PROVIDENCE HEALTH SYSTEM-SOUTHERN CALIFORNIA: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
PROVIDENCE HEALTH SYSTEM-SOUTHERN CALIFORNIA (EIN 51-0216589)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201313199349310591
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T17:15:11-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN911194016EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Clark Nuber PSBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110900 NE 4th Suite 1700AddressLine1
CityBellevueCity
StateWAState
ZIP Code98004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN510216589EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE HEALTH SYSTEM -SO CALIFORNIABusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPROVNameControl
Phone4255253985Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 Lind Avenue SW No 9016AddressLine1
CityRentonCity
StateWAState
ZIP Code980579016ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTodd HofheinsName
TitleEVP/CFOTitle
Phone4255253985Phone
Date Signed2013-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSara Elizabeth J Hyre CPAName
PTINP00235495PTIN
Phone4254544919Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRod Hochman MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11801 Lind Avenue SW No 9016AddressLine1
CityRentonCity
StateWAState
ZIP Code980579016ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1727687229GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitehttps://california.providence.org/Pages/Home.aspxWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1903YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionHealthcare with special concern for the poor & vulnerable in So. California.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees11713TotalNbrEmployees
Total Nbr Volunteers2630TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year32258250ContributionsGrantsPriorYear
Contributions Grants Current Year26328334ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1542061864ProgramServiceRevenuePriorYear
Program Service Revenue CY1527531826ProgramServiceRevenueCY
Investment Income Prior Year8047853InvestmentIncomePriorYear
Investment Income Current Year9541035InvestmentIncomeCurrentYear
Other Revenue Prior Year25673650OtherRevenuePriorYear
Other Revenue Current Year69246939OtherRevenueCurrentYear
Total Revenue Prior Year1608041617TotalRevenuePriorYear
Total Revenue Current Year1632648134TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year3698520GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY7504982GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year896995752SalariesEtcPriorYear
Salaries Etc Current Year924318561SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year474068TotalFundrsngExpCurrentYear
Other Expense Prior Year754617997OtherExpensePriorYear
Other Expenses Current Year739451851OtherExpensesCurrentYear
Total Expenses Prior Year1655312269TotalExpensesPriorYear
Total Expenses Current Year1671275394TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-47270652RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-38627260RevenuesLessExpensesCY
Total Assets BOY3422595451TotalAssetsBOY
Total Assets EOY4259536833TotalAssetsEOY
Total Liabilities BOY2740654563TotalLiabilitiesBOY
Total Liabilities EOY3517644082TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY681940888NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY741892751NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAs 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 & vulnerable in Southern California.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense947947088Expense
Grants0Grants
Revenue1078592546Revenue
DescriptionAcute Care - Inpatient Patient Days - 326,767Admissions - 74,361OUR MISSION - As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.OUR CORE VALUES - Respect, Compassion, Justice, Excellence, and StewardshipPROVIDENCE CARESWhether tenderly holding a special-needs child who requires round-the-clock care, or easing the way for a stroke patient who faces both physical and financial struggles, the people of Providence are called to a mission of service. Our lifework is to provide excellent care for everyone, at all stages of life, regardless of ability to pay. This has been the Providence mission since the Sisters of Providence arrived on the shores of the Columbia River 150 years ago, committed to the care and healing of poor and vulnerable frontier neighbors. Providence Health System-Southern California is a not-for-profit network of hospitals, care centers, physicians, clinics, home health services and affiliated services. We continue a tradition of caring that the Sisters of Providence began in the West 150 years ago.There is nothing more valuable than good health. When the unemployment rate in Los Angeles County surpassed 10 percent, many people were in need of help with not only basic healthcare needs, but critical needs.Providence Health & Services Southern California answered needs across the region, contributing nearly $167 million in charity care and in services to the under-served in 2012 through its community benefits program. Providence Cares.We care about school children who've never seen a dentist, about indigent emergency patients who desperately need follow-up care and for the elderly who need a ride to the doctor or just a friendly phone call to say hello.In the South Bay, employees collected boxes and boxes of Christmas gifts for families in need, many from working families who had lost their homes. In the San Fernando Valley, an outbreak of whooping cough prompted our School Nurse Program to provide free vaccinations to children. Providence Cares about the communities we serve.We understand the importance of preventive care and provide several programs aimed at keeping people out of the hospital by meeting their basic healthcare needs, diagnosing chronic illnesses and providing care before a treatable conditions become critical.We are driven by a commitment to the Providence Mission of compassionate care for all, especially the poor and vulnerable, and to our core values of Respect, Compassion, Justice, Stewardship and Excellence. Providence honored that tradition in 2012 by providing a total of $250,000 to 14 nonprofit groups in the San Fernando and Santa Clarita valleys that served the homeless, the uninsured in need of medical care, school children in low-income areas and others in need. The money came from the Mother Joseph Fund, which held a portion of proceeds from the Valley Service Area ministries.As part of the South Bay Service Area's community benefits programs, employees of Providence Little Company of Mary Medical Center San Pedro donated children's outfits to Barton School. Nearly 60 percent of the school's 800 children are from lower-income households. The ministry also collected more than 200 pairs of shoes to donate to a project that helped the homeless. Finally, a Christmas appeal drew gifts for 23 families in need. We help our neighbors across Southern California - and the West - because Providence Cares. OUR FACILITIES:Providence Saint Joseph Medical Center in BurbankProvidence Holy Cross Medical Center in Mission HillsProvidence Tarzana Medical Center in TarzanaProvidence Little Company of Mary Medical Center in TorranceProvidence Little Company of Mary Medical Center in San PedroProvidence Health System - Southern California has entered into a joint agreement with the Bioethics Institute at Loyola Marymount University in Westchester, California. Loyola Marymount faculty will now be available to Providence hospitals to assist with bioethics education.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense325750309Expense
Grants0Grants
Revenue379064938Revenue
DescriptionAcute Care - Outpatient - including emergency/trauma services. Patient Visits - 722,609 San Pedro Peninsula Hospital dba Little Company of Mary-San Pedro Hospital (LCM-SPH) provides care to the sick and dying and their families through the Catholic Health Ministry. In October 1992, LCM-SPH affiliated with Little Company of Mary Health Services (LCMHS) and became part of its integrated system. Due to the changing economic conditions of health care, LCMHS sought a strategic partner to be able to continue its commitment to meet the health needs of the community and remain financially strong. On September 1, 1999 LCMHS affiliated with Providence Health & Services, an exempt 501(c)(3) corporation headquartered in Renton, Washington. Providence Health & Services is a not - for - profit Catholic organization with the same mission and values as LCMHS and its affiliated organizations.LCM-SPH accomplishes its Mission of providing health care services to the community in a variety of hospital and ambulatory settings. LCM-SPH operates an acute general hospital that provides comprehensive inpatient, outpatient and emergency services. Major service areas within the acute hospital include medical/surgical, obstetrics, geropsychiatry, rehabilitation and chemical dependency. The hospital also has an outpatient diagnostic imaging center. In addition to its acute hospital, LCM-SPH provides sub-acute care services to the community .The Mission of Little Company of Mary Sisters and the Sisters of Providence is reflected in the historical significance of their names to continue the healing ministry of Jesus. They are committed to care for the sick, dying and needy.Providence Health & Services Southern California - LCM Services Area is committed to the fulfillment of the Mission of the Sisters through the delivery of expanded charitable services. In keeping with this mission it has established a Social Accountability budget to return the value of the system's tax exemption to the community.Providence Little Company of Mary San Pedro was among the first recipients of Press Ganey's new Best Place to Practice Award which was given to only six hospitals nationwide. This award recognizes hospitals who have reached and sustained the 95th percentile on their physician surveys for two consecutive reporting periods that are not more than twenty-four months apart.HealthGrades recognized Providence Tarzana Medical Center with 5-Star ratings for the treatment of heart attack and heart failure for the sixth consecutive year and Providence Saint Joseph Medical Center with a Maternity Care Excellence Award, ranking Providence Saint Joseph among the top five percent of rated hospitals in the nation for five years.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense65378679Expense
Grants0Grants
Revenue74377477Revenue
DescriptionLong-Term Care, Subacute Skilled Nursing & Home Health Programs. Long-Term Care Days - 96,717; Home Health Visits - 56,255.Description

Activity Other ActivityOther (3 entries)

ExpenseExpenseGrantsGrantsRevenueRevenueDescriptionDescription
411449905512225Providence High School for children of the Northern San Fernando Valley and surrounding area. School Days - 182 Students - 396.Providence High School is a Catholic, accredited, college-preparatory school for young men and women. The School is located in the San Fernando Valley and serves the Greater Los Angeles area. The School offers a challenging college-preparatory academic program, carefully designed to give students opportunities for growth and experience in preparation for university course work. The School has received full accreditation from the Western Association of Schools and Colleges, and the Western Catholic Educational Association.
00-271176Health Care Joint Ventures
750498275049820Grant & Allocations - See Schedule I.
FieldValueIRS element (for citing)
Total Of Other Program Service Exp11619481TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt7504982TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev5241049TotalOfOtherProgramServiceRev
Total Program Service Expense1350695557TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With10962116NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees11713NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address1OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Karl E Fritschel CPABusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4255253339TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11801 Lind Ave SW 9016AddressLine1
CityRentonCity
StateWAState
ZIP Code980579016ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (52 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Lucille Dean SP
Chair of the Board0.2012.90XX000
M Adrian Davis LCM -Dcd 512
Director0.202.70X000
Mary Corita Heid RSM
Director0.205.40X000
Michael A Stein
Director0.206.10X0183000
Michael Holcomb
Director0.207.50X0190500
Dana A Rasmussen
Director0.205.80X0183000
James S Roberts MD
Director0.208.90X0205000
Peter J Snow
Director0.205.60X0205000
Jeffrey B Clode MD -Thru 612
Director0.206.90X087500
Sallye Liner
Director0.204.00X0153000
Owen B Robinson
Director0.205.30X0153000
Cheryl M Scott
Director0.204.50X0150000
Ellen L Wolf
Director0.207.60X0153000
Isiaah Crawford
Director0.204.00X0150000
Martha Diaz Aszkenazy
Director0.207.60X0151750
Kirby McDonald
Director0.204.50X0151750
Dave Olsen
Director0.205.40X0151750
Charles Chuck Watts
Director0.206.00X0151750
John Nordstrom - Thru 712
Director0.200.60X000
John F Koster MD
President/CEO PH&S0.2053.80X04069812382715
Jeffrey W Rogers
Corporate Secretary0.2049.80X0623631319793
Todd Hofheins
SVP/CFO0.2059.80X055572540426
Michael Hunn
SVP/CE So. CA. Region60.000.00X089303667267
Karl J Carrier - Thru 812
CFO/CA. Region55.000.00X0556630153501
Dave Mast - Eff 912
CFO/CA. Region40.000.00X033150126097
Michael L Butler
Group President0.0065.0001406031890844X
Rod Hochman MD
Group President0.0065.0001438710332177X
John V Fletcher
VP/Operations Support0.0055.0001575373259253X
Janice J Jones
SVP/CAO0.0055.0001031256204051X
Myron Berdischewsky MD
SVP/CMQO0.0060.0002359308166605X
Kerry Carmody
COO/CA Region0.0040.000683958192618X
Larry S Bowe
CEO/PHCMC0.0040.000638626333422X
Terry L Smith
SVP/Management Svcs.0.0060.0001012414349119X
Ray Williams
SVP/Physician Svcs0.0055.0001240435162999X
David Brown
VP/ Strat. & Bus. Develop.0.0055.000360109137998X
Cindy Strauss
SVP/Chief Legal Officer0.0055.000621810205922X
Phil Jackson
VP/Physician Svc. & PMG0.0055.000609104157689X
John O Mudd
SVP/Mission Leadership0.0055.000505083114350X
Cindra R Syverson
SVP/CHRO0.0060.000562260220668X
Claudia Haglund
VP/Governance & Spons.0.0050.000501085219670X
Joel S Gilbertson
VP/Gov't & Public Affairs0.0060.000456934105567X
Nancy Carlson
CEO/LCMMCSP0.0050.00052743193272X
Dale Surowitz
CEO/PTMC0.0040.000466565180594X
Orest Holubec
VP/ Communications0.0055.00041049953484X
Debbie Burton
VP/CNO0.0065.000405452233827X
Bernard J Klein MD
CMO - HCMC40.000.00354323037947X
Glen Komatsu
CMO - TCH40.000.00418403019261X
Elizabeth Z Zuanich
CEO/LCM Service Area40.000.00330729049596X
William C Scott
CMO - SJMC40.000.00350161020761X
Richard A Glimp
CMO - LCMH40.000.00311882018358X
Eugene Al Parrish
Former SVP/RCE Alaska Region0.000.00048551957205X
John Kenagy
Former VP/CIO0.000.00085867414815X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1765498TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs25428971TotalReportableCompFrmRltdOrgs
Total Other Compensation5821871TotalOtherCompensation
Number Individuals GT100 K1420NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Healthcare Partner Inc MED
19191 S Vermont Avenue 21FTorranceCA90502Medical Services11066503
Therapeutic Associates Inc
7100 Fort Dent Way Ste 220SeattleWA98188Physical/Occup. Therapy Svc5511926
Swinerton Builders
17731 Mitchell N Suite 200IrvineCA926146028Construction5477622
Perot Systems Healthcare
PO Box 31498HartfordCT061501498IT Consulting4751279
Transcend Services Incorpor
PO Box 740209AtlantaGA303740209Medical Records Services4209841
FieldValueIRS element (for citing)
Number Of Contractors GT100 K335NumberOfContractorsGT100K
Membership Dues5735MembershipDues
Fundraising Events3256FundraisingEvents
Related Organizations10541094RelatedOrganizations
Government Grants14431808GovernmentGrants
All Other Contributions1346441AllOtherContributions
Noncash Contributions2424115NoncashContributions
Total Contributions26328334TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Acute - Inpatient90009910776517361077651736
Acute - Outpatient621400370321709370321709
LTC/HomeCare/Hospice6230007432424074324240
Tuition & Fees61160055053175505317
Loss / Healthcare JVs900099-271176-271176
FieldValueIRS element (for citing)
Total Program Service Revenue1527531826TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5440749TotalRevenueColumn
Exclusion$5,440,749ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real3252562Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real2388189Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real864373Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column864373TotalRevenueColumn
Exclusion$864,373ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities96182314Securities
Other190002Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities92220848Securities
Other51182Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3961466Securities
Other138820Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4100286TotalRevenueColumn
Exclusion$4,100,286ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events101090GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events3256CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses48324FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column52766TotalRevenueColumn
Exclusion$52,766ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming12140GrossIncomeGaming
Gaming Direct Expenses0GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column12140TotalRevenueColumn
Exclusion$12,140ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory500386GrossSalesOfInventory
Cost Of Goods Sold330552CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column169834TotalRevenueColumn
Exclusion$169,834ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Cafeteria7222105028317$5,028,317
Pharmacy Services4461102125562$2,125,562
Laboratory Services621500231689231689

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column60762258TotalRevenueColumn
Related Or Exempt Function Income9512495RelatedOrExemptFunctionIncome
Exclusion$51,249,763ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue68147826TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1632648134TotalRevenueColumn
Related Or Exempt Function Income1537276010RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$69,043,790ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total7004132Total
Program Services7004132ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total500850Total
Program Services500850ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total5008325Total
Management And General5008325ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total599370979Total
Program Services495284063ProgramServices
Management And General103781041ManagementAndGeneral
Fundraising305875Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total47820763Total
Program Services38249111ProgramServices
Management And General9567504ManagementAndGeneral
Fundraising4148Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total228338239Total
Program Services192497846ProgramServices
Management And General35815109ManagementAndGeneral
Fundraising25284Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total43780255Total
Program Services35942658ProgramServices
Management And General7816480ManagementAndGeneral
Fundraising21117Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total8763540Total
Program Services2072411ProgramServices
Management And General6691129ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total12343Total
Management And General12343ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total90580Total
Management And General90580ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total153191137Total
Program Services114085112ProgramServices
Management And General39106025ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3679260Total
Program Services413524ProgramServices
Management And General3189502ManagementAndGeneral
Fundraising76234Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total36308820Total
Program Services25715122ProgramServices
Management And General10557300ManagementAndGeneral
Fundraising36398Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total16497674Total
Program Services1373379ProgramServices
Management And General15124295ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total31272232Total
Program Services22524407ProgramServices
Management And General8747825ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1887731Total
Program Services832282ProgramServices
Management And General1055449ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1329055Total
Program Services562357ProgramServices
Management And General764705ManagementAndGeneral
Fundraising1993Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total31782194Total
Program Services31782194ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total32575727Total
Management And General32575727ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total78967499Total
Program Services48456557ProgramServices
Management And General30510942ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total7178749Total
Program Services5141690ProgramServices
Management And General2037059ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies1829914461815353941456052
Healthcare Taxes5846833858468338
Bad Debts4778869347788693
UBI Taxes4603346033

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total46620800Total
Program Services40465437ProgramServices
Management And General6152344ManagementAndGeneral
Fundraising3019Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1671275394Total
Program Services1350695557ProgramServices
Management And General320105769ManagementAndGeneral
Fundraising474068Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5690631BOY
EOY2241499EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY51912765BOY
EOY70255720EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY667599BOY
EOY409030EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY196218679BOY
EOY207812822EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY52856704BOY
EOY51658210EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY22661294BOY
EOY22881102EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY10183581BOY
EOY16312135EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1712613635LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec890878568LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY856858573BOY
EOY821735067EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY84211177BOY
EOY93667627EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY59432694BOY
EOY93078295EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2081901754BOY
EOY2879485326EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3422595451BOY
EOY4259536833EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY158168423BOY
EOY169015012EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
EOY13511EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY6113023BOY
EOY6340155EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY433935002BOY
EOY430590000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2142438115BOY
EOY2911685404EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2740654563BOY
EOY3517644082EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY639990616BOY
EOY689287304EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY22041981BOY
EOY31505699EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY19908291BOY
EOY21099748EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY681940888BOY
EOY741892751EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3422595451BOY
EOY4259536833EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-38627260ReconcilationRevenueExpenses
Reconciliation Unrealized Invest6046441ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment359ReconcilationPriorAdjustment
Reconcilation Other Changes92532323ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members1MailingsMembers
Mailings Members$0MailingsMembersAmount
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$72,010DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB72010TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationLobbying activities, with the exception of advocacy, are limited to direct contact with government officials and mailings to the general public and legislators for the purpose of expressing opinions on legislative matters. Expenses include employee salaries, postage and incidental traveling expenditures.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance369341BeginningOfYearBalance
Contributions1000Contributions
Investment Earnings Or Losses19389InvestmentEarningsOrLosses
Grants Or Scholarships15928GrantsOrScholarships
End Of Year Balance373802EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance357604BeginningOfYearBalance
Contributions10000Contributions
Investment Earnings Or Losses1737InvestmentEarningsOrLosses
End Of Year Balance369341EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance104970BeginningOfYearBalance
Contributions238850Contributions
Investment Earnings Or Losses13784InvestmentEarningsOrLosses
End Of Year Balance357604EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance103609BeginningOfYearBalance
Investment Earnings Or Losses1361InvestmentEarningsOrLosses
End Of Year Balance104970EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance103609BeginningOfYearBalance
End Of Year Balance103609EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis102794045OtherCostOrOtherBasis
Book Value102794045BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis818241797OtherCostOrOtherBasis
Depreciation323677210Depreciation
Book Value494564587BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis26856698OtherCostOrOtherBasis
Depreciation19752151Depreciation
Book Value7104547BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis745319350OtherCostOrOtherBasis
Depreciation547449207Depreciation
Book Value197870143BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis19401745OtherCostOrOtherBasis
Book Value19401745BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings821735067TotalOfBookValueLandBuildings

Other Assets OtherAssets (9 entries)

DescriptionDescriptionBook ValueBookValue
Unamortized Bond Financing Costs6484129
Due from Affiliates2805794444
Miscellaneous Receivables25234169
Library Inventory13000
Third Party Settlements34160080
Bond Premium Discount5577788
Trustee Held Funds1846736
Resident Trust Funds4881
Acute Medicaid EHR Incent Rec370099
FieldValueIRS element (for citing)
Total Book Value Other Assets2879485326TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (9 entries)

DescriptionDescriptionAmountAmount
Due to Affiliates$2,787,523,965
Liability for Risk Sharing$6,985,733
Miscellaneous Other Liabilities$1,191,281
Capitalized Lease Obligation$3,700,723
LT Asset Retirement Obligation - FIN 47$13,813,817
IBNR Payable$1,795,749
Taxable Bond Issue$76,105,791
Third Party Settlements$19,346,348
Liability for Unpaid Claims$1,221,997
FieldValueIRS element (for citing)
Total Of Amounts2911685404TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4:The School has one endowment fund established for scholarship purposes that is donor-restricted.
Description of Uncertain Tax Positions Under FIN 48: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.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GALANameOfEvent1
Gross Receipts Event1104346GrossReceiptsEvent1
Charitable Contributions Event13256CharitableContributionsEvent1
Gross Revenue Event1101090GrossRevenueEvent1
Food And Beverage Event132013FoodAndBeverageEvent1
Entertainment Event12500EntertainmentEvent1
Other Direct Expenses Event113811OtherDirectExpensesEvent1
Gross Receipts Total104346GrossReceiptsTotal
Charitable Contributions Total3256CharitableContributionsTotal
Gross Revenue Total Events101090GrossRevenueTotalEvents
Food And Beverage Total Events32013FoodAndBeverageTotalEvents
Entertainment Total Events2500EntertainmentTotalEvents
Other Direct Expenses Total Events13811OtherDirectExpensesTotalEvents
Direct Expense Summary Events48324DirectExpenseSummaryEvents
Net Income Summary52766NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage250.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage350.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense42368127TotalCommunityBenefitExpense
Net Community Benefit Expense42368127NetCommunityBenefitExpense
Percent Of Total Expense0.02610PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense344206411TotalCommunityBenefitExpense
Direct Offsetting Revenue255776500DirectOffsettingRevenue
Net Community Benefit Expense88429911NetCommunityBenefitExpense
Percent Of Total Expense0.05450PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense386574538TotalCommunityBenefitExpense
Direct Offsetting Revenue255776500DirectOffsettingRevenue
Net Community Benefit Expense130798038NetCommunityBenefitExpense
Percent Of Total Expense0.08060PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense11004215TotalCommunityBenefitExpense
Direct Offsetting Revenue156542DirectOffsettingRevenue
Net Community Benefit Expense10847673NetCommunityBenefitExpense
Percent Of Total Expense0.00670PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense4689126TotalCommunityBenefitExpense
Direct Offsetting Revenue5800DirectOffsettingRevenue
Net Community Benefit Expense4683326NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense5652521TotalCommunityBenefitExpense
Direct Offsetting Revenue34213DirectOffsettingRevenue
Net Community Benefit Expense5618308NetCommunityBenefitExpense
Percent Of Total Expense0.00350PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense1076757TotalCommunityBenefitExpense
Net Community Benefit Expense1076757NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense22422619TotalCommunityBenefitExpense
Direct Offsetting Revenue196555DirectOffsettingRevenue
Net Community Benefit Expense22226064NetCommunityBenefitExpense
Percent Of Total Expense0.01380PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense408997157TotalCommunityBenefitExpense
Direct Offsetting Revenue255973055DirectOffsettingRevenue
Net Community Benefit Expense153024102NetCommunityBenefitExpense
Percent Of Total Expense0.09440PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$47,788,693BadDebtExpenseAmount
Amount Reimbursed By Medicare1140160826AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare348741034CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall791419792MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities5NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (5 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursFacility Reporting GroupFacilityReportingGroupCritical Access HospitalCriticalAccessHospitalEr OtherErOther
Providence St Joseph Medical Center
1501 S Buena Vista StBurbankCA91505XXXA
Providence LCM Med Ctr - Torrance
24101 Torrance BoulevardTorranceCA90505XXXA
Providence Holy Cross Medical Center
315031 Rinaldi StMission HillsCA91345XXXAXX
Providence Tarzana Medical Center
418321 Clark StreetTarzanaCA91356XXXA
Providence LCM Med Ctr - San Pedro
51300 West Seventh StreetSan PedroCA90732XXXA

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIBusinessNameLine1
FieldValueIRS element (for citing)
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent250.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent350.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities4NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Providence St Elizabeth Care Center
10425 Magnolia BoulevardNorth HollywoodCA91601Skilled Nursing
Providence LCM Sub-Acute Care Center
1322 West Sixth StreetSan PedroCA90732Skilled Nursing
Providence LCM Transitional Care Ctr
4320 Maricopa StreetTorranceCA90503Transitional Care
Facey Medical Foundation
15451 San Fernando Mission BlvdMission HillsCA91345Clinical Network

Form990 Schedule H Part VI Form990ScheduleHPartVI (24 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 6a: In addition to having Community Benefit information included in the consolidated Providence Health & Services Community Benefit Report, this information is also included in the Providence Health System - Southern California Regional Community Benefit Report.
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 $ 47788693.
Part II: COMMUNITY BUILDING ACTIVITIES:Providence Health & Services, California Region did not track or report the financial impact of their community building activities.
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: It is Providence's policy to exclude any Medicare shortfall from Community Benefit information.The amount reported on Part III, Section B, Line 6, was determined by applying the Cost-to-Charge Ratio to the Medicare revenue.
Part III, Line 9b: BILLING & 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 (or the patient's legal representative) seeking financial assistance from Providence 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 III - LINE 4It 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 VI, Line 2: NEEDS ASSESSMENT: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: COMMUNITY INFORMATION:Providence Health & Services, Southern California Region, operates five medical centers and outpatient centers, clinics, hospice and community outreach programs serving a wide area stretching from the northern reaches of Los Angeles County to the South Bay Area. The region is marked by great wealth, but also by large pockets of poverty. The region is composed of the coastal South Bay Service Area and the inland Valley Service Area. The service areas are separated by some 30 miles, but work as one sharing quality practices and commitment to the Providence Mission to serve those who are poor and vulnerable. The Providence Mission drives numerous programs aimed at easing those challenged by the continuing economic slump, providing free and low-cost health care, partnering with agencies with similar missions and focusing on preventive care with the hopes of improving the health of the communities served by Providence. In the California Region's Valley Service Area, home to more than 2.1 million, 39.4% of the population is Hispanic; 42.7%, white; 10%, Asian; and 3.6%, African-American. Nearly 20% of the population is uninsured, 17.9% receive Medi-Cal; 10.3%, Medicare; and 51.8%, private or other insurance. Approximately 11.2% of the population is age 65 and above. Children, newborn to age 13, represent 19% of the total population. The 65- to 84-year-old age group is projected to increase the most over the next five years while the 25- to 44-year-old age group is projected to decrease during that period. While Providence provides outreach to those who are poor and vulnerable across the service area, pockets of lower income households tend to be clustered in the northeastern San Fernando Valley. Our community benefit services are especially concentrated there and focused on preventive medicine and health education.The South Bay Service Area covers 14 separate municipalities with a total population of 824,038, of which 35.7% are Hispanic; 34%, white;16.8%, Asian; 9.7%, African-American; and 3.8%, other. The coastal area includes upper income and affluent communities, while the crescent of communities forming the eastern Service Area boundaries are among the most impoverished in Los Angeles County. Data show 18.9% of residents are uninsured; 14.1% receive Medi-Cal; 11.8%, Medicare; and 55.3% have private insurance. Twelve percent of the population is 65 and older; children, newborn to 13 years, represent 18.7% of the total population. South Bay Service Area ZIP code demographics vividly document significant disparities related to age, educational attainment, household income and home ownership. With the Providence Mission as our guide, community outreach resources are directed to six underserved communities in the South Bay Service Area: Gardena, Hawthorne and Lawndale on the northern boundaries and Harbor City, Wilmington and the 90731 ZIP code area of San Pedro along the southern boundaries.
Part VI, Line 5: PROMOTION OF COMMUNITY HEALTH:As a not-for-profit Catholic health care ministry, Providence Health & Services live out its Mission and embraces its responsibility to provide for the needs of the communities it serves - especially the poor and vulnerable. Providence's not-for-profit, tax-exempt status enables Providence to serve its communities, to solicit donations through its foundations and to access capital to respond to community needs that otherwise would go unmet. The charitable purpose of Providence Health & Services and each of its ministries is guided by one Mission and set of core values based on Catholic health care and guided by the legacy of the Sisters of Providence. As one system committed to caring for those who are poor and vulnerable, Providence Health & Services has developed a single framework for consistently reporting charity care and community benefit. Locally, Providence ministries are empowered to apply these policies to meet the needs of their community. Additionally, Providence ministries conduct local assessments to make sure the needs of the community are met. The Greater Los Angeles Area has a growing population of poor, uninsured and under-insured in need of basic health care, and the safety net has been further stretched by the current economic slowdown. In each service area, access to low cost or free primary care is the top health care need identified by the separate needs assessments conducted in the San Fernando Valley and South Bay regions. As the home to a large number of immigrants, all of whom have immediate health care and health education needs, finding a medical home and connecting children and adults to health care remains our greatest challenge. Untreated diabetes is epidemic, and among the growing Latino population the ability to provide services in Spanish is critical to successful clinical outcomes. Providence plays a leadership role in providing program infrastructure to the most economically disadvantaged communities in the service area and seeks to improve management of these chronic conditions. Each hospital's emergency department is open 24 hours and no patient is ever denied emergency care regardless of ability to pay. Because more and more patients utilize emergency rooms as primary care, Providence medical centers provide fast-track service for routine health issues and bilingual lay people to guide and direct children and adults to appropriate community based follow up services. Providence Southern California coordinates programs for vulnerable populations and sponsors and recruits volunteers for efforts by other groups and government agencies that share the Providence Mission of outreach to the poor and vulnerable. A mobile health clinic travels the San Fernando Valley five days a week providing very low-cost medical care for those in need, focusing on those with chronic illnesses to help them manage their conditions. In the South Bay, a mobile clinic visits 10 schools each week and provides free primary care to uninsured children. Across both service areas, medical teams work also with patients to find low-cost medical care and resources, and Providence provides free and low-cost laboratory and imaging work to area community clinics. Providence also provides several outreach programs for vulnerable populations including the elderly, immigrants and children from low-income families. Those community benefit programs, funded by medical center operations and external grants, include: a school nurse program at 14 Catholic schools in lower-income areas; senior peer counseling; Latino Health Promoters who provide health screenings and education; free removal of anti-social tattoos for former gang members and others; a faith community nurse outreach program that brings health care services to our communities through partnerships with area faith congregations; and a team of promotoras who reach out to help parents enroll their children in Medi-Cal or Healthy Families. A portion of proceeds from each hospital ministry is held in the Mother Joseph Fund and distributed to support community benefit projects that support the Providence Mission of outreach to the poor and vulnerable. For example, Providence partnered over the summer with the Los Angeles County Department of Public Health to provide free T-DAP vaccinations (tetanus, diphtheria and pertussis) at a dozen schools in the San Fernando Valley and South Bay. The goal was not only preventive medicine but to help families meet the demands of a new state law requiring vaccinations for the 2011-12 school year and exclusion of students who could not provide evidence of TDAP vaccination. Based on the findings of the needs assessments conducted in each of the service areas, programs have been developed to address the needs of those who are poor and vulnerable and that run the spectrum from birth to the elderly. Providence funds programs for young parents; provides a developmental therapy program for infants with special needs; free flu shot campaigns for all ages; counseling for adolescents, teens and young adults who have strayed off their paths; and health screenings and health education programs for all ages. Providence has developed palliative care programs at all its medical centers and operates the largest hospice program in Southern California, one that includes the area's only children's hospice. In the San Fernando Valley, a new program, Providence Access to Care, was initiated. This program involves community care coordinators and other professionals who identify indigent and uninsured emergency department patients to ensure they have access to free or low-cost prescriptions, specialists and ongoing medical care. Access to Care staff members contact these patients after discharge from the emergency department to arrange for free or low-cost follow-up medical care and track their progress, reminding them of appointments and keeping records of the referrals made.In 2012, the Providence Access to Care Program had 2,998 patients referred to the program for assistance. Of this total, 2,502 were new client referrals to the program. After the first year that the program was operating, 50% of the patients referred to the Access to Care Program did not return to the emergency departments after being linked with a medical provider in the community. For those patients who did have a return visit to the emergency department during this time period, in the majority of cases their visit to the emergency department was justified as a serious or emergent condition. In the South Bay Service Area, a program called Creating Opportunity for Physical Activity (COPA) is offered in partnership with 13 urban public schools across three public school districts and offers a "peer coach" training model to almost 200 classroom teachers who have little or no training in physical education. Over a two year period, these teacher peer coaches become independent in physical education instruction using a curriculum developed by Providence that is directly linked to California grade level physical education standards. At six Lawndale elementary schools, a new pilot program known as "Instant Recess," in partnership with the UCLA School of Public Health, uses the same peer coach training model to help teachers integrate 10 minute bursts of physical activity into the classroom schedule. COPA trains teachers to provide P.E. instruction, using fun, skill and compassion to create a culture of daily physical activity. Preliminary evaluation by an independent evaluator has documented statistically significant increases in the number of students achieving the Healthy Fitness Zone, as measured by Fitnessgram.The other major program improvement, directly linked to the needs assessment, was the implementation of a pilot project, Get Out and Live (GOAL), designed to help adults improve their ability to manage their diabetes. This program is offered at the Vasek Polak Health Clinic, a primary care clinic for uninsured adults, sponsored by Providence Southern California. The clinic uses a low cost, fixed price service delivery model staffed by nurse practitioners and in 2012, was a medical home for 4,869 adults. The GOAL project, for adults with diabetes, involves the modification of a standardized self care curriculum to incorporate three additional classes that include group visits. During the group visit, one of the clinicians that the patient normally sees in the clinic provides both medical education and a one on one visit with the patient to go over lab results and answer any questions.
Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEM: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 and Montessori school, 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 21 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, Spokane and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California.Providence Southern California continuously looks toward more efficient processes to ensure funding is available for community outreach programs to help those most in need. The poor and vulnerable run the spectrum from birth to the elderly, all with specific needs that are addressed by the Providence's outreach efforts. Providence funds programs for young parents; provides a developmental therapy program for infants with special needs; free flu shot campaigns for all ages; counseling for adolescents, teens and young adults who have strayed off their paths; and health screenings and health education programs for all ages. Providence has developed palliative care programs at all its medical centers and operates the largest hospice program in Southern California, one that includes the area's only children's hospice.In terms of community outreach, each of the five medical centers serves vastly different populations and tailors programs appropriately. In many cases, Providence Southern California partners with local charities such as Meet Each Need with Dignity (MEND) in the northern San Fernando Valley, the Burbank Temporary Aid Center (BTAC) in Burbank and Harbor Interfaith in San Pedro, which supports the working poor with shelter, food, job training, life skills education and other services.
CA,WA,OR,MT,AKReports Filed With StatesPart VI, Line 7
See belowPart V, Line 8 Facility Reporting Group A
Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.Facility 1 -- Providence St. Joseph Medical CenterPart V, Section B, line 14g:
Facility 1 -- Providence St. Joseph Medical CenterPart V, Section B, line 22:
Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.Facility 2 -- Providence LCM Med. Ctr. - TorrancePart V, Section B, line 14g:
Facility 2 -- Providence LCM Med. Ctr. - TorrancePart V, Section B, line 22:
Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.Facility 3 -- Providence Holy Cross Medical CenterPart V, Section B, line 14g:
Facility 3 -- Providence Holy Cross Medical CenterPart V, Section B, line 22:
Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.Facility 4 -- Providence Tarzana Medical CenterPart V, Section B, line 14g:
Facility 4 -- Providence Tarzana Medical CenterPart V, Section B, line 22:
Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.Facility 5 -- Providence LCM Med. Ctr. - San PedroPart V, Section B, line 14g:
Facility 5 -- Providence LCM Med. Ctr. - San PedroPart V, Section B, line 22:

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Providence Health & Services Foundation
501 S Buena Vista StBurbankCA91505953544877501 ( c)(3)4533878Mother Joseph distributions, special event tables, gift shop donation, donor wall.
Providence Little Company of Mary Foundation
4101 Torrance BlvdTorranceCA91505510224944501 ( c)(3)2390314Operating Expenses
Valley Economic Alliance
5121 Van Nuys Blvd 200Sherman OaksCA91403954524503501 ( c)(3)28666Gold & Gala Sponsor, Pro-AM Sponsor, lunch contribution/Annual Support local programs
Santa Clarita Performing Arts Center
26455 Rockwell Canyon RdSanta ClaritaCA91355953574259501 ( C)(3)10000Support arts education outreach program.
Burbank Chamber of Commerce
200 W Magnolia BlvdBurbankCA91502950583680501(c)(6)6350Platinum Sponsor-Relay for Life
American Cancer Society
500 N Victory BlvdBurbankCA91502941170350501( c)(3)5000Back to School event & dinner sponsor
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants5TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (5 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
Family Allowance - 2nd Student2233000FMVTuition Reduction
Scholarships84134800FMVTuition Reduction
Employee Discount1946800FMVTuition Reduction
Financial Aid99280750FMVTuition Reduction
Legacy Discount115500FMVTuition Reduction

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: In the application for support/financial aid, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds were used, along with a report of the number of children/families served over the year. Grants made to affiliated foundations are monitored on a monthly basis since the financial statements of these organizations are readily available. Other grants are made that comply with the mission and further the tax exempt purpose of the organization.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (33 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
John F Koster MD
President/CEO PH&S01257618027944250177690353700029015044525270339126
Jeffrey W Rogers
Corporate Secretary04446460178408057703007350190580943424048099
Todd Hofheins
SVP/CFO03623600175788017577018701021725059615100
Michael Hunn
SVP/CE So. CA. Region0511618036364901776904857201869509603030216958
Karl J Carrier - Thru 812
CFO/CA. Region03550330184020017577013090002260107101310106408
Dave Mast - Eff 912
CFO/CA. Region0323001085000001694709150035759800
Michael L Butler
Group President087349505161680163680863387027457022968750435962
Rod Hochman MD
Group President09863100250000020240003070760251010177088700
John V Fletcher
VP/Operations Support0547460010101440177690238549020704018346260388497
Janice J Jones
SVP/CAO059345803705910672070180325023726012353070154703
Myron Berdischewsky MD
SVP/CMQO0496463018280760347690142532024073025259130404844
Kerry Carmody
COO/CA Region04618090204572017577017012302249508765760112149
Larry S Bowe
CEO/PHCMC03392590282367017000030925102417109720480226393
Terry L Smith
SVP/Management Svcs.06200950326004066315032685402226501361533069195
Ray Williams
SVP/Physician Svcs04918040452500029613101372530257460140343400
David Brown
VP/ Strat. & Bus. Develop.027952908000305770117392020606049810700
Cindy Strauss
SVP/Chief Legal Officer037681001800000650000173813032109082773200
Phil Jackson
VP/Physician Svc. & PMG039391901651180500670134924022765076679300
John O Mudd
SVP/Mission Leadership03590510128263017769094957019393061943300
Cindra R Syverson
SVP/CHRO0396975016470805770197231023437078292800
Claudia Haglund
VP/Governance & Spons.033871501447930175770202296017374072075500
Joel S Gilbertson
VP/Gov't & Public Affairs03372090102148017577084156021411056250100
Nancy Carlson
CEO/LCMMCSP03448590177504050680748790183930620703085111
Dale Surowitz
CEO/PTMC03879950779930577015990602068806471590118217
Orest Holubec
VP/ Communications02790420119255012202033565019919046398300
Debbie Burton
VP/CNO03035180843570175770214734019093063927900
Bernard J Klein MD
CMO - HCMC344323010000000211620167850392270000
Glen Komatsu
CMO - TCH335437065966017000024100168510437664000
Elizabeth Z Zuanich
CEO/LCM Service Area2670250532370104670338270157690380325000
William C Scott
CMO - SJMC33666101350000045410162200370922000
Richard A Glimp
CMO - LCMH3058820600000024430159150330240000
Eugene Al Parrish
Former SVP/RCE Alaska Region083787039984201890049393078120542724056382
John Kenagy
Former VP/CIO07522805185350264911080470676808734890115387

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aThe 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 approval by the SVP/Chief Human Resources Officer. During 2012, a total of one first-class ticket was purchased for disclosed personnel. 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 2012, the following Key Employees received gross-up payments: Arnold R. Schaffer - Relocation Phil Jackson - Relocation Bruce Lamoureux - Gift Card The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Discretionary Spending Account Providence Health & Services provides an executive flex spending allowance per year (paid bi-weekly). This benefit is provided as discretionary spending because the organization does not reimburse for or provide additional executive benefits, such as a car allowance, additional executive life or disability insurance, or other market-based executive benefits practices. This benefit was discontinued for Calendar Year 2012. 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 SVP/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 2012, the following Key Employees received relocation/housing program payments: Arnold R. Schaffer Phil Jackson Terry L. Smith Ray Williams The amounts reported for these relocation payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation.
Part I, Lines 4a-bNONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan C) ESP = Elective Survivor Plan d) NQ = Non-Qualified 409(a) Payout 1) John F. Koster, MD a) Taxable SERP Earned but not Paid- $1,872,867 b) SERP Interest Credit - $327,363 2) Jeffrey W. Rogers a) Taxable SERP Earned but not Paid - $44,273 b) ESP Interest Credit - $87,150 c) SERP Interest Credit - $136,048 3) Michael L. Butler a) SERP Interest Credit - $301,732 b) SERP Earned but not Vested - $527,516 4) Rod Hochman, MD a) NQ - $202,400 b) SERP Earned but not Vested - $284,676 5) Gregory Van Pelt a) Taxable SERP Earned but not Paid - $183,330 b) ESP Interest Credit - $96,202 c) SERP Interest Credit - $240,115 6) Arnold R. Schaffer a) Taxable SERP Earned but not Paid - $819,315 b) SERP Interest Credit - $157,753 7) John V. Fletcher a) Taxable SERP Earned but not Paid - $511,574 b) Taxable CBRP Earned but not Paid - $5,997 c) ESP Interest Credit - $50,355 d) SERP Interest Credit - $122,030 8) Janice J. Jones a) Taxable SERP Earned but not Paid - $147,676 b) Taxable CBRP Earned but not Paid - $264 c) Non-Taxable SERP Earned - $1 d) SERP Interest Credit - $144,057 9) Myron Berdischewsky, MD a) Taxable SERP Earned but not Paid - $1,522,140 b) Non-Taxable SERP Earned - $43,658 c) SERP Interest Credit - $82,406 10) Michael Hunn a) Taxable SERP Earned but not Paid - $222,462 b) SERP Interest Credit - $44,426 11) Cindra R. Syverson a) SERP Interest Credit - $33,544 b) SERP Earned but not Vested - $148,036 12) Terry L. Smith a) Taxable SERP Earned but not Paid - $68,857 b) Taxable CBRP Earned but not Paid - $673 c) ESP Interest Credit - $67,068 d) SERP Interest Credit - $164,038 13) Ray Williams a) SERP Earned but not Vested - $119,753 14) David Brown a) SERP Earned but not Vested - $74,810 b) SERP Interest Credit - $15355 15) Cindy Strauss a) NQ - $48,000 b) SERP Earned but not Vested - $161,294 16) Phil Jackson a) SERP Interest Credit - $9,748 b) SERP Earned but not Vested - $85,986 17) Eugene "Al" Parrish a) Taxable SERP Earned but not Paid - $293,361 b) Non-Taxable SERP Earned - $39,762 18) John Kenagy a) Taxable SERP Earned but not Paid - $417,225 19) Karl J. Carrier a) Taxable SERP Earned but not Paid - $88,273 b) DCSERP Interest Credit - $12,009 c) DBSERP Interest Credit - $83,879 20) Dave Mast a) SERP Earned but Not Vested - $9,702 21) Kerry L. Carmody a) Taxable SERP Earned but not Paid - $100,430 b) SERP Interest Credit - $114,826 22) Larry S. Bowe a) Taxable SERP Earned but not Paid - $189,643 b) SERP Interest Credit - $282,628 23) Nancy Carlson a) Taxable SERP Earned but not Paid - $80,985 b) Taxable CBRP Earned but not Paid - $563 c) SERP Interest Credit - $49,901 24) Dale Surowitz a) SERP Interest Credit - $24,831 c) SERP Earned but not Vested - $115,534
Part I, Lines 4a-bSEVERANCE 1) John Kenagy - $188,084
Part IIIFORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS PROGRAM The Providence Executive Performance Awards 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 2012, 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 quality focused. In 2012 the percent allocation for each of these strategic priorities was: Mission driven 10% Financially responsible 10% People centered 10% Service oriented 10% Quality focused 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.Supplemental Information

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
CA Health Facilities Financing Authority
A52164382813033F7L82008-11-06284698621Refinance bank loan used for Acquisition of Providence Tarzana Medical Ctr.000
CA Health Facilities Financing Authority
B52164382813033LBZ92009-07-29145060500Construction of Patient Tower @ Holy Cross Med. Ctr.000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A79000002070000284698621221458221268711930258732520081011
B14506050028220725001295530001343494020110011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropPrcntge Bond Financed PropPrcntgeBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A01000.000100.000000.00010110.0070011
B00000.000000.000000.00000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A010000001
B010000001

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSCHEDULE K, PART III, LINE 2Identifier
Return ReferencePRIVATE BUSINESS USEReturnReference
ExplanationLease of Pediatric Services to Children's Hospital of Los Angeles.Explanation

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionDebt ForgivenDescription
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9902424115NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierMethod for Determining Number of Contributors:Identifier
Return ReferencePart I, Column (b):ReturnReference
ExplanationThe amounts shown on Part I, Col. B reflect the number of donations received of the specific type of item.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6The sole Member of the Corporation is Providence Health & Services.
Form 990, Part VI, Section A, line 7aThe powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause.
Form 990, Part VI, Section A, line 7bThe 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 any strategic plan of the Foundation. D) To approve the annual fundraising plan including special events, annual, capital and planned giving activities. E) To approve the acceptance of any gift that carries conditions or limitations or any gift restricted to services, programs or facilities not currently offered or approved to be offered by the Corporate Member's Board of Directors.
Form 990, Part VI, Section B, line 11The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS.
Form 990, Part VI, Section B, line 12cProvidence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict.
Form 990, Part VI, Section B, line 15It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined by the Providence Board's Human Resources Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Board retains an independent consultant each year to review salaries of those in the most significant leadership roles in the organization. Part of the consultant's role is to review an extensive array of compensation surveys of large, not-for-profit health care systems in the United States. Providence is one of the larger health systems in the country, and as such, the Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources Committee. 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 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.
Form 990, Part VI, Section C, line 19Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon 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 VIIMichael Hunn - 501 S. Buena Vista Street, Burbank, CA 91505. Karl J. Carrier - Thru 8/12 - 501 S. Buena Vista Street, Burbank, CA 91505. Dave Mast - Eff. 9/12 - 501 S. Buena Vista Street, Burbank, CA 91505. Kerry Carmody - 501 S. Buena Vista Street, Burbank, CA 91505. Larry S. Bowe - 15031 Rinaldi Street, Mission Hills, CA 91346. Nancy Carlson - 1300 West 7th Street, San Pedro, CA 90732. Dale Surowitz - 18321 Clark Street, Tarzana, CA 91356.Contact Addresses for Officers, Directors, Etc
Form 990, Part XI, line 9:Recipient Organization Adjustment 33,680,056. IAF Consolidated Equity Transfers -153,284,729. IAF Expenses -59,000. Contributions Reclassifications 4,132,059. SOP Employee Discount 46,800. UR NA Suspense 24. Transfer Net Assets Oakland 43. Rounding -4. Interaffiliate Revenues 238,017,074. Capital Transfer for Affiliation Agreement -30,000,000.Changes in Net Assets or Fund Balances:
FORM 990, PART I, LINE 6Our volunteers provide valuable assistance to all of our ministries through a variety of services. Some specific examples include the following: BEYOND FIFTY VOLUNTEER In conjunction with the Beyond Fifty Program, volunteers may sign up to work on Beyond Fifty projects with the Beyond Fifty Program manager. These projects usually involve mailings and/or filing. CLERICAL VOLUNTEERS Clerical volunteers perform general office work such as filing, mailing, data entry, word processing, answering phones, making charts and copying forms. They work in most of the business and clinical offices throughout the hospital. CLINICAL VOLUNTEERS Clinical volunteers work on the nursing floors in 4 hour shifts. They help with trays and feeding, check on patients to be sure they are comfortable. They also put away clean linens, make beds, run errands for the nurses, keep the nurse's kitchen in order, take patients for wheelchair walks and discharge patients. EMERGENCY ROOM VOLUNTEERS These volunteers work a four hours shift once a week. Duties include making phone calls to recently discharged patients checking on their condition and asking a few brief questions regarding the care they received while a patient, helping at the registration desk, checking on each patient to see if they need anything, running errands for the staff, answering phones, discharging patients by wheel chair, making beds, etc. INFORMATION DESK They must be able to multi-task answer phones, direct patients and be willing to walk patients to their destinations. They must have excellent customer relation skills. MESSENGER CENTER Volunteers work a four hours shift answering the messenger phone, carrying lab samples, charts, x-rays, etc. and transporting ambulatory patients by wheel chair within the hospital. The messengers also work on mailing projects for various departments. This is an opportunity for those who like to walk and enjoy a variety of experiences as well as enjoying the constant contact with others. MUSIC PROGRAM Volunteers who sing or play a musical instrument schedule four hours per week to visit patients and sing or play for them. Harpists and guitar players are needed as well as other movable instruments which can be played individually. PATIENT VISITOR These volunteers visit the newly admitted patients to welcome them and provide a friendly ear for requests, complaints or just a brief visit. The volunteer must be outgoing and friendly, able to make easy conversation. PETS WITH A PURPOSE This program is in conjunction with Recreation Therapy. Pet volunteers visit patients with their dogs. The dogs are chosen for their friendly personalities and must pass behavioral tests and training to qualify. Visiting is done on a rotating schedule. All applications must be approved by Recreation Therapy Manager. SPIRITUAL CARE VOLUNTEERS Eucharistic Ministers visit the sick and bring Holy Communion to patients requesting the service. This is done on a rotating basis as the volunteer is available. Other volunteers work on projects such as little gifts and handouts for patients. SURGERY WAITING ROOM DESK Another customer service job places the volunteer in the Surgery Waiting room. He/she must keep track of all patients' family members and other visitors and dispense information regarding the patient in surgery. Duties include keeping the room neat, monitoring the television, making and service coffee and tea and cleaning up at the end of the shift. The volunteer must also maintain a pleasant, helpful attitude at all times. Volunteers with Providence High School assist in the following capacities: * Meeting Attendance * Preparing special mailings * Laundry * Building Props and making costumes * Supervision of special events * Setting up for special events * Cleaning up after events * Hospitality for events * Video special events * Chaperoning field trips and dances * Courier Service * Traffic ControlVOLUNTEERS
FORM 990, PART VIIAs 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.RELIGIOUS COMMUNITY MEMBERS
FROM 990, PART XII, LINE 2CThe 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.AUDIT & COMPLIANCE
FORM 990, SCHEDULE R - RELATED ORGANIZATIONSOn February 1, 2012, Providence Health & Services (the Health System) and Swedish Health Services (Swedish) effected an affiliation Agreement, which integrated the operations of the two health systems. The Health System and Swedish have affiliated to create a fully integrated, nonprofit, charitable health care system serving the communities throughout Western Washington. No cash or other purchase consideration was transferred to effect the affiliation. Effective July 1, 2012, Providence Health System - Southern California entered into an affiliation agreement with Facey Medical Foundation and Facey Medical Group. The Facey Medical Foundation is a nonprofit medical foundation, which operates ten clinics in the North San Fernando, Santa Clarita, San Gabriel and Simi Valleys. These sites are staffed by the Facey Medical Group physicians pursuant to a professional services agreement. No cash or other purchase consideration was transferred to effect the affiliation.AFFILIATION AGREEMENTS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (62 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
Providence Health & Services - Washington
1801 Lind Avenue SW 9016RentonWA980579016510216586Healthcare SystemWA501( c)(3)Line 3Providence Health & Services0
Providence Health & Services - Oregon
1801 Lind Avenue SW 9016RentonWA980579016510216587Healthcare SystemOR501( c)(3)Line 3Providence Health & Services0
Everett Transitional Care Services
PO Box 5128EverettWA982065128943264605Transitional CareWA501( c)(3)Line 90N/A
Providence Oregon Management Corporation
1801 Lind Avenue SW 9016RentonWA980579016930813977Shell CorporationOR501( c)(3)Line 1PH & S - Oregon0
Providence Plan Partners
4400 NE Halsey Bldg 2PortlandOR97213911861964Healthcare ServicesOR501( c)(4)N/APH & S - Oregon0
Providence Health Plan
4400 NE Halsey Bldg 2PortlandOR97213930863097Health Service ContractorOR501( c)(4)N/AProvidence Plan Partners0
Providence Health Assurance
4400 NE Halsey Bldg 2PortlandOR97213550828701Medicaid Healthcare ProviderOR501( c)(4)N/AProvidence Health Plan0
Providence Medical Institute
4101 Torrance BlvdTorranceCA90503330283773HealthcareCA501( c)(3)Line 11/Type IPHS - So California1
Little Company of Mary Ancillary Services Corporation
4101 Torrance BlvdTorranceCA90503330844408Imaging ServicesCA501( c)(3)Line 9PHS - So California1
Providence TrinityCare Hospice
5315 Torrance Blvd Suite B1TorranceCA90503953264139HospiceCA501( c)(3)Line 9PHS - So California1
Providence Blanchet Association
1700 Providence PlCentraliaWA98531911789266HousingWA501( c)(3)Line 7PH & S - Washington0
St Luke Association
350 Washington Ave SEChehalisWA98352943176618HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Rossi Association
1700 Providence PlCentraliaWA98531311584166HousingWA501( c)(3)Line 9PH & S - Washington0
Lundberg Association
5921 E BurnsidePortlandOR97215911562797HousingOR501( c)(3)Line 7PH & S - Oregon0
Providence St Francis Association
3415 12th Avenue NEOlympiaWA98506943244854HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Peter Claver Association
7101 38th Avenue SouthSeattleWA98118311629656HousingWA501( c)(3)Line 7PH & S - Washington0
Providence St Elizabeth House Association
3201 SW Graham StSeattleWA98126912171539HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Gamelin House Association
4515 MLK Jr Way S Ste 200SeattleWA98108311744654HousingWA501( c)(3)Line 7PH & S - Washington0
The Gamelin Association
312 North Fourth StYakimaWA98901911180824HousingWA501( c)(3)Line 7PH & S - Washington0
The Gamelin Oregon Association
5520 NE GlisanPortlandOR97213911214491HousingOR501( c)(3)Line 9PH & S - Oregon0
The Gamelin California Association
540 23rd StOaklandCA94612911293869HousingCA501( c)(3)Line 9PHS - So California1
Gamelin Washington Association
1423 First AvenueSeattleWA98101201910170HousingWA501( c)(3)Line 7PH & S - Washington0
Providence Foundation
1801 Lind Avenue SW 9016RentonWA980579016943078543Support PH&S InstitutionsWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Alaska Foundation
3300 Providence Drive - B Tower2AnchorageAK99508920093565Support PHS-AlaskaAK501( c)(3)Line 11/Type IPH & S - Washington0
Providence St Peter Foundation
413 Lilly Road NEOlympiaWA985065166911097056Support Affiliated Tax-Exempt OrganizationWA501( c)(3)Line 7PH & S - Washington0
Providence Health Care Foundation (Centralia)
914 S Scheuber RoadCentraliaWA98531911433382Support Providence Centralia HospitalWA501( c)(3)Line 7PH & S - Washington0
Providence Mount St Vincent Foundation
4831 - 35th Avenue SWSeattleWA981262799911188119Support Providence Mount St.VincentWA501( c)(3)Line 7PH & S - Washington0
Providence Marianwood Foundation
3725 Providence Point Drive SEIssaquahWA980297219931554288Support Providence MarianwoodWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Newberg Health Foundation
1001 Providence DriveNewbergOR97132930889144Support Providence Newberg Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Seaside Hospital Foundation
725 S Wahanna RdSeasideOR97138930927320Support Providence Seaside HospitalOR501( c)(3)Line 7PH & S - Oregon0
Providence Community Health Foundation
1111 Crater Lake AveMedfordOR97504930692907Support Providence Medford Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Benedictine Nursing Center Foundation
540 South Main StMt AngelOR973629532911940286Support Providence Benedictine Nursing CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Portland Medical Foundation
4805 NE Glisan StPortlandOR972132967931231494Support Providence Portland Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence St Vincent Medical Foundation
9205 SW Barnes RdPortlandOR97225930575982Support Providence St. Vincent Medical CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence Milwaukie Foundation
10150 SE 32ndMilwaukieOR97222943079515Support Providence Milwaukie HospitalOR501( c)(3)Line 7PH & S - Oregon0
Providence Child Center Foundation
830 NE 47thPortlandOR97213930800140Support Providence Child CenterOR501( c)(3)Line 7PH & S - Oregon0
Providence TrinityCare Hospice Foundation
5315 Torrance Blvd Suite B1TorranceCA90503330261016Support TrinityCare HospiceCA501( c)(3)Line 7PHS - So California1
Providence Little Company of Mary Foundation
4101 Torrance BlvdTorranceCA90503510224944Support Little Company of Mary Service AreaCA501( c)(3)Line 7PHS - So California1
PH&S FoundationSFVSA & SCVSA
501 S Buena Vista StreetBurbankCA91505953544877Support Program & Activities of SFVSA & SCVSACA501( c)(3)Line 7PHS - So California1
Providence Hospice of Seattle Foundation
425 Pontius Avenue North 300SeattleWA981095452912077378Support Hospice of SeattleWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Health & Services - Western Washington
1801 Lind Avenue SW 9016RentonWA980579016911303277HealthcareWA501( c)(3)Line 3Providence MinistriesWHC0
Providence Health & Services
1801 Lind Avenue SW 9016RentonWA980579016911549796Shell CorporationWA501( c)(3)Line 11/Type I0N/A
Providence Health & Services - Montana
500 W Broadway PO Box 4587MissoulaMT598064587810231793HealthcareMT501( c)(3)Line 3PH & S - Washington0
Providence St Joseph Medical Center
PO Box 1010PolsonMT598601010810463482HealthcareMT501( c)(3)Line 3PH & S - Washington0
St Thomas Child and Family Center
1710 Benefis CourtGreat FallsMT59405810233495Early Childhood EducationMT501( c)(3)Line 1PH & S - Washington0
Sisters of Providence of Montana Corporation
1801 Lind Avenue SW 9016RentonWA980579016262612415Shell CorporationMT501( c)(3)Line 1PH & S - Washington0
Providence Health Care Foundation - Eastern Washington
101 W 8th AveSpokaneWA99204320014330Support PH&S-WA. Ministries in E. WA.WA501( c)(3)Line 7PH & S - Washington0
St Patrick Hospital Foundation
500 West Broadway PO Box 4587MissoulaMT598064587237056976Support Healthcare in W. MontanaMT501( c)(3)Line 7PH & S - Washington0
University of Great Falls
1301 20th Street SouthGreat FallsMT59405810231777Post Secondary EducationMT501( c)(3)Line 2PH & S - Washington0
E WA & MT Unemployment Compensation Insurance Trust
1801 Lind Avenue SW 9016RentonWA980579016911082119Unemployment BenefitsWA501( c)(3)Line 11/Type IPH & S - Washington0
Providence Willamette Falls Medical Foundation
1500 Division StreetOregon CityOR97045931003750Support Willamette Falls HospitalOR501( c)(3)Line 11/Type IPH & S - Oregon0
Providence Hood River Memorial Hospital Foundation Inc
811 13th StHood RiverOR97031930921990Support Providence Hood River Memorial HospitalOR501( c)(3)Line 7PH & S - Oregon0
Providence Hospice and Home Care Foundation
2731 Wetmore Avenue Suite 500EverettWA98201272552749Support Program & Ministries of PHHCWA501(c )(3)Line 7PH & S - Washington0
Providence St Mary Foundation
401 W Poplar StWalla WallaWA99362452841492Support Program & Ministries of SMMCWA501(c )(3)Line 7PH & S - Washington0
Facey Medical Foundation
15451 San Fernando Mission Blvd 200Mission HillsCA913451420954322584Support Facey Medical GroupCA501(c )(3)Line 7PHS - So California1
Swedish Health Services
747 BroadwaySeattleWA98122910433740HealthcareWA501(c )(3)Line 3Western HealthConnect0
Swedish Edmonds
21601 76th Ave WEdmondsWA98026272305304HealthcareWA501(c )(3)Line 3Western HealthConnect0
Swedish Medical Center Foundation
747 BroadwaySeattleWA98122910983214Support Swedish Health ServicesWA501(c )(3)Line 7Swedish Health Services0
Global To Local Health Initiative
747 BroadwaySeattleWA98122273133200HealthcareWA501(c )(3)Line 7Swedish Health Services0
Swedish MJM Holdings
747 BroadwaySeattleWA98122273139262Holding CompanyWA501(c )(3)Line 11/Type ISwedish Health Services0
Marsha Rivkin Center for Ovarian Cancer Research
747 BroadwaySeattleWA98122912054035Ovarian Cancer ResearchWA501(c )(3)Line 7Swedish Health Services0
Western HealthConnect
747 BroadwaySeattleWA98122454171900Shell CorporationWA501(c )(3)Line 11/Type IProvidence Ministries0

Form990 Schedule R Part III Form990ScheduleRPartIII (28 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipShare Of Total IncomeShareOfTotalIncome
Providence Imaging Center
3340 Providence DriveAnchorageAK99508920118807Medical ImagingAKPH&S - WARelated00
Pathology Associates Medical Laboratories LLC
611 N PerrySpokaneWA99202270943279Outpatient LabWABourget Health Services IncRelated00
California Laboratory Associates LLC
501 Buena VistaBurbankCA91505273888692Outpatient LabCAPHS - So CaliforniaRelated00-21928570.85900
Surgery Ctr at Tanasbourne LLC
1235 NE 47th Ave 260PortlandOR97213208187971Ambulatory Surgery CenterORPH&S - ORRelated00
Distribution Operations Center LLC
1801 Lind Ave SW 9016RentonWA98057271054858Supplies Purchasing AgentWAPH&S - WARelated00
Broadway Imaging LLC
500 W BroadwayMissoulaMT59802522405971Medical ImagingMTPH&S - MTRelated00
Ctr for Med Imaging-Bridgeport LLC
1235 NE 47th AvePortlandOR97213260796953Imaging - DiagnosticsORPH&S - ORRelated00
Ctr for MedImaging-Tanasbourne LLC
1235 NE 47th AvePortlandOR97213200477972Imaging - DiagnosticsORPH&S - ORRelated00
Portland Medical Imaging LLC
10538 SE Washington StPortlandOR97216201054971Imaging - DiagnosticsORPH&S - ORRelated00
Oregon Advanced Imaging LLC
881 OHare ParkwayMedfordOR97504450471748Medical ImagingORPH&S - ORRelated00
Minor & James Medical PLLC
515 Minor Avenue 200SeattleWA98104911340223Physician ClinicWASwedish MJM Holdings IncN/A00
Clackamas Radiation Oncology Center LLC
1235 NE 47th Ave 288PortlandOR97213260381897Radiation OncologyORPH&S - ORRelated00
PETCT Imaging at Swedish Cancer Institute LLC
1221 Madison StreetSeattleWA98104203132044Medical ImagingWASwedish Health ServicesRelated00
Mountainstar Clinical Laboratories LLC
611 N PerrySpokaneWA99202261345983Outpatient LabMTPAML LLCRelated00
PacLab LLC
611 N PerrySpokaneWA99202911743952Outpatient LabWAPH&S - WARelated00
Center for Specialty Surgery LLC
11782 SW Barnes RdPortlandOR97225263638838Ambulatory Surgery CenterORPH&S - ORRelated00
Oregon Outpatient Surgery Center
7300 SW Childs RdTigardOR97224223883387Ambulatory Surgery CenterORPH&S - ORRelated00
ProvidenceUSP Santa Clarita GP LLC
11550 Indian Hills Road 160Mission HillsCA91345202829660Ambulatory Surgery CenterCAPHS - So CaliforniaRelated00
ProvidenceUSP Surgery Ctrs LLC
11550 Indian Hills Road 160Mission HillsCA91345200905938Ambulatory Surgery CenterCAPHS - So CaliforniaRelated00
Alpha Medical Laboratory LLC
611 N PerrySpokaneWA99202912017347Outpatient LabIDPAML LLCRelated00
Canby Medical Center I LLC
2747 Pence Loop SESalemOR97302205470937Real Estate - MOBORPH&S - ORRelated00
Greater Valley Medical Building LP
501 S Buena Vista StBurbankCA91505954570858Real Estate - MOBCAPHS - So CaliforniaInvestment0031917350.50000564393
Medalia Healthcare LLC
1801 Lind Ave SW 9016RentonWA98057911660459Physician BenefitsWAPH&S - WAInvestment00
Prov Radiation Oncology Develop Assn LLC
1235 NE 47th AvePortlandOR97213260682491Real Estate - MOBORPH&S - ORInvestment00
ProvidenceSilverton Rehab LLC
1235 NE 47th Ave 260PortlandOR97213481287267Rehab ServicesORPH&S - ORRelated00
Southern Idaho Regional Laboratory LLC
611 N PerrySpokaneWA99202820511819Outpatient LabIDPAML LLCRelated00
Tri-Cities Laboratory LLC
611 N PerrySpokaneWA99202911773986Outpatient LabWAPAML LLCRelated00
Providence Partners for Health LLC
501 S Buena Vista StBurbankCA91505454041798Clinical Quality & IntegrationCAPHS - So CaliforniaRelated006563220.50000271343

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrg
Providence Health Ventures Inc
4101 Torrance BlvdTorranceCA90503330122216InvestmentCAN/AC0
Caron Health Corporation
510 W Front StMissoulaMT59802810486082Medical Physician ServiceMTN/AC0
Providence Health Care Ventures Inc
101 W 8th Ave TAF C-9SpokaneWA99204900155714Clinical/Medical LabWAN/AC0
Providence Physician Services Co
101 W 8th Ave TAF C-9SpokaneWA99204911216033Clinical/Medical LabWAN/AC0
Yakima Medical Arts Inc
611 N Perry 100SpokaneWA99202910787963Rental Real EstateWAN/AC0
Bourget Health Services Inc
PO Box 2687SpokaneWA99220911354431Clinical/Medical LabWAN/AC0
1221 Madison Street Owners Assoc
747 BroadwaySeattleWA98122201954319Owners' AssociationWAN/AC0
Washington Cancer Centers PC
1560 N 115th G-16SeattleWA98133911792791Cancer TreatmentWAN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Providence Health & Services Foundation
C5223893Cost
Providence Little Company of Mary Foundation
C2576949Cost
Providence Little Company of Mary Foundation
B2390314Cost
Providence Health & Services Foundation
B4533878Cost

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