PROVIDENCE TRINITYCARE HOSPICE FOUNDATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
PROVIDENCE TRINITYCARE HOSPICE FOUNDATION (EIN 33-0261016)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-10
IRS object ID
201713149349302751
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-10T12:58:52-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN911194016PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Clark Nuber PSBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110900 NE 4th Suite 1400AddressLine1Txt
CityBellevueCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN330261016EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Providence TrinityCare HospiceBusinessNameLine1Txt
Business Name Line2FoundationBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlPROVBusinessNameControlTxt
Phone3105433440PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15315 Torrance Blvd No B1AddressLine1Txt
CityTorranceCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90503ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSusan DolbertPersonNm
Person TitlePresidentPersonTitleTxt
Phone8188473024PhoneNum
Signature2017-11-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSara Elizabeth J Hyre CPAPreparerPersonNm
PTINP00235495PTIN
Phone4254544919PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address170.173.0.16IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-10IPDt
IP Tm10:58:23IPTm
IP TimezonePSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdC5F3CFF4C26DED891B80F887CA75C12EDBBE0CDFAtSubmissionCreationDeviceId
At Submission Filing Device IdC5F3CFF4C26DED891B80F887CA75C12EDBBE0CDFAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBen ChandlerPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15315 Torrance Blvd No B1AddressLine1Txt
CityTorranceCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90503ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$9,664,345GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresscalifornia.providence.org/trinitycare/giving/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionSupport Providence TrinityCare Hospice in Torrance, CA.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers100TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,731,860PYContributionsGrantsAmt
CY Contributions Grants$2,618,586CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$175,459PYInvestmentIncomeAmt
CY Investment Income$232,886CYInvestmentIncomeAmt
PY Other Revenue-$28,021PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$4,879,298PYTotalRevenueAmt
CY Total Revenue$2,851,472CYTotalRevenueAmt
PY Grants And Similar Paid$1,540,954PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,434,011CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$797,763PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$944,468CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$27,460PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$18,775CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$795,627CYTotalFundraisingExpenseAmt
PY Other Expenses$257,392PYOtherExpensesAmt
CY Other Expenses$344,316CYOtherExpensesAmt
PY Total Expenses$2,623,569PYTotalExpensesAmt
CY Total Expenses$3,741,570CYTotalExpensesAmt
PY Revenues Less Expenses$2,255,729PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$890,098CYRevenuesLessExpensesAmt
Total Assets BOY$10,651,846TotalAssetsBOYAmt
Total Assets EOY$10,070,416TotalAssetsEOYAmt
Total Liabilities BOY$195,246TotalLiabilitiesBOYAmt
Total Liabilities EOY$224,667TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$10,456,600NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$9,845,749NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAs People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Support Providence TrinityCare Hospice in Torrance, CA.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$632,570ExpenseAmt
Grant$632,570GrantAmt
Revenue$0RevenueAmt
DescTrinityKids Care Program Started in 2001, TrinityKids Care remains the only dedicated pediatric hospice and palliative care program in Los Angeles and Orange counties. The program helps children with life-limiting conditions live as normal a life as possible, for as long as possible, in their own homes. The program gives these families access to a continuum of total care with the primary goal of keeping the children in their homes with their families. What began as a true labor of love with three children grew to serve more than 300 children in 2016. Funding is used to support the clinical staff, provide value added services, specialized medications, and other supplies. TrinityKids Care program helps children to live well and die gently.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$555,683ExpenseAmt
Grant$555,683GrantAmt
Revenue$0RevenueAmt
DescProvidence Institute for Human Caring - In 2014 Providence Institute for Human Caring was established as a program of Providence TrinityCare Hospice. The focus is on making Whole Person Care the new normal by, 1) Sharing expertise and best practices among our clinicians, 2) Offering educational programs for our clinicians and those from other health care providers, 3) Increasing training and support services among community organizations, 4) Supporting and accelerating community-based care through educational forums, 5) Elevating the importance of this issue nationally through news media, academic publications, and live presentations before both professional and public audiences, 6) Improving patient satisfaction, and 7) Improving family, caregiver and clinician well-being and satisfaction. Funding from the Foundation supports the operation of this program through the ministry.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$444,362ExpenseAmt
Grant$444,362GrantAmt
Revenue$0RevenueAmt
DescPalliative Care Program The outpatient and in-home palliative care programs offer care from an interdisciplinary palliative care-trained team from the time of diagnosis to cure and survivorship or to hospice and death. The team includes a physician, nurse practitioner, RN, social worker and chaplain working in close collaboration with the patient's curative medical team (medical oncologist, radiation oncologist, surgeon, primary care physician etc.) Not only does the team provide services as described by established national guidelines and standards, but their paradigm of care is broadened by embracing a richer scope of care entitled "Whole Person Care." This practice results in patients and families feeling like collaborative partners in their illness experience; with aligned goals, more support and caring, and health care providers experiencing greater job satisfaction while providing higher quality care.Funding from the Foundation supports the operation of this program through the ministry.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (3 entries)

ExpenseExpenseAmtGrantGrantAmtRevenueRevenueAmtDescDesc
$324,997$324,997$0Call Center Development - Funds provided by the Foundation supported developing a 24/7 Call Center process enabling Providence TrinityCare to grow in both breadth of services and volume by centralizing calls from patients, families, referral sources and physicians for hospice and outpatient palliative care programs. The funds for this one-year transfer were used to create a plan under the management of a project manager, train staff on the Electronic Health Record systems and test and implement the processes to assure the highest quality, compassionate care at the point of service for even more patients and families.
$291,397$291,397$0Patient Care Assistance (Charity Care), Necessities of Life, Bereavement and Volunteer Services - No one is ever turned away from TrinityCare Hospice due to an inability to pay or lack of insurance. For these patients, and for those who are underinsured, the Foundation provides assistance to make any and all of our hospice services available. 26 individuals were provided complete charity care support through the provision of hospice care and bereavement follow-up for their bereaved loved ones. Another 135 patients and families were assisted through Necessities of Life philanthropic support for needs such as groceries, diapers, and household supplies. 2,907 families were followed for 13 months through bereavement support and education provided by social workers, social work interns and highly trained volunteers. More than 100 individuals volunteered in 2016 with patients and families to provide companionship; run errands; lead Legacy Art projects; play and write music; transport families in the TrinityKids Care van; serve as "standardized patients; and deliver special Veterans' Day cupcakes to cheer and thank veterans for their service. During the holidays, 46 families received gifts, clothing, and household goods donated by caring community members.
$185,002$185,002$0The Gathering Place A center for loss of life and life transitions, offering counseling to those in the community who have suffered the death of a loved one from any cause. It is staffed by licensed professionals, graduate-level mental health interns and trained volunteers. The Gathering Place serves children ages 5 through adults - whether or not their loved one was on our hospice service. In 2016, the program provided services to 245 bereaved community members, who received services that included one-on-one supportive education, and participation in 14 nine-week long support groups to help these individuals through the grieving process. Additionally, The Gathering Place assists at times of tragic loss in the local South Bay community as requested by schools, police and fire departments. Funding from the Foundation supports the oepration of this program through the ministry.
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$801,396TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$801,396TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$2,434,011TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing AddressYes (1)OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Karl E Fritschel CPABusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone4255253339PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 Lind Ave SW 9016AddressLine1Txt
CityRentonCityNm
State AbbreviationWAStateAbbreviationCd
ZIP980579016ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
James A Zapp
Chair1.000.00Yes (X)Yes (X)$0$0$0
John Kirk
Vice Chair1.000.00Yes (X)Yes (X)$0$0$0
Gary Kuwahara
Treasurer1.000.00Yes (X)Yes (X)$0$0$0
Marcia Potter
Secretary1.000.00Yes (X)Yes (X)$0$0$0
Michael Clark
Director1.000.00Yes (X)$0$0$0
Susan Dolbert - Eff 816
President0.5054.50Yes (X)Yes (X)$0$237,933$7,195
Suzi Gulcher
Director1.000.00Yes (X)$0$0$0
Robert Hellrigel
Corporate Member0.5054.50Yes (X)$0$620,281$196,789
Patricia Modrzejewski-Thru 716
President10.0050.00Yes (X)Yes (X)$0$886,903$42,005
Jim Sala
Director1.000.00Yes (X)$0$0$0
Scott Sharpe
Vice President1.000.00Yes (X)Yes (X)$0$0$0
Tom Sullivan
Director1.000.00Yes (X)$0$0$0
Lynn Taylor
Director1.000.00Yes (X)$0$0$0
Barbara Roberts - Thru 116
Executive Director50.000.00Yes (X)$0$177,486$23,062
Ben Chandler - Eff 216
Executive Director50.000.00Yes (X)$0$151,182$13,798
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,073,785TotReportableCompRltdOrgAmt
Total Other Compensation$282,849TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$6,713FederatedCampaignsAmt
Related Organizations$1,097,798RelatedOrganizationsAmt
Government Grants$40,800GovernmentGrantsAmt
All Other Contributions$1,473,275AllOtherContributionsAmt
Noncash Contributions$21,248NoncashContributionsAmt
Total Contributions$2,618,586TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$257,504TotalRevenueColumnAmt
Exclusion$257,504ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$6,788,255SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$6,812,873SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$24,618SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$24,618TotalRevenueColumnAmt
Exclusion-$24,618ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,851,472TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$232,886ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,432,322TotalAmt
Program Services$2,432,322ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$1,689TotalAmt
Program Services$1,689ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$220,261TotalAmt
Management And General$91,705ManagementAndGeneralAmt
Fundraising$128,556FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$574,993TotalAmt
Management And General$226,397ManagementAndGeneralAmt
Fundraising$348,596FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$95,427TotalAmt
Management And General$38,171ManagementAndGeneralAmt
Fundraising$57,256FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$53,787TotalAmt
Management And General$21,515ManagementAndGeneralAmt
Fundraising$32,272FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$11,671TotalAmt
Management And General$10,510ManagementAndGeneralAmt
Fundraising$1,161FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$18,775TotalAmt
Fundraising$18,775FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$87,598TotalAmt
Management And General$87,598ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$50,171TotalAmt
Management And General$3,883ManagementAndGeneralAmt
Fundraising$46,288FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$31,005TotalAmt
Management And General$12,402ManagementAndGeneralAmt
Fundraising$18,603FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$17,833TotalAmt
Fundraising$17,833FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$17,535TotalAmt
Fundraising$17,535FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$40,913TotalAmt
Management And General$3,304ManagementAndGeneralAmt
Fundraising$37,609FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Recruitment$50,620$15,581$35,039
Donor Recognition$35,195$35,195
Dues & Subscriptions$1,775$866$909

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,741,570TotalAmt
Program Services$2,434,011ProgramServicesAmt
Management And General$511,932ManagementAndGeneralAmt
Fundraising$795,627FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,251,716BOYAmt
EOY$434,512EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,462,578BOYAmt
EOY$723,958EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$334,000BOYAmt
EOY$59,000EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$10,510LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$10,510LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

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

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$7,603,552BOYAmt
EOY$8,852,946EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,651,846BOYAmt
EOY$10,070,416EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,416BOYAmt
EOY$22,217EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$183,830BOYAmt
EOY$202,450EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$195,246BOYAmt
EOY$224,667EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,434,009BOYAmt
EOY$4,039,593EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,487,790BOYAmt
EOY$3,828,986EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,534,801BOYAmt
EOY$1,977,170EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,456,600BOYAmt
EOY$9,845,749EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,651,846BOYAmt
EOY$10,070,416EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$890,098ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$279,249NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$2OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,807,108CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,997,371CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,274,292CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,731,860CurrentTaxYearMinus1YearAmt
Current Tax Year$2,618,586CurrentTaxYearAmt
Total$14,429,217TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,807,108CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,997,371CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,274,292CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,731,860CurrentTaxYearMinus1YearAmt
Current Tax Year$2,618,586CurrentTaxYearAmt
Total$14,429,217TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$2,633,351SubstantialContributorsTotAmt
Public Support Total170$11,795,866PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$164,970CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$175,988CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$173,617CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$161,263CurrentTaxYearMinus1YearAmt
Current Tax Year$257,504CurrentTaxYearAmt
Total$933,342TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,344CurrentTaxYearMinus4YearsAmt
Total$8,344TotalAmt
FieldValueIRS element (for citing)
Total Support$15,370,903TotalSupportAmt
Public Support CY1700.76740PublicSupportCY170Pct
Public Support PY1700.74150PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,044,739BeginningYearBalanceAmt
Contributions$1,462,782ContributionsAmt
Investment Earnings Or Losses$512,134InvestmentEarningsOrLossesAmt
Grants Or Scholarships$1,238,384GrantsOrScholarshipsAmt
End Year Balance$4,781,271EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,264,739BeginningYearBalanceAmt
Contributions$2,062,000ContributionsAmt
Investment Earnings Or Losses-$280,000InvestmentEarningsOrLossesAmt
Grants Or Scholarships$2,000GrantsOrScholarshipsAmt
End Year Balance$4,044,739EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,965,932BeginningYearBalanceAmt
Contributions$133,176ContributionsAmt
Investment Earnings Or Losses$165,631InvestmentEarningsOrLossesAmt
End Year Balance$2,264,739EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,664,338BeginningYearBalanceAmt
Contributions$50,000ContributionsAmt
Investment Earnings Or Losses$290,626InvestmentEarningsOrLossesAmt
Grants Or Scholarships$39,032GrantsOrScholarshipsAmt
End Year Balance$1,965,932EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,328,772BeginningYearBalanceAmt
Contributions$55,000ContributionsAmt
Investment Earnings Or Losses$280,566InvestmentEarningsOrLossesAmt
End Year Balance$1,664,338EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.58400BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.41400PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00200TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,510OtherCostOrOtherBasisAmt
Depreciation$10,510DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDue to AffiliatesDesc
Amt$202,450Amt
FieldValueIRS element (for citing)
Total Liability$202,450TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart V, Line 4:FormAndLineReferenceDesc
ExplanationThe quasi-endowment funds are to be used for any purpose the Board designates within the charitable purposes of the organization. Investment income from the two permanently restricted funds have been restricted by the donors to be used towards The Gathering Place and for areas the Foundation deems to have the greatest need.ExplanationTxt

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Email SolicitationsYes (X)EmailSolicitationsInd
Phone SolicitationsYes (X)PhoneSolicitationsInd
In Person SolicitationsYes (X)InPersonSolicitationsInd
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Solicitation Of Govt GrantsYes (X)SolicitationOfGovtGrantsInd
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising Acty0AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdActivityActivityTxtFundraiser Control Of FundsFundraiserControlOfFundsIndGross ReceiptsGrossReceiptsAmtRetained By ContractorRetainedByContractorAmtNet To OrganizationNetToOrganizationAmt
The Gobel Group
16 W Market Street 2nd FloorWest ChesterPA19382Consult on various fundraising activities0$0$14,400-$14,400
Claudia A Looney
1291 Peacock Hill DrSanta AnaCA927052305Major gift solicitations & strategies0$0$4,375-$4,375
FieldValueIRS element (for citing)
Total Retained By Contractors$18,775TotalRetainedByContractorsAmt
Total Net To Organization-$18,775TotalNetToOrganizationAmt
Licensed StatesCALicensedStatesCd

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Providence TrinityCare HospiceBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15315 Torrance BlvdAddressLine1Txt
CityTorranceCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90503ZIPCd
FieldValueIRS element (for citing)
Recipient EIN953264139RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$2,432,322CashGrantAmt
Purpose Of GrantSupport OperationsPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationThe grant funds are recorded as a separate restricted fund and each month an amount is transferred for the grant purpose expenses. This way the use of grant funds is monitored at the end of each month. The grant money is distributed based on the total expenses incurred on each specific program. The accountant runs the expense report each month for each program and distributes grant money to those programs. These program expenses are limited by a budget prepared at the beginning of the year.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Susan Dolbert - Eff 816
President$0$171,867$0$25,000$0$41,066$0$527$0$6,668$0$245,128$0$0
Robert Hellrigel
Corporate Member$0$393,690$0$222,195$0$4,396$0$174,041$0$22,748$0$817,070$0$0
Patricia Modrzejewski-Thru 716
President$0$382,153$0$483,680$0$21,070$0$25,970$0$16,035$0$928,908$0$0
Barbara Roberts - Thru 116
Executive Director$0$160,873$0$16,613$0$0$0$14,784$0$8,278$0$200,548$0$0
Ben Chandler - Eff 216
Executive Director$0$134,548$0$0$0$16,634$0$6,925$0$6,873$0$164,980$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 4bNONQUALIFIED RETIREMENT PLANS A) DCRP = Defined Contribution Restoration Plan B) SERP = Supplemental Executive Retirement Plan 1) Patricia E. Modrzejewski a) Taxable DCRP Earned - $18,448 2) Robert Hellrigel a) SERP Earned but not Vested - $136,978 b) SERP Interest Credit - $10,404
FORM 990, SCHEDULE J, PART II - EXECUTIVE INCENTIVE PROGRAMThe 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.
FORM 990 - PART VII & SCHEDULE J - COMPENSATIONBoard Members showing compensation from a related organization receive this compensation for their services to the related organization and not for their position on the Board.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6Providence TrinityCare Hospice is the sole Corporate Member.
Form 990, Part VI, Section A, line 7aThe powers of the Corporate Member include the provision to approve the number of Trustees if less than 7 or greater than 20, appoint Board of Trustees of the Foundation, and to remove such Trustees at any time with or without cause.
Form 990, Part VI, Section A, line 7bThe following powers are reserved exclusively to the Corporate Member: A) To adopt and amend the Articles of Incorporation and the By laws of the Foundation after consultation with the Foundation Board of Trustees. B) To approve the merger, consolidation, or affiliation of the Foundation with another corporation, organization or program, or the dissolution of the Foundation. C) To approve any strategic plan of the Foundation. D) To approve the annual fundraising plan including special events, annual, capital and planned giving activities. E) To approve the acceptance of any gift that carries conditions or limitations or any gift restricted to services, programs or facilities not currently offered or approved to be offered by the Corporate Member's Board of Directors.
Form 990, Part VI, Section B, line 11bThe 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 12cAll employees and Trustees are required to review and sign the Providence Health & Services Conflict of Interest Disclosure statement. This statement indicates that they have received a copy of Providence's policies on confidentiality and conflict of interest. This form is re-reviewed and re-signed each year and the forms are kept on file in the Foundation's offices. Questions about conflict of interest are first brought to the Corporate Member of the Board of Trustees. Further questions would be brought to the Hospice Operating Board of Directors for resolution.
Form 990, Part VI, Section B, line 15It 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. 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. The Foundation Executive Director is compensated by a related organization which uses a market based compensation program utilizing several independent third party compensation market surveys to establish pay ranges for the position. The related organization then establishes the individual rate of pay within the range based on relevant experience, skills and competencies. The rate offered to the Executive Director at the time of hire was determined through discussion between the Regional CEO, Regional Director of HR and the Administrative Director of HR. The ranges and rate of pay are reviewed on an annual basis by Regional HR.
Form 990, Part VI, Section C, line 19Public 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, EtcRobert Hellrigel - 1801 Lind Avenue SW, #9016, Renton, WA 98057.
Form 990, Part XI, line 9:Rounding -2.
FORM 990, PART XII, LINE 2C - AUDIT & COMPLIANCEThe Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; and informs the Board of Directors of critical risk areas and recommended mitigation.
FORM 990, PART I, LINE 5 & PART V, LINE 2A - EMPLOYEE COMPENSATIONThe employees working at the Foundation are paid by Providence Health System - Southern California - EIN# 51-0216589. Therefore, no W-2s are issued by the reporting organization.
FORM 990, PART I, LINE 6 - VOLUNTEERSThe volunteers for Providence TrinityCare Hospice Foundation provide an array of services and are involved in all aspects of planning and executing our special events, as well as assisting in day-to-day office projects. These services include: paper product preparation and coordination; mailing coordination; event registration, event set-up; event break-down and clean-up; auction item procurement and preparation; auction coordination and execution at special events; office filing and information packet assembly.
FORM 990, SCHEDULE R - RELATED ORGANIZATIONSAFFILIATION 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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (110 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Providence Health & Services - Washington
1801 Lind Avenue SW 9016RentonWA980579016510216586Healthcare SystemWA501( c)(3)Line 3Providence Health & Services0
Providence Health & Services - Oregon
1801 Lind Avenue SW 9016RentonWA980579016510216587Healthcare SystemOR501( c)(3)Line 3Providence Health & Services0
Providence Health System - So California
1801 Lind Avenue SW 9016RentonWA980579016510216589Healthcare SystemCA501( c)(3)Line 3Providence Health & Services0
Everett Transitional Care Services
PO Box 5128EverettWA982065128943264605Transitional CareWA501( c)(3)Line 100N/A
Providence Plan Partners
4400 NE Halsey Bldg 2PortlandOR97213911861964Healthcare ServicesWA501( c)(4)N/APH & S - Oregon0
Providence Health Plan
4400 NE Halsey Bldg 2PortlandOR97213930863097Health Service ContractorOR501( c)(4)N/AProvidence Plan Partners0
Providence Health Assurance
4400 NE Halsey Bldg 2PortlandOR97213550828701Medicaid Healthcare ProviderOR501( c)(4)N/AProvidence Health Plan0
Providence Medical Institute
4101 Torrance BlvdTorranceCA90503330283773HealthcareCA501( c)(3)Line 12/Type IPHS - So California0
Little Company of Mary Ancillary Services Corporation
4101 Torrance BlvdTorranceCA90503330844408Imaging ServicesCA501( c)(3)Line 10PHS - So California0
Providence TrinityCare Hospice
5315 Torrance Blvd Suite B1TorranceCA90503953264139HospiceCA501( c)(3)Line 10PHS - So California0
Providence Blanchet Association
1700 Providence PlCentraliaWA98531911789266Supportive HousingWA501( c)(3)Line 7PH & S - Washington0
St Luke Association
350 Washington Ave SEChehalisWA98352943176618Supportive HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Rossi Association
1700 Providence PlCentraliaWA98531311584166Supportive HousingWA501( c)(3)Line 10PH & S - Washington0
Lundberg Association
5921 E BurnsidePortlandOR97215911562797Supportive HousingOR501( c)(3)Line 7PH & S - Oregon0
Providence St Francis Association
3415 12th Avenue NEOlympiaWA98506943244854Supportive HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Peter Claver Association
7101 38th Avenue SouthSeattleWA98118311629656Supportive HousingWA501( c)(3)Line 7PH & S - Washington0
Providence St Elizabeth House Association
3201 SW Graham StSeattleWA98126912171539Supportive HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Gamelin House Association
4515 MLK Jr Way S Ste 200SeattleWA98108311744654Supportive HousingWA501( c)(3)Line 7PH & S - Washington0
The Gamelin Association
312 North Fourth StYakimaWA98901911180824Supportive HousingWA501( c)(3)Line 7PH & S - Washington0
The Gamelin Oregon Association
5520 NE GlisanPortlandOR97213911214491Supportive HousingOR501( c)(3)Line 10PH & S - Oregon0
The Gamelin California Association
540 23rd StOaklandCA94612911293869Supportive HousingCA501( c)(3)Line 10PHS - So California0
Gamelin Washington Association
1423 First AvenueSeattleWA98101201910170Supportive HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Dethman House
1205 Montello AveHood RiverOR97031473385506Supportive HousingWA501( c)(3)Line 70N/A
Providence Foundation
1801 Lind Avenue SW 9016RentonWA980579016943078543Support PH&S and W. HealthConnectWA501( c)(3)Line 12/Type IPH & S - Washington0
Providence Alaska Foundation
3300 Providence Drive - B Tower2AnchorageAK99508920093565Support PHS-AlaskaAK501( c)(3)Line 12/Type IPH & S - Washington0
Providence St Peter Foundation
413 Lilly Road NEOlympiaWA985065166911097056Support Affiliated Tax-Exempt OrganizationWA501( c)(3)Line 7PH & S - Washington0
Providence Health Care Foundation (Centralia)
914 S Scheuber RoadCentraliaWA98531911433382Support Providence Centralia HospitalWA501( c)(3)Line 7PH & S - Washington0
Providence Mount St Vincent Foundation
4831 - 35th Avenue SWSeattleWA981262799911188119Support Providence Mount St.VincentWA501( c)(3)Line 7PH & S - Washington0
Providence Marianwood Foundation
3725 Providence Point Drive SEIssaquahWA980297219931554288Support Providence MarianwoodWA501( c)(3)Line 12/Type IPH & S - Washington0
Providence Newberg Health Foundation
1001 Providence DriveNewbergOR97132930889144Support Providence Newberg Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Seaside Hospital Foundation
725 S Wahanna RdSeasideOR97138930927320Support Providence Seaside HospitalOR501( c)(3)Line 7PH & S - Oregon0
Providence Community Health Foundation
1111 Crater Lake AveMedfordOR97504930692907Support Providence Medford Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Benedictine Nursing Center Foundation
540 South Main StMt AngelOR973629532911940286Support Providence Benedictine Nursing CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Portland Medical Foundation
4805 NE Glisan StPortlandOR972132967931231494Support Providence Portland Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence St Vincent Medical Foundation
9205 SW Barnes RdPortlandOR97225930575982Support Providence St. Vincent Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Milwaukie Foundation
10150 SE 32ndMilwaukieOR97222943079515Support Providence Milwaukie HospitalOR501( c)(3)Line 7PH & S - Oregon0
Providence Child Center Foundation
830 NE 47thPortlandOR97213930800140Support Providence Child CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Little Company of Mary Foundation
4101 Torrance BlvdTorranceCA90503510224944Support Little Company of Mary Service AreaCA501( c)(3)Line 7PHS - So California0
PH&S FoundationSFVSA & SCVSA
501 S Buena Vista StreetBurbankCA91505953544877Support Program & Activities of SFVSA & SCVSACA501( c)(3)Line 7PHS - So California0
Providence Hospice of Seattle Foundation
425 Pontius Avenue North 300SeattleWA981095452912077378Support Hospice of SeattleWA501( c)(3)Line 12/Type IPH & S - Washington0
Providence Health & Services - Western Washington
1801 Lind Avenue SW 9016RentonWA980579016911303277HealthcareWA501( c)(3)Line 3Providence MinistriesWHC0
Providence Health & Services
1801 Lind Avenue SW 9016RentonWA980579016911549796Support Providence InstitutionsWA501( c)(3)Line 12/Type IIProvidence St Joseph Health0
Providence Health & Services - Montana
500 W Broadway PO Box 4587MissoulaMT598064587810231793HealthcareMT501( c)(3)Line 3PH & S - Washington0
Providence St Joseph Medical Center
PO Box 1010PolsonMT598601010810463482HealthcareMT501( c)(3)Line 3PH & S - Washington0
St Thomas Child and Family Center
1710 Benefis CourtGreat FallsMT59405810233495Early Childhood EducationMT501( c)(3)Line 10PH & S - Washington0
Sisters of Providence of Montana Corporation
1801 Lind Avenue SW 9016RentonWA980579016262612415Shell CorporationMT501( c)(3)Line 1PH & S - Washington0
Providence Health Care Foundation - Eastern Washington
101 W 8th AveSpokaneWA99204320014330Support PH&S-WA. Ministries in E. WA.WA501( c)(3)Line 7PH & S - Washington0
St Patrick Hospital Foundation
500 West Broadway PO Box 4587MissoulaMT598064587237056976Support Healthcare in W. MontanaMT501( c)(3)Line 7PH & S - Washington0
University of Great Falls
1301 20th Street SouthGreat FallsMT59405810231777Post Secondary EducationMT501( c)(3)Line 2Providence Health & Services0
E WA & MT Unemployment Compensation Insurance Trust
1801 Lind Avenue SW 9016RentonWA980579016911082119Unemployment BenefitsWA501( c)(3)Line 12/Type IPH & S - Washington0
Providence Willamette Falls Medical Foundation
1500 Division StreetOregon CityOR97045931003750Support Willamette Falls HospitalOR501( c)(3)Line 12/Type IPH & S - Oregon0
Providence Hood River Memorial Hospital Foundation Inc
811 13th StHood RiverOR97031930921990Support Providence Hood River Memorial HospitalOR501( c)(3)Line 7PH & S - Oregon0
Providence Hospice and Home Care Foundation
2731 Wetmore Avenue Suite 500EverettWA98201272552749Support Program & Ministries of PHHCWA501(c )(3)Line 7PH & S - Washington0
Providence St Mary Foundation
401 W Poplar StWalla WallaWA99362452841492Support Program & Ministries of SMMCWA501(c )(3)Line 7PH & S - Washington0
Facey Medical Foundation
15451 San Fernando Mission Blvd 200Mission HillsCA913451420954322584Support Facey Medical GroupCA501(c )(3)Line 7PHS - So California0
Swedish Health Services
747 BroadwaySeattleWA98122910433740HealthcareWA501(c )(3)Line 3Western HealthConnect0
Swedish Edmonds
21601 76th Ave WEdmondsWA98026272305304HealthcareWA501(c )(3)Line 3Western HealthConnect0
Swedish Medical Center Foundation
747 BroadwaySeattleWA98122910983214Support Swedish Health ServicesWA501(c )(3)Line 7Swedish Health Services0
Global To Local Health Initiative
2800 South 192nd St 104SeaTacWA98188273133200HealthcareWA501(c )(3)Line 7Swedish Health Services0
Swedish MJM Holdings
747 BroadwaySeattleWA98122273139262Holding CompanyWA501(c )(3)Line 12/Type ISwedish Health Services0
Marsha Rivkin Center for Ovarian Cancer Research
747 BroadwaySeattleWA98122912054035Ovarian Cancer ResearchWA501(c )(3)Line 7Swedish Health Services0
Western HealthConnect
747 BroadwaySeattleWA98122454171900Shell CorporationWA501(c )(3)Line 12/Type IIPH&S Western Washington0
Inland Northwest Health Services
601 W 1st AvenueSpokaneWA99201911307555HealthcareWA501( c)(3)Line 3PH&S - Washington0
Kadlec Regional Medical Center
888 Swift BlvdRichlandWA99352910655392HealthcareWA501(c )(3)Line 3Western HealthConnect0
Kadlec Neurological Resource Center
1268 Lee BlvdRichlandWA99352911266345HealthcareWA501(c )(3)Line 10Western HealthConnect0
Kadlec Foundation
888 Swift BlvdRichlandWA99352237005501Support Kadlec Regional Medical CenterWA501(c )(3)Line 12/Type IKadlec Regional Medical Center0
PacMed Clinics
1200 12th Ave SSeattleWA98144562290878HealthcareWA501(c )(3)Line 10Western HealthConnect0
Seattle Science Foundation
550 17th AveSeattleWA98122611502822Physician CollaborationWA501(c )(3)Line 7Western HealthConnect0
Providence Saint John's Health Center
2121 Santa Monica BlvdSanta MonicaCA90404951684082HealthcareCA501(c )(3)Line 3PHS - So California0
John Wayne Cancer Institute
2200 Santa Monica BlvdSanta MonicaCA90404954291515Cancer TreatmentCA501(c )(3)Line 4Providence Saint John's Health Center0
Saint John's HospitalHealth Center Foundation
2121 Santa Monica BlvdSanta MonicaCA90404956100079Support Saint John Health Center & JWCICA501(c )(3)Line 7Providence Saint John's Health Center0
Providence St Joseph Health
1801 Lind Avenue SW 9016RentonWA98057811244422Support PH&S and St. Joseph Health SystemWA501(c )(3)Line 12, Type III0N/A
Institute for Systems Biology
401 Terry Ave NSeattleWA98109912003593Predict, prevent & cure diseaseWA501(c )(3)Line 7Western HealthConnect0
Providence Saint John's Medical Foundation
20555 Earl StTorranceCA90503814542216HealthcareCA501(c )(3)PendingPHS - So California0
Institute for Mental Health & Wellness
1801 Lind Avenue SW 9016RentonWA98057814260130Mental HealthcareWA501(c )(3)Line 7PH&SSt Joseph Health System0
Covenant Health Network Inc
3345 Michelson Drive Suite 100IrvineCA92612461259908HealthcareCA501 (C )(3)Line 12, Type IIISt Joseph Health System0
Covenant ACO
3615 19th StreetLubbockTX79410611573313HealthcareTX501 (C )(3)Line 12, Type ICovenant Health System0
Covenant Health System
3615 19th StreetLubbockTX79410752765566HealthcareTX501 (C )(3)Line 3St Joseph Health System0
Covenant Health System Foundation
3623 22nd PlaceLubbockTX79410752897026HealthcareTX501 (C )(3)Line 7Covenant Health System0
Covenant Medical Group
3420 22nd PlaceLubbockTX79410752743883HealthcareTX501 (C )(3)Line 3Covenant Health System0
Covenant Health Partners
3615 19Th StreetLubbockTX79410463516417HealthcareTX501 (C )(3)Line 12, Type ICovenant Health System0
HMTS Inc
1 Hoag DriveNewport BeachCA92658453583707HealthcareCA501 (C )(3)Line 12, Type IHoag Memorial Hospital Presbyterian0
Hoag Charity Sports
330 Placentia AveNewport BeachCA92663452982422SupportCA501 (C )(3)Line 7Hoag Hospital Foundation0
Hoag Hospital Foundation
330 Placentia AveNewport BeachCA92663953222343FundraisingCA501 (C )(3)Line 7Hoag Memorial Hospital Presbyterian0
Hoag Memorial Hospital Presbyterian
1 Hoag Road Box 6100Newport BeachCA92663951643327HealthcareCA501 (C )(3)Line 3Covenant Health Network0
Home Care Partners
1165 Montgomery DrSanta RosaCA95405680318656InactiveCA501 (C )(3)Line 3Santa Rosa Memorial Hospital0
Hospice Of Lubbock
3702 21st StreetLubbockTX79410752133781HealthcareTX501 (C )(3)Line 10Covenant Health System0
Lubbock Methodist Hospital Foundation
3615 19th StreetLubbockTX79410752220963HealthcareTX501 (C )(3)Line 7Covenant Health System0
Methodist Children's Hospital
3610 21st StreetLubbockTX79410752428911HealthcareTX501 (C )(3)Line 3Covenant Health System0
Methodist Hospital Levelland
1900 College AvenueLevellandTX79336752246348HealthcareTX501 (C )(3)Line 3Covenant Health System0
Methodist Hospital Plainview
2601 Dimmitt RoadPlainviewTX79072752426010HealthcareTX501 (C )(3)Line 3Covenant Health System0
Mission Hospital Regional Medical Ctr
27700 Medical Center RoadMission ViejoCA92691951643360HealthcareCA501 (C )(3)Line 3Covenant Health Network0
Queen Of The Valley Medical Center
1000 Trancas StreetNapaCA94558941243669HealthcareCA501 (C )(3)Line 3St Joseph Health System0
Redwood Memorial Foundation
3300 Renner DriveFortunaCA95540942779313HealthcareCA501 (C )(3)Line 7Redwood Memorial Hospital0
Redwood Memorial Hospital
3300 Renner DriveFortunaCA95540941384665HealthcareCA501 (C )(3)Line 3St Joseph Health System0
Santa Rosa Memorial Hospital
1165 Montgomery DrSanta RosaCA95405941231005HealthcareCA501 (C )(3)Line 3St Joseph Health System0
SRM Alliance Hospital Services (Pvh)
400 North McDowell BlvdPetalumaCA94954680395200HealthcareCA501 (C )(3)Line 3Santa Rosa Memorial Hospital0
St Joseph Health System
3345 Michelson Drive Suite 100IrvineCA92612953589356HealthcareCA501 (C )(3)Line 12, Type IProvidence St Joseph Health0
St Joseph Health System Foundation
3345 Michelson Drive Suite 100IrvineCA92612330143024HealthcareCA501 (C )(3)Line 7St Joseph Health System0
St Joseph Home Care Network
1111 Sonoma Ste 308Santa RosaCA95405680331084HealthcareCA501 (C )(3)Line 10St Joseph Health System0
St Joseph Hospital Of Eureka
2700 Dolbeer StreetEurekaCA95501941156596HealthcareCA501 (C )(3)Line 3St Joseph Health System0
St Joseph Hospital Of Orange
1100 West Stewart DriveOrangeCA92868951643359HealthcareCA501 (C )(3)Line 3Covenant Health Network0
St Jude Hospital Yorba Linda
200 West Center St PromenadeAnaheimCA92805330185031HealthcareCA501 (C )(3)Line 3St Joseph Health System0
St Jude Hospital Inc
101 East Valencia Mesa DriveFullertonCA92635951643324HealthcareCA501 (C )(3)Line 3Covenant Health Network0
St Mary Medical Center
18300 Highway 18Apple ValleyCA92307951914489HealthcareCA501 (C )(3)Line 3Covenant Health Network0
St Mary Of The Plains Hospital Fdn
4000 24th StreetLubbockTX79410751653181HealthcareTX501 (C )(3)Line 7Covenant Health System0
St Joseph Health Northern California LLC
3345 Michelson DriveIrvineCA92612814791043HealthcareCA501 (C )(3)Line 3St Joseph Health System0
Sisters Of St Joseph Of Orange
480 S BataviaOrangeCA92868951643383Religious OrgCA501 (C )(3)Line 10N/A
St Joseph Health Ministry
3345 Michelson Drive Suite 100IrvineCA92612271666576Religious OrgCA501 (C )(3)Line 1Sisters of St Joseph of Orange0
Kadlec Auxiliary Inc
888 Swift BlvdRichlandWA99352916033089Support Kadlec Regional Medical CenterWA501 (C )(3)Line 12, Type IIIKadlec Regional Medical Center0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (40 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Alpha Medical Laboratory LLC
611 N PerrySpokaneWA99202912017347Outpatient LabIDN/A
Broadway Imaging LLC
500 W BroadwayMissoulaMT59802522405971Medical ImagingMTN/A
California Laboratory Associates LLC
501 Buena VistaBurbankCA91505273888692Outpatient LabCAN/A
Center for Specialty Surgery LLC
11782 SW Barnes RdPortlandOR97225263638838Ambulatory Surgery CenterORN/A
Clackamas Radiation Oncology Center LLC
4400 NE Halsey St Bldg II 495PortlandOR97213260381897Radiation OncologyORN/A
Ctr for Med Imaging-Bridgeport LLC
4400 NE Halsey 495PortlandOR97213260796953Imaging - DiagnosticsORN/A
Ctr for Med Imaging-Tanasbourne LLC
4400 NE Halsey 495PortlandOR97213200477972Imaging - DiagnosticsORN/A
Greater Valley Medical Building LP
501 S Buena Vista StBurbankCA91505954570858Real Estate - MOBCAN/A
Minor & James Medical PLLC
515 Minor Avenue 200SeattleWA98104911340223Physician ClinicWAN/A
Mountainstar Clinical Laboratories LLC
611 N PerrySpokaneWA99202261345983Outpatient LabMTN/A
Oregon Advanced Imaging LLC
881 OHare ParkwayMedfordOR97504450471748Medical ImagingORN/A
Oregon Outpatient Surgery Center
7300 SW Childs RdTigardOR97224223883387Ambulatory Surgery CenterORN/A
PacLab LLC
611 N PerrySpokaneWA99202911743952Outpatient LabWAN/A
Pathology Associates Medical Laboratories LLC
611 N PerrySpokaneWA99202270943279Outpatient LabWAN/A
PETCT Imaging at Swedish Cancer Institute LLC
1221 Madison StreetSeattleWA98104203132044Medical ImagingWAN/A
Portland Medical Imaging LLC
4400 NE Halsey 495PortlandOR97213201054971Imaging - DiagnosticsORN/A
Prov Radiation Oncology Develop Assn LLC
4400 NE Halsey 495PortlandOR97213260682491Real Estate - MOBORN/A
Providence Imaging Center
3340 Providence DriveAnchorageAK99508920118807Medical ImagingAKN/A
Providence Partners for Health LLC
501 S Buena Vista StBurbankCA91505454041798Clinical Quality & IntegrationCAN/A
Providence Surgery Center LLC
902 N Orange StMissoulaMT59802841401625Ambulatory Surgery CenterMTN/A
ProvidenceSilverton Rehab LLC
4400 NE Halsey 425PortlandOR97213481287267Rehab ServicesORN/A
ProvidenceUSP Santa Clarita GP LLC
11550 Indian Hills Road 160Mission HillsCA91345202829660Ambulatory Surgery CenterCAN/A
ProvidenceUSP Surgery Ctrs LLC
11550 Indian Hills Road 160Mission HillsCA91345200905938Ambulatory Surgery CenterCAN/A
Southern Idaho Regional Laboratory LLC
611 N PerrySpokaneWA99202820511819Outpatient LabIDN/A
The Madison Spokane Inn LLC
15 West Rockwood BlvdSpokaneWA99204841606484Hotel ServicesWAN/A
Tri-Cities Laboratory LLC
611 N PerrySpokaneWA99202911773986Outpatient LabWAN/A
HCSA Properties LLC
1600 M Street NWAuburnWA98001460620892Real estate rentalWAN/A
Covenant Long-Term Care LP
4000 24th StreetLubbockTX79410205033419HealthcareTXN/A
Heritage Investment Group I LLC
500 S Main Street Ste 1000OrangeCA92868271000061InvestmentsCAN/A
Hoag Orthopedic Institute
1 Hoag Drive Box 6100Newport BeachCA92658611588294HealthcareCAN/A
Lubbock Surgery Center Ltd
4000 24th StreetLubbockTX79410752177401HealthcareTXN/A
Methodist Diagnostic Imaging
4000 24th StreetLubbockTX79410752343261HealthcareTXN/A
Mission Ambulatory Surgicenter Ltd
27800 Medical Center Road Ste 362Mission ViejoCA92691330355575HealthcareCAN/A
Newport Imaging Center
360 San MiguelNewport BeachCA92660330191776HealthcareCAN/A
SHA LLC
12940 North Highway 183AustinTX78750752569094HealthcareTXN/A
St Joseph Physician Ventures I LLC
1100 West Stewart DriveOrangeCA92868454521884Real EstateCAN/A
North Bay Endoscopy Center
1383 N McDowell Blvd Suite 110PetalumaCA94954611559876HealthcareCAN/A
Southern California Surgery Center LLC
18321 Ventura Blvd Ste 740TarzanaCA91356330939000HealthcareCAN/A
Mission Viejo Physician Partners I LLC
27700 Medical Center RoadMission ViejoCA92691471559873HealthcareCAN/A
Advanced Surgery Institute LLC
1739 4th StreetSanta RosaCA95404262299255HealthcareCAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Providence Health Ventures Inc
4101 Torrance BlvdTorranceCA90503330122216InvestmentCAN/AC0
Caron Health Corporation
510 W Front StMissoulaMT59802810486082Medical Physician ServiceMTN/AC0
Providence Health Care Ventures Inc
101 W 8th Ave TAF C-9SpokaneWA99204900155714Clinical/Medical LabWAN/AC0
Providence Physician Services Co
101 W 8th Ave TAF C-9SpokaneWA99204911216033Clinical/Medical LabWAN/AC0
Yakima Medical Arts Inc
611 N Perry 100SpokaneWA99202910787963Rental Real EstateWAN/AC0
Bourget Health Services Inc
PO Box 2687SpokaneWA99220911354431Clinical/Medical LabWAN/AC0
1221 Madison Street Owners Assoc
747 BroadwaySeattleWA98122201954319Owners' AssociationWAN/AC0
Western HealthConnect Ventures Inc
1801 Lind Ave SW 9016RentonWA98057800953654InvestmentWAN/AC0
PHN Holdings
20555 Earl StreetTorranceCA90503461814184Strategic Planning ServicesCAN/AC0
Providence Health Network
20555 Earl StreetTorranceCA90503800886966Prepaid HealthcareCAN/AC0
Pioneer Innovations Inc
800 5th Ave 10th FloorSeattleWA98104364818191Healthcare InnovationsWAN/AC0
Vinserra Inc
1328 22nd StreetSanta MonicaCA90404953943315InvestmentCAN/AC0
American Unity Group Ltd
Captive InsuranceN/AC090 Pitts Bay Road HM08 PembrokeBDBD
Coastal Management Services Organization
1 Hoag Drive Box 6100Newport BeachCA92658330676831HealthcareCAN/AC0
Datu Health Inc
16150 Main Circle Dr Suite 250ChesterfieldMO63017463070062IT SvcsDEN/AC0
Hoag Management Services Inc
1 Hoag Drive Box 6100Newport BeachCA92658330731587HealthcareCAN/AC0
Lubbock Methodist Hosp Practice Mgmt
2107 Oxford Street Ste 300LubbockTX79410752578995InactiveTXN/AC0
Lubbock Methodist Hospital Svcs
PO Box 120LubbockTX79410752118585HealthcareTXN/AC0
Mission Viejo Medical Ventures
27800 Medical Center Rd 354Mission ViejoCA92691330212905HealthcareCAN/AC0
St Joseph Health
3345 Michelson Drive Suite 100IrvineCA92612462340232Holding CompanyCAN/AC0
St Joseph Health Source Inc
3345 Michelson Drive Suite 100IrvineCA92612461900168HealthcareCAN/AC0
St Joseph Prof Svcs Enterprses Inc
3345 Michelson Drive Suite 100IrvineCA92612330155323HealthcareCAN/AC0
Ophie Healthcare Services Inc
3345 Michelson Drive Suite 100IrvineCA92612271002825HealthcareCAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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