2018-05-09T14:09:13-05:00 2017-06-30 990 2016-07-01 530196636 Providence Hospital PROV 3147338000 1150 Varnum Street NE Washington DC 20017 Tonya Mershon Tax Officer 2017-10-24 2016 2022-09-23 18:48:47Z Darcy Burthay 1150 Varnum Street NE Washington DC 20017 218618182 false 0928 X www.provhosp.org X 1864 DC To improve the health and well-being of all people in the communities we serve. X 13 12 1963 204 0 0 1878348 1036194 204711422 211749016 46484 119754 5983316 4964110 212619570 217869074 0 0 0 92825260 88589120 0 0 0 129498330 158322548 222323590 246911668 -9704020 -29042594 217711078 196822518 166664643 193867141 51046435 2955377 Our 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. false false 225547897 212191507 PROVIDENCE HOSPITAL IS A 393 LICENSED BED ACUTE CARE HOSPITAL WITH A 252 BED HOSPITAL-BASED SKILLED NURSING HOME. FY2017, THE HOSPITAL HAD 10,153 DISCHARGES, 134,747 PATIENT DAYS, 49,268 EMERGENCY ROOM VISITS, DELIVERED MORE THAN 1,989 NEWBORN INFANTS, AND PERFORMED 4,827 OUTPATIENT SURGICAL CASES AND 1,577 INPATIENT SURGICAL CASES. 225547897 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false true false true true true false false true 220 0 true 1963 true false false false false false false false false false false X 13 12 false false false false true true true true true false false false true true true true true false true false DC X Rachel Maloney AVP Finance 2028547859 1150 Varnum Street NE Washington DC 20017 DARCY BURTHAY PRESIDENET & CEO 20.0 21.0 X X 453823 243307 26153 SISTER TERESA GEORGE TREASURER 1.0 0 X X 0 0 0 NALINI N JAIRATH PHD SECRETARY 1.0 0 X X 0 0 0 STEVE STRAZZELLA CHAIRMAN 1.0 0 X X 0 0 0 JUDI TESKE VICE-CHAIRMAN 1.0 0 X X 0 0 0 SISTER MARY BADER DC DIRECTOR 1.0 1.0 X 0 0 0 JOEL BOWERS MD DIRECTOR 1.0 0 X 0 0 0 MICHAEL FITZGERALD DIRECTOR 1.0 0 X 0 0 0 DEREK P LEEBAERT PHD DIRECTOR 1.0 0 X 0 0 0 JOHN MULLINS CPA DIRECTOR 1.0 1.0 X 0 0 0 SISTER ELYSE STAAB DC DIRECTOR 1.0 0 X 0 0 0 VERA VASWANI CHAWLA DIRECTOR 1.0 0 X 0 0 0 RODERIC L WOODSON ESQ DIRECTOR 1.0 0 X 0 0 0 SCOTT M FURNISS CFO-MINISTRY MKT DC/BALTIMORE 18.1 31.9 X 0 437628 32131 MARC EDELMAN CHIEF OPERATING OFFICER 40.0 0 X 265838 0 33052 PATRICIA EVANS MD CHIEF MEDICAL OFFICER 40.0 0 X 304494 0 30466 MOURINE EVANS CHIEF NURSING OFFICER 40.0 0 X 274194 0 17958 FRANCISCO F HOYOS CO CHIEF MEDICAL OFFICER 20.0 20.0 X 0 521187 39978 Olusola Malomo Medical Director 40.0 0 X 267075 0 37907 Rachel Maloney AVP-Finance-Controller 40.0 0 X 204103 0 25258 Paul O Oriaifo Medical Director 40.0 0 X 256958 0 35208 Taisha Williams Associate Medical Director PFC 40.0 0 X 223346 0 28561 Gregory Ziegler AVP-Finance-Revenue 40.0 0 X 206864 0 28409 AMY E FREEMAN FORMER OFFICER (END 12/2015) 0.0 50.0 X 0 1096649 25896 DAN A MACKSOOD FORMER OFFICER (END 12/2015) 0.0 0.0 X 300506 0 476 2757201 2298771 361453 102 true true false QUEST DIAGNOSTICS LLC 12436 COLLECTION CENTER DRIVE CHICAGO IL 606930124 LABORATORY SERVICES 4941462 HARMONY HEALTHCARE LLC 2909 W BAY TO BAY BLVD TAMPA FL 336298178 HEALTHCARE SERVICES 2166811 PHS TH ANESTHESIA PC PO BOX 638324 CINCINNATI OH 45263 ANESTHESIOLOGY SERVICES 2150000 UNIVERSAL PROTECTION SERVICE LLC 26375 NETWORK PLACE CHICAGO IL 606731263 SECURITY SERVICES 1623387 CONTEMPORARY NURSING SOLUTIONS INC 1000 JEFFERSON ST STE 1A LYNCHBURG VA 24504 NURSING SERVICES 1331973 29 1036194 1036194 HOSPTIAL NET PATIENT REVENUE 622110 180018852 180018852 NURSING HOME NET PATIENT REVENUE 623110 31489980 31489980 INCOME FROM JOINT VENTURE 900099 240184 240184 0 0 0 0 211749016 119754 119754 1776342 1776342 0 1776342 1776342 0 0 1391215 749108 642107 642107 FEES FROM AFFILIATES 900099 243232 243232 CONTRACT INCOME 900099 682675 682675 OTHER MISCELLANEOUS REVENUE 900099 1619754 1619754 0 0 0 0 2545661 217869074 212191507 0 4641373 1393298 1393298 75995406 69564381 6431025 -2037956 -1793457 -244499 6971496 6319097 652399 6266876 5640188 626688 41787 37608 4179 85784 85784 70642 70642 53639 53639 6836794 6153114 683680 0 63277 56949 6328 596417 536775 59642 195548 175993 19555 4688660 4219794 468866 70522 63470 7052 87734 78961 8773 4669091 4202182 466909 10805862 10805862 5890280 5301252 589028 PURCHASED SERVICES 60310756 54279680 6031076 MEDICAL SUPPLIES 24358680 24358680 IMPAIRMENT OF PPE 17000000 15300000 1700000 CONTRACT LABOR 8802210 7921989 880221 13694865 12325379 1369486 0 246911668 225547897 21363771 0 3609 3609 4816682 9394224 29457485 28884781 0 0 0 2682360 2473914 1178423 703006 219505975 171461431 60653663 48044544 0 2826734 2281918 11427491 7835267 104664631 97201255 217711078 196822518 19416346 17593002 10 0 147248287 176274139 166664643 193867141 X 51046435 2955377 51046435 2955377 217711078 196822518 X -29042594 -19048464 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true false true 53639 53639 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent 1) the portion of dues paid to National and state hospital associations that is specifically allocable to lobbying ($13,139), 2) to Carmen Group for seeking to increase the District of Columbia DSH funding ($40,500). 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 ACTIVITY Lobbying expenses represent 1) the portion of dues paid to National and state hospital associations that is specifically allocable to lobbying ($13,139), 2) to Carmen Group for seeking to increase the District of Columbia DSH funding ($40,500). 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. 2585094 2585094 143811039 114597249 29213790 767621 130418 637203 60586627 54291215 6295412 11755594 2442549 9313045 48044544 Advances to/from affiliates Other Current Assets IC AR/AP netted Accretive AR Deferred Comp Total Deferred Compensation Asset 4407915 Due from Affiliates 4629404 Advances to Affiliates 84815730 Prepaid Pension Assets 327958 Estimated Settlements from Third-Party Payor 1109623 Other Miscellaneous Receivables 1708252 Miscellaneous Current Assets 202373 97201255 Self Insurance Liability Deferred Compensation 4407915 Asset Retirement Obligation 215023 Other Misc Current Liabilities Other Miscellaneous Liabilities 3635 Pension Plan Liability Current Portion of Long-Term Debt Estimated Settlement to Third-Party Payor 4740935 Net Long-Term Debt Due to Affiliates 26727049 Debt with Ascension Health Alliance 137811605 Ascension Health Savings Plan Liability 1313012 Recovery Tail Liability 963916 Other Taxes Payable 91049 176274139 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE 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, 2017. true true X true X true X true true true false true true 2284723 2284723 0.0099 91140053 102453757 0 0.0 0 0.0 0 0 93424776 102453757 2284723 0.0099 3764114 3764114 0.0164 3527474 3527474 0.0153 0 0.0 0 0.0 0 0.0 0 0 7291588 0 7291588 0.0317 0 0 100716364 102453757 9576311 0.0417 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 3817806 1145342 54244871 70230833 -15985962 X true true 1 1 PROVIDENCE HOSPITAL 1150 VARMUM STREET NE Washington DC 20017 http:/www.provhosp.org HFD01-0212 X X X X PROVIDENCE HOSPITAL 1 false false true X X X X X X X X X X 15 true true false true X www.provhosp.org/about-us/community-health-assessment X X true 15 true www.provhosp.org/about-us/community-health-assessment false true X 200.0 300.0 X X X true true X X X X true X http://www.provhosp.org/patients-guests/financial-assistance X http://www.provhosp.org/patients-guests/financial-assistance X http://www.provhosp.org/patients-guests/financial-assistance X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3 Facility , 1 Facility , 1 - PROVIDENCE HOSPITAL. Providence is committed to conducting a community health needs assessment (CHNA) every three years to understand the health and health care status of DC communities. The assessment guides Providence in targeting its resources to achieve the greatest impact on community health through population health initiatives. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - PROVIDENCE HOSPITAL. Building on our last community health needs assessment and the information shared on our DC Health Matters website (www.dchealthmatters.org), the 2015 assessment represents a shift from a focus on individual clinical conditions to larger social determinants of health. In order to achieve this shift in direction, this assessment placed a much larger emphasis on having our community's perspective shape this work. As a result, this report includes community thoughts from the following: 113 online survey respondents, 80 community forum attendees, 60 community-based organizations, 40 focus group participants, 31 key informant interviews, 15 hospitals and community health centers, 11 government agencies, and 8 elected officials, including DC Councilmembers and Advisory Neighborhood Commissioners Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - PROVIDENCE HOSPITAL. Providence Hospital, through its membership in the DC Healthy Communities Collaborative, conducted the CHNA in partnership with three other non-profit hospitals: Howard University Hospital, Children's National Medical Center and Sibley Memorial Hospital; and three community health centers, two of which are Federally qualified health centers, Bread for the City, Community of Hope, and Unity Health Care, Inc. The DC Healthy Communities Collaborative (DCHCC) works to eliminate health disparities and create health equity for all communities in the District of Columbia to realize one healthy Capital city. With the unique perspectives of each hospital and community health center, DCHCC members provided guidance and feedback respective to populations and neighborhoods served. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - PROVIDENCE HOSPITAL. The most recent assessment, released in June 2016 was conducted in partnership with the DC Healthy Communities Collaborative (DCHCC): a consortium of DC hospitals and community health centers who have joined forces to reduce health disparities and increase health equity for the most vulnerable DC populations. Providence is a founding member of the DCHCC. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Providence Hospital. In the CHNA that was conducted in 2015 the following four (4) needs emerged as the "priority community needs": Mental Health/Behavioral Health, Place-Based Care (Bring Care to the Community), Care Coordination, and Health Literacy. In FY17 Providence Health System is addressing the identified needs Care Coordination and Mental Health via the following strategies: Prioritized Needs Care Coordination - Providence is collaborating with other DCHCC organizations to improve identification of resources by collaborating with community based organizations, government agencies and health care organizations and expanding use of community asset maps. As well as implement a multi-faceted intervention to improve care coordination across systems to ensure that health needs are being met and that the right care is being delivered in the right place, at the right time, by the right person to improve patient care and health outcomes. Mental Health - Providence is co-leading the advocacy for a District-wide capacity assessment and evaluation of mental health services for adults and children; improving care coordination for mental health and substance abuse co-occurring conditions through facilitation of direct hand-offs to the next level of care and tracking of referrals between systems. Providence is also collaborating with other DCHCC organizations to advocate for policy level solutions to improve our ability to provide mental health prevention activities and screenings and for equitable distribution of mental health services in DC. In addition, Providence is collaborating with other DCHCC organizations to develop internal system changes to improve health literacy. Needs that will not be addressed Bringing Care to the Community/Placed-based Care will not be directly addressed by Providence. However, Providence's strategies for Care Coordination and Behavioral Health will have components that align with the definition and need of Place-based Care (via telehealth). 7 Carroll Manor Nursing & Rehab Center 1150 Varnum Street NE Washington DC 20017 Skilled Nursing & Rehabilitation Center Ft Lincoln Family Medicine Center 4151 Bladensburg Road Colmar Manor MD 20722 Family Medicine Center Perry Family Health Center 128 M Street NW Suite 050 Washington DC 20001 Perry Family Health Center Model Cities Senior Wellness Center 1901 Evarts Street NE Washington DC 20018 Senior Connection Program Congress Heights Senior Wellness Ctr 3500 Martin Luther King Jr Ave SE Washington DC 20032 Senior Connection Program DC Police and Fire Clinic 920 Varnum Street NE Washington DC 20017 Occupational Health Services Schedule H, Part I, Line 6a Community Benefit Report Details The Providence Hospital Community Benefit Report is prepared by Providence Hospital; the report contains only information related to Providence Hospital. Schedule H, Part V, Section B, Line 17 Billing and Collection Policy During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The 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 III, Line 2 Bad debt expense - methodology used to estimate amount After 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 2017 was $3,817,806 at charges. Schedule H, Part III, Line 3 Bad Debt Expense Methodology The 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 footnote The 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 19. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A 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 assistance The 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 certain collection practices do not apply. Schedule H, Part V, Section B, Line 16a FAP website - PROVIDENCE HOSPITAL: Line 16a URL: http://www.provhosp.org/patients-guests/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - PROVIDENCE HOSPITAL: Line 16b URL: http://www.provhosp.org/patients-guests/financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - PROVIDENCE HOSPITAL: Line 16c URL: http://www.provhosp.org/patients-guests/financial-assistance; true true false false false false false false false DARCY BURTHAY PRESIDENET & CEO 188555 219139 200982 0 64286 24168 7309 9916 6164 2764 467296 255987 0 0 AMY E FREEMAN FORMER OFFICER (END 12/2015) 0 421670 0 577326 0 97653 0 14575 0 11321 0 1122545 0 0 DAN A MACKSOOD FORMER OFFICER (END 12/2015) 10385 0 0 0 290121 0 0 0 476 0 300982 0 0 0 SCOTT M FURNISS CFO-MINISTRY MKT DC/BALTIMORE 0 320367 0 86365 0 30896 0 16347 0 15784 0 469759 0 0 MARC EDELMAN CHIEF OPERATING OFFICER 241576 0 20650 0 3612 0 13250 0 19802 0 298890 0 0 0 PATRICIA EVANS MD CHIEF MEDICAL OFFICER 302030 0 0 0 2464 0 12150 0 18316 0 334960 0 0 0 MOURINE EVANS CHIEF NURSING OFFICER 248000 0 20650 0 5544 0 12517 0 5441 0 292152 0 0 0 FRANCISCO F HOYOS CO CHIEF MEDICAL OFFICER 0 462002 0 56089 0 3096 0 17225 0 22753 0 561165 0 0 Olusola Malomo Medical Director 256489 0 10000 0 586 0 14497 0 23410 0 304982 0 0 0 Rachel Maloney AVP-Finance-Controller 190462 0 13220 0 421 0 10369 0 14889 0 229361 0 0 0 Paul O Oriaifo Medical Director 249841 0 0 0 7117 0 16784 0 18424 0 292166 0 0 0 Taisha Williams Associate Medical Director PFC 216181 0 7000 0 165 0 10895 0 17666 0 251907 0 0 0 Gregory Ziegler AVP-Finance-Revenue 191039 0 13220 0 2605 0 9111 0 19298 0 235273 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Ascension Health, a related organization of Providence Hospital, uses the following to establish the compensation of the organization's President/CEO: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee Schedule J, Part I, Line 4a Severance or change-of-control payment THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM THE ORGANIZATION OR A RELATED ORGANIZATION: DAN A MACKSOOD - $289,615 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan 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. No distributions from the supplemental non-qualified retirement plan were made in the current year. CASH ACCOUNTS TRANSFERRED TO PARENT'S BALANCE SHEET 2016-07-01 15368984 FMV 453358926 ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 63145 501(C)(3) false false false false Schedule N, Part II CASH TRANSFER PROVIDENCE HOSPITAL TRANSFERRED ITS BEGINNING HSD CASH BALANCES TO ASCENION HEALTH ALLIANCE (45-3358926) AS OF JULY 1, 2016. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL In determining the compensation of the organization's CEO, 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 CEO 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 her compensation was decided. Form 990, Part VI, Line 6 Classes of members or stockholders Providence Hospital has a single corporate member, Ascension Health. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Providence Hospital has a single corporate member, Ascension Health, 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 stockholders Ascension 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 & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & 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 body DURING 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 policy The 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 15b Process to establish compensation of other employees IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, 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 PROVIDENCE HOSPITAL'S 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 19 Required documents available to the public The organization will provide any documents open to public inspection upon request. Form 990, Part XI, Line 9 Other changes in net assets or fund balances FAS 158 Pension - -3679480; Net Asset Transfers to Alpha Fund - -15368984; Form 990, Part XII, Line 2b Audited Financial Statements The 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 XII, Line 2c Audit Committee Providence 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. ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 631455998 453358926 NATIONAL HEALTH SYSTEM MO 501(c)(3) Type I NA false ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH SYSTEM MO 501(c)(3) Type I ASCENSION HEALTH ALLIANCE false PROVIDENCE HEALTH SERVICES INC 1150 VARNUM STREET NE WASHINGTON DC 20017 521275587 PHYSICIAN PRACTICES DC 501(c)(3) Type I PROVIDENCE HOSPITAL true PROVIDENCE HEALTH FOUNDATION INC 1150 VARNUM STREET NE WASHINGTON DC 20017 521275583 FUNDRAISING ORGANIZATION DC 501(c)(3) Type I PROVIDENCE HOSPITAL true RESOURCE PHARMACIES Inc 1150 VARNUM STREET NE WASHINGTON DC 20017 521410076 RETAIL PHARMACY DC PROVIDENCE HOSPITAL C Corporation 1485458 616810 1 true false false true false false false false false false false false true true false false true true false true PROVIDENCE HEALTH FOUNDATION INC M 103667 FAIR MARKET VALUE PROVIDENCE HEALTH SERVICES INC L 173989 FAIR MARKET VALUE PROVIDENCE HEALTH SERVICES INC P 87675 FAIR MARKET VALUE PROVIDENCE HEALTH SERVICES INC Q 69914084 FAIR MARKET VALUE PROVIDENCE HEALTH SERVICES INC R 5014719 FAIR MARKET VALUE PROVIDENCE HEALTH FOUNDATION INC C 1036194 FAIR MARKET VALUE