PROVIDENCE ST VINCENT MEDICAL FOUNDATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
PROVIDENCE ST VINCENT MEDICAL FOUNDATION (EIN 93-0575982)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-08-14
IRS object ID
201522269349302797
Schema version
2014v5.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-08-14T13:06:50-05:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN911194016PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Clark Nuber PSBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110900 NE 4th Suite 1700AddressLine1Txt
CityBellevueCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN930575982EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE ST VINCENT MEDICAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPROVBusinessNameControlTxt
Phone5032162227PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line19205 SW BARNES ROADAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97225ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKevin FinnPersonNm
Person TitleInterim Executive DirectorPersonTitleTxt
Phone5032162227PhoneNum
Signature2015-08-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSara Elizabeth J Hyre CPAPreparerPersonNm
PTINP00235495PTIN
Phone4254544919PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMarilyn SpeirnPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line19205 SW BARNES ROADAddressLine1Txt
CityPORTLANDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97225ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$57,418,959GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.providencefoundations.org/foundations/pages/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1969FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionTo support Providence St. Vincent Medical Center.ActivityOrMissionDesc
Voting Members Governing Body27VotingMembersGoverningBodyCnt
Voting Members Independent27VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers70TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,446,064PYContributionsGrantsAmt
CY Contributions Grants$29,395,611CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$12,519,005PYInvestmentIncomeAmt
CY Investment Income$4,198,945CYInvestmentIncomeAmt
PY Other Revenue$416,656PYOtherRevenueAmt
CY Other Revenue$458,104CYOtherRevenueAmt
PY Total Revenue$18,381,725PYTotalRevenueAmt
CY Total Revenue$34,052,660CYTotalRevenueAmt
PY Grants And Similar Paid$7,790,182PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$8,087,988CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$374,928PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$299,231CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$311,800CYTotalFundraisingExpenseAmt
PY Other Expenses$405,139PYOtherExpensesAmt
CY Other Expenses$367,717CYOtherExpensesAmt
PY Total Expenses$8,570,249PYTotalExpensesAmt
CY Total Expenses$8,754,936CYTotalExpensesAmt
PY Revenues Less Expenses$9,811,476PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$25,297,724CYRevenuesLessExpensesAmt
Total Assets BOY$166,304,967TotalAssetsBOYAmt
Total Assets EOY$190,228,505TotalAssetsEOYAmt
Total Liabilities BOY$6,835,674TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,993,072TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$159,469,293NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$183,235,433NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAs People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Support the ministries of Providence St. Vincent Medical Center.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$6,382,169ExpenseAmt
Grant$6,382,169GrantAmt
Revenue$0RevenueAmt
DescFunding of operations and capital at Providence St Vincent Medical Center and PH&S-Oregon. This includes $1.4 million for Heart Research, and $607,000 for Nursing Administration, in addition to helping support the day-to-day operations of the St Vincent Medical Center and expenses paid on the Medical Center's behalf.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,646,359ExpenseAmt
Grant$1,646,359GrantAmt
Revenue$0RevenueAmt
DescNursing scholarships and loans for future nurses working at Providence. Since it began, the nursing scholarship program has helped over 400 students become nurses.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$50,000ExpenseAmt
Grant$50,000GrantAmt
Revenue$0RevenueAmt
DescFunds to Catholic Charities for its administration of the Helping Hand fund, which provided living assistance to employees within the PH & S-Oregon corporation.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (2 entries)

ExpenseExpenseAmtGrantGrantAmtRevenueRevenueAmtDescDesc
$8,580$8,580$0Donation to YMCA of Columbia-Willamette for their child care program
$880$880$0Rent paid on behalf of a patient in need
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$9,460TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$9,460TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$8,087,988TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document25IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members27GoverningBodyVotingMembersCnt
Independent Voting Member27IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Kevin Kelly
President2.000.00Yes (X)Yes (X)$0$0$0
Paul Rosenbaum
Vice President2.000.00Yes (X)Yes (X)$0$0$0
Steve Shepard
Secretary2.000.00Yes (X)Yes (X)$0$0$0
Don Vollum
Treasurer2.000.00Yes (X)Yes (X)$0$0$0
Eli Morgan
Immediate Past President2.000.00Yes (X)Yes (X)$0$0$0
Sandy Andersen Albers
Trustee1.000.00Yes (X)$0$0$0
Chris Anderson
Trustee1.000.00Yes (X)$0$0$0
Tim Boyle Non-Voting eff 514
Trustee1.000.00Yes (X)$0$0$0
Peter Brix
Trustee1.000.00Yes (X)$0$0$0
Nancy Bryant
Trustee1.000.00Yes (X)$0$0$0
Chris Corrado
Trustee1.000.00Yes (X)$0$0$0
Gregory Goodman Res 714
Trustee1.000.00Yes (X)$0$0$0
Ed Jensen
Trustee1.000.00Yes (X)$0$0$0
Lynn Johnson
Trustee1.000.00Yes (X)$0$0$0
Pat Karamanos Dec 1014
Trustee1.000.00Yes (X)$0$0$0
Bruce Korter
Trustee1.000.00Yes (X)$0$0$0
Stefan Kurschner
Trustee1.000.00Yes (X)$0$0$0
Lorie Leeson
Trustee1.000.00Yes (X)$0$0$0
Paul Linnman
Trustee1.000.00Yes (X)$0$0$0
William McCormick
Trustee1.000.00Yes (X)$0$0$0
Katherine McCoy
Trustee1.000.00Yes (X)$0$0$0
John Miner
Trustee1.000.00Yes (X)$0$0$0
Susan Paulsell
Trustee1.000.00Yes (X)$0$0$0
Norma Paulus
Trustee1.000.00Yes (X)$0$0$0
Steve Plambeck
Trustee1.000.00Yes (X)$0$0$0
Tim Rippey
Trustee1.000.00Yes (X)$0$0$0
Ron Sauer
Trustee1.000.00Yes (X)$0$0$0
Dr Frederick Waller
Trustee1.000.00Yes (X)$0$0$0
Lynda Walker
Trustee1.000.00Yes (X)$0$0$0
Don Washburn
Trustee1.000.00Yes (X)$0$0$0
Dick Clark
Executive Director45.000.00Yes (X)$0$162,874$28,784
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$162,874TotReportableCompRltdOrgAmt
Total Other Compensation$28,784TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Morgan Stanley Smith BarneyBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 SW 5th Ave 2200AddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP97204ZIPCd
FieldValueIRS element (for citing)
ServicesInvestment ManagementServicesDesc
Compensation$183,561CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Federated Campaigns$2,158FederatedCampaignsAmt
Related Organizations$636,389RelatedOrganizationsAmt
All Other Contributions$28,757,064AllOtherContributionsAmt
Noncash Contributions$729,247NoncashContributionsAmt
Total Contributions$29,395,611TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,643,579TotalRevenueColumnAmt
Exclusion$2,643,579ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$24,364,637SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$22,809,271SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,555,366SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,555,366TotalRevenueColumnAmt
Exclusion$1,555,366ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$1,015,132GrossSalesOfInventoryAmt
Cost Of Goods Sold$557,028CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$458,104TotalRevenueColumnAmt
Exclusion$458,104ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,052,660TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$4,657,049ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$8,087,108TotalAmt
Program Services$8,087,108ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$880TotalAmt
Program Services$880ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$177,954TotalAmt
Management And General$53,386ManagementAndGeneralAmt
Fundraising$124,568FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$105,413TotalAmt
Management And General$31,624ManagementAndGeneralAmt
Fundraising$73,789FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$15,864TotalAmt
Management And General$4,759ManagementAndGeneralAmt
Fundraising$11,105FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$6,285TotalAmt
Management And General$6,285ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$231,487TotalAmt
Management And General$231,487ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$21,541TotalAmt
Management And General$6,462ManagementAndGeneralAmt
Fundraising$15,079FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$24,943TotalAmt
Fundraising$24,943FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$31,261TotalAmt
Management And General$9,378ManagementAndGeneralAmt
Fundraising$21,883FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,089TotalAmt
Management And General$927ManagementAndGeneralAmt
Fundraising$2,162FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$11,367TotalAmt
Management And General$3,410ManagementAndGeneralAmt
Fundraising$7,957FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtFundraisingFundraisingAmtManagement And GeneralManagementAndGeneralAmt
Donor Recognition$23,960$23,960
Property Tax$3,507$3,507
Dues & Subscriptions$1,370$959$411
OR Form CT-12$1,200$1,200

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$7,707TotalAmt
Management And General$2,312ManagementAndGeneralAmt
Fundraising$5,395FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,754,936TotalAmt
Program Services$8,087,988ProgramServicesAmt
Management And General$355,148ManagementAndGeneralAmt
Fundraising$311,800FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,174,779BOYAmt
EOY$2,400,257EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,507,721BOYAmt
EOY$19,218,520EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$4,465,896BOYAmt
EOY$3,492,766EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$73,099BOYAmt
EOY$117,407EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$250,081LandBldgEquipCostOrOtherBssAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$45,081BOYAmt
EOY$250,081EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$148,430,819BOYAmt
EOY$152,890,970EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$10,607,572BOYAmt
EOY$11,858,504EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$166,304,967BOYAmt
EOY$190,228,505EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$30,346BOYAmt
EOY$25,507EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$2,035,074BOYAmt
EOY$2,033,314EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,770,254BOYAmt
EOY$4,934,251EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,835,674BOYAmt
EOY$6,993,072EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$126,066,339BOYAmt
EOY$127,552,478EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,807,253BOYAmt
EOY$44,054,131EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,595,701BOYAmt
EOY$11,628,824EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$159,469,293BOYAmt
EOY$183,235,433EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$166,304,967BOYAmt
EOY$190,228,505EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$25,297,724ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,531,584NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,586,764CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,300,462CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,177,617CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,446,064CurrentTaxYearMinus1YearAmt
Current Tax Year$4,395,611CurrentTaxYearAmt
Total$27,906,518TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,586,764CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,300,462CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,177,617CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,446,064CurrentTaxYearMinus1YearAmt
Current Tax Year$4,395,611CurrentTaxYearAmt
Total$27,906,518TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$2,067,972SubstantialContributorsTotAmt
Public Support Total170$25,838,546PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$527,512CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$350,343CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$467,600CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$516,526CurrentTaxYearMinus1YearAmt
Current Tax Year$2,643,579CurrentTaxYearAmt
Total$4,505,560TotalAmt
FieldValueIRS element (for citing)
Total Support$32,412,078TotalSupportAmt
Gross Receipts Rltd Activities$4,415,134GrossReceiptsRltdActivitiesAmt
Public Support CY1700.79720PublicSupportCY170Pct
Public Support PY1700.84920PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePart II, SECTION A, LINE 1FormAndLineReferenceDesc
ExplanationUNUSUAL GRANTS During 2014, the organization received a grant in the amount of $25,000,000 from disinterested persons. This grant is considered unusual due to its large amount and its impact on the organization's public support test. This unusual grant is excluded from calculations on Schedule A, Part II, lines 1 and 5.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

Art Public Exhibition Amounts ArtPublicExhibitionAmountsGrp

FieldValueIRS element (for citing)
Assets Included$264,878AssetsIncludedAmt
FieldValueIRS element (for citing)
Collection Used Pub ExhibitionYes (X)CollectionUsedPubExhibitionInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,142,606BeginningYearBalanceAmt
Contributions$138,107ContributionsAmt
Investment Earnings Or Losses$397,687InvestmentEarningsOrLossesAmt
Grants Or Scholarships$521,647GrantsOrScholarshipsAmt
End Year Balance$16,156,753EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,352,379BeginningYearBalanceAmt
Contributions$634,472ContributionsAmt
Investment Earnings Or Losses$1,636,050InvestmentEarningsOrLossesAmt
Grants Or Scholarships$480,295GrantsOrScholarshipsAmt
End Year Balance$16,142,606EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,964,166BeginningYearBalanceAmt
Contributions$22,120ContributionsAmt
Investment Earnings Or Losses$1,827,274InvestmentEarningsOrLossesAmt
Grants Or Scholarships$461,181GrantsOrScholarshipsAmt
End Year Balance$14,352,379EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$13,557,000BeginningYearBalanceAmt
Contributions$217,345ContributionsAmt
Investment Earnings Or Losses-$372,498InvestmentEarningsOrLossesAmt
Grants Or Scholarships$437,681GrantsOrScholarshipsAmt
End Year Balance$12,964,166EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$12,178,000BeginningYearBalanceAmt
Contributions$6,000ContributionsAmt
Investment Earnings Or Losses$1,691,000InvestmentEarningsOrLossesAmt
Grants Or Scholarships$318,000GrantsOrScholarshipsAmt
End Year Balance$13,557,000EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.72000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.28000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$230,410InvestmentCostOrOtherBasisAmt
Book Value$230,410BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$19,671InvestmentCostOrOtherBasisAmt
Book Value$19,671BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$250,081TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
Cash Surrender Value - Life Insurance$150,948
Artwork and Paintings$264,878
Cemetery Plots$3,600
Gift Annuities & Trusts$11,397,411
Due from Affiliates$41,667
FieldValueIRS element (for citing)
Total Book Value Other Assets$11,858,504TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Gift Annuity and Trust Liabilities$4,692,979
Due to Affiliates$241,272
FieldValueIRS element (for citing)
Total Liability$4,934,251TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part III, Line 4:Artwork received through the Foundation is displayed throughout the hospital to enhance the environment for the patients and their families.
Part V, Line 4:The endowment funds provide for medical research, patient care and capital needs of Providence St Vincent Medical Center. In 2014 funds were used for diabetic research, medical education, medical ethics,and Camp Erin, which provides support for grieving children.
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.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
PH&S-OR dba Providence St Vincent Medical Center
9205 SW Barnes RdPortlandOR97225510216587501 (c)(3)$4,480,891Operational Support
PH&S-OR dba Providence Shared Services
PO Box 13993PortlandOR97213510216587501 (c)(3)$1,901,278Operational Support
University of Portland
5000 N Willamette BlvdPortlandOR97203930401259501 (c)(3)$1,646,359Medical Education
Catholic Charities
2740 SE Powell BlvdPortlandOR97202930386801501 (c)(3)$50,000Employee Assistance Funds
YMCA of Columbia - Willamette
955 SW Barbur Blvd 240PortlandOR97203930386981501 (c)(3)$8,580Child Center Program
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationAs most grants go to an affiliated company, the Foundation has access to the Financial reports of Providence St. Vincent Medical Center and can review these records for appropriate use of funds. Providence's regional nursing manager works with all educational institutions to monitor the nursing education funds provided to each school. The Foundation has worked closely with Catholic Charities in establishing an Employee Assistance Program. Financial records are provided as requested by the Foundation. Scholarship grants to individuals are monitored through follow up reports from the recipients.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonDick ClarkPersonNm
TitleExecutive DirectorTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$161,271CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$1,603BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$15,080DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$13,704NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$191,658TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution37ContributionCnt
Noncash Contributions Rpt F990$520,907NoncashContributionsRptF990Amt
Method Of Determining RevenuesStock PriceMethodOfDeterminingRevenuesTxt

Real Estate Residential RealEstateResidentialGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$205,000NoncashContributionsRptF990Amt
Method Of Determining RevenuesAppraisalMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescJewelryDesc
Contribution1ContributionCnt
Noncash Contributions Rpt F990$3,340NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received1Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Column (b):FormAndLineReferenceDesc
ExplanationThe amounts shown on Part I, Col. B reflect the number of donations received of the specific type of item.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6The Corporate Member of the Foundation is Providence Health & Services - Oregon, a not-for-profit corporation.
Form 990, Part VI, Section A, line 7aThe Corporate Member has the power to approve the number of Directors, appoint the Board of Directors of the Foundation and remove such Directors at any time with or without cause.
Form 990, Part VI, Section A, line 7bThe following powers are reserved exclusively to the Corporate Member: * Adopt and amend the Articles of Incorporation and the Bylaws of the Foundation after consultation with the Foundation's Board of Directors. * Approve the merger, consolidation, or affiliation of the Foundation with another corporation, organization or program, or the dissolution of the Foundation. * Approve any strategic plan of the Foundation. * Approve the annual fundraising plan including special events, annual, capital and planned giving activities. * Approve the acceptance of any gift that carries conditions or limitations or any gift restricted to services, programs or facilities not currently offered or approved to be offered by the Corporate Member's Board. * Develop and implement investment policies and/or guidelines that will be used by the Foundation in determining appropriate investments.
Form 990, Part VI, Section B, line 11The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Foundation Director and signing Board Officer will review the Form 990 in detail. Once approved, an electronic copy of the Form 990 is emailed to the Board prior to filing with the IRS.
Form 990, Part VI, Section B, line 12cProvidence 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 15It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined 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. Performance incentives allow executives to earn additional compensation if they achieve specific organizational and individual goals for furthering Providence operating principles - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated customer satisfaction, meeting employee satisfaction goals and reaching financial performance objectives. The Board of Directors conducts a thorough process to ensure performance incentives are aligned with appropriate practices for not-for-profit health care systems. The 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. The Foundation Executive Director is compensated by a related organization which uses a market based compensation program utilizing several independent third party compensation market surveys to establish pay ranges for the position. The related organization then establishes the individual rate of pay within the range based on relevant experience, skills and competencies. The rate offered to the Executive Director at the time of hire was determined through discussion between the Regional CEO, Regional Director of HR and the Administrative Director of HR. The ranges and rate of pay are reviewed on an annual basis by Regional HR.
Form 990, Part VI, Section C, line 19Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon request. The consolidated financial statements are available on our public Internet site www2.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site.
Form 990, PART XII, LINE 2c - AUDIT & COMPLIANCEThe Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation.
Form 990, PART I, LINE 5 & Part V, Line 2a - EMPLOYEE COMPENSATIONThe employees working at the Foundation are paid by Providence Health & Services - Oregon EIN# 51-0216587. Therefore, no W-2s are issued by the reporting organization.
FORM 990, PART I, LINE 6 - VOLUNTEERSVolunteers assist in the gift shop with cashiering, assisting customers, and delivering flowers to patient rooms.
FORM 990, SCHEDULE R - RELATED ORGANIZATIONSAFFILIATION AGREEMENTS Effective March 1, 2014, the Health System entered into an affiliation agreement with Sisters of Charity of Leavenworth Health System (SCL) to transfer sponsorship of Saint John's Health Center (Saint John's) to the Health System. Saint John's operates a nonprofit medical center, a cancer institute, and physician clinics to serve the Santa Monica, California community and surrounding area. Effective May 1, 2014, the Health System entered into an affiliation agreement with PacMed Clinics (PacMed). PacMed is a private, nonprofit, multi-specialty medical group with nine clinics in the Puget Sound area and more than 150 primary care and specialty providers at the date of affiliation. Pursuant to the affiliation agreement, Western HealthConnect became PacMed's sole corporate Member. No cash or other purchase consideration was transferred to effect the affiliation. Effective June 13, 2014, the Health System entered into an affiliation agreement with Kadlec Health System (Kadlec). Kadlec operates a nonprofit medical center, a neurological resource center, a supporting foundation, and physician clinics to serve the tri-cities area of Kennewick, Pasco, and Richland, Washington. Pursuant to the affiliation agreement, Western HealthConnect became the sole member of Kadlec. No cash or other purchase consideration was transferred to effect the affiliation.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1PSV Properties LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line19205 SW Barnes RoadAddressLine1Txt
CityPortlandCityNm
State AbbreviationORStateAbbreviationCd
ZIP97225ZIPCd
FieldValueIRS element (for citing)
Primary ActivitiesReal EstatePrimaryActivitiesTxt
Legal Domicile StateORLegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Providence St Vincent Medical FoundationBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (72 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Providence Health & Services - Washington
1801 Lind Avenue SW 9016RentonWA980579016510216586Healthcare SystemWA501( c)(3)Line 3Providence Health & Services0
Providence Health & Services - Oregon
1801 Lind Avenue SW 9016RentonWA980579016510216587Healthcare SystemOR501( c)(3)Line 3Providence Health & Services0
Providence Health System - So California
1801 Lind Avenue SW 9016RentonWA980579016510216589Healthcare SystemCA501( c)(3)Line 3Providence Health & Services0
Everett Transitional Care Services
PO Box 5128EverettWA982065128943264605Transitional CareWA501( c)(3)Line 90N/A
Providence Oregon Management Corporation
1801 Lind Avenue SW 9016RentonWA980579016930813977Shell CorporationOR501( c)(3)Line 1PH & S - Oregon0
Providence Plan Partners
4400 NE Halsey Bldg 2PortlandOR97213911861964Healthcare ServicesOR501( c)(4)N/APH & S - Oregon0
Providence Health Plan
4400 NE Halsey Bldg 2PortlandOR97213930863097Health Service ContractorOR501( c)(4)N/AProvidence Plan Partners0
Providence Health Assurance
4400 NE Halsey Bldg 2PortlandOR97213550828701Medicaid Healthcare ProviderOR501( c)(4)N/AProvidence Health Plan0
Providence Medical Institute
4101 Torrance BlvdTorranceCA90503330283773HealthcareCA501( c)(3)Line 11/Type IPHS - So California0
Little Company of Mary Ancillary Services Corporation
4101 Torrance BlvdTorranceCA90503330844408Imaging ServicesCA501( c)(3)Line 9PHS - So California0
Providence TrinityCare Hospice
5315 Torrance Blvd Suite B1TorranceCA90503953264139HospiceCA501( c)(3)Line 9PHS - So California0
Providence Blanchet Association
1700 Providence PlCentraliaWA98531911789266HousingWA501( c)(3)Line 7PH & S - Washington0
St Luke Association
350 Washington Ave SEChehalisWA98352943176618HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Rossi Association
1700 Providence PlCentraliaWA98531311584166HousingWA501( c)(3)Line 9PH & S - Washington0
Lundberg Association
5921 E BurnsidePortlandOR97215911562797HousingOR501( c)(3)Line 7PH & S - Oregon0
Providence St Francis Association
3415 12th Avenue NEOlympiaWA98506943244854HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Peter Claver Association
7101 38th Avenue SouthSeattleWA98118311629656HousingWA501( c)(3)Line 7PH & S - Washington0
Providence St Elizabeth House Association
3201 SW Graham StSeattleWA98126912171539HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Gamelin House Association
4515 MLK Jr Way S Ste 200SeattleWA98108311744654HousingWA501( c)(3)Line 7PH & S - Washington0
The Gamelin Association
312 North Fourth StYakimaWA98901911180824HousingWA501( c)(3)Line 7PH & S - Washington0
The Gamelin Oregon Association
5520 NE GlisanPortlandOR97213911214491HousingOR501( c)(3)Line 9PH & S - Oregon0
The Gamelin California Association
540 23rd StOaklandCA94612911293869HousingCA501( c)(3)Line 9PHS - So California0
Gamelin Washington Association
1423 First AvenueSeattleWA98101201910170HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Foundation
1801 Lind Avenue SW 9016RentonWA980579016943078543Support PH&S InstitutionsWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Alaska Foundation
3300 Providence Drive - B Tower2AnchorageAK99508920093565Support PHS-AlaskaAK501( c)(3)Line 11/Type IPH & S - Washington0
Providence St Peter Foundation
413 Lilly Road NEOlympiaWA985065166911097056Support Affiliated Tax-Exempt OrganizationWA501( c)(3)Line 7PH & S - Washington0
Providence Health Care Foundation (Centralia)
914 S Scheuber RoadCentraliaWA98531911433382Support Providence Centralia HospitalWA501( c)(3)Line 7PH & S - Washington0
Providence Mount St Vincent Foundation
4831 - 35th Avenue SWSeattleWA981262799911188119Support Providence Mount St.VincentWA501( c)(3)Line 7PH & S - Washington0
Providence Marianwood Foundation
3725 Providence Point Drive SEIssaquahWA980297219931554288Support Providence MarianwoodWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Newberg Health Foundation
1001 Providence DriveNewbergOR97132930889144Support Providence Newberg Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Seaside Hospital Foundation
725 S Wahanna RdSeasideOR97138930927320Support Providence Seaside HospitalOR501( c)(3)Line 7PH & S - Oregon0
Providence Community Health Foundation
1111 Crater Lake AveMedfordOR97504930692907Support Providence Medford Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Benedictine Nursing Center Foundation
540 South Main StMt AngelOR973629532911940286Support Providence Benedictine Nursing CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Portland Medical Foundation
4805 NE Glisan StPortlandOR972132967931231494Support Providence Portland Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Milwaukie Foundation
10150 SE 32ndMilwaukieOR97222943079515Support Providence Milwaukie HospitalOR501( c)(3)Line 7PH & S - Oregon0
Providence Child Center Foundation
830 NE 47thPortlandOR97213930800140Support Providence Child CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence TrinityCare Hospice Foundation
5315 Torrance Blvd Suite B1TorranceCA90503330261016Support TrinityCare HospiceCA501( c)(3)Line 7PHS - So California0
Providence Little Company of Mary Foundation
4101 Torrance BlvdTorranceCA90503510224944Support Little Company of Mary Service AreaCA501( c)(3)Line 7PHS - So California0
PH&S FoundationSFVSA & SCVSA
501 S Buena Vista StreetBurbankCA91505953544877Support Program & Activities of SFVSA & SCVSACA501( c)(3)Line 7PHS - So California0
Providence Hospice of Seattle Foundation
425 Pontius Avenue North 300SeattleWA981095452912077378Support Hospice of SeattleWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Health & Services - Western Washington
1801 Lind Avenue SW 9016RentonWA980579016911303277HealthcareWA501( c)(3)Line 3Providence MinistriesWHC0
Providence Health & Services
1801 Lind Avenue SW 9016RentonWA980579016911549796Shell CorporationWA501( c)(3)Line 11/Type IIProvidence Ministries0
Providence Health & Services - Montana
500 W Broadway PO Box 4587MissoulaMT598064587810231793HealthcareMT501( c)(3)Line 3PH & S - Washington0
Providence St Joseph Medical Center
PO Box 1010PolsonMT598601010810463482HealthcareMT501( c)(3)Line 3PH & S - Washington0
St Thomas Child and Family Center
1710 Benefis CourtGreat FallsMT59405810233495Early Childhood EducationMT501( c)(3)Line 9PH & S - Washington0
Sisters of Providence of Montana Corporation
1801 Lind Avenue SW 9016RentonWA980579016262612415Shell CorporationMT501( c)(3)Line 1PH & S - Washington0
Providence Health Care Foundation - Eastern Washington
101 W 8th AveSpokaneWA99204320014330Support PH&S-WA. Ministries in E. WA.WA501( c)(3)Line 7PH & S - Washington0
St Patrick Hospital Foundation
500 West Broadway PO Box 4587MissoulaMT598064587237056976Support Healthcare in W. MontanaMT501( c)(3)Line 7PH & S - Washington0
University of Great Falls
1301 20th Street SouthGreat FallsMT59405810231777Post Secondary EducationMT501( c)(3)Line 2PH & S - Washington0
E WA & MT Unemployment Compensation Insurance Trust
1801 Lind Avenue SW 9016RentonWA980579016911082119Unemployment BenefitsWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Willamette Falls Medical Foundation
1500 Division StreetOregon CityOR97045931003750Support Willamette Falls HospitalOR501( c)(3)Line 11/Type IPH & S - Oregon0
Providence Hood River Memorial Hospital Foundation Inc
811 13th StHood RiverOR97031930921990Support Providence Hood River Memorial HospitalOR501( c)(3)Line 7PH & S - Oregon0
Providence Hospice and Home Care Foundation
2731 Wetmore Avenue Suite 500EverettWA98201272552749Support Program & Ministries of PHHCWA501(c )(3)Line 7PH & S - Washington0
Providence St Mary Foundation
401 W Poplar StWalla WallaWA99362452841492Support Program & Ministries of SMMCWA501(c )(3)Line 7PH & S - Washington0
Facey Medical Foundation
15451 San Fernando Mission Blvd 200Mission HillsCA913451420954322584Support Facey Medical GroupCA501(c )(3)Line 7PHS - So California0
Swedish Health Services
747 BroadwaySeattleWA98122910433740HealthcareWA501(c )(3)Line 3Western HealthConnect0
Swedish Edmonds
21601 76th Ave WEdmondsWA98026272305304HealthcareWA501(c )(3)Line 3Western HealthConnect0
Swedish Medical Center Foundation
747 BroadwaySeattleWA98122910983214Support Swedish Health ServicesWA501(c )(3)Line 7Swedish Health Services0
Global To Local Health Initiative
2800 South 192nd St 104SeaTacWA98188273133200HealthcareWA501(c )(3)Line 7Swedish Health Services0
Swedish MJM Holdings
747 BroadwaySeattleWA98122273139262Holding CompanyWA501(c )(3)Line 11/Type ISwedish Health Services0
Marsha Rivkin Center for Ovarian Cancer Research
747 BroadwaySeattleWA98122912054035Ovarian Cancer ResearchWA501(c )(3)Line 7Swedish Health Services0
Western HealthConnect
747 BroadwaySeattleWA98122454171900Shell CorporationWA501(c )(3)Line 11/Type IIPH&S Western Washington0
Inland Northwest Health Services
601 W 1st AvenueSpokaneWA99201911307555HealthcareWA501( c)(3)Line 3PH&S - Washington0
PHN Holdings
20555 Earl StreetTorranceCA90503461814184Strategic/Planning services for PHNCAPendingNAPHS - So California0
Providence Health Network
20555 Earl StreetTorranceCA90503800886966Prepaid HealthcareCAPendingNAPHN Holdings0
Kadlec Regional Medical Center
888 Swift BlvdRichlandWA99352910655392HealthcareWA501(c )(3)Line 3Western HealthConnect0
Kadlec Neurological Resource Center
1268 Lee BlvdRichlandWA99352911266345HealthcareWA501(c )(3)Line 9Western HealthConnect0
Kadlec Foundation
888 Swift BlvdRichlandWA99352237005501Support Kadlec Regional Medical CenterWA501(c )(3)Line 11/Type IKadlec Regional Medical Center0
PacMed Clinics
1200 12th Ave SSeattleWA98144562290878HealthcareWA501(c )(3)Line 9Western HealthConnect0
Providence Saint John's Health Center
2121 Santa Monica BlvdSanta MonicaCA90404951684082HealthcareCA501(c )(3)Line 3PHS - So California0
John Wayne Cancer Institute
2200 Santa Monica BlvdSanta MonicaCA90404954291515Cancer TreatmentCA501(c )(3)Line 4Providence Saint John's Health Center0
Saint John's HospitalHealth Center Foundation
2121 Santa Monica BlvdSanta MonicaCA90404956100079Support Saint John Health Center & JWCICA501(c )(3)Line 7Providence Saint John's Health Center0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (26 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
Providence Imaging Center
3340 Providence DriveAnchorageAK99508920118807Medical ImagingAKN/A
California Laboratory Associates LLC
501 Buena VistaBurbankCA91505273888692Outpatient LabCAN/A
Broadway Imaging LLC
500 W BroadwayMissoulaMT59802522405971Medical ImagingMTN/A
Ctr for Med Imaging-Bridgeport LLC
4400 NE Halsey 495PortlandOR97213260796953Imaging - DiagnosticsORN/A
Ctr for Med Imaging-Tanasbourne LLC
4400 NE Halsey 495PortlandOR97213200477972Imaging - DiagnosticsORN/A
Pathology Associates Medical Laboratories LLC
611 N PerrySpokaneWA99202270943279Outpatient LabWAN/A
Portland Medical Imaging LLC
4400 NE Halsey 495PortlandOR97213201054971Imaging - DiagnosticsORN/A
Oregon Advanced Imaging LLC
881 OHare ParkwayMedfordOR97504450471748Medical ImagingORN/A
Minor & James Medical PLLC
515 Minor Avenue 200SeattleWA98104911340223Physician ClinicWAN/A
Providence Surgery Center LLC
902 N Orange StMissoulaMT59802841401625Ambulatory Surgery CenterMTN/A
Clackamas Radiation Oncology Center LLC
4400 NE Halsey St Bldg II 495PortlandOR97213260381897Radiation OncologyORN/A
PETCT Imaging at Swedish Cancer Institute LLC
1221 Madison StreetSeattleWA98104203132044Medical ImagingWAN/A
PacLab LLC
611 N PerrySpokaneWA99202911743952Outpatient LabWAN/A
The Madison Spokane Inn LLC
15 West Rockwood BlvdSpokaneWA99204841606484Hotel ServicesWAN/A
Center for Specialty Surgery LLC
11782 SW Barnes RdPortlandOR97225263638838Ambulatory Surgery CenterORN/A
Oregon Outpatient Surgery Center
7300 SW Childs RdTigardOR97224223883387Ambulatory Surgery CenterORN/A
ProvidenceUSP Santa Clarita GP LLC
11550 Indian Hills Road 160Mission HillsCA91345202829660Ambulatory Surgery CenterCAN/A
ProvidenceUSP Surgery Ctrs LLC
11550 Indian Hills Road 160Mission HillsCA91345200905938Ambulatory Surgery CenterCAN/A
Alpha Medical Laboratory LLC
611 N PerrySpokaneWA99202912017347Outpatient LabIDN/A
Greater Valley Medical Building LP
501 S Buena Vista StBurbankCA91505954570858Real Estate - MOBCAN/A
Prov Radiation Oncology Develop Assn LLC
4400 NE Halsey 495PortlandOR97213260682491Real Estate - MOBORN/A
Providence Partners for Health LLC
501 S Buena Vista StBurbankCA91505454041798Clinical Quality & IntegrationCAN/A
ProvidenceSilverton Rehab LLC
4400 NE Halsey 425PortlandOR97213481287267Rehab ServicesORN/A
Southern Idaho Regional Laboratory LLC
611 N PerrySpokaneWA99202820511819Outpatient LabIDN/A
Mountainstar Clinical Laboratories LLC
611 N PerrySpokaneWA99202261345983Outpatient LabMTN/A
Tri-Cities Laboratory LLC
611 N PerrySpokaneWA99202911773986Outpatient LabWAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtOwnershipOwnershipPct
Providence Health Ventures Inc
4101 Torrance BlvdTorranceCA90503330122216InvestmentCAN/AC0
Caron Health Corporation
510 W Front StMissoulaMT59802810486082Medical Physician ServiceMTN/AC0
Providence Health Care Ventures Inc
101 W 8th Ave TAF C-9SpokaneWA99204900155714Clinical/Medical LabWAN/AC0
Providence Physician Services Co
101 W 8th Ave TAF C-9SpokaneWA99204911216033Clinical/Medical LabWAN/AC0
Yakima Medical Arts Inc
611 N Perry 100SpokaneWA99202910787963Rental Real EstateWAN/AC0
Bourget Health Services Inc
PO Box 2687SpokaneWA99220911354431Clinical/Medical LabWAN/AC0
1221 Madison Street Owners Assoc
747 BroadwaySeattleWA98122201954319Owners' AssociationWAN/AC0
Washington Cancer Centers PC
1560 N 115th G-16SeattleWA98133911792791Cancer TreatmentWAN/AC0
Western HealthConnect Ventures Inc
1801 Lind Ave SW 9016RentonWA98057800953654InvestmentWAN/AC0
Charitable Remainder Trusts (7)
InvestmentORYes (1)Providence St Vincent Medical Foundation1.00000
Charitable Remainder Trusts (1)
InvestmentORYes (1)Providence St Vincent Medical Foundation0.70000
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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