2011-11-15T14:22:11-06:00 2010-12-31 Clark Nuber PS 10900 NE 4th Suite 1700 Bellevue WA 98004 990 2010-01-01 510216586 PROVIDENCE HEALTH & SERVICES - WASHINGTON PROV 4255253985 1801 Lind Ave SW No 9016 Renton WA 980579016 Michael L Butler 4255253985 2011-11-15 1 Sara Elizabeth J Hyre CPA 4254544919 2010 2016-03-07 17:11:31Z John F Koster MD 1801 Lind Ave SW No 9016 Renton WA 980579016 5445843673 0 X www2.providence.org X 1859 WA Healthcare with special concern for the poor and vulnerable in WA. & AK. 14 14 20514 4445 7168602 2121731 26982046 26384935 2853487457 3026006930 -106535625 50267367 404263172 341671989 3178197050 3444331221 8775310 13924007 0 0 1630936059 1686837618 0 0 1860224 1575609655 1710954254 3215321024 3411715879 -37123974 32615342 4398800953 5026204416 2851020875 3395073104 1547780078 1631131312 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 & vulnerable in WA. & AK. 0 0 1279230065 0 1595335831 Acute Care - Inpatient 514,529 Adult & Pediatric Admissions 113,869 Patient DaysOUR MISSION - As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service. OUR CORE VALUES - Respect, Compassion, Justice, Excellence, and Stewardship Providence cares Whether tenderly holding a special-needs child who requires round-the-clock care, or easing the way for a stroke patient who faces both physical and financial struggles, the people of Providence are called to a mission of service. Our lifework is to provide excellent care for everyone, at all stages of life, regardless of ability to pay. This has been the Providence mission since the Sisters of Providence arrived on the shores of the Columbia River 150 years ago, committed to the care and healing of poor and vulnerable frontier neighbors. Providence Health & Services - Washington is a not-for-profit network of hospitals, care centers, physicians, clinics, home health services and affiliated services. We continue a tradition of caring that the Sisters of Providence began in the West 150 years ago. 845101719 0 1053931649 Acute Care - Outpatient 1,605,246 Emergency & Ancillary Visits 204295853 0 254778638 LTC/Hospice/Housing & Assisted Living - 392,541 Days for Long-Term Care/Asst. Living; 254,806 Home Health Visits; 298,176 Hospice Days 95145894 0 118657041 Primary Care 643,466 Clinic Visits 26417942 0 32945981 Healthcare Joint Ventures 13924007 13924007 0 Grant & Allocations - See Schedules F & I 135487843 13924007 151603022 2464115480 1 1 0 1 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 1 0 0 1 1 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 X 1910 0 1 20514 1 1 1 0 0 0 0 1 1 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WA 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 18000 0 0 Michael Holcomb 3.70 X 15000 0 0 Dana A Rasmussen 3.40 X 15000 0 0 Paul A Redmond 3.00 X 18000 0 0 James S Roberts MD 6.00 X 15000 0 0 Peter J Snow 4.10 X 15000 0 0 Jeffrey B Clode MD 5.40 X 18000 0 0 Sallye Liner 3.50 X 3750 0 0 Owen B Robinson 5.50 X 15000 0 0 Cheryl M Scott 3.00 X 15000 0 0 Ellen L Wolf 6.80 X 15000 0 0 John F Koster MD 50.00 X 2346502 0 794703 Michael L Butler 65.00 X 1038275 0 340314 Jeffrey W Rogers 50.00 X 1259397 0 465326 Eugene Al Parrish 50.00 X 1047158 0 332492 John V Fletcher 60.00 X 1277503 0 584795 Dan T Harris 50.00 X 515050 0 225105 Anthony J Dorsch 50.00 X 341283 0 57131 Janice J Jones 55.00 X 1140032 0 349285 Gregory Van Pelt 60.00 X 2314095 0 484343 Russell Danielson 50.00 X 4449992 0 397656 Arnold R Schaffer 60.00 X 1980618 0 371481 John O Mudd 55.00 X 856420 0 395919 Keith Marton MD 60.00 X 717815 0 215947 Claudia Haglund 50.00 X 501163 0 126574 Joel S Gilbertson 50.00 X 454656 0 56288 Cindra R Syverson 55.00 X 485868 0 108238 John Kenagy 60.00 X 447695 0 141020 James N Leonard 50.00 X 1090246 0 191655 Deborah Burton 60.00 X 341476 0 168307 Myron Berdischewsky MD 60.00 X 609142 0 268959 David Brown 55.00 X 342030 0 110948 Andrew C Agwunobi 50.00 X 639421 0 169960 Michael Hunn 60.00 X 490880 0 166313 Bruce Lamoureux 50.00 X 581808 0 187925 David T Brooks 50.00 X 527400 0 173114 Medrice Coluccio 50.00 X 505460 0 325144 Elaine Couture 50.00 X 459702 0 88274 Andrew T Howlett 40.00 X 1537020 0 26640 Atul Thakker 40.00 X 975269 0 101971 Perry E Camp 40.00 X 863789 0 12978 Steven A Burdick 40.00 X 849622 0 67623 James N Dunlap 40.00 X 843443 0 26640 Richard J Umbdenstock 0.00 X 32220 0 0 Michael J Madden 0.00 X 359717 0 0 Charles E Hawley 0.00 X 2137748 0 17773 Thomas Johnson 0.00 X 325409 0 91452 Michael Wilson 0.00 X 855851 0 38187 Ryland Davis 0.00 X 530000 0 93000 36233925 0 7773480 1834 1 1 0 M A Mortenson Company 14719 NE 29th Place Bellevue WA 98007 Construction 159419718 Health Services NW 2201 Lind Ave Suite 300 Renton WA 98057 AR Collections 21567695 Emergency Physician Services PS 5633 N Lidgerwood Spokane WA 99208 ER Services 8160482 Everett Clinic 3901 Hoyt Avenue Everett WA 98201 Hospitalists 5042251 Hospital Specialists PLLC 2815 W Horizon Rdg Ct Spokane WA 99208 Med. Director Prof Fees 4785251 595 97083 685186 9319950 7110446 9172270 3900 26384935 Acute Care/Inpatient 900099 1578385799 1578385799 Acute Care/Outpatient 621400 1042733896 1042733896 LTC/Homecare/Hospice 621610 252071680 252071680 Primary Care 621110 117399127 117396340 2787 Healthcare JVs 900099 34120408 32595938 1524470 1296020 1296020 3026006930 37580649 37580649 32335682 17335 13204025 7353 19131657 9982 19141639 1132621 18009018 1946414960 51909586 1932666316 52971512 13748644 -1061926 12686718 12686718 290181 685186 459874 -169693 -169693 29215 10534 18681 18681 2787995 2192838 595157 595157 Laboratory Revenue 621500 17184875 16611560 573315 Pharmacy Revenue 446110 15396180 6160684 3165993 6069503 Cafeteria Revenue 722210 15163059 479039 14684020 274342091 8397223 290366 265654502 322086205 3444331221 3055649140 7168591 355128555 12275094 12275094 464682 464682 1184231 1184231 18956648 2208171 16748477 1265153578 978268422 285955985 929171 94986402 64735024 30132010 119368 212634298 145589272 66781491 263535 95106692 70013516 25024333 68843 23540 22834 706 5464204 563566 4900638 2182709 2182709 740670 740670 4576644 4576644 369824148 222229217 147505008 89923 8224126 4742997 3449545 31584 544775591 516541610 28089279 144702 37714213 6023558 31657767 32888 62098201 43805372 18259077 33752 11538731 5043854 6465510 29367 6301222 1917893 4368058 15271 32086707 26873142 5213565 14826391 6956493 7869898 175850182 111411610 64433368 5204 34063307 25322460 8734262 6585 Prof. Liab. Trust/Pensi 161015933 161015933 Bad Debt Expense 160106907 158994939 1095975 15993 Licenses & Taxes 54481087 51737285 2743800 2 Dues & Memberships 7736354 2709927 5008675 17752 UBI Taxes 2877243 2877243 14446144 4480311 9909549 56284 3411715879 2464115480 945740175 1860224 10012560 11471118 304633739 432605628 2336203 1250712 372551034 398880521 30249917 30028902 53426797 56491834 26416553 29576566 3606649189 1638897046 1761674668 1967752143 987879784 1073682884 80046362 88778494 8027870 12189344 761545466 923496270 4398800953 5026204416 404237970 424425773 7559811 7636121 579280000 737200000 225728 200322 253166673 252924980 1606550693 1972685908 2851020875 3395073104 X 1503834909 1577741340 34679662 43738253 9265507 9651719 1547780078 1631131312 4398800953 5026204416 X 32615342 50735892 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 1 12856 1 0 1 348942 1 193136 0 1 378872 933806 0 Explanation of Other Lobbying Activities: Part II-B, Line 1i: With passage of the Patient Protection and Affordable Care Act, Congress moved our nation forward toward a more equitable, sustainable and higher quality health care system. This historic legislation addresses many of the critical issues limiting access to health coverage and driving unsustainable costs. Reforming health care is a continuing journey and important work remains. Congress must preserve the reforms passed this year and work to ensure access to those people still uninsured, stabilize and strengthen access to the Medicaid program and empower a redesign of the delivery of health care to improve quality and efficiency. Providence accepts its role in leading health care reform in the communities we serve. We embrace our accountability as a health care provider to deliver high-quality, low-cost care. A better, more sustainable health care system requires a partnership between improvements in both care delivery and public policy. The following issues were a priority for 2010: ENSURE EVERYONE HAS ACCESS TO HEALTHCARE. We believe access to quality, affordable health care is a basic human right. No one should ever become sick - or worse, lose their life - because they couldn't access health care services. Everyone, whether they are covered by private insurance or a government program, should have a primary care provider and access to necessary specialty care. We urged Congress to create mechanisms that will make coverage available to those not included in the health exchanges or public programs. * Provide an option for immigrants to purchase coverage with private dollars through the health insurance exchanges. * Create funding sources to strengthen the role of community resources, such as the Healthy Communities Access Program and Project Access, that link remaining uninsured individuals and families with health care providers in their communities. TRANSFORM THE DELIVERY OF HEALTH CARE. Making health care more affordable requires a change in how health care is organized and delivered to patients. Current reimbursement models do not support this redesign of care. Patients will receive better care when health care providers are paid to coordinate with each other. We urged Congress to continue to promote the development of new payment models that create financial incentives to reduce over-utilization and improve quality and care coordination. * Provide necessary oversight to the dialogue between stakeholders and CMS to ensure smooth and rapid implementation of new delivery models, such as bundled payment, accountable care organizations, the patient- centered health home and other concepts through the CMS Innovation Center. * Continue to reform physician payments to focus on quality and outcomes, rather than the quantity of tests and treatments performed. * Ensure federal funding spreads the adoption of electronic health records equally across all types of providers in both rural and urban areas. REMOVE BARRIERS TO COORDINATED CARE. Increased collaboration among health care providers means patients and their families receive more efficient and higher quality care. Some existing rules, however, restrict the ability of providers to deliver this coordinated care. We urged Congress to address legal and regulatory barriers to collaboration. * Establish permanent waivers or exemptions to requirements of the civil monetary penalties, anti-kickback and Stark laws and regulations for provider organizations participating in bundled payment, accountable care organizations and other new collaborative delivery models. * Require the Department of Justice and the Federal Trade Commission to update their joint statement of enforcement to reflect the development of new collaborative care models. PROTECT THE POOR AND VULNERABLE. During times of economic crisis, safety-net programs have become increasingly more important to ensuring access to care. State budget challenges threaten the stability of Medicaid programs across the country - putting at risk vital services to the most needy. We urged Congress to ensure sufficient federal funding for state Medicaid programs to preserve safety-net services. * Design Medicaid eligibility expansions to include mechanisms that ensure access for enrollees by requiring states to maintain adequate payment rates for providers - particularly primary care. * Increase federal Medicaid funding to bridge the gap for states until the reform legislation goes into effect and develop new financing solutions to ensure the long-term stability of the program. STRENGHTEN THE HEALTH CARE WORKFORCE. We are facing a worsening shortage of health care workers in this nation, driven by an aging workforce and growing community need. We urged Congress to continue the federal effort to increase the number of primary care physicians, nurses and other health care professionals through reforms that expand medical education, including focused funding through grants and other mechanisms that increase enrollment in nursing schools and train new health care workers. * Streamline the application process for workforce training grants and other funding mechanisms to ensure that funds are made available to organizations in a timely, straightforward manner and encourage collaboration between health care organizations and educational institutions. * Refine policies as necessary to increase the number of health care professionals practicing in our communities, including scholarships, loan forgiveness for physicians and other health care professionals who meet a primary care service obligation, and loan deferment for medical residents going into primary care. 7596645 364798 677288 174880 8463851 6401153 106633 1289282 162845 7578 30000 7596645 8854708 287226 -2413940 326841 6401153 0.00000 1.00000 0.00000 0 1 1 11082216 136575536 147657752 162047075 1431549453 722119246 871477282 13295473 94491718 65556135 42231056 33071534 1196559671 851221665 378409540 57302933 470673580 527976513 1967752143 Due From Affiliates 503481520 Trustee Held Funds 209885914 Unamortized Finance Costs 12862915 Assets Held Under Securities Lending 139919935 Other Long-Term Receivables 12507359 Third Party Settlements 34826113 Charitable Trusts & Gift Annuities 2011437 CSV of Life Insurance 394100 Deferred Compensation 457F 4807817 Bond Premium Discount 2799160 923496270 Self-Insured Trusts 219981687 Due To Affiliates 535206915 Taxable Bond Issues 254170821 Accrued Pension Costs 755308166 LT Asset Retirement Obligation - FIN 47 17953102 Liabilities Under Securities Lending 142344783 Other Long-Term Payables 13662890 Third Party Settlements 34057544 1972685908 Description of Intended Use of Endowment Funds: Part V, Line 4: The Endowment Funds are intended to be used to support the mission and programs of Providence Sacred Heart Medical Center. 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 Central America and the Caribbean 0 0 Grantmaking 914955 Russia & Newly Independent States 0 0 Grantmaking 123926 Sub-Saharan Africa 0 0 Grantmaking 20350 North America 0 0 Grantmaking 125000 0 0 0 1184231 0 1184231 Central America and the Caribbean Medical Supplies 534384 Medical Supplies Cost Central America and the Caribbean Medical Supplies 124488 Medical Supplies Cost Russia & Newly Independent States Medical Supplies 123926 Medical Supplies Cost Central America and the Caribbean Medical Supplies 105040 Medical Supplies Cost Sub-Saharan Africa Medical Supplies 20350 Medical Supplies Cost Central America and the Caribbean Medical Supplies 151043 Medical Supplies Cost North America Medical Supplies 125000 Medical Supplies Cost 7 0 1 0 0 0 0 0 Procedure for Monitoring Grants Outside the U.S.: Schedule F, Part I, Line 2: We only provide grants to non-governmental, charitable organizations that conduct foreign activities. For the donations we require a potential recipient to first complete an application. We have two types of applications; one for donations that will be taken by a person on a plane and part of medical team, the other for container donations that will be shipped. The type of information gathered is different for each application. We always ask for the name of the specific clinic, program or hospital that will be at the clinic. We also ask for information about who will be served/benefit from these donations. We also ask that the recipient provide us feedback on how useful the donations were and what problems they may have encountered. Other Information Schedule F, Part V Form 926 is not required to be filed because the transfer to a foreign corporation does not meet the reporting requirements in IRC Section 6038B(a)(1)(A). Providence O'Christmas Trees 768211 539549 228662 29241 98885 273045 Golf Classic 97565 67847 29718 1843 18946 13136 15994 2 109591 77790 31801 519 363 650 500 6752 975367 685186 290181 2362 48550 112671 500 295791 459874 -169693 29215 2793 1673 6068 1 29215 2793 1673 6068 10534 18681 WA 1 0 0 0 0.00000 1.00000 Patricia L Szabo 4831 35th Avenue SW Seattle WA 98126 0 Patricia L Szabo 0 Provided oversight of sale of raffle tickets and accounting for proceeds received. X 0 1 1 X 1 X 1 X 1 1 1 0 1 1 86006660 86006660 0.02650 487832308 398672821 89159487 0.02740 11674794 9918196 1756598 0.00050 585513762 408591017 176922745 0.05440 5961134 691450 5269684 0.00160 30650381 7021911 23628470 0.00730 65831292 42710847 23120445 0.00710 2793254 667538 2125716 0.00070 7262879 31035 7231844 0.00220 112498940 51122781 61376159 0.01890 698012702 459713798 238298904 0.07330 25640 25640 0.00000 1000 1000 0.00000 32845 32845 0.00000 76783 76783 0.00000 4159 4159 0.00000 4668 4668 0.00000 145095 145095 0 43519340 0 608176503 799965504 -191789001 X 1 1 11 1 Providence Alaska Medical Center

3200 Providence Drive Anchorage AK 99508

X X X X X 2 Providence SHMC & Children's Hospital

101 West 8th Avenue Spokane WA 99204

X X X X 3 Providence St Peter Hospital

413 Lilly Road NE Olympia WA 98506

X X X 4 Providence Regional Med Ctr-Colby

1321 Colby Avenue Everett WA 98201

X X X 5 Providence Regional Med Ctr-Pacific

916 Pacific Avenue Everett WA 98208

X X X 6 Providence Holy Family Hospital

5633 North Lidgerwood Street Spokane WA 99208

X X X 7 Providence Centralia Hospital

914 S Scheuber Road Centralia WA 98531

X X 8 Providence St Mary Medical Center

401 W Poplar St Walla Walla WA 99362

X X X 9 Providence Mt Carmel Hospital

982 East Columbia Colville WA 99114

X X X X 10 Providence St Joseph's Hospital

500 East Webster Street Chewelah WA 99109

X X X 11 Providence Kodiak Is Medical Center

1915 Rezanof Drive Kodiak Island AK 99615

X X Providence Alaska Medical Center 1 Providence SHMC & Children's Hopsital 2 Providence St Peter Hospital 3 Providence Regional Med Ctr Colby 4 Providence Regional Med Ctr Pacific 5 Providence Holy Family Hospital 6 Providence Centralia hospital 7 Providence St Mary Medical Center 8 Providence Mt Carmel Hospital 9 Providence St Joseph's Hospital 10 Providence Kodiak Is Medical Center 11 42 Providence Marianwood

3725 Providence Pt Dr SE Issaquah WA 98029

Long-Term Care Providence Elderplace

4515 Martin Luther King Jr Way S Seattle WA 98108

In-Home Service Agency Prov St Peter Chemical Dependency Cter

2505 Olympic Highway N Suite 140 Shelton WA 98584

Chemical Dependency Center Prov St Peter Chemical Dependency Cter

24070 NE Highway 3 Suite A Belfair WA 98528

Chemical Dependency Center Prov St Peter Chemical Dependency Cter

508 1/2 Eighth Street Hoquiam WA 98550

Chemical Dependency Center Prov Internal Medicine Hawks Prairie

8645 Martin Way E Lacey WA 98516

Internal Medicine Clinic Prov South Sound Internal Medicine

3425 Ensign Rd NE Olympia WA 98506

Internal Medicine Clinic Prov Family Medicine West Olympia

1217 Cooper Pt Road SW Olympia WA 98502

Family Medicine Clinic Providence Clinic at Panorama

1450 Northwest Lane SW Olympia WA 98502

Family Medicine Clinic Providence Internal Medicine

1010 S Scheuber Road Centralia WA 98531

Internal Medicine Clinic Providence Imaging Center

908 S Scheuber Road Centralia WA 98531

Patient Diagnostic Imaging Prov Rochester Family Pract Clinic

18313 Paulson St SW Rochester WA 98579

Family Practice Medicine Providence Centralia Womens Center

1000 S Scheuber Road Centralia WA 98531

Comprehensive Women's Health Care Providence Physical Therapy

1809 Cooks Hill Road Centralia WA 98531

Patient Physical Therapy Service Prov Western WA Oncology-Lacey

4525 Third Avenue Suite 200 Lacey WA 98503

Outpatient Oncology Services Prov Western WA Oncology-Aberdeen

954 Anderson St Suite 102 Aberdeen WA 98520

Outpatient Oncology Services Prov Western WA Oncology-Centralia

2015 Cooks Hill Road Suite 200 Centralia WA 98531

Outpatient Oncology Services Providence SoundHomeCare & Hospice

3432 South Bay Road NE Olympia WA 98506

Home Care and Hospice Services Providence Mother Joseph Care Center

3333 Ensign Road NE Olympia WA 98506

Long-Term Care Providence Mount St Vincent

4831 35th Ave SW Seattle WA 98126

Long-Term Care/Assisted Living Prov Infusion & Pharmacy Services

2201 Lind Ave SW Renton WA 98057

Pharmaceutical Services Providence Hospice of Seattle

425 Pontius Avenue North Seattle WA 98109

Hospice Services Providence Home Services

2201 Lind Ave SW Suite 160 Renton WA 98057

Home Health Services Providence Millcreek Medical Bldg

12800 Bothell-Everett Highway Everett WA 98208

Medical Building Providence Everett Healthcare Clinic

1001 N Broadway Everett WA 98201

Clinic Pavillion for Women & Children

900 Pacific Avenue Everett WA 98201

Clinic Prov Physician Group-Harbour Point

4112 Harbour Pointe Blvd SW Ste 100 Mukilteo WA 98275

Clinic Prov Physician Group-North Everett

1330 Rockefeller Everett WA 98201

Clinic Prov Physician Group-Marysville

11603 State Avenue Suite G Marysville WA 98272

Clinic Prov Physician Group-Monroe

14692 179th Avenue SE Suite 100 Monroe WA 98272

Clinic Millcreek OBGYN

12800 Bothell-Everett Hywy Suite 110 Everett WA 98208

Clinic Pacific Campus OBGYN

900 Pacific Avenue Suite 501 Everett WA 98201

OB/Gyn Services Providence Dominicare

110 South Third Street East Chewelah WA 99109

Home Health Providence VNA Home Health

611 N Perry Bldg 2 Suite 202 Spokane WA 99202

Home Health Prov Emily Court Assisted Living

34 East 8th Avenue Spokane WA 99202

Assisted Living Providence St Joseph Care Center

17 East 8th Avenue Spokane WA 99202

Skilled Nursing Facility Providence Adult Day Health

6018 North Astor Spokane WA 99208

Adult Day Health Providence Extended Care Center

4900 Eagle Street Anchorage AK 99503

Skilled Nursing Facility Providence Alaska Physician Service Org

3200 Providence Drive Anchorage AK 99508

Behavioral & Family Medicine Providence Kodiak Island Counseling Ctr

717 E Rezanof Drive Kodiak Island AK 99615

Behavioral Medicine Providence Residential Treatment Program

3400 E 20th Avenue Anchorage AK 99508

Adolescent Residential Treatment Providence Crisis Recovery Center

3760 Piper Street Anchorage AK 99508

Behavioral Medicine Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ XXX-XX-XXXX. Part II: COMMUNITY BUILDING ACTIVITIES:Many of the activities reported in Part II demonstrate the eastern Washington Providence hospitals' efforts to actively engage and partner with the community to help address specific needs. We collaborate with more than 80 community partners in Spokane and Stevens counties that share our commitment to serving the poor and vulnerable. Together, we are able to maximize resources to reach the greatest number of people, providing needed services such as immunizations, screenings, education, medication, shelter and food. Below is a list of a few of the many organizations Providence hospitals support in eastern Washington:* Catholic Charities* Christ Clinic* Community Detox Services of Spokane* Northeast Tri-County Health District (Colville)* Partners with Children and Families* Prescriptions for Life (Chewelah)* Project Access* Ronald McDonald House* Rural Resources Family Center (Colville)* Spokane Prescription Access Program* Tri-County Community Health Fund (Stevens county)* Second Harvest (food bank)* Community Health Association Spokane dental program (a federally quality health center)* Washington Poison Control CenterIn addition, many Providence Health Care leaders and staff participate in community collaboration efforts through their membership on boards and advisory groups. These boards include United Way, domestic and family violence organizations, educational boards, stroke conference boards, domestic terrorism training, and many more where the expertise of the local hospital staff and administration can offer valuable information to the group for partnership and collaborative efforts in attempts to improve the health and wellbeing of the community. Often the hospital has been asked to provide a representative for the board or advisory group by the community.Providence Sacred Heart, Children's Hospital, and Holy Family also participate as major sponsors of community events that benefit the community at large. Examples include:* American Brain Tumor Association* American Heart Association* American Cancer Society* American Red Cross* Cancer Patient Care* March of Dimes* Special Olympics* Women Helping Women* YWCAProvidence St. Peter Hospital, in the Southwest Washington Service Area, sponsors a program called Grief Works, which assists people who are grieving from the loss of a spouse, child, or sibling. The work involves pastoral care support and counseling in both individual and group sessions. In addition, Providence leaders serve on local boards. Examples include the board of Behavioral Health Resources, a not-for-profit mental health provider, and the Hands On Children's Museum, which promotes healthy family living. 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 (or the patient's legal representative) seeking financial assistance from Providence provides the individual facility with information concerning health benefits coverage, financial status (i.e. income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs.For patients who have an application pending determination for either government-sponsored coverage or for the hospitals' own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency.Eligibility for financial assistance will be determined as closely as possible to the date of service. PART III, 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 I, LINE 7, COL. FOur total expense from Form 990, Part IX, Line 25, column (A) was $3,289,815,715. The bad debt expense included in this amount was $160,106,907. This left us with total expense of $3,129,708,808 for purposes of calculating line 7, column f. Part VI, Line 2: NEEDS ASSESSMENT:We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys. Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care.These general guidelines are applied across all service areas covered in Providence Health & Services - Washington. These include: Northwest Washington Service Area, Southwest Washington Service Area, Southeast Washington Service Area, Providence Health Care in Eastern Washington and PH & S - WA. in Alaska.Providence Sacred Heart Medical Center and Providence Holy Family Hospital partnered with the Spokane Regional Health District and the Institute for Public Policy and Economic Analysis at Eastern Washington University and their Community Indicators Initiative as part of our comprehensive needs assessment. In addition, focus groups were held to gather information from organizations directly addressing the needs of the low income and uninsured. Quantitative and qualitative data were also used to identify the issues the hospitals should target to address in the Spokane community for the next three years, beginning in 2010.Providence Mount. Carmel Hospital and Providence St. Joseph's Hospital partnered with the Northeast Health District and the Institute for Public Policy and Economic Analysis at Eastern Washington University and their Northeast Trends Initiative. In addition, focus groups were held to gather information from organizations directly addressing the needs of the low income and uninsured. Quantitative and qualitative data were also used to identify the issues the hospitals should target to address in the Stevens County community for the next three years, beginning in 2011.Providence ministries in eastern Washington are governed by a community ministry board. In addition, our foundation boards are composed of community members. The results of our needs assessments are presented to these boards for their review and input. The civic leaders that serve on Providence boards connect the Providence Mission with a local perspective on community needs. The Providence Health Care Eastern Washington Community Ministry Board approves the community needs assessments.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 and broad needs of the community, beyond just the need for free and discounted health care services. Part VI, Line 3: COMMUNICATION TO THE PUBLIC:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients. Part VI, Line 4: COMMUNITY INFORMATION:The Northwest Washington Region includes Providence Regional Medical Center Everett (PRMCE), which is the only tertiary provider in Snohomish County and is located on two campuses in Everett, Washington. The hospital's primary service area is Snohomish County, with a population of 708,683. Within this geography, the average age is 36.5 years and only 10% of the population is over age 65, although this is estimated to grow to 12.5% by 2016. The average household income is $76,219, and approximately 7% of households are living below the poverty line in Snohomish County. In addition, 9.5% of Snohomish County residents are unemployed, which is higher than the national unemployment rate. The secondary service area includes Skagit, Island, San Juan and Whatcom counties, totaling an additional 491,631 people. Within this geography, the average age is 39.2 years, with 16% of the population over age 65. The average household income is $63,777. In 2010, PRMCE provided more than $52 million in charity care and community benefit.Spokane County is the furthest east county along Interstate 90, and located on the Idaho border. It is largely urban with the second most populated city in the state - Spokane - with a population of 460,000. Providence Sacred Heart Medical Center & Children's Hospital and Providence Holy Family Hospital are located in Spokane County. About 12.5% of its population is over the age of 65. The leading causes of death in Spokane County are cancer, heart disease and stroke. The maternal smoking rate is two times higher than the state average.Stevens County is in northeast Washington, north of Spokane County with Pend Orielle County to the east and Ferry County to the west. It is largely rural, with a number of miles between health care facilities. Providence Mount Carmel Hospital (75 miles north of Spokane) and Providence St. Joseph's Hospital are about 25 miles apart in Colville and Chewelah, Washington respectively. The Stevens County population is around 44,300 people. A high percentage of the rural population is over the age of 65, at nearly 17%. The leading causes of hospitalizations are unintended injury and heart disease, which are above the state average. The drug crime rate has continued to increase and is higher than the state average.The primary service area for these five Providence hospitals is defined as Spokane and Stevens counties. As the region's major quaternary hospital, Providence Sacred Heart Medical Center & Children's Hospital serves a much broader tertiary market which spans eastern Washington, north Idaho, western Montana and northeastern Oregon, with a population over 1.6 million. Approximately 43% of patients are covered by Medicare, 25% are covered by Medicaid and just over 2% are uninsured. With approximately 15% of the population for most of the counties served living in poverty, this service area is characterized by lower income levels than the state average.The Southwest Washington Region includes Providence St. Peter Hospital in Olympia, Washington and Providence Centralia Hospital in Centralia Washington. The hospitals deliver care to a five-county area including Thurston, Mason, Lewis, Grays Harbor and Pacific counties. For Providence St. Peter Hospital, the hospital serves 484,679 people in its primary and secondary service area; the average age of the population in this geography is 39.5 years, with 15.7% of the population over age 65. The average household income is $61,515. Providence Centralia Hospital serves 121,894 people in its service area, and the average age is 39.5 years, with 16.6% of the population over age 65. The average household income is $54,776. Within the Southwest Washington Region, 7.4% of households are below the poverty line. The unemployment rates for the counties served by the Southwest Washington Region include Thurston County (7.5%), Lewis County (12.6%), Mason County (10.3%), Grays Harbor County (12.6%) and Pacific County (12.2%).The Southeast Washington Region includes Providence St. Mary Medical Center in Walla Walla, Washington. The hospital serves a population totaling 83,226 people in its primary service area in Walla Walla County and Columbia County in Washington and five towns in Umatilla County, Oregon. Within this geography, 16% of the population is over age 65 and the average household income is $54,032. The unemployment rate in Walla Walla County is 6.5% and Columbia County is 10.5%. The hospital also serves 92,739 people in its secondary service area, which is comprised of Garfield County, Washington and Union, Wallowa and Umatilla counties in Oregon. Within the secondary market, 15% of the population is over age 65 and the average household income is $53,372. In total, almost 10 percent of households are living below the poverty line.The geographic difficulties of a vast land mass, relatively undeveloped infrastructure and often extreme weather conditions make meeting the health care needs of Alaskans a unique challenge. Providence Health & Services Alaska serves the health needs of all people across the vast state of Alaska (population of 710,231). Providence Alaska has 14 ministries. Most facilities are located in the Anchorage area, yet Providence Alaska expands it services through a presence in three rural communities as well as telemedicine and electronic intensive care unit (eICU) services extended to communities in Alaska and Oregon. Alaska's population is diverse (28 percent is a minority) and is widely distributed across great distances (only half the population accessible by road). Alaska has a significant number of high-need communities as ranked by the Thompson Reuters Community Need Index. Alaska is a demographically young state with 51 percent of the population under age 35, although the fastest growing age group is the over 55 population. Providence Alaska Medical Center (PAMC) is the only comprehensive tertiary referral center serving all Alaskans. In addition to PAMC, Providence Alaska has a family practice residency program, a continuum of post-acute care services, and a developing medical group located in Anchorage. Anchorage is the second most-diverse city in the nation with more than 90 languages spoken within the Anchorage school district. Thirty-five percent of the Anchorage community is a minority. While PAMC's primary market is the Municipality of Anchorage, it serves residents throughout the state. By percentage of gross revenue in 2010, approximately 27.8 percent of revenue was from Medicare, 18.8 percent from Medicaid and the remainder from other payers. The percentage of bad debt/charity care/self pay discount continues to remain high, at nearly 8.6 percent. While the economic recession has impacted Alaska to a lesser degree than other states, the unemployment rate in Anchorage was 6.2 percent in September. Of families with children under 18 years old, 7.6 percent are below the poverty line. Providence Alaska manages three critical access hospitals located in the remote communities of Kodiak, Seward and Valdez, all co-located with skilled nursing facilities. Community mental health centers are operated in Kodiak and Valdez. Each hospital serves as the primary health care provider for their community. Providence Kodiak Island Medical Center serves the Kodiak Island Borough, which has a population of just over 13,000. Geographically isolated, the island can only be accessed by air or sea. More than half of the population on Kodiak Island was white in 2010 (51 percent). The next largest ethnic groups were Asian (20 percent) and then American Indian/Native Alaskan (13 percent). Commercial fishing is of historic and current economic importance and employment swings seasonally - with lower unemployment rates in the summer and higher rates in winter months. For July, peak employment period, the unemployment rate was 6.4 percent in 2010. Providence Seward Medical Center serves the communities of Seward and Moose Pass. Seward is located at the head of Resurrection Bay on the Kenai Peninsula. The town is 126 miles south of Anchorage. The majority of the population in Seward was white in 2010 (75 percent). The next largest ethnic groups were American Indian/Native Alaskan (18 percent) and then Black (3 percent). In the 2008 needs assessment, 13 percent of respondents went without basic needs such as food, child care, health care or clothing in the last 12 months. When asked what specifically they went without, most respondents reported "health care" and "dental care" (61 percent each). SEE CONTINUATION. Part VI, Line 6: FURTHERANCE OF EXEMPT PURPOSE:As a not-for-profit Catholic health care ministry, Providence Health & Services embraces its responsibility to provide for the needs of the communities it serves - especially the poor and vulnerable. Providence's not-for-profit, tax-exempt status enables Providence to serve its communities, to solicit donations through its foundations and to access capital to respond to community needs that otherwise would go unmet. Health care is fundamentally different from most other goods and services. It is about the most human and intimate needs of people, their families and communities. This critical difference is why we should work together to preserve and strengthen the not-for-profit sector in health care.In Snohomish County, Providence Regional Medical Center promotes the health of the community in a number of unique ways, one of which is a community outreach program called Inside Out: The Original Organ Show. This innovative health education program, directed primarily at middle and high-school students, provides audiences with compelling health information-presented in a truly unique way-that empowers them to make informed decisions about behaviors and lifestyle choices that impact their long-term well-being. Inside Out takes viewers on a fantastic voyage through the human body. Actual human organs, such as hearts, lungs, brains, livers, kidneys and aortas are shown. Some are healthy; others have been damaged by substance abuse, poor eating habits and unsafe behaviors. Comparing healthy and cancerous lungs, clinical educators show the effects of smoking. Holding up a heart with a bullet hole through it, they describe the danger of gun violence. Using an aorta covered with hard, jagged plaque, they talk about how high cholesterol can lead to heart attacks. Displaying the shattered remains of a human brain, they talk about the unintended consequences of accidental prescription drug overdose. This program has been offered to the community for more than 20 years and in that time, thousands of people have written to tell how it changed, and possibly saved, their life.Providence Health Care, in Eastern Washington, formed an innovative collaboration 17 years ago with the other hospital system (then Empire health System) to better serve the community needs by jointly sponsoring Inland Northwest Health Services (INHS) - a not-for-profit organization that provides vital community services including air ambulance service, inpatient rehabilitation services, community health education, medical transpiration (non-ambulance), and an extensive medical information system that connects 38 hospitals across the inland northwest region. INHS represents a collaborative approach to health care that is unlike any other and brings unique partnerships and innovative technologies and more cost-effective care to Spokane and the Northwest. The Providence Health Care Community Ministry Board is made up of volunteer community leaders. The board's primary delegated responsibilities include quality of care and service (including oversight of medical staff privileging), strategic planning, and Mission effectiveness. In its role in Mission effectiveness, the board is responsible for reviewing and approving the community needs assessment and selection of priority community needs. In addition, the board approves recommendations for financial support of community programs and services (representing a $2.5 million investment in 2010).Providence hospitals in Spokane are also the sole providers of many essential services in Spokane. Many of these services are subsidized as they operate at a loss. For example, Providence Sacred Heart Medical Center is the only inpatient psychiatric program in the region, and Providence Holy Family Hospital provides the only inpatient detox program in the community. Other unique services include an inpatient maternity clinic for uninsured, low income women located at Sacred Heart, transplant services (heart, kidney, pancreas) and numerous pediatric subspecialties. In addition, all Providence Health Care hospitals operate 24/7 emergency departments that serve all patients, regardless of ability to pay. And, as the only Level II Trauma Center in the inland northwest region, Providence Sacred Heart medical Center serves a unique role of caring for the most critically ill and injured patients from the vast service area. Other examples of how Providence Health Care and its eastern Washington ministries further its tax exempt status in support of the health of the community include:* Mobile Mammography van that provides mammography services to underserved populations in outlying communities.* Tele-medicine, and tele-continuing medical education for physicians and nurses throughout the region.* Providing educational opportunities for medical professionals throughout the community, including management oversight and subsidizes residency programs including family medicine, internal medicine, radiology and psychiatry as well as funding for medical research.* Medical staff at Providence hospitals have open privileges across all hospital facilities in the area.* Level I heart attack and Level I stroke programs collaborate with rural hospitals throughout the vast inland northwest region to support the delivery of high quality, prompt medical care for patients suffering a stroke or heart attack. Providence in Southwest Washington provided more than $39.6 million in total community benefits including $16.6 million in charity care and $14 million to cover the difference between the costs of providing care for people insured by government-sponsored programs and the amount paid by the government for those services.Providence Southwest Washington hospitals subsidize a broad range of services that provide health benefits to the community but do not generate enough income to be financially self-sustaining. Examples include more than $4 million in programs such as psychiatry, chemical dependency, sexual assault clinic and pediatrics.* Providence is proud to collaborate with community partners to offer an intervention program that helps guide treatment decisions for frequent emergency department patients with chronic conditions and, in many cases, an addiction to pain medication. The Emergency Department Consistent Care Program (EDCCP) has assisted nearly 700 patients, expanded to include five hospitals in a five-county region and dramatically reduced emergency visits. This program helps provide a safety net for patients who would otherwise have nowhere to turn* Based in Olympia and Centralia, the Providence Chemical Dependency and Psychiatric Centers provide structured treatments designed to empower patients with knowledge and support so they can achieve abstinence from drug and alcohol addictions. In 2010, Providence subsidized the centers with more than $2.5 million, providing 13,000 inpatient days for chemical dependency patients and 5,536 patient days for psychiatry patients. Another 14,000 outpatient substance abuse patients and their families received services that would not be available without Providence.* In 2010, the Providence Centralia Hospital Emergency Department was crowded with patients who were using it for primary care and as a dental clinic. The hospital collaborated with local agencies and providers and donated space near the emergency department to support a federally- qualified health center - Valley View Health Centers. As a result, nearly 6,000 local patients were able to access primary medical care and establish a medical home in the new clinic.* The physicians, nurses, nurse practitioners and medical social workers at the Providence St. Peter Sexual Assault Clinic work with physicians, law enforcement and Child Protective Services on behalf of victims of sexual abuse. Serving residents of Thurston, Lewis, Mason, Grays Harbor, Pacific and Cowlitz counties, our specialists are on call 24 hours a day, seven days a week to provide medical evaluations for children, adolescents and adults. In 2010, the clinic provided more than $381,000 in subsidized medical services for nearly 300 individuals.*In 2010, Providence donated $101,000 to Thurston County Project Access. This community-based, physician- led program helps low- income, uninsured residents with acute, urgent medical conditions find access to health care services. Project Access is a best-practice initiative that has been successfully replicated in more than 30 communities nationwide. It is coordinated locally through the CHOICE Regional Health Network. Last year, Providence and other Thurston County partners in the program helped 487 patients gain access to more than $2 million in diagnostic testing and specialty services they would otherwise not receive. SEE CONTINUATION. Part VI, Line 6: Part VI, Line 7: AFFILIATED HEALTH CARE SYSTEM: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, OrThe charitable purpose of Providence Health & Services and each of its ministries is guided by one Mission and set of core values based on Catholic health care and guided by the legacy of the Sisters of Providence. As one system committed to caring for 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 ministries are empowered to apply these policies to meet the local needs of their community. Additionally, Providence ministries conduct local assessments to make sure the needs of the community are met. From a local ministry perspective, one of the benefits of being affiliated with a larger system is the ability to collaborate on community health initiatives. One recent example in Snohomish County was the Hands-On Health Fair, a free monthly community health fair. At the health fair, visitors had the chance to learn about and improve their health from all aspects of Providence. From Providence Physician Group primary care, attendees were able to get free heel scans to test for osteoporosis. From Providence Physician Group specialty care, they were able to learn about new treatments for debilitating vein health issues. From Providence Regional Medical Center Everett, they learned about heart and brain health, including exercise, how to perform CPR, and the warning signs of stroke. From the Providence Regional Cancer Partnership, they learned about breast and prostate health. From Providence Hospice and Home Care, they learned about the life-saving benefits of the Lifeline program. From the Providence Health & Services regional Revenue Cycle team, they were able to get information to assist them in paying for medical care. And from the Providence Health Plan, they were informed of new options for Medicare Advantage. Working individually, none of these ministries of Providence could have created or presented a comprehensive health fair. By collaborating, they were able to join together and promote the health of the community in more than 30 individual topic areas to a group of over 500 attendees for the first event alone.In the eastern Washington Region, Providence Health Care is made up of 11 ministries offering comprehensive, coordinated health care across the full continuum of care. In addition to our five hospitals, Providence Health Care includes home health care, skilled nursing/long term care and transitional care, an assisted living facility, home chore services, a physician group with more than 140 physicians, a medical laboratory and the region's only adult day health program. All of these ministries serve the Providence Mission and provide care for all, especially to those who are poor and vulnerable. This coordinated system of care ensures patients receive the right care from the right provider, at the right time, at the right cost. While the Providence physician group is at the core of coordinating patient care, patients may enter the Providence Health Care system at any ministry level depending on need. This comprehensive, open system ensures patients receive a full spectrum of coordinated care, regardless of their ability to pay.Providence Health & Services in Southwest Washington touches more lives in Thurston, Mason, Lewis, Grays Harbor and Pacific counties than any other health care provider.* Providence St. Peter Hospital is a 390-bed, not-for-profit regional teaching hospital founded by the Sisters of Providence in 1887. Located in Olympia, the hospital offers comprehensive medical, surgical and behavioral health services to residents of Southwest Washington. St. Peter is a regional leader in cardiology, oncology, orthopedics and neuro-sciences. The Joint Commission has designated the hospital a Stroke Center of Excellence since 2007.* Providence Centralia Hospital is a 127-bed, not-for-profit community- based hospital. The services the hospital provides make it the heart of medical care in Lewis County. As a community hospital with outstanding technology, Providence Centralia Hospital is large enough to provide state-of-the-art services such as MRI, 64-slice CT scans and digital mammography. The hospital is also small enough to offer personal, compassionate care to everyone it serves* Providence Medical Group operates more than 20 clinics, with more than 135 specialized providers in Lewis, Thurston and Grays Harbor counties. The group provides primary and specialty care, including family medicine, internal medicine, cardiology, neurosurgery, oncology, diabetes care, general surgery, endocrinology, obstetrics/gynecology, physiatry, psychiatry and urology.* Providence Senior and Community Services provide a full continuum of health care services for those living with chronic and/or life-limiting conditions. Offering access and choice through innovative, customer-centered options, services are provided in the home or in a variety of facility settings including Providence SoundHomeCare and Hospice and Providence Mother Joseph Care Center and through supportive housing, including Providence St. Francis House (Olympia); Providence Blanchet House (Centralia); Providence Rossi House (Centralia) and Providence Place (Chehalis).Providence St. Mary Medical Center provides a comprehensive range of medical care to the residents of a rural area in southeastern Washington and northeastern Oregon, with a special emphasis on caring for the poor and vulnerable. The medical center bases its decisions on what services or specialists to bring to the community based on community needs studies. For some services, most notably chemotherapy and radiation treatment for cancer, Providence St. Mary offers the only care available in a 45 mile radius. A guest house provides free lodging for low income patients driving great distances for care.Providence Alaska has 14 ministries. Most facilities are located in the Anchorage area, yet Providence Alaska expands it services through a presence in three rural communities as well as telemedicine and electronic intensive care unit (eICU) services extended to communities in Alaska and Oregon. The ministries in Providence Alaska work to care for each patient as they need care across the full continuum of health care services. Providence Alaska Medical Center is the only comprehensive tertiary referral center serving all Alaskans. The medical center features the Childrens Hospital at Providence (the only one of its kind in Alaska), the states only Level III NICU, Heart and Cancer Centers, the states largest emergency department, full diagnostic, rehab and surgical services as well as both inpatient and outpatient mental health and substance abuse services for adults and children. Providence Alaska has a family practice residency program that trains physicians in primary care with the intent of increasing providers in distant Alaskan communities. A continuum of post acute care services, including home health, hospice, assisted living and a skilled nursing facility provides care for patients as close to home as possible. A developing medical group provides primary and specialty care in the community. The three critical access hospitals located in the remote communities of Kodiak, Seward and Valdez are all co-located with skilled nursing facilities. Community mental health centers are operated in Kodiak and Valdez. These services combined in these communities provide a solid foundation for access to health care. Providence Alaska also partners to provide additional services through five joint ventures including: Providence Imaging Center in both Anchorage and Soldotna, St. Elias Long Term Acute Care Hospital, Imaging Associates of Providence in both Anchorage and Wasilla, LifeMed Alaska (a medical transport / air ambulance service), and Creekside Surgery Center. Part VI, Line 7: Reports Filed With States Part VI, Line 7 WA,OR,CA,MT,AK CONTINUATION OF COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 Providence Valdez Medical Center serves the community of Valdez. Valdez is one of Alaska's most important port cities. It is located about 120 air miles and 305 road miles east of Anchorage. The population is close to 4,000 and is located within 222 square miles of land area. In 2010, the majority (79 percent) of the population in the City of Valdez were white, with 8 percent of the population American Indian/Alaska Native. The median age was 37 years old in Valdez according to the 2010 Census, a slightly older median age than its statewide counterpart (34 years old). In the 2011 community health needs assessment, approximately one in 12 community survey respondents reported that they or their family had to go without basic needs in the year prior to the survey. Of those who went without basic needs, almost half said they went without dental care (49 percent) and/or health care (46 percent). CONTINUATION OF PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 In Walla Walla County, Providence St. Mary Medical Center participates with other health, education, governmental and social service agencies in a community health assessment, sponsored by the Walla Walla County Health Department. The assessment identifies the areas of greatest need in the health of the community. Providence St. Mary uses this data in addition to other information to guide its community outreach. In recent years, the most critical need identified through this process is at-risk youth access to health care and services. To meet this need, Providence St. Mary provided funding to establish eastern Washington's first school-based health clinic, which operates as an independent not-for-profit at an alternative high school in Walla Walla. Providence St. Mary now provides annual funding to the clinic. The medical center also donates the use of a building to Trilogy Recovery Community, an independent not-for-profit youth drug and alcohol recovery center.Providence St. Mary utilizes the Providence Telestroke Network, run through the Providence Brain Institute in Portland, Oregon, to ensure that every patient coming into the emergency department with symptoms of stroke can be seen by a neurologist, regardless of the hour. With strokes, the faster a patient is diagnosed and treated, the less damage the stroke can do. Receiving the right treatment quickly can mean the difference between life and death, and between a good recovery and a lifelong disability. In Alaska, access to health care is one of the most critical community needs. To address this need, Providence Alaska and its local ministries are involved in and supportive of many programs, activities and services. In addition to having 24/7 emergency room care, each community is pursuing trauma designation to ensure every Alaskan receives exemplary and timely care. Providence Alaska is governed by a community ministry board made up of independent community members from across the state. Additionally, each hospital has an advisory board made up of local community members. Providence Alaska Medical Center has an electronic intensive care unit (eICU) that serves communities across Alaska and one community in Oregon. PAMC is also expanding its telemedicine capabilities to provide stroke care to local and distant communities. Within the community of Anchorage, Providence is a long-time partner of Anchorage Project Access (APA). The volunteer network provides medical services, accepting and treating APA-referred patients as any other insured patients. PAMC will continue to provide funding and office space for the program. To address access to health care in Kodiak, Providence Kodiak Island Medical Center is partnering with the Healthy Tomorrows (HT) coalition to improve the mental and physical wellness of local youth. Programs include: safe-and-sober activities for students, student skill-building groups, physical activities at schools, Yellow Ribbon suicide prevention and an online "get-fit" challenge.To address access to care in Seward, Providence Seward Medical Center is partnering with the Seward Health and Wellness coalition. Programs include: Free primary care for up to 70 residents, expanding availability of charity care/sliding fee scale in the clinic, expanding the Know Your Numbers campaign and increasing access to dietary support and physical activities.To address access to care in Valdez, Providence Valdez Medical Center is partnering with the Sound Wellness Advisory Network (SWAN) and Valdez Parks and Rec to improve health in Valdez. Programs include: Healthier You Campaign, increased access to healthy activities, wellness education, and biometric screenings. 1 Providence General Foundation PO Box 1067 Everett WA 98206 911041617 501(c)(3) 2016711 Employee Assistance Fund, Operational Support Providence Alaska Foundation 3200 Providence Drive Anchorage AK 99508 920093565 501(c)(3) 1308104 Ministry Support INHS - Health Partners & IRM PO Box 469 Spokane WA 99210 911307555 501(c)(3) 1293292 Comm Health Education United Way of Anchorage 701 W 8th Avenue Ste 230 Anchorage AK 99501 920027948 501(c)(3) 1267378 Community Benefit University of Alaska 3211 Providence Dr K101A Anchorage AK 99508 926000147 Other 757500 Community Benefit Providence St Peter Foundation 413 Lilly Road NE Olympia WA 98506 911097056 501(c)(3) 672211 Ministry Support Providence Mount St Vincent Foundation 4831 35th Avenue Southwest Seattle WA 98126 911188119 501(c)(3) 551942 Ministry Support Providence Hospice of Seattle Foundation 425 Pontius Ave N 300 Seattle WA 981095452 912077378 501(c)(3) 491191 Ministry Support Providence Health Care Foundation 914 S Scheuber Rd Centralia WA 98531 911433382 501(c)(3) 292577 Ministry Support Everett Community College 2000 Tower Street Everett WA 98201 910759103 Other 271500 The Registered Nurse Residency Program Anchorage Neighborhood Health Center PO Box 201849 Anchorage AK 995201849 920047965 501(c)(3) 250000 Community Health Sacred Heart Childrens Foundation 101 W 8th Avenue Spokane WA 99220 320014330 501(c)(3) 174569 Ministry Support Christ Clinic 914 W Carlisle Spokane WA 99205 911435174 501(c)(3) 170500 Building Expansion Campaign & Psychiatric Nurse Practitioner Providence Marianwood Foundation 3725 Providence Point Drive SE Issaquah WA 98029 931554288 501(c)(3) 106253 Ministry Support Anchorage Project Access PO Box 196604 Anchorage AK 99519 920152080 501(c)(3) 101250 Healthcare Access Alaska Sports Hall of Fame Inc 1415 Echo Canyon Rd Anchorage AK 995166908 810649085 501(c)(3) 100000 Community Benefit Partners with Families & Children 613 S Washington Spokane WA 99204 680576560 501(c)(3) 96792 Financial & Child Assistance / Monthly Sponsorship Ronald McDonald House 1015 W Fifth Ave Spokane WA 99204 911176115 501(c)(3) 96500 Building Expansion Campaign The American Heart Association 3700 Woodland Avenue 700 Anchorage AK 99517 135613797 501(c)(3) 96217 Healthcare Lincoln Health Center 534 South 3rd ST Suite 16 Walla Walla WA 99362 270401462 501(c)(3) 90000 School Based Clinic Catholic Charities Spokane PO Box 2253 Spokane WA 99210 910569880 501(c)(3) 77456 Land Purchase & House of Charity Prescription Drug Assistance Foundation 200 Broadway Suite 100 Seattle WA 98122 331134368 501(c)(3) 72400 Prescription Drug Assistance University of Washington 1959 NE Pacific St NW125 Seattle WA 98195 916001537 Other 71250 Palliative Medicine Fellowship Medical Team International PO Box 10 Portland OR 97207 930878944 501 (c)(3) 63250 Haiti Medical Assistance Catholic Medical Mission Board Inc 10 West 17th Street New York NY 100115765 135602319 501(c)(3) 50000 Community Health Catholic Relief Services PO Box 17090 Baltimore MD 212037090 135563422 501(c)(3) 50000 Community Benefit Alaska EHR Alliance 4120 Laurel St Ste 206 Anchorage AK 995085392 202141045 501 (c)(3) 72574 Community Health American Cancer Society 3851 Piper Street Suite U240 Anchorage AK 99508 841316555 501(c)(3) 46962 Community Health American Cancer Society 728 134th Street SW Ste 101 Everett WA 98204 841316555 501(c)(3) 42500 Community Benefit Inland NW Genetics 2607 S SE Blvd Bldg A100 Spokane WA 99223 910937457 501(c)(3) 39273 Community Health Community Detox Services of Spokane PO Box 2845 Spokane WA 99220 911108762 501(c)(3) 37800 Community Health Project Access 104 S Freya Street Suite 114 Spokane WA 99202 910827958 501(c)(3) 36000 Building Expansion Campaign March of Dimes 1904 Third Avenue Suite 230 Seattle WA 98101 131846366 501(c)(3) 35000 Community Benefit The Foraker Group 161 Klevin Street Ste 101 Anchorage AK 995081506 920177787 501(c)(3) 35000 Community Benefit Choice Regional Health Network 2409 Pacific Avenue SE Olympia WA 98501 911704039 501(c)(3) 30000 Thurston County Project Access Sisters of Providence Pariseau 1801 Lind Avenue SW Renton WA 98057 911289932 501(c)(3) 27750 Community Benefit YWCA 930 N Monroe St Spokane WA 99201 910565025 501(c)(3) 25634 Community Benefit March of Dimes Foundation 255 E Firewood Ln Ste 102 Anchorage AK 99503 131846366 501(c)(3) 25350 Healthcare American Heart Association 140 S Arthur Street Suite 610 Spokane WA 99202 135613797 501(c)(3) 25000 Community Benefit Anchorage School District 1805 Academy Dr Ste 101 Anchorage AK 995075301 928000078 Other 25000 Health Education Christian Health Associates 1825 Academy Drive Anchorage AK 995075391 920152088 501(c)(3) 25000 Community Health Covenant House of Alaska PO Box 104640 Anchorage AK 995104640 133419755 501(c)(3) 24002 Community Benefit Alaska Native Tribal Health Co 4000 Ambassador Dr Anchorage AK 99508 920162721 501(c)(3) 24000 Community Health Mill Creek Business Association 13300 Bothell Everett Highway Mill Creek WA 98012 911852335 501(c)(6) 22000 Community Benefit Catholic Social Services Inc 225 Cordova Street Bldg B Anchorage AK 995012409 920037322 501(c)(3) 20150 Community Benefit Alaska School Activities Association 4048 Laurel St 203 Anchorage AK 99508 920116510 501(c)(3) 20000 Community Benefit Run of The Mill Committee 15418 Main Street Suite 102 Mill Creek WA 98012 743178567 501(c)(3) 20000 Cancer Patient Assistance Spokane County Medical Society Foundation 104 S Freva St Suite 114 Spokane WA 99202 911728909 501(c)(3) 18300 Patient Transportation St Joseph Family Center 1016 N Superior Spokane WA 99202 910564989 501(c)(3) 15850 Care for Working Poor King County Project Access 1111 Harvard Avenue Seattle WA 98122 204377921 501(c)(3) 15000 Project Access provides labs, imaging, and other hospital based or clinic based services for low income people or the uninsured Seward Community Foundation 400 L Street Ste 100 Anchorage AK 995011900 920155067 501(c)(3) 15000 Community Health Washington State Medical Association 2033 Sixth Ave Suite 1100 Seattle WA 98121 916074463 501 (c)(6) 15000 Community Health Women Helping Women Fund 1325 W First Ave Suite 318 Spokane WA 99201 911561874 501(c)(3) 15000 Families/Youth Suicide Prevention Program Meals on Wheels 1222 W 2nd Ave Spokane WA 99201 910833015 501(c)(3) 14400 Feed Bodies, Nurturing Souls & Saving Lives Program YWCA of Snohomish County 2720 Rockefeller Everett WA 98201 910565561 501(c)(3) 13250 Community Benefit United Way of Snohomish County 3120 McDougal Avenue Suite 200 Everett WA 98201 910606507 501(c)(3) 11000 Helping Hands For Hard Times American Red Cross Snohomish Co Chapter 2530 Lombard Everett WA 98201 910581658 501(c)(3) 10405 First Aid Kits for Migrants Everett Silver Tips Hockey Club 2000 Hewitt Avenue Suite 100 Everett WA 98201 980376631 Other 10380 Community Benefit Breast Cancer Focus Inc PO Box 242464 Anchorage AK 99524 911842524 501(c)(3) 10100 Healthcare Education The Leukemia and Lymphoma Society 530 Dexter Avenue N 300 Seattle WA 98109 135644916 501(c)(3) 10100 Healthcare The Wall Walla Valley Chamber of Commerce 29 E Sumach Walla Walla WA 98362 910457015 501(c)(3) 10100 Community Development Rotary Club of Everett PO Box 1225 Everett WA 98201 916032628 501(c)(4) 10050 Student Scholarship 5 Miler for Mens Cancer Research PO Box 100225 Anchorage AK 995100225 920158284 501(c)(3) 10000 Community Health Alaska State Medical Association PO Box 230630 Anchorage AK 99523 926002176 501(c)(6) 10000 Community Health Group Health Foundation 320 Westlake Ave N Ste 100 Seattle WA 98109 911246278 501 (c)(3) 10000 Health Gala Sponsorship Lilac Bloomsday Association 1610 W Riverside Spokane WA 99201 911054846 501(c)(3) 10000 Bloomsday Sponsorship/Trade Show Rasmuson Foundation 301 W Northern Lights Blvd 400 Anchorage AK 995032648 916340739 501(c)(3) 10000 Community Benefit Spokane District Dental Society Foundation PO Box 4432 Spokane WA 99220 208248281 501(c)(3) 10000 Community Education The Anchorage Running Club PO Box 243362 Anchorage AK 995243362 920085126 501(c)(3) 10000 Community Health Life Services of Spokane 2659 N Ash Spokane WA 99205 911494402 501(c)(3) 9950 Maternity Home/Young Lives/HOPE Program St Anne's Children's & Family Center 25 W 5th Ave Spokane WA 99204 910569880 501(c)(3) 9920 Support Preschool Childhood Education Tri County Health - TCCHF Get Fit Colville 1200 E Columbia Colville WA 99114 431992627 501(c)(3) 9000 Community Health Holy Family Foundation 5633 N Lidgerwood Spokane WA 99028 911107079 501(c)(3) 8000 ER Clothing Bank Program National Multiple Sclerosis Society 192 Nickerson Street Suite 100 Seattle WA 98109 910742424 501(c)(3) 8000 Healthcare Rural Resources 956 S Main St Colville WA 99114 910793447 501(c)(3) 7950 Community Services United Way of Valdez PO Box 707 Valdez AK 996860707 920090499 501(c)(3) 7927 Community Benefit Alaska State Hospital & Nursing Home Association 943 W Sixth Avenue Ste 120 Anchorage AK 99501 920034538 501(c)(6) 7500 Healthcare Rainier View Elementary 3015 S 368th Street Federal Way WA 98003 911572095 Other 7500 Community Benefit Washington Center for Nursing 1101 Andover Park W Suite 105 Tukwila WA 98188 680568743 501 (c)(3) 7500 Community Health Mid-City Concerns 1222 W Second Ave Spokane WA 99201 910833015 501(c)(3) 7320 Meals on Wheels Pope Kids Place 230 Washington Way Centralia WA 98531 911685519 501(c)(3) 7000 Support Cost of Respite Care Providence Heritage House at the Market 1533 Western Avenue Seattle WA 98101 510216586 501(c)(3) 6690 Ministry Support Municipality of Anchorage 715 L Street Ste 200 Anchorage AK 995013359 920059987 Government 6100 Community Education American Cancer Society 920 N Washington Ste 200 Spokane WA 99201 841316555 501(c)(3) 6000 Relay for Life The WaterFall Foundation PO Box 70049 Fairbanks AK 997070049 541980898 501(c)(3) 6000 Community Benefit Washington Poison Center 155 NE 100th St 100 Seattle WA 98125 943214597 501(c)(3) 6000 Community Education Beans Cafe PO Box 100940 Anchorage AK 99510 920072522 501(c)(3) 5900 Community Benefit Northeast Tri County Health District 240 E Dominion Ave Colville WA 99114 911358169 Other 5900 Pertussis Outbreak Assistance Catholic Charities PO Box 2253 Spokane WA 99210 202823241 501(c)(3) 5750 House of Charity Mental Health UW School of Nursing PO Box 357260 Seattle WA 98195 916001537 Other 5480 Nursing Education 77 13 Patient Transport 3645 65076 FMV Patient Transport Medical Supplies 37 3507 Cost DME Assistance Prescription Medications 70 70585 Cost Medication Housing Assistance 109 5470 Cost Housing Employee Assistance 313 218422 Cost Assistance for Necessities of Life Life Saver Program 30 1500 FMV Mammograms for Uninsured or Underinsured Indigents - Food 34241 3258 Cost Base amount for food plus supply cost used 0 0 Medical Mission Grants 113 96864 Cost Medical Mission Trips 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 X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 John F Koster MD 1073328 0 1236674 0 36500 0 777729 0 16974 0 3141205 0 0 0 Michael L Butler 734748 0 283527 0 20000 0 317186 0 23128 0 1378589 0 0 0 Jeffrey W Rogers 418582 0 825815 0 15000 0 446566 0 18760 0 1724723 0 0 0 Eugene Al Parrish 491513 0 535611 0 20034 0 310289 0 22203 0 1379650 0 0 0 John V Fletcher 516196 0 708989 0 52318 0 564812 0 19983 0 1862298 0 0 0 Dan T Harris 380239 0 119811 0 15000 0 222393 0 2712 0 740155 0 0 0 Anthony J Dorsch 236771 0 89478 0 15034 0 43051 0 14080 0 398414 0 0 0 Janice J Jones 552837 0 534946 0 52249 0 326291 0 22994 0 1489317 0 0 0 Gregory Van Pelt 678198 0 1545235 0 90662 0 463313 0 21030 0 2798438 0 0 0 Russell Danielson 511864 0 3879403 0 58725 0 373761 0 23895 0 4847648 0 0 0 Arnold R Schaffer 609272 0 1144945 0 226401 0 349661 0 21820 0 2352099 0 0 0 John O Mudd 325749 0 494171 0 36500 0 381188 0 14731 0 1252339 0 0 0 Keith Marton MD 211843 0 237842 0 268130 0 198251 0 17696 0 933762 0 0 0 Claudia Haglund 314668 0 142918 0 43577 0 109252 0 17322 0 627737 0 0 0 Joel S Gilbertson 311580 0 97519 0 45557 0 38285 0 18003 0 510944 0 0 0 Cindra R Syverson 365566 0 105302 0 15000 0 87877 0 20361 0 594106 0 0 0 John Kenagy 324910 0 91285 0 31500 0 122409 0 18611 0 588715 0 0 0 James N Leonard 123875 0 868855 0 97516 0 181599 0 10056 0 1281901 0 0 0 Deborah Burton 252225 0 61612 0 27639 0 153009 0 15298 0 509783 0 0 0 Myron Berdischewsky MD 369222 0 182574 0 57346 0 245165 0 23794 0 878101 0 0 0 David Brown 250803 0 76227 0 15000 0 93721 0 17227 0 452978 0 0 0 Andrew C Agwunobi 481918 0 142503 0 15000 0 155800 0 14160 0 809381 0 0 0 Michael Hunn 363490 0 111813 0 15577 0 153028 0 13285 0 657193 0 0 0 Bruce Lamoureux 393724 0 156550 0 31534 0 173765 0 14160 0 769733 0 0 0 David T Brooks 392584 0 119816 0 15000 0 158954 0 14160 0 700514 0 0 0 Medrice Coluccio 391009 0 82951 0 31500 0 317956 0 7188 0 830604 0 0 0 Elaine Couture 320003 0 108199 0 31500 0 76730 0 11544 0 547976 0 0 0 Andrew T Howlett 900476 0 636544 0 0 0 16500 0 10140 0 1563660 0 0 0 Atul Thakker 870144 0 88625 0 16500 0 89699 0 12272 0 1077240 0 0 0 Perry E Camp 556637 0 290652 0 16500 0 3675 0 9303 0 876767 0 0 0 Steven A Burdick 256102 0 578520 0 15000 0 56115 0 11508 0 917245 0 0 0 James N Dunlap 502141 0 341302 0 0 0 16500 0 10140 0 870083 0 0 0 Richard J Umbdenstock 0 0 32220 0 0 0 0 0 0 0 32220 0 0 0 Michael J Madden 0 0 343217 0 16500 0 0 0 0 0 359717 0 0 0 Charles E Hawley 25690 0 2048448 0 63610 0 17773 0 0 0 2155521 0 0 0 Thomas Johnson 8513 0 62573 0 254323 0 85036 0 6416 0 416861 0 0 0 Michael Wilson 0 0 397319 0 458532 0 32415 0 5772 0 894038 0 0 0 Ryland Davis 2202 0 395569 0 132229 0 90238 0 2762 0 623000 0 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 Officers & Key Employees received gross-up payments: Russell Danielson Joel Gilbertson Orest Holubec Eugene "Al" Parrish Arnold R. Schaffer Myron Berdischewsky Anthony J. Dorsch Bruce Lamoureux 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 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) Daniel T. Harris a) DBSERP Earned - $ 1,332 b) DCSERP Earned - $ 198,809 29) Anthony J. Dorsch a) DCSERP Earned - $ 27,985 30) James N. Leonard a) Taxable DBSERP Vested but not Paid - $ 868,855 b) DCSERP Earned - $ 179,404 31) Andrew C. Agwunobi a) DBSERP Earned - $ 240 b) DCSERP Earned - $ 145,788 32)Bruce Lamoureux a) Taxable DBCBRP Vested but not Paid - $ 23,755 b) DBSERP Earned - $ 408 c) DCSERP Earned - $ 160,161 33) David T. Brooks a) DBSERP Earned - $ 636 b) DCSERP Earned - $ 143,874 34) Medrice Coluccio a) DBSERP Earned - $ 300 b) DCSERP Earned - $ 299,232 35) Elaine S. Couture a) Taxable DBCBRP Vested but not Paid - $ 9,294 b) DCSERP Earned - $ 56,452 36) Atul Thakker a) DCRP Earned - $73,337 37) Steven A. Burdick a) Taxable DBSERP Vested but not Paid - $ 482,268 b) DCSERP Earned - $ 29,376 c) ESP Interest Credit - $ 15,592 38) Michael Wilson a) Taxable DBSERP Paid- $ 362,173 b) Non-Taxable DBSERP Vested but not Paid - $ 31,411 c) DCRP Earned - $ 951 39) Ryland Davis a) Taxable DBSERP Paid - $ 395,569 b) DCSERP Earned - $ 89,882 Part I, Lines 4a-b SEVERANCE 1)Keith Marton, MD - $201,412 2)Thomas Johnson - $223,731 3)James N. Leonard - $ 83,313 4)Michael Wilson - $ 458,532 5)Ryland Davis - $ 132,229 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. Washington Health Care Facilities Authority 911108929 93978EA77 2006-06-22 208792185 Refund WHCFA Series 1999 & Capital projects in Washinton 1 0 0 Washington Health Care Facilities Authority 911108929 93978EB27 2006-06-22 165050000 Refund WHCFA Series 2002A & B and Series 1994 & 1995 0 0 0 Washington Health Care Facilities Authority 911108929 93978E7V8 2010-07-01 173543991 To Finance a Portion of construction of a Tower in Everett 0 0 0 Alaska Industrial Development and Export 926001185 011903AW1 2003-05-16 24968713 Refund Municipality of Anchorage Series 1987 and Bonds & Series 1991 0 0 0 1610000 208792185 1651096 1980039 3336312 146353342 57122492 2009 0 1 1 1 165050000 1660244 2465562 160924194 2002 1 0 1 1 173543991 2543991 171000000 2011 0 0 1 1 22995000 24968713 305852 24662861 1987 1 0 1 1 0 1 0 0 1 0.00010 0.00000 0.00010 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Alaska Industrial Development and Export 926001185 011903BEO 2003-09-04 37426100 Reimburse Alaska Region for Capital expenditures made in 2002 & 2003 0 0 0 Alaska Industrial Development and Export 926004485 011903CT6 2006-11-30 57177110 Reimburse Alaska Medical Center for portion of costs to construct cancer ctr 0 0 0 8200000 37426100 501778 36924322 2003 0 0 1 1 57177110 646775 56530335 2008 0 0 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 John F Koster MD Officer 346569745 Purchase of Supplies through cooperative of which Dr. Koster is a Director 0 Form 990, Part VI, Section A, line 6 Providence 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 appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause. Form 990, Part VI, Section A, line 7b Other powers of the Corporate Member include the power: 1) To adopt or change the mission, philosophy, and values, including the strategic plan and mission statement 2) To amend or repeal the Articles of Incorporation or Bylaws 3) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale transfer, assignment or encumbering of assets exceeding a specified threshold, or the sale or transfer of any property which may have historical or religions significance 4) To approve the dissolution or liquidation 5) To approve the annual operating and capital budgets 6) To appoint the certified public accountants 7) To appoint the certified public accountants 8) To approve the closure of any institution or major ministry or work of the 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. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 8,229,418. Investment expenses: 1,188. Prior period adjustments: -115,960. FAS 136 4,051,294. Interaffiliate Transactions 44,081,375. Net Assets Transfers -5,511,453. Rounding 30. Total to Form 990, Part XI, Line 5: 50,735,892. 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. AUDIT & COMPLIANCE FORM 990, PART XII, LINE 2C The 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 Volunteers do a variety of routine, non-direct patient care tasks designed to enhance and make the patient and visitor hospital experience positive and comfortable, as well as, to provide trained staff more time for direct patient care such as: Routine clerical duties such as filing, sorting, stuffing, labeling, compiling large mailings or packets, copying, faxing & inputting routine data into databases Answering phones, taking messages, and making phone calls with scripted information Greeting people and directing/escorting to correct areas Volunteering in gift shop by helping customers find items and ringing up sales Assisting in counting and labeling items or equipment during large inventory projects Visiting with patients and families, getting warm blankets for patients & delivering flowers and mail to patients and departments Providing coffee, current magazines, newspapers and puzzles to patient families in waiting rooms Make pillows for rehab, cardiac and family birth center patients Make bread for oncology patients and families Keeping brochure and education racks full VOLUNTEERS INVOLVED WITH HOSPICE CARE: Patient Care Volunteers help to support the hospice patient and their family during the course of their illness meeting a variety of needs including respite, companionship, helping with light household tasks and providing personal services such as letter writing, reading and running errands. Transitions Volunteers help to support clients and their family facing a life limiting illness with a prognosis of 12 months or less with a variety of needs. Duties are similar to those of patient care volunteers. Bereavement Volunteers help surviving families/significant others of Hospice patients for 13 months following the death of the patient. Safe Crossings Volunteers provide support services to children connected with Providence Hospice of Seattle regarding issues around terminal illness and assist with bereavement support. Complementary therapy volunteers perform the same services as patient care volunteers with the addition of offering a licensed modality such as massage, Reiki, music therapy or animal-assisted activities (animal/animal handler must be Delta Certified) if requested by the patient, family and care team. Stepping Stones volunteers help support children and their families facing a life limiting illness in a variety of ways. Volunteers may read books, play games or serve as one-to-one support to families. Camp Erin volunteers assist with an annual weekend grief camp sponsored by Providence Hospice and The Moyer Foundation for children ages 5-17. 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. Providence Assurance Inc 3131 Camelback Road Ste 400 Phoenix AZ 85016 208194071 Insurance Captive AZ 0 27178338 Providence Health & Services - Washington Legacy LLC PO Box 196606 Anchorage AK 99519 320252199 Real Estate AK 3547573 56080023 Providence Health & Services - Washington Health Services Asset Management LLC 1801 Lind Ave SW 9016 Renton WA 98057 271698016 A/R & Collections WA 588835 498257 Providence Health & Services - Washington 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 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 1 Providence Imaging Center 3340 Providence Drive Anchorage AK 99508 920118807 Medical Imaging AK PH&S - WA Related 26139000 13286000 0 1 0.99000 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 708684 5096811 0 1 0.50000 Medalia Healthcare LLC 1801 Lind Ave SW 9016 Renton WA 98057 911660459 Physician Benefits WA PH&S - WA Investment -225082 94352 0 1 0.51000 Distribution Operations Center LLC 1801 Lind Ave SW 9016 Renton WA 98057 271054858 Supplies Purchasing Agent WA PH&S - WA Related -2159276 3963141 0 1 0.44440 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 Canby Medical Center I LLC 2747 Pence Loop SE Salem OR 97302 205470937 Real Estate - MOB OR Willamette Falls Hospital Related 0 0 ProvidenceUSP Santa Clarita GP LLC 11550 Indian Hills Road 160 Mission Hills CA 91345 202829660 Ambulatory Surgery Center 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 1 0 1 1 0 0 1 1 1 1 Providence St Peter Foundation B 672211 Cost Providence St Peter Foundation C 3350208 Cost Providence Alaska Foundation B 1308104 Cost Providence Alaska Foundation C 2772605 Cost Providence Mount St Vincent Foundation B 551942 Cost Providence Mount St Vincent Foundation C 1092720 Cost Providence Hospice of Seattle Foundation B 491191 Cost Providence Hospice of Seattle Foundation C 825893 Cost Providence Health Care Foundation B 292577 Cost Providence Health Care Foundation C 813681 Cost Providence Marianwood Foundation B 106253 Cost Providence Marianwood Foundation C 373805 Cost Providence Hospice & Home Care Foundation Snohomish County C 76995 Cost Sacred Heart Children's Foundation B 174569 Cost Sacred Heart Children's Foundation C 37474 Cost