2014-11-17T14:42:32-06:00 2013-12-31 911194016 Clark Nuber PS 10900 NE 4th Suite 1700 Bellevue WA 98004 990 2013-01-01 810231793 PROVIDENCE HEALTH & SERVICES - MONTANA PROV 4255253985 1801 Lind Avenue SW No 9016 Renton WA 980579016 Todd Hofheins EVP/CFO 4255253985 2014-11-17 1 Sara Elizabeth J Hyre CPA P00235495 4254544919 2013 2015-11-30 17:44:51Z Providence St Patrick Hospital Rod Hochman MD 1801 Lind Avenue SW No 9016 Renton WA 980579016 299955287 0 0928 X www.saintpatrick.org X 1991 MT Healthcare with special concern for the poor and vulnerable in Missoula, MT. 17 17 2088 214 0 0 705281 3695267 271705062 267512524 3080516 1878509 5125451 3326954 280616310 276413254 953157 1173312 0 0 115375865 124555674 0 0 0 149363894 145858036 265692916 271587022 14923394 4826232 232956044 252366176 111822956 135037946 121133088 117328230 X As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Healthcare with special concern for the poor and vulnerable in Missoula, MT. 0 0 82178181 0 118720589 Acute Care - InpatientTotal Admissions: 8,879Total Patient Days: 43,610HistorySt. Patrick Hospital opened in 1873 under the sponsorship of the Sisters of Providence. The present facility opened in 1984, the fourth St. Pat's on this site above the Clark Fork River. In May 2000, we became more involved with national medical research and education. The hospital has 253 licensed beds. Approximately 95% of our patients come from our 17-county service area. Sponsorship In April 1873, the Sisters of Providence came to the Missoula valley to compassionately serve those in need, especially the poor and vulnerable. They opened St. Patrick Hospital, a not-for-profit mission, which quickly grew from a one-room structure to its current state-of-the-art medical center. St. Pat's continues to be sponsored by Providence Ministries, with a commitment to reveal God's healing presence to those who come to us for care. HIGHLIGHTS:* Mountain-Pacific Quality Health's 2013 Commitment to Quality Award was presented to Providence St. Patrick Hospital. Mountain-Pacific Quality Health's quality awards reflect continued expectations of engaging patients and families in improving care as well as top performance on quality indicators and system changes, as promoted by today's healthcare industry. Strong leadership support is considered, since it is vital for achieving and sustaining excellent patient safety and improvements in patient care. * Providence St. Patrick Hospital was named one of the nation's 50 Top Cardiovascular Hospitals by Truven Health Analytics. This is the seventh time Providence St. Patrick Hospital has been recognized with this honor. The 50 Top Cardiovascular Hospitals study evaluates performance in key areas: risk-adjusted mortality, risk-adjusted complications, core measures (a group of measures that assess process of care), percentage of coronary bypass patients with internal mammary artery use, 30-day mortality rates, 30-day readmission rates, severity-adjusted average length of stay, and wage- and severity-adjusted average cost. * Providence St. Patrick Hospital has achieved Magnet recognition by the American Nurses Credentialing Center's (ANCC) Magnet Recognition Program, which ensures that rigorous standards for nursing excellence are met. Magnet is the highest recognition an organization can receive for nursing care as established by the ANCC, a subsidiary of the American Nurses Association (ANA). St. Patrick Hospital is proud to be only one of two hospitals in the state of Montana to hold this prominent designation. Out of the 6,000 healthcare organizations in the U.S., fewer than 400 have achieved Magnet status. * St. Patrick Hospital Nuclear Medicine Department has been awarded the American College of Radiology (ACR) accreditation. The Department has been accredited since 2002. The ACR awards accreditation to facilities for the achievement of high practice standards after a peer-review evaluation of its practice. The program evaluates personnel qualifications, adequacy of facility equipment, quality control procedures and quality assurance programs. All findings are reported to the practice via a comprehensive report that includes recommendations for improvement. * Providence St. Patrick Hospital earned the Cardiac Surgery Excellence Award, the Spine Surgery Excellence Award, and the Distinguished Hospital Award for Clinical Excellence from Healthgrades, a U.S. company that develops and markets quality and safety ratings of healthcare providers. Healthgrades examines outcomes and complications through an analysis of MedPar and allpayer data based on over 30 cohorts, and is risk-adjusted for complications and mortality. * Providence St. Patrick Hospital has been recognized as a Top Performer by The Joint Commission on Key Quality Measures for 2012. As a Top Performer, St. Pat's is in the top 33% of all Joint Commission-accredited hospitals reporting accountability measure performance data for 2012. The hospital was recognized for the measure sets for Heart Attack, Heart Failure, Pneumonia and Surgical Care. * Providence St. Patrick Hospital received the Mountain-Pacific Quality Health Foundation Quality Achievement Award and the Commitment to Quality Award. Both awards recognize hospitals for providing high-quality care in the areas of heart attack, heart failure, pneumonia and surgical infection prevention. Mountain-Pacific began the Quality Awards Program to recognize hospitals for their commitment to demonstrating and maintaining exemplarily improvements in patient care. The 2013 Hospital Quality Awards reflect continued expectations of patient/family engagement as well as top performance on quality indicators and system changes as promoted by today's healthcare industry. * Providence St. Patrick Hospital was given the Women's Choice Award for one of America's 100 Best Hospitals for Patient Experience in Montana. The hospitals are highly rated by women for creating an extraordinary patient experience for women and their families. The process begins with scores derived for each hospital in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) database. The score takes a subset of the questions HCAHPS uses that research and experience shows are more important to women than to men. WomenCertified applies weight to each of those questions to adjust for relative importance to arrive at a numerical score. The scoring is objective and uniform. The 100 best scores in each of the four categories determine the America's 100 Best Hospitals for Outstanding Patient Experience by WomenCertified award winners. * Providence St. Patrick Hospital was given the Women's Choice Award for being a Best Hospital for Patient Experience in Heart Care. The hospitals are highly rated by women for creating an extraordinary patient experience for women and their families. * Becker's Hospital Review has named Providence St. Patrick Hospital one of "100 Great Community Hospitals," a list based on hospitals' quality of care and service to community. Whether independent or part of a larger health system, the hospitals work with limited resources to provide the quality of care and the experience patients expect. The Becker's Hospital Review editorial team selected community hospitals based on rankings and awards from iVantage Health Analytics, Truven Health Analytics (formerly Thomson Reuters), Healthgrades and The Joint Commission. The hospitals on the list have fewer than 550 beds and minimal teaching programs, and are often located in rural areas as the only hospitals in their communities. * The American College of Surgeons officially reverified the Trauma Center at Providence St. Patrick Hospital as an ACS Level II Trauma Center. We invite the American College of Surgeons to review our Trauma Program every three years. This year the two trauma surgeon surveyors did not find any deficiencies in our program and easily identified a dozen strengths of our trauma program. We are the only Level II trauma center in Western Montana within a 300-mile radius. In addition to this survey, we also have a concurrent survey with the state of Montana trauma services representative to continue our designation as a state Regional Trauma Center. * Representatives from Sightlife, a non-profit health organization and eye bank, awarded St. Patrick Hospital with the 2012 Vision Award. The Vision Award goes to the hospital in the state with the highest number of cornea donors and cornea recipients. Because of the hospital's dedicated, caring staff, 65 cornea donors resulted in 94 individuals receiving sight-restoring transplants-more than any other hospital in Montana. 76507773 0 110528706 Acute Care - OutpatientTotal Visits: 186,470See Line 4a Narrative 51197183 0 34757478 Primary CareTotal Visits: 244,025Grant Creek Family Medicine is Montana's First Patient-Centered Medical Home. A patient-centered medical home is a clinic staffed by healthcare providers who work as a team. Led by your primary care provider, your team manages all of your healthcare needs, including routine and urgent care,preventive care and referrals to outside providers or specialists when necessary.In order to improve the health of our employees and dependents, St. Pat's developed Home Base, an employee healthcare program. Employees and dependents are connected with a primary care provider and a healthcare team to work with patients who have cardiometabolic risk factors to improve their health and wellness. 1173312 1173312 0 Grants and Allocations.See Schedule I. 4209100 0 6080773 Healthcare Joint VenturesThrough partnerships, St. Patrick's is able to provide additional healthcare services to the community. 5382412 1173312 6080773 215265549 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 2088 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 0 1 1 1 MT X Karl E Fritschel CPA 4255253339 1801 Lind Ave SW 9016 Renton WA 980579016 X Michael Holcomb Chair of the Board 0.10 8.60 X X 0 60335 0 Lucille Dean SP Director 0.10 9.40 X 0 0 0 Mary Corita Heid RSM Director 0.10 5.00 X 0 0 0 Michael A Stein Director 0.10 6.00 X 0 18335 0 Eugene Al Parrish Director 0.10 5.00 X 0 15335 0 Dana A Rasmussen Director 0.10 4.30 X 0 18335 0 James S Roberts MD Director 0.10 9.00 X 0 30835 0 Peter J Snow Director 0.10 5.70 X 0 20835 0 Bob Wilson Director 0.10 5.00 X 0 15335 0 Sallye Liner Director 0.10 4.00 X 0 15335 0 Cheryl M Scott Director 0.10 4.60 X 0 15335 0 Ellen L Wolf Director 0.10 7.10 X 0 15335 0 Isiaah Crawford Director 0.10 4.10 X 0 15335 0 Martha Diaz Aszkenazy Director 0.10 7.70 X 0 15335 0 Kirby McDonald Director 0.10 4.60 X 0 15335 0 Dave Olsen Director 0.10 5.50 X 0 15335 0 Charles Chuck Watts Director 0.10 4.60 X 0 15335 0 John F Koster MD - Thru 0313 President / CEO 0.10 53.90 X 0 3202727 247248 Rod F Hochman MD - Eff 0413 President / CEO 0.10 64.90 X 0 1402907 515903 Todd Hofheins EVP/CFO 0.10 59.90 X 0 570367 90110 Jeffrey W Rogers - Thru 513 Corporate Secretary 0.10 49.90 X 0 1040781 189880 Cindy Strauss - Eff 613 SVP/Chief Counsel/Corp. Secretary 0.10 59.90 X 0 955824 248254 Jeffrey Fee CEO/St. Patrick Hospital 50.00 0.00 X 0 462350 165296 Kirk Bodlovic CFO/St. Patrick Hospital 50.00 0.00 X 0 179553 34813 Terry L Smith SVP/Management Svcs 0.00 60.00 X 0 1612950 226158 Deborah Burton SVP/Chief Nrsg. Officer 0.00 65.00 X 0 1347109 66039 Michael L Butler President/Operations & Services 0.00 60.00 X 0 1272743 742629 Randy Axelrod MD EVP/Clinical & Patient Svcs 0.00 60.00 X 0 1055259 219690 Janice J Jones SVP/CAO 0.00 55.00 X 0 999701 159493 Myron Berdischewsky MD SVP/CMQO 0.00 60.00 X 0 855510 158577 Jack Friedman SVP/Account Care & Payor Rel. 0.00 55.00 X 0 826281 177752 Ray Williams SVP/Physicians Svcs 0.00 55.00 X 0 761267 203589 Cindra R Syverson SVP/CHRO 0.00 60.00 X 0 717450 292188 Craig L Wright MD SVP/Physicians Svcs 0.00 60.00 X 0 708798 451637 John O Mudd SVP/Mission Leadership 0.00 55.00 X 0 542246 208258 Claudia Haglund VP/Governance & Sponsorship 0.00 50.00 X 0 494375 157049 Joel S Gilbertson SVP/Comm.Ptrshp & External Affairs 0.00 55.00 X 0 456594 126245 David Brown VP/Strategy & Innovation 0.00 55.00 X 0 434606 168959 Orest Holubec SVP/Marketing & Communications 0.00 60.00 X 0 423960 61310 Gary Flaming SVP/Chief Risk Officer 0.00 57.00 X 0 381771 94294 Mark Wakai Chief Operations & Strategy Ofc 50.00 0.00 X 332931 0 35242 Joyce Dombrouski RN Chief Acute Svc. Ofc. 50.00 0.00 X 283666 0 40758 Craig Aasved Chief Mgmt. Svcs. Ofc. 58.00 2.00 X 271571 0 33567 James M Maxwell MD Physician - Surgical 50.00 0.00 X 936530 0 52833 Mark L Sanz MD Physician - Cardiology 50.00 0.00 X 743063 0 46852 James T Maddux MD Physician - Cardiology 50.00 0.00 X 678040 0 39317 George T Bandow MD Physician 50.00 0.00 X 596502 0 26588 Peter Szekely MD Physician 50.00 0.00 X 584122 0 29199 Bruce Whitfield Former CFO 0.00 0.00 X 0 162221 1117 4426425 21169375 5310844 138 1 1 0 Broadway Imaging LLC 554 West Broadway Missoula MT 59806 Imaging Services 16405135 Western MT Emergency Phys PO Box 4506 Missoula MT 59802 ER Physicians 5876588 Metro Aviation Inc PO Box 7008 Shreveport LA 71137 Helicopter Maintenance 2605909 Montana Cancer Specialists PO Box 7877 Missoula MT 59802 Cancer Specialist Services 1889965 Bouten Construction 627 N Napa Street Spokane WA 99220 Construction Services 1306619 67 2000 639270 3053997 3695267 Acute Care - Inpatient 622110 117496612 117496612 Acute Care -Outpatient 621400 109389185 109389185 Primary Care 621110 34545954 34545954 Joint Ventures 900099 6080773 6080773 267512524 871616 871616 2947190 3811978 -864788 -864788 -864788 20515687 19508794 1006893 1006893 1006893 244083 221261 22822 22822 Imaging Services 900099 1829649 1829649 Laboratory 900099 419507 419507 Pharmacy 900099 224612 224612 1695152 101254 1593898 4168920 276413254 270087546 0 2630441 X 1134007 1134007 39305 39305 945494 658258 287236 95567564 80260338 15307226 6659442 5662392 997050 14660716 11479172 3181544 6722458 5403883 1318575 451825 451825 734737 839 733898 1966 1966 108145 108145 42943660 38695290 4248370 788509 788509 3821750 3010557 811193 6632059 592312 6039747 4656310 3852445 803865 658655 457760 200895 192610 140776 51834 2459336 2459336 19148852 19148852 9112277 7110852 2001425 3380746 3354777 25969 Medical Supplies 45836981 45836981 License and Taxes 2233800 2221390 12410 Bad Debts 1519611 1519611 Dues & Subscriptions 642837 286576 356261 533370 300183 233187 271587022 215265549 56321473 0 113329 142761 1544081 1239318 42486445 45269269 11889664 11429919 5044127 5518645 1629555 221066 228676028 144805326 80821360 83870702 32907447 34048903 13172722 11842293 43347314 58783300 232956044 252366176 21829396 24219179 74396 17623 55411286 53034998 34507878 57766146 111822956 135037946 X 117230295 112892347 2984846 3468261 917947 967622 121133088 117328230 232956044 252366176 X 4826232 -474191 -8156899 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 1966 0 0 1 1966 0 Part II-B, Line 1: The portion of monthly dues paid to the Montana Hospital Association designated for lobbying. 10594524 10594524 98597569 60402025 38195544 2464633 2025363 439270 108656052 82377938 26278114 8363250 8363250 83870702 Unamortized Bond Financing Costs 403961 Cash Surrender Value of Life Insurance 56316 Due from Affiliates 52505933 Other Receivables 4560327 Third Party Settlements 989737 Trustee Held Funds 11 EHR Medicare Incentive Receivable 267015 58783300 Due to Affiliates 48561260 Bond Premium Discount 1201881 Obligation for Financing Lease 5737500 Capitalized Lease Obligation 1501334 Third Party Settlements 764171 57766146 X Part X, Line 2: The Health System recognizes the effect of income tax positions only if those positions are more likely than not of being sustained upon an audit by the taxing authority. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. 1 1 1 X 1 X 1 1 1 0 1 1 0 0 15790153 15790153 0.05850 0 0 19869244 12427550 7441694 0.02760 0 0 14254 16076 -1822 0.00000 35673651 12443626 23230025 0.08610 0 0 163270 163270 0.00060 0 0 1375712 1375712 0.00510 0 0 21685383 10640164 11045219 0.04090 0 0 60334 60334 0.00020 0 0 4007 4007 0.00000 23288706 10640164 12648542 0.04680 58962357 23083790 35878567 0.13290 0 0 6810 6810 0.00000 0 0 60000 60000 0.00020 0 0 20827 20827 0.00010 87637 87637 0.00030 1 1519611 133536975 103807536 29729439 X 1 1 1 NONE 1 1 Providence St Patrick Hospital 500 West Broadway Missoula MT 59802 montana.providence.org 13200 X X X X Rehab and Psych Providence St Patrick Hospital 1 1 X X X X X X X X X 12 1 1 1 X http://montana.providence.org/hospitals/ X X X X X X 1 0 1 1 100.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 X X X 1 X 0 1 Providence St. Patrick Hospital Part V, Section B, Line 3: The Community Health Assessment workgroup included representatives from the Missoula City-County Health Department, Community Medical Center, St. Patrick Hospital, Partnership Health Center, Air Quality Advisory Council, Curry Health Center, Maternal Child Health Advisory Council, Missoula Aging Services, Missoula Indian Center, Water Quality Advisory Council, WORD, Inc. and the YWCA. Providence St. Patrick Hospital Part V, Section B, Line 4: Providence St. Joseph Medical Center Providence St. Patrick Hospital Part V, Section B, Line 14g: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office. Providence St. Patrick Hospital Part V, Section B, Line 18e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence St. Patrick Hospital Part V, Section B, Line 20d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family. Providence St. Patrick Hospital Part V, Section B, Line 22: For non medically necessary services a patient may be charged full billed charges. 1 Broadway Building 500 West Broadway Missoula MT 59802 Outpatient Services Part I, Line 3c: The PH&S sliding fee scale will be used to determine the amount to be written off as charity care for guarantors with income between 101% and 400% of the current federal poverty level after all funding possibilities available to the guarantor have been exhausted or denied and personal financial resources and assets have been reviewed for possible funding to pay for billing charges. Part I, Line 6a: In addition to providing its own smaller Community Benefit Report, St. Patrick's Community Benefit information is included in the consolidated report for Providence Health & Services.www.saintpatrick.org/index.aspx/Serving_Our_Community/Community_Benefit_Reports 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 $ 1,519,611. Part II, Community Building Activities: Physical Improvements/Housing: Habitat for HumanityThe 2009-2013 Consolidated Plan for the City's Community Development Block Grant indicates that the development of supportive housing initiatives for special populations, e.g. single income families, people with disabilities, seniors and persons with HIV/AIDS, present the greatest need in Missoula county. In 2000, 25% of area owners and 51% of renters paid more than 30% of their incomes for housing; by 2007, 40% of homeowners and more than 59% of renters paid more than 30% of their incomes on housing in Missoula County. In 2007, an estimated 23.3% of the city's residents were living at or below the federal poverty standard. Half of all the single parent families headed by women live below the poverty threshold and more than 70% of the female headed families with children younger than six live in poverty. Having a safe and affordable place to live is critical to the overall health of the individual, family and community, therefore supporting housing initiatives for vulnerable populations is enhancing public health. The funding provided by St. Patrick Hospital for the Habitat Home was for addressing the need of one single mother with four children. Additionally, St. Patrick Hospital participates and supports other community-wide housing efforts, such as the At Risk Housing Coalition and the North Missoula Community Land Trust housing program. Community Support: Kids Table St. Patrick Hospital partners with the Kid's Table, a program of the Missoula Food Bank that provides nutritious meals for children during the summer months when they are unable to access a meal at school. This program is helping address childhood hunger because kids who grow up with the threat of hunger are more likely to underperform in school, and are at higher risk of a number of health-related issues that range from obesity and diabetes to depression and anxiety.Community Health Improvement/Advocacy: Medication and enrollment assistance for health coverageUninsured patients often do not fill critical prescriptions due to cost and forego care due to lack of coverage, which affects their long term health. This program assists low income and self pay patients with the assistance they need to access patient assistance programs of pharmaceutical companies and state/federal coverage options. With the high uninsured rate in Missoula County at 19%; the total number of seniors living in poverty at 69% and the many patients with mental illness that St. Patrick Hospital serves, we work to bridge patient needs with programs that can support them.In addition to the free and discounted care that we provide, we also have State Health Insurance certified counselors trained to assist uninsured and underinsured residents in our community in securing options for both medical (ACA) and pharmaceutical coverage. This program is not done for marketing purposes and meets a necessary public health objective.Community Health Improvement: Environmental StewardshipGreen 4 Good (G4G) is the program at St. Patrick Hospital to help decrease the environmental impacts of our daily healthcare work. As a hospital, we are charged with caring for people in times of need; requiring resources such as supplies, heat, and electricity to do so. At the same time, healthcare causes pollution through its energy use, waste creation and use of toxic chemicals. Through G4G, St. Patrick Hospital works to reduce impacts to the natural environment, in turn creating a healthier environment for patients, staff members, and communities. Activities include efforts to reduce energy consumption, waste (Waste Overhaul) to streamline commingled recycling, expand pharmaceutical waste disposal, improve segregation of infectious waste), Toxic Chemicals and Engagement for both internal and external customers. The Kids Ride Free program is a community sponsored program of Mountain Line public transportation system that seeks to provide children transportation that removes barriers for participation in educational, summer feeding programs and other critical services in the community. St. Patrick Hospital also sees the Kids Ride Free program as an important part of our Green for Good environmental initiative as well. The support of both of these programs is meeting a public health objective and not done for marketing purposes. Part III, Line 4: It is Providence's policy to exclude all bad debts from Community benefit information.The Consolidated Audited Financial Statements do not contain a footnote specific to Bad Debt Expense.Bad debt expense is reported in the audited financials as a separate line item within expenses from operations. Bad debt expense represents the amount of gross charges for patients who do not have insurance and which Providence was unable to qualify for assistance under either government programs or our internal charity care policy. Part III, Line 8: The amount reported on Part III, Section B, line 6, was determined by applying the Cost-to-Charge Ratio to the Medicare revenue. Part III, Line 9b: Billing and Collection PracticesProvidence has written policies about when and under whose authority patient debt is advanced for collection, and uses its best efforts to ensure that patient accounts are processed fairly and consistently.Providence ensures that practices to be used by their outside (non-hospital) collection agencies conform to the standards set forth in this policy, and obtains written commitments from such agencies that they will adhere to those standards. Providence also conducts an assessment of each collection agency's adherence to the policy. Such assessments are conducted at least annually.At time of billing, we provide to all low-income uninsured patients the same information concerning services and charges provided to all other patients who receive care at the hospital.When sending a bill to a patient, Providence includes a) a statement that indicates that if the patient meets certain income requirements the patient may be eligible for a government-sponsored program or for financial assistance from the hospital; and b) a statement that provides the patient with the name and telephone number of a hospital employee or office from whom or which the patient may obtain information about Providence's financial assistance policies for patients and how to apply for such assistance.Any patient seeking financial assistance from Providence (or the patient's legal representative) provides the individual facility with information concerning health benefits coverage, financial status (i.e. income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs.For patients who have an application pending determination for either government-sponsored coverage or for the hospitals own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency.Eligibility for financial assistance will be determined as closely as possible to the date of service. Part VI, Line 2: We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care. Part VI, Line 3: Communication to the Public:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients. Part VI, Line 4: The Western Montana Region of Providence Health & Services is one of Montana's largest health care providers. Our not-for-profit network includes hospitals, physicians, clinics, care centers, hospice and home health programs and diverse community services across western Montana. With more than 40 clinics and two hospitals statewide, our ministries work together to provide quality care to all, with a special focus on the poor and vulnerable. Since our beginnings in Missoula in 1873, we have worked collaboratively across traditional boundaries to develop patient-focused practices to help make lifelong quality care accessible and affordable. The hospital serves a primary service area of about 200,000 people in western Montana and 400,000 others in contiguous areas. St. Patrick Hospital provides cardiac and neurosurgical services along with other acute inpatient medical/surgical services and inpatient rehabilitation and neurobehavioral medicine. St. Patrick Hospital operates the only level 2 Trauma Center in Western Montana and has accredited chest pain, stroke and child advocacy programs (FirstSTEP).At St. Patrick Hospital, 53% of patients are covered by Medicare, another 7% are covered by Medicaid and 7% are self-pay and uninsured. St. Patrick Hospital serves a higher percentage of older adults, with 15% of the primary service area's population over the age of 65. With approximately 16% of the population living in poverty, the community is characterized by lower income levels than the national average. Part VI, Line 5: Providence Medical Group manages 32 primary care and specialty provider practices, employing 133 total providers. St. Patrick Hospital, St. Joseph Medical Center and Providence Medical Group collectively build and support coordinated services across the continuum of care to meet regional residents' needs, while mutually supporting organizational, operational, and fiscal health. Joint ventures include research collaborations (cardiac, neuroscience, and oncology) with the University of Montana; affiliations with long term care facilities; a federally qualified health center and a surgery center, among others. The associated providers with Providence Medical Group ensured increased access to primary care with 154,709 patient encounters and have made those services affordable through a patient financial assistance program. St. Patrick Hospital management is directed by an independent governing board which helps direct the hospital in its Mission to serve the community. The composition of the governing board represents the diversity of the community by having representatives from local government, social service agencies, medical providers, independent business representatives and interested community members. The St. Patrick Hospital Board reviews and develops the community benefit plan, providing information and insight into community needs and resources and helping set priorities for what community needs are to be addressed. They also receive regular updates on the overall community benefit strategy and specific programs to assess whether the organization is having an impact on the health of the community. The Institute of Medicine and Humanities is a joint program of The University of Montana and St. Patrick Hospital. The institute fosters the human dimensions of health care by working at the interface of the humanities and medicine. Since its inception in 1987, the Institute of Medicine and Humanities has employed both the traditional humanities and the fine arts to illuminate and understand major issues that confront health care in contemporary society. As medicine has changed, the institute has also evolved its focus to look more broadly at opportunities to make a difference through education in the health care environment with an emphasis on health, as opposed to health care specifically. This includes education of the public about important health care issues; education of undergraduates interested in the health care profession; and education of graduate level nursing, pharmacy and medical students in ethics, collaborative care and team building and conflict resolution. Part VI, Line 6: 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.As a ministry of Providence Health & Services, St. Patrick Hospital is guided by a Mission and set of core values based on Catholic health care and inspired by the legacy of the Sisters of Providence. As one Catholic health system committed to caring for the poor and vulnerable, Providence Health & Services has developed a single framework for consistently reporting charity care and community benefit. Our responsibility to stewardship drives us to a standardized approach to supply chain so that we can deliver excellent patient care while reducing the cost of delivered supplies. Our commitment to respect and fairness means Providence has a system-wide compensation policy. Locally, Providence St. Joseph Medical Center is empowered to apply these policies to meet the local needs of their community. St. Patrick Hospital has affiliate relationships with the following critical access hospitals in western Montana: Community Medical Hospital in Anaconda; Clark Fork Valley Hospital in Plains and Granite County Hospital in Phillipsburg. These critical access hospitals are limited service hospitals designed to provide essential services to rural communities. St. Patrick Hospital supports its rural community hospitals by allowing them to purchase supplies and medical equipment at a very low cost due to the purchasing abilities of the whole Providence system. These critical access hospitals are able to maintain access to critical medical services in very rural counties by Providence's support, in fact, every one of these hospitals is located in a county that has the federal designation as health provider shortage areas. St. Patrick Hospital conducts local assessments to make sure the needs of the community are met. The community board of directors oversees and approves the annual community benefit plan that addresses the health care disparities within the community. The community benefit plan is developed and reviewed annually to ensure that the proposed outcomes are being met. This plan is implemented in concert with others in the community to increase the accountability that we share with them to improve the health of our community and to not duplicate services. 1 St Patrick Hospital Foundation 900 N Orange Suite 201 Missoula MT 59802 237056976 501 (C)(3) 542148 Contribution for Operational Support Deer Lodge Medical Center 1100 Hollenback Ln Deer Lodge MT 59722 810469886 501 (C)(3) 314469 EPIC Setup Costs Loyola Sacred Heart High School 320 Edith Missoula MT 59801 810244544 501 (C)(3) 50000 Support Catholic Education The Poverello Center 535 Ryman St Missoula MT 59802 237439391 501 (C)(3) 50000 Support service to hungry & homeless Missoula County United Way 412 W Alder St Missoula MT 59807 810287854 501 (C)(3) 42500 Community Benefit Partnership Health Care 323 W Alder Missoula MT 59802 363843543 501 (C)(3) 35000 Support Healthcare in Community Catholic Social Services Of Montana PO Box 907 Helena MT 59801 920037322 501 (C)(3) 35000 Serving Catholic social services in MT Missoula Aging Service 337 Stephens Ave Missoula MT 59801 810379543 501 (C)(3) 28950 Support community service for the aging 8 0 Medication Assistance to low income patients 698 0 39305 Cost Medication Assistance to low income patients. Part I, Line 2: In the application for support, 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. 1 1 0 0 0 0 0 0 0 John F Koster MD - Thru 0313 President / CEO 0 1316766 0 1868461 0 17500 0 215651 0 31597 0 3449975 0 0 Rod F Hochman MD - Eff 0413 President / CEO 0 1051406 0 334001 0 17500 0 486988 0 28915 0 1918810 0 0 Todd Hofheins EVP/CFO 0 432363 0 120504 0 17500 0 65303 0 24807 0 660477 0 0 Jeffrey W Rogers - Thru 513 Corporate Secretary 0 442462 0 529200 0 69119 0 168789 0 21091 0 1230661 0 0 Cindy Strauss - Eff 613 SVP/Chief Counsel/Corp. Secretary 0 413323 0 525001 0 17500 0 223587 0 24667 0 1204078 0 0 Jeffrey Fee CEO/St. Patrick Hospital 0 359850 0 102500 0 0 0 142677 0 22619 0 627646 0 0 Kirk Bodlovic CFO/St. Patrick Hospital 0 168746 0 10807 0 0 0 15801 0 19012 0 214366 0 0 Terry L Smith SVP/Management Svcs 0 639022 0 906428 0 67500 0 202105 0 24053 0 1839108 0 0 Deborah Burton SVP/Chief Nrsg. Officer 0 323817 0 1005792 0 17500 0 42736 0 23303 0 1413148 0 296416 Michael L Butler President/Operations & Services 0 954645 0 300598 0 17500 0 713468 0 29161 0 2015372 0 0 Randy Axelrod MD EVP/Clinical & Patient Svcs 0 613884 0 315700 0 125675 0 192796 0 26894 0 1274949 0 0 Janice J Jones SVP/CAO 0 604348 0 377853 0 17500 0 132205 0 27288 0 1159194 0 0 Myron Berdischewsky MD SVP/CMQO 0 527449 0 310561 0 17500 0 134979 0 23598 0 1014087 0 0 Jack Friedman SVP/Account Care & Payor Rel. 0 508016 0 300765 0 17500 0 151382 0 26370 0 1004033 0 0 Ray Williams SVP/Physicians Svcs 0 120595 0 200000 0 440672 0 179162 0 24427 0 964856 0 0 Cindra R Syverson SVP/CHRO 0 404069 0 312381 0 1000 0 267888 0 24300 0 1009638 0 0 Craig L Wright MD SVP/Physicians Svcs 0 509167 0 128777 0 70854 0 432646 0 18991 0 1160435 0 0 John O Mudd SVP/Mission Leadership 0 368604 0 158842 0 14800 0 189558 0 18700 0 750504 0 0 Claudia Haglund VP/Governance & Sponsorship 0 342176 0 134699 0 17500 0 136830 0 20219 0 651424 0 0 Joel S Gilbertson SVP/Comm.Ptrshp & External Affairs 0 354361 0 84733 0 17500 0 103698 0 22547 0 582839 0 0 David Brown VP/Strategy & Innovation 0 303119 0 131437 0 50 0 146627 0 22332 0 603565 0 0 Orest Holubec SVP/Marketing & Communications 0 328545 0 77915 0 17500 0 39407 0 21903 0 485270 0 0 Gary Flaming SVP/Chief Risk Officer 0 266837 0 97434 0 17500 0 75446 0 18848 0 476065 0 0 Mark Wakai Chief Operations & Strategy Ofc 269951 0 57831 0 5149 0 17027 0 18215 0 368173 0 0 0 Joyce Dombrouski RN Chief Acute Svc. Ofc. 221270 0 44638 0 17758 0 24634 0 16124 0 324424 0 0 0 Craig Aasved Chief Mgmt. Svcs. Ofc. 234240 0 37331 0 0 0 15665 0 17902 0 305138 0 0 0 James M Maxwell MD Physician - Surgical 647556 0 255474 0 33500 0 31875 0 20958 0 989363 0 0 0 Mark L Sanz MD Physician - Cardiology 642855 0 82608 0 17600 0 26517 0 20335 0 789915 0 0 0 James T Maddux MD Physician - Cardiology 631694 0 0 0 46346 0 18124 0 21193 0 717357 0 0 0 George T Bandow MD Physician 413061 0 183441 0 0 0 8000 0 18588 0 623090 0 0 0 Peter Szekely MD Physician 73347 0 493275 0 17500 0 11475 0 17724 0 613321 0 0 0 Bruce Whitfield Former CFO 0 0 0 0 0 162221 0 1117 0 0 0 163338 0 0 Part I, Line 1a The reporting organization did not provide any of the benefits listed in Part I, Line 1a. However, as part of Providence's philosophy of transparency, the narrative that follows relates to the compensation and benefits provided by the related organization. Providence Health & Services Expense Reimbursement Procedures include the following policies: First Class Travel or Charter Travel or Travel of Companions Air travel is reimbursable for tourist or economy class and should be at the least expensive airfare; which permits departures and arrivals at reasonable times and reasonable distance traveled. Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class air travel will only be reimbursed when tourist or economy class air travel is not available and business travel is mandated by a supervisor. In the rare circumstance that an executive must fly on a first class full fare ticket, their senior level supervisor must approve this expense. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approved by the Executive Vice President, Chief Human Resource Officer. Spouse or Companion Travel Travel expenses incurred by a PH&S employee's spouse or companion will not be reimbursed by PH&S unless the spouse or companion is required to, or invited to attend a PH&S System-sponsored meeting. These expenses may be considered a taxable benefit by the IRS and if so, will be included on the employee's W- 2. During 2013, none of the Officers, Directors or Key Employees listed on Form 990, Part VII utilized First Class or Companion Travel. Tax Indemnifications or Gross-Up Payments Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2013, the following Key Employee received gross-up payments: Craig Wright, MD - Relocation The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding "rent" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The Executive Vice President/Chief Human Resources Officer may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2013, the following Key Employees received relocation/housing program payments: Craig Wright, MD Ray Williams Terry Smith Randy Axelrod The amounts reported for these relocation/housing payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Part I, Lines 4a-b NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan C) ESP = Elective Survivor Plan 1) John F. Koster, MD a) Taxable SERP Earned but not Paid- $350,711 b) SERP Interest Credit - $191,190 2) Rod Hochman, MD a) SERP Earned but not Vested- $444,760 b) SERP Interest Credit - $24,378 3) Todd Hofheins a) SERP Earned but not Vested - $57,974 4) Jeffrey W. Rogers a) Taxable SERP Earned but not Paid - $44,111 b) SERP Interest Credit- $97,420 c) ESP Interest Credit - $7,567 5) Cindy Strauss a) SERP Earned but not Vested - $190,313 b) SERP Interest Credit - $14,149 6) Terry Smith a) Taxable SERP Earned but not Paid - $67,662 b) Taxable CBRP Earned but not Paid - $147 c) Non-Taxable CBRP Earned but not Paid - $353 d) ESP Interest Credit - $5,823 e) SERP Interest Credit - $118,609 7) Debbie Burton a) Taxable SERP Earned but not Paid - $915,149 b) SERP Interest Credit - $20,728 8) Mike Butler a) SERP Earned but not Vested - $478,094 b) SERP Interest Credit - $201,306 9) Randy Axelrod, MD a) SERP Earned but not Vested- $181,321 10) Jan Jones a) Taxable CBRP Earned but not Paid - $84 b) Taxable SERP Earned but not Paid - $148,227 c) Non-Taxable CBRP Earned - $101 a) SERP Interest Credit - $100,997 11) Myron Berdischewsky, MD a) Taxable CBRP Earned but not Paid - $2,548 b) Taxable SERP Earned but not Paid - $108,227 c) Non-Taxable CBRP Earned - $2,060 d) SERP Interest Credit - $105,170 12) Jack Friedman a) Taxable SERP Earned but not Paid - $54,169 b) SERP Interest Credit - $100,470 13) Ray Williams a) SERP Interest Credit - $12,906 b) SERP Earned but not Vested - $153,506 14) Cindra Syverson a) SERP Earned but not Vested - $144,043 b) SERP Interest Credit - $103,147 15) Craig Wright, MD a) SERP Earned but not Vested - $221,797 b) SERP Interest Credit - $181,734 16) Jack Mudd a) Taxable SERP Earned but not Paid - $50,004 b) SERP Interest Credit - $165,857 17) Claudia Haglund a) Taxable SERP Earned but not Paid - $35,007 b) SERP Interest Credit - $70,109 c) ESP Interest Credit - $2,161 18) Joel Gilbertson a) SERP Earned but not Vested - $52,868 b) SERP Interest Credit - $32,392 19) David Brown a) SERP Interest Credit - $39,209 b) SERP Earned but not Vested - $80,917 20) Orest Holubec a) SERP Interest Credit - $6,443 b) SERP Earned but not Vested - $21,490 21) Gary Flaming a) SERP Interest Credit - $4,233 b) Taxable SERP Earned but not Paid - $17,362 c) Taxable CBRP Earned but not Paid - $1,640 d) Non-Taxable CBRP Earned - $4,730 22) Jeffrey Fee a) SERP Earned but Not Vested - $85,008 b) SERP Interest Credit - $39,695 23) James M. Maxwell, MD a) Taxable CBRP Earned but not Paid - $188,807 24) Mark L. Sanz, MD a) Taxable CBRP Earned but not Paid - $42,608 25) George T. Bandow, MD a) Taxable CBRP Earned but not Paid - $73,272 Part I, Lines 4a-b Severance 1) Ray Williams - $376,916 2) Bruce Whitfield - $162,221 FORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS PROGRAM The Providence Executive Incentive Program provides a lump sum award annually as a percent of the executive's base pay. Percent opportunities are aligned with our total compensation philosophy as outlined in Part VI, Section B, Line 15 (Process for determining compensation of top management, officers & key employees). The performance award is based on the level of accomplishment of annual system objectives and personal objectives. In 2013, 50 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's five strategic priorities of: mission driven, financially responsible, people centered, service oriented and EPIC watchlist. In 2013 the percent allocation for each of these strategic priorities was: Mission driven 5% Financially responsible 15% People centered 10% Service oriented 10% EPIC Watchlist 10% To ensure affordability of the program, the organization (system, region or entity) must meet a threshold of 50 percent of budgeted net operating income. A Montana Facility Finance Authority 810302402 61204KCB5 2006-06-22 60097553 Refunded Series 1999 Bonds - 7/20/99; Refunded Series 2002 Bonds - 8/7/02 0 0 0 A 5140000 60097553 642381 59447664 2002 0 1 1 1 A 0 0 0 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: Montana Facility Finance Authority Date the Rebate Computation was Performed: 06/22/2011 SCHEDULE K, PART IV, LINE 2C The most recent rebate computation for the bonds was completed through June 22, 2011. Form 990, Part VI, Section A, line 6 The sole Member of the Corporation is Providence Health & Services, a Washington not-for-profit corporation. Form 990, Part VI, Section A, line 7a The powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause. Additionally, the Member may appoint and remove the President/CEO with or without cause, after requesting a recommendation for the Board of Directors. Form 990, Part VI, Section A, line 7b The following powers reside with the Member: * To adopt or change the mission, philosophy, and values of the Corporation. * To amend or repeal the Articles of Incorporation and the Bylaws of the Corporation. * To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale, transfer, assignment or encumbering of the assets, in excess of a specified amount. * To approve the dissolution and/or liquidation or the consolidation or merger of the Corporation. * To approve the annual operating and capital budget and approval any deviations from the budget exceeding a specified amount. * To appoint the Corporation's certified public accountants after receiving recommendation of the Board of Directors. * To approve the closure of any institution or major ministry or work within this Corporation. Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict. Form 990, Part VI, Section B, line 15b It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are 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. 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 written 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 Jeffrey Fee - 500 West Broadway, Missoula, MT 59802. Kirk Bodlovic - 500 West Broadway, Missoula, MT 59802. Mark Wakai - 500 West Broadway, Missoula, MT 59802. Joyce Dombrouski, RN - 500 West Broadway, Missoula, MT 59802. Craig Aasved - 500 West Broadway, Missoula, MT 59802. Form 990, Part IX, line 11g Agency/Contract Labor: Program service expenses 990,975. Management and general expenses 1,533,510. Fundraising expenses 0. Total expenses 2,524,485. Medical Director & Med Physician Fees: Program service expenses 11,240,547. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,240,547. Repairs & Maintenance: Program service expenses 1,960,297. Management and general expenses 518,658. Fundraising expenses 0. Total expenses 2,478,955. Billing & Collections: Program service expenses 0. Management and general expenses 5,720. Fundraising expenses 0. Total expenses 5,720. Transcription & Translation Services: Program service expenses 61,000. Management and general expenses 3,000. Fundraising expenses 0. Total expenses 64,000. Dietary: Program service expenses 3,259. Management and general expenses 18,228. Fundraising expenses 0. Total expenses 21,487. Other Patient Services: Program service expenses 18,166,500. Management and general expenses 16,849. Fundraising expenses 0. Total expenses 18,183,349. Other Administrative Services: Program service expenses 5,280,166. Management and general expenses 1,309,671. Fundraising expenses 0. Total expenses 6,589,837. General Consulting Fees: Program service expenses 992,546. Management and general expenses 842,734. Fundraising expenses 0. Total expenses 1,835,280. Form 990, Part XI, line 9: Recipient Organization Adjustment 533,091. Interaffiliate Equity Transfer -7,001,611. Foundation Revenue from Balance Sheet -13,720. Interaffiliate Expenses -1,674,663. Rounding 4. FORM 990, PART XII, LINE 2C - AUDIT & COMPLIANCE The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the System's 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 IX, COLUMN D FUNDRAISING EXPENSES This entity had no fundraising expenses as all fundraising is handled through an affiliated Foundation. FORM 990, PART I, LINE 6 - VOLUNTEERS Volunteers are engaged in the following activities: * Guild Spring Luncheon * Guild Regional Meeting (selected & prepared favors, arranged breakfast & menus) * New service in International Heart Institute * Shamrock Shops * Guild Annual Meeting and Luncheon * Archiving * Hospitality, social events & special projects FORM 990, PART VII - RELIGIOUS COMMUNITY MEMBERS As members of the Religious Community, each Sister has taken a vow of poverty as a compulsory part of her religious life. Any compensation for services of a Sister inures only for the benefit of the Community, not the individual members. All payments for services are made directly to the Religious Community. FORM 990, PART V, LINE 1 - ISSUANCE OF FORM 1099 All 1099s for 2013 were issued by Providence Health & Services - Washington #51-0216586. Therefore, none are shown for the reporting organization. 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 I N/A 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 1 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 747 Broadway Seattle WA 98122 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 I PH&S Western Washington 0 Inland Northwest Health Services 601 W 1st Avenue Spokane WA 99201 911307555 Healthcare WA 501( c)(3) Line 3 PH&S - Washington 0 PHN Holdings 20555 Earl Street Torrance CA 90503 461814184 Strategic/Planning services for PHN CA 501( c)(4) Pending PHS - So California 0 Providence Health Network 20555 Earl Street Torrance CA 90503 800886966 Prepaid Healthcare CA 501( c)(4) Pending PHN Holdings 0 Alpha Medical Laboratory LLC 611 N Perry Spokane WA 99202 912017347 Outpatient Lab ID N/A Broadway Imaging LLC 500 W Broadway Missoula MT 59802 522405971 Medical Imaging MT PH&S - MT Related 7148938 5571103 0 1 0.75000 California Laboratory Associates LLC 501 Buena Vista Burbank CA 91505 273888692 Outpatient Lab CA N/A Center for Specialty Surgery LLC 11782 SW Barnes Rd Portland OR 97225 263638838 Ambulatory Surgery Center OR N/A Clackamas Radiation Oncology Center LLC 4400 NE Halsey St Bldg II 495 Portland OR 97213 260381897 Radiation Oncology OR N/A Ctr for Med Imaging-Bridgeport LLC 4400 NE Halsey St Bldg II 495 Portland OR 97213 260796953 Imaging - Diagnostics OR N/A Ctr for MedImaging-Tanasbourne LLC 4400 NE Halsey St Bldg II 495 Portland OR 97213 200477972 Imaging - Diagnostics OR N/A Greater Valley Medical Building LP 501 S Buena Vista St Burbank CA 91505 954570858 Real Estate - MOB CA N/A Medalia Healthcare LLC 1801 Lind Ave SW 9016 Renton WA 98057 911660459 Physician Benefits WA N/A Minor & James Medical PLLC 515 Minor Avenue 200 Seattle WA 98104 911340223 Physician Clinic WA N/A Mountainstar Clinical Laboratories LLC 611 N Perry Spokane WA 99202 261345983 Outpatient Lab MT N/A Oregon Advanced Imaging LLC 881 OHare Parkway Medford OR 97504 450471748 Medical Imaging OR N/A Oregon Outpatient Surgery Center 7300 SW Childs Rd Tigard OR 97224 223883387 Ambulatory Surgery Center OR N/A PacLab LLC 611 N Perry Spokane WA 99202 911743952 Outpatient Lab WA N/A Pathology Associates Medical Laboratories LLC 611 N Perry Spokane WA 99202 270943279 Outpatient Lab WA N/A PETCT Imaging at Swedish Cancer Institute LLC 1221 Madison Street Seattle WA 98104 203132044 Medical Imaging WA N/A Portland Medical Imaging LLC 4400 NE Halsey St Bldg II 495 Portland OR 97213 201054971 Imaging - Diagnostics OR N/A Prov Radiation Oncology Develop Assn LLC 4401 NE Halsey St Bldg II 495 Portland OR 97213 260682491 Real Estate - MOB OR N/A Providence Imaging Center 3340 Providence Drive Anchorage AK 99508 920118807 Medical Imaging AK N/A Providence Partners for Health LLC 501 S Buena Vista St Burbank CA 91505 454041798 Clinical Quality & Integration CA 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 Southern Idaho Regional Laboratory LLC 611 N Perry Spokane WA 99202 820511819 Outpatient Lab ID 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 0 1 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 St Patrick Hospital Foundation B 542148 Cost St Patrick Hospital Foundation C 582498 Cost Caron Health Corporation Q 2482328 Cost Providence St Joseph Medical Center Q 46761 Cost