2015-12-21T13:14:27-06:00 2014-12-31 911194016 Clark Nuber PS 10900 NE 4th Suite 1700 Bellevue WA 98004 990 2014-01-01 911307555 INLAND NORTHWEST HEALTH SERVICES INLA 5092328100 PO BOX 469 SPOKANE WA 992100469 Helen Andrus CFO 5092328100 2015-12-21 1 Sara Elizabeth J Hyre CPA P00235495 4254544919 2014 2016-03-07 17:11:31Z Elaine Couture PO BOX 469 SPOKANE WA 992100469 140725579 0 X www.inhs.info X 1994 WA To provide unique, effective, affordable services using collaborative and innovative approaches for the benefits of the entire health care continuum. 6 3 1258 195 1011489 0 3427553 1545773 130738788 108420832 106976 15693 -489806 29475464 133783511 139457762 452474 497374 0 0 79031417 83388653 0 0 463602 47843228 49200895 127327119 133086922 6456392 6370840 101085837 120009905 43292197 41612374 57793640 78397531 X To provide unique, effective, affordable services using collaborative and innovative approaches for the benefits of the entire health care continuum. 0 0 48051639 0 47881784 Inland Northwest Health Services, a not for profit corporation, provides collaborative, community-benefitting health care. With the guidance of its sole Member, Providence Health & Services-Washington, INHS provides unique, affordable services using collaborative and innovative approaches for the benefit of the entire health care continuum. These local, regional and national solutions improve efficiencies and health outcomes in rehabilitation and clinical services, critical care, transportation, information technology, health care education and other health care services, and incorporate the highest ideals from its Member's Christian heritage in the provision of medical care.St. Luke's Rehabilitation Institute specializes in comprehensive inpatient and outpatient therapy sessions for children and adults and provide rehabilitation treatment for stroke, spinal cord injuries, orthopedic issues and brain injuries. Conveniently located in Spokane, Washington, St. Luke's Rehabilitation Institute serves patients throughout the Inland Northwest including patients in central and eastern Washington, northern Idaho and western Montana. As a division of INHS, St. Luke's Rehabilitation Institute offers high quality outpatient rehabilitation services at several convenient locations. Committed to providing hope, quality of care and recovery, St. Luke's is the state's largest provider of rehabilitation services for stroke, spinal cord injury, head injury and injury or diseases to bones, joints or muscles. After illness or injury, there is a need to gain strength, skills and function to allow people to return to the highest quality of life possible. St. Luke's works as a team with patients and their families to achieve this goal. With a main campus located in downtown Spokane, St. Luke's combines compassionate care with expertise to provide inpatient physical rehabilitation services to patients of all ages.During 2014, the organization had 20,600 resident days and 57,960 outpatient visits.Northwest MedStar, a non-profit organization, is the region's premier critical care transport service dedicated to the safe, compassionate care and transport of critically ill or injured patients to health care facilities throughout the Pacific Northwest. From its bases in Spokane, Tri-Cities, Moses Lake, the Palouse area, Brewster and Missoula, Northwest MedStar provides thousands of helicopter, fixed wing and ground-based transports each year with the highest level of advanced care.In addition to its air ambulance service, Northwest MedStar provides ongoing outreach education for emergency medical workers throughout the region. With a fleet of helicopters and fixed wing planes, Northwest MedStar is accredited by the Commission on Accreditation of Medical Transport Systems (CAMTS), the "seal of approval" for the air medical industry.During 2014, MedStar provided 1,795 airport shuttles, 2,303 ground ambulance transports, 1,216 fixed wing aircraft flights, and 1,930 helicopter flights. Inland Northwest Health Services (INHS) is committed to helping health care professionals maintain skills and stay abreast of the latest recognized medical advances that are vital to quality care and improved patient outcomes.INHS provides certification and continuing education opportunities for EMS and health care providers on-line, in the classroom and at your location.Formerly called the EMS Training Center, INHS provides and coordinates medical training for health care providers throughout the Inland Northwest. With more than 1000 American Heart Association instructors and 39 participating agencies, our training is unsurpassed in quality and availability, with a variety of class locations as well as custom courses designed for specific educational needs.A community's health resources are often scattered across different entities, making it difficult for community members to easily access all that is available to them. Inland Northwest Health Services Community Wellness remedies this challenge by providing a central location for public and professional health education, screenings, interventions and wellness assessments.Northwest TeleHealth provides access to consultations with health care specialists through a robust video-conferencing network of more than 100 units throughout the Northwest. This technology facilitates live, confidential interaction for two or more locations involved in patient consults, rural medicine, health education, medical training, business administration and other related activities.The Center of Occupational Health & Education (COHE) Community of Eastern Washington is a public-private collaboration between the Washington State Department of Labor & Industries and St. Luke's Rehabilitation Institute in Spokane, WA. COHE is an alliance unlike any in the nation and the results are impressive, far exceeding expectations for patient outcomes - including cost savings and satisfaction by providers, patients, and employers. 33472305 0 33353985 Acute Inpatient Services - see line 4a. 29193354 0 29090160 Engage, a division of INHS, has grown to become one of the largest MEDITECH hosting partners in the United States.With 20 years of extensive MEDITECH experience, Engage provides a wide range of infrastructure solutions including hardware refresh, virtualization, data migration, data center migration and implementation. Engage leverages strong relationships with BridgeHead Software, IBM, HP, and NetApp to deliver fully tested and certified MEDITECH solutions. As one of MEDITECH's largest hosting partners, Engage hosts and operates large MEDITECH environments including the integration of the wide range of applications typically found in a hospital environment.Over 225 application analysts provide the MEDITECH implementation and customer support needed for the complexities of the hospital environment. Engage has expertise with MEDITECH application implementation and consulting spanning the MEDITECH application portfolio from financials to advanced clinicals. Using this strong expertise across Systems Technology as well as applications and workflow, Engage customers were some of the first in the country to attest for Meaningful Use Stages 1 & 2 and successfully complete ONC Meaningful Use audits. 1532646 0 1527229 Other Service Revenue - see line 4a. 497374 497374 0 Grants & Allocations - See Schedule I. 2030020 497374 1527229 112747318 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 171 0 1 1258 1 1 1 0 0 0 0 1 1 0 0 0 0 X 6 3 0 0 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 X Karl E Fritschel CPA 4255253339 1801 Lind Avenue SW 9016 Renton WA 980579016 X R Ronald Wells Chair and Treasurer 2.00 0.00 X X 0 0 0 Gary A Livingston PhD Vice Chair & Secretary 2.00 0.00 X X 0 0 0 Mike Reilly Director 2.00 0.00 X 0 0 0 Jeff Collins MD Director 2.00 48.00 X 0 391418 42480 Todd Hofheins Director 0.10 59.90 X 0 607162 112921 Aaron Martin Director 0.10 64.90 X 0 563108 18041 Tom Fritz Thru 1014 Chief Executive Officer 50.00 0.00 X 775307 0 20573 Frederick Lee Galusha Engage Chief Executive 50.00 0.00 X 494086 0 21338 Nancy Vorhees Chief Administrative Officer 50.00 0.00 X 308055 0 17539 John D Craig Jr Thru 1014 Chief Financial Officer 50.00 0.00 X 390643 0 20842 Phyllis Anita Gabel Chief Human Resource Officer 50.00 0.00 X 280112 0 18236 Elaine Couture Eff 1114 CEO 2.00 58.00 X 0 613109 110561 Helen Andrus Eff 1114 CFO 2.00 48.00 X 0 235180 33785 Ulrike Berzau Administrator 40.00 0.00 X 279921 0 16344 Michael Smyly Chief Bus. Dev. Officer 40.00 0.00 X 327286 0 24377 Daniel Engle Senior Director 40.00 0.00 X 251580 0 16604 Michael Billing Hospital Administrator 40.00 0.00 X 179789 0 16426 Marcia Cheadle Senior Director 40.00 0.00 X 226760 0 15762 Gregory Carter CMO 40.00 0.00 X 321464 0 16723 Vivian M Moise Physiatrist 40.00 0.00 X 270485 0 19406 Roger Stevens Chief - Hospital Applications 40.00 0.00 X 261084 0 15451 Mark S Gordon Physiatrist - Inpatient 40.00 0.00 X 271321 0 16298 John F Long Physiatrist 40.00 0.00 X 218087 0 19530 Chad Skidmore Dir. Network Services 40.00 0.00 X 215623 0 20682 5071603 2409977 613919 131 0 1 1 Metro Aviation Inc 1214 Hawn Avenue Shreveport LA 71107 Aviation Services 11036096 Mediware Information Systems Inc 11711 W 79th Street Lenexa KS 66214 Healthcare IT Services 531627 Cerium Networks Inc 1636 W 1st Avenue Spokane WA 99201 Healthcare IT Services 458404 Health Care Systems Inc 5755 Carmichael Parkway Montgomery AL 36117 Healthcare IT Services 458371 Right Systems Inc 101 W Cataldo Suite 101 Spokane WA 99201 Healthcare IT Services 333851 50 784135 47500 20966 599908 93264 1545773 Acute Care Outpatient 621400 46412484 46412484 Acute Care Inpatient 900099 32330485 32330485 Info Resource Mgmnt. 541519 28197499 27186010 1011489 Other Service Revenue 900099 1480364 1480364 108420832 15693 15693 2114604 1232817 881787 881787 881787 140856 47500 35000 105856 105856 Affil. Info Res. Mgmt. 541519 13783261 13783261 Contract Staff Service 900099 9945017 9945017 MedStar Premiums 900099 2016206 2016206 2743337 1416120 1327217 28487821 139457762 110841669 1011489 26058831 X 497374 497374 3993540 330481 3663059 62085407 55130060 6706814 248533 3491486 2975355 501311 14820 9089350 7764881 1295703 28766 4728870 3981111 730302 17457 141844 141844 162985 162985 22054 22054 23331296 20700326 2554602 76368 336779 336779 6176995 4815966 1320358 40671 1084824 938403 143608 2813 1593625 1229048 353604 10973 232038 162465 69573 594368 594368 4379352 3435149 944203 262891 206331 54948 1612 Bad Debt 5992737 5992737 Medical Supplies 1695034 1513275 181759 Taxes & Licenses 777283 618413 154437 4433 Dues & Subscriptions 389385 316206 71177 2002 2027405 1545369 466882 15154 133086922 112747318 19876002 463602 20332578 3294073 4457657 6948885 174022 163654 1028401 394640 149828760 54674337 66838839 95154423 331740 307334 63711 59866 7858889 13687030 101085837 120009905 20644859 20078728 0 4157456 3078047 6257359 5951284 0 12232523 12504315 43292197 41612374 X 56709953 77763173 1062117 612788 21570 21570 57793640 78397531 101085837 120009905 X 6370840 4145 14228906 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 22054 22054 132135489 132157543 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 25381 25168 26341 22054 98944 250000 250000 250000 250000 1000000 1500000 21570 21570 21570 21570 21570 21570 21570 21570 21570 21570 1.00000 0 0 1372797 1372797 15858976 52762838 18047940 50573874 63400 12021 51379 24669 71848280 36614376 35258573 7897800 7897800 95154423 Other Miscellaneous Receivables 13687030 13687030 Third Party Settlements 10504315 Due to Affiliates 2000000 12504315 X Part V, Line 4: The organization's only permanent restricted funds are to be used for Team St. Luke's (Wheelchair Sports) activities. Part X, Line 2: Providence Health & Services, 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. Chef's Culinary Classic 99220 22500 76720 13500 8000 Festival of Flowers 89136 25000 64136 4000 9500 188356 47500 140856 17500 9500 8000 35000 105856 1 1 1 X 1 X 1 1 0 1 1 690689 690689 0.00540 12477203 4643703 7833500 0.06160 3027177 2678560 348617 0.00270 16195069 7322263 8872806 0.06970 3183747 2867383 316364 0.00250 495324 495324 497374 497374 0.00390 4176445 3362707 813738 0.00640 20371514 10684970 9686544 0.07610 1 5992737 38806228 39371011 -564783 X 1 1 1 1 St Luke's Rehabilitation Institute 711 S Cowley Street Spokane WA 99202 www.st-lukes.org 157 X St Luke's Rehabilitation Institute 1 0 0 1 X X X X X X X X X X 13 1 0 0 1 X www.st-lukes.org/CHNA/ X 1 13 1 www.st-lukes.org/CHNA/ 0 0 1 X 150.000000000000 300.000000000000 X 1 1 X X X 1 X X X X 1 X 0 X X X 0 X X 0 0 St. Luke's Rehabilitation Institute Part V, Section B, Line 3j: Availability of St. Luke's Community Health Needs Assessment. St. Luke's Rehabilitation Institute Part V, Section B, Line 5: A Planning and Implementation Committee was formed to guide the St. Luke's CHNA and implementation strategy process. The Planning and Implementation Committee (PIC) consisted of individuals from St. Luke's and its parent company, Inland Northwest Health Services, with evaluation, community benefit, public relations, and communications experience. The PIC established the scope, timelines, methods, principles, and guidelines for conducting the CHNA and developing the implementation strategy. The PIC, in conjunction with St. Luke's administration, adopted the 2012 CHNA of Spokane County, sponsored jointly by the Spokane Regional Health District, Providence Health Care, and Empire Health Foundation.The PIC and St. Luke's administration endorsed the plan to augment the 2012 Spokane County CHNA with additional information from further community input on health issues affecting the community that St. Luke's serves. St. Luke's sought input from organizations serving and representing the interests of our defined community patients across the lifespan from Spokane County with rehabilitation needs arising from neurological or orthopedic injuries or conditions. Input was sought from public and private agencies providing health or related services within the County, including staff from the Spokane Regional Health District, and societies and support groups. The inclusion of societies and support groups was deemed critical since it allowed, in many cases, for us to hear directly from patients and family members of the vulnerable populations St. Luke's serves. Personal invitations were sent to specific members of these organizations to attend one of six focus groups, with 6-12 people in each group. To assure representation by a full spectrum of community members serving and representing the interests of our defined community, focus groups were held with three audiences:-Patients/family caregivers and support groups;-Community partners who work with St. Luke's to meet the needs of our patient populations;-Community program services that overlap with St. Luke's, but who don't necessarily have direct interaction with St. Luke's St. Luke's Rehabilitation Institute Part V, Section B, Line 11: Given the four primary health needs identified by our Community, St. Luke's has elected to address each of the four health needs as we feel that we have the expertise and competency to effectively address each need. In addressing these needs, St. Luke's is committed to working with other facilities and organizations in the community who are also addressing these needs.The four significant health needs identified through the CHNA are:1. Care coordination and management of services for patients;2. Access to services/providers;3. Mental health services;4. Education and resources for patients and their informal caregivers. St. Luke's Rehabilitation Institute Part V, Section B, Line 22d: The hospitals used the average of the largest negotiated commercial insurance rate. Part V, Section B, Line 16 Financial Assistance Policy Website Availability St. Luke's Rehabilitation Institute Part V, Section B, line 16b website: www.st-lukes.org/Patient-Accounts/ 1 Northwest MedStar 6315 E Rutter Ave Spokane WA 99212 Air and ground ambulance Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 5,992,737. Part II, Community Building Activities: INHS provides medical care to the community regardless of the patients' ability to pay. The mission of INHS includes charitable activities such as free care to the needy and care at discounted charges to below cost for Federal and State government sponsored programs. INHS promotes the health of the community by offering many health education programs and support groups. INHS oversees a variety of health care divisions and services that work together to improve outcomes, lead the way in health care innovation and create healthier communities:-St. Luke's Rehabilitation Institute: Provides accredited inpatient and outpatient physical rehabilitation services at the state's only freestanding hospital.-Engage: Sets the national standard in how health information technology improves a community's patient care and lowers costs.-Northwest MedStar: Provides safe, compassionate care and air transport of critically ill or injured patients to health care facilities throughout the Northwest.Community Wellness: Improves the health of the community through screenings, assessments, involvement and education.-Northwest TeleHealth: Links the region to a variety of resources at 115 locations over a robust telemedicine, video-conferencing network.-Health Training: Provides and coordinates medical training for health care professionals throughout the Inland Northwest.-COHE Community of Eastern Washington: Works cooperatively in developing programs to improve the quality, cost effectiveness and consistency of care for injured workers. Part III, Line 2: Bad debt expense represents the amount of gross charges for patients who do not have insurance and which the organization 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 organization'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: Patients who are known to qualify for charity care or financial assistance are contacted by the Patient Accounts Patient Advocate. The Patient Advocate will work with the patient and/or family to qualify the patient for charity care or discounted care.INHS provides medical care to the community regardless of the patients' ability to pay. The Mission of INHS includes charitable activities such as free care to the needy and care at discounted charges to below cost for Federal and State government sponsored programs. Part VI, Line 2: For the 2013 St. Luke's CHNA, the following questions were considered by the community focus groups when prioritizing community health needs and services to meet the needs of the population served by St. Luke's:1. Does the community recognize the issue as a need?2. Can existing community programs be leveraged to help more people?3. Would a project/program address the needs of the disabled, vulnerable, underserved?4. How many people would benefit from the project/program?5. Would a project/program be feasible and effective?6. Would the project/program improve or maintain individual health outcomes?7. Does the project/program duplicate services that are already available in the community?8. Does the project/program further St. Luke's goal of getting patients back to living their lives as independently as possible?Persons representing the community's interests were engaged in the focus groups. Following the community focus groups, a summary of all the focus groups was delivered to each attendee with an invitation to provide us with feedback about whether the summary captured the essence of the conversation correctly, whether pertinent features of the focus group conversation were missing, and whether further input would help define or clarify issues of importance. Part VI, Line 3: Information regarding the INHS charity care policy, including the appropriate forms, is posted on the website for patients to access. In addition, hard-copy versions are available at the point of service; information about payment options, scholarships and charity care are included in the information sent to patients regarding their bill and staff members are trained to work with patients who need assistance in determining how they can apply for government assistance, scholarships and/or charity care. Part VI, Line 4: St. Luke's Rehabilitation Institute, located in Spokane, Washington, is a private, not-for-profit, 102-bed post-acute care hospital specializing in medical rehabilitation for people with neurological or orthopedic injuries and illnesses. It is the only free-standing inpatient rehabilitation facility in Spokane County. In 2012, more than 1,532 patients received inpatient care through St. Luke's with 93% of these patients coming from Spokane County. Nearly half of these patients received care for stroke, traumatic brain injury, or spinal cord injury. Of the 399 patients receiving inpatient care for stroke at St. Luke's in 2012, one was younger than 18, 128 were between the ages of 18-64, and 270 were age 65 or older. In 2012, of the 217 patients receiving inpatient care for brain injury at St. Luke's, 11 were younger than 18, 114 were between the ages of 18-64, and 92 were age 65 or older. Of the 96 patients receiving inpatient care for spinal cord injury at St. Luke's in 2012, 2 were younger than 18, 56 were between the ages of 18-64, and 38 were age 65 or older. The remaining inpatients received rehabilitation services for a variety of medical conditions, such as cardiac conditions, pulmonary conditions, orthopedic and other major trauma injuries, post-surgical care, amputations and other limb deficiencies, and other neurological conditions.Given the primary geographic area we serve and the specific patient populations for which St. Luke's provides services, the 2013 St. Luke's Community Health Needs Assessment (CHNA) and Implementation Strategy defines the community served by St. Luke's to be patients across the lifespan from Spokane County with rehabilitation needs arising from neurological or orthopedic injuries or conditions. This definition includes the needs of those with vulnerabilities due to disability orsocioeconomic challenge.According to the US Census, Spokane County's population in 2010 was 471,221, with 44% of the residents living in the City of Spokane, 19% living in the City of Spokane Valley, and the remaining 37% living in suburban and rural areas. In 2010, the county population was comprised of:-23% youth (0-17 years of age)-14% seniors (65+ years of age)Among county residents in 2010, the racial and ethnic make-up was:-2% African American-2% American Indian or Alaskan Native-3% Asian, Native Hawaiian/Pacific Islander-5% Hispanic-86% Non-Hispanic WhiteThe Spokane County high school graduation rate was greater than 80% in 2010, which exceeded the Washington State high school graduation rate of 77%. The 2010 Census estimated the median household income for Spokane County to be $46,320. Spokane County's unemployment rate has exceeded 9% since 2010.The 2010 Washington State Population Survey estimated that 20% of Spokane County adults under age 65 were uninsured, while 6% of children (under age 18) were uninsured. The Spokane Regional Health District indicated that the top three causes of death among all deaths in Spokane County in 2010 were cancer at 22%, heart disease at 20%, and stroke at 6%. Combined, these conditions made up almost half of all deaths in Spokane County. St. Luke's sees survivors of each of these conditionsin its patient populations. The 2011 American Community Survey conducted annually by the US Census Bureau estimated that among those age 18-64 in Spokane County, 6% were living with ambulatory difficulty (walking or climbing stairs), 2% were living with self-care difficulty (dressing or bathing), and 4% had difficulty living independently (difficulty doing errands alone such as visiting a doctor's office or shopping). Among people age 65 and older in Spokane County in 2011, an estimated 24% were living with ambulatory difficulty, 8% were living with self-care difficulty, and 17% had difficulty living independently.Therefore, the elderly bear an inequitable share of disability-related outcomes in our community.At the conclusion of skilled inpatient care services (and often during receipt of home health services) the primary responsibility for providing care to a person with disability falls to a family member or friend. In Spokane County, the 2011 Behavioral Risk Factor Surveillance Survey estimated that more than 16% of county residents had provided care to a family member or friend in the last month. This represents an extended health care need to assure that family caregivers are educated and trained for their responsibilities, and not burdened to such a degree that they, themselves, become the patients.Falls were the leading cause of fatal and nonfatal unintentional injury for those 65 and older in Spokane County between 2007 and 2011 according to the Washington State Department of Health. During that period, 858 deaths per 100,000 population were attributed to falls among those 65 and older in Spokane County. This exceeded the death rate from falls for the state of Washington (525 deaths per 100,000). Also during that period, 8,492 hospitalizations per 100,000 population were attributed to nonfatal falls among those 65 and older in Spokane County. This exceeded the rate of hospitalizations from nonfatal falls for the state of Washington (7,538 hospitalizations per 100,000). The local public health authority, the Spokane Regional Health District (SRHD), reports that 1 in 6 seniors (16%) in Spokane County reported falling in the past three months. SRHD also reports that seniors with a disability were 2.5 times more likely to report a fall than were seniors without a disability. Due to these high rates of death, injury, and healthcare use arising from falls, especially in seniors, falls have been recognized by the Spokane Regional Health District as a major public health problem in Spokane County for the elderly. Falls are also a major concern in the population served by St. Luke's.Our assessment identified a number of strong community assets available to respond to the health needs of Spokane County residents, especially those with vulnerabilities due to disability or socioeconomic challenge. This includes acute care hospitals in addition to St. Luke's as a medical rehabilitation hospital, ambulatory surgical facilities, a child birth center, Medicare assignment skilled nursing facilities, home healthcare agencies, health centers and clinics (including several federally qualified health centers), disease or medical condition-specific societies/associations and support groups, community transportation services, and public or private community partners. The list is not exhaustive, and does not contain reference to the hundreds of primary and specialty health care providers, mental health care providers, and dentists practicing in Spokane County. Part VI, Line 5: INHS provides medical care to the community regardless of the patients' ability to pay. The mission of INHS includes charitable activities such as free care to the needy and care at discounted charges to below cost for Federal and state government sponsored programs. INHS promotes the health of the community by offering many health education programs and support groups. A division of INHS is MedStar which operates an air ambulance service to improve the outcomes of emergency medical situations. Part VI, Line 6: At the end of 2013, INHS affiliated with Providence Health & Services. 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 Providence Health Care Foundation Eastern Washington PO Box 2555 Spokane WA 99220 320014330 501 (c)(3) 296400 Support care for children Kootenai Health Foundation Inc 2003 Lincoln Way Coeur dAlene ID 83814 820380784 501 (c)(3) 55969 Support care for children American Heart Association Inc PO Box 4002030 Des Moines IA 50340 135613797 501 (c)(3) 10000 Support for heart disease and stroke Association of Washington Business PO Box 658 Olympia WA 98507 910496803 501 (c)(6) 8500 Sponsor Leadership/Legislative Summits Partners With Families & Children Spokane 1321 W Broadway Spokane WA 99201 680576560 501 (c)(3) 5000 Support care for children 4 1 Part I, Line 2: In the application for support/financial aid, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds were used, along with a report of the number of children/families served over the year. Grants made to affiliated foundations are monitored on a monthly basis since the financial statements of these organizations are readily available. Other grants are made that comply with the mission and further the tax exempt purpose of the organization X 1 1 0 1 0 0 0 0 0 0 0 Jeff Collins MD Director 0 371265 0 20153 0 0 0 21984 0 20496 0 433898 0 0 Todd Hofheins Director 0 589662 0 0 0 17500 0 89039 0 23882 0 720083 0 0 Aaron Martin Director 0 463108 0 100000 0 0 0 11700 0 6341 0 581149 0 0 Tom Fritz Thru 1014 Chief Executive Officer 437160 0 318592 0 19555 0 16040 0 4533 0 795880 0 0 0 Frederick Lee Galusha Engage Chief Executive 312347 0 161280 0 20459 0 16805 0 4533 0 515424 0 0 0 Nancy Vorhees Chief Administrative Officer 201298 0 91651 0 15106 0 16900 0 639 0 325594 0 0 0 John D Craig Jr Thru 1014 Chief Financial Officer 250262 0 131829 0 8552 0 16900 0 3942 0 411485 0 0 0 Phyllis Anita Gabel Chief Human Resource Officer 176120 0 94014 0 9978 0 16900 0 1336 0 298348 0 0 0 Elaine Couture Eff 1114 CEO 0 463902 0 131707 0 17500 0 71400 0 21120 0 705629 0 0 Helen Andrus Eff 1114 CFO 0 217680 0 0 0 17500 0 20972 0 12813 0 268965 0 0 Ulrike Berzau Administrator 188491 0 82445 0 8985 0 15727 0 617 0 296265 0 0 0 Michael Smyly Chief Bus. Dev. Officer 178344 0 140324 0 8618 0 16900 0 7477 0 351663 0 0 0 Daniel Engle Senior Director 192766 0 51923 0 6891 0 9100 0 7504 0 268184 0 0 0 Michael Billing Hospital Administrator 169724 0 0 0 10065 0 12192 0 4234 0 196215 0 0 0 Marcia Cheadle Senior Director 170923 0 46499 0 9338 0 12056 0 3706 0 242522 0 0 0 Gregory Carter CMO 311372 0 0 0 10092 0 9017 0 7706 0 338187 0 0 0 Vivian M Moise Physiatrist 240718 0 20850 0 8917 0 14878 0 4528 0 289891 0 0 0 Roger Stevens Chief - Hospital Applications 199841 0 52604 0 8639 0 14827 0 624 0 276535 0 0 0 Mark S Gordon Physiatrist - Inpatient 245695 0 18600 0 7026 0 15488 0 810 0 287619 0 0 0 John F Long Physiatrist 194330 0 17600 0 6157 0 14770 0 4760 0 237617 0 0 0 Chad Skidmore Dir. Network Services 162625 0 45080 0 7918 0 13222 0 7430 0 236275 0 0 0 Part I, Line 1a Membership fees are paid to The Spokane Club for Key Employees for the sole purpose of holding business meetings with customers, clients and vendors. Amounts are not included as taxable compensation for the Key Employees. Part I, Line 4b NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan 1) Jeff Collins, MD a) Taxable CBRP Earned but not Paid - $20,153 b) Non-Taxable CBRP Earned but not Paid - $185 2) Todd Hofheins a) SERP Earned but not Vested - $61,763 3) Elaine Couture a) Taxable SERP Earned but not Paid - $131,451 b) SERP Interest Credit - $48,789 c) Taxable CBRP Paid - $256 SCHEDULE J - PART II - COMPENSATION The Officers and Directors shown with compensation from a related organization are paid by Providence Health & Services - Washington for their respective positions at Providence related ministries. None are compensated for their services to INHS. SCHEDULE J, PART I - BONUSES Some Officers and Key Employees of the reporting organization receive bonuses based on the annual performance in meeting goals, overall performance, divisional financial information and community service involvement. SCHEDULE J, PART II, COLUMN B(ii) - EXECUTIVE PERFORMANCE AWARDS For those individuals paid by the related organization, Providence Health & Services, the following describes their Performance Award 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 A Washington Health Care Facilities Authority 911108929 2009-06-18 7462500 Condominiumized Portion of Building 0 0 0 A 1500000 7462500 7462500 2009 0 0 1 1 A 0 0 0 0 0.01730 0.01730 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 SCHEDULE K, PART IV, LINE 2 Since the proceeds were expended within the first six months and there is no reserve fund, no rebate calculations are required. Form 990, Part VI, Section A, line 4 The organizing documents were amended to reflect the new Sole Corporate Member as Providence Health & Services-Washington. Form 990, Part VI, Section A, line 6 The sole Corporate Member is Providence Health & Services-Washington, 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. Form 990, Part VI, Section A, line 7b Powers reserved to the Corporate Member: 1) To move the corporation's health care facility. 2) To add one or more Members. 3) To amend or revoke the Articles of Incorporation or to repeal, alter or substitute Bylaws. 4) To sell, lease, transfer, or otherwise dispose of all or substantially all of the assets. 5) To merge or consolidate the Corporation. 6) To dissolve the Corporation. 7) To change the Mission of the Corporation. 8) To approve the acquisition of assets, the incurrence of indebtedness, or the lease, sale, transfer, assignment or encumbering of assets for any transaction in excess of an amount specified by the Member. 9) To undertake any activity or to perform or permit any medical procedure which the Member believes offends the moral or ethical values or directives of the Member. Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by experienced Providence Health & Services staff and reviewed by the internal Director of Taxes of 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 Conflict of Interest policies are updated annually at the board level and updated annually for all employees during their evaluation. Form 990, Part VI, Section B, line 15 For officers and key employees paid by INHS, compensation packages are calculated by an outside third party and then reviewed and approved by the Board of Directors. For officers and key employees paid through Providence Health & Services, the following discusses the process utilized. 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 Todd Hofheins - 1801 Lind Ave. SW #9016, Renton, WA 98057. Aaron Martin - 1801 Lind Ave. SW #9016, Renton, WA 98057. Form 990, Part IX, line 11g Aircraft Services: Program service expenses 11,036,096. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,036,096. Repairs & Maintenance: Program service expenses 6,333,854. Management and general expenses 1,977,898. Fundraising expenses 63,291. Total expenses 8,375,043. Other Purchased Services: Program service expenses 2,376,636. Management and general expenses 356,209. Fundraising expenses 5,812. Total expenses 2,738,657. Consulting Fees: Program service expenses 689,590. Management and general expenses 170,752. Fundraising expenses 5,947. Total expenses 866,289. Agency/Contract Labor: Program service expenses 264,150. Management and general expenses 49,743. Fundraising expenses 1,318. Total expenses 315,211. Form 990, Part XI, line 9: 2011 Fixed Assets Valuation Adjustment 14,228,906. FORM 990, PART XII, LINE 2C - AUDIT & COMPLIANCE As part of the Consolidated Providence Health & Services Audited Financial Statements, the following applies: The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the System's consolidated financial statements and reporting, the audit process and the System's internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the System's internal and external auditors; the System's investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. FORM 990, PART I, LINE 6 - VOLUNTEERS 1. St. Luke's Volunteers: Mail Delivery, Administrative Support, PBX Reception, 1st Floor Reception, Patient Dining & Care, Warehouse Services, Housekeeping, Food Service, Patient Activity, Patient Companion, Magazine Cart, Skilled Clerical/Data Entry. 2. Patient Escort Volunteers: Prospective therapy school students that volunteered with inpatient therapy. 3. SLRI & Foundation Boards: Provided operational and financial oversight. 4. MedStar Volunteers: Serving at Felts Field office as Skilled Clerical/Data Entry or Community Outreach Volunteers representing MedStar at community fairs and functions throughout the service area. 5. TSL: Volunteers for Team St. Luke's. 6. WFB: Volunteers at Wells Fargo Building. Typically, college interns placed in an Administrative Support capacity. 7. Special Events: Volunteers from the community that would help us with various events (Festival of Wine, Chef's Culinary Classic, Halloween Party, Thanksgiving Dinner, etc). FORM 990 - SCHEDULE R - RELATED ORGANIZATIONS 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. IHNS Leasing CO LLC 601 W 1st Avenue Spokane WA 99201 912010377 Leasing of Aircraft to INHS WA 2187088 9272032 INHS 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 Bldg 2 Portland OR 97213 911861964 Healthcare Services OR 501( c)(4) N/A PH & S - Oregon 0 Providence Health Plan 4400 NE Halsey Bldg 2 Portland OR 97213 930863097 Health Service Contractor OR 501( c)(4) N/A Providence Plan Partners 0 Providence Health Assurance 4400 NE Halsey Bldg 2 Portland OR 97213 550828701 Medicaid Healthcare Provider OR 501( c)(4) N/A Providence Health Plan 0 Providence Medical Institute 4101 Torrance Blvd Torrance CA 90503 330283773 Healthcare CA 501( c)(3) Line 11/Type I PHS - So California 0 Little Company of Mary Ancillary Services Corporation 4101 Torrance Blvd Torrance CA 90503 330844408 Imaging Services CA 501( c)(3) Line 9 PHS - So California 0 Providence TrinityCare Hospice 5315 Torrance Blvd Suite B1 Torrance CA 90503 953264139 Hospice CA 501( c)(3) Line 9 PHS - So California 0 Providence Blanchet Association 1700 Providence Pl Centralia WA 98531 911789266 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 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 St Portland OR 97213 260796953 Imaging - Diagnostics OR N/A Ctr for MedImaging-Tanasbourne LLC 4400 NE Halsey St 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 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 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 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 St 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 1 0 0 0 0 0 0 0 0