2015-11-04T12:42:28-06:00 2014-12-31 911194016 Clark Nuber PS 10900 NE 4th Suite 1700 Bellevue WA 98004 990 2014-01-01 911861964 PROVIDENCE PLAN PARTNERS PROV 5035746330 4400 NE Halsey Bldg 2 Portland OR 97213 Jeffrey Butcher Treasurer/CFO 5035746330 2015-11-04 1 Sara Elizabeth J Hyre CPA P00235495 4254544919 2014 2016-03-07 17:11:31Z Jack Friedman 4400 NE Halsey Bldg 2 Portland OR 97213 8707895 0 X N/A X 1997 OR Health Care Services. 16 16 0 0 0 0 0 0 3604122 3476681 401793 252142 0 0 4005915 3728823 28350 54365 0 0 2595035 2755328 0 0 0 2721567 2647227 5344952 5456920 -1339037 -1728097 17626466 36188571 16360530 36624432 1265936 -435861 X As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Health Care Services. 0 0 2557442 0 3067625 Providence Preferred Provider Program (PPO), as part of Providence Plan Partners (PPP), is a network of medical practitioners, hospitals and ancillary medical providers throughout Oregon and southwest Washington designed to manage the cost, delivery, and quality of healthcare in these communities. PPO offers employers, self-insured employers, health and welfare trusts and other healthcare purchasers a program for reducing the cost of healthcare services, while maintaining the quality of medical care to enrollees. PPO acts as a liaison between hospitals and payors by informing payors and enrollees of the agreements entered on their behalf by PPO. PPO neither assumes risk or responsibility for payment to hospitals or providers nor guarantees payment by payors or performance by hospitals or providers of any of the terms of conditions set forth in any payor agreements. As of December 2014 there were 115,623 individuals that were eligible to use the Providence Preferred Provider Network. 1690409 0 409056 Providence MCO Program (MCO), as part of Providence Plan Partners (PPP), is an Oregon certified workers' compensation program designed to complement the claims management program of employers. As such, the program aims to provide coordinated, high quality medical care to workers who suffer work-related injuries or illnesses and focuses on early return-to-work strategies that keep employees productive during recovery. The program is functionally and structurally similar to Preferred Provider Program (PPO), although focused on workers' compensation only. During 2014, there were 371,000 individuals that were eligible to use the Providence MCO Program. 54365 54365 0 Grants and allocations to 501(c)(3) organizations. - SEE SCHEDULE I 4302216 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 X 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 0 0 0 OR X Jeff Butcher CFO 5035746390 4400 NE Halsey Bldg 2 Portland OR 97213 X Michael Holcomb Chair of the Board 0.10 7.30 X X 0 60360 0 Chauncey Boyle SP Director 0.10 5.50 X 0 0 0 Marian Schubert CSJ - Eff914 Director 0.10 4.50 X 0 0 0 Phyllis Hughes RSM Director 0.10 5.00 X 0 0 0 Carolina Reyes MD Director 0.10 4.20 X 0 15360 0 Michael A Stein Director 0.10 6.00 X 0 15360 0 Eugene Al Parrish Director 0.10 5.00 X 0 15360 0 Peter J Snow Director 0.10 5.70 X 0 20860 0 Bob Wilson Director 0.10 5.00 X 0 18360 0 Sallye Liner Director 0.10 4.20 X 0 15360 0 Ellen L Wolf Director 0.10 7.10 X 0 15360 0 Isiaah Crawford Director 0.10 4.10 X 0 15360 0 Martha Diaz Aszkenazy Director 0.10 7.70 X 0 18360 0 Kirby McDonald Director 0.10 4.60 X 0 15360 0 Dave Olsen Director 0.10 5.50 X 0 17860 0 Charles Chuck Watts Director 0.10 4.60 X 0 15360 0 Jack Friedman President/CEO 17.00 33.00 X 0 596381 179337 Cindy Strauss Secretary/SVP/Chief Counsel 0.10 59.90 X 0 488042 235786 Alison S Schrupp CSO 18.00 37.00 X 0 438576 57157 Barbara L Christensen Chief Sales & Mkt. Officer 15.00 30.00 X 0 361568 76221 Michael G White COO 17.00 33.00 X 0 357280 84830 Bruce W Wilkinson CIO 15.00 30.00 X 0 360789 68539 Robert A Gluckman CMO 17.00 33.00 X 0 440907 139689 Jeffrey Butcher Treasurer/CFO 17.00 33.00 X 0 288842 45180 Carrie Smith Chief Compliance Officer 17.00 33.00 X 0 231528 38112 Dave Underriner SVP/CEO - OR.Region 1.00 64.00 X 0 661297 97504 William Olson CFO/OR. Region 1.00 49.00 X 0 502797 52174 Stephanie C Dreyfuss Dir. Network Develop. 13.00 27.00 X 0 264495 23871 Mark A Whitaker Medical Director 13.00 27.00 X 0 264040 26221 James H Mackay Medical Director 17.00 33.00 X 0 258616 87126 Susan Abate Dir. Quality Med. Mgr. 13.00 27.00 X 0 217183 74513 Rakesh Pai Medical Director 13.00 27.00 X 0 207631 24394 Jeff W Rogers Former Corporate Secretary 0.00 0.00 X 0 231112 390991 Greg Van Pelt Former CE/OR. Region 0.00 0.00 X 0 1054305 147461 0 7484069 1849106 0 1 1 0 Providence Health & Services - Oregon PO Box 3395 Portland OR 97208 Hospital & Healthcare Services 5580740 Swedish Health Services 747 Broadway Seattle WA 98122 Hospital & Healthcare Services 2192478 Glisan Care Center 9750 NE Glisan Portland OR 97220 Healthcare Services 536983 Lawrence Convalescent Center 812 SE 48th Avenue Portland OR 97215 Healthcare Services 468476 Washington Care Services 2821 S Walden Seattle WA 98144 Healthcare Services 466105 32 PPO Hospital Fees 900099 1318546 1318546 PPO Admin Fees 900099 1148478 1148478 PPO Physician Fees 900099 600601 600601 MCO Admin Fees 900099 408906 408906 MCO Physicians Fees 900099 150 150 3476681 104820 104820 5126394 4979072 147322 147322 147322 3728823 3476681 0 252142 X 54365 54365 1933932 1707548 226384 821396 723753 97643 63086 18954 44132 25837 25837 992336 578159 414177 96152 89173 6979 200673 128301 72372 370649 259047 111602 200624 180713 19911 29784 26679 3105 8291 5178 3113 569190 462090 107100 1713 1543 170 Electronic Claims 36802 36802 Subscriptions 11808 11808 Penalties & Fines 11219 5607 5612 Dues & Memberships 10532 8759 1773 18531 15545 2986 5456920 4302216 1154704 0 1111 1936142 4535952 665052 441093 9639 2490799 3343355 8649386 8917496 3885087 18939925 17626466 36188571 5180915 22297003 193404 191641 10986211 14135788 16360530 36624432 X 9729010 9729010 -14413589 -14413589 5950515 4248718 1265936 -435861 17626466 36188571 -1728097 26300 0 X X 0 1 X 1 0 0 Due from Affiliates 18939925 18939925 Due to Affiliates 14135788 14135788 X Part X, Line 2: The Health System 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. 1 Vancouver National Historic Reserve Trust 750 Anderson Street Vancouver WA 98661 911937645 501(C)(3) 54365 Providence Academy Restoration 1 0 Part I, Line 2: We request and condition upon each of the following: 1) The program summary and budget; 2) Verification of malpractice and liability coverage; 3) Updates provided every six months; 4) Documentation evidencing tax-exempt or municipal status; 5) Documentation showing that they serve the low income and uninsured regardless of ability to pay for services; 6) Provide upon request, financial reporting of the budgeted use of grant funds. 1 1 0 0 0 0 0 0 0 Jack Friedman President/CEO 0 531342 0 47539 0 17500 0 151650 0 27687 0 775718 0 0 Cindy Strauss Secretary/SVP/Chief Counsel 0 470542 0 0 0 17500 0 212878 0 22908 0 723828 0 0 Alison S Schrupp CSO 0 280908 0 151560 0 6108 0 43536 0 13621 0 495733 0 0 Barbara L Christensen Chief Sales & Mkt. Officer 0 263251 0 80474 0 17843 0 60143 0 16078 0 437789 0 0 Michael G White COO 0 299120 0 40660 0 17500 0 78872 0 5958 0 442110 0 0 Bruce W Wilkinson CIO 0 241002 0 102287 0 17500 0 50454 0 18085 0 429328 0 0 Robert A Gluckman CMO 0 391235 0 49672 0 0 0 120754 0 18935 0 580596 0 0 Jeffrey Butcher Treasurer/CFO 0 257552 0 31290 0 0 0 27084 0 18096 0 334022 0 0 Carrie Smith Chief Compliance Officer 0 190240 0 24048 0 17240 0 24239 0 13873 0 269640 0 0 Dave Underriner SVP/CEO - OR.Region 0 579486 0 64286 0 17525 0 69322 0 28182 0 758801 0 0 William Olson CFO/OR. Region 0 365263 0 137374 0 160 0 35655 0 16519 0 554971 0 0 Stephanie C Dreyfuss Dir. Network Develop. 0 212918 0 34077 0 17500 0 11700 0 12171 0 288366 0 0 Mark A Whitaker Medical Director 0 256251 0 2744 0 5045 0 11700 0 14521 0 290261 0 0 James H Mackay Medical Director 0 244241 0 14375 0 0 0 72614 0 14512 0 345742 0 0 Susan Abate Dir. Quality Med. Mgr. 0 192833 0 24350 0 0 0 66971 0 7542 0 291696 0 0 Rakesh Pai Medical Director 0 190131 0 0 0 17500 0 6335 0 18059 0 232025 0 0 Jeff W Rogers Former Corporate Secretary 0 0 0 12493 0 218619 0 390991 0 0 0 622103 0 467812 Greg Van Pelt Former CE/OR. Region 0 915 0 76369 0 977021 0 129106 0 18355 0 1201766 0 0 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 2014, there was one First Class ticket utilized by Officers, Directors or Key Employees listed on Form 990, Part VII. Tax Indemnifications or Gross-Up Payments Providence Health & Services follows the federal and state taxation laws related to gifts and gift cards paid to an employee. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to handle these transactions, Providence reports the payments to as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee. During 2014, the following Listed Persons received gross-up payments related to taxable gifts: Alison Schrupp Barbara Christensen William Olson The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Part I, Lines 4a-b NON-QUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan C) ESP = Elective Survivor Plan 1) Cindy Strauss a) SERP Earned but not Vested - $173,177 b) SERP Interest Credit - $20,200 2) Jack Friedman a) Taxable SERP Earned but not Paid - $47,539 b) SERP Interest Credit - $100,696 3) Alison S. Schrupp a) SERP Interest Credit - $12,791 b) Taxable SERP Earned but Not Paid - $67,803 c) Taxable CBRP Earned but Not Paid - $1,589 d) ESP Interest Credit - $3,441 4) Barbara L. Christensen a) SERP Interest Credit - $3,249 b) Taxable SERP Earned but Not Paid - $18,689 c) ESP Interest Credit - $3,082 5) Michael G. White a) SERP Interest Credit - $1,434 b) SERP Earned but Not Vested - $47,219 6) Bruce W. Wilkinson a) SERP Interest Credit - $20,616 b) Taxable SERP Earned but Not Paid - $70,036 c) Taxable CBRP Earned but Not Paid - $2 7) Robert A. Gluckman a) SERP Interest Credit - $16,911 b) SERP Earned but not Vested - $71,830 c) Taxable CBRP Paid - $132 8) Jeff Butcher a) SERP Earned but Not Vested - $14,525 b) SERP Interest Credit - $859 9) David T. Underriner a) Taxable SERP Earned but not Paid - $64,286 b) SERP Interest Credit - $11,146 c) ESP Interest Credit - $3,151 10) William Olson a) Taxable CBRP Paid - $3 b) Taxable SERP Earned but Not Paid - $69,951 11) James H. Mackay a) Taxable CBRP Paid - $8,546 b) Non-Taxable CBRP Earned but Not Paid - $1,403 12) Jeff Rogers a) Taxable CBRP Paid - $12,493 b) Non-Taxable CBRP Earned but not Paid - $10,159 c) SERP Earned but not Paid - $242,193 d) ESP Paid - $218,619 13) Greg Van Pelt a) Taxable SERP Earned but Not Paid - $76,369 b) Non-taxable SERP Earned but Not Paid - $87,510 Part I, Lines 4a-b SEVERANCE Greg Van Pelt - $735,779 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 2014, 100 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. For 2014, the percent allocation for each of these strategic priorities is outlined below: * Creating Healthier Communities, Together Community Benefit: 10% System Leadership Council - 10% System Role including Providence Senior & Community Services (PSCS) - 10% Region Role Regional Chief Executives (RCEs) and Reports * Inspire and Develop Our People Core Leader Engagement: 10% System Leadership Council - 10% Providence Strategic and Management Services (PSMS) System Role including PSCS - 10% Region Role RCEs and Reports Employee Health Index: 5% System Leadership Council - 5% System Role including PSCS - 5% System Region Role RCEs and Reports * Building Enduring Relationships with Consumers MyChart Activations: 5% System Leadership Council - 5% System Role including PSCS - 5% Region Role RCEs and Reports Patient Loyalty Index: 5% System Leadership Council - 5% System Role including PSCS - 5% Region Role RCEs and Reports * Create Alignment with Clinicians & Care Teams Clinical Excellence Index: 10% System Leadership Council - 10% System Role including PSCS - 10% Region Role RCEs and Reports * Develop and Thrive Under New Care Delivery & Economic Models Salary Expense as % of Net Service Revenue: 10% System Leadership Council - 10% PSMS System Role including PSCS - 10% Region Role RCEs and Reports Supply Expense as % of Net Service Revenue: 5% System Leadership Council - 5% System Role including PSCS - 5% Region Role RCEs and Reports Primary Care Panel Size: 5% System Leadership Council - 5% System Role including PSCS - 5% Region Role RCEs and Reports Clinical Network Performance: 10% System Leadership Council - 10% System Role including PSCS - 10% System Region Role RCEs and Reports * Grow by Optimizing Expert-to-Expert Capabilities Free Cash Flow: 15% System Leadership Council - 15% System Role including PSCS - 15% Region Role RCEs and Reports Unduplicated Patient Count: 10% System Leadership Council - 10% System Role including PSCS - 10% Region Role RCEs and Reports TOTAL ALLOCATION: 100% Leadership Council - 100% System Role including PSCS - 100% Region Role RCEs and Reports Form 990, Part VI, Section A, line 6 The Member of the Corporation is Providence Health & Services - Oregon. Form 990, Part VI, Section A, line 7a The Corporate Member has the power to: 1) Fix the number of Directors, select the Directors and to remove such Directors at any time with or without cause. 2) Appoint the Chairperson of the Board of Directors, determine the term of office and to remove such Chairperson with or without cause. Form 990, Part VI, Section A, line 7b The Corporate Member has the power: 1) To adopt or change the mission, philosophy, and values, including the strategic plan and mission statement. 2) To amend or repeal the Articles of Incorporation or Bylaws. 3) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale transfer, assignment or encumbering of assets exceeding a specified threshold, or the sale or transfer of any property which may have historical or religions significance. 4) To approve the establishment of any new Corporation in which this Corporation has a controlling interest. 5) To approve the dissolution or liquidation. 6) To approve the annual operating and capital budgets. 7) To appoint the certified public accountants. 8) To approve, according to established guidelines, any joint venture of corporate affiliations. 9) To approve lending of corporate funds. 10) To approve the closure of any institution or major ministry or work of the Corporation. Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict. Form 990, Part VI, Section B, line 15 It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are reviewed by the Providence Board's Human Resources 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. 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. Each year, the Board Chair conducts a formal performance evaluation of the President/CEO that considers input from the other directors and senior leaders reporting to the President. The evaluation is discussed with the Human Resources Committee and then a recommendation is made by the committee to the full Board. The Board Chair and the Chair of the Human Resources Committee also meet with an independent consultant to develop a salary recommendation; which is reviewed and approved first by the committee and then by the Board of Directors. Additionally, the President/CEO utilizes the market information provided by the consultant along with formal performance evaluations, to determine salary recommendations for other senior executives. This process includes a rigorous analysis of those recommendations with the Human Resources Committee as a part of the review and approval process. Performance incentives allow executives to earn additional compensation if they achieve specific organizational goals for furthering Providence operating commitments and strategic objectives - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated patient 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 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. 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 Michael Holcomb - 1801 Lind Avenue SW, Renton, WA 98057. Chauncey Boyle, SP - 1801 Lind Avenue SW, Renton, WA 98057. Marian Schubert, CSJ - Eff.9/14 - 1801 Lind Avenue SW, Renton, WA 98057. Phyllis Hughes, RSM - 1801 Lind Avenue SW, Renton, WA 98057. Carolina Reyes, MD - 1801 Lind Avenue SW, Renton, WA 98057. Michael A. Stein - 1801 Lind Avenue SW, Renton, WA 98057. Eugene "Al" Parrish - 1801 Lind Avenue SW, Renton, WA 98057. Peter J. Snow - 1801 Lind Avenue SW, Renton, WA 98057. Bob Wilson - 1801 Lind Avenue SW, Renton, WA 98057. Sallye Liner - 1801 Lind Avenue SW, Renton, WA 98057. Ellen L. Wolf - 1801 Lind Avenue SW, Renton, WA 98057. Isiaah Crawford - 1801 Lind Avenue SW, Renton, WA 98057. Martha Diaz Aszkenazy - 1801 Lind Avenue SW, Renton, WA 98057. Kirby McDonald - 1801 Lind Avenue SW, Renton, WA 98057. Dave Olsen - 1801 Lind Avenue SW, Renton, WA 98057. Charles (Chuck) Watts - 1801 Lind Avenue SW, Renton, WA 98057. Cindy Strauss - 1801 Lind Avenue SW, Renton, WA 98057. Jeff W. Rogers - 1801 Lind Avenue SW, Renton, WA 98057. Form 990, Part IX, line 11g Consulting Fees: Program service expenses 335,688. Management and general expenses 267,114. Fundraising expenses 0. Total expenses 602,802. Network Fees: Program service expenses 74,365. Management and general expenses 0. Fundraising expenses 0. Total expenses 74,365. Other: Program service expenses 82,749. Management and general expenses 82,526. Fundraising expenses 0. Total expenses 165,275. Records Management: Program service expenses 4,226. Management and general expenses 466. Fundraising expenses 0. Total expenses 4,692. Contract Maintenance: Program service expenses 5,066. Management and general expenses 558. Fundraising expenses 0. Total expenses 5,624. Advisors: Program service expenses 3,280. Management and general expenses 31. Fundraising expenses 0. Total expenses 3,311. Professional Fees - Actuarial: Program service expenses 0. Management and general expenses 44,304. Fundraising expenses 0. Total expenses 44,304. Rx Admin Fee: Program service expenses 62,095. Management and general expenses 0. Fundraising expenses 0. Total expenses 62,095. ID Cards: Program service expenses 0. Management and general expenses 16,994. Fundraising expenses 0. Total expenses 16,994. Electronic Data Interchange: Program service expenses 8,942. Management and general expenses 0. Fundraising expenses 0. Total expenses 8,942. Translation: Program service expenses 1,748. Management and general expenses 1,748. Fundraising expenses 0. Total expenses 3,496. Surveys: Program service expenses 0. Management and general expenses 436. Fundraising expenses 0. Total expenses 436. 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; the investment committee; 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 Providence Plan Partners are paid by Providence Health & Services - Washington dba Health System Office EIN# 91-0725998 or Providence Health & Services - Oregon EIN# 51-0216587. Therefore, no W-2s are issued by the reporting organization. FORM 990, PART VII - RELIGIOUS COMMUNITY MEMBERS As members of the Religious Community, each Sister has taken a vow of poverty as a compulsory part of her religious life. Any compensation for services of a Sister inures only for the benefit of the Community, not the individual members. All payments for services are made directly to the Religious Community. FORM 990, SCHEDULE R - RELATED ORGANIZATIONS AFFILIATION AGREEMENTS Effective March 1, 2014, the Health System entered into an affiliation agreement with Sisters of Charity of Leavenworth Health System (SCL) to transfer sponsorship of Saint John's Health Center (Saint John's) to the Health System. Saint John's operates a nonprofit medical center, a cancer institute, and physician clinics to serve the Santa Monica, California community and surrounding area. Effective May 1, 2014, the Health System entered into an affiliation agreement with PacMed Clinics (PacMed). PacMed is a private, nonprofit, multi-specialty medical group with nine clinics in the Puget Sound area and more than 150 primary care and specialty providers at the date of affiliation. Pursuant to the affiliation agreement, Western HealthConnect became PacMed's sole corporate Member. No cash or other purchase consideration was transferred to effect the affiliation. Effective June 13, 2014, the Health System entered into an affiliation agreement with Kadlec Health System (Kadlec). Kadlec operates a nonprofit medical center, a neurological resource center, a supporting foundation, and physician clinics to serve the tri-cities area of Kennewick, Pasco, and Richland, Washington. Pursuant to the affiliation agreement, Western HealthConnect became the sole member of Kadlec. No cash or other purchase consideration was transferred to effect the affiliation. 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 N/A 0 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 Health Plan 4400 NE Halsey Bldg 2 Portland OR 97213 930863097 Health Service Contractor OR 501( c)(4) N/A Providence Plan Partners 1 Providence Health Assurance 4400 NE Halsey Bldg 2 Portland OR 97213 550828701 Medicaid Healthcare Provider OR 501( c)(4) N/A Providence Health Plan 1 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 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 St Luke Association 350 Washington Ave SE Chehalis WA 98352 943176618 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Rossi Association 1700 Providence Pl Centralia WA 98531 311584166 Housing WA 501( c)(3) Line 9 PH & S - Washington 0 Lundberg Association 5921 E Burnside Portland OR 97215 911562797 Housing OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence St Francis Association 3415 12th Avenue NE Olympia WA 98506 943244854 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Peter Claver Association 7101 38th Avenue South Seattle WA 98118 311629656 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence St Elizabeth House Association 3201 SW Graham St Seattle WA 98126 912171539 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 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 The Gamelin Association 312 North Fourth St Yakima WA 98901 911180824 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 The Gamelin Oregon Association 5520 NE Glisan Portland OR 97213 911214491 Housing OR 501( c)(3) Line 9 PH & S - Oregon 0 The Gamelin California Association 540 23rd St Oakland CA 94612 911293869 Housing CA 501( c)(3) Line 9 PHS - So California 0 Gamelin Washington Association 1423 First Avenue Seattle WA 98101 201910170 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Foundation 1801 Lind Avenue SW 9016 Renton WA 980579016 943078543 Support PH&S Institutions WA 501( c)(3) Line 11/Type I PH & S - Washington 0 Providence Alaska Foundation 3300 Providence Drive - B Tower2 Anchorage AK 99508 920093565 Support PHS-Alaska AK 501( c)(3) Line 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 TrinityCare Hospice Foundation 5315 Torrance Blvd Suite B1 Torrance CA 90503 330261016 Support TrinityCare Hospice CA 501( c)(3) Line 7 Providence TrinityCare Hospice 0 Providence Little Company of Mary Foundation 4101 Torrance Blvd Torrance CA 90503 510224944 Support Little Company of Mary Service Area CA 501( c)(3) Line 7 PHS - So California 0 PH&S FoundationSFVSA & SCVSA 501 S Buena Vista Street Burbank CA 91505 953544877 Support Program & Activities of SFVSA & SCVSA CA 501( c)(3) Line 7 PHS - So California 0 Providence Hospice of Seattle Foundation 425 Pontius Avenue North 300 Seattle WA 981095452 912077378 Support Hospice of Seattle WA 501( c)(3) Line 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 PH & S - Washington 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 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 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 Portland OR 97213 260796953 Imaging - Diagnostics OR N/A Ctr for MedImaging-Tanasbourne LLC 4400 NE Halsey 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 St Bldg II 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 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 4401 NE Halsey St Bldg II 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 Bldg III 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 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 Providence Health Plan Q 169394102 Cost Providence Health Assurance Q 8416717 Cost