AND INFORMATION SET (HEDIS), WHICH ALLOW US TO BENCHMARK OUR CARE AND SERVICE, AND IMPLEMENT A TARGETED APPROACH TO IMPROVING MEMBER HEALTH AND SERVICE. IN 2017, OUR HEDIS SCORE PUT US IN THE 90TH PERCENTILE FOR COMMERCIAL PLANS IN SIX MEASURES INCLUDING: FOLLOW-UP CARE FOR CHILDREN PRESCRIBED ADHD MEDICATION, COMPREHENSIVE DIABETES CARE (HBA1C TESTING), PHARMACOTHERAPY MANAGEMENT OF COPD EXACERBATION, AND USE OF IMAGING STUDIES FOR LOW BACK PAIN. IN RECOGNITION OF OUTSTANDING SERVICE AND HIGH HEDIS CLINICAL QUALITY SCORES, THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) AWARDED PHP AN ACCREDITATION STATUS OF COMMENDABLE. PHP ALSO EARNED A 4.0 RATING AND WAS RECOGNIZED BY NCQA AS THE HIGHEST-RATED PPO HEALTH PLAN IN OREGON (OUT OF NINE PPO PLANS). DURING 2017, PHP SERVED APPROXIMATELY 269,000 MEMBERS. 53752831 0 86561356 PROVIDENCE OFFERS PROVIDENCE ADMINISTRATIVE SERVICES ONLY (ASO) FOR LARGE GROUPS CAPABLE OF SELF-FUNDING THE RISK EXPERIENCE OF THE GROUP, BUT ALSO WANT THE DEDICATED AND COMPASSIONATE SERVICE THAT PROVIDENCE DELIVERS FOR CLAIMS ADMINISTRATION, MEMBER SERVICE, AND SKILLED MEDICAL MANAGEMENT. ASO GROUPS ARE OFFERED OPTIONS FOR A WIDE ARRAY OF PLAN BENEFITS, INCLUDING PREVENTATIVE CHOICES AIMED AT IMPROVING EMPLOYEE HEALTH AND WELLNESS, ALTERNATIVE CARE, GROUP HEALTH REPORTING AND METRICS, ACCESS TO PROVIDENCE PROVIDER NETWORKS AND PROPRIETARY HEALTH INNOVATIONS, AND CONSUMER CHOICE PLANS WHICH OFFER QUALIFIED HEALTH SAVINGS ACCOUNT (HSA) OPTIONS. THIS PROGRAM SERVED APPROXIMATELY 286,000 MEMBERS IN 2017. 443265 443265 0 GRANTS AND ALLOCATIONS TO 501(C)(3) ORGANIZATIONS: SEE SCHEDULE I 1345971275 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 19594 0 1 0 0 0 0 0 0 0 X 6 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 OR X MICHAEL G WHITE 5035747500 4400 NE HALSEY BLDG 2 PORTLAND OR 97213 ISIAAH CRAWFORD PHD DIRECTOR 0.10 4.10 X 0 30360 0 GILBERT RODRIGUES MD DIRECTOR 2.00 3.00 X 0 0 0 HEATH SCHIESSER DIRECTOR 2.00 3.00 X 0 0 0 MICHAEL L COTTON PRESIDENT / CEO 32.00 18.00 X X 0 868879 631210 TODD HOFHEINS DIRECTOR (PART YEAR) 0.10 59.90 X 0 2139115 45475 DEBRA CANALES DIRECTOR 0.10 59.90 X 0 1674402 1236264 RHONDA MEDOWS MD CHAIR 2.00 58.00 X X 0 1582404 1126342 MICHAEL G WHITE CFO/TREASURER 32.00 18.00 X 0 519290 381963 GREG ZAMUDIO SECRETARY 30.00 20.00 X 0 293516 151477 STEPHANIE C DREYFUSS DIR. NETWORK DEVELOP. 25.60 14.40 X 0 365872 37118 BRAD GARRIGUES CHIEF MARKETING OFFICER 32.00 18.00 X 0 433308 55648 ROBERT A GLUCKMAN CHIEF MEDICAL OFFICER 32.00 18.00 X 0 665503 470055 MARK JENSEN CHIEF SERVICES OFFICER 32.00 18.00 X 0 280098 53791 JON MCANNIS CHIEF INFO. OFFICER 32.00 18.00 X 0 303693 32971 ALISON SCHRUPP CHIEF ADMIN. OFF. (TERM 2017) 35.20 19.80 X 0 662359 54486 CARRIE L SMITH CHIEF COMPLIANCE OFFICER 32.00 18.00 X 0 346992 50421 MICHAEL J CEMBROLA AVP SALES AND ACCOUNT SVCS 25.60 14.40 X 0 295761 16968 ASHA N CHESNUTT MEDICAL DIRECTOR 25.60 14.40 X 0 271117 39231 LAUREL C SOOT MEDICAL DIRECTOR 25.60 14.40 X 0 274812 40243 ANDREW D TARAB AVP INFORMATICS 25.60 14.40 X 0 279232 22455 GREGORY DIETZMAN AVP HEALTH CARE SERVICES 25.60 14.40 X 0 243950 56773 CINDY STRAUSS FORMER SECRETARY 0.00 60.00 X 0 1743082 1020214 0 13273745 5523105 0 1 1 0 KIBBLE & PRENTICE HOLDING COMPANY PO BOX 62949 VIRGINIA BEACH VA 23466 INSURANCE COMMISSIONS 1105159 PACIFIC BENEFIT CONSULTANTS INC 450 COUNTRY CLUB RD 330 EUGENE OR 97401 INSURANCE COMMISSIONS 839166 THE PARTNERS GROUP 11740 SW 68TH PARKWAY STE 200 PORTLAND OR 97223 INSURANCE COMMISSIONS 793413 MONTGOMERY & GRAHAM INC 412 JEFFERSON PARKWAY STE 100 LAKE OSWEGO OR 97035 INSURANCE COMMISSIONS 714872 BROWN & BROWN OF OREGON INC PO BOX 29018 PORTLAND OR 97296 INSURANCE COMMISSIONS 679168 76 HEALTH INS. PREMIUMS 900099 1294627843 1294627843 ASO FEES 900099 86561356 86561356 1381189199 7521487 7521487 4673717 3560760 1112957 1112957 1112957 996091752 995088249 1003503 1003503 1003503 1390827146 1381189199 0 9637947 443265 443265 2676756 2356210 320546 62230416 54778213 7452203 17587330 15724847 1862483 230816 151761 79055 199192 199192 688677 688677 20020367 18199860 1820507 928837 926280 2557 9979931 5594387 4385544 11211156 7258837 3952319 6980482 4562981 2417501 434622 352920 81702 240643 88027 152616 4519962 4519962 1657063 1657063 39296 39296 MEDICAL CLAIMS 1183183970 1183183970 COMMISSIONS 30902573 30902573 COVER OREGON TAX 9752510 9752510 LOSS-DISPOSAL OF ASSETS 3550797 3550797 8298414 8143837 154577 1375757075 1345971275 29785800 0 27807473 61150833 151929 311492 117243658 46748334 71455474 70495324 316991309 345670437 262448449 250293781 60312408 64609063 739167042 792530930 4589672 5232356 32227637 21584289 210996365 236405805 247813674 263222450 X 0 0 73716441 73716441 417636927 455592039 491353368 529308480 739167042 792530930 X 15070071 -12156093 35041134 X X 0 1 X 1 0 17507420 17507420 66116129 25760036 40356093 1069478 1015704 53774 22046908 18259642 3787266 10503723 1712952 8790771 70495324 PROVIDENCE HEALTH ASSURANCE 250293781 F 250293781 INVESTMENT INCOME ACCRUALS 1264045 REINSURANCE RECEIVABLE 4970795 PROVIDER INCENTIVE RECEIVABLES 34656821 HEALTHCARE RECEIVABLES 14400123 UNINSURED PLAN RECEIVABLES 4715330 PREMIUM RECEIVABLES 4601949 64609063 UNPAID CLAIMS & WITHHOLDINGS 122238726 DUE TO CMS 62113151 FUNDS HELD UNDER CONTRACTS 27780883 DUE TO AFFILIATES 15166710 AGGREGATE HEALTH POLICY RESERVES 7000000 MISCELLANEOUS PAYABLES 2106335 236405805 X 1304968800 1391687 1391687 1303577113 688677 86561356 87250033 1390827146 1288465908 0 1288465908 688677 86602490 87291167 1375757075 Part X, Line 2: PHP HAS RECEIVED A DETERMINATION LETTER FROM THE IRS THAT IT IS EXEMPT FROM FEDERAL INCOME TAXES, EXCEPT FOR UNRELATED BUSINESS INCOME AND POLITICAL EXPENDITURES, IN ACCORDANCE WITH SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE. PHP'S MANAGEMENT EVALUATES TAX POSITIONS TAKEN BY PHP AND RECOGNIZES A TAX LIABILITY IF PHP HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY PHP AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2017, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PHP IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. PHP'S MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2014. Part XI, Line 2d - Other Adjustments: ACCRUAL OF STRAIGHT-LINE LEASE AMOUNT Part XI, Line 4b - Other Adjustments: ASO FEES Part XII, Line 4b - Other Adjustments: ASO FEES STATUTORY INVESTMENT ADJUSTMENT 1 BLANCHET HOUSE 1500 NE IRVING STREET SUITE 440 PORTLAND OR 97232 936031009 501(c)(3) 25000 PROVIDING FOOD, TRANSITIONAL SHELTER, AND AID TO MEN IN THE METRO AREA BOYS AND GIRLS CLUB 8203 SE 7TH AVE SUITE 100 PORTLAND OR 97202 930474800 501(c)(3) 25000 TO EMPOWER CHILDREN AND CREATE HEALTHIER COMMUNITIES CATHOLIC CHARITIES 2740 SE POWELL BLVD PORTLAND OR 97202 930386801 501(c)(3) 101005 SUPPORTING TRANSITIONAL HOUSING, REFUGEE RESETTLEMENT, AND SERVE THE POOR AND VULNERABLE CENTRAL CITY CONCERN 232 NW 6TH AVENUE PORTLAND OR 97209 930728816 501(c)(3) 25000 PROVIDING TREATMENT AND TRANSITIONAL HOUSING TO THE HOMELESS AND LOW INCOME POPLUATIONS CLACKAMAS VOLUNTEERS IN MEDICINE-THE FOUNDERS CLINIC 700 MOLALLA AVE OREGON CITY OR 97045 371621141 501(c)(3) 5000 PROVIDE ACCESS TO HEALTHCARE IN CLACKAMAS COUNTY MEALS ON WHEELS 7710 SW 31ST AVENUE PORTLAND OR 97219 930584318 501(c)(3) 25000 SERVING NUTRITIOUS MEALS TO THE ELDERLY SAINT CHILD 2850 SW CEDAR HILLS BLVD 55 BEAVERTON OR 97005 931212633 501(c)(3) 16033 TO PROVIDE SUBSTANCE ABUSE TREATMENT, SERVING THE POOR AND VULNERABLE OF THE TRI COUNTY AREA UNITED METHODIST 2620 NE FREMONT ST PORTLAND OR 97212 930395576 501(c)(3) 16033 BRINGING FOOD AND HOPE TO SCHOOL CHILDREN AT RISK OF HUNGER ON THE WEEKEND PROVIDENCE PORTLAND MEDICAL FOUNDATION 4805 NE GILSAN PORTLAND OR 97213 931231494 501(c)(3) 200000 ASSIST WITH MEDICAL BILLS FOR THE NEEDY 9 Part I, Line 2: WE REQUEST AND CONDITION GRANTS UPON EACH OF THE FOLLOWING: 1) THE PROGRAM SUMMARY AND BUDGET; 2) VERIFICATION OF MALPRACTICE AND LIABILITY COVERAGE; 3) UPDATES PROVIDED EVERY SIX MONTHS; 4) DOCUMENTATION EVIDENCING TAX-EXEMPT OR MUNICIPAL STATUS; 5) DOCUMENTATION SHOWING THAT THEY SERVE THE LOW INCOME AND UNINSURED REGARDLESS OF ABILITY TO PAY FOR SERVICES; 6) PROVIDE UPON REQUEST, FINANCIAL REPORTING OF THE BUDGETED USE OF GRANT FUNDS. 1 1 0 0 0 0 0 0 0 MICHAEL L COTTON PRESIDENT / CEO 0 611375 0 236780 0 20724 0 609419 0 21791 0 1500089 0 0 TODD HOFHEINS DIRECTOR (PART YEAR) 0 15196 0 527139 0 1596780 0 10544 0 34931 0 2184590 0 777867 DEBRA CANALES DIRECTOR 0 835135 0 795839 0 43428 0 1213992 0 22272 0 2910666 0 0 RHONDA MEDOWS MD CHAIR 0 858356 0 681403 0 42645 0 1101998 0 24344 0 2708746 0 0 MICHAEL G WHITE CFO/TREASURER 0 315194 0 182906 0 21190 0 377695 0 4268 0 901253 0 0 GREG ZAMUDIO SECRETARY 0 221199 0 71588 0 729 0 127463 0 24014 0 444993 0 0 STEPHANIE C DREYFUSS DIR. NETWORK DEVELOP. 0 252824 0 53486 0 59562 0 20973 0 16145 0 402990 0 2288 BRAD GARRIGUES CHIEF MARKETING OFFICER 0 244390 0 140343 0 48575 0 44343 0 11305 0 488956 0 0 ROBERT A GLUCKMAN CHIEF MEDICAL OFFICER 0 393426 0 126524 0 145553 0 440000 0 30055 0 1135558 0 121282 MARK JENSEN CHIEF SERVICES OFFICER 0 203863 0 41876 0 34359 0 29529 0 24262 0 333889 0 0 JON MCANNIS CHIEF INFO. OFFICER 0 258726 0 34143 0 10824 0 14072 0 18899 0 336664 0 0 ALISON SCHRUPP CHIEF ADMIN. OFF. (TERM 2017) 0 210852 0 62909 0 388598 0 43698 0 10788 0 716845 0 26107 CARRIE L SMITH CHIEF COMPLIANCE OFFICER 0 242460 0 48268 0 56264 0 35475 0 14946 0 397413 0 2314 MICHAEL J CEMBROLA AVP SALES AND ACCOUNT SVCS 0 199838 0 81880 0 14043 0 2799 0 14169 0 312729 0 0 ASHA N CHESNUTT MEDICAL DIRECTOR 0 266915 0 2051 0 2151 0 12815 0 26416 0 310348 0 0 LAUREL C SOOT MEDICAL DIRECTOR 0 267099 0 4823 0 2890 0 13122 0 27121 0 315055 0 0 ANDREW D TARAB AVP INFORMATICS 0 222492 0 26292 0 30448 0 14016 0 8439 0 301687 0 0 GREGORY DIETZMAN AVP HEALTH CARE SERVICES 0 177295 0 22812 0 43843 0 21222 0 35551 0 300723 0 0 CINDY STRAUSS FORMER SECRETARY 0 697944 0 624379 0 420759 0 988958 0 31256 0 2763296 0 386962 Part I, Line 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY A RELATED ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE HEALTH & SERVICES - WASHINGTON. Part I, Lines 4a-b THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS THIS YEAR: - TODD HOFHEINS: $ 793,260 - ALISON SCHRUPP: $ 197,957 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 THREE YEAR OR AGE 65 VESTING SCHEDULE. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. THE AMOUNTS SHOWN IN COLUMN F OF PART II REFLECT CURRENT YEAR PAYOUTS FROM THESE PLANS. Part II - Executive Incentive Program THE PROVIDENCE EXECUTIVE INCENTIVE PROGRAM PROVIDES A LUMP SUM AWARD ANNUALLY AS A PERCENT OF THE EXECUTIVE'S BASE PAY. PERCENT OPPORTUNITIES ARE ALIGNED WITH OUR TOTAL COMPENSATION PHILOSOPHY AS OUTLINED IN PART VI, SECTION B, LINE 15 (PROCESS FOR DETERMINING COMPENSATION OF TOP MANAGEMENT, OFFICERS & KEY EMPLOYEES). FOR PROVIDENCE LEADERS, THE PERFORMANCE AWARD IS BASED ON THE LEVEL OF ACCOMPLISHMENT OF ANNUAL SYSTEM AND FUNCTIONAL (OR MARKET) OBJECTIVES. IN 2017, 60 PERCENT OF THE PARTICIPANT AWARDS WERE BASED ON PRE-DETERMINED ORGANIZATIONAL GOALS CONSISTENT WITH PROVIDENCE'S STRATEGIC PRIORITIES. 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% THE REMAINING 40% WAS BASED ON A ROBUST SET OF FUNCTION SPECIFIC GOALS DESIGNED TO ALIGN CRITICAL MISSION AND BUSINESS DRIVERS. Form 990, Part VI, Section A, line 6 PROVIDENCE HEALTH & SERVICES - OREGON IS THE SOLE CORPORATE MEMBER OF PROVIDENCE HEALTH PLAN. Form 990, Part VI, Section A, line 7a THE POWER OF THE PROVIDENCE HEALTH PLAN HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBER RESERVE THE RIGHT TO APPOINT DIRECTORS TO THE PROVIDENCE HEALTH PLAN BOARD. Form 990, Part VI, Section A, line 7b THE FOLLOWING POWERS RESIDE WITH THE MEMBER: * TO ADOPT OR CHANGE THE MISSION, PHILOSOPHY, AND VALUES, INCLUDING THE STRATEGIC PLAN AND MISSION STATEMENT. * TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS. * TO APPROVE THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE, TRANSFER, ASSIGNMENT OR ENCUMBERING OF ASSETS, EXCEEDING A SPECIFIED THRESHOLD, OR THE SALE OR TRANSFER OF ANY PROPERTY WHICH MAY HAVE HISTORICAL OR RELIGIOUS SIGNIFICANCE. * TO APPROVE THE DISSOLUTION AND/OR LIQUIDATION OR THE CONSOLIDATION OR MERGER OF THE CORPORATION. * TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANTS. * TO APPROVE, ACCORDING TO ESTABLISHED GUIDELINES, ANY JOINT VENTURE OF CORPORATE AFFILIATION. * TO APPROVE THE LENDING OF CORPORATE FUNDS. * TO APPROVE THE CLOSURE OF ANY INSTITUTION OR MAJOR MINISTRY OR WORK OF THE CORPORATION. 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 A RELATED ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE ST. JOSEPH HEALTH'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ST. JOSEPH HEALTH ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE ST. JOSEPH HEALTH HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE ST. JOSEPH HEALTH MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE ST. JOSEPH HEALTH'S LEGAL ENTITIES. PROVIDENCE ST. JOSEPH HEALTH ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE ST. JOSEPH HEALTH HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS OFFICERS, INCLUDING OUR SENIOR EXECUTIVES. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED BY THE PROVIDENCE ST. JOSEPH HEALTH COMMITTEE. THE BOARD RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE ST. JOSEPH HEALTH IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS WHOSE REVENUE IS SIMILAR TO THAT OF PROVIDENCE ST. JOSEPH HEALTH. ADDITIONALLY, PROVIDENCE ST. JOSEPH HEALTH'S LABOR MARKET CONTINUES TO SPREAD ACROSS HEALTH CARE AND INTO GENERAL INDUSTRY. BECAUSE OF THIS, PROVIDENCE ST. JOSEPH HEALTH ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY FOR-PROFIT MARKET DATA, WHERE APPLICABLE. BASE SALARIES FOR PROVIDENCE ST. JOSEPH HEALTH EXECUTIVES ARE GENERALLY TARGETED TO THE MEDIAN LEVEL OF THE MARKET, AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY ACHIEVE SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE ST. JOSEPH HEALTH OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS AND MIRRORS BEST PRACTICES. THE PROCESS TO REVIEW COMPENSATION WAS LAST COMPLETED 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. Form 990, Part XI, line 9: NET ASSET TRANSFER FROM AFFILIATE 50,000,000. NET ASSET TRANSFER TO AFFILIATE -15,000,000. STATUTORY INVESTMENT ADJUSTMENT 41,134. SUPPLEMENTAL SCHEDULE O NARRATIVE PROVIDENCE ST. JOSEPH HEALTH SYSTEM ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 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 & SERVICES IN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON. ST. JOSEPH HEALTH SYSTEM IN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA. COVENANT ACO 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. CARE WA 501(c)(3) 10 N/A 0 FACEY MEDICAL FOUNDATION 15451 SAN FERNANDO MISSION BLVD 200 MISSION HILLS CA 913451420 954322584 SUPPORT CA 501(c)(3) 7 PHS SOCAL 1 GAMELIN WASHINGTON ASSOCIATION 1423 FIRST AVENUE SEATTLE WA 98101 201910170 SUPPORT WA 501(c)(3) 7 PHS WA 1 GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC WA 98188 273133200 HEALTHCARE WA 501(c)(3) 7 SHS 1 HMTS INC 1 HOAG DRIVE NEWPORT BEACH CA 92658 453583707 HEALTHCARE CA 501(c)(3) 12,I HMHP 1 HOAG CHARITY SPORTS 330 PLACENTIA AVE NEWPORT BEACH CA 92663 452982422 SUPPORT CA 501(c)(3) 7 HHF 1 HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH CA 92663 953222343 FUNDRAISING CA 501(c)(3) 7 HMHP 1 HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG ROAD BOX 6100 NEWPORT BEACH CA 92663 951643327 HEALTHCARE CA 501(c)(3) 3 CHN 1 HOSPICE OF LUBBOCK 3702 21ST STREET LUBBOCK TX 79410 752133781 HEALTHCARE TX 501(c)(3) 10 CHS 1 INLAND NORTHWEST HEALTH SERVICES 601 W 1ST AVENUE SPOKANE WA 99201 911307555 HEALTHCARE WA 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