2015-12-04T10:07:28-06:00 2014-12-31 911194016 Clark Nuber PS 10900 NE 4th Suite 1700 Bellevue WA 98004 990 2014-01-01 910655392 KADLEC REGIONAL MEDICAL CENTER KADL 5099464611 888 SWIFT BLVD RICHLAND WA 993523583 Dan Harris Treasurer 5099464611 2015-12-04 1 Sara Elizabeth J Hyre CPA P00235495 4254544919 2014 2016-03-07 17:11:31Z Lane Savitch 888 SWIFT BLVD RICHLAND WA 993523583 442282017 0 X www.kadlec.org X 1947 WA The mission of Kadlec Regional Medical Center is to provide quality health care to every patient. 16 16 3231 483 0 0 1547709 3082689 384778671 296970742 3724851 5899402 52915 135732798 390104146 441685631 0 18257275 0 0 196012072 232751762 0 0 586951 178947836 227174180 374959908 478183217 15144238 -36497586 434880580 480145478 257365650 302326276 177514930 177819202 X The mission of Kadlec Regional Medical Center is to provide quality health care to every patient. 0 0 204945755 167391778 When Kadlec opened its doors in 1944, the hospital was established to care for the Hanford area workers and their families. Since then, we have grown to a regional medical center providing care for the people throughout the Mid-Columbia.As a not-for-profit, private corporation governed by local volunteer trustees, our decisions are made with our community's best interest in mind. We are dedicated to bringing you and your family not only some of the latest high-tech medical equipment but our staff is committed to providing all our patients with compassionate, high quality care. The Medical Center is a licensed 200+ bed acute-care facility providing both inpatient and outpatient medical services for citizens of Richland, Kennewick, and Pasco, Washington as well as surrounding communities and Northeast Oregon.Kadlec is the home to a growing open heart surgery and interventional cardiology program, the region's only level III Neonatal Intensive Care Unit, a world-class all digital outpatient imaging center as well as a number of other innovative services and programs. Outpatient care: Kadlec introduced a new concept in outpatient care with the opening of its Healthplex in 2014. It is the home to over 20 outpatient services and programs. The 50,000 square-foot facility located in Richland also includes a health library, meeting space, a demonstration kitchen, indoor and outdoor walking paths and a retail shop with difficult-to-find specialty medical equipmentt. Also in 2014, Kadlec announced its accreditation by the Accreditation Council for Graduate Medical Education for a new Family Medicine Residency Program. The first class of six residents was announced in the spring of 2015, with the program getting underway that summer. The program will add six residents a year to the three-year program.In 2014, Kadlec was recognized as a Top Performer on Key Quality Measures by The Joint Commission. Kadlec was one of 17 hospitals in the state to receive this distinction, and one of nine in the four core measures of heart attack, heart failure, pneumonia and surgical care. Kadlec was also the first hospital in the area to receive The Joint Commission's Gold Seal of Approval for hip and knee replacement. Total Admissions: 14,796ER Admissions: 11,881Operating Room Cases: 8,938Births: 2,762Physician Clinic Visits: 350,051 139056427 113575919 Inpatient Care - see line 4a 18902053 15438467 Primary Care - see line 4a 18257275 18257275 Grants and Allocations to community organizations 1271798 1038756 Healthcare Joint Ventures - see line 4a 19529073 18257275 1038756 382433308 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 388 0 1 3231 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 1 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 WA X Karl E Fritschel CPA 4255253339 2001 Lind Ave SW 9016 Renton WA 980579016 X Susan Kreid Thru 61214 Chair 2.00 1.00 X X 0 0 0 Tom Cowan Thru 61214 Vice Chair 2.00 1.00 X X 0 0 0 David Merkley MD Thru 61214 Secretary 2.00 1.00 X X 0 0 0 Sandra Gamble Thru 61214 Treasurer 2.00 1.00 X X 0 0 0 Steve King Thru 61214 Member 2.00 1.00 X 0 0 0 David Lippes Thru 61214 Member 2.00 1.00 X 0 0 0 Wayne Martin PhD Thru 61214 Member 2.00 1.00 X 0 0 0 Thomas Rado MD Thru 61214 Member 2.00 1.00 X 0 0 0 John Samsell MD Thru 61214 Member 2.00 1.00 X 0 0 0 Ronald Schwartz MD Thru 314 Member 2.00 1.00 X 0 0 0 Sam Volpentest Thru 61214 Member 2.00 1.00 X 0 0 0 Jerry Roach Thru 61214 Member 2.00 1.00 X 0 0 0 Mark Gehlen Thru 61214 Member 2.00 1.00 X 0 0 0 Larry Jecha MD Thru 61214 Member 2.00 1.00 X 0 0 0 Michele Dickinson Thru 61214 Member 2.00 1.00 X 0 0 0 Michael Holcomb Eff 61314 Chair of the Board 0.10 7.30 X X 0 60360 0 Chauncey Boyle SP Eff 61314 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 Eff 61314 Director 0.10 5.00 X 0 0 0 Carolina Reyes MD Eff 61314 Director 0.10 4.20 X 0 15360 0 Michael A Stein Eff 61314 Director 0.10 6.00 X 0 15360 0 Eugene Al Parrish Eff 61314 Director 0.10 5.00 X 0 15360 0 Peter J Snow Eff 61314 Director 0.10 5.70 X 0 20860 0 Bob Wilson Eff 61314 Director 0.10 5.00 X 0 18360 0 Sallye Liner Eff 61314 Director 0.10 4.20 X 0 15360 0 Ellen L Wolf Eff 61314 Director 0.10 7.10 X 0 15360 0 Isiaah Crawford Eff 61314 Director 0.10 4.10 X 0 15360 0 Martha Diaz Aszkenazy Eff 61314 Director 0.10 7.70 X 0 18360 0 Kirby McDonald Eff 61314 Director 0.10 4.60 X 0 15360 0 Dave Olsen Eff 61314 Director 0.10 5.50 X 0 17860 0 Charles Chuck Watts Eff 61314 Director 0.10 4.60 X 0 15360 0 Rand Wortman President/CEO - KRMC 56.00 0.00 X 0 0 0 Julie Meek VP Finance/CFO - KRMC 50.00 0.00 X 560919 0 18399 Joel Gilbertson Eff 61314 President 1.00 59.00 X 0 419681 103211 Dan Harris Eff 61314 VP/Treasurer 1.00 59.00 X 0 576901 48417 Cindy Strauss Eff 61314 Corp. Secretary 1.00 59.00 X 0 488042 234850 Jeffrey Clark VP/Support Services 50.00 0.00 X 426001 0 18792 Kirk Harper VP/CNO 50.00 0.00 X 351047 0 11426 Dale Hoekema VP/CMO 50.00 0.00 X 592897 0 24539 Ken Lester President/Kadlec Clinic 50.00 0.00 X 522337 0 36256 David Roach VP/CIO 50.00 0.00 X 444130 0 17056 Lane Savitch President/ CEO 50.00 0.00 X 635947 0 12349 Glenn Welch VP/Foundation Develop. Dir. 6.00 40.00 X 313510 0 3889 William Wingo VP/Corporate Counsel 50.00 0.00 X 476263 0 18399 Mike Butler President/Operations & Services 1.00 59.00 X 0 1540500 492128 Debra Canales EVP/Chief People & Experience Ofc. 1.00 55.00 X 0 1076219 23317 Lisa Vance SVP/Clinical Program Services 1.00 59.00 X 0 709715 58431 Randy Axelrod MD EVP/Clinical & Patient Svcs 1.00 59.00 X 0 701506 245640 Jack Friedman SVP/Account Care & Payor Rel. 1.00 49.00 X 0 596381 177566 Aaron Martin SVP/Strategy & Innovation 1.00 64.00 X 0 563108 18041 Craig L Wright MD SVP/Physician Svcs 1.00 59.00 X 0 549952 312082 Janice Newell SVP/Chief Information Officer 1.00 54.00 X 0 529442 220834 Deborah Burton SVP/Chief Nrsg. Officer 1.00 59.00 X 0 519689 55382 David Brown VP/Strategy & Business Development 1.00 54.00 X 0 493612 143130 Orest Holubec SVP/Marketing & Communications 1.00 54.00 X 0 486207 53563 Mark Gargett VP/Digital Integration 1.00 49.00 X 0 476541 80347 Gary Flaming SVP/Chief Risk Officer 1.00 54.00 X 0 415719 89217 Teresa Spalding VP/Revenue Cycle 1.00 59.00 X 0 414859 44903 Mike Waters VP,CAO/Physician Services 1.00 64.00 X 0 354643 38345 Dave Hunter VP/Supply Chain Management 1.00 54.00 X 0 351919 68009 Steve Burdick CE/Southeast WA. Region 1.00 59.00 X 0 306230 98428 Dana White VP/Real Estate & Construction 1.00 54.00 X 0 287642 64743 Hannan Chaugle Physician 50.00 0.00 X 1122697 0 18425 Iyad Jamall Physician 50.00 0.00 X 965750 0 4000 Dae Young Lee Physician 50.00 0.00 X 882189 0 11693 Fadi Thabit Abdallah AlQaisi Physician 50.00 0.00 X 867381 0 15262 Matthew Fewel Neurosurgeon 50.00 0.00 X 831598 0 20993 8992666 12117188 2902062 361 0 1 0 Bouten Construction PO Box 3507 Spokane WA 99220 Construction Services 12207441 Premier Anesthesia of Richland 2655 Northwinds Pkwy Alpharetta GA 30009 Medical Services 4515925 Xtend Healthcare 500 W Main St Ste 14 Hendersonville TN 37075 Medical Services 2483477 Davis Partnership Architects 2301 Blake St Ste 100 Denver CO 80205 Architectural Services 1859342 Quorum Health Resources 105 Continental Place Brentwood TN 37027 Consulting Services 1842199 91 78814 3003875 3082689 Outpatient Revenue 621400 167124927 167124927 Inpatient Revenue 900099 113394860 113394860 Primary Care 621110 15413855 15413855 Healthcare JVs 900099 1037100 1037100 296970742 5783847 5783847 975451 562403 413048 413048 413048 149538 33983 115555 115555 115555 Pharmacy 446110 75397866 75397866 Lab 621500 55253693 55253693 Cost Recovery 900099 2622091 474178 2147913 2046100 2046100 135319750 441685631 297444920 0 141158022 18257275 18257275 4399482 4085972 313510 188856004 144611758 44186750 57496 5080138 3860152 1210083 9903 20926056 15665020 5220847 40189 13490082 10098530 3365644 25908 1842199 1842199 1518025 486 1488646 28893 62053 62053 100366 100366 38082738 22772806 15306270 3662 1281668 959443 319764 2461 10814870 7251112 3545404 18354 2431849 1820456 606723 4670 11360079 8504033 2834229 21817 1355754 658215 697539 432438 323718 107889 831 9699252 8921289 777963 21527455 16115221 5370890 41344 3115500 2237319 878181 Medical Supplies 65812544 65812544 Loss on Refinancing 30127682 30127682 Bad Debt 8907244 8907244 Dues, Licenses & Fees 7202461 5473346 1715140 13975 11500003 10055659 1440406 3938 478183217 382433308 95162958 586951 29179320 23865386 491411 73810 59207385 58125188 1428950 2016782 2562515 1660479 2360376 280031868 12717812 210083584 267314056 111641008 65366455 4645170 952000 20820461 19648611 33583111 434880580 480145478 47876041 39168546 215591 185750000 178770000 3429497 11314775 2079646 4607934 18230466 68249430 257365650 302326276 X 174252159 177618805 3262771 200397 177514930 177819202 434880580 480145478 X -36497586 -2603565 39405423 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 100366 0 0 0 100366 0 Part II-B, Line 1: Dues to AHA and WSHA; payment to Keller McIntyre for Government relations & strategic development for policies and government funding. 13605108 13605108 194935588 3100104 191835484 1482823 213082 1269741 66318499 9404626 56913873 3689850 3689850 267314056 Due from Affiliates 669303 Miscellaneous Receivables 12525546 Trustee Held Funds 9749005 457B Contributions 4916420 Unamortized Bond Financing Costs 1725920 Deposits 490456 Professional Liability Trust 3506461 33583111 Bond Premium 21194040 457B Contributions 4916420 Malpractice Insurance 4664999 Due to Affiliates 12500000 Third Party Settlements 17051787 Miscellaneous Payables 4809964 Employee Medical 3112220 68249430 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 1 1 X 1 X 1 1 1 0 1 1 703 3210741 3210741 0.00680 11628 53119310 32262852 20856458 0.04440 12331 56330051 32262852 24067199 0.05120 12331 56330051 32262852 24067199 0.05120 0 8907244 79363853 96359028 -16995175 X 1 1 1 1 Kadlec Regional Medical Center 888 Swift Blvd Richland WA 99352 www.kadlec.org/ HAC.FS.161 X X X Inpatient Rehab Kadlec Regional Medical Center 1 0 0 1 X X X X X X X X X 13 1 1 1 1 X kadlec.org/community/community-health-improvement-plan X 1 13 1 www.kadlec.org/uploads/CHIP_FINAL_edKWjz.pdf 0 0 1 X 200.000000000000 300.000000000000 X 1 1 X X X X 1 X X X X X X X 1 X 0 X 1 X 0 0 Kadlec Regional Medical Center Part V, Section B, Line 5: Community Health Needs Assessment was conducted by the Benton Franklin Community Health Alliance (BFCHA). Kadlec is proud to partner with other local health agencies to continue to assess and address community needs through programs and activities that provide treatment and promote health and wellness. Members of the BFCHA and various key partners have worked together to better understand current and future health needs of Benton and Franklin Counties. This process of assessing, prioritizing and addressing health needs in the region was facilitated by local hospitals and public health. It is a strategic, county-wide, community-based approach for creating and maintaining healthy communities. A steering committee of 20+ members representing diverse organizations from across the counties provided oversight and guidance and worked together to better align efforts among community partners and create a more strategic framework for local healthimprovement activities. Kadlec Regional Medical Center Part V, Section B, Line 6a: Kennewick General Hospital, Lourdes Health Network, and PMH Medical Center Kadlec Regional Medical Center Part V, Section B, Line 11: See "Community Health Improvement Plan For the People of Benton and Franklin Counties" located at www.kadlec.org/uploads/CHIP_FINAL_edKWjz.pdf Kadlec Regional Medical Center Part V, Section B, Line 22d: Medicare cost-to-charge ratio. Part V, Section B, Line 16 Financial Assistance Policy Website Availability Kadlec Regional Medical Center Part V, Section B, line 16a website: www.kadlec.org/patients-and-visitors/billing-assistance Kadlec Regional Medical Center Part V, Section B, line 16b website: kadlec.org/uploads/Kadlec_Financial_Assistance_Form_English.pdf Kadlec Regional Medical Center Part V, Section B, line 16c website: kadlec.org/patients-and-visitors/billing-assistance Part I, Line 3c: The organization uses FPG to determine the patient's eligibility for free or discounted care. In addition, the organization will review family assets, including bank statements; the patient's future earning capacity; the existence of other extraordinary family expenses, including rent expenses; and the patient's ability to make payments over time, as reflected by a third party credit report or other documentation. Part I, Ln 7 Col(f): Bad debt expense represents the amount of gross charges for patients who do not have insurance and which Kadlec was unable to qualify for assistance under either government programs or our internal charity care policy. The Bad Debt expense included on Form 990, Part IX, Line 25(A), but subtracted for purposes of calculating the percentage in this column is $8,907,244. Part II, Community Building Activities: Kadlec embraces its responsibility to provide for the needs of the communities it serves. Health care is fundamentally different from most other goods and services. It is about the most human and intimate needs of people, their families and communities. This critical difference is why we should work together to preserve and strengthen the not-for-profit sector in health care.Kadlec is actively involved with public, private and other health systems in working towards better health outcomes for the entire community.The organization did not track or report the financial impact of their community building activities. Part III, Line 2: Bad debt expense represents the amount of gross charges for patients who do not have insurance and which Providence was unable to qualify for assistance under either government programs or our internal charity care policy. Part III, Line 4: The Health System provides for an allowance against patient accounts receivable for amounts that could become uncollectible. The Health System estimates this allowance based on the aging of accounts receivable, historical collection experience by payor, and other relevant factors. There are various factors that can impact the collection trends, such as changes in the economy, which in turn have an impact on unemployment rates and the number of uninsured and underinsured patients, the increased burden of copayments to be made by patients with insurance coverage and business practices related to collection efforts. These factors continuously change and can have an impact on collection trends and the estimation process used by the Health System. The provision for bad debts in 2014 has decreased from 2013 as a result of the expansion of Medicaid programs and initiatives to assist patients in their Medicaid enrollment. The Health System records a provision for bad debts in the period of services on the basis of past experience, which has historically indicated that many patients are unresponsive or are otherwise unwilling to pay the portion of their bill for which they are financially responsible. Part III, Line 8: It is Kadlec's policy to exclude any Medicare shortfall from Community Benefit information. The amount reported on Part III, Section B, line 6, was determined by applying the Cost-to-Charge Ratio to the Medicare revenue. Part III, Line 9b: Billing and Collection Practices1. Kadlec makes all reasonable attempts to confirm that patients are not eligible for assistance programs prior to collection agency assignment.2. Kadlec activity prior to transferring an account - Prior to transfer to a collection agency, Kadlec will send a minimum of 3 statements and make two phone attempts to the patient at the address and phone number provided by the patient. Statements and communications will inform the patient of their financial responsibility and of Financial Assistance.3. In cases where a voluntary trust deed has secured a Kadlec debt, Kadlec does not execute a lien that forces the sale, vacancy or foreclosure of an assistance patient's primary residence to pay for outstanding medical bills. Part VI, Line 2: The Strategic issues were identified through a process called compression planning. The committee found consensus around two strategic issues: How to promote healthy weight and reduce obesity, and how to improve access to health care services.These issues were identified as having the greatest feasibility based on the available resources, the potential for change,alignment with the community vision, and overlapped in all four assessments. As the core team examined the evidence, it became clear that root-cause analysis was necessary to identify the factors that resulted in the health issues.For example, mental illness and prenatal care were both identified as top concerns. Through dialogue, the committee discovered that both fit well within the access to health care services strategic issue.Cultural differences, both racial and economic, were discussed as having a potential role in contributing to an increasedincidence of obesity and a higher propensity for emergency room use. These and other factors frequently have causal relationships associated with both strategic issues.Those connections will become more apparent as specific objectives for access and obesity are developed in the next phase of the assessment process. Communication and education will play an important role in implementing the strategies and activities to work towards community improvement.How to PROMOTE HEALTHY WEIGHT AND REDUCE OBESITYGoal #1: Community members will make more healthy food choicesGoal #2: Community members will be more physically activeGoal #3: Mothers will breastfeed their infants (when possible)How to improve ACCESS TO HEALTH CARE SERVICESGoal #1: Resources will be identified to lessen the barriers and costs of healthcareGoal #2: The community will experience coordinated health care.Goal #3: The health system will have the capacity to meet the needs of the community Part VI, Line 3: Kadlec posts notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings. Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Kadlec ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Kadlec attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations. Kadlec shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients. Part VI, Line 4: Benton and Franklin Counties contain the metropolitan areas of three neighboring cities: Kennewick, Pasco and Richland (commonly called the Tri-Cities). These cities are located at the confluence of the Yakima, Snake, and Columbia Rivers in the semi-arid region of southeastern Washington. Other cities situated within the area include Benton City, Connell, Kahlotus, Patterson, Prosser, and West Richland. Located approximately 20 miles from TriCities, Prosser is the county seat for Benton County and is home to several of the area's largest wineries. Pasco is the county seat for Franklin County and is home to large agricultural processors.The total population of Benton and Franklin Counties was 253,340 (2010 Census) and the TriCities is the fourth-largest metropolitan area in Washington State. According to the US Census Bureau, the Kennewick-Pasco-Richland metropolitan area was the fastest growing in the nation from April 1, 2010 to July 1, 2011. Franklin County experienced an average growth rate of 4.8% per year over the past 10 years and Benton County has seen an average growth of 2.0% per year during the same time frame. In 2012, according to the U.S. Census, the area population grew to an estimated 262,500 people.The median age of each county is younger than Washington State at 37.3; Benton County has a median age of 35.6 years; Franklin County has a median age of 28.4 years. In 2010, the median household income was $57,603 in Benton County and $47,719 in Franklin County, compared to $58,890 in Washington State and $52,762 in the U.S.According to the Washington State Office of Financial Management, the 2011 unemployment rate for Washington State was 9.2%, which was higher than Benton (7.6%) and Franklin (8.8%) Counties. In Benton County, 78% of 9th grade students graduate high school in four years, and 63% of adults age 25-44 have attended college. In Franklin County, 68% of 9th grade students graduate high school within 4 years and 40% of adults aged 25-44 have attended college. According to the U.S. Census Bureau, Benton County's 2011 population was estimated to be 80.8% Caucasian, and 18.8% of Hispanic/Latino ethnicity. Franklin County's population was 53.3% Caucasian, and approximately 50.5% was Hispanic/Latino. Part VI, Line 6: During 2014, Kadlec celebrated its 70th anniversary, reflecting on how it changed the lives of so many it has served through the years. But, 2014 was also a year Kadlec looked forward with the announcement of its affiliation with the not-for-profit health system Providence Health & Services. The Providence affiliation brought important support to Kadlec as it continues to meet the growing medical needs of the region. It also helped jump-start projects including:Construction of the final four-story of the River Pavilion, which includes a new Intensive Care Unit and additional patient roomsConstruction of the long-awaited 600-space parking garage on the Kadlec campusConstruction of a dedicated electrophysiology lab to support Kadlec's growing cardiac servicesCommitment of $3 million to Columbia Basin College for a second health science centerKadlec's affiliation with Providence also allowed Kadlec and Washington State University Tri-Cities to team together to improve the future of health care in the region with the establishment of an $18-million endowment through Kadlec Foundation. Earnings on the endowment will fund five doctoral facility positions at WSU Tri-Cities to increase the number of nurses earning a Doctor of Nursing Practice (DNP) degree in the region.Providence Health & Services owns or operates 32 general acute care hospitals, three ambulatory care centers, five medical groups, six long-term care facilities, seven homecare and hospice entities, five assisted living facilities, a children's nursing center, a high school, a university, 13 low-income housing projects, the Health Plan, a health services contractor, two programs of all inclusive care for the elderly, and 22 controlled fundraising foundations.The Health System provides inpatient, outpatient, primary care, and home care services in Alaska, Washington, Montana, Oregon and Southern California. The Health System operates these businesses primarily in the greater metropolitan areas of Anchorage, Alaska; Everett, Seattle, Edmonds, Issaquah, Spokane and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California. Part VI, Line 7, Reports Filed With States WA 1 Kadlec Foundation 800 Swift Blvd Richland WA 99352 237005501 501(c)(3) 18000000 Community health support Washington State University Foundation 255 E Main Street 201 Pullman WA 99163 911075542 501(c)(3) 54800 Support of nursing program Grace Clinic 800 W Canal Drive Kennewick WA 99336 770592408 501(c)(3) 52500 Community health support March of Dimes Foundation 1275 Mamaroneck Avenue White Plains NY 10605 131846366 501(c)(3) 20000 Community health support Children's Developmental Center 1549 Georgia Ave SE Richland WA 99352 910876634 501(c)(3) 11500 Community health support American Heart Association Inc 7272 Greenville Ave Dallas TX 75231 135613797 501(c)(3) 10000 2014 Heart Chase Girls on the Run Southeast WA 1307 Goethals Dr Richland WA 99354 463677125 501(c)(3) 10000 Community health support Tri-Cities Cancer Center 7350 W Deschutes Ave No A Kennewick WA 99336 911594526 501(c)(3) 10000 2014 Umbrella support Leadership Tri-Cities 1110 N Center Parkway Kennewick WA 99336 911723036 501(c)(3) 7000 Community health support American Diabetes Association 1701 N Beauregard St Alexandria VA 22311 131623888 501(c)(3) 6000 Walk to Fight Diabetes 10 0 Part I, Line 2: Kadlec provides grants and support to organizations that have a current 501(C)(3) exempt status and whose mission is consistent with the exempt purpose of Kadlec Regional Medical Center. X X 1 1 X X X X 0 1 0 0 0 0 0 0 0 Julie Meek VP Finance/CFO - KRMC 318178 0 225241 0 17500 0 14300 0 4099 0 579318 0 0 0 Joel Gilbertson Eff 61314 President 0 402181 0 0 0 17500 0 81301 0 21910 0 522892 0 0 Dan Harris Eff 61314 VP/Treasurer 0 429749 0 147152 0 0 0 37904 0 10513 0 625318 0 0 Cindy Strauss Eff 61314 Corp. Secretary 0 470542 0 0 0 17500 0 212878 0 21972 0 722892 0 0 Jeffrey Clark VP/Support Services 235011 0 173490 0 17500 0 12783 0 6009 0 444793 0 0 0 Kirk Harper VP/CNO 211811 0 139236 0 0 0 9742 0 1684 0 362473 0 0 0 Dale Hoekema VP/CMO 356297 0 219100 0 17500 0 14300 0 10239 0 617436 0 0 0 Ken Lester President/Kadlec Clinic 301487 0 220850 0 0 0 0 0 36256 0 558593 0 0 0 David Roach VP/CIO 262140 0 181990 0 0 0 12957 0 4099 0 461186 0 0 0 Lane Savitch President/ CEO 343328 0 275119 0 17500 0 8250 0 4099 0 648296 0 0 0 Glenn Welch VP/Foundation Develop. Dir. 208647 0 104863 0 0 0 0 0 3889 0 317399 0 0 0 William Wingo VP/Corporate Counsel 262256 0 196507 0 17500 0 14300 0 4099 0 494662 0 0 0 Mike Butler President/Operations & Services 0 983000 0 540000 0 17500 0 466289 0 25839 0 2032628 0 0 Debra Canales EVP/Chief People & Experience Ofc. 0 706646 0 265000 0 104573 0 11700 0 11617 0 1099536 0 0 Lisa Vance SVP/Clinical Program Services 0 434708 0 246809 0 28198 0 38628 0 19803 0 768146 0 0 Randy Axelrod MD EVP/Clinical & Patient Svcs 0 681191 0 0 0 20315 0 222505 0 23135 0 947146 0 0 Jack Friedman SVP/Account Care & Payor Rel. 0 531342 0 47539 0 17500 0 151650 0 25916 0 773947 0 0 Aaron Martin SVP/Strategy & Innovation 0 463108 0 100000 0 0 0 11700 0 6341 0 581149 0 0 Craig L Wright MD SVP/Physician Svcs 0 519920 0 0 0 30032 0 293065 0 19017 0 862034 0 0 Janice Newell SVP/Chief Information Officer 0 511942 0 0 0 17500 0 208385 0 12449 0 750276 0 0 Deborah Burton SVP/Chief Nrsg. Officer 0 346075 0 156114 0 17500 0 31767 0 23615 0 575071 0 0 David Brown VP/Strategy & Business Development 0 354112 0 139500 0 0 0 121500 0 21630 0 636742 0 0 Orest Holubec SVP/Marketing & Communications 0 348449 0 120258 0 17500 0 31673 0 21890 0 539770 0 0 Mark Gargett VP/Digital Integration 0 360689 0 115852 0 0 0 57037 0 23310 0 556888 0 0 Gary Flaming SVP/Chief Risk Officer 0 264317 0 133902 0 17500 0 70770 0 18447 0 504936 0 0 Teresa Spalding VP/Revenue Cycle 0 312558 0 84801 0 17500 0 32445 0 12458 0 459762 0 0 Mike Waters VP,CAO/Physician Services 0 324643 0 30000 0 0 0 28185 0 10160 0 392988 0 0 Dave Hunter VP/Supply Chain Management 0 300714 0 33705 0 17500 0 49466 0 18543 0 419928 0 0 Steve Burdick CE/Southeast WA. Region 0 264563 0 24668 0 16999 0 76395 0 22033 0 404658 0 0 Dana White VP/Real Estate & Construction 0 270802 0 0 0 16840 0 43097 0 21646 0 352385 0 0 Hannan Chaugle Physician 618065 0 487132 0 17500 0 14300 0 4125 0 1141122 0 0 0 Iyad Jamall Physician 636575 0 329175 0 0 0 0 0 4000 0 969750 0 0 0 Dae Young Lee Physician 453123 0 411566 0 17500 0 5285 0 6408 0 893882 0 0 0 Fadi Thabit Abdallah AlQaisi Physician 669727 0 180154 0 17500 0 11239 0 4023 0 882643 0 0 0 Matthew Fewel Neurosurgeon 831598 0 0 0 0 0 14250 0 6743 0 852591 0 0 0 Part I, Line 1a PRE-AFFILIATION (Through 6/12/14): The Board is allowed to take their companion on the annual Board Retreat. The Travel Policy states that it will only reimburse unpaid Board members for spouse's meals and baggage fees. Meadow Springs Country Club dues are paid by the Medical Center. Country club dues are a bona fide business expense and are not reported as taxable income. POST AFFILIATION: 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 were three First Class tickets 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 relocation expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2014, the following Listed Persons received gross-up payments: Debra Canales Lisa Vance Craig Wright, MD The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding "rent" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The Executive Vice President/Chief People and Experience Officer may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2014, the following Listed Persons received relocation/housing program payments: Debra Canales Lisa Vance Craig Wright, MD The amounts reported for these relocation/housing payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Part I, Line 3 PRE-AFFILIATION: The reporting organization uses an independent third party to determine appropriate compensation. These recommendations are reviewed and approved by the Compensation Committee. Part I, Line 4b NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan 1) Joel Gilbertson a) SERP Earned but not Vested- $48,936 b) SERP Interest Credit - $13,976 2) Dan Harris a) Taxable CBRP Earned but not Paid - $1,363 b) Taxable SERP Earned but not Paid - $145,789 c) SERP Interest Credit - $5,721 3) Cindy Strauss a) SERP Earned but not Vested - $173,177 b) SERP Interest Credit - $20,200 4) Mike Butler a) SERP Earned but not Vested - $375,980 b) SERP Interest Credit - $55,936 5) Lisa Vance a) Taxable CBRP Paid - $65 b) Taxable SERP Earned but not Paid - $246,744 c) SERP Interest Credit - $5,405 6) Randy Axelrod a) SERP Earned but not Vested - $210,806 7) Jack Friedman a) Taxable SERP Earned but not Paid - $47,539 b) SERP Interest Credit - $100,696 8) Craig Wright, MD a) SERP Earned but not Vested - $172,424 b) SERP Interest Credit - $91,172 9) Janice Newell a) SERP Earned but not Vested - $185,427 b) SERP Interest Credit - $4,758 10) Deborah Burton a) Taxable SERP Earned but not Paid - $156,114 b) SERP Interest Credit - $4,843 11) David Brown a) SERP Earned but not Vested - $74,010 b) SERP Interest Credit - $19,770 12) Orest Holubec a) SERP Earned but not Vested - $18,642 b) SERP Interest Credit - $1,332 13) Mark Gargett a) Taxable SERP Earned but not Paid - $111,973 b) Taxable CBRP Paid - $3,879 c) SERP Interest Credit - $22,957 15) Gary Flaming a) Taxable SERP Earned but not Paid - $127,565 b) Taxable CBRP Paid - $6,338 c) SERP Interest Credit - $1,640 16) Teresa Spalding a) Taxable SERP Earned but not Paid - $84,574 b) Taxable CBRP Paid - $227 17) Mike Waters a) SERP Earned but not Vested - $9,742 b) SER Interest Credit - $243 18) Dave Hunter a) Taxable SERP Earned but not Paid - $33,139 b) Taxable CBRP Paid - $566 c) SERP Interest Credit - $19,890 19) Steve Burdick a) Taxable SERP Earned but not Paid - $24,668 b) SERP Interest Credit - $39,558 c) ESP Interest Credit - $2,889 20) Dana White a) SERP Earned but not Vested - $14,595 EXECUTIVE PERFORMANCE AWARDS - POST-AFFILIATION 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 A Washington Health Care Facilities Authority 911108929 93978HKM6 2014-11-06 200084061 Refinance outstanding bonds to bring into the Providence Obligated Group 0 0 0 A 200084061 1674013 198347949 62099 2014 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 Form 990, Part VI, Section A, line 3 The Pre-Affiliation Board of Directors hired Quorum Health Resources as a Management Company to oversee day to day operations of the Medical Center. Rand Wortman (President & CEO) was compensated by Quorum for his services related to the Medical Center. Total payments for services in 2014 were $1,238,551. Form 990, Part VI, Section A, line 4 The organizing documents were amended to reflect the new Sole Corporate Member as Western HealthConnect. Form 990, Part VI, Section A, line 6 The sole Corporate Member is Western HealthConnect, a Washington nonprofit corporation. Form 990, Part VI, Section A, line 7a The powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause. Form 990, Part VI, Section A, line 7b The following powers are reserved to and exercised exclusively by the Corporate Member: 1) To amend or repeal the Articles of Incorporation or Bylaws. 2) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale, transfer, assignment or encumbering of the assets. 3) To approve the dissolution, liquidation, consolidation or merger with another corporation or entity with concurrence of the Kadlec Community Board. 4) To approve the annual operating and capital budgets. 5) To appoint certified public accountants and receive the annual audit report from such accountants. Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by experienced staff and reviewed by the Director of Taxes for Providence Health & Services 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 As a result of Kadlec's affiliation with Providence Health & Services, Kadlec adopted new policies and procedures. 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 PRE-AFFILIATION: An independent third party is used to determine appropriate compensation for the Executive Team. The compensation packages are reviewed and approved by the Compensation Committee of the Board. POST-AFFILIATION: Process for determining compensation of top management, officers & key employees: 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. Form 990, Part VII Joel Gilbertson (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Dan Harris (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Cindy Strauss (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Michael Holcomb (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Chauncey Boyle, SP (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Marian Schubert, CSJ -(Eff.9/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Phyllis Hughes, RSM (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Carolina Reyes, MD (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Michael A. Stein (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Eugene "Al" Parrish (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Peter J. Snow (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Bob Wilson (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Sallye Liner (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Ellen L. Wolf (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Isiaah Crawford (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Martha Diaz Aszkenazy (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Kirby McDonald (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Dave Olsen (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Charles (Chuck) Watts (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Mike Butler - 1801 Lind Ave SW #9016, Renton, WA 98057. Debra Canales - 1801 Lind Ave SW #9016, Renton, WA 98057. Lisa Vance - 1801 Lind Ave SW #9016, Renton, WA 98057. Randy Axelrod, MD - 1801 Lind Ave SW #9016, Renton, WA 98057. Jack Friedman - 1801 Lind Ave SW #9016, Renton, WA 98057. Aaron Martin - 1801 Lind Ave SW #9016, Renton, WA 98057. Craig L. Wright, MD - 1801 Lind Ave SW #9016, Renton, WA 98057. Janice Newell - 1801 Lind Ave SW #9016, Renton, WA 98057. Deborah Burton - 1801 Lind Ave SW #9016, Renton, WA 98057. David Brown - 1801 Lind Ave SW #9016, Renton, WA 98057. Orest Holubec - 1801 Lind Ave SW #9016, Renton, WA 98057. Mark Gargett - 1801 Lind Ave SW #9016, Renton, WA 98057. Gary Flaming - 1801 Lind Ave SW #9016, Renton, WA 98057. Teresa Spalding - 1801 Lind Ave SW #9016, Renton, WA 98057. Mike Waters - 1801 Lind Ave SW #9016, Renton, WA 98057. Dave Hunter - 1801 Lind Ave SW #9016, Renton, WA 98057. Steve Burdick - 1801 Lind Ave SW #9016, Renton, WA 98057. Dana White - 1801 Lind Ave SW #9016, Renton, WA 98057. Form 990, Part XI, line 9: Affiliation Valuation Adjustment -195,752,474. Contributions from Kadlec Foundation not on GL -22,640. Grants to Kadlec Foundation not on GL 18,000,000. Gain on Affiliation Valuation 217,760,030. Book/Tax difference - Investment in Cancer Center -579,493. FORM 990. SCHEDULE R - RELATED ORGANIZATIONS AFFILIATION AGREEMENTS Effective March 1, 2014, Providence Health & Services ,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. FORM 990, PART I, LINE 6 - VOLUNTEERS Anyone over the age of 15 can volunteer at Kadlec Regional Medical Center. You can become a member of the Auxiliary or work under the direction of the volunteer coordinator and unit managers in specific areas, including Education and Rehabilitation. All volunteers undergo orientation and take a TB test before they begin their service. The Auxiliary: Each year over 200 members of the Kadlec Auxiliary assist in over 30 different areas ranging from clerical work to mail delivery, from the Critical Care Unit to the Birth Center, from staffing the Information Desk to operating the Gift Shop and from escorting patients and families around the medical center to two sewing groups making important items for use with the medical center. Junior Volunteer Program: Kadlec Regional Medical Center offers opportunities for students aged 15 years and above to volunteer in the Junior Volunteer Program. You may remain a Junior Volunteer through the summer following high school graduation. Services that Junior Volunteers take part in include Nutrition Services, Magazine Cart, Information Desk, Patient Escort, Gift Shop and Education. Junior Volunteers usually work one service a week for 1-3 hours. Pet Partner Program: Pet visitation is a valuable service to those who are missing family, friends and pets during their stay in the hospital. Upon completion of orientation, Kadlec Regional Medical Center allows members of the Delta Society an opportunity to bring their dogs to visit patients. The Delta Society is a Washington-based group that selects and trains pets to become pet partners. Kadlec Music Program: Kadlec's Music Program is another way to volunteer at the medical center. Over 20 musical volunteers play a Baby Grand Piano in the Main Lobby or walk the halls playing their instruments. The musicians range from age 10 to over 70. They provide music throughout the week which can be heard not only in the lobby, but also in the Critical Care Waiting Area. Kadlec Clinic LLC 945 Goethals Ste 220 Richland WA 99352 204265899 Primary Care Physician Services WA Kadlec Health System Kadlec Neuroscience Center LLC 888 Swift Blvd Ste 300 Richland WA 99352 201613946 Neurological Related Physician Services WA Kadlec Health System TriCities Nephrology LLC 309 Bradley Ste 109 Richland WA 99352 271041915 Nephrology Physician Services WA Kadlec Health System 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 Plan Partners 4400 NE Halsey Portland OR 97213 911861964 Healthcare Services OR 501( c)(4) N/A PH & S - Oregon 0 Providence Health Plan 4400 NE Halsey Portland OR 97213 930863097 Health Service Contractor OR 501( c)(4) N/A Providence Plan Partners 0 Providence Health Assurance 4400 NE Halsey 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 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 PHS - So California 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 Neurological Resource Center 1268 Lee Blvd Richland WA 99352 911266345 Healthcare WA 501(c )(3) Line 9 Kadlec Regional Medical Center 1 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 1 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 St Bldg II 495 Portland OR 97213 260796953 Imaging - Diagnostics OR N/A Ctr for MedImaging-Tanasbourne LLC 4400 NE Halsey St Bldg II 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 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 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 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 for PHN CA N/A C 0 Providence Health Network 20555 Earl Street Torrance CA 90503 800886966 Prepaid Healthcare CA N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 Kadlec Foundation B 18000000 Cost Kadlec Foundation C 78814 Cost Kadlec Neurological Resource Center O 215479 Cost