2011-11-11T16:40:34-06:00 2010-12-31 990 2010-01-01 510224944 Providence Little Company of Mary Foundation PROV 3105436900 4101 Torrance Blvd Torrance CA 90503 Joseph M Zanetta 3105436900 2011-11-11 2010 2016-03-07 17:11:31Z Joseph M Zanetta 4101 Torrance Blvd Torrance CA 90503 15447916 0 X www.lcmhs.org/foundation X 1975 CA Support Little Company of Mary Service Area in Southern California. 49 49 0 100 -19868 -13287 6150146 7455597 0 0 931525 1216600 -33976 72135 7047695 8744332 5216752 5251072 0 0 1437383 1481897 0 0 1321905 1275173 884724 7929308 7617693 -881613 1126639 47802167 50407386 4502971 3912329 43299196 46495057 X As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Support Little Company of Mary Service Area in Southern California. 0 0 1019140 1019140 0 The mission of Providence Little Company of Mary and its affiliates is part of the larger mission of the Sisters of Little Company of Mary to make visible the healing presence of Jesus. Our mission embraces the care of the sick and dying through the Catholic health ministry and to meeting the health needs of our communities. We commit to caring for the whole person - physical, emotional and spiritual. Our core values are Respect, Compassion, Justice, Excellence and Stewardship. Programs Supported through Philanthropy in 2010:Clinical Centers of Excellence* Edmond R. and Virginia G. Doak Center for Palliative Care* Neonatal Intensive Care Unit* Providence Little Company of Mary Women's Imaging Centers* Providence Little Company of Mary Recovery Center* Rehabcentre* Jeanette L. Vachon Imaging Center* Vasek Polak Cardiovascular Institute* Vasek Polak Health Clinic* Providence Little Company of Mary Women and Childrens ClinicCommunity Outreach and Charitable Care* Collaborative for Alternatives to Violence and Abuse (CAVA)* Creating Opportunity for Physical Activity (COPA)* Emilie Gamelin Fund for Employee Assistance* Mary Potter Program for Human Dignity* Ningen Dock/Japanese Health* Partners for Healthy Kids Mobile Pediatric Van* Sexual Assault Response Team Centers (SART)Nursing* Centofante Nursing Scholarships* San Pedro Hospital Institute for Nursing* George W. and Virginia Schneider Institute for Nursing * Steinmetz Nursing Workforce Development 3848078 3848078 0 Support Providence Little Company of Mary Medical Center San Pedro & Providence Medical InstituteSee Part III, Line 4a 287579 287579 0 Support Community Outreach Programs:Charitable clinical services are provided to those in the service area who are underinsured, uninsured or unable to pay for their own medical care. These programs were made possible through funding by the Foundation. 1662 1662 0 Support TrinityCare Hospice. 63398 63398 0 Nursing Scholarships to assist 19 individuals further their medical education.The Al and Mary Centofante Nursing Education Endowment provides financial support for registered nurses, licensed vocational nurses and interested unlicensed employees of Little Company of Mary Service Area to return to school and pursue a higher degree in nursing. The scholarship recipients are chosen on a competitive basis, based on their commitment to Little Company of Mary, their commitment to advance their education and their personal financial need. 31215 31215 0 Other Scholarships and Miscellaneous Charity. 96275 96275 5251072 1 1 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 1 X 1 1 1 0 1 1 0 0 0 0 1 1 0 0 0 0 X 49 49 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X Karl E Fritschel CPA 4255253339 1801 Lind Ave SW 9016 Renton WA 98057 Bruce Ferguson 3.00 X X 0 0 0 Anthony A Arminio 2.00 X X 0 0 0 James L Hunter 2.00 X X 0 0 0 Sandra Fisler 2.00 X X 0 0 0 James Lester 3.00 X X 0 0 0 Juan Torres 3.00 X X 0 0 0 David S Alverson JD 2.00 X X 0 0 0 Cathy Alessandra 2.00 X 0 0 0 Edward Balazs 2.00 X 0 0 0 Richard D Brombach 2.00 X 0 0 0 Raju Chhabria 2.00 X 0 0 0 Nicholas V Colonna 2.00 X 0 0 0 David Conforti 2.00 X 0 0 0 Thomas Connaghan 2.00 X 0 0 0 Donald M Culler 2.00 X 0 0 0 Paula Del Vicario 2.00 X 0 0 0 Moshe Faynsod MD 2.00 X 0 0 0 Janet O Fogle 2.00 X 0 0 0 David Fong 2.00 X 0 0 0 Rex E Fountain Jr 2.00 X 0 0 0 Stephen Gale 2.00 X 0 0 0 Katherine Greenberg 2.00 X 0 0 0 Susan Hatchard Hill 2.00 X 0 0 0 Jon L Jacobson 2.00 X 0 0 0 Shelley Joyce 2.00 X 0 0 0 Lynne Rosenberg Kidd 2.00 X 0 0 0 Sister Terrence Landini LCM 2.00 X 0 0 0 Sandra A Lash 2.00 X 0 0 0 Yvonne Liu 2.00 X 0 0 0 Jeff MacLean 2.00 X 0 0 0 Sharon Martinez 2.00 X 0 0 0 Timothy B McOsker JD 2.00 X 0 0 0 Ron Melendez MD 2.00 X 0 0 0 Betsy Miller 2.00 X 0 0 0 Stephan M Morikawa 2.00 X 0 0 0 Tracy Nickl 2.00 X 0 0 0 Harlyne Norris 2.00 X 0 0 0 Thomas E O'Hern 2.00 X 0 0 0 Karen Olds 2.00 X 0 0 0 Sister Carol Pacini LCM 2.00 X 0 0 0 Marilyn M Prindle 2.00 X 0 0 0 Stanley Raskin Esq 2.00 X 0 0 0 Paul R Sanford 2.00 X 0 0 0 Scott Sharpe 2.00 X 0 0 0 Edward C Simpson III 2.00 X 0 0 0 Patricia M Sullivan 2.00 X 0 0 0 Nicholas G Tonsich JD 2.00 X 0 0 0 Daniel J Vogelzang 2.00 X 0 0 0 Linda Wenglikowski 2.00 X 0 0 0 Joseph M Zanetta 40.00 X 0 312218 34375 0 312218 34375 0 0 1 0 Clifford Associates 200 S Los Robles Avenue Ste 320 Pasadena CA 91101 Investment Manager 109020 1 637956 2426025 577971 3813645 54527 7455597 1189410 1189410 333582 296613 36969 36969 -19868 56837 6091451 6064261 27190 27190 27190 266661 637956 293695 -27034 -27034 111215 49015 62200 62200 8744332 0 -19868 1308603 4868880 4868880 382192 382192 336420 111019 225401 838068 273087 564981 227329 74258 153071 80080 20495 59585 25710 25710 132240 132240 214488 162241 52247 109219 37778 71441 29590 21603 7987 25588 16218 9370 24986 11611 13375 173196 173196 112 112 Bad Debts 136313 136313 Dues & Subscriptions 6727 5936 791 Postage 6555 4922 1633 7617693 5251072 1044716 1321905 100 100 2511328 2084656 3250566 2451528 716950 51095 3310 2522 5643232 171128 5019916 5472104 32171446 36394560 4128551 3950821 47802167 50407386 57674 59542 346412 74126 1052956 1020696 3045929 2757965 4502971 3912329 X 19757330 22987624 9821097 8804800 13720769 14702633 43299196 46495057 47802167 50407386 X 1126639 2069222 X X 0 1 1 X 1 1 X 9461420 5089073 10028304 6150146 7406582 38135525 9461420 5089073 10028304 6150146 7406582 38135525 3571181 34564344 1591611 1720663 640303 991729 1522992 6467298 91717 26000 31263 35166 184146 44786969 0.77180 0.72880 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 3000 0 0 3000 0 Explanation of Other Lobbying Activities: Part II-B, Line 1i: Two Board members traveled to Washington, D.C. to seek an appropriation of $3 million to update and repair the hospital's heliport. The cost shown here reflects the travel costs of these two members. 20560828 1039659 725603 239835 22086255 19466139 972888 306924 185123 20560828 19217258 139163 369410 259692 19466139 0.38000 0.62000 0.00000 0 0 1891000 1891000 3669284 158045 3511239 76217 6731 13083 69865 5472104 Receivable Under Unitrust Agreement 1519271 Charitable Remainder Unitrust 1306572 Gift Annuities 1042230 Accrued Interest on Investments 76313 Stock Contributions 6435 3950821 Charitable Remainder Trust Obligations 596574 Due To Affiliates 1854888 Gift Annuities Obligations 283823 Security Deposits Payable 22680 2757965 8744332 7617693 1126639 2118237 -49015 2069222 3195861 11001148 2118237 2118237 8882911 109020 -247599 -138579 8744332 7805287 296613 296613 7508674 109020 -1 109019 7617693 Description of Intended Use of Endowment Funds: Part V, Line 4: Only the income from the investment of these endowment funds are used in accordance with the donor stipulations, either towards program expenses or added back to the endowment. The Foundation's endowment consists of approximately 33 individual funds established for a variety of purposes. Some of these purposes include nursing education, palliative care, cardiology and oncology services and leadership development. Description of Uncertain Tax Positions Under FIN 48: Part X: The Foundation adopted Financial Accounting Standards Board (FASB) ASC 740-10-25 which was previously referenced, FASB Interpretation No. 48, Accounting for Uncertainty in Income Taxes, an Interpretation of FASB Statement 109 (FIN 48) on January 1, 2009. FIN 48 clarifies the accounting for uncertainty in income taxes recognized in an enterprise's financial statements. FIN 48 also prescribes a recognition and measurement standard for the financial statement recognition and measurement of an income tax position taken or expected to be taken in the tax return. Only tax positions that meet the more likely than not recognition threshold at the effective date may be recognized or continue to be recognized upon adoption. In addition, FIN 48 provides guidance on derecognition, classification, interest and penalties, accounting in interim periods, disclosure and transition. The adoption of FIN 48 did not have a significant impact on the financial statements of the Foundation. Part XI, Line 8 - Other Adjustments: Non-Cash Donation -49,015. Part XII, Line 4b - Other Adjustments: Rental Expenses -296,613. Rounding -1. Non-Cash Donation 49,015. Part XIII, Line 2d - Other Adjustments: Rental Expenses 296,613. Part XIII, Line 4b - Other Adjustments: Rounding -1. Sellabration 499020 310032 188988 5313 83214 71194 Golf Classic 268297 200674 67623 38697 23708 28534 4 137300 127250 10050 18705 24330 904617 637956 266661 62715 106922 124058 293695 -27034 111215 49015 1 1.00000 111215 49015 49015 62200 CA 1 0 0 0 0.50000 0.50000 Kathryn Eisenhower 4101 Torrance Blvd Torrance CA 90503 0 Kathryn Eisenhower 0 Provides detail accounting of all Raffle transactions. X 0 1 PHS - So Cal dba Providence LCM Medical Center Torrance 4101 Torrance Blvd Torrance CA 90505 510216589 501(C)(3) 1019140 Support various Charitable programs PHS - So Cal dba Providence LCM Medical Center San Pedro 1300 W 7th Street San Pedro CA 90732 510216589 501(C)(3) 2741996 Support various Charitable programs Providence Medical Institute 4101 Torrance Blvd Torrance CA 90505 330283773 501(C)(3) 1106082 Support various Charitable programs 2 0 Community Outreach Programs 19 0 287579 Cost Funding for charitable clinical services for those underinsured, uninsured or unable to pay for their care. Nursing Education Scholarships 19 63398 Other Education Scholarships 9 7000 Employee Assistance 1 0 24215 Cost Medical and funeral assistance. Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The grant funds are recorded as a separate restricted fund and each month an amount is transferred for the grant purpose expenses. This way the use of grant fund is monitored at the end of each month. The grant money is distributed based on the total expenses incurred on each specific program. The accountant runs the expense report each month for each program from the database and distributes grant money to those programs. These program expenses are limited by budgets prepared at the beginning of the year. For nursing scholarships, the following criteria must be met: 1) Full-time or part time employees of a Little Company of Mary entity for at least one year. 2) Have the requried minimum performance appraisal rating. 3) Be enrolled or plan to enroll in a program for BSN or MSN degree in nursing. 4) Describe the need for financial assistance. 5) If accepted, the recipient must maintain a GPA of 3.0 or greater, work 24 hours or more a week and commit to at least 1 year of service after attaining their degree. X X X X X 0 1 0 0 0 0 0 0 0 Joseph M Zanetta 0 254632 0 57586 0 0 0 24202 0 10173 0 346593 0 0 Part I, Line 4b Part I, Line 4b: A) DBSERP = Defined Benefit Supplemental Executive Retirement Plan B) DBCBRP = Defined Benefit Cash Balance Restoration Plan C) DCRP = Defined Contribution Restoration Plan 1) Joseph Zanetta * Taxable DBSERP Vested but not Paid - $ 2,520 * Taxable DBCBRP Vested but not Paid - $ 604 * DCRP Earned - $6,866 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 Providences 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%. X 1 49015 FMV 0 1 0 Method for Determining Number of Contributors: Part I, Column (b): The amount shown in Part I, Col. B reflects the number of donations received of the specific type of item. Form 990, Part VI, Section A, line 6 Little Company of Mary Health Services is the sole Corporate Member. Form 990, Part VI, Section A, line 7a The powers of the Corporate Member include the provision to approve the number of Trustees if less than 20 or greater than 60, appoint the Board of Trustees of the Foundation, and to remove such Trustees at any time with or without cause. Form 990, Part VI, Section A, line 7b The following powers are reserved exclusively to the Corporate Member: A) To adopt and amend the Articles of Incorporation and the By laws of the Foundation after consultation with the Foundation Board of Trustees. B) To approve the merger, consolidation, or affiliation of the Foundation with another corporation, organization or program, or the dissolution fo 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 11 The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Executive Committee of the Board of Trustees will review the Form 990 in detail. Once approved, an electronic copy of the Form 990 is emailed to the Board prior to filing with the IRS. Form 990, Part VI, Section B, line 12c All Board members are required to complete the Annual Conflict of Interest Statement. This is monitored by the Compliance and Audit Staff. Form 990, Part VI, Section B, line 15 It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined by the Providence Board's Human Resources Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Board retains an independent consultant each year to review salaries of those in the most significant leadership roles in the organization. Part of the consultant's role is to review an extensive array of compensation surveys of large, not-for-profit health care systems in the United States. Providence is one of the larger health systems in the country, and as such, the Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources Committee. Performance incentives allow executives to earn additional compensation if they achieve specific organizational and individual goals for furthering Providence operating principles & advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated customer satisfaction, meeting employee satisfaction goals and reaching financial performance objectives. The Board of Directors conducts a thorough process to ensure performance incentives are aligned with appropriate practices for not-for-profit health care systems. The Board's process for executive compensation fully complies with IRS standards and mirrors the best practices recommended in the "Report to Congress and the Nonprofit Sector on Governance, Transparency, and Accountability" submitted to the Senate Finance Committee by the Panel on the Nonprofit Sector. Locally, the Audit Committee of the Board of Trustees applies these principles and conducts an annual review of the compensation package for the President of the Foundation. Form 990, Part VI, Section C, line 19 The Annual Report of the Foundation is distributed to all donors and includes complete Audited Financial Statements. This information is available to the general public upon request. The governing documents and the Conflict of Interest policy are available upon request. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 2,118,237. Non-Cash Donation -49,015. Total to Form 990, Part XI, Line 5: 2,069,222. AUDIT & COMPLIANCE FORM 990, PART XII, LINE 2C The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. VOLUNTEERS FORM 990, PART I, LINE 6 We had 3 major fundraising events in 2010 - Golf Classic, Sellabration Gala and For Our Children Food and Wine Festival. The volunteer services varied for each event. Volunteers are vital to the success of special events at Providence Little Company of Mary. Volunteers help with event check-in; they served as witnesses for hole-in-ones and course contests at Golf Classic. They assisted with the Live and Silent auction set-up and distribution. They also assisted with administrative preparations, general load-in, set-up and tear down at each event. Volunteers are an important part of Special Events. They provide much need resources for events. Volunteers help reduce event expenses as we do not have the resources to hire additional staff. Volunteers also help promote community involvement - through word of mouth they help promote our programs to friends, family and other community members. EMPLOYEE COMPENSATION FORM 990, PART I, LINE 5 & PART V, LINE 2A Employees of the Foundation are compensated by Providence Health System - Southern California EIN# 51-0216589. The Ex-Officio members of the Board are compensated for their respective direct services to the Little Company of Mary Hospitals by Providence Health & Services - WA. dba Health System Office #91-0725998. Therefore, no W-2s are issued by the reporting organization. Providence LCM Foundation Real Estate Holdings LLC 4101 Torrance Blvd Torrance CA 91505 270799595 Real Estate Holdings CA 36969 5716390 Providence Little Company of Mary Foundation 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 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 Patrick Hospital and Health Sciences Center 500 W Broadway PO Box 4587 Missoula MT 598064587 810231793 Healthcare MT 501( c)(3) Line 3 PH & S - Washington 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 Related 0 0 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 Caron Health Corporation 510 West Front Street Missoula MT 59802 810486082 Medical Physician Service MT 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 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1