PROVIDENCE HEALTH SYSTEM-SOUTHERN CALIFORNIA: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- PROVIDENCE HEALTH SYSTEM-SOUTHERN CALIFORNIA (EIN 51-0216589)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-15
- IRS object ID
- 201143199349306834
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-15T14:27:04-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clark Nuber PS | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4th Suite 1700 | AddressLine1 |
| City | Bellevue | City |
| State | WA | State |
| ZIP Code | 98004 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 510216589 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PROV | NameControl |
| Phone | 4255253985 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 Lind Avenue SW No 9016 | AddressLine1 |
| City | Renton | City |
| State | WA | State |
| ZIP Code | 980579016 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael L Butler | Name |
| Title | Exec VP/CFO | Title |
| Phone | 4255253985 | Phone |
| Date Signed | 2011-11-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Sara Elizabeth J Hyre CPA | Name |
| Phone | 4254544919 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | John F Koster MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 Lind Avenue SW No 9016 | AddressLine1 |
| City | Renton | City |
| State | WA | State |
| ZIP Code | 980579016 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1641233110 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www2.providence.org/california/Pages/default.aspx | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1903 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | Healthcare with special concern for the poor & vulnerable in So. California. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 11197 | TotalNbrEmployees |
| Total Nbr Volunteers | 2471 | TotalNbrVolunteers |
| Total Gross UBI | 5123628 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 1000644 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 11800022 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 13976543 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1310942656 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1363669257 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -43789772 | InvestmentIncomePriorYear |
| Investment Income Current Year | 6034226 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 198264755 | OtherRevenuePriorYear |
| Other Revenue Current Year | 88936155 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1477217661 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1472616181 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 2856375 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 5381160 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 798225785 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 837019951 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 126000 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 236159 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 663679424 | OtherExpensePriorYear |
| Other Expenses Current Year | 562921450 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1464887584 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1405322561 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 12330077 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 67293620 | RevenuesLessExpensesCY |
| Total Assets BOY | 3248842364 | TotalAssetsBOY |
| Total Assets EOY | 3279160875 | TotalAssetsEOY |
| Total Liabilities BOY | 2650196555 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2618522196 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 598645809 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 660638679 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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 Southern California. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 777460235 | Expense |
| Grants | 0 | Grants |
| Revenue | 948094824 | Revenue |
| Description | Acute Care - Inpatient Patient Days - 327,464Admissions - 71,177OUR MISSION - As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.OUR CORE VALUES - Respect, Compassion, Justice, Excellence, and StewardshipPROVIDENCE CARESWhether tenderly holding a special-needs child who requires round-the-clock care, or easing the way for a stroke patient who faces both physical and financial struggles, the people of Providence are called to a mission of service. Our lifework is to provide excellent care for everyone, at all stages of life, regardless of ability to pay. This has been the Providence mission since the Sisters of Providence arrived on the shores of the Columbia River 150 years ago, committed to the care and healing of poor and vulnerable frontier neighbors. Providence Health System-Southern California is a not-for-profit network of hospitals, care centers, physicians, clinics, home health services and affiliated services. We continue a tradition of caring that the Sisters of Providence began in the West 150 years ago.Providence Health System - Southern California has entered into a joint agreement with the Bioethics Institute at Loyola Marymount University in Westchester, California. Loyola Marymount faculty will now be available to Providence hospitals to assist with bioethics education and Little Company of Mary- Torrance Hospital will host clinical rounds for graduate students.OUR FACILITIES:Providence Saint Joseph Medical Center in BurbankProvidence Holy Cross Medical Center in Mission HillsProvidence Tarzana Medical Center in TarzanaProvidence Little Company of Mary Medical Center in TorranceProvidence Little Company of Mary Medical Center in San Pedro | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 279424950 | Expense |
| Grants | 0 | Grants |
| Revenue | 340752281 | Revenue |
| Description | Acute Care - Outpatient - including emergency/trauma services. Patient Visits - 673,893 San Pedro Peninsula Hospital dba Little Company of Mary-San Pedro Hospital (LCM-SPH) provides care to the sick and dying and their families through the Catholic Health Ministry. In October 1992, LCM-SPH affiliated with Little Company of Mary Health Services (LCMHS) and became part of its integrated system. Due to the changing economic conditions of health care, LCMHS sought a strategic partner to be able to continue its commitment to meet the health needs of the community and remain financially strong. On September 1, 1999 LCMHS affiliated with Providence Health & Services, an exempt 501(c)(3) corporation headquartered in Renton, Washington. Providence Health & Services is a not - for - profit Catholic organization with the same mission and values as LCMHS and its affiliated organizations.LCM-SPH accomplishes its Mission of providing health care services to the community in a variety of hospital and ambulatory settings. LCM-SPH operates an acute general hospital that provides comprehensive inpatient, outpatient and emergency services. Major service areas within the acute hospital include medical/surgical, obstetrics, geropsychiatry, rehabilitation and chemical dependency. The hospital also has an outpatient diagnostic imaging center. In addition to its acute hospital, LCM-SPH provides sub-acute care services to the community .The Mission of Little Company of Mary Sisters and the Sisters of Providence is reflected in the historical significance of their names to continue the healing ministry of Jesus. They are committed to care for the sick, dying and needy.Providence Health & Services Southern California - LCM Services Area is committed to the fulfillment of the Mission of the Sisters through the delivery of expanded charitable services. In keeping with this mission it has established a Social Accountability budget to return the value of the system's tax exemption to the community.Providence Little Company of Mary San Pedro was among the first recipients of Press Ganey's new Best Place to Practice Award which was given to only six hospitals nationwide. This award recognizes hospitals who have reached and sustained the 95th percentile on their physician surveys for two consecutive reporting periods that are not more than twenty-four months apart.HealthGrades recognized Providence Tarzana Medical Center with 5-Star ratings for the treatment of heart attack and heart failure for the sixth consecutive year and Providence Saint Joseph Medical Center with a Maternity Care Excellence Award, ranking Providence Saint Joseph among the top five percent of rated hospitals in the nation for five years. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 57219656 | Expense |
| Grants | 0 | Grants |
| Revenue | 69778051 | Revenue |
| Description | Long-Term Care, Subacute Skilled Nursing & Home Health Programs. Long-Term Care Days - 98,538; Home Health Visits - 56,843. | Description |
Activity Other ActivityOther (3 entries)
| ExpenseExpense | GrantsGrants | RevenueRevenue | DescriptionDescription |
|---|---|---|---|
| 4428588 | 303990 | 5284604 | High School for children of the Northern San Fernando Valley and surrounding area. School Days - 185 Students - 424.The School is a Catholic, accredited, college-preparatory school for young men and women. The School is located in the San Fernando Valley and serves the Greater Los Angeles area. The School offers a challenging college-preparatory academic program, carefully designed to give students opportunities for growth and experience in preparation for university course work. The School has received full accreditation from the Western Association of Schools and Colleges, and the Western Catholic Educational Association. |
| 1832759 | 0 | 2235007 | Primary Care - 37,611 Visits |
| 5077170 | 5077170 | 0 | Grant & Allocations - See Schedule I. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 11338517 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 5381160 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 7519611 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 1125443358 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 1 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 0 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 2080 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 11197 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 1 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Karl E Fritschel CPA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4255253339 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 Lind Ave SW 9016 | AddressLine1 |
| City | Renton | City |
| State | WA | State |
| ZIP Code | 980579016 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (50 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Lucille Dean SP | |||||||||
| Chair of the Board | 11.80 | X | X | 0 | 0 | 0 | |||
| M Adrian Davis LCM | |||||||||
| Director | 3.20 | X | 0 | 0 | 0 | ||||
| Mary Corita Heid RSM | |||||||||
| Director | 3.80 | X | 0 | 0 | 0 | ||||
| Michael A Stein | |||||||||
| Director | 4.70 | X | 0 | 18000 | 0 | ||||
| Michael Holcomb | |||||||||
| Director | 3.70 | X | 0 | 15000 | 0 | ||||
| Dana A Rasmussen | |||||||||
| Director | 3.40 | X | 0 | 15000 | 0 | ||||
| Paul A Redmond | |||||||||
| Director | 3.00 | X | 0 | 18000 | 0 | ||||
| James S Roberts MD | |||||||||
| Director | 6.00 | X | 0 | 15000 | 0 | ||||
| Peter J Snow | |||||||||
| Director | 4.10 | X | 0 | 15000 | 0 | ||||
| Jeffrey B Clode MD | |||||||||
| Director | 5.40 | X | 0 | 18000 | 0 | ||||
| Sallye Liner | |||||||||
| Director | 3.50 | X | 0 | 3750 | 0 | ||||
| Owen B Robinson | |||||||||
| Director | 5.50 | X | 0 | 15000 | 0 | ||||
| Cheryl M Scott | |||||||||
| Director | 3.00 | X | 0 | 15000 | 0 | ||||
| Ellen L Wolf | |||||||||
| Director | 6.80 | X | 0 | 15000 | 0 | ||||
| John F Koster MD | |||||||||
| President/CEO | 50.00 | X | 0 | 2346502 | 794703 | ||||
| Michael L Butler | |||||||||
| Exec. VP/CFO | 65.00 | X | 0 | 1038275 | 340314 | ||||
| Jeffrey W Rogers | |||||||||
| Corporate Secretary | 50.00 | X | 0 | 1259397 | 465326 | ||||
| Arnold R Schaffer | |||||||||
| SVP/Reg. Ops | 60.00 | X | 0 | 1980618 | 371481 | ||||
| Michael Hunn | |||||||||
| CEO - CA. Region | 60.00 | X | 0 | 490880 | 166313 | ||||
| Karl J Carrier | |||||||||
| CFO - CA. Region | 55.00 | X | 0 | 731249 | 267303 | ||||
| Eugene Al Parrish | |||||||||
| CEO - AK. Region | 50.00 | 0 | 1047158 | 332492 | X | ||||
| John V Fletcher | |||||||||
| CEO - WA/MT. Region | 60.00 | 0 | 1277503 | 584795 | X | ||||
| Janice J Jones | |||||||||
| SVP/CAO | 55.00 | 0 | 1140032 | 349285 | X | ||||
| Gregory Van Pelt | |||||||||
| CEO - OR. Region | 60.00 | 0 | 2314095 | 484343 | X | ||||
| Russell Danielson | |||||||||
| Former CEO - OR. Region | 50.00 | 0 | 4449992 | 397656 | X | ||||
| John O Mudd | |||||||||
| SVP/Mission Ldrship. | 55.00 | 0 | 856420 | 395919 | X | ||||
| Keith Marton MD | |||||||||
| VP/CMQO | 60.00 | 0 | 717815 | 215947 | X | ||||
| Claudia Haglund | |||||||||
| VP/Gov./Sponsorship | 50.00 | 0 | 501163 | 126574 | X | ||||
| Joel S Gilbertson | |||||||||
| VP/Gov.& Public Affairs | 50.00 | 0 | 454656 | 56288 | X | ||||
| Cindra R Syverson | |||||||||
| VP/CHRO | 55.00 | 0 | 485868 | 108238 | X | ||||
| John Kenagy | |||||||||
| VP/CIO | 60.00 | 0 | 447695 | 141020 | X | ||||
| Nancy Carlson | |||||||||
| CEO - LCMMCSP | 50.00 | 0 | 958503 | 162048 | X | ||||
| Deborah Burton | |||||||||
| VP/Chief Nursing Officer | 60.00 | 0 | 341476 | 168307 | X | ||||
| Myron Berdischewsky MD | |||||||||
| VP/CMQO | 60.00 | 0 | 609142 | 268959 | X | ||||
| David Brown | |||||||||
| VP/Strat. Mgmnt.Svces | 55.00 | 0 | 342030 | 110948 | X | ||||
| Larry S Bowe | |||||||||
| CEO - PHCMC | 40.00 | 0 | 740479 | 365212 | X | ||||
| Kerry L Carmody | |||||||||
| COO - CA. Region | 40.00 | 0 | 655482 | 345755 | X | ||||
| Barry Wolfman | |||||||||
| CEO - PSJMC | 40.00 | 0 | 476353 | 28923 | X | ||||
| Dale Surowitz | |||||||||
| CEO - PTMC | 40.00 | 0 | 468825 | 133454 | X | ||||
| Jeffrey Winter | |||||||||
| CAO - CA. Region | 40.00 | 0 | 383090 | 14160 | X | ||||
| Bernard MD J Klein | |||||||||
| CMO - HCMC | 40.00 | 401110 | 0 | 45126 | X | ||||
| Glen Komatsu | |||||||||
| CMO - TCH | 40.00 | 397334 | 0 | 45365 | X | ||||
| Laurence Eason | |||||||||
| CMO - LCMH | 40.00 | 385561 | 0 | 41066 | X | ||||
| Patricia E Modrzejewski | |||||||||
| Exec. Dir. - PH&S FDN | 40.00 | 342638 | 0 | 37296 | X | ||||
| Kenneth P Keller | |||||||||
| Reg. Dir.-Phys.Bus.Svc. | 40.00 | 337905 | 0 | 12949 | X | ||||
| Richard J Umbdenstock | |||||||||
| Former Director | 0.00 | 0 | 32220 | 0 | X | ||||
| Michael J Madden | |||||||||
| Former VP/Advocacy | 0.00 | 0 | 359717 | 0 | X | ||||
| Charles E Hawley | |||||||||
| Former VP/Public Affairs | 0.00 | 0 | 2137748 | 17773 | X | ||||
| Thomas Johnson | |||||||||
| Former VP/Communications | 0.00 | 0 | 325409 | 91452 | X | ||||
| Matthew Gerlach | |||||||||
| Former CAO - CA. Region | 0.00 | 0 | 342100 | 13259 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1864548 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 29874642 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 7500049 | TotalOtherCompensation |
| Number Individuals GT100 K | 1286 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Swinerton Builders | |||||
| 17731 Mitchell N Ste 200 | Irvine | CA | 926146028 | Construction | 52720496 |
| Therapeutic Associates Inc | |||||
| 7100 Fort Dent Way Ste 220 | Seattle | WA | 98188 | Physical/Occup. Therapy Svc | 4960624 |
| Perot Systems | |||||
| PO Box 31498 | Hartford | CT | 061501498 | IT Consulting | 4618515 |
| The Stahl Companies | |||||
| 11230 Gold Express Dr Ste 310 | Gold River | CA | 956704484 | Construction Management | 3620593 |
| HMC Architects | |||||
| 3270 Inland Empire Blvd | Ontario | CA | 91764 | Architects | 3477459 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 449 | NumberOfContractorsGT100K |
| Membership Dues | 5457 | MembershipDues |
| Fundraising Events | 4722 | FundraisingEvents |
| Related Organizations | 11132236 | RelatedOrganizations |
| Government Grants | 1109838 | GovernmentGrants |
| All Other Contributions | 1724290 | AllOtherContributions |
| Noncash Contributions | 1088845 | NoncashContributions |
| Total Contributions | 13976543 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Acute - Inpatient | 900099 | 946370167 | 946370167 |
| Acute - Outpatient | 621400 | 340132426 | 340132426 |
| LTC/HomeCare/Hospice | 623000 | 69651119 | 69651119 |
| Tuition & Fees | 611600 | 5284604 | 5284604 |
| Primary Care | 900099 | 2230941 | 2230941 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1363669257 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6090408 | TotalRevenueColumn |
| Exclusion | $6,090,408 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 4224782 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2543303 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1681479 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1681479 | TotalRevenueColumn |
| Exclusion | $1,681,479 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 165693425 | Securities |
| Other | 101953 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 165192687 | Securities |
| Other | 658873 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 500738 | Securities |
| Other | -556920 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -56182 | TotalRevenueColumn |
| Exclusion | -$56,182 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 65120 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 4722 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 21149 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 43971 | TotalRevenueColumn |
| Exclusion | $43,971 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 47140 | GrossIncomeGaming |
| Gaming Direct Expenses | 3000 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 44140 | TotalRevenueColumn |
| Exclusion | $44,140 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 341453 | GrossSalesOfInventory |
| Cost Of Goods Sold | 197917 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 143536 | TotalRevenueColumn |
| Exclusion | $143,536 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Laboratory Services | 621500 | 4933406 | 409778 | 4523628 | |
| Cafeteria | 722210 | 4096869 | $4,096,869 | ||
| Management Services | 900099 | 600000 | 600000 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 77392754 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2065732 | RelatedOrExemptFunctionIncome |
| Exclusion | $75,327,022 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 87023029 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1472616181 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1366144767 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 5123628 | UnrelatedBusinessRevenue |
| Exclusion | $87,371,243 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5008370 | Total |
| Program Services | 5008370 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 372790 | Total |
| Program Services | 372790 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6280052 | Total |
| Management And General | 6280052 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 580442821 | Total |
| Program Services | 465993285 | ProgramServices |
| Management And General | 114301133 | ManagementAndGeneral |
| Fundraising | 148403 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34449603 | Total |
| Program Services | 27530350 | ProgramServices |
| Management And General | 6910356 | ManagementAndGeneral |
| Fundraising | 8897 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 173870514 | Total |
| Program Services | 146153684 | ProgramServices |
| Management And General | 27704121 | ManagementAndGeneral |
| Fundraising | 12709 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41976961 | Total |
| Program Services | 33389551 | ProgramServices |
| Management And General | 8576546 | ManagementAndGeneral |
| Fundraising | 10864 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35361 | Total |
| Management And General | 35361 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3085527 | Total |
| Program Services | 101838 | ProgramServices |
| Management And General | 2983689 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7405 | Total |
| Management And General | 7405 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 76816 | Total |
| Management And General | 76816 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 122067553 | Total |
| Program Services | 92269938 | ProgramServices |
| Management And General | 29797615 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3176244 | Total |
| Program Services | 1830305 | ProgramServices |
| Management And General | 1339189 | ManagementAndGeneral |
| Fundraising | 6750 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 212175277 | Total |
| Program Services | 195819524 | ProgramServices |
| Management And General | 16320583 | ManagementAndGeneral |
| Fundraising | 35170 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9403526 | Total |
| Program Services | 1341648 | ProgramServices |
| Management And General | 8061878 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 47219381 | Total |
| Program Services | 23776783 | ProgramServices |
| Management And General | 23442598 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2227170 | Total |
| Program Services | 862156 | ProgramServices |
| Management And General | 1365014 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1073553 | Total |
| Program Services | 592235 | ProgramServices |
| Management And General | 481084 | ManagementAndGeneral |
| Fundraising | 234 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24974745 | Total |
| Program Services | 24804120 | ProgramServices |
| Management And General | 170625 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4571624 | Total |
| Program Services | 885307 | ProgramServices |
| Management And General | 3686317 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59094397 | Total |
| Program Services | 38124116 | ProgramServices |
| Management And General | 20970281 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10125332 | Total |
| Program Services | 9622503 | ProgramServices |
| Management And General | 502829 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Bad Debts | 52561170 | 52561170 | ||
| Dues & Subscriptions | 2540821 | 783078 | 1757118 | 625 |
| License & Taxes | 1322867 | 1085248 | 237619 | |
| Recruitment | 1212794 | 750801 | 461993 | |
| UBI Taxes | 1017078 | 1017078 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4952809 | Total |
| Program Services | 1784558 | ProgramServices |
| Management And General | 3155744 | ManagementAndGeneral |
| Fundraising | 12507 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1405322561 | Total |
| Program Services | 1125443358 | ProgramServices |
| Management And General | 279643044 | ManagementAndGeneral |
| Fundraising | 236159 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3059724 | BOY |
| EOY | 3721548 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72383279 | BOY |
| EOY | 83427057 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1556567 | BOY |
| EOY | 1100568 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 194374905 | BOY |
| EOY | 189554906 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 892813 | BOY |
| EOY | 3442627 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20735715 | BOY |
| EOY | 23059946 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7036380 | BOY |
| EOY | 26040713 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1588630260 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 743961965 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 780821473 | BOY |
| EOY | 844668295 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75934919 | BOY |
| EOY | 79849974 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65306522 | BOY |
| EOY | 69548922 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2026740067 | BOY |
| EOY | 1954746319 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3248842364 | BOY |
| EOY | 3279160875 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 372851220 | BOY |
| EOY | 496158886 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73480 | BOY |
| EOY | 4554084 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6083622 | BOY |
| EOY | 18250477 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 446470001 | BOY |
| EOY | 435840001 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 339751 | BOY |
| EOY | 117469 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1824378481 | BOY |
| EOY | 1663601279 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2650196555 | BOY |
| EOY | 2618522196 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 540875532 | BOY |
| EOY | 601933824 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42126986 | BOY |
| EOY | 37926383 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15643291 | BOY |
| EOY | 20778472 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 598645809 | BOY |
| EOY | 660638679 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3248842364 | BOY |
| EOY | 3279160875 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 67293620 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -5300750 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 1 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 0 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Other Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1i: | ReturnReference |
| Explanation | Lobbying activities, with the exception of advocacy, are limited to direct contact with government officials and mailings to the general public and legislators for the purpose of expressing opinions on legislative matters. Expenses include employee salaries, postage and incidental traveling expenditures. Providence Health System - Southern California does not allocate expenses to lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 104970 | BeginningOfYearBalance |
| Contributions | 238850 | Contributions |
| Investment Earnings Or Losses | 13784 | InvestmentEarningsOrLosses |
| End Of Year Balance | 357604 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 103609 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1361 | InvestmentEarningsOrLosses |
| End Of Year Balance | 104970 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 103609 | BeginningOfYearBalance |
| End Of Year Balance | 103609 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 113680073 | OtherCostOrOtherBasis |
| Book Value | 113680073 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 624727728 | OtherCostOrOtherBasis |
| Depreciation | 281563001 | Depreciation |
| Book Value | 343164727 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16545601 | OtherCostOrOtherBasis |
| Depreciation | 10847647 | Depreciation |
| Book Value | 5697954 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 641610420 | OtherCostOrOtherBasis |
| Depreciation | 451551317 | Depreciation |
| Book Value | 190059103 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 192066438 | OtherCostOrOtherBasis |
| Book Value | 192066438 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 844668295 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (7 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Unamortized Bond Financing Costs | 8470029 |
| Due from Affiliates | 1787472115 |
| Miscellaneous Receivables | 4989540 |
| Library Inventory | 13000 |
| Third Party Settlements | 126749765 |
| Bond Premium Discount | 6510179 |
| Trustee Held Funds | 20541691 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1954746319 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 322140 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (9 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due to Affiliates | $1,571,929,916 |
| Liability for Risk Sharing | $4,269,692 |
| Miscellaneous Other Liabilities | $139,320 |
| Capitalized Lease Obligation | $7,025,223 |
| LT Asset Retirement Obligation - FIN 47 | $13,690,803 |
| IBNR Payable | $1,855,464 |
| Taxable Bond Issue | $55,954,178 |
| Third Party Settlements | $7,522,498 |
| Liability for Unpaid Claims | $892,045 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1663601279 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | The School has one endowment fund established for scholarship purposes that is donor-restricted. |
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | The Health System recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GALA | NameOfEvent1 |
| Gross Receipts Event1 | 44956 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 4262 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 40694 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 2667 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 105 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 2584 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 1906 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Magazine Drive | NameOfEvent2 |
| Gross Receipts Event2 | 23930 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 23930 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 9707 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 1 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 956 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 460 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 496 | GrossRevenueOtherEvents |
| Other Direct Expenses Other Events | 4180 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 69842 | GrossReceiptsTotal |
| Charitable Contributions Total | 4722 | CharitableContributionsTotal |
| Gross Revenue Total Events | 65120 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 2667 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 105 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 2584 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 15793 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 21149 | DirectExpenseSummaryEvents |
| Net Income Summary | 43971 | NetIncomeSummary |
Gaming Information GamingInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Revenue Other Gaming | 47140 | GrossRevenueOtherGaming |
| Non Cash Prizes Other Gaming | 3000 | NonCashPrizesOtherGaming |
| Volunteer Labor Other Gaming | 1 | VolunteerLaborOtherGaming |
| Volunteer Labor Prcnt Other Gaming | 1.00000 | VolunteerLaborPrcntOtherGaming |
| Gross Revenue Total Gaming | 47140 | GrossRevenueTotalGaming |
| Non Cash Prizes Total Gaming | 3000 | NonCashPrizesTotalGaming |
| Direct Expense Summary Gaming | 3000 | DirectExpenseSummaryGaming |
| Net Gaming Income Summary | 44140 | NetGamingIncomeSummary |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | CA | StatesWhereGamingConducted |
| Licensed | 1 | Licensed |
| License Suspended Etc | 0 | LicenseSuspendedEtc |
| Gaming With Nonmembers | 0 | GamingWithNonmembers |
| Member Of Other Entity | 0 | MemberOfOtherEntity |
| Percentage Of Gaming Othr Facility | 1.00000 | PercentageOfGamingOthrFacility |
| Name Of Gaming Rec Keeper Person | Paula Green | NameOfGamingRecKeeperPerson |
Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 511 S Buena Vista Street | AddressLine1 |
| City | Burbank | City |
| State | CA | State |
| ZIP Code | 91505 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contract With3rd Party For Gam Rev | 0 | ContractWith3rdPartyForGamRev |
| Gaming Manager Name Person | Vickie Bagwell | GamingManagerNamePerson |
| Gaming Manager Compensation | 0 | GamingManagerCompensation |
| Gaming Manager Services Provided | All activities related to the raffle are coordinated through the Development Department. | GamingManagerServicesProvided |
| Gaming Manager Is Employee | X | GamingManagerIsEmployee |
| Charitable Distrib Required | 0 | CharitableDistribRequired |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24379517 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14560065 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9819452 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00730 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 224419020 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 130481553 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 93937467 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06940 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 248798537 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 145041618 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 103756919 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07670 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18507608 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 434783 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 18072825 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01340 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5842717 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1805 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5840912 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18291678 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13618393 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4673285 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1770626 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1770626 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 44412629 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14054981 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 30357648 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02250 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 293211166 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 159096599 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 134114567 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09920 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $8,066,777 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 436715695 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 593114289 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -156398594 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 5 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (5 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours | Critical Access HospitalCriticalAccessHospital | Er OtherErOther |
|---|---|---|---|---|---|---|---|---|---|
| Providence St Joseph Medical Center | |||||||||
| 1 | 501 S Buena Vista St | Burbank | CA | 91505 | X | X | X | ||
| Providence LCM Med Ctr - Torrance | |||||||||
| 2 | 4101 Torrance Boulevard | Torrance | CA | 90505 | X | X | X | ||
| Providence Holy Cross Medical Center | |||||||||
| 3 | 15031 Rinaldi St | Mission Hills | CA | 91345 | X | X | X | X | X |
| Providence Tarzana Medical Center | |||||||||
| 4 | 18321 Clark Street | Tarzana | CA | 91356 | X | X | X | ||
| Providence LCM Med Ctr - San Pedro | |||||||||
| 5 | 1300 West Seventh Street | San Pedro | CA | 90732 | X | X | X | ||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (5 entries)
| Hospital Facility NumberHospitalFacilityNumber |
|---|
| Providence St Joseph Medical Center |
| 1 |
| Providence LCM Med Ctr - Torrance |
| 2 |
| Providence Holy Cross Medical Center |
| 3 |
| Providence Tarzana Medical Center |
| 4 |
| Providence LCM Med Ctr - San Pedro |
| 5 |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Providence St Elizabeth Care Center | ||||
| 10425 Magnolia Boulevard | North Hollywood | CA | 91601 | Skilled Nursing |
| Providence LCM Sub-Acute Care Center | ||||
| 1322 West Sixth Street | San Pedro | CA | 90732 | Skilled Nursing |
| Providence LCM Transitional Care Ctr | ||||
| 4320 Maricopa Street | Torrance | CA | 90503 | Transitional Care |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 6a: In addition to having Community Benefit information included in the consolidated Providence Health & Services Community Benefit Report, this information is also included in the Providence Health System - Southern California Regional Community benefit Report. | ||
| Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 52561170. | ||
| Part II: COMMUNITY BUILDING ACTIVITIES:Providence Health & Services, California Region did not track or report the financial impact of their community building activities. However, our dedication to contribute to the health needs of the community is ongoing in several endeavors. Providence has numerous partnerships with local nonprofits that share the Mission to care for the poor and vulnerable. Much of this outreach is aimed at education on health care, fitness and nutrition, with the goal of reducing the growing numbers of residents facing diabetes, heart disease, hypertension and other chronic conditions that if untreated, can cause serious illness and frequent hospitalization. Examples include the following:*In 2010, the Valley Service Area distributed grants to 14 Valley Service Area nonprofit groups. The community agencies serve the homeless, the uninsured in need of medical care, the mentally ill, HIV/AIDS patients, school children in low-income areas and immigrants suffering a life-threatening but curable disease called Chagas that is caused by a parasite found in Central America. This marked the first distribution of money from the Mother Joseph Fund, created in 2003. The funds hold a percentage of proceeds from operations from the three Valley medical centers. *In the Valley Service Area, Providence provides laboratory tests and imaging for the Samuel Dixon Family Health Centers in Santa Clarita, a nonprofit that also saw its client base rise sharply with the recession and increase in unemployment. *Food, school supplies and other items are collected periodically for low-income families. A meal was provided to low-income and homebound seniors at the holidays. Proper nutrition is a key component contributing to good health.*Providence physicians and nurses volunteered at the Remote Areas Medical event, which served thousands of low-income patients. The South Bay Service Areas Partners for Healthy Kids Mobile Clinic provided pediatric check-ups and immunizations.*Both Service Areas provide nutrition and fitness education programs for school in low-income areas, programs designed to limit the risks of chronic illness related to poor nutrition and lack of exercise. *Financial contributions were made to a local high school that operates a health careers training program. With the shortage of key health care professionals this program encourages more high school students to enter the health care field and help meet the growing need for medical care services among the population. | ||
| Part III, Line 4: It is Providence's policy to exclude all bad debts from Community benefit information.The Consolidated Audited Financial Statements do not contain a footnote specific to Bad Debt Expense.Bad debt expense is reported in the audited financials as a separate line item within expenses from operations. Bad debt expense represents the amount of gross charges for patients who do not have insurance and which Providence was unable to qualify for assistance under either government programs or our internal charity care policy. | ||
| Part III, Line 8: It is Providence's policy to exclude any Medicare shortfall from Community Benefit information.The amount reported on Part III, Section B, Line 6, was determined by applying the Cost-to-Charge Ratio to the Medicare revenue. | ||
| Part III, Line 9b: BILLING & COLLECTION PRACTICESProvidence has written policies about when and under whose authority patient debt is advanced for collection, and uses its best efforts to ensure that patient accounts are processed fairly and consistently.Providence ensures that practices to be used by their outside (non-hospital) collection agencies conform to the standards set forth in this policy, and obtains written commitments from such agencies that they will adhere to those standards. Providence also conducts an assessment of each collection agency's adherence to the policy. Such assessments are conducted at least annually.At time of billing, we provide to all low-income uninsured patients the same information concerning services and charges provided to all other patients who receive care at the hospital.When sending a bill to a patient, Providence includes a) a statement that indicates that if the patient meets certain income requirements the patient may be eligible for a government-sponsored program or for financial assistance from the hospital; and b) a statement that provides the patient with the name and telephone number of a hospital employee or office from whom or which the patient may obtain information about Providence's financial assistance policies for patients and how to apply for such assistance.Any patient (or the patient's legal representative) seeking financial assistance from Providence provides the individual facility with information concerning health benefits coverage, financial status (i.e. income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs.For patients who have an application pending determination for either government-sponsored coverage or for the hospitals' own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency.Eligibility for financial assistance will be determined as closely as possible to the date of service. | ||
| PART III, SECTION A, LINE 1The reporting entity reports bad debt expense in accordance with HFMA Statement #15 with the exception of the following sections: 8.1(b) and 9.1. | ||
| Part VI, Line 2: NEEDS ASSESSMENT:We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care. | ||
| Part VI, Line 3: COMMUNICATION TO THE PUBLIC:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients. | ||
| Part VI, Line 4: COMMUNITY INFORMATION:Providence Health & Services, Southern California Region, operates five medical centers and outpatient centers, clinics, hospice and community outreach programs serving a wide area stretching from the northern reaches of Los Angeles County to the South Bay Area. The region is marked by great wealth, but also by large pockets of poverty. The region is composed of the coastal South Bay Service Area and the inland Valley Service Area. The service areas are separated by some 30 miles, but work as one sharing quality practices and commitment to the Providence Mission to serve the poor and vulnerable. The Mission drives numerous programs aimed at easing those challenged by the continuing economic slump, providing free and low-cost health care, partnering with agencies with similar missions and focusing on preventive care with the hopes of improving the health of the communities served by Providence. In the California Region's Valley Service Area, home to more than 1.5 million, 48% of the population is Hispanic; 34.9%, white; 9.4%, Asian; and 4.1%, African-American. Nearly 21% of the population is uninsured, 15.5% receive Medi-Cal; 10.9%, Medicare; and 52.8%, private or other insurance. Approximately 11.2% of the population is age 65 and above. Children, newborn to age 13, represent 19.2% of the total population. The 65- to 84-year-old age group is projected to increase the most over the next five years while the 25 to 44 age group is projected to decrease during that period. While Providence provides outreach to the poor and vulnerable across the service area, pockets of lower income households tend to be clustered in the northeastern San Fernando Valley. Our community benefit services are especially concentrated there and focused on preventive medicine and health education.The South Bay Service Area covers 14 separate municipalities with a total population of 824,038, of which 35.7% are Hispanic; 34%, white;16.8%, Asian; 9.7%, African-American; and 3.8%, other. The coastal area includes upper income and affluent communities, while the crescent of communities forming the eastern Service Area boundaries are among the most impoverished in Los Angeles County. Data show 18.9% of residents are uninsured; 14.1% receive Medi-Cal; 11.8%, Medicare; and 55.3% have private insurance. Twelve percent of the population is 65 and over; children, newborn to 13 years, represent 18.7% of the total population. South Bay Service Area ZIP code demographics vividly document significant disparities related to age, educational attainment, household income and home ownership. With the Providence Mission as our guide, community outreach resources are directed to six underserved communities in the South Bay Service Area: Gardena, Hawthorne and Lawndale on the northern boundaries and Harbor City, Wilmington and the 90731 ZIP code area of San Pedro along the southern boundaries. | ||
| Part VI, Line 6: 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.As the economic slowdown continues, the Greater Los Angeles Area has a growing population of poor, uninsured and under-insured in need of basic health care. It also is home to a large number of immigrants with immediate health care and health education needs. Untreated diabetes and heart disease are epidemic, particularly among the area's Latino population, and Providence recognizes the need to help communities manage these illnesses in individuals before they become emergencies and the risks of complications escalate. Each hospital's Emergency Department is open 24 hours and no patient is ever denied emergency care regardless of ability to pay. Because more and more patients utilize emergency rooms as primary care, Providence medical centers provide fast-track service for routine health issues. In the Valley Service Area, Providence Southern California coordinates programs for vulnerable populations and sponsors and recruits volunteers for efforts by other groups and government agencies that share the Providence Mission of outreach to the poor and vulnerable. A mobile health clinic travels the San Fernando Valley five days a week providing very low-cost medical care for those in need, focusing on the chronically ill to help them manage their illnesses. Medical teams work also with patients to find low-cost prescriptions, and Providence provides laboratory work. Providence Holy Cross Medical Center also has an ongoing relationship with the low-cost Samuel Dixon Health Centers in the Santa Clarita Valley, providing lab and diagnostics services at deeply discounted rates for the centers' uninsured clients. Providence also provides several outreach programs for vulnerable populations including the elderly, immigrants and children from low-income families. Those community benefit programs, funded by medical center proceeds, include a school nurse program at 12 Catholic schools in lower-income areas, senior peer counseling, Latino Health Promoters who provide health screenings and education, free removal of anti-social tattoos for former gang members and others, and a parish nurse outreach program that brings health care services to our communities. A portion of proceeds from each hospital ministry is held in the Mother Joseph Fund and distributed annually as grants to community programs that match the Providence Mission of outreach to the poor and vulnerable. In 2010, grants were awarded to 14 not-for-profit groups that serve the homeless, the uninsured in need of medical care, school children in low-income areas and others in need. To tackle a resurgence of pertussis (whooping cough,) the Providence School Nurse Program teamed in the summer with the Los Angeles County Department of Public Health to provide free T-DAP vaccinations (tetanus, diphtheria and pertussis) at several schools. The goal was not only preventive medicine but to help families meet the demands of a new state law requiring the vaccinations for the 2011-12 school year. In the South Bay Service Area, a program called Creating Opportunity for Physical Activity (COPA) is offered in partnership with 13 schools with activities ranging from classroom exercise to nutrition education to counseling students in the awkward pre-teen years. At six Lawndale elementary schools, youngsters stop and dance and roll in the grass during brief "instant recess," under a COPA program created to give kids a healthy boost of energy between classes or when they hit that time of day when eyes start glazing over. COPA trains teachers to provide P.E. instruction, using fun, skill and compassion while helping students with motor skills development and fitness. The goal is to educate children, families and educators in teaching children healthy lifestyles, combating an epidemic of childhood obesity, and the related medical complications. Also in the South Bay, the Partners for Healthy Kids van is a welcome sight each week at schools in Lawndale, Gardena, Wilmington and San Pedro, working-class neighborhoods hit particularly hard by a dismal economy. Run by a bilingual staff, Partners for Healthy Kids provides free pediatric care, wellness education and referrals to dental and specialty care when needed. For 16 years, health care professionals have traveled in the brightly designed, kid-friendly mobile clinic, providing such services as well baby exams, dermatology, X-rays and treatment for minor injuries, tuberculosis checks, diabetes care and treatment for asthma, strep throat and other common childhood ailments. The clinic also visits health fairs over the summer to provide immunizations and vision, dental and blood pressure checks for children heading back to school. Referrals are made to low-cost clinics, including Providence's own Vasek Polak Health Clinic. This Hawthorne clinic serves uninsured adults and provides primary and urgent medical services for the community. | ||
| 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, Oregon; and Los Angeles, California.The charitable purpose of Providence Health & Services and each of its ministries is guided by one Mission and set of core values based on Catholic health care and guided by the legacy of the Sisters of Providence. As one system committed to caring for 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 needs of their community. Additionally, Providence ministries conduct local assessments to make sure the needs of the community are met. The stubbornly bleak economy has driven Providence Health System - Southern California to continuously look toward more efficient processes to ensure funding is available for community outreach programs to help those most in need. The poor and vulnerable run the spectrum from birth to the elderly, all with specific needs that are addressed by the Providence's outreach efforts. Providence funds programs for young parents; provides a developmental therapy program for infants with special needs; free flu shot campaigns for all ages; counseling for adolescents, teens and young adults who have strayed off their paths; and health screenings and health education programs for all ages. Providence has developed palliative care programs at all its medical centers and operates the largest hospice program in Southern California, one that includes the area's only children's hospice. New in 2010 was Access to Care, a program that involves social workers and other professionals who identify indigent and uninsured emergency department patients, the homeless in particular, to ensure they have access to free or low-cost prescriptions, specialists and follow-up care. Access to Care staff members contact these patients after discharge to arrange for free or low-cost follow-up health care and track their progress, reminding them of appointments and keeping records.In terms of community outreach, each of the five medical centers serves vastly different populations and tailors programs appropriately. In many cases, Providence Health System - Southern California partners with local charities such as Meet Each Need with Dignity (MEND) in the northern San Fernando Valley, the Burbank Temporary Aid Center (BTAC) in Burbank and Harbor Interfaith in San Pedro, which supports the working poor with shelter, food, job training, life skills education and other services. | ||
| CA,WA,OR,MT,AK | Reports Filed With States | Part VI, Line 7 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (12 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| The Wellness Community | |||||||
| 530 Hampshire Road | Westlake Village | CA | 91361 | 770205691 | 501( c)(3) | 38600 | Community Health |
| Providence Little Company of Mary Foundation | |||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 510224944 | 501( c)(3) | 2147039 | Community Benefit |
| American Heart Association | |||||||
| 1710 Gilbreth Rd | Burlingame | CA | 940101317 | 135613797 | 501( c)(3) | 25000 | Sponsorship of Cause & Heart Walk |
| Torrance Unified School District | |||||||
| 2335 Plaza Del Amo | Torrance | CA | 90509 | 956003151 | 501( c)(3) | 23698 | Health Education |
| Westfield Corporation | |||||||
| 11601 Wildshire Blvd 11th Floor | Los Angeles | CA | 90025 | 861127608 | Other | 22620 | Mall Walker Sponsorship |
| Economic Alliance Of SFV | |||||||
| 5121 Van Nuys Blvd Ste 200 | Sherman Oaks | CA | 91403 | 954524503 | 501( c)(3) | 31000 | Community Support |
| Providence TrinityCare Hospice | |||||||
| 2601 Airport Drive 230 | Torrance | CA | 90505 | 953264139 | 501( c)(3) | 10000 | Community Health |
| National Health Foundation | |||||||
| 515 S Figueroa 1300 | Los Angeles | CA | 90071 | 237314808 | 501( c)(3) | 10000 | Community Health |
| California Institute for Nursing & Health Care | |||||||
| PO Box 70007 | Oakland | CA | 94612 | 820570413 | 501( c)(3) | 10000 | Nursing Education |
| Santa Clarita Community College District | |||||||
| 26455 Rockwell Canyon Rd | Santa Clarita | CA | 91355 | 952561360 | Government | 7500 | Sponsor of Arts Educ. Outreach |
| Burbank YMCA | |||||||
| 321 E Magnolia Blvd | Burbank | CA | 91502 | 951664139 | 501( c)(3) | 5500 | YMCA Burbank Turkey Trot |
| Providence Health & Services Foundation | |||||||
| 501 S Buena Vista St | Burbank | CA | 91505 | 953544877 | 501( c)(3) | 2601031 | Community Benefit |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 11 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII (10 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance | Amount Of Cash GrantAmountOfCashGrant |
|---|---|---|---|---|---|
| Family Allowance - 2nd Student | 31 | 55000 | FMV | Tuition Reduction | |
| Scholarship - Department $100 | 32 | 3200 | FMV | Tuition Reduction | |
| Employee Discount | 13 | 29250 | FMV | Tuition Reduction | |
| Academic Scholarships | 19 | 29500 | FMV | Scholarships | |
| Financial Aid | 152 | 187040 | FMV | Tuition Reduction | |
| College Scholarships | 1 | 7500 | FMV | Nursing Education | |
| Sponsorship of Family Need Help | 1 | 25000 | FMV | Assistance for food, clothing & shelter | |
| Confidence Grant Scholarship | 100 | 26000 | FMV | Scholarships | 1000 |
| American Nurses Credential | 1 | 3900 | FMV | Fees/Registration | |
| High School Blood Program Recipient | 6 | 5400 | FMV | H.S. Blood Donors' Tuition Reduction |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | 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, along with a report of the number of children/families served over the year. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Class Or Charter Travel | X | FirstClassOrCharterTravel |
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Discretionary Spending Account | X | DiscretionarySpendingAccount |
| Housing Allowance Or Residence | X | HousingAllowanceOrResidence |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (36 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| John F Koster MD | |||||||||||||
| 0 | 1073328 | 0 | 1236674 | 0 | 36500 | 0 | 777729 | 0 | 16974 | 0 | 3141205 | 0 | 0 |
| Michael L Butler | |||||||||||||
| 0 | 734748 | 0 | 283527 | 0 | 20000 | 0 | 317186 | 0 | 23128 | 0 | 1378589 | 0 | 0 |
| Jeffrey W Rogers | |||||||||||||
| 0 | 418582 | 0 | 825815 | 0 | 15000 | 0 | 446566 | 0 | 18760 | 0 | 1724723 | 0 | 0 |
| Arnold R Schaffer | |||||||||||||
| 0 | 609272 | 0 | 1144945 | 0 | 226401 | 0 | 349661 | 0 | 21820 | 0 | 2352099 | 0 | 0 |
| Michael Hunn | |||||||||||||
| 0 | 363490 | 0 | 111813 | 0 | 15577 | 0 | 153028 | 0 | 13285 | 0 | 657193 | 0 | 0 |
| Karl J Carrier | |||||||||||||
| 0 | 375923 | 0 | 323826 | 0 | 31500 | 0 | 253143 | 0 | 14160 | 0 | 998552 | 0 | 0 |
| Eugene Al Parrish | |||||||||||||
| 0 | 491513 | 0 | 535611 | 0 | 20034 | 0 | 310289 | 0 | 22203 | 0 | 1379650 | 0 | 0 |
| John V Fletcher | |||||||||||||
| 0 | 516196 | 0 | 708989 | 0 | 52318 | 0 | 564812 | 0 | 19983 | 0 | 1862298 | 0 | 0 |
| Janice J Jones | |||||||||||||
| 0 | 552837 | 0 | 534946 | 0 | 52249 | 0 | 326291 | 0 | 22994 | 0 | 1489317 | 0 | 0 |
| Gregory Van Pelt | |||||||||||||
| 0 | 678198 | 0 | 1545235 | 0 | 90662 | 0 | 463313 | 0 | 21030 | 0 | 2798438 | 0 | 0 |
| Russell Danielson | |||||||||||||
| 0 | 511864 | 0 | 3879403 | 0 | 58725 | 0 | 373761 | 0 | 23895 | 0 | 4847648 | 0 | 0 |
| John O Mudd | |||||||||||||
| 0 | 325749 | 0 | 494171 | 0 | 36500 | 0 | 381188 | 0 | 14731 | 0 | 1252339 | 0 | 0 |
| Keith Marton MD | |||||||||||||
| 0 | 211843 | 0 | 237842 | 0 | 268130 | 0 | 198251 | 0 | 17696 | 0 | 933762 | 0 | 0 |
| Claudia Haglund | |||||||||||||
| 0 | 314668 | 0 | 142918 | 0 | 43577 | 0 | 109252 | 0 | 17322 | 0 | 627737 | 0 | 0 |
| Joel S Gilbertson | |||||||||||||
| 0 | 311580 | 0 | 97519 | 0 | 45557 | 0 | 38285 | 0 | 18003 | 0 | 510944 | 0 | 0 |
| Cindra R Syverson | |||||||||||||
| 0 | 365566 | 0 | 105302 | 0 | 15000 | 0 | 87877 | 0 | 20361 | 0 | 594106 | 0 | 0 |
| John Kenagy | |||||||||||||
| 0 | 324910 | 0 | 91285 | 0 | 31500 | 0 | 122409 | 0 | 18611 | 0 | 588715 | 0 | 0 |
| Nancy Carlson | |||||||||||||
| 0 | 287362 | 0 | 639641 | 0 | 31500 | 0 | 150504 | 0 | 11544 | 0 | 1120551 | 0 | 0 |
| Deborah Burton | |||||||||||||
| 0 | 252225 | 0 | 61612 | 0 | 27639 | 0 | 153009 | 0 | 15298 | 0 | 509783 | 0 | 0 |
| Myron Berdischewsky MD | |||||||||||||
| 0 | 369222 | 0 | 182574 | 0 | 57346 | 0 | 245165 | 0 | 23794 | 0 | 878101 | 0 | 0 |
| David Brown | |||||||||||||
| 0 | 250803 | 0 | 76227 | 0 | 15000 | 0 | 93721 | 0 | 17227 | 0 | 452978 | 0 | 0 |
| Larry S Bowe | |||||||||||||
| 0 | 317263 | 0 | 408216 | 0 | 15000 | 0 | 350248 | 0 | 14964 | 0 | 1105691 | 0 | 0 |
| Kerry L Carmody | |||||||||||||
| 0 | 210954 | 0 | 420528 | 0 | 24000 | 0 | 334211 | 0 | 11544 | 0 | 1001237 | 0 | 0 |
| Barry Wolfman | |||||||||||||
| 0 | 356540 | 0 | 88313 | 0 | 31500 | 0 | 14763 | 0 | 14160 | 0 | 505276 | 0 | 0 |
| Dale Surowitz | |||||||||||||
| 0 | 348432 | 0 | 105393 | 0 | 15000 | 0 | 119294 | 0 | 14160 | 0 | 602279 | 0 | 0 |
| Jeffrey Winter | |||||||||||||
| 0 | 313959 | 0 | 15000 | 0 | 54131 | 0 | 0 | 0 | 14160 | 0 | 397250 | 0 | 0 |
| Bernard MD J Klein | |||||||||||||
| 328854 | 0 | 72156 | 0 | 100 | 0 | 31778 | 0 | 13348 | 0 | 446236 | 0 | 0 | 0 |
| Glen Komatsu | |||||||||||||
| 318109 | 0 | 62725 | 0 | 16500 | 0 | 32234 | 0 | 13131 | 0 | 442699 | 0 | 0 | 0 |
| Laurence Eason | |||||||||||||
| 317389 | 0 | 68172 | 0 | 0 | 0 | 31394 | 0 | 9672 | 0 | 426627 | 0 | 0 | 0 |
| Patricia E Modrzejewski | |||||||||||||
| 261059 | 0 | 65079 | 0 | 16500 | 0 | 34204 | 0 | 3092 | 0 | 379934 | 0 | 0 | 0 |
| Kenneth P Keller | |||||||||||||
| 277170 | 0 | 55287 | 0 | 5448 | 0 | 291 | 0 | 12658 | 0 | 350854 | 0 | 0 | 0 |
| Richard J Umbdenstock | |||||||||||||
| 0 | 0 | 0 | 32220 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 32220 | 0 | 0 |
| Michael J Madden | |||||||||||||
| 0 | 0 | 0 | 343217 | 0 | 16500 | 0 | 0 | 0 | 0 | 0 | 359717 | 0 | 0 |
| Charles E Hawley | |||||||||||||
| 0 | 25690 | 0 | 2048448 | 0 | 63610 | 0 | 17773 | 0 | 0 | 0 | 2155521 | 0 | 0 |
| Thomas Johnson | |||||||||||||
| 0 | 8513 | 0 | 62573 | 0 | 254323 | 0 | 85036 | 0 | 6416 | 0 | 416861 | 0 | 0 |
| Matthew Gerlach | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 342100 | 0 | 587 | 0 | 12672 | 0 | 355359 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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, CHRO. During 2010, a total of four first-class tickets were purchased. Tax Indemnifications or Gross-Up Payments Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2010, the following Key Employees received gross-up payments: Russell Danielson Joel Gilbertson Orest Holubec Eugene "Al" Parrish Arnold R. Schaffer Myron Berdischewsky The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Discretionary Spending Account Providence Health & Services provides an executive flex spending allowance per year (paid bi-weekly). This benefit is provided as discretionary spending because the organization does not reimburse for or provide additional executive benefits, such as a car allowance, additional executive life or disability insurance, or other market-based executive benefits practices. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding "rent" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The vice president/chief human resources officer may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2010, the following Key Employees received relocation payments: Joel Gilbertson Orest Holubec Arnold R. Schaffer Myron Berdischewsky 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) ESP = Elective Survivor Plan E) 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) Karl J. Carrier a) Taxable DBSERP Vested but not Paid - $ 204,428 b) Non-Taxable DBSERP Vested but not Paid - $ 34,265 c) DCSERP Earned - $ 195,688 29) Kerry L. Carmody a) Taxable DBSERP Vested but not Paid - $ 269,804 b) Non-Taxable DBSERP Vested but not Paid - $43,849 c) DCSERP Earned - $ 239,969 30) Barry A. Wolfman a) DBSERP Earned - $ 168 31) Dale Surowitz a) DBSERP Earned - $ 96 b) DCSERP Earned - $ 115,331 32) Larry S. Bowe a) Taxable DBSERP Vested but not Paid - $ 299,404 b) Non-Taxable DBSERP Earned but not Paid - $ 18,280 c) DCSERP Earned - $ 308,310 33) Nancy Carlson a) Taxable DBSERP Vested but not Paid - $ 539,300 b) Taxable DBCBRP Vested but not Paid - $ 136 c) DCSERP Earned - $ 136,241 | |
| Part I, Lines 4a-b | SEVERANCE 1)Keith Marton, MD - $201,412 2)Thomas Johnson - $223,731 3)Matthew Gerlach - $342,100 | |
| 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. | Supplemental Information |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| CA Health Facilities Financing Authority | |||||||
| 521643828 | 13033LLC9 | 2008-11-06 | 284698621 | Refinance bank loan used for Acquisition of Providence Tarzana Medical Ctr. | 1 | 0 | 0 |
| CA Health Facilities Financing Authority | |||||||
| 521643828 | 13033LBZ9 | 2009-07-29 | 145060500 | Construction of Patient Tower @ Holy Cross Med. Ctr. | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Amount Bond DefeasedAmountBondDefeased | Total ProceedsTotalProceeds | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Capitalized InterestCapitalizedInterest | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6800000 | 2070000 | 284698621 | 2755700 | 4582212 | 68711929 | 211404480 | 2008 | 1 | 0 | 1 | 1 | ||
| 145060500 | 2072500 | 129553060 | 2011 | 0 | 0 | 0 | 1 | 4162333 | 20482810 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|---|
| 0 | 1 | 0 | 0 | 1 | 0.00700 | 0.00000 | 0.00700 | 1 |
| 0 | 0 | 0 | 0 | 1 | 0.00000 | 0.00000 | 0.00000 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 |
| 0 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part V Form990ScheduleKPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K, PART III, LINE 2 | Identifier |
| Return Reference | PRIVATE BUSINESS USE | ReturnReference |
| Explanation | Lease of Pediatric Services to Children's Hospital of Los Angeles. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John F Koster MD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Officer | Relationship |
| Amount Of Transaction | 151417660 | AmountOfTransaction |
| Description Of Transaction | Purchase of Supplies through cooperative of which Dr. Koster is a Director | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | Trust Interest | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 1088845 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Method for Determining Number of Contributors: | Identifier |
| Return Reference | Part I, Column (b): | ReturnReference |
| Explanation | The amount shown in Part I, Col. B reflects the number of donations received of the specific type of item. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | The sole Member of the Corporation is Providence Health & Services. | |
| 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 | The following powers are reserved exclusively to the Corporate Member: A) To adopt and amend the Articles of Incorporation and the Bylaws of the Foundation after consultation with the Foundation's Board of Directors. B) To approve the merger, consolidation, or affiliation of the Foundation with another corporation, organization or program, or the dissolution of the Foundation. C) To approve any strategic plan of the Foundation. D) To approve the annual fundraising plan including special events, annual, capital and planned giving activities. E) To approve the acceptance of any gift that carries conditions or limitations or any gift restricted to services, programs or facilities not currently offered or approved to be offered by the Corporate Member's Board of Directors. | |
| Form 990, Part VI, Section B, line 11 | The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS. | |
| 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 12c | |
| 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 Boards 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 B, line 15 | |
| 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. | Form 990, Part VI, Section C, line 19 | |
| Contact Addresses for Officers, Directors, Etc | John Kenagy - 1300 West 7th St., San Pedro , CA 90732. Larry S. Bowe - 15031 Rinaldi St., Mission Hills, CA 91346. Kerry L. Carmody - 501 S. Buena Vista St., Burbank, CA 91505. Barry Wolfman - 501 S. Buena Vista St., Burbank, CA 91505. Dale Surowitz - 18321 Clark Street, Tarzana, CA 91356. Jeffrey Winter - 501 S. Buena Vista St., Burbank, CA 91505. Karl J. Carrier - 501 S. Buena Vista St., Burbank, CA 91505. | Form 990, Part VII |
| Changes in Net Assets or Fund Balances: | Net unrealized gains on investments: 1,960,625. Prior period adjustments: -3,810. IAF Consolidated Transfers -5,836,939. Rounding 5. FAS 136 -1,430,031. Provision for Income Tax 9,400. Total to Form 990, Part XI, Line 5: -5,300,750. | Form 990, Part XI, line 5: |
| VOLUNTEERS | Our volunteers provide valuable assistance to all of our ministries through a variety of services. Some specific examples include the following: BEYOND FIFTY VOLUNTEER In conjunction with the Beyond Fifty Program, volunteers may sign up to work on Beyond Fifty projects with the Beyond Fifty Program manager. These projects usually involve mailings and/or filing. CLERICAL VOLUNTEERS Clerical volunteers perform general office work such as filing, mailing, data entry, word processing, answering phones, making charts and copying forms. They work in most of the business and clinical offices throughout the hospital. CLINICAL VOLUNTEERS Clinical volunteers work on the nursing floors in 4 hour shifts. They help with trays and feeding, check on patients to be sure they are comfortable. They also put away clean linens, make beds, run errands for the nurses, keep the nurse's kitchen in order, take patients for wheelchair walks and discharge patients. EMERGENCY ROOM VOLUNTEERS These volunteers work a four hours shift once a week. Duties include making phone calls to recently discharged patients checking on their condition and asking a few brief questions regarding the care they received while a patient, helping at the registration desk, checking on each patient to see if they need anything, running errands for the staff, answering phones, discharging patients by wheel chair, making beds, etc. ESCORTS These volunteers work closely with the Information Desk escorting patients and visitors to their destinations within the hospital complex. INFORMATION DESK They must be able to multi-task answer phones, direct patients and be willing to walk patients to their destinations. They must have excellent customer relation skills. MESSENGER CENTER Volunteers work a four hours shift answering the messenger phone, carrying lab samples, charts, x-rays, etc. and transporting ambulatory patients by wheel chair within the hospital. The messengers also work on mailing projects for various departments. This is an opportunity for those who like to walk and enjoy a variety of experiences as well as enjoying the constant contact with others. MUSIC PROGRAM Volunteers who sing or play a musical instrument schedule four hours per week to visit patients and sing or play for them. Harpists and guitar players are needed as well as other movable instruments which can be played individually. PATIENT VISITOR These volunteers visit the newly admitted patients to welcome them and provide a friendly ear for requests, complaints or just a brief visit. The volunteer must be outgoing and friendly, able to make easy conversation. PETS WITH A PURPOSE This program is in conjunction with Recreation Therapy. Pet volunteers visit patients with their dogs. The dogs are chosen for their friendly personalities and must pass behavioral tests and training to qualify. Visiting is done on a rotating schedule. All applications must be approved by Recreation Therapy Manager. SHORT STAY AMBASSADOR These volunteers telephone patients after surgery to follow up on their progress and make sure things are going well. SPIRITUAL CARE VOLUNTEERS Eucharistic Ministers visit the sick and bring Holy Communion to patients requesting the service. This is done on a rotating basis as the volunteer is available. Other volunteers work on projects such as little gifts and handouts for patients. SURGERY WAITING ROOM DESK Another customer service job places the volunteer in the Surgery Waiting room. He/she must keep track of all patients' family members and other visitors and dispense information regarding the patient in surgery. Duties include keeping the room neat, monitoring the television, making and service coffee and tea and cleaning up at the end of the shift. The volunteer must also maintain a pleasant, helpful attitude at all times. TEEN VOLUNTEERS These programs are open to teens 15 years and over who are willing to commit to 100 hours of volunteer service over the summer or during the school year from September to May. The Teen Volunteer Summer Program begins June 21st and ends on September 1st. Teens may also volunteer during the school year if they are able to commit 2 hours after school twice a week. Volunteers with Providence High School assist in the following capacities: Clerical work Chaperoning field trips Staffing athletic snack shop Aiding teachers in the classroom or on extracurricular activities | FORM 990, PART I, LINE 6 |
| RELIGIOUS COMMUNITY MEMBERS | 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. | FORM 990, PART VII |
| HOURS WORKED | Hours shown reflect the hours worked for the entire Health System and have not been allocated to the individual reporting entity. | FORM 990, PART VII, SECTION A |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (55 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Providence Health & Services - Washington | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 510216586 | Healthcare System | WA | 501( c)(3) | Line 3 | Providence Health & Services | 0 | |
| Providence Health & Services - Oregon | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 510216587 | Healthcare System | OR | 501( c)(3) | Line 3 | Providence Health & Services | 0 | |
| Everett Transitional Care Services | |||||||||||
| PO Box 1067 | Everett | WA | 982061067 | 943264605 | Transitional Care | WA | 501( c)(3) | Line 9 | 0 | N/A | |
| Providence Oregon Management Corporation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 930813977 | Shell Corporation | OR | 501( c)(3) | Line 1 | PH & S - Oregon | 0 | |
| Providence Plan Partners | |||||||||||
| 3601 SW Murray Blvd 10 | Beaverton | OR | 97005 | 911861964 | Healthcare Services | OR | 501( c)(4) | N/A | PH & S - Oregon | 0 | |
| Providence Health Plan | |||||||||||
| 3601 SW Murray Blvd 10 | Beaverton | OR | 97005 | 930863097 | Health Service Contractor | OR | 501( c)(4) | N/A | Providence Plan Partners | 0 | |
| Providence Health Assurance | |||||||||||
| 3601 SW Murray Blvd 10 | Beaverton | OR | 97005 | 550828701 | Medicaid Healthcare Provider | OR | 501( c)(4) | N/A | Providence Health Plan | 0 | |
| Providence Medical Institute | |||||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 330283773 | Healthcare | CA | 501( c)(3) | Line 11/Type I | PHS - So California | 0 | |
| Little Company of Mary Ancillary Services Corporation | |||||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 330844408 | Imaging Services | CA | 501( c)(3) | Line 9 | PHS - So California | 0 | |
| Providence TrinityCare Hospice | |||||||||||
| 2601 Airport Drive 230 | Torrance | CA | 90505 | 953264139 | Hospice | CA | 501( c)(3) | Line 9 | PHS - So California | 0 | |
| Providence Health System Housing | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 943230587 | Assisted Living | AK | 501( c)(3) | Line 9 | PH & S - Washington | 0 | |
| Providence Blanchet Association | |||||||||||
| 1700 Providence Pl | Centralia | WA | 98531 | 911789266 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| St Luke Association | |||||||||||
| 350 Washington Ave SE | Chehalis | WA | 98352 | 943176618 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Rossi Association | |||||||||||
| 1700 Providence Pl | Centralia | WA | 98531 | 311584166 | Housing | WA | 501( c)(3) | Line 9 | PH & S - Washington | 0 | |
| Lundberg Association | |||||||||||
| 5921 E Burnside | Portland | OR | 97215 | 911562797 | Housing | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence St Francis Association | |||||||||||
| 3415 12th Avenue NE | Olympia | WA | 98506 | 943244854 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Peter Claver Association | |||||||||||
| 7101 38th Avenue South | Seattle | WA | 98118 | 311629656 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence St Elizabeth House Association | |||||||||||
| 3201 SW Graham St | Seattle | WA | 98126 | 912171539 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Gamelin House Association | |||||||||||
| 4515 MLK Jr Way S Ste 200 | Seattle | WA | 98108 | 311744654 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| The Gamelin Association | |||||||||||
| 312 North Fourth St | Yakima | WA | 98901 | 911180824 | Housing | WA | 501( c)(3) | Line 1 | PH & S - Washington | 0 | |
| The Gamelin Oregon Association | |||||||||||
| 5520 NE Glisan | Portland | OR | 97213 | 911214491 | Housing | OR | 501( c)(3) | Line 9 | PH & S - Oregon | 0 | |
| The Gamelin California Association | |||||||||||
| 540 23rd St | Oakland | CA | 94612 | 911293869 | Housing | CA | 501( c)(3) | Line 9 | PHS - So California | 0 | |
| Gamelin Washington Association | |||||||||||
| 1423 First Avenue | Seattle | WA | 98101 | 201910170 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Foundation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 943078543 | Support PH&S Institutions | WA | 501( c)(3) | Line 11/Type I | PH & S - Washington | 0 | |
| Providence Alaska Foundation | |||||||||||
| 3300 Providence Drive - B Tower2 | Anchorage | AK | 99508 | 920093565 | Support PHS-Alaska | AK | 501( c)(3) | Line 11/Type I | PH & S - Washington | 0 | |
| Providence St Peter Foundation | |||||||||||
| 413 Lilly Road NE | Olympia | WA | 985065166 | 911097056 | Support Affiliated Tax-Exempt Organization | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Health Care Foundation (Centralia) | |||||||||||
| 914 S Scheuber Road | Centralia | WA | 98531 | 911433382 | Support Providence Centralia Hospital | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Mount St Vincent Foundation | |||||||||||
| 4831 - 35th Avenue SW | Seattle | WA | 981262799 | 911188119 | Support Providence Mount St.Vincent | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Marianwood Foundation | |||||||||||
| 3725 Providence Point Drive SE | Issaquah | WA | 980297219 | 931554288 | Support Providence Marianwood | WA | 501( c)(3) | Line 11/Type I | PH & S - Washington | 0 | |
| Providence Newberg Health Foundation | |||||||||||
| 1001 Providence Drive | Newberg | OR | 97132 | 930889144 | Support Providence Newberg Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Seaside Hospital Foundation | |||||||||||
| 725 S Wahanna Rd | Seaside | OR | 97138 | 930927320 | Support Providence Seaside Hospital | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Community Health Foundation | |||||||||||
| 1111 Crater Lake Ave | Medford | OR | 97504 | 930692907 | Support Providence Medford Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Benedictine Nursing Center Foundation | |||||||||||
| 540 South Main St | Mt Angel | OR | 973629532 | 911940286 | Support Providence Benedictine Nursing Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Portland Medical Foundation | |||||||||||
| 4805 NE Glisan St | Portland | OR | 972132967 | 931231494 | Support Providence Portland Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence St Vincent Medical Foundation | |||||||||||
| 9205 SW Barnes Rd | Portland | OR | 97225 | 930575982 | Support Providence St. Vincent Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Milwaukie Foundation | |||||||||||
| 10150 SE 32nd | Milwaukie | OR | 97222 | 943079515 | Support Providence Milwaukie Hospital | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Child Center Foundation | |||||||||||
| 830 NE 47th | Portland | OR | 97213 | 930800140 | Support Providence Child Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence TrinityCare Hospice Foundation | |||||||||||
| 2601 Airport Drive 230 | Torrance | CA | 90505 | 330261016 | Support TrinityCare Hospice | CA | 501( c)(3) | Line 7 | PHS - So California | 1 | |
| 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 | 1 | |
| 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 | 1 | |
| Providence Hospice of Seattle Foundation | |||||||||||
| 425 Pontius Avenue North 300 | Seattle | WA | 981095452 | 912077378 | Support Hospice of Seattle | WA | 501( c)(3) | Line 11/Type I | PH & S - Washington | 0 | |
| The John Gabriel Ryan Association | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 911303277 | Healthcare | WA | 501( c)(3) | Line 3 | PH & S - Washington | 0 | |
| Providence Health & Services | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 911549796 | Shell Corporation | WA | 501( c)(3) | Line 11/Type I | 0 | N/A | |
| St Patrick Hospital and Health Sciences Center | |||||||||||
| 500 W Broadway PO Box 4587 | Missoula | MT | 598064587 | 810231793 | Healthcare | MT | 501( c)(3) | Line 3 | PH & S - Washington | 0 | |
| St Joseph Hospital Corporation | |||||||||||
| PO Box 1010 | Polson | MT | 598601010 | 810463482 | Healthcare | MT | 501( c)(3) | Line 3 | PH & S - Washington | 0 | |
| St Thomas Child and Family Center | |||||||||||
| 1710 Benefis Court | Great Falls | MT | 59405 | 810233495 | Early Childhood Education | MT | 501( c)(3) | Line 1 | PH & S - Washington | 0 | |
| Sisters of Providence of Montana Corporation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 262612415 | Shell Corporation | MT | 501( c)(3) | Line 1 | PH & S - Washington | 0 | |
| Sacred Heart Children's Foundation | |||||||||||
| PO Box 2555 | Spokane | WA | 99220 | 320014330 | Support Sacred Heart Children's Hospital | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| St Patrick Hospital and Health Foundation | |||||||||||
| 500 West Broadway PO Box 4587 | Missoula | MT | 598064587 | 237056976 | Support Healthcare in W. Montana | MT | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| University of Great Falls | |||||||||||
| 1301 20th Street South | Great Falls | MT | 59405 | 810231777 | Post Secondary Education | MT | 501( c)(3) | Line 2 | PH & S - Washington | 0 | |
| E WA & MT Unemployment Compensation Insurance Trust | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 911082119 | Unemployment Benefits | WA | 501( c)(3) | Line 11/Type I | PH & S - Washington | 0 | |
| Providence Willamette Falls Medical Foundation | |||||||||||
| 1500 Division Street | Oregon City | OR | 97045 | 931003750 | Support Willamette Falls Hospital | OR | 501( c)(3) | Line 11/Type I | PH & S - Oregon | 0 | |
| Willamette Falls Hospital dba Providence Willamette Falls Medical Center | |||||||||||
| 1500 Division Street | Oregon City | OR | 97045 | 930426018 | Healthcare | OR | 501(c )(3) | Line 3 | PH & S - Oregon | 0 | |
| Providence Hood River Memorial Hospital Foundation Inc | |||||||||||
| 811 13th St | Hood River | OR | 97031 | 930921990 | Support Providence Hood River Memorial Hospital | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Hospice and Home Care Foundation | |||||||||||
| 2731 Wetmore Avenue Suite 500 | Everett | WA | 98201 | 272552749 | Support Program & Activities of PHHC | WA | 501(c )(3) | Line 7 | PH & S - Washington | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (28 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Providence Imaging Center | |||||||||||||
| 3340 Providence Drive | Anchorage | AK | 99508 | 920118807 | Medical Imaging | AK | PH&S - WA | Related | 0 | 0 | |||
| Providence Surgery Centers LLC | |||||||||||||
| PO Box 233889 | Anchorage | AK | 99523 | 203567411 | Surgery | AK | PH&S - WA | Related | 0 | 0 | |||
| Mountainstar Clinical Laboratories LLC | |||||||||||||
| 611 N Perry | Spokane | WA | 99202 | 261345983 | Outpatient Lab | MT | PAML LLC | Related | 0 | 0 | |||
| Broadway Imaging LLC | |||||||||||||
| 500 W Broadway | Missoula | MT | 59802 | 522405971 | Medical Imaging | MT | St Patrick Hospital & Health Sciences | Related | 0 | 0 | |||
| Center for Medical Imaging-Tanasbourne LLC | |||||||||||||
| 1235 NE 47th Ave 288 | Portland | OR | 97213 | 200477972 | Imaging - Diagnostics | OR | PH&S - OR | Related | 0 | 0 | |||
| Center for Medical Imaging-Bridgeport LLC | |||||||||||||
| 1235 NE 47th Ave 288 | Portland | OR | 97213 | 260796953 | Imaging - Diagnostics | OR | PH&S - OR | Related | 0 | 0 | |||
| Center for Specialty Surgery LLC | |||||||||||||
| 11782 SW Barnes Rd | Portland | OR | 97225 | 263638838 | Ambulatory Surgery Center | OR | PH&S - OR | Related | 0 | 0 | |||
| Clackamas Radiation Oncology Center LLC | |||||||||||||
| 1235 NE 47th Ave 288 | Portland | OR | 97213 | 260381897 | Radiation Oncology | OR | PH&S - OR | Related | 0 | 0 | |||
| Oregon Outpatient Surgery Center | |||||||||||||
| 7300 SW Childs Rd | Tigard | OR | 97224 | 223883387 | Ambulatory Surgery Center | OR | PH&S - OR | Related | 0 | 0 | |||
| Surgery Center at Tanasbourne LLC | |||||||||||||
| 1235 NE 47th Ave 260 | Portland | OR | 97213 | 208187971 | Ambulatory Surgery Center | OR | PH&S - OR | Related | 0 | 0 | |||
| ProvidenceSilverton Rehab LLC | |||||||||||||
| 1235 NE 47th Ave 260 | Portland | OR | 97213 | 481287267 | Rehab Services | OR | PH&S - OR | Related | 0 | 0 | |||
| Portland Medical Imaging LLC | |||||||||||||
| 10538 SE Washington St | Portland | OR | 97216 | 201054971 | Imaging - Diagnostics | OR | PH&S - OR | Related | 0 | 0 | |||
| Providence Radiation Oncology Development Assn LLC | |||||||||||||
| 1235 NE 47th Ave 288 | Portland | OR | 97213 | 260682491 | Real Estate - MOB | OR | PH&S - OR | Investment | 0 | 0 | |||
| Central Point MRI LLC | |||||||||||||
| 870 S Front St | Central Point | OR | 97502 | 261975164 | MRI Services | OR | PH&S - OR | Related | 0 | 0 | |||
| Greater Valley Medical Building LP | |||||||||||||
| 501 S Buena Vista St | Burbank | CA | 91505 | 954570858 | Real Estate - MOB | CA | PHS - So California | Investment | 0 | 1 | 567900 | 4330189 | 0.50000 |
| Pathology Associates Medical Laboratories LLC | |||||||||||||
| 611 N Perry | Spokane | WA | 99202 | 270943279 | Outpatient Lab | WA | Bourget Health Services Inc | Related | 0 | 0 | |||
| Southern Idaho Regional Laboratory LLC | |||||||||||||
| 611 N Perry | Spokane | WA | 99202 | 820511819 | Outpatient Lab | ID | PAML LLC | Related | 0 | 0 | |||
| Tri-Cities Laboratory LLC | |||||||||||||
| 611 N Perry | Spokane | WA | 99202 | 911773986 | Outpatient Lab | WA | PAML LLC | Related | 0 | 0 | |||
| Alpha Medical Laboratory LLC | |||||||||||||
| 611 N Perry | Spokane | WA | 99202 | 912017347 | Outpatient Lab | ID | PAML LLC | Related | 0 | 0 | |||
| PacLab LLC | |||||||||||||
| 611 N Perry | Spokane | WA | 99202 | 911743952 | Outpatient Lab | WA | PH&S - WA | Related | 0 | 0 | |||
| HealthServicesNW LLC | |||||||||||||
| PO Box 389672 | Seattle | WA | 98138 | 311750915 | Medical Billing | WA | PH&S - WA | Related | 0 | 0 | |||
| Medalia Healthcare LLC | |||||||||||||
| 1801 Lind Ave SW 9016 | Renton | WA | 98057 | 911660459 | Physician Benefits | WA | PH&S - WA | Investment | 0 | 0 | |||
| Distribution Operations Center LLC | |||||||||||||
| 1801 Lind Ave SW 9016 | Renton | WA | 98057 | 271054858 | Supplies Purchasing Agent | WA | PH&S - WA | Related | 0 | 0 | |||
| Oregon Advanced Imaging LLC | |||||||||||||
| 881 OHare Parkway | Medford | OR | 97504 | 450471748 | Medical Imaging | OR | PH&S - OR | Related | 0 | 0 | |||
| ProvidenceUSP Surgery Centers LLC | |||||||||||||
| 11550 Indian Hills Rd 160 | Mission Hills | CA | 91345 | 200905938 | Ambulatory Surgery Center | CA | PHS - So California | Related | 0 | 1 | 400122 | 2371853 | 0.53000 |
| California Laboratory Associates LLC | |||||||||||||
| 501 Buena Vista | Burbank | CA | 91505 | 273888692 | Outpatient Lab | CA | PHS - So California | Related | 0 | 1 | 0.85900 | ||
| 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 Rd 160 | Mission Hills | CA | 91345 | 202829660 | Ambulatory Surgery Center | CA | PHS - So California | Related | 0 | 1 | -92135 | 2695384 | 0.55000 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| 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 |
| Providence Health Ventures Inc | ||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 330122216 | Investment | CA | N/A | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Providence Health & Services Foundation | ||
| C | 7745440 | Cost |
| Providence Little Company of Mary Foundation | ||
| C | 3238744 | Cost |
| Providence Health & Services Foundation | ||
| B | 2601031 | Cost |
| Providence Little Company of Mary Foundation | ||
| B | 2147039 | Cost |
Comments