PROVIDENCE TRINITYCARE HOSPICE FOUNDATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- PROVIDENCE TRINITYCARE HOSPICE FOUNDATION (EIN 33-0261016)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-08-11
- IRS object ID
- 201632249349301303
- Schema version
- 2015v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-08-11T11:23:44-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 911194016 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clark Nuber PS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4th Suite 1700 | AddressLine1Txt |
| City | Bellevue | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330261016 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Providence TrinityCare Hospice | BusinessNameLine1Txt |
| Business Name Line2 | Foundation | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROV | BusinessNameControlTxt |
| Phone | 3105433440 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5315 Torrance Blvd No B1 | AddressLine1Txt |
| City | Torrance | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90503 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Barbara Roberts | PersonNm |
| Person Title | Executive Director | PersonTitleTxt |
| Phone | 3105433440 | PhoneNum |
| Signature | 2016-08-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Sara Elizabeth J Hyre CPA | PreparerPersonNm |
| PTIN | P00235495 | PTIN |
| Phone | 4254544919 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Barbara Roberts | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5315 Torrance Blvd No B1 | AddressLine1Txt |
| City | Torrance | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90503 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,823,123 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | california.providence.org/trinitycare/giving/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | Support Providence TrinityCare Hospice in Torrance, CA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 115 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,274,292 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,731,860 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $205,748 | PYInvestmentIncomeAmt |
| CY Investment Income | $175,459 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$152 | PYOtherRevenueAmt |
| CY Other Revenue | -$28,021 | CYOtherRevenueAmt |
| PY Total Revenue | $3,479,888 | PYTotalRevenueAmt |
| CY Total Revenue | $4,879,298 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $853,869 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,540,954 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $527,163 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $797,763 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $9,000 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $27,460 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $696,347 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $160,933 | PYOtherExpensesAmt |
| CY Other Expenses | $257,392 | CYOtherExpensesAmt |
| PY Total Expenses | $1,550,965 | PYTotalExpensesAmt |
| CY Total Expenses | $2,623,569 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,928,923 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,255,729 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,743,417 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,651,846 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $153,558 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $195,246 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,589,859 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,456,600 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | As 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $594,965 | ExpenseAmt |
| Grant | $594,965 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | TrinityKids Care ProgramStarted 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 almost 300 children in 2015. Funding is used to support the clinical staff, provide value added services, specialized equipment and other supplies. TrinityKids Care program helps children to live well and die gently. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $260,500 | ExpenseAmt |
| Grant | $260,500 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | Providence Institute for Human Caring was established as a program of Providence TrinityCare Hospice. Foundation funds are provided to support this program which seeks to accomplish the following:The focus is on making "Whole Person Care" the new normal by:* Sharing expertise and best practices among our clinicians* Offering educational programs for our clinicians and those from other health care providers* Increasing training and support services among community organizations* Supporting and accelerating community-based care through educational forums* Elevating the importance of this issue nationally through news media, academic publications, and live presentations before both professional and public audiences* Improving patient satisfaction* Improving family, caregiver and clinician well-being and satisfaction. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $254,359 | ExpenseAmt |
| Grant | $254,359 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | Palliative Care Program The new 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. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (3 entries)
| ExpenseExpenseAmt | GrantGrantAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|---|
| $204,301 | $204,301 | $0 | Other support to TrinityCare Hospice. This includes support of the Hospice's Necessities of Life program, which provides payments on behalf of needy families who are served by the Hospice. Those payments cover expenses such as utilities, groceries, and household items. During 2015, $88,747 was sent to the Hospice for this program. Also included here is the purchase of iPads and related equipment to connect the Hospice teams to patients using a secured program (similar to Facetime) to determine next steps and assist families while someone is sent in person to assist them. The equipment provides additional support to monitor and confirm the status of a patient. About $70,000 was spent on this equipment during 2015. |
| $151,829 | $151,829 | $0 | Patient Care Assistance (Charity Care) 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. |
| $75,000 | $75,000 | $0 | The Gathering Place A center for loss and 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 received care from our hospice services. In 2015, the program provided services to 323 bereaved community members, who received services that included one-on-one counseling meetings, and involvement in over 24 different support groups to help these individuals through the grieving process. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $431,130 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $431,130 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $1,540,954 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (1) | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Karl E Fritschel CPA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4255253339 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 Lind Ave SW 9016 | AddressLine1Txt |
| City | Renton | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 980579016 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| Ned Mansour | |||||||
| Vice Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Scott Sharpe | |||||||
| Vice Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| James A Zapp | |||||||
| Chair | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| John Kirk | |||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Marcia Potter | |||||||
| Secretary | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Michael Clark | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Bunni Dybnis - Res 715 | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Suzi Gulcher | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Gary Kuwahara | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Jim Sala | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Tom Sullivan | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Lynn Taylor | |||||||
| Director | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| Robert Hellrigel | |||||||
| Corporate Member | 0.50 | 54.50 | Yes (X) | $0 | $516,090 | $188,433 | |
| Patricia Modrzejewski | |||||||
| President | 0.50 | 55.00 | Yes (X) | Yes (X) | $0 | $458,381 | $48,836 |
| Barbara Roberts | |||||||
| Executive Director | 50.00 | 0.00 | Yes (X) | $0 | $164,410 | $16,173 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,138,881 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $253,442 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $6,135 | FederatedCampaignsAmt |
| Fundraising | $146,605 | FundraisingAmt |
| Related Organizations | $1,134,529 | RelatedOrganizationsAmt |
| Government Grants | $40,800 | GovernmentGrantsAmt |
| All Other Contributions | $3,403,791 | AllOtherContributionsAmt |
| Noncash Contributions | $6,024 | NoncashContributionsAmt |
| Total Contributions | $4,731,860 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $161,263 | TotalRevenueColumnAmt |
| Exclusion | $161,263 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,900,000 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,885,804 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,196 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,196 | TotalRevenueColumnAmt |
| Exclusion | $14,196 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $8,200 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $146,605 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $53,022 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$44,822 | TotalRevenueColumnAmt |
| Exclusion | -$44,822 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $21,800 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $4,999 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,801 | TotalRevenueColumnAmt |
| Exclusion | $16,801 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,879,298 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $147,438 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,540,954 | TotalAmt |
| Program Services | $1,540,954 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,916 | TotalAmt |
| Management And General | $69,166 | ManagementAndGeneralAmt |
| Fundraising | $103,750 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $578,895 | TotalAmt |
| Management And General | $231,558 | ManagementAndGeneralAmt |
| Fundraising | $347,337 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,683 | TotalAmt |
| Management And General | $2,673 | ManagementAndGeneralAmt |
| Fundraising | $4,010 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,269 | TotalAmt |
| Management And General | $15,708 | ManagementAndGeneralAmt |
| Fundraising | $23,561 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,579 | TotalAmt |
| Fundraising | $7,579 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,460 | TotalAmt |
| Fundraising | $27,460 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,459 | TotalAmt |
| Management And General | $34,459 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,388 | TotalAmt |
| Management And General | $3,769 | ManagementAndGeneralAmt |
| Fundraising | $49,619 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,264 | TotalAmt |
| Management And General | $20,905 | ManagementAndGeneralAmt |
| Fundraising | $31,359 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,911 | TotalAmt |
| Fundraising | $5,911 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,932 | TotalAmt |
| Fundraising | $12,932 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,220 | TotalAmt |
| Management And General | $7,395 | ManagementAndGeneralAmt |
| Fundraising | $8,825 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | FundraisingFundraisingAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad Debt Allowance | $50,000 | $50,000 | |
| Donor Recognition | $21,838 | $21,838 | |
| Dues & Subscriptions | $2,801 | $2,166 | $635 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,623,569 | TotalAmt |
| Program Services | $1,540,954 | ProgramServicesAmt |
| Management And General | $386,268 | ManagementAndGeneralAmt |
| Fundraising | $696,347 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $887,835 | BOYAmt |
| EOY | $1,251,716 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,623 | BOYAmt |
| EOY | $1,462,578 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $836,295 | BOYAmt |
| EOY | $334,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,088 | BOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,510 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,510 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,866,658 | BOYAmt |
| EOY | $7,603,552 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,918 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,743,417 | BOYAmt |
| EOY | $10,651,846 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,433 | BOYAmt |
| EOY | $11,416 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,125 | BOYAmt |
| EOY | $183,830 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $153,558 | BOYAmt |
| EOY | $195,246 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,101,260 | BOYAmt |
| EOY | $4,434,009 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,335,974 | BOYAmt |
| EOY | $4,487,790 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,625 | BOYAmt |
| EOY | $1,534,801 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,589,859 | BOYAmt |
| EOY | $10,456,600 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,743,417 | BOYAmt |
| EOY | $10,651,846 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,255,729 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$388,988 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,576,678 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,807,108 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,997,371 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,274,292 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,731,860 | CurrentTaxYearAmt |
| Total | $13,387,309 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,576,678 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,807,108 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,997,371 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,274,292 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,731,860 | CurrentTaxYearAmt |
| Total | $13,387,309 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $2,843,521 | SubstantialContributorsTotAmt |
| Public Support Total170 | $10,543,788 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $119,305 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $164,970 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $175,988 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $173,617 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $161,263 | CurrentTaxYearAmt |
| Total | $795,143 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,018 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,344 | CurrentTaxYearMinus3YearsAmt |
| Total | $36,362 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $14,218,814 | TotalSupportAmt |
| Public Support CY170 | 0.74150 | PublicSupportCY170Pct |
| Public Support PY170 | 0.70380 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,264,739 | BeginningYearBalanceAmt |
| Contributions | $2,062,000 | ContributionsAmt |
| Investment Earnings Or Losses | -$280,000 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,000 | GrantsOrScholarshipsAmt |
| End Year Balance | $4,044,739 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,965,932 | BeginningYearBalanceAmt |
| Contributions | $133,176 | ContributionsAmt |
| Investment Earnings Or Losses | $165,631 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,264,739 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,664,338 | BeginningYearBalanceAmt |
| Contributions | $50,000 | ContributionsAmt |
| Investment Earnings Or Losses | $290,626 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $39,032 | GrantsOrScholarshipsAmt |
| End Year Balance | $1,965,932 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,328,772 | BeginningYearBalanceAmt |
| Contributions | $55,000 | ContributionsAmt |
| Investment Earnings Or Losses | $280,566 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,664,338 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,243,229 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $85,543 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,328,772 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.61930 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.37950 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00120 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,510 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,510 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due to Affiliates | Desc |
| Amt | $183,830 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $183,830 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $4,436,000 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$388,988 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$19,824 | OtherRevenueAmt |
| Revenue Not Reported | -$408,812 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,844,812 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $34,459 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $27 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $34,486 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,879,298 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,569,000 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,569,000 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $34,459 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $20,110 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $54,569 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,623,569 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | The quasi-endowment funds are to be used for any purpose the Board designates within the charitable purposes of the organization. Investment income from 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. 2015 endowment expenditures supported TrinityCare Hospice staff training. |
| Part X, Line 2: | The Health System (Providence Health & Services) recognizes the effect of income tax positions only if those positions are more likely than not of being sustained upon an audit by the taxing authority. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. |
| Part XI, Line 2d - Other Adjustments: | Equity Transfer - Reclassed to Expense -19,824. |
| Part XI, Line 4b - Other Adjustments: | Rounding 27. |
| Part XII, Line 4b - Other Adjustments: | Rounding 286. Equity Transfer - Grant Expense 19,824. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | ActivityActivityTxt | Fundraiser Control Of FundsFundraiserControlOfFundsInd | Gross ReceiptsGrossReceiptsAmt | Retained By ContractorRetainedByContractorAmt | Net To OrganizationNetToOrganizationAmt |
|---|---|---|---|---|---|---|---|---|
| Gobel & Associates | ||||||||
| 2 State St 805 | Rochester | NY | 14614 | Consult on Grateful Family fundraising activities | 0 | $0 | $15,060 | -$15,060 |
| Claudia A Looney | ||||||||
| 1291 Peacock Hill Dr | Santa Ana | CA | 927052305 | Major gift solicitations & strategies | 0 | $0 | $11,200 | -$11,200 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $26,260 | TotalRetainedByContractorsAmt |
| Total Net To Organization | -$26,260 | TotalNetToOrganizationAmt |
| Licensed States | CA | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Sunday By The Sea | Event1Nm |
| Gross Receipts Event1 | $154,805 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $146,605 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $8,200 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $20,171 | RentFacilityCostsEvent1Amt |
| Entertainment Event1 | $750 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $32,101 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $154,805 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $146,605 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $8,200 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $20,171 | RentFcltyCostsTotalEventsAmt |
| Entertainment Total Events | $750 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $32,101 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $53,022 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$44,822 | NetIncomeSummaryAmt |
Gaming Information GamingInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Revenue Other Gaming | $21,800 | GrossRevenueOtherGamingAmt |
| Non Cash Prizes Other Gaming | $4,999 | NonCashPrizesOtherGamingAmt |
| Volunteer Labor Other Gaming | Yes (1) | VolunteerLaborOtherGamingInd |
| Volunteer Labor Other Gaming | 0.95000 | VolunteerLaborOtherGamingPct |
| Gross Revenue Total Gaming | $21,800 | GrossRevenueTotalGamingAmt |
| Non Cash Prizes Total Gaming | $4,999 | NonCashPrizesTotalGamingAmt |
| Direct Expense Summary Gaming | $4,999 | DirectExpenseSummaryGamingAmt |
| Net Gaming Income Summary | $16,801 | NetGamingIncomeSummaryAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | CA | StatesWhereGamingConductedCd |
| Licensed | Yes (1) | LicensedInd |
| License Suspended Etc | 0 | LicenseSuspendedEtcInd |
| Gaming With Nonmembers | 0 | GamingWithNonmembersInd |
| Member Of Other Entity | 0 | MemberOfOtherEntityInd |
| Gaming Other Facility | 1.00000 | GamingOtherFacilityPct |
| Individual With Books | Jan Marie Perry | IndividualWithBooksNm |
Persons With Books US Address PersonsWithBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 S Buena Vista Street | AddressLine1Txt |
| City | Burbank | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91505 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct With3rd Prty For Game Rev | 0 | CntrctWith3rdPrtyForGameRevInd |
Gaming Manager Business Name GamingManagerBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jan Marie Perry | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Manager Compensation | $0 | GamingManagerCompensationAmt |
| Gaming Manager Services Prov | Oversee the procedures to organize and execute the raffles and awards. | GamingManagerServicesProvTxt |
| Gaming Manager Is Employee | Yes (X) | GamingManagerIsEmployeeInd |
| Charitable Distribution Rqr | 0 | CharitableDistributionRqrInd |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Providence TrinityCare Hospice | |||||||
| 2601 Airport Dr Ste 230 | Torrance | CA | 90503 | 953264139 | 501(C)(3) | $1,521,130 | Support Hospice Program |
| Providence Little Company of Mary Foundation | |||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 510224944 | 501(C)(3) | $19,824 | Support Hospice Services |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Robert Hellrigel | ||||||||||||||
| Corporate Member | $0 | $401,310 | $0 | $114,780 | $0 | $0 | $0 | $165,705 | $0 | $22,728 | $0 | $704,523 | $0 | $0 |
| Patricia Modrzejewski | ||||||||||||||
| President | $0 | $402,448 | $0 | $37,933 | $0 | $18,000 | $0 | $32,165 | $0 | $16,671 | $0 | $507,217 | $0 | $0 |
| Barbara Roberts | ||||||||||||||
| Executive Director | $0 | $158,386 | $0 | $6,024 | $0 | $0 | $0 | $8,506 | $0 | $7,667 | $0 | $180,583 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | Providence Health & Services Expense Reimbursement Procedures include the following policies: First Class Travel or Charter Travel or Travel of Companions Air travel is reimbursable for tourist or economy class 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 air travel will only be reimbursed when tourist or economy class air travel is not available and business travel is mandated by a supervisor. In the rare circumstance that an executive must fly on a first class full fare ticket, their senior level supervisor must approve this expense. 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 People and Experience Officer. 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 2015, there were 2 First Class tickets utilized by Officers, Directors or Key Employees listed on Form 990, Part VII. |
| Part I, Line 4b | NONQUALIFIED RETIREMENT PLANS A) CBRP = Cash Balance Restoration Plan B) SERP = Supplemental Executive Retirement Plan 1) Patricia E. Modrzejewski a) Taxable CBRP Earned - $11,578 b) Non-taxable CBRP Earned - $132 2) Robert Hellrigel a) SERP Earned but not Vested - $129,551 b) SERP Interest Credit - $6,970 |
| FORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS 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). The performance award is based on the level of accomplishment of annual system objectives, in combination with personal goals for top executives. In 2015, 50 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's six strategic priorities of: creating healthier communities together, inspire and develop our people, building enduring relationships with consumers, create alignment with clinicians & care teams, develop and thrive under new care delivery & economic models, and grow by optimizing expert-to-expert capabilities. The remaining 50% was based on a robust set of personal goals designed to align critical mission and business drivers, executive team talent development (deepening talent pipeline for top 200+leaders) and professional development. In 2015 the percent allocation for each of these strategic priorities was as outlined below: * Success Measures - System Goals : 50% Community Benefit - 5% Caregiver (Employee) Engagement - 7.5% MyChart Activations - 5% Patient Loyalty Index - 5% Clinical Excellence Index - 7.5% Free Cash Flow - 5% Salary Expense / Net Operating Revenue - 2.5% Primary Care Panel Size - 5% Total Growth in Operating Revenue - 7.5% * Success Measures - Personal Goals : 50% Mission/Business Driver - 15% Exec Talent Development - 20% Professional Development - 15% TOTAL ALLOCATION: 100% |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | Providence TrinityCare Hospice is the sole Corporate Member. |
| Form 990, Part VI, Section A, line 7a | The 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 7b | The 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 11 | The Form 990 is prepared internally by experienced Providence Health & Services staff and reviewed by the PH&S Director of Taxes and external tax advisors. The Executive Director and Finance & Investment Committee reviewed the Form 990 in detail. Once approved, an electronic copy of the Form 990 is emailed to the Board prior to filing with the IRS. |
| Form 990, Part VI, Section B, line 12c | All 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 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 Health & Services 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 Health & Services has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined by the Providence Health & Services System Board's Human Resources Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Providence Health & Services System 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 System Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources Committee. Performance incentives allow executives to earn additional compensation if they achieve specific organizational and individual goals for furthering Providence operating principles - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated customer satisfaction, meeting employee satisfaction goals and reaching financial performance objectives. The Board of Directors conducts a thorough process to ensure performance incentives are aligned with appropriate practices for not-for-profit health care systems. The Providence Health & Services System Board's process for executive compensation fully complies with IRS standards and mirrors the best practices recommended in the "Report to Congress and the Nonprofit Sector on Governance, Transparency, and Accountability" submitted to the Senate Finance Committee by the Panel on the Nonprofit Sector. Based upon the above principles, the Executive Director's compensation is reviewed annually by the PHS - So. California HR Department. |
| 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 | Robert Hellrigel - 1801 Lind Avenue SW, #9016, Renton, WA 98057. |
| 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 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 COMPENSATION | The 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 - VOLUNTEERS | Volunteers for Providence TrinityCare Hospice Foundation provide an array of services, 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 cleaning; auction item procurement and preparation; auction coordination at special events; filing and information packet assembling. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (73 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 9 | 0 | N/A | |
| Providence Oregon Management Corporation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 930813977 | Shell Corporation | OR | 501( c)(3) | Line 1 | PH & S - Oregon | 0 | |
| Providence Plan Partners | |||||||||||
| 4400 NE Halsey Bldg 2 | Portland | OR | 97213 | 911861964 | Healthcare Services | OR | 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 11/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 9 | PHS - So California | 0 | |
| Providence TrinityCare Hospice | |||||||||||
| 5315 Torrance Blvd Suite B1 | Torrance | CA | 90503 | 953264139 | Hospice | CA | 501( c)(3) | Line 9 | 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 9 | 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 9 | PH & S - Oregon | 0 | |
| The Gamelin California Association | |||||||||||
| 540 23rd St | Oakland | CA | 94612 | 911293869 | Supportive Housing | CA | 501( c)(3) | Line 9 | 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) | Pending | 0 | N/A | |
| Providence Foundation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 943078543 | Support PH&S Institutions | WA | 501( c)(3) | Line 11/Type II | PH & S - Washington | 0 | |
| Providence Alaska Foundation | |||||||||||
| 3300 Providence Drive - B Tower2 | Anchorage | AK | 99508 | 920093565 | Support PHS-Alaska | AK | 501( c)(3) | Line 11/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 11/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 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 11/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 | Shell Corporation | WA | 501( c)(3) | Line 11/Type II | Providence Ministries | 0 | |
| Providence Health & Services - Montana | |||||||||||
| 500 W Broadway PO Box 4587 | Missoula | MT | 598064587 | 810231793 | Healthcare | MT | 501( c)(3) | Line 3 | PH & S - Washington | 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 9 | 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 - Washington | 0 | |
| 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 11/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 11/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 11/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 11/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 9 | Western HealthConnect | 0 | |
| Kadlec Foundation | |||||||||||
| 888 Swift Blvd | Richland | WA | 99352 | 237005501 | Support Kadlec Regional Medical Center | WA | 501(c )(3) | Line 11/Type I | Kadlec Regional Medical Center | 0 | |
| PacMed Clinics | |||||||||||
| 1200 12th Ave S | Seattle | WA | 98144 | 562290878 | Healthcare | WA | 501(c )(3) | Line 9 | 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 | Shell Corporation | WA | 501(c )(3) | Pending | 0 | N/A | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (26 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| Providence Imaging Center | |||||||
| 3340 Providence Drive | Anchorage | AK | 99508 | 920118807 | Medical Imaging | AK | N/A |
| California Laboratory Associates LLC | |||||||
| 501 Buena Vista | Burbank | CA | 91505 | 273888692 | Outpatient Lab | CA | N/A |
| Broadway Imaging LLC | |||||||
| 500 W Broadway | Missoula | MT | 59802 | 522405971 | Medical Imaging | MT | 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 |
| Pathology Associates Medical Laboratories LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 270943279 | Outpatient Lab | WA | N/A |
| Portland Medical Imaging LLC | |||||||
| 4400 NE Halsey 495 | Portland | OR | 97213 | 201054971 | Imaging - Diagnostics | OR | N/A |
| Oregon Advanced Imaging LLC | |||||||
| 881 OHare Parkway | Medford | OR | 97504 | 450471748 | Medical Imaging | OR | N/A |
| Minor & James Medical PLLC | |||||||
| 515 Minor Avenue 200 | Seattle | WA | 98104 | 911340223 | Physician Clinic | WA | N/A |
| Providence Surgery Center LLC | |||||||
| 902 N Orange St | Missoula | MT | 59802 | 841401625 | Ambulatory Surgery Center | MT | N/A |
| Clackamas Radiation Oncology Center LLC | |||||||
| 4400 NE Halsey St Bldg II 495 | Portland | OR | 97213 | 260381897 | Radiation Oncology | OR | N/A |
| PETCT Imaging at Swedish Cancer Institute LLC | |||||||
| 1221 Madison Street | Seattle | WA | 98104 | 203132044 | Medical Imaging | WA | N/A |
| PacLab LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 911743952 | Outpatient Lab | WA | N/A |
| The Madison Spokane Inn LLC | |||||||
| 15 West Rockwood Blvd | Spokane | WA | 99204 | 841606484 | Hotel Services | WA | N/A |
| Center for Specialty Surgery LLC | |||||||
| 11782 SW Barnes Rd | Portland | OR | 97225 | 263638838 | Ambulatory Surgery Center | OR | N/A |
| Oregon Outpatient Surgery Center | |||||||
| 7300 SW Childs Rd | Tigard | OR | 97224 | 223883387 | Ambulatory Surgery Center | 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 |
| Alpha Medical Laboratory LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 912017347 | Outpatient Lab | ID | N/A |
| Greater Valley Medical Building LP | |||||||
| 501 S Buena Vista St | Burbank | CA | 91505 | 954570858 | Real Estate - MOB | CA | N/A |
| Prov Radiation Oncology Develop Assn LLC | |||||||
| 4400 NE Halsey 495 | Portland | OR | 97213 | 260682491 | Real Estate - MOB | OR | N/A |
| Providence Partners for Health LLC | |||||||
| 501 S Buena Vista St | Burbank | CA | 91505 | 454041798 | Clinical Quality & Integration | CA | N/A |
| ProvidenceSilverton Rehab LLC | |||||||
| 4400 NE Halsey 425 | Portland | OR | 97213 | 481287267 | Rehab Services | OR | N/A |
| Southern Idaho Regional Laboratory LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 820511819 | Outpatient Lab | ID | N/A |
| Mountainstar Clinical Laboratories LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 261345983 | Outpatient Lab | MT | N/A |
| Tri-Cities Laboratory LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 911773986 | Outpatient Lab | WA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 |
| Washington Cancer Centers PC | |||||||||
| 1560 N 115th G-16 | Seattle | WA | 98133 | 911792791 | Cancer Treatment | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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