2011-11-15T11:19:28-06:00 2010-12-31 Clark Nuber PS 10900 NE 4th Suite 1700 Bellevue WA 98004 990 2010-01-01 810231793 PROVIDENCE HEALTH & SERVICES - MONTANA PROV 4255253985 1801 Lind Avenue SW No 9016 Renton WA 980579016 Michael L Butler 4255253985 2011-11-15 1 Sara Elizabeth J Hyre CPA 4254544919 2010 2016-02-24 21:20:13Z Providence St Patrick Hospital John F Koster MD 1801 Lind Avenue SW No 9016 Renton WA 980579016 273494804 0 0928 X www.saintpatrick.org X 1991 MT Healthcare with special concern for the poor and vulnerable in Missoula, MT. 14 14 1993 239 0 0 1639107 1549836 226855266 246088910 101155 1563405 5732865 5595733 234328393 254797884 792458 728409 0 0 94865907 103862142 0 0 0 125201152 134419077 220859517 239009628 13468876 15788256 201150520 213565446 95501316 96414498 105649204 117150948 X As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Healthcare with special concern for the poor and vulnerable in Missoula, MT. 0 0 89472596 0 125023194 Acute Care - InpatientTotal Admissions: 8,144Total Patient Days: 39,959HistorySt. Patrick Hospital opened in 1873 under the sponsorship of the Sisters of Providence. The present facility opened in 1984, the fourth St. Pat's on this site above the Clark Fork River. In May 2000, we changed our name from "St. Patrick Hospital" to "St. Patrick Hospital and Health Sciences Center" to reflect our increasing involvement with national medical research and education. The hospital has 195 acute-care beds, and 18 transitional-care beds. Approximately 95% of our patients come from our 17-county service area. In November 1999, after imploding the old hospital called the Broadway Building, construction began for a new outpatient services building next to our present hospital building. The Broadway Building opened in March 2002, with two underground floors of parking and six stories of physician offices and outpatient services. Physicians include those from the Western Montana Clinic, the Montana Neuroscience Institute, and the Montana Cancer Center, among others. Outpatient services include physical, occupational, and speech therapy, diabetes services, and cardiac rehabilitation. Sponsorship Providence Health & Services - MT. dba Providence St. Patrick Hospital is a not-for-profit medical center affiliated with the Sisters of Providence. The Sisters share responsibilities with community leaders in the form of a governing board, which helps direct the hospital in its endeavors. This governing board, in turn, reports to and is directed by Providence Health and Services. Providence Health and Services is a holding company that represents the Sisters of Providence in leading their sponsored healthcare, higher education, and human services ministries in eastern Washington and western Montana. Sponsorship is a special type of not-for-profit ownership. As sponsors, the Sisters of Providence and Providence Health and Services are accountable to the community, the Catholic church, and state and federal governments for fulfilling the missions of each sponsored organization.HIGHLIGHTS:In recognition of excellence, the following awards and accolades were received by the hospital:2010 Energy Star Award for Providence Center To qualify for the ENERGY STAR, a building or manufacturing plant must score in the top 25 percent based on EPA's National Energy Performance Rating System. To determine the performance of a facility, EPA compares energy use among other, similar types of facilities on a scale of 1-100; buildings that achieve a score of 75 or higher may be eligible for the ENERGY STAR. The EPA rating system accounts for differences in operating conditions, regional weather data, and other important considerations. National Children's Alliance (NCA) Accreditation First Step Resource Center - a Children's Advocacy Center at Providence St. Patrick Hospital has been awarded accreditation by National Children's Alliance (NCA) following an extensive application and site review process. As the accrediting agency for Children's Advocacy Centers (CAC) across the country, NCA awards various levels of accreditation and membership to centers responding to allegations of child abuse in ways that are effective and efficient, and put the needs of child victims of abuse first. Accreditation is the highest level of membership with NCA and denotes excellence in service provision. This accreditation reflects the impressive collaborative multi-agency response to child abuse in the Missoula community.Silver Medal of Honor-Life Center Northwest For excellence in organ transplantation practices based on the national data established comparing number of eligible deaths and actual donors.Care Delivery Innovation Funding of Providence Health & Services to Chronic Disease Prevention & Management Program Amount of Award $48,135 This funding will be used to implement Better Choices, Better Health, in the Western Montana Service Area. Better Choices, Better Health is a Stanford Self-Management workshop for people with chronic conditions and illnesses. The workshops will be facilitated by trained lay persons within the community who also have chronic conditions. Self-management workshops help people gain confidence and learn the skills needed to better manage the physical and emotional challenges which are often associated with a chronic condition. The workshops in Missoula started in May 2011.Care Delivery Innovation Funding to Advance Care Planning Throughout the Continuum Amount of Award: $74,603 The Care Delivery Innovation Council of Providence Health & Services Washington/Montana Region set aside $500,000 in 2010 to be paid out to teams needing seed money to conduct projects that would support the vision of Providence and test new models of care. Funding was awarded to St. Patrick Hospital and the Western Montana Service Area for advance care planning. The objectives for this collaborative project include adopting the Five Wishes Advance Directive document throughout Missoula County and the surrounding area, establishing and assisting with community education regarding advance care planning, and implementing the Disease-specific Advance Care Planning -Respecting Choices curriculum as a pilot within the Congestive Heart Failure Clinic. The pilot will also serve to provide standardized POLST interview education/certification, development and deployment of in-hospital communication processes, and development of standardized handoff processes with skilled nursing. Environmental Leadership Circle AwardProvidence St. Patrick Hospital was inducted in to the Environmental Leadership Circle through Practice Greenhealth, one of only three hospitals in the nation that were inducted in May 2010. Practice Greenhealth is a non-profit group helping hospitals and healthcare facilities to operate with fewer environmental impacts. The Environmental Leadership Award is the premier award recognizing health care facilities that exemplify environmental excellence and are setting the highest standards for environmental practices and sustainability in health care. To be considered, facilities must meet the criteria for the Mercury-Free Award, recycle at least 25% of their total waste, be leading the health care sector in innovation and sustainability, and be leaders in their community. It is a honor and a tribute to the hundreds of staff that participate in our efforts for recycling, energy conservation, commuting, and sharing ideas. 65008867 0 90839168 Acute Care - OutpatientTotal Visits: 148,560 Outcomes Excellence Award for Cardiac Rehabilitation Program The Cardiac Rehabilitation Program at Providence St. Patrick Hospital received the Outcomes Excellence 2010 Award on April 29, 2010 from the Regional Cardiac Rehabilitation Montana Outcomes Project. This project is sponsored by the Montana Association of Cardiovascular and Pulmonary Rehabilitation and the Cardiovascular Health Program within the Department of Public Health & Human Services. Of the 10 quality indicators evaluated, the Providence St. Patrick Hospital Cardiac Rehab Program exceeded the regional mean more often than any of all large or interventional hospitals from 12 states tracking and reporting a uniform set of quality indicators. This is the third consecutive year that St. Patrick Cardiac Rehab has received this award.Providence St. Patrick Hospital and Health Sciences Center Diabetes Care Services Accreditation The Providence St. Patrick Hospital Diabetes Care Services Department received accreditation from the American Association of Diabetes Educators in April 2010 signifying their compliance with the National Standards for Diabetes Self-Management Education (DSME). The overall objectives of DSME are to help patients make informed decisions, use appropriate self-care behaviors, solve problems and collaborate with the health care team and to improve clinical outcomes, health and quality of life. 37606080 0 27290066 Primary CareTotal Visits: 104,282See Line 4a Narrative 10153 0 14258 Long-Term Care/Assisted Living/Home CareSee Line 4a Narrative 728409 728409 0 Grants and Allocations.See Schedule I. 4224624 0 5903142 Joint Ventures 4963186 728409 5917400 197050729 1 1 0 1 0 0 0 0 0 1 0 1 1 1 1 0 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1 1993 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 MT X Karl E Fritschel CPA 4255253339 1801 Lind Ave SW 9016 Renton WA 980579016 X Lucille Dean SP 11.80 X X 0 0 0 M Adrian Davis LCM 3.20 X 0 0 0 Mary Corita Heid RSM 3.80 X 0 0 0 Michael A Stein 4.70 X 0 18000 0 Michael Holcomb 3.70 X 0 15000 0 Dana A Rasmussen 3.40 X 0 15000 0 Paul A Redmond 3.00 X 0 18000 0 James S Roberts MD 6.00 X 0 15000 0 Peter J Snow 4.10 X 0 15000 0 Jeffrey B Clode MD 5.40 X 0 18000 0 Sallye Liner 3.50 X 0 3750 0 Owen B Robinson 5.50 X 0 15000 0 Cheryl M Scott 3.00 X 0 15000 0 Ellen L Wolf 6.80 X 0 15000 0 John F Koster MD 50.00 X 0 2346502 794703 Michael L Butler 65.00 X 0 1038275 340314 Jeffrey W Rogers 50.00 X 0 1259397 465326 Jeffrey Fee 50.00 X 0 460661 109009 Bruce E Whitfield 50.00 X 262397 0 30056 Eugene Al Parrish 50.00 X 0 1047158 332492 John V Fletcher 60.00 X 0 1277503 584795 Janice J Jones 55.00 X 0 1140032 349285 Gregory Van Pelt 60.00 X 0 2314095 484343 Russell Danielson 50.00 X 0 4449992 397656 Arnold R Schaffer 60.00 X 0 1980618 371481 John O Mudd 55.00 X 0 856420 395919 Keith Marton MD 60.00 X 0 717815 215947 Claudia Haglund 50.00 X 0 501163 126574 Joel S Gilbertson 50.00 X 0 454656 56288 Cindra R Syverson 55.00 X 0 485868 108238 John Kenagy 60.00 X 0 447695 141020 Orest Holubec 50.00 X 0 335415 22577 Deborah Burton 60.00 X 0 341476 168307 Myron Berdischewsky MD 60.00 X 0 609142 268959 David Brown 55.00 X 0 342030 110948 Gary Flaming 55.00 X 0 314477 76918 Michael Hunn 60.00 X 0 490880 166313 Mark H Wakai 50.00 X 323681 0 35697 Craig E Aasved 55.00 X 319263 0 33533 Mark L Sanz MD 50.00 X 673835 0 76624 James M Maxwell MD 50.00 X 673092 0 85565 James T Maddux MD 50.00 X 659696 0 61555 Clifford Sheehan MD 42.00 X 638953 0 71004 George T Bandow MD 50.00 X 576089 0 42551 Richard J Umbdenstock 0.00 X 0 32220 0 Michael J Madden 0.00 X 0 359717 0 Charles E Hawley 0.00 X 0 2137748 17773 Thomas Johnson 0.00 X 0 325409 91452 4127006 26229114 6633222 97 1 1 0 Western MT Emergency Phys POBox 4506 Missoula MT 59802 ER Physicians 5469238 Health Services Northwest 2201 Lind Avenue SW Ste 300 Renton WA 98057 AR Collections 2674111 Metro Aviation Inc PO Box 7008 Shreveport LA 71137 Helicopter Maintenance 2086218 Tamarack Management Inc PO Box 7609 Missoula MT 59807 Hospitalists 1202854 Neurological Associates PC 554 W Broadway 3rd Fl 1 Missoula MT 59802 Neurologists 639000 54 105 1478851 54392 16488 1549836 Acute Care - Inpatient 622110 123693180 123693180 Acute Care - Outpatien 621400 89878461 89878461 Primary Care 621110 26668930 26668930 Joint Ventures 900099 5834231 5834231 LTC, Home Care 621610 14108 14108 246088910 1337076 1337076 3191871 2032433 1159438 1159438 1159438 16706472 16478832 1311 227640 -1311 226329 226329 206420 184344 22076 22076 BIC Outside Services 900099 1372134 1372134 Fees Contracted 900099 510814 510814 BioMed 900099 371717 371717 2159554 726253 1433301 4414219 254797884 249069828 0 4178220 728409 728409 1529042 347734 1181308 82353955 71965268 10388687 4996316 4185419 810897 9119691 7108420 2011271 5863138 4743428 1119710 1626314 1626314 104122 71844 32278 14635 14635 94298 94298 39913933 34280642 5633291 1198421 1179117 19304 44043893 42969836 1074057 1700096 607095 1093001 3449487 2623542 825945 538285 403301 134984 252773 129581 123192 3059261 3059261 11000140 550007 10450133 9917563 6530303 3387260 2162025 599231 1562794 Bad Debts 12198530 12198530 License and Taxes 2030273 2028520 1753 Dues & Suscriptions 401548 310767 90781 Recruitment 299367 286314 13053 Relocation 214913 111743 103170 199200 32417 166783 239009628 197050729 41958899 0 929496 2876903 4893224 1908127 17500 36322428 33809578 13627035 12976034 5675247 5447484 2162373 2558040 201979082 115302266 90565135 86676816 27766781 29333719 6674619 12380653 12534182 25580592 201150520 213565446 18675758 19951612 1150979 1786093 58178662 58178662 17495917 16498131 95501316 96414498 X 105352823 112111652 296381 3836140 1203156 105649204 117150948 201150520 213565446 X 15788256 -4286512 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 2044 0 0 0 2044 0 10594524 10594524 95356342 50043635 45312707 2248610 1828717 419893 90699367 63429914 27269453 3080239 3080239 86676816 Invest in Prov. Surgery Center, LLC 805097 C Invest in Broadway Imaging, LLC 2544816 C Invest in Partners in Home Care, Inc. 1353754 C Invest in Tamarack Management, Inc. 2514069 C Invest in Foundation 5162917 C 12380653 Unamortized Bond Financing Costs 499052 Cash Surrender Value of Life Insurance 131801 Due from Affiliates 24924852 Other Receivables 24887 25580592 Other Payables 59572 Due to Affiliates 6251008 Bond Premium Discount 1484798 Obligation for Financing Lease 6345000 Capitalized Lease Obligation 1630653 Third Party Settlements 727100 16498131 Description of Uncertain Tax Positions Under FIN 48: Part X: 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. 1 1 1 X 1 X 1 1 1 0 1 1 0 0 11167329 11167329 0.04830 0 0 16068790 11261486 4807304 0.02080 0 0 146895 136441 10454 0.00000 27383014 11397927 15985087 0.06910 0 0 586091 586091 0.00250 0 0 281032 281032 0.00120 0 0 36688900 24945861 11743039 0.05080 0 0 69932 69932 0.00030 0 0 35000 35000 0.00020 37660955 24945861 12715094 0.05500 65043969 36343788 28700181 0.12410 0 0 1000 1000 0.00000 0 0 1250 1250 0.00000 0 0 6167 6167 0.00000 8417 8417 0 4982002 0 85060605 109390167 -24329562 X 1 1 1 NONE 1 1 Providence St Patrick Hospital

500 West Broadway Missoula MT 59802

X X X X Rehab and Psych Providence St Patrick Hospital 1 Part I, Line 6a: In addition to providing its own smaller Community Benefit Report, St. Patrick's Community Benefit information is included in the consolidated report for Providence Health & Services.www.saintpatrick.org/index.aspx/Serving_Our_Community/Community_Benefit_Reports Part I, L7 Col(f): Our total expense from Form 990, Part IX, Line 25, column (A) was $239,009,628. The bad debt expense included in this amount was $12,198,530. The organizational share of joint venture expenses was $4,224,624. This left us with total expense of $231,035,722 for purposes of calculating line 7, column f. Part II: Physical Improvements/Housing:HABITAT FOR HUMANITYAnalysis of Need:Through the 2009-2013 Consolidated Plan for the City's Community Development Block Grant the development of supportive housing initiatives for special populations e.g. single income families, people with disabilities, seniors and persons with HIV/AIDS present the greatest need in Missoula County. In 2000, 25% of area owners and 51% of renters paid more than 30 % of their incomes for housing; by 2007, 40% of homeowners and over 59% of renters paid more than 30% of their incomes on housing in Missoula County. In 2007, an estimated 23.3% of the City's residents live at or below the federal poverty standard. Half of all the single parent families headed by women live below the poverty threshold and more than 70% of the femaile headed families with children younger than 6 live in poverty. Having a safe and affordable place to live is critical to the overall health of the individual, family and community, therefore supporting housing initiatives for vulnerable populations is enhancing public health. The funding provided by SPH for the Habitat Home was for addressing the need of one single mother with four children. Additionally, SPH participates and supports other community wide housing efforts such as the At Risk Housing Coalition and the North Missoula Community Land Trust Land Trust housing program. Community Support:Lowell Summer Reading Program and Kids Ride FreeAnalysis of Need:Lowell Elementary school, the hospital's neighborhood school is located in the most vulnerable neighborhood in Missoula County. Key statistics about this neighborhood include; 26% of children live in poverty, 48% of single head of households live in poverty and 27% of all individuals are uninsured. The Summer Reading program provides critical academic support for those children in the Title one program and attempts to address the high percentage of neighborhood residents who don't have a high school diploma. Additionally, we partner with the Kid's Cafe, a program of the Missoula Food Bank that provides a nutritious meal for children in this program. The Kids Ride Free program is a community sponsored program of Mountain Line public transportation system that seeks to provide children transportation that removes barriers for participation in educational, summer feeding programs and other critical services in the community. SPH also sees this program as an important initiative in our Green for Good environmental program as well. The support of both of these programs is meeting a public health objective. Community Support: Leadership MissoulaAnalysis of Need: The Missoula community needs to identify and motivate new leaders to sustain changes for creating a healthier community.We want to identify and motivate potential leaders to address community needs and problems and offer them alternatives for dealing with these issues. The participation of the hospital in this training benefits the larger community. In fact, over 50% of those participating in Leadership Missoula are from the social service sector and this allows for greater collaboration amongst them. 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 and Collection PracticesProvidence has written policies about when and under whose authority patient debt is advanced for collection, and uses its best efforts to ensure that patient accounts are processed fairly and consistently.Providence ensures that practices to be used by their outside (non-hospital) collection agencies conform to the standards set forth in this policy, and obtains written commitments from such agencies that they will adhere to those standards. Providence also conducts an assessment of each collection agency's adherence to the policy. Such assessments are conducted at least annually.At time of billing, we provide to all low-income uninsured patients the same information concerning services and charges provided to all other patients who receive care at the hospital.When sending a bill to a patient, Providence includes a) a statement that indicates that if the patient meets certain income requirements the patient may be eligible for a government-sponsored program or for financial assistance from the hospital; and b) a statement that provides the patient with the name and telephone number of a hospital employee or office from whom or which the patient may obtain information about Providence's financial assistance policies for patients and how to apply for such assistance.Any patient seeking financial assistance from Providence (or the patient's legal representative) provides the individual facility with information concerning health benefits coverage, financial status (i.e. income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs.For patients who have an application pending determination for either government-sponsored coverage or for the hospitals own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency.Eligibility for financial assistance will be determined as closely as possible to the date of service. PART III, SECTION A, LINE 1The reporting entity reports bad debt expense in accordance with HFMA Statement #15 with the exception of the following sections: 8.1(b) and 9.1. Part VI, Line 2: We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care. Part VI, Line 3: Communication to the Public:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients. Part VI, Line 4: Providence St. Patrick Hospital (SPH) is located in Missoula, Montana and serves a primary service area of about 200,000 people in western Montana and 400,000 others in contiguous areas. At SPH, 55% of patients are covered by Medicare, another 8% are covered by Medicaid and 8% are self-pay and uninsured. SPH serves a higher percentage of older adults, with 15% of the primary service area's population over the age of 65. With approximately 19% of the population living in poverty, the community is characterized by lower income levels than the national average. Part VI, Line 6: Providence Medical Group manages 32 primary care and specialty provider practices, employing 133 total providers. Providence St. Patrick Hospital, St. Joseph Medical Center and Providence Medical Group collectively build and support coordinated services across the continuum of care to meet regional residents' needs, while mutually supporting organizational, operational, and fiscal health. Joint ventures include research collaborations (cardiac, neuroscience, and oncology) with the University of Montana; affiliations with long term care facilities; a federally qualified health center and a surgery center, among others. The associated providers with Providence Medical Group ensured increased access to primary care with 154,709 patient encounters and have made those services affordable through a patient financial assistance program. Providence St. Patrick Hospital management is directed by an independent governing Community Board which helps direct the hospital in its Mission to serve the community. The composition of the Community Board represents the diversity of the community by having representatives from local government, social service agencies, medical providers, independent business representatives and interested community members. The Providence St. Patrick Hospital Community Board reviews and develops the community benefit plan, providing information and insight into community needs and resources and helping set priorities for what community needs are to be addressed. They also receive regular updates on the overall community benefit strategy and specific programs to assess whether the organization is having an impact on the health of the community. The Institute of Medicine and Humanities is a joint program of The University of Montana and Providence St. Patrick Hospital. The institute fosters the human dimensions of health care by working at the interface of the humanities and medicine. Since its inception in 1987, the Institute of Medicine and Humanities has employed both the traditional humanities and the fine arts to illuminate and understand major issues that confront health care in contemporary society. As medicine has changed, the institute has also evolved its focus to look more broadly at opportunities to make a difference through education in the health care environment with an emphasis on health, as opposed to health care specifically. This includes education of the public about important health care issues; education of undergraduates interested in the health care profession; and education of graduate level nursing, pharmacy and medical students in ethics, collaborative care and team building and conflict resolution. Part VI, Line 7: Providence Health & Services owns and operates 27 general acute care hospitals, 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, 12 low-income housing projects, the Health Plan, a health services contractor, two programs of all inclusive care for the elderly, and 20 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, Spokane and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California.As a ministry of Providence Health & Services, Providence St. Patrick Hospital is guided by a Mission and set of core values based on Catholic health care and inspired by the legacy of the Sisters of Providence. As one Catholic health system committed to caring for the poor and vulnerable, Providence Health & Services has developed a single framework for consistently reporting charity care and community benefit. Our responsibility to stewardship drives us to a standardized approach to supply chain so that we can deliver excellent patient care while reducing the cost of delivered supplies. Our commitment to respect and fairness means Providence has a system-wide compensation policy. Locally, Providence St. Joseph Medical Center is empowered to apply these policies to meet the local needs of their community. Providence St. Patrick Hospital has affiliate relationships with the following critical access hospitals in western Montana: Community Medical Hospital in Anaconda; Clark Fork Valley Hospital in Plains and Granite County Hospital in Phillipsburg. These critical access hospitals are limited service hospitals designed to provide essential services to rural communities. Providence St. Patrick Hospital supports its rural community hospitals by allowing them to purchase supplies and medical equipment at a very low cost due to the purchasing abilities of the whole Providence system. These critical access hospitals are able to maintain access to critical medical services in very rural counties by Providence's support, in fact, every one of these hospitals is located in a county that has the federal designation as health provider shortage areas. Providence St. Patrick Hospital conducts local assessments to make sure the needs of the community are met. The community board of directors oversees and approves the annual community benefit plan that addresses the health care disparities within the community. The community benefit plan is developed and reviewed annually to ensure that the proposed outcomes are being met. This plan is implemented in concert with others in the community to increase the accountability that we share with them to improve the health of our community and to not duplicate services. 1 ST PATRICK HOSPITAL FOUNDATION 900 N ORANGE SUITE 201 MISSOULA MT 59801 237056976 501(C)(3) 497465 OPERATIONAL SUPPORT PARTNERSHIP HEALTH CENTER 323 W ALDER MISSOULA MT 59802 363843543 501(C)(3) 35000 ACCESS TO MENTAL HEALTH THERAPY CATHOLIC SOCIAL SERVICES OF MONTANA PO BOX 907 HELENA MT 59624 920037322 501(C)(3) 35000 PASTORAL OUTREACH & EDUCATION MISSOULA CITY COUNTY HEALTH DEPARTMENT 301 WEST ALDER MISSOULA MT 59802 816001397 Government 26142 CATCH CONTRACT WITH HEALTH DEPT MISSOULA AGING SERVICE 337 STEPHENS AVE MISSOULA MT 59801 810379543 501(C)(3) 25000 SPONSORSHIP OF SENIOR VAN AND PARA TRANSIT SERVICE UNITED WAY 534 NORTH HIGGINGS AVENUE MISSOULA MT 59802 810287854 501(C)(3) 20000 COMMUNITY SUPPORT 6 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: In the application for support, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds were used. X X X X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 John F Koster MD 0 1073328 0 1236674 0 36500 0 777729 0 16974 0 3141205 0 0 Michael L Butler 0 734748 0 283527 0 20000 0 317186 0 23128 0 1378589 0 0 Jeffrey W Rogers 0 418582 0 825815 0 15000 0 446566 0 18760 0 1724723 0 0 Jeffrey Fee 0 322333 0 123203 0 15125 0 98892 0 10117 0 569670 0 0 Bruce E Whitfield 189123 0 52803 0 20471 0 18183 0 11873 0 292453 0 0 0 Eugene Al Parrish 0 491513 0 535611 0 20034 0 310289 0 22203 0 1379650 0 0 John V Fletcher 0 516196 0 708989 0 52318 0 564812 0 19983 0 1862298 0 0 Janice J Jones 0 552837 0 534946 0 52249 0 326291 0 22994 0 1489317 0 0 Gregory Van Pelt 0 678198 0 1545235 0 90662 0 463313 0 21030 0 2798438 0 0 Russell Danielson 0 511864 0 3879403 0 58725 0 373761 0 23895 0 4847648 0 0 Arnold R Schaffer 0 609272 0 1144945 0 226401 0 349661 0 21820 0 2352099 0 0 John O Mudd 0 325749 0 494171 0 36500 0 381188 0 14731 0 1252339 0 0 Keith Marton MD 0 211843 0 237842 0 268130 0 198251 0 17696 0 933762 0 0 Claudia Haglund 0 314668 0 142918 0 43577 0 109252 0 17322 0 627737 0 0 Joel S Gilbertson 0 311580 0 97519 0 45557 0 38285 0 18003 0 510944 0 0 Cindra R Syverson 0 365566 0 105302 0 15000 0 87877 0 20361 0 594106 0 0 John Kenagy 0 324910 0 91285 0 31500 0 122409 0 18611 0 588715 0 0 Orest Holubec 0 128753 0 75000 0 131662 0 13893 0 8684 0 357992 0 0 Deborah Burton 0 252225 0 61612 0 27639 0 153009 0 15298 0 509783 0 0 Myron Berdischewsky MD 0 369222 0 182574 0 57346 0 245165 0 23794 0 878101 0 0 David Brown 0 250803 0 76227 0 15000 0 93721 0 17227 0 452978 0 0 Gary Flaming 0 212910 0 70067 0 31500 0 61683 0 15235 0 391395 0 0 Michael Hunn 0 363490 0 111813 0 15577 0 153028 0 13285 0 657193 0 0 Mark H Wakai 257023 0 64249 0 2409 0 24053 0 11644 0 359378 0 0 0 Craig E Aasved 231986 0 58422 0 28855 0 21911 0 11622 0 352796 0 0 0 Mark L Sanz MD 673810 0 0 0 25 0 63205 0 13419 0 750459 0 0 0 James M Maxwell MD 673067 0 0 0 25 0 71601 0 13964 0 758657 0 0 0 James T Maddux MD 643171 0 0 0 16525 0 54768 0 6787 0 721251 0 0 0 Clifford Sheehan MD 638928 0 0 0 25 0 59432 0 11572 0 709957 0 0 0 George T Bandow MD 413264 0 162800 0 25 0 31102 0 11449 0 618640 0 0 0 Richard J Umbdenstock 0 0 0 32220 0 0 0 0 0 0 0 32220 0 0 Michael J Madden 0 0 0 343217 0 16500 0 0 0 0 0 359717 0 0 Charles E Hawley 0 25690 0 2048448 0 63610 0 17773 0 0 0 2155521 0 0 Thomas Johnson 0 8513 0 62573 0 254323 0 85036 0 6416 0 416861 0 0 Part I, Line 1a The Providence 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 VP, Chief Human Resources Officer. During 2010, a total of four first-class tickets were purchased. 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 2010, the following Key Employees received gross-up payments: Russell Danielson Joel Gilbertson Orest Holubec Eugene "Al" Parrish Arnold R. Schaffer Myron Berdischewsky 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. 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 vice president/chief human resources officer may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2010, the following Key Employees received relocation payments: Joel Gilbertson Orest Holubec Arnold R. Schaffer Myron Berdischewsky Craig E. Aasved The amounts reported for these relocation payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Part I, Lines 4a-b NONQUALIFIED RETIREMENT PLANS A) DBSERP = Defined Benefit Supplemental Executive Retirement Plan B) DCSERP = Defined Contribution Supplemental Executive Retirement Plan C) DBCBRP = Defined Benefit Cash Balance Restoration Plan D) DCRP = Defined Contribution Restoration Plan E) ESP = Elective Survivor Plan F) SOP = Share Option Plan 1) John F. Koster, MD a) Taxable DBSERP Vested but not Paid - $736,499 b) DCSERP Earned - $756,501 2) Michael L. Butler a) DBSERP Earned but not Vested - $1,296 b) DCSERP Earned - $292,794 3) Jeffrey W. Rogers a) Taxable DBSERP Vested but not Paid - $697,854 b) Non-Taxable DBSERP Vested but not Paid - $ 283,728 c) DCSERP Earned - $44,923 d) ESP Interest Credit - $73,103 4) Russell Danielson a) Taxable DBSERP Paid - $ 3,315,890 b) Non-Taxable DBSERP Vested but not Paid - $74,603 c) DCSERP Earned - $217,379 d) ESP Interest Credit - $69,081 5) Gregory Van Pelt a) Taxable DBSERP Vested but not Paid - $ 1,308,937 b) Non-Taxable DBSERP Vested but not Paid - $248,979 c) DCSERP Earned - $89,556 d) ESP Interest Credit - $80,697 e) SOP Paid - $54,162 6) Arnold R. Schaffer a) Taxable DBSERP Vested but not Paid - $873,172 b) DCSERP Earned - $333,896 7) John V. Fletcher a) Taxable DBSERP Vested but not Paid - $ 484,554 b) Non-Taxable DBSERP Vested but not Paid - $20,519 c) DCSERP Earned - $474,635 d) ESP Interest Credit - $42,239 e) SOP Paid - $15,818 8) Janice J. Jones a) Taxable DBSERP Vested but not Paid - $ 299,823 b) Taxable DBCBRP Vested but not Paid - $ 64 c) DCSERP Earned - $303,348 c) SOP Paid - $15,749 9) Eugene "Al" Parrish a) Taxable DBSERP Vested but not Paid - $288,259 b) DCSERP Earned - $295,970 10) John O. Mudd a) Taxable DBSERP Vested but not Paid - $362,132 b) DCSERP Earned - $372,693 11) Keith Marton, MD a) DBSERP Earned but not Vested - $180 b) DCSERP Earned - $193,810 12) Myron Berdischewsky, MD a) DCSERP Earned - $222,924 13) Claudia Haglund a) Taxable DBSERP Vested but not Paid - $41,847 b) DCSERP Earned - $43,139 c) ESP Interest Credit - $20,878 d) SOP Paid - $ 14,583 14) Michael Hunn a) DBSERP Earned but not Vested - $324 b) DCSERP Earned - $141,373 15) Cindra R. Syverson a) DCSERP Earned - $78,225 16) Joel S. Gilbertson a) DCSERP Earned - $25,015 17) John Kenagy a) DBSERP Earned but not Vested - $324 b) DCSERP Earned - $108,023 18) David S. Brown a) DCSERP Earned - $70,731 19) Deborah Burton a) DBSERP Earned but not Vested - $300 b) DCSERP Earned - $135,764 20) Orest Holubec a) DCSERP Earned - $6,543 21) Gary K. Flaming a) DCSERP Earned - $15,811 22) David H. Hunter a) DBCBRP Earned but not Paid - $203 b) DCSERP Earned - $110,680 23) Patricia A. Roscoe a) DCSERP Earned - $38,038 24) Charles E. Hawley a) Taxable DBSERP Paid - $ 1,947,717 b) DCSERP Earned - $12,926 c) SOP Paid - $ 28,456 25) Michael J. Madden a) Taxable DBSERP Paid - $ 343,217 26) Thomas Johnson a) DCSERP Earned - $82,979 27) Richard J. Umbdenstock a) DBSERP Paid - $ 32,220 28) Jeffrey Fee a) DBSERP Earned but not Vested - $444 b) DCSERP Earned - $84,761 29) Bruce E. Whitfield a) DCRP Earned - $2,607 30) Mark H. Wakai a) DCRP Earned - $8,723 31) Craig E. Aasved a) DCRP Earned - $5,751 Part I, Lines 4a-b SEVERANCE 1)Keith Marton, MD - $201,412 2)Thomas Johnson - $223,731 Supplemental Information Part III FORM 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 2010, 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 2010 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. Montana Facility Finance Authority 810302402 61204KCB5 2006-06-22 60089901 Refunded Series 1999 Bonds - 7/20/99; Refunded Series 2002 Bonds - 8/7/02 0 0 0 60089901 29144899 642236 2002 0 1 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 John F Koster MD Officer 33715108 Purchase of supplies through cooperative on which Dr. Koster is a Director. 0 Form 990, Part VI, Section A, line 6 The sole Member of the Corporation is Providence Health & Services, a Washington not-for-profit corporation. Form 990, Part VI, Section A, line 7a The powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause. Additionally, the Member may appoint and remove the President/CEO with or without cause, after requesting a recommendation for the Board of Directors. Form 990, Part VI, Section A, line 7b The following powers reside with the Member: * To adopt or change the mission, philosophy, and values of the Corporation. * To amend or repeal the Articles of Incorporation and the Bylaws of the Corporation. * To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale, transfer, assignment or encumbering of the assets, in excess of a specified amount. * To approve the dissolution and/or liquidation or the consolidation or merger of the Corporation. * To approve the annual operating and capital budget and approval any deviations from the budget exceeding a specified amount * To appoint the Corporation's certified public accountants after receiving recommendation of the Board of Directors. * To approve the closure of any institution or major ministry or work within this Corporation. Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict. Form 990, Part VI, Section B, line 15 It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined by the Providence Board's Human Resources Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Board retains an independent consultant each year to review salaries of those in the most significant leadership roles in the organization. Part of the consultant's role is to review an extensive array of compensation surveys of large, not-for-profit health care systems in the United States. Providence is one of the larger health systems in the country, and as such, the Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources Committee. 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 19 Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon written request. The consolidated financial statements are available on our public Internet site www2.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site. Contact Addresses for Officers, Directors, Etc Form 990, Part VII Jeffrey Fee - 500 West Broadway, Missoula, MT 59802. Bruce E. Whitfield - 500 West Broadway, Missoula, MT 59802. Mark H. Wakai - 500 West Broadway, Missoula, MT 59802. Craig E. Aasved - 500 West Broadway, Missoula, MT 59802. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 370,421. Prior period adjustments: -26. FAS 136 5,162,916. Interdivisional Transfers -9,815,695. Grant Reclassifications -4,128. Total to Form 990, Part XI, Line 5: -4,286,512. HOURS WORKED FORM 990, PART VII, LINE 1A The average hours per week reflect hours worked for the entire Providence Health & Services healthcare system and are not allocated to the individual reporting entity. FUNDRAISING EXPENSES FORM 990, PART IX, COLUMN D This entity had no fundraising expenses as all fundraising is handled through an affiliated Foundation. VOLUNTEERS FORM 990, PART I, LINE 6 Following is a listing of services and departments through which St. Pat's volunteers serve our staff, patients and visitors. Volunteers with St. Patrick Hospital provide staffing in the following areas. Shifts are usually three and half to four hours in length. * Broadway Building Outpatient Pharmacy * Day Surgery * Distribution and Delivery * Emergency Department - Greeter, Staff Support * First Class Crew - second and fourth Thursdays * Foot Clinic - first and third Mondays * Gift Shop, Hospital "Shamrock Shop" * Gift Shop, Broadway Building "Shamrock Shop" * Information Center - Broadway Building * Information Desk - Hospital * Intensive Care Unit Information Center * International Heart Institute * Mended Hearts Patient Visitation * Montana Cancer Center * Rehabilitation Services Dining Host or Hostess * Shampoo Service * St. Patrick House Partner * Sunrise Coffee Service * Surgical (Cardiac) Waiting Area In addition, volunteers serve in many of our hospital departments. Requests are often for special one-time clerical projects but some departments need volunteer help weekly. Areas covered included: * Administration * Admissions * Facilities Engineering (grounds assistance) * Foundation * Health Information Management, formerly Medical Records * Human Resources (desk coverage, various days and times) * Laboratory (clerical) * Library * Occupational Health Services * Occupational Therapy * Physical Therapy - U of Montana Pre-PT students only * Print Shop * Radiology * Security (assist with name badge project) * Wellness (desk coverage during lunch) * Women's Center RELIGIOUS COMMUNITY MEMBERS FORM 990, PART VII As members of the Religious Community, each Sister has taken a vow of poverty as a compulsory part of her religious life. Any compensation for services of a Sister inures only for the benefit of the Community, not the individual members. All payments for services are made directly to the Religious Community. ISSUANCE OF FORM 1099 FORM 990, PART V, LINE 1 All 1099s for 2010 were issued by Providence Health & Services - Washington #51-0216586. Therefore, none are shown for the reporting organization. NAME OF ORGANIZATION FORM 990, PAGE 1, BLOCK C The official date for filing the Corporate Name Change with the Secretary of State in Montana was April 14, 2011. However, since the name has been changed already in the IRS database, early adoption of the name change was applied to this return to match the information in the IRS database. Providence Health & Services - Washington 1801 Lind Avenue SW 9016 Renton WA 980579016 510216586 Healthcare System WA 501( c)(3) Line 3 Providence Health & Services 0 Providence Health & Services - Oregon 1801 Lind Avenue SW 9016 Renton WA 980579016 510216587 Healthcare System OR 501( c)(3) Line 3 Providence Health & Services 0 Providence Health System - So California 1801 Lind Avenue SW 9016 Renton WA 980579016 510216589 Healthcare System CA 501( c)(3) Line 3 Providence Health & Services 0 Everett Transitional Care Services PO Box 1067 Everett WA 982061067 943264605 Transitional Care WA 501( c)(3) Line 9 N/A 0 Providence Oregon Management Corporation 1801 Lind Avenue SW 9016 Renton WA 980579016 930813977 Shell Corporation OR 501( c)(3) Line 1 PH & S - Oregon 0 Providence Plan Partners 3601 SW Murray Blvd 10 Beaverton OR 97005 911861964 Healthcare Services OR 501( c)(4) N/A PH & S - Oregon 0 Providence Health Plan 3601 SW Murray Blvd 10 Beaverton OR 97005 930863097 Health Service Contractor OR 501( c)(4) N/A Providence Plan Partners 0 Providence Health Assurance 3601 SW Murray Blvd 10 Beaverton OR 97005 550828701 Medicaid Healthcare Provider OR 501( c)(4) N/A Providence Health Plan 0 Providence Medical Institute 4101 Torrance Blvd Torrance CA 90503 330283773 Healthcare CA 501( c)(3) Line 11/Type I PHS - So California 0 Little Company of Mary Ancillary Services Corporation 4101 Torrance Blvd Torrance CA 90503 330844408 Imaging Services CA 501( c)(3) Line 9 PHS - So California 0 Providence TrinityCare Hospice 2601 Airport Drive 230 Torrance CA 90505 953264139 Hospice CA 501( c)(3) Line 9 PHS - So California 0 Providence Health System Housing 1801 Lind Avenue SW 9016 Renton WA 980579016 943230587 Assisted Living AK 501( c)(3) Line 9 PH & S - Washington 0 Providence Blanchet Association 1700 Providence Pl Centralia WA 98531 911789266 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 St Luke Association 350 Washington Ave SE Chehalis WA 98352 943176618 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Rossi Association 1700 Providence Pl Centralia WA 98531 311584166 Housing WA 501( c)(3) Line 9 PH & S - Washington 0 Lundberg Association 5921 E Burnside Portland OR 97215 911562797 Housing OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence St Francis Association 3415 12th Avenue NE Olympia WA 98506 943244854 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Peter Claver Association 7101 38th Avenue South Seattle WA 98118 311629656 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence St Elizabeth House Association 3201 SW Graham St Seattle WA 98126 912171539 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Gamelin House Association 4515 MLK Jr Way S Ste 200 Seattle WA 98108 311744654 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 The Gamelin Association 312 North Fourth St Yakima WA 98901 911180824 Housing WA 501( c)(3) Line 1 PH & S - Washington 0 The Gamelin Oregon Association 5520 NE Glisan Portland OR 97213 911214491 Housing OR 501( c)(3) Line 9 PH & S - Oregon 0 The Gamelin California Association 540 23rd St Oakland CA 94612 911293869 Housing CA 501( c)(3) Line 9 PHS - So California 0 Gamelin Washington Association 1423 First Avenue Seattle WA 98101 201910170 Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Foundation 1801 Lind Avenue SW 9016 Renton WA 980579016 943078543 Support PH&S Institutions WA 501( c)(3) Line 11/Type I PH & S - Washington 0 Providence Alaska Foundation 3300 Providence Drive - B Tower2 Anchorage AK 99508 920093565 Support PHS-Alaska AK 501( c)(3) Line 11/Type I PH & S - Washington 0 Providence St Peter Foundation 413 Lilly Road NE Olympia WA 985065166 911097056 Support Affiliated Tax-Exempt Organization WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Health Care Foundation (Centralia) 914 S Scheuber Road Centralia WA 98531 911433382 Support Providence Centralia Hospital WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Mount St Vincent Foundation 4831 - 35th Avenue SW Seattle WA 981262799 911188119 Support Providence Mount St.Vincent WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Marianwood Foundation 3725 Providence Point Drive SE Issaquah WA 980297219 931554288 Support Providence Marianwood WA 501( c)(3) Line 11/Type I PH & S - Washington 0 Providence Newberg Health Foundation 1001 Providence Drive Newberg OR 97132 930889144 Support Providence Newberg Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Seaside Hospital Foundation 725 S Wahanna Rd Seaside OR 97138 930927320 Support Providence Seaside Hospital OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Community Health Foundation 1111 Crater Lake Ave Medford OR 97504 930692907 Support Providence Medford Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Benedictine Nursing Center Foundation 540 South Main St Mt Angel OR 973629532 911940286 Support Providence Benedictine Nursing Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Portland Medical Foundation 4805 NE Glisan St Portland OR 972132967 931231494 Support Providence Portland Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence St Vincent Medical Foundation 9205 SW Barnes Rd Portland OR 97225 930575982 Support Providence St. Vincent Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Milwaukie Foundation 10150 SE 32nd Milwaukie OR 97222 943079515 Support Providence Milwaukie Hospital OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Child Center Foundation 830 NE 47th Portland OR 97213 930800140 Support Providence Child Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence TrinityCare Hospice Foundation 2601 Airport Drive 230 Torrance CA 90505 330261016 Support TrinityCare Hospice CA 501( c)(3) Line 7 PHS - So California 0 Providence Little Company of Mary Foundation 4101 Torrance Blvd Torrance CA 90503 510224944 Support Little Company of Mary Service Area CA 501( c)(3) Line 7 PHS - So California 0 PH&S FoundationSFVSA & SCVSA 501 S Buena Vista Street Burbank CA 91505 953544877 Support Program & Activities of SFVSA & SCVSA CA 501( c)(3) Line 7 PHS - So California 0 Providence Hospice of Seattle Foundation 425 Pontius Avenue North 300 Seattle WA 981095452 912077378 Support Hospice of Seattle WA 501( c)(3) Line 11/Type I PH & S - Washington 0 The John Gabriel Ryan Association 1801 Lind Avenue SW 9016 Renton WA 980579016 911303277 Healthcare WA 501( c)(3) Line 3 PH & S - Washington 0 Providence Health & Services 1801 Lind Avenue SW 9016 Renton WA 980579016 911549796 Shell Corporation WA 501( c)(3) Line 11/Type I N/A 0 St Joseph Hospital Corporation PO Box 1010 Polson MT 598601010 810463482 Healthcare MT 501( c)(3) Line 3 PH & S - Washington 0 St Thomas Child and Family Center 1710 Benefis Court Great Falls MT 59405 810233495 Early Childhood Education MT 501( c)(3) Line 1 PH & S - Washington 0 Sisters of Providence of Montana Corporation 1801 Lind Avenue SW 9016 Renton WA 980579016 262612415 Shell Corporation MT 501( c)(3) Line 1 PH & S - Washington 0 Sacred Heart Children's Foundation PO Box 2555 Spokane WA 99220 320014330 Support Sacred Heart Children's Hospital WA 501( c)(3) Line 7 PH & S - Washington 0 St Patrick Hospital and Health Foundation 500 West Broadway PO Box 4587 Missoula MT 598064587 237056976 Support Healthcare in W. Montana MT 501( c)(3) Line 7 PH & S - Washington 0 University of Great Falls 1301 20th Street South Great Falls MT 59405 810231777 Post Secondary Education MT 501( c)(3) Line 2 PH & S - Washington 0 E WA & MT Unemployment Compensation Insurance Trust 1801 Lind Avenue SW 9016 Renton WA 980579016 911082119 Unemployment Benefits WA 501( c)(3) Line 11/Type I PH & S - Washington 0 Providence Willamette Falls Medical Foundation 1500 Division Street Oregon City OR 97045 931003750 Support Willamette Falls Hospital OR 501( c)(3) Line 11/Type I PH & S - Oregon 0 Willamette Falls Hospital dba Providence Willamette Falls Medical Center 1500 Division Street Oregon City OR 97045 930426018 Healthcare OR 501(c )(3) Line 3 PH & S - Oregon 0 Providence Hood River Memorial Hospital Foundation Inc 811 13th St Hood River OR 97031 930921990 Support Providence Hood River Memorial Hospital OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Hospice and Home Care Foundation 2731 Wetmore Avenue Suite 500 Everett WA 98201 272552749 Support Program & Activities of PHHC WA 501(c )(3) Line 7 PH & S - Washington 0 Providence Imaging Center 3340 Providence Drive Anchorage AK 99508 920118807 Medical Imaging AK PH & S - WA Related 0 0 Providence Surgery Centers LLC PO Box 233889 Anchorage AK 99523 203567411 Surgery AK PH & S - WA Related 0 0 Mountainstar Clinical Laboratories LLC 611 N Perry Spokane WA 99202 261345983 Outpatient Lab MT PAML LLC Related 0 0 Broadway Imaging LLC 500 W Broadway Missoula MT 59802 522405971 Medical Imaging MT St Patrick Hospital & Health Sciences Center Related 5151995 5232923 0 1 0.75000 Center for Medical Imaging-Tanasbourne LLC 1235 NE 47th Ave 288 Portland OR 97213 200477972 Imaging - Diagnostics OR PH & S - OR Related 0 0 Center for Medical Imaging-Bridgeport LLC 1235 NE 47th Ave 288 Portland OR 97213 260796953 Imaging - Diagnostics OR PH & S - OR Related 0 0 Center for Specialty Surgery LLC 11782 SW Barnes Rd Portland OR 97225 263638838 Ambulatory Surgery Center OR PH & S - OR Related 0 0 Clackamas Radiation Oncology Center LLC 1235 NE 47th Ave 288 Portland OR 97213 260381897 Radiation Oncology OR PH & S - OR Related 0 0 Oregon Outpatient Surgery Center 7300 SW Childs Rd Tigard OR 97224 223883387 Ambulatory Surgery Center OR PH & S - OR Related 0 0 Surgery Center at Tanasbourne LLC 1235 NE 47th Ave 260 Portland OR 97213 208187971 Ambulatory Surgery Center OR PH & S - OR Related 0 0 ProvidenceSilverton Rehab LLC 1235 NE 47th Ave 260 Portland OR 97213 481287267 Rehab Services OR PH & S - OR Related 0 0 Portland Medical Imaging LLC 10538 SE Washington St Portland OR 97216 201054971 Imaging - Diagnostics OR PH & S - OR Related 0 0 Providence Radiation Oncology Development Assn LLC 1235 NE 47th Ave 288 Portland OR 97213 260682491 Real Estate - MOB OR PH & S - OR Investment 0 0 Central Point MRI LLC 870 S Front St Central Point OR 97502 261975164 MRI Services OR PH & S - OR Related 0 0 Greater Valley Medical Building LP 501 S Buena Vista St Burbank CA 91505 954570858 Real Estate - MOB CA PHS - So California Investment 0 0 Pathology Associates Medical Laboratories LLC 611 N Perry Spokane WA 99202 270943279 Outpatient Lab WA Bourget Health Services Inc Related 0 0 Southern Idaho Regional Laboratory LLC 611 N Perry Spokane WA 99202 820511819 Outpatient Lab ID PAML LLC Related 0 0 Tri-Cities Laboratory LLC 611 N Perry Spokane WA 99202 911773986 Outpatient Lab WA PAML LLC Related 0 0 Alpha Medical Laboratory LLC 611 N Perry Spokane WA 99202 912017347 Outpatient Lab ID PAML LLC Related 0 0 PacLab LLC 611 N Perry Spokane WA 99202 911743952 Outpatient Lab WA PH & S - WA Related 0 0 HealthServicesNW LLC PO Box 389672 Seattle WA 98138 311750915 Medical Billing WA PH & S - WA Related 0 0 Medalia Healthcare LLC 1801 Lind Ave SW 9016 Renton WA 98057 911660459 Physician Benefits WA PH & S - WA Investment 0 0 Distribution Operations Center LLC 1801 Lind Ave SW 9016 Renton WA 98057 271054858 Supplies Purchasing Agent WA PH & S - WA Related 0 0 Oregon Advanced Imaging LLC 881 OHare Parkway Medford OR 97504 450471748 Medical Imaging OR PH & S - OR Related 0 0 ProvidenceUSP Surgery Centers LLC 11550 Indian Hills Road 160 Mission Hills CA 91345 200905938 Ambulatory Surgery Center CA PHS - So California Related 0 0 California Laboratory Associates LLC 501 Buena Vista Burbank CA 91505 273888692 Outpatient Lab CA PHS - So California Related 0 0 Providence Health Ventures Inc 4101 Torrance Blvd Torrance CA 90503 330122216 Investment CA N/A C Providence Health Care Ventures Inc 101 West 8th Ave TAF C-9 Spokane WA 99204 900155714 Clinical/Medical Lab WA N/A C Providence Physician Services Co 101 West 8th Ave TAF C-9 Spokane WA 99208 911216033 Clinical/Medical Lab WA N/A C Yakima Medical Arts Inc 611 N Perry Suite 100 Spokane WA 99202 910787963 Rental Real Estate WA N/A C Bourget Health Services Inc PO Box 2687 Spokane WA 99220 911354431 Clinical/Medical Lab WA N/A C Caron Health Corporation 510 West Front Street Missoula MT 59802 810486082 Medical Physician Service MT PH & S - MT dba Providence St Patrick Hospital C 1.00000 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 St Patrick Hospital & Health Foundation B 497465 Cost St Patrick Hospital & Health Foundation C 1393282 Cost St Joseph Hospital Corporation O 4517098 Cost Caron Health Corporation P 2643454 Cost Caron Health Corporation O 148859 Cost