2014-11-17T11:38:56-06:00 2013-12-31 911194016 Clark Nuber PS 10900 NE 4th Suite 1700 Bellevue WA 98004 990 2013-01-01 953544877 PROVIDENCE HEALTH & SERVICES FOUNDATION SAN FERNANDO & SANTA CLARITA VALLEYS SA PROV 8188473024 501 SOUTH BUENA VISTA STREET BURBANK CA 915054809 Patricia Modrzejewski President 8188473024 2014-11-17 1 Sara Elizabeth J Hyre CPA P00235495 4254544919 2013 2015-11-30 17:44:51Z Patricia Modrzejewski 501 SOUTH BUENA VISTA STREET BURBANK CA 915054809 24517263 0 X www.providencepowerofgiving.org X 1980 CA Support Providence St.Joseph Med. Center, Holy Cross Med. Center and Tarzana Med. Center. 22 19 0 356 0 0 16981235 15547969 0 0 1104342 1108310 171023 139675 18256600 16795954 5223893 4262144 0 0 3042203 3224582 30886 18585 3603662 925764 1123572 9222746 8628883 9033854 8167071 53540359 61591999 1480671 2102160 52059688 59489839 X Support Providence St. Joseph Medical Center, Providence Holy Cross Medical Center and Providence Tarzana Medical Center. As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service. 0 0 4262144 4262144 0 The purpose of Providence Health & Services Foundation SF&SCV SA is to raise funds primarily for Providence Saint Joseph Medical Center, Providence Holy Cross Medical Center, and Providence Tarzana Medical Center. The medical centers are committed to their missions of continuing the healing ministry of Jesus in the world of today, with special concern for those who are poor and vulnerable. The medical centers work in partnership with community organizations to reach out to those in need. Through these collaborative efforts, they improve access to health care and provide health education resources in the surrounding communities. During 2013, some of the larger grants paid to the three medical centers were used for the neuroscience/stroke research center at Saint Joseph ($834,853), the new patient wing at Holy Cross ($800,000), the First 5 LA-Welcome Baby program at Holy Cross ($403,007), critical care transport to the emergency room at Saint Joseph ($257,870) and emergency department outreach at Holy Cross ($218,189). 4262144 1 1 0 0 0 1 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 1 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 X 3 1 1 0 0 0 0 0 0 1 1 0 0 0 1 0 X 22 19 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X GERTIE MCDEVITT 8188473024 501 S Buena Vista Street Burbank CA 91505 X Norman Coulson Chair 3.00 0.00 X X 0 0 0 Thomas Bruehl Vice Chair 3.00 0.00 X X 0 0 0 Gerald S Puchlik Secretary 3.00 0.00 X X 0 0 0 Edward A Romano Treasurer 3.00 0.00 X X 0 0 0 Patricia E Modrzejewski President 40.00 15.00 X X 0 393931 34581 Lee Kanan Alpert Director 3.00 0.00 X 0 0 0 William Baribault - Eff 213 Director 3.00 0.00 X 0 0 0 Sister Sheila Browne Director 3.00 0.00 X 0 0 0 Honorable Mitch Englander Director 3.00 0.00 X 0 0 0 Bruce Ferguson - Eff 213 Director 3.00 0.00 X 0 0 0 Albert J Ghirardelli Esq Director 3.00 0.00 X 0 0 0 Earl Greinetz Director 3.00 0.00 X 0 0 0 Bradley D Howard Director 3.00 0.00 X 0 0 0 Michael Hunn Director 3.00 57.00 X 0 1050356 120379 Robert J Kelley Director 3.00 0.00 X 0 0 0 Peter J Lynch Director 3.00 0.00 X 0 0 0 Michael J Madden Director 3.00 0.00 X 0 0 0 Richard Marciniak Director 3.00 0.00 X 0 0 0 Raffi-Jean MesrobianMD Director 3.00 0.00 X 0 1000 0 Michael S Overing Esq Director 3.00 0.00 X 0 0 0 Dale Surowitz Director 3.00 56.00 X 0 540243 227914 Maria O Uribe Director 3.00 0.00 X 0 0 0 0 1985530 382874 0 0 1 0 0 585 817074 4616759 403007 9710544 2345230 15547969 716665 716665 7031989 6640344 391645 391645 391645 461737 817074 481875 -20138 -20138 65265 10000 55265 55265 693638 589090 104548 104548 16795954 0 0 1247985 4126816 4126816 135328 135328 322114 48317 273797 2291512 343727 1947785 610956 91644 519312 44161 44161 31496 23622 7874 18585 18585 114324 85743 28581 133483 9812 123671 230513 230513 259582 54263 205319 35417 5313 30104 150419 22563 127856 70008 70008 18919 2838 16081 Dues & Subscriptions 34844 5227 29617 406 406 8628883 4262144 763077 3603662 898536 719609 636884 3340890 4367252 4324968 1168495 409876 32869 44038 127672 131248 12886 21819 1581945 286436 1264543 1295509 31809742 37877647 13221480 13426395 53540359 61591999 102690 161860 5000 1372981 1940300 1480671 2102160 X 25672688 31194839 23235000 24921000 3152000 3374000 52059688 59489839 53540359 61591999 X 8167071 -712875 -24045 X X 0 1 X 1 0 X 6799417 16600084 12090110 16981235 15547969 68018815 6799417 16600084 12090110 16981235 15547969 68018815 10095759 57923056 1158187 833103 1133038 785716 716665 4626709 99040 24019 118170 26727 35127 303083 72948607 4402552 0.79400 0.76190 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 33326 2995723 1 1 0 185094 X 0 2261000 265000 60000 97000 2489000 2075000 109000 106000 29000 2261000 2184148 88000 87000 70000 214148 2075000 1948380 189942 45826 2184148 1729568 155630 63182 1948380 0.00000 0.93400 0.06600 0 0 1225079 1225079 356866 286436 70430 1295509 Artwork, Books 185094 Gift Annuities and Trust Funds 13224527 Life Insurance 16774 13426395 Due To Affiliates 785246 Reserve-Gift Annuities & Trust Funds 1155054 1940300 X 11895000 -712875 -41591 -754466 12649466 114324 4032164 4146488 16795954 8668000 195865 195865 8472135 114324 42424 156748 8628883 Part III, Line 4: Artwork received through the Foundation is displayed throughout the Medical Centers to enhance the environment for the patients and their families. Part V, Line 4: There are three main endowments. At Holy Cross Medical Center there is a nursing excellence endowment. The investment income from this endowment supports nursing education and excellence. At Saint Joseph there is a patient care endowment. The investment income from this endowment supports patient care technology. The third endowment is a cancer center endowment. The investment income from this is used to fund operating and capital costs for the cancer center. 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. 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. Part XI, Line 2d - Other Adjustments: Bank Charges -41,591. Part XI, Line 4b - Other Adjustments: Gross up Auto Donation 405. Equity Transfers 4,203,220. In-Kind Donations 24,047. Rounding 357. Gift Shop Expenses -195,865. Part XII, Line 2d - Other Adjustments: Gift Shop Expenses 195,865. Part XII, Line 4b - Other Adjustments: Gross up Auto Donation 405. Bank Charges 41,591. Rounding 428. X X X X X X 1 Claudia ALooney 1291 Peacock Hill Drive Santa Ana CA 927052305 See Part IV. 0 0 18585 -18585 18585 -18585 CA Golf Tourney 358420 252020 106400 27895 22753 30644 19835 Gala 387409 265913 121496 133765 1499 11500 30401 4 532982 299141 233841 4802 95352 57143 1585 44701 1278811 817074 461737 32697 251870 89286 13085 94937 481875 -20138 65265 10000 1 0.95000 65265 10000 10000 55265 CA 1 0 0 0 1.00000 Gertie McDevitt 501 S Buena Vista St Burbank CA 91505 0 Jacqueline Jordan 0 Event planner and coordinator X 0 Schedule G, Part I, Line 2b, Column (v) Consultation - Board, visioning. 1 PHS-SO CAL dba Providence St Joseph Medical Center 501 S Buena Vista Street Burbank CA 91505 510216589 501(C)(3) 1889178 Support Medical Center PHS-SO CAL dba Providence Holy Cross Medical Center 15031 Rinaldi Street Mission Hills CA 91346 510216589 501(C)(3) 1792642 Support Medical Center Providence Medical Institute 4101 Torrance Blvd Torrance CA 90503 330283773 501(C)(3) 190839 Support Medical Institute PHS-SO CAL dba Providence Little Co of Mary Medical Center - San Pedro 1300 W 7th Street San Pedro CA 90732 510216589 501(C)(3) 58332 Support Medical Center PHS-SO CAL dba Providence Tarzana Medical Center 18321 Clark Street Tarzana CA 91356 510216589 501(C)(3) 48072 Support Medical Center PHS-SO CAL dba Regional Office 501 S Buena Vista Street Burbank CA 91505 510216589 501(C)(3) 51000 Operational Support Child Development Institute 6340 Variel Suite A Woodland Hills CA 91367 954545540 501(C)(3) 45000 Support community services coordinator Guardian Angel School 10919 Norris Avenue Pacoima CA 91331 956005762 501(C)(3) 18122 Support school counseling program PHS-SO CAL dba Providence St Elizabeth Care Center 10425 Magnolia North Hollywood CA 91601 510216589 501(C)(3) 10000 Support Medical Center PHS-SO CAL dba Providence High School 511 S Buena Vista Street Burbank CA 91505 510216589 501(C)(3) 3000 Support High School 4 0 Support of clinics that provide medical services for those unable to pay - Samuel Dixon and Access to Care programs. 5098 0 129929 Fair Market Value Lab work, x-rays, and other medical services for individuals who are unable to pay for the services Toy drive for Network for Good 275 0 5399 Fair Market Value Toys for needy children Part I, Line 2: Since a majority grants go to affiliated companies, the Foundation has direct access to the financial reports of the funded organizations and reviews them for appropriate use of the funds. Grants to unrelated organizations are reviewed and monitored by the Board Finance Committee and President. 0 1 0 0 0 0 0 0 0 Patricia E Modrzejewski President 0 308595 0 67836 0 17500 0 27682 0 6899 0 428512 0 0 Michael Hunn Director 0 536537 0 496319 0 17500 0 93588 0 26791 0 1170735 0 0 Dale Surowitz Director 0 456988 0 83255 0 0 0 209345 0 18569 0 768157 0 0 Part I, Line 4b NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan 1) Patricia E. Modrzejewski a) Taxable CBRP Earned - $4,492 b) Non-Taxable CBRP Earned but Not Paid- $511 2) Michael Hunn a) SERP Interest Credit - $ 76,056 b) Taxable SERP Earned but Not Paid - $261,669 3) Dale Surowitz a) SERP Interest Credit - $56,934 b) SERP Earned but Not Vested - $132,731 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. X 1 24047 Fair Market X 9 2321183 Fair Market 1 0 1 0 Part I, Column (b): The amounts shown on Part I, Col. B reflect the number of donations received of the specific type of item. Part I, Line 33: In-kind donations are received for raffles/auctions. These donations are not valued and recorded as revenue as the values are not readily ascertainable. The donor's estimate of value is used to set a value for silent auction purposes only, since the value is not otherwise verifiable. Form 990, Part VI, Section A, line 6 The Corporate Member of the Foundation is Providence Health System - Southern California, a California nonprofit religious corporation. Form 990, Part VI, Section A, line 7a The Powers of the Corporate Member include the provision to approve the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause. Form 990, Part VI, Section A, line 7b The following powers are reserved exclusively to the Corporate Member: A) To adopt and amend the articles of incorporation and the Bylaws of the Foundation after consultation with the Foundation's Board of Directors. B) To approve the merger, consolidation, or affiliation of the Foundation with another Corporation, organization or program, or the dissolution of the Foundation. C) To approve the annual fundraising plan and strategic plan of the Foundation. 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 Foundation President reviewed 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 12c Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict. Form 990, Part VI, Section B, line 15 It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are 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 President 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 President 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 19 Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon written request. The consolidated Health System 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 XI, line 9: In-Kind Donations Not on Books -24,047. Rounding 2. Form 990, Part XII, Line 2c - AUDIT & COMPLIANCE The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. Form 990, Part VII, Section A - EMPLOYEE COMPENSATION The employees working at the Foundation are paid by Providence Health System - Southern California EIN# 51-0216589. Therefore, no W-2s are issued by the reporting organization. Form 990, Part I, Line 6 - VOLUNTEERS Volunteers provide a variety of services for the Foundation, including but not limited to: - Clerical - copying, collating, stuffing envelopes, deliveries within the facilities. - Special events - assist with registration, greeting, answering questions, selling tickets to silent auctions/raffles, running errands, set up, clean up, decorating. - Appreciation events and activities - organize and put on fashion shows, teas and other events, and thank you calls to show appreciation to donors. - Gift shop - accounting, retail clerks, cashiers, purchasing, organization. - Board - board meetings, committee meetings, prospect introductions and cultivation meetings. 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 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 Health & Services - Montana 500 W Broadway PO Box 4587 Missoula MT 598064587 810231793 Healthcare MT 501( c)(3) Line 3 PH & S - Washington 0 Providence St Joseph Medical Center PO Box 1010 Polson MT 598601010 810463482 Healthcare MT 501( c)(3) Line 3 PH & S - Washington 0 St Thomas Child and Family Center 1710 Benefis Court Great Falls MT 59405 810233495 Early Childhood Education MT 501( c)(3) Line 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 N/A 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 Charitable Trusts (8) CA T 1.00000 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0