2017-11-15T16:49:07-06:00 2016-12-31 911194016 Clark Nuber PS 10900 NE 4th Suite 1400 Bellevue WA 98004 990 2016-01-01 810231793 PROVIDENCE HEALTH & SERVICES - MONTANA PROV 4255253985 1801 Lind Avenue SW No 9016 Renton WA 980579016 Jo Ann Escasa-Haigh EVP/CFO - Operations 4255253985 2017-11-15 1 Sara Elizabeth J Hyre CPA P00235495 4254544919 170.173.0.16 2017-11-15 14:48:52 PS P C5F3CFF4C26DED891B80F887CA75C12EDBBE0CDF C5F3CFF4C26DED891B80F887CA75C12EDBBE0CDF 2016 2017-02-10 21:41:12Z Providence St Patrick Hospital Mike Butler 1801 Lind Avenue SW No 9016 Renton WA 980579016 463348214 0 0928 X http://montana.providence.org/hospitals/ X 1991 MT Healthcare with special concern for the poor and vulnerable in Missoula, MT. 13 13 2366 223 272340 59656 1683716 1026678 330809446 436386880 156473 2027634 4353030 4518825 337002665 443960017 2936060 1025589 0 0 114397395 130762136 0 0 0 210711414 327326779 328044869 459114504 8957796 -15154487 306869501 254404251 161351881 113964805 145517620 140439446 X As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Healthcare with special concern for the poor and vulnerable in Missoula, MT. 0 0 262532147 0 292283413 Acute Care - Inpatient & OutpatientTotal Admissions: 9,988Total Patient Days: 47,107Total Outpatient Visits: 261,297HIGHLIGHTS/ACHIEVEMENTS:In 2015 St. Patrick Hospital opened a Family Maternity Center and started delivering babies for the first time in over 40 years. In 2016 there were 483 babies delivered at the hospital.* Mountain-Pacific Quality Health presented Providence St. Patrick Hospital with the 2016 Hospital Commitment to Quality Award. Mountain-Pacific Quality Health's quality awards reflect continued expectations of engaging patients and families in improving care as well as top performance on quality indicators and system changes, as promoted by today's health care industry. Strong leadership support is considered, since it is vital for achieving and sustaining excellent patient safety and improvements in patient care. In addition, St. Pat's earned Mountain Pacific's new award called Chasing Zero, for demonstrating sustained periods of zero infections for specific hospital-acquired infections. * Providence St. Patrick Hospital was named one of the nation's 50 Top Cardiovascular Hospitals by Truven Health Analytics. This is the ninth time Providence St. Patrick Hospital has been recognized with this honor. The 50 Top Cardiovascular Hospitals study evaluates performance in key areas: risk-adjusted mortality, risk-adjusted complications, core measures (a group of measures that assess process of care), percentage of coronary bypass patients with internal mammary artery use, 30-day mortality rates, 30-day readmission rates, severity-adjusted average length of stay, and wage- and severity-adjusted average cost.* St. Patrick Hospital's Emergency Department and Catheterization Laboratory received the 2016 Mission: Lifeline Receiving Center GOLD Recognition Award Mission from the American Heart Association/American Stroke Association for our quality of heart attack care as demonstrated through the 2015 ACTION Registry -GWTG data. This award recognizes success in implementing a high quality care program, ensuring that our ST-Elevation Myocardial Infarction (STEMI) program treats patients according to nationally accepted guidelines. STEMI is a serious heart attack during which one of the heart's major arteries is blocked, and must be treated quickly and appropriately for the patient to survive. * Providence St. Patrick Hospital was one of 844 hospitals to receive an "A" ranking among the safest hospitals in the United States according to Leapfrog Hospital Safety Grades, a national patient safety watchdog. Leapfrog Safety Grades assign A, B, C, D and F letter grades to hospitals nationwide and provide the most complete picture of patient safety in the U.S. * St. Patrick Hospital received recognition from US News and World Report for being a top 50 Hospital for urology care in 2016. Hospitals are scored on volume of high-risk patients, nurse staffing and patient survival. Specific criteria that contributed to the ranking included our patient's 30-day survival rate (score 10/10), the use of advanced technologies (score 6/6), patient services (score 8/9), Magnet recognition, serving as a Level II trauma center and having an Intensivist program. In addition, St. Pat's was recognized as "high performing" in aortic valve surgery, heart bypass surgery and pulmonology.* Providence St. Patrick Hospital was awarded the Partner for Change Award from Practice Greenhealth for implementation of a significant number of environmental stewardship programs and best practices, and continuously improving and expanding upon these programs on the path to sustainability.* Providence St. Patrick Hospital was given the Women's Choice Award for one of America's 100 Best Hospitals for Patient Experience in Montana. The hospitals are highly rated by women for creating an extraordinary patient experience for women and their families. The process begins with scores derived for each hospital in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) database. The score takes a subset of the questions HCAHPS uses that research and experience shows are more important to women than to men. WomenCertified applies weight to each of those questions to adjust for relative importance to arrive at a numerical score. The scoring is objective and uniform. The 100 best scores in each of the four categories determine the America's 100 Best Hospitals for Outstanding Patient Experience by WomenCertified award winners. 87056906 0 87283338 Capitation Revenue - See Line 4a Narrative 71350933 0 49599364 Primary CareTotal Visits: 281,450* Nine Western Montana Providence Medical Group medical clinics received national recognition as Level 3 Patient-Centered Medical Homes, the highest accreditation possible, by the National Committee of Quality Assurance (NCQA). Level 3 status involves meeting and documenting requisite elements in six categories, such as tracking and coordinating patient care, easing access to providers through improved hours and scheduling, and measuring and improving clinic/provider performance. NCQA recognition ensures that these clinics use evidence-based, patient-centered processes that focus on highly coordinated care and long?term interactive relationships between the care teams and the patient. A patient-centered medical home is a model of primary care that combines teamwork and information technology to improve care, improve the patient's care experience, and reduce costs. Medical homes foster ongoing partnerships between patients and their clinicians using multi-disciplinary care teams to coordinate treatment, follow-up and support. Research confirms that medical homes advance the "triple aim" of higher quality, better patient experience and cost containment.In Missoula, the PMG clinics include: * Broadway Internal Medicine* Grant Creek Family Medicine* Montana Internal Medicine* Women's Care & Family Wellness * Missoula Family MedicalPMG clinics outside of Missoula include:* Florence Family Medicine in Florence* Lifespan Family Medicine in Stevensville* St. Joseph Medical Clinic in Polson * St. Joseph Medical Clinic in Ronan* With a grant from The Montana Health Foundation, Grant Creek Family Practice, a patient-centered medical home, began to integrate behavioral health into the primary care setting. The practice hired a licensed clinical social worker, with the goal of providing patients seamless, effective, mental health care. Following Grant Creek's lead, this service will be implemented into the eight other Western Montana Providence patient-centered medical homes, with specialty support from Providence Western Montana psychiatric services. 1025589 1025589 0 Grants and Allocations.See Schedule I. 0 0 9971334 Healthcare Joint VenturesThrough partnerships, St. Patrick's is able to provide additional healthcare services to the community. 1025589 1025589 9971334 421965575 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 2366 1 1 1 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 0 0 1 1 MT X Karl E Fritschel CPA 4255253339 1801 Lind Ave SW 9016 Renton WA 980579016 X Richard Blair Chair - Eff. 7/16 0.10 4.60 X X 0 30180 0 Dave Olsen Vice Chair - Eff. 7/16 0.10 5.50 X X 0 24135 0 Dick P Allen Director - Eff. 7/16 0.10 2.00 X 0 15180 0 Isiaah Crawford Director 0.10 4.10 X 0 24360 0 Sister Lucille Dean SP Director - Eff. 7/16 0.10 2.10 X 0 0 0 Sister Diane Hejna CSJ RN Director - Eff. 7/16 0.10 1.90 X 0 0 0 Michael Holcomb Director /Chair Thru 6/16 0.10 5.30 X X 0 45360 0 Phyllis Hughes RSM Director 0.10 5.00 X 0 0 0 Sallye Liner Director 0.10 4.70 X 0 20360 0 Mary Lyons PhD Director - Eff. 7/16 0.10 1.50 X 0 15180 0 Walter Noce Jr Director - Eff. 7/16 0.10 2.00 X 0 15180 0 Carolina Reyes MD Director 0.10 4.60 X 0 22860 0 Phoebe Yang Director - Eff. 7/16 0.10 2.00 X 0 12680 0 Fr Tom Kopfensteiner Director - Res. 12/16 0.10 2.00 X 0 6400 0 Chauncey Boyle SP Director - Thru 6/16 0.10 3.10 X 0 0 0 Marian Schubert CSJ Director - Thru 6/16 0.10 2.80 X 0 0 0 Michael A Stein Director - Thru 6/16 0.10 3.10 X 0 7680 0 Eugene Al Parrish Director - Thru 6/16 0.10 2.80 X 0 7680 0 Bob Wilson Director - Thru 6/16 0.10 2.90 X 0 9120 0 Martha Diaz Aszkenazy Director - Thru 6/16 0.10 3.90 X 0 9180 0 Kirby McDonald Director - Thru 6/16 0.10 2.80 X 0 7680 0 Charles Chuck Watts Director - Thru 6/16 0.10 2.80 X 0 9180 0 Rod F Hochman MD President / CEO - Thru 6/16 1.00 64.00 X 0 4060921 43543 Mike Butler President - Eff. 7/16 1.00 59.00 X 0 6906693 349633 Todd Hofheins EVP/CFO /Treas. Thru 11/16 1.00 59.00 X 0 1571440 60670 Jo Ann Escasa-Haigh Interim CFO/Treasurer - Eff.12/16 1.00 49.00 X 0 755416 168190 Cindy Strauss EVP/Chief Legal Officer 1.00 59.00 X 0 1462780 58266 Jeffrey Fee CE/Western MT. Region 40.00 10.00 X 0 599953 102582 Kirk Bodlovic CFO/St. Patrick Hospital 50.00 0.00 X 0 270622 43819 Debra Canales EVP/CAO 1.00 59.00 X 0 2092357 611609 Janice Newell SVP/Chief Information Officer 1.00 59.00 X 0 1137493 34098 Joel Gilbertson SVP/Community Partnerships 1.00 59.00 X 0 842027 247847 Orest Holubec SVP/Chief Comm./Ext. Affairs Officer 1.00 54.00 X 0 782688 207806 Greg Till VP/Chief Talent Officer 1.00 64.00 X 0 776011 122367 Sharon Toncray SVP / Chief Labor Employee Counsel 1.00 59.00 X 0 764977 243728 Jack Mudd - Thru 316 SVP/Mission Leadership 1.00 28.00 X 0 718728 157778 Paul Stoddart - Thru 916 VP/Marketing 1.00 54.00 X 0 641423 22381 Robert Hellrigel SVP-CE / Senior & Comm. Services 1.00 54.00 X 0 620281 196789 Mark Gargett VP/Digital Integration 1.00 49.00 X 0 610787 65970 David Brown VP/Strategy & Business Development 1.00 54.00 X 0 700461 226430 Debbie Burton SVP/ Chief Nrsg. Officer 1.00 59.00 X 0 713480 90015 Mary Cranstoun VP/Total Rewards 1.00 59.00 X 0 663031 114417 Aaron Martin SVP/Strategy & Innovation 1.00 69.00 X 0 852934 219285 Tom McDonagh VP/Chief Investment Officer 1.00 57.00 X 0 849462 53521 Rhonda Medows MD EVP/Population Health 1.00 59.00 X 0 1565700 320279 Harvey Smith SVP/Chief Customer Svc. Officer 1.00 49.00 X 0 1226156 23791 Lisa Vance SVP/Clinical Program Services 1.00 59.00 X 0 1220348 125445 Mike Waters VP,CAO/Physician Services 1.00 64.00 X 0 703777 184023 Amy Compton-Phillips EVP/Chief Clinical Officer 1.00 54.00 X 0 1113493 278894 Simone Musco MD Physician 50.00 0.00 X 936561 0 38820 Michael Yerkey MD Physician 50.00 0.00 X 853135 0 34483 Mark L Sanz MD Physician - Cardiology 50.00 0.00 X 726265 0 49022 James Maddux MD Physician 50.00 0.00 X 711616 0 46510 James M Maxwell MD Physician 50.00 0.00 X 696073 0 53606 Randy Axelrod MD EVP/Clinical & Patient Services 0.00 0.00 X 0 1419333 0 Craig Wright MD SVP/Physician Services 0.00 0.00 X 0 1119939 20455 Jack Friedman SVP/Accountable Care & Payor Rel. 0.00 0.00 X 0 299327 0 3923650 37344433 4616072 201 1 1 0 Broadway Imaging LLC 500 West Broadway Missoula MT 59802 Imaging Services 20737680 Western MT Emergency Phys 500 West Broadway Missoula MT 59802 ER Physicians 6861694 Montana Cancer Specialists PO Box 7877 Missoula MT 59807 Cancer Specialist Services 3786011 Bouten Construction PO Box 3507 Spokane WA 99220 Construction Services 1436769 Cross Country Staffing File 50941 Los Angeles CA 90074 Staffing 1436658 32 556717 469362 599 1026678 Acute Care 622110 289549520 289549520 Capitation Revenue 900099 87283338 87283338 Primary Care 621110 48969751 48969751 Healthcare JVs 900099 9971334 9971334 Pharmacy 900099 358428 358428 254509 254509 436386880 922753 922753 1998768 3629626 -1630858 -1630858 -1630858 15960128 818600 15381063 292784 579065 525816 1104881 1104881 127811 84724 43087 43087 BIC Outside Services 900099 1948784 1948784 Gain on Debt Refinanci 900099 625860 625860 Laundry & Linen 900099 357129 272340 84789 3174823 801785 2373038 6106596 443960017 439137449 272340 3523550 X 943963 943963 81626 81626 974862 974862 119365521 105708383 13657138 2338980 2052533 286447 99176 91054 8122 7983597 6969754 1013843 95213 95213 2290 2290 74974 74974 133677 133677 54083899 50797853 3286046 117770 117770 4084201 3473908 610293 459347 235457 223890 4789445 4266721 522724 724527 490922 233605 322554 253418 69136 1790353 1790353 86654463 73069662 13584801 8329829 7109057 1220772 7939 7939 Cost Care Svc Claims 86370915 86370915 Medical Supplies 70609453 70568119 41334 Bad Debts 5073068 5073068 UBI Tax 25000 25000 3577862 2493100 1084762 459114504 421965575 37148929 0 166262 191721 1235629 1845992 46545090 42192567 10349916 9997498 4779315 4928964 123561 281425 253134087 172124352 86013896 81009735 35890435 37586490 16534851 19034962 105230546 57334897 306869501 254404251 23335872 21393079 113383 46331231 43198256 91571395 49373470 161351881 113964805 X 139954617 134102326 3690421 4516030 1872582 1821090 145517620 140439446 306869501 254404251 X -15154487 555617 9520696 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 25474 1 49500 0 0 74974 0 Part II-B, Line 1: The portion of monthly dues paid to the Montana Hospital Association designated for lobbying. Initiative Support. Costs associated with the direct contact with legislators. 12388753 12388753 111099915 69601073 41498842 3007299 2335152 672147 124320035 100188127 24131908 2318085 2318085 81009735 Invest in Prov. Surgery Center, LLC 2271803 C Invest in Broadway Imaging, LLC 3333183 C Invest in Partners in Home Care, Inc. 3965187 C Invest in Tamarack Management, Inc. 1572404 C Invest in Foundation 7460519 C Invest in N. Rockies Health Assoc. 431866 C 19034962 Unamortized Bond Financing Costs 136804 Cash Surrender Value of Life Insurance 55975 Due from Affiliates 52303904 Other Receivables 584327 Third Party Settlements 4217726 Trustee Held Funds 36161 57334897 Due to Affiliates 44292762 Obligation for Financing Lease 4927500 Capitalized Lease Obligation 43211 Third Party Settlements 109997 49373470 1 1 1 X 300.000000000000 1 X 1 1 1 0 1 1 759 3470020 3470020 0.00760 10458 45198159 30514571 14683588 0.03230 7 28089 21121 6968 0.00000 11224 48696268 30535692 18160576 0.03990 2667 283762 283762 0.00060 4 4942142 4942142 0.01090 95344 25066601 13152629 11913972 0.02620 208 28085 28085 0.00010 112 27708 27708 0.00010 98335 30348298 13152629 17195669 0.03790 109559 79044566 43688321 35356245 0.07780 233423 25000 25000 0.00010 2 60720 60720 0.00010 2 17160 17160 0.00000 1828 44279 44279 0.00010 235255 147159 147159 0.00030 1 5073068 134081883 173814397 -39732514 X 1 1 2 Providence Surgery Center LLC Outpatient surgical services 0.76560 0.20310 1 1 Providence St Patrick Hospital 500 West Broadway Missoula MT 59802 montana.providence.org/hospitals/ 13200 X X X X Rehab and Psych Providence St Patrick Hospital 1 0 0 1 X X X X X X X X X 14 1 1 1 1 X See part V, Section C X http://www.missoulacounty.us/home/showdocument?id=82 X 1 15 1 communitybenefit.providence.org/community-health-needs-assessments/ 0 1 X 300.000000000000 350.000000000000 X X X X 1 1 X X X 1 X www2.providence.org/obp/docs/mt-charity-care-policy.pdf X www2.providence.org/obp/docs/financialassistancerequest(english).pdf X www.providence.org/obp/mt/financial-assistance X X X X X X X 1 X 0 X X X X X 1 X 0 1 Providence St. Patrick Hospital Part V, Section B, Line 5: The Community Health Assessment workgroup met throughout 2014, collecting and talking about data so that we can better understand health status, community assets and resources, and challenges in Missoula County. The workgroup included the following representatives: Carol Bensen, Providence St. Patrick HospitalChris Coburn, Planned ParenthoodCindy Hotchkiss, MCCHDClaire Francoeur, APRN, Grant Creek Family MedicineCody Bradwell, VolunteerEllen Leahy, MCCHDGuy Hanson, MCCHD Air Quality Advisory CouncilIan Magruder, MCCHD Water Quality Advisory CouncilJeff Darrah, Animal Control, MCCHDKaren Myers, Providence St. Patrick HospitalKim Mansch, Partnership Health CenterMary Windecker, Community Medical CenterMerry Hutton, Providence St. Patrick HospitalLeeAnn Johnson, Missoula Indian CenterPeter Chap, University of Montana InternRobin Nielson-Cerquone, MCCHDStacy Rye, United Way of Missoula CountySteve Schmidt, Missoula Forum for Children and YouthSusan Kohler, Missoula Aging Services Providence St. Patrick Hospital Part V, Section B, Line 6a: Community Medical Center Providence St. Patrick Hospital Part V, Section B, Line 6b: Missoula City-County Health Department, Grant Creek Family Medicine, Missoula Aging Services, Missoula Forum for Children & Youth, Missoula Indian Center, Partnership Health Center, United Way of Missoula County. Providence St. Patrick Hospital Part V, Section B, Line 11: Based on the data, input from the community, and group discussion, the two priority issues are: improving access to healthcare and reducing obesity. There was an extensive list of needs and issues identified through this assessment process and the organization is unable to address all of them during this cycle due to funding and resource availability. There are other community organizations focusing on such issues, and PH&S-MT will be an engaged partner with other community led collaborative efforts.Please see "Community Health Improvement Plan" located at communitybenefit.providence.org/community-health-needs-assessments/ Providence St. Patrick Hospital Part V, Section B, Line 16j: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office. Providence St. Patrick Hospital Part V, Section B, Line 20e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence St. Patrick Hospital Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges. Part V, Section B, Line 7a communitybenefit.providence.org/community-health-needs-assessments/ 22 1 - Florence Family Medicine 5549 Old Highway 93 Florence MT 59833 Outpatient Services 2 - Montana Spine and Pain Center 1103 Westwood Drive Suite 200 Hamilton MT 59840 Outpatient Services 3 - Bariatric Services 500 West Broadway 5th Floor Missoula MT 59802 Outpatient Services 4 - Broadway Internal Medicine 500 W Broadway Broadway Bldg 4th Fl Missoula MT 59802 Outpatient Services 5 - Endocrinology Diabetes and Nutrition 900 N Orange St Suite 304 Missoula MT 59802 Outpatient Services 6 - Grant Creek Family Medicine 3075 N Reserve Street Suite Q Missoula MT 59808 Outpatient Services 7 - Infectious Disease 902 N Orange Street Missoula MT 59802 Outpatient Services 8 - Long Term Mobility Care 500 W Broadway Missoula MT 59802 Outpatient Services 9 - Missoula Family Medical 900 N Orange Street Suite 303 Missoula MT 59802 Outpatient Services 10 - Missoula Midwives 601 W Spruce Street Suite D Missoula MT 59802 Outpatient Services 11 - Montana Internal Medicine 2819 Great Northern Loop Suite 200 Missoula MT 59808 Outpatient Services 12 - Montana Nephrology 500 W Broadway Broadway Bldg 4th Fl Missoula MT 59802 Outpatient Services 13 - Montana Neurosurgical Specialists 500 W Broadway Suite 310 Missoula MT 59802 Outpatient Services 14 - Montana Spine and Pain Center 500 W Broadway 3rd Fl Missoula MT 59802 Outpatient Services 15 - Occupational Health 3055 N Reserve Street Suite D Missoula MT 59808 Outpatient Services 16 - Providence Neurology Specialists 601 W Spruce Street Suite J Missoula MT 59802 Outpatient Services 17 - Providence Palliative Care 900 N Orange Street Suite 205 Missoula MT 59802 Outpatient Services 18 - Providence Psychiatry 900 N Orange Street Suite 202 Missoula MT 59802 Outpatient Services 19 - Urgent Mental Health Clinic 900 N Orange Street Suite 102 Missoula MT 59802 Outpatient Services 20 - Women's Care and Family Wellness 1211 S Reserve Street Suite 101 Missoula MT 59801 Outpatient Services 21 - Wound Care Center 902 N Orange Street Missoula MT 59802 Outpatient Services 22 - Lifespan Family Medicine 715 South Main Street Suite A Stevensville MT 59870 Outpatient Services Part I, Line 3c: The PH&S sliding fee scale set forth in Attachment B will be used to determine the amount of financial assistance to be provided in the form of a discount of 75 percent for patients or guarantors with incomes between 301% and 350% of the current federal poverty level after all funding possibilities available to the patient or guarantor have been exhausted or denied and personal financial resources and assets have been reviewed for possible funding to pay for billed charges. Financial assistance may be offered to patients or guarantors with family income in excess of 350% of the federal poverty level when circumstances indicate severe financial hardship or personal loss. Part I, Line 6a: In addition to providing its own smaller Community Benefit Report, St. Patrick's Community Benefit information is included in the consolidated report for Providence Health & Services.http://montana.providence.org/hospitals/st-patrick/community-support/ 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 $ 5,073,068. Part II, Community Building Activities: United WayUnited Way of Missoula County builds a better community for all, specifically in the areas of education, income, and health. We collaborate with diverse community partners to identify important social issues and bring together resources to address them. We give donors a trusted, one-stop way to support critical services for people in need, and we make sure that donated dollars are invested wisely and well.Childhood ObesityCATCH stands for a Coordinated Approach to Child Health. By uniting multiple players in a child's life to create a community of health, CATCH is proven to prevent childhood obesity and supported by 25 years and 120 academic papers indicating as much as 11% decrease in overweight children and obesity. Our community health programs aim to impact the messaging a child receives in physical education, the lunchroom, the classroom, and at home, to influence a child's choices not only in school, but lifelong.Let's Move! Missoula (LM!M) is a local initiative that is part of the national Let's Move! campaign to combat the epidemic of childhood obesity. Nationally, the vision of Let's Move! is to raise a healthier generation of kids. Locally, many community partners take part in LM!M. The mission of LM!M is to mobilize projects and partnerships that build healthy kids and residents of all ages - no matter where they live, work, play, or go to school. Projects focus on improving physical activity opportunities, nutrition, and access to healthy foods.Community Support: Kids TableSt. Patrick Hospital is supporting early childhood development by partnering with the Missoula Food Bank Kids Table to nourish Missoula children during their time of critical physical, cognitive, social and emotional development. The collaboration addresses local childhood hunger, especially during the summer months when kids may otherwise go hungry without school-sponsored meals. Community Health Improvement/Advocacy: Medication and enrollment assistance for health coverageUninsured patients often do not fill critical prescriptions due to cost and forego care due to lack of coverage, which affects their long term health. This program assists low income and self pay patients with the assistance they need to access patient assistance programs of pharmaceutical companies and state/federal coverage options. With the high uninsured rate in Missoula County at 19%, the total number of seniors living in poverty at 69% and the many patients with mental illness that St. Patrick Hospital serves, we work to bridge patient needs with programs that can support them.In addition to the free and discounted care that we provide, we also have State Health Insurance certified counselors trained to assist uninsured and underinsured residents in our community in securing options for both medical (ACA) and pharmaceutical coverage. This program is not done for marketing purposes and meets a necessary public health objective.Community Health Improvement: Environmental StewardshipGreen 4 Good (G4G) is an initiative at St. Patrick Hospital to decrease the environmental impacts of our daily healthcare work. As a hospital, we are charged with caring for people in times of need; requiring resources such as supplies, heat, and electricity to do so. At the same time, healthcare causes pollution through its energy use, waste creation, and use of toxic chemicals. Through G4G, St. Patrick Hospital works to reduce impacts to the natural environment, in turn creating a healthier environment for patients, staff members, and communities. This Environmental Stewardship Report highlights G4G's accomplishments in 2016. Energy ReductionIn 2016 we continued our work to decrease the hospital's energy use. In 2016 we saw an increased average daily census, seeing more patients and offering more services, and were still able to decrease electricity use by 173,615 kwh from the previous year.Goals 4 GoodIn May 2016 we introduced a new program called Goals 4 Good. Each month we ask that caregivers pledge to complete a certain goal designed to reduce their environmental impact both at home and at work. These goals can help to reduce CO2 emissions, save water, decrease waste, use less energy, or increase engagement. Below are a few accomplishments from 2016.--Saved 16,569 gallons of water by turning off the water while brushing teeth--Sustainably commuted 2,597 miles which saved 2,281 pounds of CO2--Diverted 30 pounds of plastic from the landfill by shopping with reusable bagsProvidence Garden 2016 was our third successful growing season at the Providence Garden. Each week throughout the summer our garden coordinators harvest produce and deliver it to the Missoula Food Bank, in 2016 we donated 916 pounds. That garden saw increased use by patients and caregivers alike. Caregivers often ate lunch at the picnic table or strolled through the garden on their way home. Several therapists held sessions with their patients in the garden. On August 5th we hosted a first Friday celebration in the garden that included food and beverages accompanied by music from a local folk musician and clay creations from a local artist. Engagement This year we --Installed seven water bottle fill stations throughout the hospital and encouraged caregivers to bring their own bottles to work and reduce plastic bottle waste. We logged 22,302 bottle fills in 2016.--Celebrated Earth Week by focusing on the Pope's encyclical, Laudato Si': On Care for our Common Home. We had games, prizes, lunchtime lectures, and free giveaways. --Sponsored a Providence team to volunteer at the annual Clark Fork River Cleanup. Thirteen caregivers and their families spent a Saturday cleaning up a section of the river near the hospital.--Offered on-site delivery of Community Supported Agriculture (CSA) shares from Western Montana Grower's Cooperative. We had 60 caregivers participate in the summer and 14 participate in the fall. --Met with department leaders to discuss environmental stewardship successes and opportunities in their respective areas.--Developed a quarterly dashboard to report on energy use, Goals 4 Good results, and other program highlights.--Installed an announcement board in the cafe to share information related to environmental stewardship.--Volunteered with Climate Smart Missoula to "green" the River City Roots Festival. A group of employees helped with recycling efforts, answered questions, and helped to educate the community about sustainability efforts.--Educated the community through Healthbreak and Nurse's Notes. Part III, Line 2: Bad debt expense represents the amount of gross charges for patients who do not have insurance and which PH&S-MT was unable to qualify for assistance under either government programs or our internal charity care policy. Part III, Line 4: The Health System provides for an allowance against patient accounts receivable for amounts that could become uncollectible. The Health System estimates this allowance based on the aging of accounts receivable, historical collection experience by payor, and other relevant factors. There are various factors that can impact the collection trends, such as changes in the economy, which in turn have an impact on unemployment rates and the number of uninsured and underinsured patients, the increased burden of copayments to be made by patients with insurance coverage and business practices related to collection efforts. These factors continuously change and can have an impact on collection trends and the estimation process used by the Health System. The Health System records a provision for bad debts in the period of services on the basis of past experience, which has historically indicated that many patients are unresponsive or are otherwise unwilling to pay the portion of their bill for which they are financially responsible. Part III, Line 8: It is Providence's policy to exclude any Medicare shortfall from Community Benefit information. The amount reported on Part III, Section B, line 6, was determined by applying the Cost-to-Charge Ratio to the Medicare revenue. Part III, Line 9b: Billing and Collection PracticesProvidence has written policies about when and under whose authority patient debt is advanced for collection, and uses its best efforts to ensure that patient accounts are processed fairly and consistently.Providence ensures that practices to be used by their outside (non-hospital) collection agencies conform to the standards set forth in this policy, and obtains written commitments from such agencies that they will adhere to those standards. Providence also conducts an assessment of each collection agency's adherence to the policy. Such assessments are conducted at least annually.At time of billing, we provide to all low-income uninsured patients the same information concerning services and charges provided to all other patients who receive care at the hospital.When sending a bill to a patient, Providence includes a) a statement that indicates that if the patient meets certain income requirements the patient may be eligible for a government-sponsored program or for financial assistance from the hospital; and b) a statement that provides the patient with the name and telephone number of a hospital employee or office from whom or which the patient may obtain information about Providence's financial assistance policies for patients and how to apply for such assistance.Any patient seeking financial assistance from Providence (or the patient's legal representative) provides the individual facility with information concerning health benefits coverage, financial status (i.e. income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs.For patients who have an application pending determination for either government-sponsored coverage or for the hospitals own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency.Eligibility for financial assistance will be determined as closely as possible to the date of service. Part VI, Line 2: We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care.The Missoula County 'Community Health Assessment Committee' with input from the Providence St. Patrick Hospital Board's Mission and Community Needs Committee met over 12 months to discuss the most pressing health concerns as well as to gather and review data to identify the greatest community needs. CHA Work Group members collected community input specifically for use in the report. Two focus groups for the community at large, conducted by St. Patrick Hospital in collaboration with Community Medical Center and Partnership Health Center, held on May 14 and 16, 2014. Community survey administered by St. Patrick Hospital in May 2014. Focus group at Missoula Aging Services, conducted by MCCHD and Partnership Health Center, held on September 16, 2014. Focus group at Missoula Indian Center, conducted by MCCHD, held on September 16, 2014. Survey posted with CHA report on MCCHD website, October through November 2014. Presentations at community council meetings in Bonner, East Missoula, and Frenchtown, conducted by MCCHD in November 2014. Community input meeting, conducted by MCCHD, held at the Missoula Public Library on November 19, 2014. Missoula County CHA was approved December 2014. The CHA group identified two priority areas to address in the CHIP (Community Health Improvement Plan) December 2014. The SPH Mission and Community Needs Committee met to approve the priority areas identified for the CHIP and the additional objectives that Providence will work on to address community needs. Part VI, Line 3: Communication to the Public:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills. The financial counselors are available to meet with patients or families if they have a question about their bill or those needing assistance in filling out applications for coverage for a variety of programs such as Medicaid, CHIP or ACA-market place plans. The financial counselors are available every day of the week.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients. Part VI, Line 4: St. Patrick Hospital is a Catholic, not-for-profit acute care tertiary medical center located in Missoula, Montana. The hospital serves a primary service area of about 200,000 people in western Montana and 400,000 others in contiguous areas. St. Patrick Hospital provides cardiac and neurosurgical services along with other acute inpatient medical/surgical services and inpatient rehabilitation and neurobehavioral medicine. St. Patrick Hospital operates the only level 2 Trauma Center in Western Montana and has accredited chest pain, stroke and child advocacy programs (FirstSTEP).The US Census estimates Missoula County's 2013 population at 111,807, the second most populous county in Montana. The City of Missoula is the county seat and has an estimated 2013 population of 69,122, almost 62% of the total county population. The US census estimated growth rate for Missoula County between 2010 and 2013 is 2.3%.Poverty levels are high in Missoula County, and wages are low. The US census 2013 estimates are that 18% of county residents living in poverty, compared to 15% in Montana. Part VI, Line 5: St. Patrick Hospital, St. Joseph Medical Center and Providence Medical Group collectively build and support coordinated services across the continuum of care to meet regional residents' needs, while mutually supporting organizational, operational, and fiscal health. Joint ventures include research collaborations (cardiac, neuroscience, and oncology) with the University of Montana; affiliations with long term care facilities; a federally qualified health center and a surgery center, among others. St. Patrick Hospital management is directed by an independent governing board which helps direct the hospital in its Mission to serve the community. The composition of the governing board represents the diversity of the community by having representatives from local government, social service agencies, medical providers, independent business representatives and interested community members. The St. Patrick Hospital Board reviews and develops the community benefit plan, providing information and insight into community needs and resources and helping set priorities for what community needs are to be addressed. They also receive regular updates on the overall community benefit strategy and specific programs to assess whether the organization is having an impact on the health of the community. As a ministry of Providence Health & Services, St. Patrick Hospital is guided by a Mission and set of core values based on Catholic health care and inspired by the legacy of the Sisters of Providence. As one Catholic health system committed to caring for the poor and vulnerable, Providence Health & Services has developed a single framework for consistently reporting charity care and community benefit. Our responsibility to stewardship drives us to a standardized approach to supply chain so that we can deliver excellent patient care while reducing the cost of delivered supplies. Our commitment to respect and fairness means Providence has a system-wide compensation policy. Locally, Providence St. Joseph Medical Center is empowered to apply these policies to meet the local needs of their community. St. Patrick Hospital has affiliate relationships with the following critical access hospitals in western Montana: Community Medical Hospital in Anaconda; Clark Fork Valley Hospital in Plains and Granite County Hospital in Phillipsburg. These critical access hospitals are limited service hospitals designed to provide essential services to rural communities. St. Patrick Hospital supports its rural community hospitals by allowing them to purchase supplies and medical equipment at a very low cost due to the purchasing abilities of the whole Providence system. These critical access hospitals are able to maintain access to critical medical services in very rural counties by Providence's support, in fact, every one of these hospitals is located in a county that has the federal designation as health provider shortage areas. The Institute of Medicine and Humanities is a joint program of The University of Montana and St. Patrick Hospital. The institute fosters the human dimensions of health care by working at the interface of the humanities and medicine. Since its inception in 1987, the Institute of Medicine and Humanities has employed both the traditional humanities and the fine arts to illuminate and understand major issues that confront health care in contemporary society. As medicine has changed, the institute has also evolved its focus to look more broadly at opportunities to make a difference through education in the health care environment with an emphasis on health, as opposed to health care specifically. This includes education of the public about important health care issues; education of undergraduates interested in the health care profession; and education of graduate level nursing, pharmacy and medical students in ethics, collaborative care and team building and conflict resolution.St. Patrick Hospital conducts local assessments to make sure the needs of the community are met. The community board of directors oversees and approves the annual community benefit plan that addresses the health care disparities within the community. The community benefit plan is developed and reviewed annually to ensure that the proposed outcomes are being met. This plan is implemented in concert with others in the community to increase the accountability that we share with them to improve the health of our community and to not duplicate services. Part VI, Line 6: Effective 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 MT 1 St Patrick Hospital Foundation dba Providence Montana Health Foundation 900 N Orange Suite 201 Missoula MT 59802 237056976 501 (C)(3) 662520 Contribution for Operational Support University of Montana Foundation PO Box 7159 Missoula MT 59807 810362989 501 (C)(3) 60000 Pledge to Missoula College Building Fund Catholic Social Services Of Montana PO Box 907 Helena MT 59624 920037322 501 (C)(3) 35000 Serving Catholic social services in MT Missoula County Public Schools 215 South 6th West Missoula MT 59801 810504312 Government 30000 Sponsor Health Science Academy at Big Sky High School Special Olympics Montana PO Box 3507 Great Falls MT 59403 810367064 501 (C)(3) 25000 Montana Special Olympics Sponsorship Missoula County United Way 412 W Alder St Missoula MT 59807 810287854 501 (C)(3) 25000 Support Healthcare in Community American Heart Association PO Box 50085 Prescott AZ 86304 135613797 501 (C)(3) 17500 Building healthier lives free of cardiovascular disease & stroke Missoula Community Foundation PO Box 8806 Missoula MT 59807 810539830 501 (C)(3) 15000 Sponsor Climate Smart Missoula North Missoula Community Development Corporation 1500 Burns Street Missoula MT 59802 810509941 501 (C)(3) 15000 Burns Street nutrition program support City of Missoula 435 Ryman St Missoula MT 59802 816001293 Government 15000 Support Let's Move Missoula before school program Missoula Aging Service 337 Stephens Ave Missoula MT 59801 810379543 501 (C)(3) 10000 Support care transitions program Missoula Food Bank 219 South Third Street West Missoula MT 59801 810414143 501 (C)(3) 6000 Support for community programs St Francis Xavier Parish 420 West Pine Street Missoula MT 59802 810233122 501 (C)(3) 5500 Support for 125th Anniversary Celebration Tamarack Grief Resource Center 405 S 1st St W Missoula MT 59801 262278278 501 (C)(3) 5000 Support for bereavement and trauma care 14 0 Tuition Assistance 25 81626 Cost Tuition for Nursing Program Students at UGF Part I, Line 2: In general those donation requests come directly to the Administrative team. If appropriate in nature, the Admin team may hand off to the Mission and Community needs assessment subcommittee of the Board for their recommendation. If it goes to the subcommittee the requesting party comes before the subcommittee to present their need which includes intended use of the funds. Either way the Admin team must give final approval. The Admin team either sees the deployment of the funds in specific Community projects and/or they will ask for reports from the group on how the funds impacted the specific community project. Most of them come with some sort of formal recognition of St. Pats as a primary donor. Scholarships are awarded based on need and other criteria. Specific follow up is monitored through the affiliated University of Great Falls. 1 1 0 0 0 0 0 0 0 Rod F Hochman MD President / CEO - Thru 6/16 0 1912650 0 2130271 0 18000 0 25159 0 18384 0 4104464 0 0 Mike Butler President - Eff. 7/16 0 1241463 0 5618732 0 46498 0 324347 0 25286 0 7256326 0 2182191 Todd Hofheins EVP/CFO /Treas. Thru 11/16 0 765052 0 762582 0 43806 0 33684 0 26986 0 1632110 0 0 Jo Ann Escasa-Haigh Interim CFO/Treasurer - Eff.12/16 0 284195 0 465096 0 6125 0 158719 0 9471 0 923606 0 0 Cindy Strauss EVP/Chief Legal Officer 0 657902 0 762672 0 42206 0 35775 0 22491 0 1521046 0 0 Jeffrey Fee CE/Western MT. Region 0 367073 0 214880 0 18000 0 79978 0 22604 0 702535 0 0 Kirk Bodlovic CFO/St. Patrick Hospital 0 223638 0 46909 0 75 0 24308 0 19511 0 314441 0 0 Debra Canales EVP/CAO 0 801127 0 1168376 0 122854 0 598119 0 13490 0 2703966 0 0 Janice Newell SVP/Chief Information Officer 0 576214 0 517269 0 44010 0 18550 0 15548 0 1171591 0 0 Joel Gilbertson SVP/Community Partnerships 0 443246 0 350838 0 47943 0 224819 0 23028 0 1089874 0 0 Orest Holubec SVP/Chief Comm./Ext. Affairs Officer 0 396372 0 343782 0 42534 0 185290 0 22516 0 990494 0 0 Greg Till VP/Chief Talent Officer 0 396660 0 378331 0 1020 0 99936 0 22431 0 898378 0 0 Sharon Toncray SVP / Chief Labor Employee Counsel 0 408183 0 308273 0 48521 0 221561 0 22167 0 1008705 0 0 Jack Mudd - Thru 316 SVP/Mission Leadership 0 249590 0 426247 0 42891 0 141404 0 16374 0 876506 0 0 Paul Stoddart - Thru 916 VP/Marketing 0 239356 0 306938 0 95129 0 11537 0 10844 0 663804 0 0 Robert Hellrigel SVP-CE / Senior & Comm. Services 0 393690 0 222195 0 4396 0 174041 0 22748 0 817070 0 0 Mark Gargett VP/Digital Integration 0 386259 0 224528 0 0 0 42448 0 23522 0 676757 0 0 David Brown VP/Strategy & Business Development 0 388819 0 311642 0 0 0 203986 0 22444 0 926891 0 0 Debbie Burton SVP/ Chief Nrsg. Officer 0 355010 0 315852 0 42618 0 66297 0 23718 0 803495 0 0 Mary Cranstoun VP/Total Rewards 0 372857 0 272174 0 18000 0 91147 0 23270 0 777448 0 0 Aaron Martin SVP/Strategy & Innovation 0 542637 0 292297 0 18000 0 210328 0 8957 0 1072219 0 0 Tom McDonagh VP/Chief Investment Officer 0 478005 0 330119 0 41338 0 28774 0 24747 0 902983 0 0 Rhonda Medows MD EVP/Population Health 0 824899 0 698359 0 42442 0 299110 0 21169 0 1885979 0 0 Harvey Smith SVP/Chief Customer Svc. Officer 0 579168 0 628988 0 18000 0 7950 0 15841 0 1249947 0 0 Lisa Vance SVP/Clinical Program Services 0 571069 0 606964 0 42315 0 110502 0 14943 0 1345793 0 0 Mike Waters VP,CAO/Physician Services 0 426739 0 274903 0 2135 0 172012 0 12011 0 887800 0 0 Amy Compton-Phillips EVP/Chief Clinical Officer 0 713661 0 303268 0 96564 0 251731 0 27163 0 1392387 0 0 Simone Musco MD Physician 578045 0 340441 0 18075 0 17360 0 21460 0 975381 0 0 0 Michael Yerkey MD Physician 560895 0 274165 0 18075 0 13197 0 21286 0 887618 0 0 0 Mark L Sanz MD Physician - Cardiology 430661 0 277529 0 18075 0 28173 0 20849 0 775287 0 0 0 James Maddux MD Physician 646041 0 47500 0 18075 0 25044 0 21466 0 758126 0 0 0 James M Maxwell MD Physician 627998 0 50000 0 18075 0 33125 0 20481 0 749679 0 0 0 Randy Axelrod MD EVP/Clinical & Patient Services 0 0 0 564384 0 854949 0 0 0 0 0 1419333 0 0 Craig Wright MD SVP/Physician Services 0 14760 0 551522 0 553657 0 2107 0 18348 0 1140394 0 0 Jack Friedman SVP/Accountable Care & Payor Rel. 0 0 0 299327 0 0 0 0 0 0 0 299327 0 0 Part I, Line 1a The reporting organization did not provide any of the benefits listed in Part I, Line 1a. However, as part of Providence's philosophy of transparency, the narrative that follows relates to the compensation and benefits provided by the related organization. Providence Health & Services Expense Reimbursement Procedures include the following policies: Travel or Charter Travel or Travel of Companions Air travel is reimbursable and should be at the least expensive airfare; which permits departures and arrivals at reasonable times and reasonable distance traveled. Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class full fare tickets and charter must be approved by a senior level supervisor. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approved by the Executive Vice President, Chief Administrative Officer (EVP, CAO) of Providence St. Joseph Health. Spouse or Companion Travel. Travel expenses incurred by a PH&S employee's spouse or companion will not be reimbursed by PH&S unless the spouse or companion is required to, or invited to attend a PH&S System-sponsored meeting. These expenses may be considered a taxable benefit by the IRS and if so, will be included on the employee's W- 2. During 2016, there were 23 First Class tickets utilized by Officers, Directors or Key Employees listed on Form 990, Part VII. Tax Indemnifications or Gross-Up Payments - Relocation Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2016, there were 3 Key Employees receiving gross-up payments. The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation on the Form 990. Tax Indemnifications or Gross-Up Payments - Financial/Retirement Planning Providence Health & Services follows the federal and state taxation laws related to other expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay these other expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the financial/retirement planning benefits, during 2016 only, to offset the personal tax burden to the employee for IRS allowable expenses. During 2016, there were 4 Officers, 13 Key Employees and 1 Former Key Employee receiving this type of gross-up payment. The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation on the Form 990. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding "rent" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The EVP, CAO PSJH may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2016, there were 3 Key Employees receiving relocation/housing program payments. The amounts reported for these relocation/housing payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation on the Form 990. Part I, Lines 4a-b NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan 1) Rod Hochman, MD a) SERP Earned but not Paid - $71,434 2) Cindy Strauss a) SERP Earned but not Paid - $23,073 3) Michael Butler a) SERP Vested but not Paid - $4,194,363 b) SERP Interest Credit - $280,622 4) Jo Ann Escasa-Haigh a) SERP Earned but not Vested - $144,759 5) Jeff Fee a) SERP Interest Credit - $54,517 6) Debra Canales a) SERP Earned but not Vested - $578,244 7) Rhonda Medows, MD a) SERP Earned but not Vested - $267,369 b) SERP Interest Credit - $11,866 8) Lisa Vance a) SERP Interest Credit - $79,015 9) Janice Newell a) SERP Earned but not Paid - $23,422 10) Amy Compton-Phillips a) SERP Earned but not Vested - $223,438 b) SERP Interest Credit - $8,418 11) Aaron Martin a) SERP Earned but not Vested - $188,376 12) Joel Gilbertson a) SERP Earned but not Vested - $160,455 b) SERP Interest Credit - $39,169 13) Orest Holubec a) SERP Earned but not Vested - $144,707 b) SERP Interest Credit - $19,483 14) Greg Till a) SERP Earned but not Vested - $78,010 b) SERP Interest Credit - $10,002 15) Sharon Toncray a) SERP Earned but not Vested- $172,369 b) SERP Interest Credit - $22,823 16) Jack Mudd a) SERP Earned but not Paid - $5,896 b) SERP Interest Credit - $115,845 17) Debbie Burton a) SERP Earned but not Paid - $16,879 b) SERP Interest Credit - $37,391 18) Mike Waters a) SERP Earned but not Vested - $143,129 b) SERP Interest Credit - $10,334 19) David Brown a) SERP Earned but not Vested - $134,921 b) SERP Interest Credit - $42,528 20) Mary Cranstoun a) SERP Earned but not Vested - $77,234 21) Paul Stoddart a) SERP Interest Credit - $8,530 22) Robert Hellrigel a) SERP Earned but not Vested - $136,978 b) SERP Interest Credit - $10,404 23) Mark Gargett a) SERP Earned but not Paid - $12,295 b) SERP Interest Credit - $11,400 24) Randy Axelrod, MD a) SERP Paid - $564,384 25) Craig Wright, MD a) SERP Earned but not Paid - $233,982 Part I, Lines 4a-b SEVERANCE 1) Paul Stoddart - $77,130 2) Randy Axelrod - $850,776 3) Craig Wright, MD - $525,300 FORM 990, SCHEDULE J, 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 2016, 60 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's strategic priorities. In 2016 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. A Montana Facility Finance Authority 810302402 61204KCB5 2016-09-28 43198256 See Part VI 0 0 0 A 43198255 113566 43057974 26715 2002 1 0 1 1 A 0 1 0 0 0 0 0 0 1 A 1 Issue A. Part I, Question (f) Current refunding of the Montana Facility Finance Authority Series 2006B bonds. SCHEDULE K - PART I - BOND ISSUES The 2016F Series issued by the Montana Facility Finance Authority was issued to cover the refunding of the 2006B Series bonds for both Providence Health & Services - Montana and Providence St. Joseph Medical Center located in Polson, MT. Since this bond issue is spread across two separate legal entities, the amounts shown reflect only the portion allocated directly to Providence Health & Services - Montana. Form 990, Part VI, Section A, line 6 The sole Member of the Corporation is Providence Health & Services, a Washington not-for-profit corporation. Form 990, Part VI, Section A, line 7a The powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause. Additionally, the Member may appoint and remove the President/CEO with or without cause, after requesting a recommendation for the Board of Directors. Form 990, Part VI, Section A, line 7b The following powers reside with the Member: * To adopt or change the mission, philosophy, and values of the Corporation. * To amend or repeal the Articles of Incorporation and the Bylaws of the Corporation. * To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale, transfer, assignment or encumbering of the assets, in excess of a specified amount. * To approve the dissolution and/or liquidation or the consolidation or merger of the Corporation. * To approve the annual operating and capital budget and approval any deviations from the budget exceeding a specified amount. * To appoint the Corporation's certified public accountants after receiving recommendation of the Board of Directors. * To approve the closure of any institution or major ministry or work within this Corporation. Form 990, Part VI, Section B, line 11b The Form 990 is prepared internally by experienced Providence Health & Services staff and reviewed by the internal PH&S Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict. Form 990, Part VI, Section B, line 15 It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence 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 has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence 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 and approved by the full Board of Directors, none of whom is a Providence employee. 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 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. Additionally, Providence's labor market continues to spread across health care and into general industry. Because of this, Providence also takes into consideration general industry for-profit market data, where applicable. Base salaries for Providence executives are generally targeted to the median level of the market, as identified by the independent consultant and reviewed with the Executive Compensation Committee. Each year, the Board Chair conducts a formal performance evaluation of the President/CEO that considers input from the other directors and senior leaders reporting to the President. The evaluation is discussed with the Executive Compensation Committee and then a recommendation is made by the committee to the full Board. The Board Chair and the Chair of the Executive Compensation Committee also meet with an independent consultant to develop a salary recommendation; which is reviewed and approved first by the committee and then by the Board of Directors. Additionally, 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 operating commitments and strategic objectives. The Board of Directors conducts a thorough 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. Form 990, Part VI, Section C, line 19 Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon request. The consolidated financial statements are available on our public Internet site www2.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site. Form 990, Part VII Contact Addresses for Officers, Directors, Etc Jeffrey Fee - 500 West Broadway, Missoula, MT 59802. Kirk Bodlovic - 500 West Broadway, Missoula, MT 59802. Form 990, Part IX, line 11g Agency/Contract Labor: Program service expenses 746,611. Management and general expenses 7,744. Fundraising expenses 0. Total expenses 754,355. Medical Director & Med Physician Fees: Program service expenses 18,232,107. Management and general expenses 42,834. Fundraising expenses 0. Total expenses 18,274,941. Repairs & Maintenance: Program service expenses 3,034,289. Management and general expenses 500,326. Fundraising expenses 0. Total expenses 3,534,615. Billing & Collections: Program service expenses 0. Management and general expenses 3,222. Fundraising expenses 0. Total expenses 3,222. Transcription & Translation Services: Program service expenses 37,782. Management and general expenses 0. Fundraising expenses 0. Total expenses 37,782. Dietary: Program service expenses 5,383. Management and general expenses 3,990. Fundraising expenses 0. Total expenses 9,373. Other Patient Services: Program service expenses 20,514,168. Management and general expenses 2,157. Fundraising expenses 0. Total expenses 20,516,325. Other Administrative Services: Program service expenses 5,473,327. Management and general expenses 1,128,302. Fundraising expenses 0. Total expenses 6,601,629. General Consulting Fees: Program service expenses 2,754,186. Management and general expenses 1,597,471. Fundraising expenses 0. Total expenses 4,351,657. Form 990, Part XI, line 9: Recipient Organization Adjustment 954,787. IAF Rent Revenue 1,035,434. IAF Rent Expenses -1,036,308. Rounding 1. Affiliate Transfers 8,566,782. FORM 990, PART XII, LINE 2C - AUDIT & COMPLIANCE The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the System's financial statements and reporting, the audit process and the System's internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the System's internal and external auditors; the System's investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. FORM 990, PART IX, COLUMN D FUNDRAISING EXPENSES This entity had no fundraising expenses as all fundraising is handled through an affiliated Foundation. FORM 990, PART I, LINE 6 - VOLUNTEERS Volunteers with St. Patrick Hospital provide staffing in the following areas. Shifts are usually three and half to four hours in length. * Broadway Building Outpatient Pharmacy - Assist Pharmacy staff and serve customers of the Broadway Building Pharmacy. * Day Surgery - Act as hostess or host to patients' families. * Distribution and Delivery - Make supply deliveries throughout hospital on the even hour or as directed for rush orders. * First Class Crew - Work on special projects as requested by hospital departments. * Foot Clinic - Greet patients and visitors of St. Pat's Foot Care Service Clinics. * Gift Shop, Broadway Building "Shamrock Shop" - Customer service volunteer provides necessities and gift items to patients, visitors and staff of St. Patrick Hospital. * Information Center-Broadway Building - Provide hospitality by greeting and escorting patients and visitors to desired locations in the Broadway Building or Hospital, or provide clear directions for them. * Information Desk - Hospital - Provide hospitality by greeting hospital patients and visitors. Volunteers at the Information Desk provide the front door first impression of our hospital. * International Heart Institute-Provide information and assistance to patients and families seeking a particular location or service. Additional tasks include stocking supplies in exam rooms and recycling. * Intensive Care Unit Information - Serve as a hostess or host, and thoughtfully and considerately provide help to families of critically ill patients. * Mended Hearts Patient Visitation- Offer help, support and encouragement to heart disease patients and their families. Mended Heart Volunteers are members of Mended Hearts Chapter 324 and are heart disease survivors. * Cancer Center- Provides support to patients by offering non-medical assistance to enhance perception of quality care and hospitality. * Neurobehavioral Medicine Visitor Registration- Assist Neurobehavioral Health (NBH) staff and serve patients and visitors of the facility. * Patient and Guest Escort Services- Help hospital visitors find their way from one location to another within St. Patrick Hospital and the Broadway Building. Assist patients upon admission or discharge. * Stocking Patient Room Cabinets-Times are flexible, determined by the nursing floor. * Sunrise Coffee Service- Early morning service offering hospital patients by coffee, tea or juice and a newspaper. * St. Patrick House - Assist staff of St. Patrick House by offering excellent hospitality to visitors and residents of the house and by completing routine tasks required for efficient operation of St. Patrick House. In addition, volunteers serve in many of our hospital departments. Requests are often for special one-time clerical projects but some departments need volunteer help weekly: - Providence Montana Health Foundation Office - Learning Center (Library) - Print Shop - Volunteer Services Office FORM 990, PART VII - RELIGIOUS COMMUNITY MEMBERS As members of the Religious Community, each Sister has taken a vow of poverty as a compulsory part of her religious life. Any compensation for services of a Sister inures only for the benefit of the Community, not the individual members. All payments for services are made directly to the Religious Community. FORM 990, PART V, LINE 1 - ISSUANCE OF FORM 1099 All 1099s for 2016 were issued by Providence Health & Services - Washington #51-0216586. Therefore, none are shown for the reporting organization. FORM 990, SCHEDULE R - RELATED ORGANIZATIONS AFFILIATION AGREEMENTS Effective April 1, 2016, the Health System (Providence Health & Services) entered into a business combination agreement with the Institute for Systems Biology (ISB). The transaction was accounted for as an acquisition under ASC 958-805. On July 1, 2016, Providence Health & Services (PHS) and St. Joseph Health System (SJHS) entered into a business combination agreement, the purpose of which was to better serve both organizations' communities, maintain strong traditions of Catholic healthcare, and provide greater affordability and access to healthcare services. As part of the business combination, PHS and SJHS aligned under a single parent corporation, Providence St. Joseph Health, with a consolidated board of directors and cosponsorship from the public juridic persons Providence Ministries and St. Joseph Health Ministry. SJHS provides a full range of care facilities including 16 acute care hospitals, home health agencies, hospice care, outpatient services, skilled nursing facilities, community clinics, and physician groups spanning California, west Texas, and eastern New Mexico. The results of operations of these entities have been included in the combined statements of operations of the Health System since July 1, 2016, the effective date of the business combination. Providence Health & Services - Washington 1801 Lind Avenue SW 9016 Renton WA 980579016 510216586 Healthcare System WA 501( c)(3) Line 3 Providence Health & Services 0 Providence Health & Services - Oregon 1801 Lind Avenue SW 9016 Renton WA 980579016 510216587 Healthcare System OR 501( c)(3) Line 3 Providence Health & Services 0 Providence Health System - So California 1801 Lind Avenue SW 9016 Renton WA 980579016 510216589 Healthcare System CA 501( c)(3) Line 3 Providence Health & Services 0 Everett Transitional Care Services PO Box 5128 Everett WA 982065128 943264605 Transitional Care WA 501( c)(3) Line 10 N/A 0 Providence Plan Partners 4400 NE Halsey Bldg 2 Portland OR 97213 911861964 Healthcare Services WA 501( c)(4) N/A PH & S - Oregon 0 Providence Health Plan 4400 NE Halsey Bldg 2 Portland OR 97213 930863097 Health Service Contractor OR 501( c)(4) N/A Providence Plan Partners 0 Providence Health Assurance 4400 NE Halsey Bldg 2 Portland OR 97213 550828701 Medicaid Healthcare Provider OR 501( c)(4) N/A Providence Health Plan 0 Providence Medical Institute 4101 Torrance Blvd Torrance CA 90503 330283773 Healthcare CA 501( c)(3) Line 12/Type I PHS - So California 0 Little Company of Mary Ancillary Services Corporation 4101 Torrance Blvd Torrance CA 90503 330844408 Imaging Services CA 501( c)(3) Line 10 PHS - So California 0 Providence TrinityCare Hospice 5315 Torrance Blvd Suite B1 Torrance CA 90503 953264139 Hospice CA 501( c)(3) Line 10 PHS - So California 0 Providence Blanchet Association 1700 Providence Pl Centralia WA 98531 911789266 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 St Luke Association 350 Washington Ave SE Chehalis WA 98352 943176618 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Rossi Association 1700 Providence Pl Centralia WA 98531 311584166 Supportive Housing WA 501( c)(3) Line 10 PH & S - Washington 0 Lundberg Association 5921 E Burnside Portland OR 97215 911562797 Supportive Housing OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence St Francis Association 3415 12th Avenue NE Olympia WA 98506 943244854 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Peter Claver Association 7101 38th Avenue South Seattle WA 98118 311629656 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence St Elizabeth House Association 3201 SW Graham St Seattle WA 98126 912171539 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Gamelin House Association 4515 MLK Jr Way S Ste 200 Seattle WA 98108 311744654 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 The Gamelin Association 312 North Fourth St Yakima WA 98901 911180824 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 The Gamelin Oregon Association 5520 NE Glisan Portland OR 97213 911214491 Supportive Housing OR 501( c)(3) Line 10 PH & S - Oregon 0 The Gamelin California Association 540 23rd St Oakland CA 94612 911293869 Supportive Housing CA 501( c)(3) Line 10 PHS - So California 0 Gamelin Washington Association 1423 First Avenue Seattle WA 98101 201910170 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Dethman House 1205 Montello Ave Hood River OR 97031 473385506 Supportive Housing WA 501( c)(3) Line 7 N/A 0 Providence Foundation 1801 Lind Avenue SW 9016 Renton WA 980579016 943078543 Support PH&S and W. HealthConnect WA 501( c)(3) Line 12/Type I PH & S - Washington 0 Providence Alaska Foundation 3300 Providence Drive - B Tower2 Anchorage AK 99508 920093565 Support PHS-Alaska AK 501( c)(3) Line 12/Type I PH & S - Washington 0 Providence St Peter Foundation 413 Lilly Road NE Olympia WA 985065166 911097056 Support Affiliated Tax-Exempt Organization WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Health Care Foundation (Centralia) 914 S Scheuber Road Centralia WA 98531 911433382 Support Providence Centralia Hospital WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Mount St Vincent Foundation 4831 - 35th Avenue SW Seattle WA 981262799 911188119 Support Providence Mount St.Vincent WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Marianwood Foundation 3725 Providence Point Drive SE Issaquah WA 980297219 931554288 Support Providence Marianwood WA 501( c)(3) Line 12/Type I PH & S - Washington 0 Providence Newberg Health Foundation 1001 Providence Drive Newberg OR 97132 930889144 Support Providence Newberg Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Seaside Hospital Foundation 725 S Wahanna Rd Seaside OR 97138 930927320 Support Providence Seaside Hospital OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Community Health Foundation 1111 Crater Lake Ave Medford OR 97504 930692907 Support Providence Medford Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Benedictine Nursing Center Foundation 540 South Main St Mt Angel OR 973629532 911940286 Support Providence Benedictine Nursing Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Portland Medical Foundation 4805 NE Glisan St Portland OR 972132967 931231494 Support Providence Portland Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence St Vincent Medical Foundation 9205 SW Barnes Rd Portland OR 97225 930575982 Support Providence St. Vincent Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Milwaukie Foundation 10150 SE 32nd Milwaukie OR 97222 943079515 Support Providence Milwaukie Hospital OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Child Center Foundation 830 NE 47th Portland OR 97213 930800140 Support Providence Child Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence TrinityCare Hospice Foundation 5315 Torrance Blvd Suite B1 Torrance CA 90503 330261016 Support TrinityCare Hospice CA 501( c)(3) Line 7 Providence TrinityCare Hospice 0 Providence Little Company of Mary Foundation 4101 Torrance Blvd Torrance CA 90503 510224944 Support Little Company of Mary Service Area CA 501( c)(3) Line 7 PHS - So California 0 PH&S FoundationSFVSA & SCVSA 501 S Buena Vista Street Burbank CA 91505 953544877 Support Program & Activities of SFVSA & SCVSA CA 501( c)(3) Line 7 PHS - So California 0 Providence Hospice of Seattle Foundation 425 Pontius Avenue North 300 Seattle WA 981095452 912077378 Support Hospice of Seattle WA 501( c)(3) Line 12/Type I PH & S - Washington 0 Providence Health & Services - Western Washington 1801 Lind Avenue SW 9016 Renton WA 980579016 911303277 Healthcare WA 501( c)(3) Line 3 Providence MinistriesWHC 0 Providence Health & Services 1801 Lind Avenue SW 9016 Renton WA 980579016 911549796 Support Providence Institutions WA 501( c)(3) Line 12/Type II Providence St Joseph Health 0 Providence St Joseph Medical Center PO Box 1010 Polson MT 598601010 810463482 Healthcare MT 501( c)(3) Line 3 PH & S - Washington 0 St Thomas Child and Family Center 1710 Benefis Court Great Falls MT 59405 810233495 Early Childhood Education MT 501( c)(3) Line 10 PH & S - Washington 0 Sisters of Providence of Montana Corporation 1801 Lind Avenue SW 9016 Renton WA 980579016 262612415 Shell Corporation MT 501( c)(3) Line 1 PH & S - Washington 0 Providence Health Care Foundation - Eastern Washington 101 W 8th Ave Spokane WA 99204 320014330 Support PH&S-WA. Ministries in E. WA. WA 501( c)(3) Line 7 PH & S - Washington 0 St Patrick Hospital Foundation 500 West Broadway PO Box 4587 Missoula MT 598064587 237056976 Support Healthcare in W. Montana MT 501( c)(3) Line 7 PH & S - Montana 1 University of Great Falls 1301 20th Street South Great Falls MT 59405 810231777 Post Secondary Education MT 501( c)(3) Line 2 Providence Health & Services 0 E WA & MT Unemployment Compensation Insurance Trust 1801 Lind Avenue SW 9016 Renton WA 980579016 911082119 Unemployment Benefits WA 501( c)(3) Line 12/Type I PH & S - Washington 0 Providence Willamette Falls Medical Foundation 1500 Division Street Oregon City OR 97045 931003750 Support Willamette Falls Hospital OR 501( c)(3) Line 12/Type I PH & S - Oregon 0 Providence Hood River Memorial Hospital Foundation Inc 811 13th St Hood River OR 97031 930921990 Support Providence Hood River Memorial Hospital OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Hospice and Home Care Foundation 2731 Wetmore Avenue Suite 500 Everett WA 98201 272552749 Support Program & Ministries of PHHC WA 501(c )(3) Line 7 PH & S - Washington 0 Providence St Mary Foundation 401 W Poplar St Walla Walla WA 99362 452841492 Support Program & Ministries of SMMC WA 501(c )(3) Line 7 PH & S - Washington 0 Facey Medical Foundation 15451 San Fernando Mission Blvd 200 Mission Hills CA 913451420 954322584 Support Facey Medical Group CA 501(c )(3) Line 7 PHS - So California 0 Swedish Health Services 747 Broadway Seattle WA 98122 910433740 Healthcare WA 501(c )(3) Line 3 Western HealthConnect 0 Swedish Edmonds 21601 76th Ave W Edmonds WA 98026 272305304 Healthcare WA 501(c )(3) Line 3 Western HealthConnect 0 Swedish Medical Center Foundation 747 Broadway Seattle WA 98122 910983214 Support Swedish Health Services WA 501(c )(3) Line 7 Swedish Health Services 0 Global To Local Health Initiative 2800 South 192nd St 104 SeaTac WA 98188 273133200 Healthcare WA 501(c )(3) Line 7 Swedish Health Services 0 Swedish MJM Holdings 747 Broadway Seattle WA 98122 273139262 Holding Company WA 501(c )(3) Line 12/Type I Swedish Health Services 0 Marsha Rivkin Center for Ovarian Cancer Research 747 Broadway Seattle WA 98122 912054035 Ovarian Cancer Research WA 501(c )(3) Line 7 Swedish Health Services 0 Western HealthConnect 747 Broadway Seattle WA 98122 454171900 Shell Corporation WA 501(c )(3) Line 12/Type II PH&S Western Washington 0 Inland Northwest Health Services 601 W 1st Avenue Spokane WA 99201 911307555 Healthcare WA 501( c)(3) Line 3 PH&S - Washington 0 Kadlec Regional Medical Center 888 Swift Blvd Richland WA 99352 910655392 Healthcare WA 501(c )(3) Line 3 Western HealthConnect 0 Kadlec Neurological Resource Center 1268 Lee Blvd Richland WA 99352 911266345 Healthcare WA 501(c )(3) Line 10 Western HealthConnect 0 Kadlec Foundation 888 Swift Blvd Richland WA 99352 237005501 Support Kadlec Regional Medical Center WA 501(c )(3) Line 12/Type I Kadlec Regional Medical Center 0 PacMed Clinics 1200 12th Ave S Seattle WA 98144 562290878 Healthcare WA 501(c )(3) Line 10 Western HealthConnect 0 Seattle Science Foundation 550 17th Ave Seattle WA 98122 611502822 Physician Collaboration WA 501(c )(3) Line 7 Western HealthConnect 0 Providence Saint John's Health Center 2121 Santa Monica Blvd Santa Monica CA 90404 951684082 Healthcare CA 501(c )(3) Line 3 PHS - So California 0 John Wayne Cancer Institute 2200 Santa Monica Blvd Santa Monica CA 90404 954291515 Cancer Treatment CA 501(c )(3) Line 4 Providence Saint John's Health Center 0 Saint John's HospitalHealth Center Foundation 2121 Santa Monica Blvd Santa Monica CA 90404 956100079 Support Saint John Health Center & JWCI CA 501(c )(3) Line 7 Providence Saint John's Health Center 0 Providence St Joseph Health 1801 Lind Avenue SW 9016 Renton WA 98057 811244422 Support PH&S and St. Joseph Health System WA 501(c )(3) Line 12, Type III N/A 0 Institute for Systems Biology 401 Terry Ave N Seattle WA 98109 912003593 Predict, prevent & cure disease WA 501(c )(3) Line 7 Western HealthConnect 0 Providence Saint John's Medical Foundation 20555 Earl St Torrance CA 90503 814542216 Healthcare CA 501(c )(3) Pending PHS - So California 0 Institute for Mental Health & Wellness 1801 Lind Avenue SW 9016 Renton WA 98057 814260130 Mental Healthcare WA 501(c )(3) Line 7 PH&SSt Joseph Health System 0 Covenant Health Network Inc 3345 Michelson Drive Suite 100 Irvine CA 92612 461259908 Healthcare CA 501 (C )(3) Line 12, Type III St Joseph Health System 0 Covenant ACO 3615 19th Street Lubbock TX 79410 611573313 Healthcare TX 501 (C )(3) Line 12, Type I Covenant Health System 0 Covenant Health System 3615 19th Street Lubbock TX 79410 752765566 Healthcare TX 501 (C )(3) Line 3 St Joseph Health System 0 Covenant Health System Foundation 3623 22nd Place Lubbock TX 79410 752897026 Healthcare TX 501 (C )(3) Line 7 Covenant Health System 0 Covenant Medical Group 3420 22nd Place Lubbock TX 79410 752743883 Healthcare TX 501 (C )(3) Line 3 Covenant Health System 0 Covenant Health Partners 3615 19Th Street Lubbock TX 79410 463516417 Healthcare TX 501 (C )(3) Line 12, Type I Covenant Health System 0 HMTS Inc 1 Hoag Drive Newport Beach CA 92658 453583707 Healthcare CA 501 (C )(3) Line 12, Type I Hoag Memorial Hospital Presbyterian 0 Hoag Charity Sports 330 Placentia Ave Newport Beach CA 92663 452982422 Support CA 501 (C )(3) Line 7 Hoag Hospital Foundation 0 Hoag Hospital Foundation 330 Placentia Ave Newport Beach CA 92663 953222343 Fundraising CA 501 (C )(3) Line 7 Hoag Memorial Hospital Presbyterian 0 Hoag Memorial Hospital Presbyterian 1 Hoag Road Box 6100 Newport Beach CA 92663 951643327 Healthcare CA 501 (C )(3) Line 3 Covenant Health Network 0 Home Care Partners 1165 Montgomery Dr Santa Rosa CA 95405 680318656 Inactive CA 501 (C )(3) Line 3 Santa Rosa Memorial Hospital 0 Hospice Of Lubbock 3702 21st Street Lubbock TX 79410 752133781 Healthcare TX 501 (C )(3) Line 10 Covenant Health System 0 Lubbock Methodist Hospital Foundation 3615 19th Street Lubbock TX 79410 752220963 Healthcare TX 501 (C )(3) Line 7 Covenant Health System 0 Methodist Children's Hospital 3610 21st Street Lubbock TX 79410 752428911 Healthcare TX 501 (C )(3) Line 3 Covenant Health System 0 Methodist Hospital Levelland 1900 College Avenue Levelland TX 79336 752246348 Healthcare TX 501 (C )(3) Line 3 Covenant Health System 0 Methodist Hospital Plainview 2601 Dimmitt Road Plainview TX 79072 752426010 Healthcare TX 501 (C )(3) Line 3 Covenant Health System 0 Mission Hospital Regional Medical Ctr 27700 Medical Center Road Mission Viejo CA 92691 951643360 Healthcare CA 501 (C )(3) Line 3 Covenant Health Network 0 Queen Of The Valley Medical Center 1000 Trancas Street Napa CA 94558 941243669 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 Redwood Memorial Foundation 3300 Renner Drive Fortuna CA 95540 942779313 Healthcare CA 501 (C )(3) Line 7 Redwood Memorial Hospital 0 Redwood Memorial Hospital 3300 Renner Drive Fortuna CA 95540 941384665 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 Santa Rosa Memorial Hospital 1165 Montgomery Dr Santa Rosa CA 95405 941231005 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 SRM Alliance Hospital Services (Pvh) 400 North McDowell Blvd Petaluma CA 94954 680395200 Healthcare CA 501 (C )(3) Line 3 Santa Rosa Memorial Hospital 0 St Joseph Health System 3345 Michelson Drive Suite 100 Irvine CA 92612 953589356 Healthcare CA 501 (C )(3) Line 12, Type I Providence St Joseph Health 0 St Joseph Health System Foundation 3345 Michelson Drive Suite 100 Irvine CA 92612 330143024 Healthcare CA 501 (C )(3) Line 7 St Joseph Health System 0 St Joseph Home Care Network 1111 Sonoma Ste 308 Santa Rosa CA 95405 680331084 Healthcare CA 501 (C )(3) Line 10 St Joseph Health System 0 St Joseph Hospital Of Eureka 2700 Dolbeer Street Eureka CA 95501 941156596 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 St Joseph Hospital Of Orange 1100 West Stewart Drive Orange CA 92868 951643359 Healthcare CA 501 (C )(3) Line 3 Covenant Health Network 0 St Jude Hospital Yorba Linda 200 West Center St Promenade Anaheim CA 92805 330185031 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 St Jude Hospital Inc 101 East Valencia Mesa Drive Fullerton CA 92635 951643324 Healthcare CA 501 (C )(3) Line 3 Covenant Health Network 0 St Mary Medical Center 18300 Highway 18 Apple Valley CA 92307 951914489 Healthcare CA 501 (C )(3) Line 3 Covenant Health Network 0 St Mary Of The Plains Hospital Fdn 4000 24th Street Lubbock TX 79410 751653181 Healthcare TX 501 (C )(3) Line 7 Covenant Health System 0 St Joseph Health Northern California LLC 3345 Michelson Drive Irvine CA 92612 814791043 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 Sisters Of St Joseph Of Orange 480 S Batavia Orange CA 92868 951643383 Religious Org CA 501 (C )(3) Line 1 N/A 0 St Joseph Health Ministry 3345 Michelson Drive Suite 100 Irvine CA 92612 271666576 Religious Org CA 501 (C )(3) Line 1 Sisters of St Joseph of Orange 0 Kadlec Auxiliary Inc 888 Swift Blvd Richland WA 99352 916033089 Support Kadlec Regional Medical Center WA 501 (C )(3) Line 12, Type III Kadlec Regional Medical Center 0 Alpha Medical Laboratory LLC 611 N Perry Spokane WA 99202 912017347 Outpatient Lab ID N/A Broadway Imaging LLC 500 W Broadway Missoula MT 59802 522405971 Medical Imaging MT PH&S - MT Related 7767813 4439581 0 1 0.75000 California Laboratory Associates LLC 501 Buena Vista Burbank CA 91505 273888692 Outpatient Lab CA N/A Center for Specialty Surgery LLC 11782 SW Barnes Rd Portland OR 97225 263638838 Ambulatory Surgery Center OR N/A Clackamas Radiation Oncology Center LLC 4400 NE Halsey St Bldg II 495 Portland OR 97213 260381897 Radiation Oncology OR N/A Ctr for Med Imaging-Bridgeport LLC 4400 NE Halsey 495 Portland OR 97213 260796953 Imaging - Diagnostics OR N/A Ctr for Med Imaging-Tanasbourne LLC 4400 NE Halsey 495 Portland OR 97213 200477972 Imaging - Diagnostics OR N/A Greater Valley Medical Building LP 501 S Buena Vista St Burbank CA 91505 954570858 Real Estate - MOB CA N/A Minor & James Medical PLLC 515 Minor Avenue 200 Seattle WA 98104 911340223 Physician Clinic WA N/A Mountainstar Clinical Laboratories LLC 611 N Perry Spokane WA 99202 261345983 Outpatient Lab MT N/A Oregon Advanced Imaging LLC 881 OHare Parkway Medford OR 97504 450471748 Medical Imaging OR N/A Oregon Outpatient Surgery Center 7300 SW Childs Rd Tigard OR 97224 223883387 Ambulatory Surgery Center OR N/A PacLab LLC 611 N Perry Spokane WA 99202 911743952 Outpatient Lab WA N/A Pathology Associates Medical Laboratories LLC 611 N Perry Spokane WA 99202 270943279 Outpatient Lab WA N/A PETCT Imaging at Swedish Cancer Institute LLC 1221 Madison Street Seattle WA 98104 203132044 Medical Imaging WA N/A Portland Medical Imaging LLC 4400 NE Halsey 495 Portland OR 97213 201054971 Imaging - Diagnostics OR N/A Prov Radiation Oncology Develop Assn LLC 4400 NE Halsey 495 Portland OR 97213 260682491 Real Estate - MOB OR N/A Providence Imaging Center 3340 Providence Drive Anchorage AK 99508 920118807 Medical Imaging AK N/A Providence Partners for Health LLC 501 S Buena Vista St Burbank CA 91505 454041798 Clinical Quality & Integration CA N/A Providence Surgery Center LLC 902 N Orange St Missoula MT 59802 841401625 Ambulatory Surgery Center MT PH&S - MT Related 1019002 2391091 0 0 0.76560 ProvidenceSilverton Rehab LLC 4400 NE Halsey 425 Portland OR 97213 481287267 Rehab Services OR N/A ProvidenceUSP Santa Clarita GP LLC 11550 Indian Hills Road 160 Mission Hills CA 91345 202829660 Ambulatory Surgery Center CA N/A ProvidenceUSP Surgery Ctrs LLC 11550 Indian Hills Road 160 Mission Hills CA 91345 200905938 Ambulatory Surgery Center CA N/A Southern Idaho Regional Laboratory LLC 611 N Perry Spokane WA 99202 820511819 Outpatient Lab ID N/A The Madison Spokane Inn LLC 15 West Rockwood Blvd Spokane WA 99204 841606484 Hotel Services WA N/A Tri-Cities Laboratory LLC 611 N Perry Spokane WA 99202 911773986 Outpatient Lab WA N/A HCSA Properties LLC 1600 M Street NW Auburn WA 98001 460620892 Real estate rental WA N/A Covenant Long-Term Care LP 4000 24th Street Lubbock TX 79410 205033419 Healthcare TX N/A Heritage Investment Group I LLC 500 S Main Street Ste 1000 Orange CA 92868 271000061 Investments CA N/A Hoag Orthopedic Institute 1 Hoag Drive Box 6100 Newport Beach CA 92658 611588294 Healthcare CA N/A Lubbock Surgery Center Ltd 4000 24th Street Lubbock TX 79410 752177401 Healthcare TX N/A Methodist Diagnostic Imaging 4000 24th Street Lubbock TX 79410 752343261 Healthcare TX N/A Mission Ambulatory Surgicenter Ltd 27800 Medical Center Road Ste 362 Mission Viejo CA 92691 330355575 Healthcare CA N/A Newport Imaging Center 360 San Miguel Newport Beach CA 92660 330191776 Healthcare CA N/A SHA LLC 12940 North Highway 183 Austin TX 78750 752569094 Healthcare TX N/A St Joseph Physician Ventures I LLC 1100 West Stewart Drive Orange CA 92868 454521884 Real Estate CA N/A North Bay Endoscopy Center 1383 N McDowell Blvd Suite 110 Petaluma CA 94954 611559876 Healthcare CA N/A Southern California Surgery Center LLC 18321 Ventura Blvd Ste 740 Tarzana CA 91356 330939000 Healthcare CA N/A Mission Viejo Physician Partners I LLC 27700 Medical Center Road Mission Viejo CA 92691 471559873 Healthcare CA N/A Advanced Surgery Institute LLC 1739 4th Street Santa Rosa CA 95404 262299255 Healthcare CA N/A Providence Health Ventures Inc 4101 Torrance Blvd Torrance CA 90503 330122216 Investment CA N/A C 0 Caron Health Corporation 510 W Front St Missoula MT 59802 810486082 Medical Physician Service MT N/A C 0 Providence Health Care Ventures Inc 101 W 8th Ave TAF C-9 Spokane WA 99204 900155714 Clinical/Medical Lab WA N/A C 0 Providence Physician Services Co 101 W 8th Ave TAF C-9 Spokane WA 99204 911216033 Clinical/Medical Lab WA N/A C 0 Yakima Medical Arts Inc 611 N Perry 100 Spokane WA 99202 910787963 Rental Real Estate WA N/A C 0 Bourget Health Services Inc PO Box 2687 Spokane WA 99220 911354431 Clinical/Medical Lab WA N/A C 0 1221 Madison Street Owners Assoc 747 Broadway Seattle WA 98122 201954319 Owners' Association WA N/A C 0 Western HealthConnect Ventures Inc 1801 Lind Ave SW 9016 Renton WA 98057 800953654 Investment WA N/A C 0 PHN Holdings 20555 Earl Street Torrance CA 90503 461814184 Strategic Planning Services CA N/A C 0 Providence Health Network 20555 Earl Street Torrance CA 90503 800886966 Prepaid Healthcare CA N/A C 0 Pioneer Innovations Inc 800 5th Ave 10th Floor Seattle WA 98104 364818191 Healthcare Innovations WA N/A C 0 Vinserra Inc 1328 22nd Street Santa Monica CA 90404 953943315 Investment CA N/A C 0 American Unity Group Ltd 90 Pitts Bay Road HM08 Pembroke BD Captive Insurance BD N/A C 0 Coastal Management Services Organization 1 Hoag Drive Box 6100 Newport Beach CA 92658 330676831 Healthcare CA N/A C 0 Datu Health Inc 16150 Main Circle Dr Suite 250 Chesterfield MO 63017 463070062 IT Svcs DE N/A C 0 Hoag Management Services Inc 1 Hoag Drive Box 6100 Newport Beach CA 92658 330731587 Healthcare CA N/A C 0 Lubbock Methodist Hosp Practice Mgmt 2107 Oxford Street Ste 300 Lubbock TX 79410 752578995 Inactive TX N/A C 0 Lubbock Methodist Hospital Svcs PO Box 120 Lubbock TX 79410 752118585 Healthcare TX N/A C 0 Mission Viejo Medical Ventures 27800 Medical Center Rd 354 Mission Viejo CA 92691 330212905 Healthcare CA N/A C 0 St Joseph Health 3345 Michelson Drive Suite 100 Irvine CA 92612 462340232 Holding Company CA N/A C 0 St Joseph Health Source Inc 3345 Michelson Drive Suite 100 Irvine CA 92612 461900168 Healthcare CA N/A C 0 St Joseph Prof Svcs Enterprses Inc 3345 Michelson Drive Suite 100 Irvine CA 92612 330155323 Healthcare CA N/A C 0 Ophie Healthcare Services Inc 3345 Michelson Drive Suite 100 Irvine CA 92612 271002825 Healthcare CA N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 St Patrick Hospital Foundation dba Providence Montana Health Foundation B 662520 Cost St Patrick Hospital Foundation dba Providence Montana Health Foundation C 556717 Cost Broadway Imaging LLC M 1948784 Cost