PROVIDENCE HOOD RIVER MEMORIAL HOSP ITAL FOUNDATION INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- PROVIDENCE HOOD RIVER MEMORIAL HOSP ITAL FOUNDATION INC (EIN 93-0921990)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-14
- IRS object ID
- 202313189349305811
- Schema version
- 2022v5.0
- 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 D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-14T10:39:35-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 346565596 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 370 17TH STREET SUITE 4800 | AddressLine1Txt |
| City | DENVER | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930921990 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROV | BusinessNameControlTxt |
| Phone | 5032166627 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 810 12TH STREET PO BOX 149 | AddressLine1Txt |
| City | HOOD RIVER | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97031 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUSAN FROST | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 5032166627 | PhoneNum |
| Signature | 2023-11-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SUSAN | PersonFirstNm |
| Person Last | FROST | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANDREW JAMESON | PreparerPersonNm |
| PTIN | P01894820 | PTIN |
| Phone | 7209314000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SUSAN FROST | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 810 12TH STREET PO BOX 149 | AddressLine1Txt |
| City | HOOD RIVER | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97031 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $999,663 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PROVIDENCEFOUNDATIONS.ORG/FOUNDATIONS/PAGES/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 59 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $499,688 | PYContributionsGrantsAmt |
| CY Contributions Grants | $759,005 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $215,223 | PYInvestmentIncomeAmt |
| CY Investment Income | $168,394 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,589 | PYOtherRevenueAmt |
| CY Other Revenue | $55,097 | CYOtherRevenueAmt |
| PY Total Revenue | $721,500 | PYTotalRevenueAmt |
| CY Total Revenue | $982,496 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $87,658 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $163,977 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $108,415 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $52,432 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $64,410 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $66,514 | PYOtherExpensesAmt |
| CY Other Expenses | $155,150 | CYOtherExpensesAmt |
| PY Total Expenses | $262,587 | PYTotalExpensesAmt |
| CY Total Expenses | $371,559 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $458,913 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $610,937 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,483,074 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,997,625 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $73,148 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $127,285 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,409,926 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,870,340 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $163,977 | ExpenseAmt |
| Grant | $163,977 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAYTOGETHER, OUR 117,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,000 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WAAS A COMPREHENSIVE HEALTH CARE ORGANIZATION, WE ARE SERVING MORE PEOPLE, ADVANCING BEST PRACTICES AND CONTINUING OUR MORE THAN 100-YEAR TRADITION OF SERVING THE POOR AND VULNERABLE. DELIVERING SERVICES ACROSS SEVEN STATES, PROVIDENCE IS COMMITTED TO TOUCHING MILLIONS OF MORE LIVES AND ENHANCING THE HEALTH OF THE AMERICAN WEST TO TRANSFORM CARE FOR THE NEXT GENERATION AND BEYOND.THROUGH COMMUNITY BENEFIT PROGRAMS AND OTHER HIGH-IMPACT INVESTMENTS, WE WORK TO ENSURE BASIC HEALTH NEEDS ARE MET AND SERVE TO REMOVE BARRIERS TO CARE, BUILD COMMUNITY RESILIENCE AND INNOVATE FOR THE FUTURE. MINISTRIES AND AFFILIATES SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT IMPROVE HEALTH AND WELL-BEING AND INCREASE EQUITABLE ACCESS TO QUALITY CARE AT THE COMMUNITY LEVEL AND AT SCALE ACROSS SEVEN STATES.WE ARE PROUD OF OUR HISTORY AND CONTINUED COMMITMENT TO HELPING BUILD A MORE EQUITABLE, SUSTAINABLE FUTURE. OUR STEADFAST COMMITMENT TO RESPONDING TO COMMUNITY NEED IS ONE OF THE MANY WAYS MINISTRIES, AFFILIATES AND CAREGIVERS LIVE OUT OUR SHARED MISSION AND CONTINUE TO SERVE AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT ENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSPROVIDENCE CONTINUES TO ADVANCE A SOCIAL RESPONSIBILITY FRAMEWORK THAT INCLUDES A STRONGER COMMITMENT TO DIVERSITY, EQUITY, INCLUSION ("DEI"), AND ENVIRONMENTAL STEWARDSHIP. IN 2022, WE ELEVATED THE WORK OF DEI, BY RESTRUCTURING RESOURCES WITH PLANS TO ALIGN AND SCALE DEI STRATEGIES ACROSS THE PROVIDENCE FAMILY OF ORGANIZATIONS. WE CONTINUE TO EXECUTE ON OUR INTEGRATED STRATEGIC & FINANCIAL PLAN WHICH CLEARLY EXPRESSES OUR COMMITMENT AND ACCELERATION OF THIS IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES IN THE COMMUNITIES WE SERVE. PROVIDENCE'S SOCIAL RESPONSIBILITY FRAMEWORK AIMS TO DEPLOY THE ASSETS OF OUR SYSTEM TO SUPPORT COMMUNITY HEALTH IMPROVEMENT, STRENGTHEN LOCAL ECONOMIES AND REDUCE OUR CARBON FOOTPRINT. WE HAVE IMPLEMENTED AN ENVIRONMENTAL STEWARDSHIP SYSTEM STRATEGY THAT ENCOURAGES WASTE REDUCTIONS, EFFICIENT ENERGY AND WATER USAGE, LOCAL AGRICULTURE PARTNERSHIPS, LESS TOXIC AND FEWER CHEMICAL USE, AND A REDUCTION IN CARBON FROM TRAVEL. WE HAVE ALSO HELD ENVIRONMENTAL STEWARDSHIP AS ONE OF THE TOP PRIORITIES FOR OUR LEADERSHIP INCENTIVE PROGRAM TO ENSURE ALIGNMENT AND MOMENTUM CONTINUES. IN APRIL 2022, PROVIDENCE PUBLISHED ITS FIRST ENVIRONMENTAL STEWARDSHIP REPORT, IN WHICH WE REPORTED 12 PERCENT REDUCTION IN CARBON EMISSIONS IN SEVEN KEY CATEGORIES IN OUR ACUTE CARE FACILITIES SINCE OUR 2019 BASELINE. AS OF SEPTEMBER 30, 2022, (THE MOST RECENT DATA AVAILABLE), WE HAVE INCREASED THAT REDUCTION TO 13 PERCENT.PROGRAM SERVICE ACCOMPLISHMENTS:HOSPICE AREA OF GREATEST NEED FUND HELPS HOSPICE PATIENTS GET WHAT THEY NEED TO HAVE THE BEST QUALITY OF LIFE DURING THIS DIFFICULT TIME. MEDICAL SUPPLIES ARE PURCHASED IN UNIQUE SITUATIONS WHERE INSURANCE DOESN'T COVER THE NEED (OR WHEN THERE IS NO INSURANCE). COVID RESTRICTIONS HAVE STILL PAUSED SOME COMPLEMENTARY THERAPIES SUCH AS MUSIC THERAPY, MASSAGE, AND ACUPUNCTURE SERVICES, BUT THEY WILL RESUME SOON.WITH HELP FROM THE FOUNDATION, DOWN MANOR BOUGHT NEW LIGHTING IN THEIR PARKING AREA AND ENHANCED SECURITY WHICH INCLUDED SECURITY CAMERAS. THEY ALSO RECEIVED SOME ENHANCED ACOUSTICS IN THEIR BANQUET ROOM, WHICH MADE IT EASIER FOR RESIDENTS TO HEAR IN THE BANQUET ROOM.THE DON BENTON CANCER SERVICES FUND PROVIDES ADDITIONAL SERVICES FOR PATIENTS UNDERGOING CHEMOTHERAPY. THE FUNDS CONTINUED TO PAY FOR THE CANCER CARE BAGS, AS WELL AS CONTINUED TO FUND THE VEGGIE RX PROGRAM. $20,000 MADE FRESH PRODUCE AVAILABLE TO SOME ONCOLOGY PATIENTS REFERRED BY THE ONCOLOGY SOCIAL WORKER. THESE PATIENTS RECEIVED FRESH WEEKLY PRODUCE AND RECIPES FROM GORGE GROWN. SUPPORT GROUPS AND MASSAGE SERVICES FOR PATIENTS ARE STILL ON PAUSE.THE FOUNDATION RAISED $75,664 IN THE FALL FROM THE HEART OF GOLD TO START THE BOB PROGRAM IN HOOD RIVER. THE BOB PROGRAM STANDS FOR BETTER OUTCOMES THROUGH BRIDGES AND WILL BE STARTING IN 2023. COUNSELORS AND PEER SUPPORT SPECIALISTS CONNECT WITH BEHAVIORAL HEALTH PATIENTS AFTER HOSPITAL DISCHARGE. THEY OFFER SUPPORT AND COUNSELING PLUS ESSENTIALS, SUCH AS HYGIENE KITS AND MEAL VOUCHERS. THESE SERVICES MAKE A TANGIBLE DIFFERENCE FOR MANY AT-RISK PEOPLE.THE PROVIDENCE HOOD RIVER HOSPITAL FOUNDATION DONATED $82,197 TO THE HOSPITAL FOR CAPITAL EQUIPMENT PURCHASES, INCLUDING THE PURCHASE OF AN IMAGE GUIDING SERVICE SYSTEM FOR ENT, A NEW DISHWASHER, A HUMIDIFIER FOR THE OR, SOFTWARE FOR SECURITY, ITEMS FOR SURGERY, AND AN UPDATED TUBE SYSTEM FOR MED/SURG AND THE LAB.THE PROVIDENCE HOOD RIVER FOUNDATION APPROVED THE PURCHASE OF BASSINETS FOR THE FAMILY BIRTH CENTER (FBC) FOR $17,400. THEY ALSO APPROVED THE ASK BY JENNIFER MCCAULEY, NURSE AND LACTATION SPECIALIST, FOR $2,400 TO FUND A MILK BANK FOR THOSE FAMILIES THAT NEED MILK FOR THEIR NEWBORN. MANY TIMES, WHEN HEADING HOME FROM THE HOSPITAL, MOMS AREN'T ABLE TO PRODUCE ENOUGH MILK YET, SO THIS IS A WAY TO BRIDGE THE GAP. THE FOUNDATION WAS ALSO ABLE TO PURCHASE A NEW BABY SIM FOR THE FAMILY BIRTH CENTER WITH FUNDS FROM AREAS OF GREATER NEED AND A GRANT FROM THE JUAN YOUNG TRUST. THIS ALLOWS THE FBC THE ABILITY TO PRACTICE FOR EMERGENCY SITUATIONS AND BE READY IF ONE OCCURS.TRAUMA NURSES TALK TOUGH HELMET SAFETY PROGRAM WAS ABLE TO GIVE OVER 385 HELMETS IN THE GORGE COMMUNITY IN 2022. ED AND TRAUMA NURSES PRESENT PROGRAMS IN THE COMMUNITY TO SCHOOL KIDS ON THE SAFETY OF PROTECTIVE GEAR SUCH AS BIKE HELMETS. PROVIDENCE HOOD RIVER FOUNDATION HAS BEEN ABLE TO PROVIDE BIKE HELMETS TO MANY CHILDREN IN THE COMMUNITY. WE PARTICIPATED IN THE CHILDREN'S COMMUNITY FAIR, HANDING OUT BIKE HELMETS. KIDS CAN SHOW UP AT THE EMERGENCY ROOM ADMITTING DESK AND ASK FOR A FREE BIKE HELMET AND GET FITTED FOR THE CORRECT SIZE HELMET. WE HAVE ALSO HAD SOME OF THE LOCAL SCHOOLS ASK FOR BIKE HELMETS FOR BIKING CLASSES AT SCHOOL, AND WE HAVE BEEN ABLE TO SUPPLY THEM WITH THE HELMETS NEEDED TO ENSURE KIDS ARE SAFE ON THEIR BIKES. | Desc |
| Total Program Service Expenses | $163,977 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | Yes (1) | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JIM MARTIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4255253985 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 LIND AVE SW | AddressLine1Txt |
| City | RENTON | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98057 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| ROBERT GOBBO MD | |||||||
| TREASURER | 1.00 | 49.00 | Yes (X) | Yes (X) | $0 | $334,732 | $53,320 |
| SUSAN FROST | |||||||
| EXECUTIVE DIRECTOR | 50.00 | 0.00 | Yes (X) | $0 | $134,146 | $31,547 | |
| BETTY GAUVIN | |||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BRANDEN BUEL | |||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CANDICE RICHARDS | |||||||
| CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CAROL FRIEND | |||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CATHERINE DALBEY | |||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DEVON WELLS | |||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ERICK HAYNIE | |||||||
| DIRECTOR - THRU 3/22 | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JACK TRUMBULL | |||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN BRUNK | |||||||
| DIRECTOR - THRU 8/22 | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARIA ELENA CASTRO | |||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MICHELE BEAMAN | |||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TERRI VANN | |||||||
| VICE CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $468,878 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $84,867 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $59,794 | FundraisingAmt |
| Related Organizations | $157,044 | RelatedOrganizationsAmt |
| Government Grants | $147,181 | GovernmentGrantsAmt |
| All Other Contributions | $394,986 | AllOtherContributionsAmt |
| Total Contributions | $759,005 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,953 | TotalRevenueColumnAmt |
| Exclusion | $98,953 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $69,441 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $69,441 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $69,441 | TotalRevenueColumnAmt |
| Exclusion | $69,441 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $15,870 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $59,794 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $17,167 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,297 | TotalRevenueColumnAmt |
| Exclusion | -$1,297 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $56,394 | TotalRevenueColumnAmt |
| Exclusion | $56,394 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $56,394 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $982,496 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $223,491 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,977 | TotalAmt |
| Program Services | $163,977 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,402 | TotalAmt |
| Management And General | $32,386 | ManagementAndGeneralAmt |
| Fundraising | $17,016 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,953 | TotalAmt |
| Management And General | $1,936 | ManagementAndGeneralAmt |
| Fundraising | $1,017 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77 | TotalAmt |
| Management And General | $50 | ManagementAndGeneralAmt |
| Fundraising | $27 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,585 | TotalAmt |
| Management And General | $20,585 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,330 | TotalAmt |
| Management And General | $15,294 | ManagementAndGeneralAmt |
| Fundraising | $8,036 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,468 | TotalAmt |
| Management And General | $1,618 | ManagementAndGeneralAmt |
| Fundraising | $850 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,394 | TotalAmt |
| Management And General | $8,781 | ManagementAndGeneralAmt |
| Fundraising | $4,613 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144 | TotalAmt |
| Management And General | $94 | ManagementAndGeneralAmt |
| Fundraising | $50 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| OTHER EXPENSES | $90,429 | $59,281 | $31,148 |
| LICENSES & TAXES | $2,424 | $1,589 | $835 |
| SPECIAL EVENTS | $2,326 | $1,525 | $801 |
| BAD DEBT | $50 | $33 | $17 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,559 | TotalAmt |
| Program Services | $163,977 | ProgramServicesAmt |
| Management And General | $143,172 | ManagementAndGeneralAmt |
| Fundraising | $64,410 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $646,771 | BOYAmt |
| EOY | $872,430 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $239 | BOYAmt |
| EOY | $73,643 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,469 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,936 | BOYAmt |
| EOY | $24,936 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $553,850 | BOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,582,873 | BOYAmt |
| EOY | $4,767,675 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $672,936 | BOYAmt |
| EOY | $1,258,941 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,483,074 | BOYAmt |
| EOY | $6,997,625 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $804 | BOYAmt |
| EOY | -$2,010 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,344 | BOYAmt |
| EOY | $129,295 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,148 | BOYAmt |
| EOY | $127,285 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,527,447 | BOYAmt |
| EOY | $4,758,043 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,882,479 | BOYAmt |
| EOY | $2,112,297 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,409,926 | BOYAmt |
| EOY | $6,870,340 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,483,074 | BOYAmt |
| EOY | $6,997,625 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $610,937 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$967,732 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$117,607 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$65,184 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $342,914 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $304,896 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $647,356 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $499,688 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $759,005 | CurrentTaxYearAmt |
| Total | $2,553,859 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $342,914 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $304,896 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $647,356 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $499,688 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $759,005 | CurrentTaxYearAmt |
| Total | $2,553,859 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $623,003 | SubstantialContributorsTotAmt |
| Public Support Total170 | $1,930,856 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $47,060 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $57,006 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $100,465 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $124,695 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $98,953 | CurrentTaxYearAmt |
| Total | $428,179 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $24,618 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $55,097 | CurrentTaxYearAmt |
| Total | $87,715 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,069,753 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $77,958 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.62900 | PublicSupportCY170Pct |
| Public Support PY170 | 0.63490 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS REVENUE - 2021 AMOUNT: $ 8,000. 2022 AMOUNT: $ 56,394. SALES OF INVENTORY LESS RETURNS - 2020 AMOUNT: $ 4,103. FUNDRAISING REVENUE - 2020 AMOUNT: $ 20,515. 2022 AMOUNT: $ -1,297. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Art Public Exhibition Amounts ArtPublicExhibitionAmountsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Included | $50,401 | AssetsIncludedAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Collection Used Pub Exhibition | Yes (X) | CollectionUsedPubExhibitionInd |
| Solicited Assets Sale | 0 | SolicitedAssetsSaleInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,391,944 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$404,026 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $49,051 | GrantsOrScholarshipsAmt |
| End Year Balance | $2,938,867 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,966,324 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $425,620 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $3,391,944 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,838,358 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $127,966 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,966,324 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,619,777 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $218,581 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $2,838,358 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,796,250 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$124,638 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $51,835 | GrantsOrScholarshipsAmt |
| End Year Balance | $2,619,777 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.30670 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.59040 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.10290 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| CHARITABLE GIFT ANNUITIES | $1,202,699 |
| OTHER ASSETS | $56,242 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,258,941 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $112,451 |
| DUE TO THIRD PARTY | $535 |
| CHARITABLE GIFT ANNUITIES/TRUST FUND OBLIGATIONS | $16,309 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $129,295 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 4: | ARTWORK RECEIVED THROUGH THE FOUNDATION IS DISPLAYED THROUGHOUT THE HOSPITAL TO ENHANCE THE ENVIRONMENT FOR THE PATIENTS AND THEIR FAMILIES. |
| PART V, LINE 4: | THE FOUNDATION'S ENDOWMENTS ARE TO SUPPORT THE GENERAL OPERATIONS OF PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL AND PROVIDENCE DOWN MANOR. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | HEARTS OF GOLD | Event1Nm |
| Gross Receipts Event1 | $75,664 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $59,794 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $15,870 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $14,017 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $300 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $2,850 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $75,664 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $59,794 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $15,870 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $14,017 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $300 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $2,850 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $17,167 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$1,297 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| PROVIDENCE HEALTH & SERVICES - OREGON | ||||||||
| 1801 LIND AVE SW | RENTON | WA | 980579019 | 510216587 | 501(C)(3) | $82,197 | $0 | OPERATIONS & CAPITAL |
| HOOD RIVER SENIOR CITIZENS INC | ||||||||
| 2010 STERLING PL | HOOD RIVER | OR | 97031 | 510154995 | 501(C)(3) | $62,626 | $0 | OPERATIONS SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT ALONG WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT GOBBO MD | ||||||||||||||
| TREASURER | $0 | $258,639 | $0 | $23,199 | $0 | $52,894 | $0 | $29,006 | $0 | $24,314 | $0 | $388,052 | $0 | $0 |
| SUSAN FROST | ||||||||||||||
| EXECUTIVE DIRECTOR | $0 | $114,893 | $0 | $18,295 | $0 | $958 | $0 | $10,386 | $0 | $21,161 | $0 | $165,693 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | PROVIDENCE EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: FIRST CLASS TRAVEL OR CHARTER TRAVEL AIR TRAVEL IS GENERALLY REIMBURSABLE 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. IN LIMITED SITUATIONS, FIRST CLASS TICKETS AND CHARTER MAY BE REIMBURSED WHEN APPROVED BY A SENIOR LEVEL SUPERVISOR. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS RELOCATION PROVIDENCE 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 TAXABLE WAGES AND ARE REPORTED AS SUCH. 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 PROVIDES A GROSS-UP FOR THE RELOCATION BENEFITS, SO THAT A PORTION OF THE REIMBURSEMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - FINANCIAL/RETIREMENT PLANNING PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO FINANCIAL AND RETIREMENT PLANNING EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THESE OTHER EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THIS BENEFIT, SO THAT A PORTION OF THE PAYMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE. |
| PART I, LINE 3 | DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE HEALTH & SERVICES - OREGON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE. |
| PART I, LINE 4B | ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(III) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. NO INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR. |
| PART I, LINE 7 | NON-FIXED PAYMENTS THE PROVIDENCE EXECUTIVE COMPENSATION COMMITTEE (OF THE BOARD) HAS APPROVED AN EXECUTIVE COMPENSATION PHILOSOPHY THAT CLOSELY TIES AN EXECUTIVE'S COMPENSATION TO PERFORMANCE - BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE EXECUTIVE. THERE IS NO GUARANTEE THAT THIS PART OF A LEADER'S COMPENSATION WILL BE PAID - IF THE PERFORMANCE OF THE ORGANIZATION OR OF THE INDIVIDUAL DOES NOT MEET THE PERFORMANCE STANDARDS FOR PAYMENT, NO PERFORMANCE-BASED PAYMENT IS MADE. THIS APPROACH IS REFLECTED IN PROVIDENCE'S LEADERSHIP ANNUAL INCENTIVE PLAN AND LONG-TERM INCENTIVE PLAN, WHICH ARE PERFORMANCE-BASED ANNUAL INCENTIVE PLANS THAT AFFORD PARTICIPATING EXECUTIVES THE OPPORTUNITY TO EARN "AT RISK" COMPENSATION THROUGH PERFORMANCE AGAINST VERY CHALLENGING GOALS. PAYOUTS WILL BE AWARDED BASED ON GOALS RELATED TO STRATEGIC OBJECTIVES, FISCAL STEWARDSHIP AND QUALITY OF CARE - THESE GOALS ARE SET BEFORE THE YEAR BEGINS AND ARE VERY CHALLENGING. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S PERFORMANCE GOALS TO MAKE SURE THEY ARE SUFFICIENTLY CHALLENGING, AND TO MAKE SURE THE GOALS ARE DESIGNED TO HELP PROVIDENCE MEET ITS MISSION AND STRATEGIC PURPOSES. EACH YEAR THE PSJH BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE INCENTIVE PERFORMANCE AND MUST CERTIFY THE ACHIEVEMENT OF PERFORMANCE GOALS BEFORE ANY AWARDS ARE PAID OUT. WHEN REVIEWING AND APPROVING TOTAL COMPENSATION FOR EXECUTIVES, THE EXECUTIVE COMPENSATION COMMITTEE INCLUDES INCENTIVE AWARDS, TO MAKE SURE THAT COMPENSATION IS REASONABLE AND WELL-SUPPORTED BY MARKET DATA. THE COMMITTEE CONSISTS ONLY OF DIRECTORS WHO ARE FREE OF CONFLICTS OF INTEREST, AND THE COMMITTEE RELIES ON MARKET SURVEY DATA GATHERED BY AN INDEPENDENT CONSULTANT. THE COMMITTEE CONDUCTS THIS REVIEW AND APPROVAL PROCESS IN A MANNER THAT IS IN ACCORDANCE WITH IRS REQUIREMENTS FOR COMPENSATION OF TAX-EXEMPT ORGANIZATION LEADERS, AND IN ACCORDANCE WITH THE BEST GOVERNANCE PRACTICES IN THE INDUSTRY. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: | AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. |
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS PROVIDENCE HEALTH & SERVICES - OREGON IS THE SOLE CORPORATE MEMBER OF PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT THE PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION'S GOVERNING BOARD. ALL NOMINATIONS THAT COME FROM THE PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE HEALTH & SERVICES - OREGON, AS THE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE FOLLOWING POWERS RESIDE WITH THE CORPORATE MEMBER: 1) TO ADOPT OR CHANGE THE MISSION, PHILOSOPHY, AND VALUES, INCLUDING THE STRATEGIC PLAN AND MISSION STATEMENT. 2) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS. 3) TO APPROVE THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE TRANSFER, ASSIGNMENT OR ENCUMBERING OF ASSETS EXCEEDING A SPECIFIED THRESHOLD, OR THE SALE OR TRANSFER OF ANY PROPERTY WHICH MAY HAVE HISTORICAL OR RELIGIOUS SIGNIFICANCE. 4) TO APPROVE THE DISSOLUTION OR LIQUIDATION. 5) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS. 6) TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANTS. 7) TO APPROVE THE CLOSURE OF ANY INSTITUTION OR MAJOR ENTITY OR WORK OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | PROCESS TO REVIEW FORM 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. |
| FORM 990, PART VI, SECTION B, LINE 12C | PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY CORE LEADERS ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE A PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S EXECUTIVE DIRECTOR IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE HEALTH & SERVICES - OREGON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. 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 ENTITY 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 SENIOR EXECUTIVES, INCLUDING ALL OFFICERS. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED AT LEAST ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS A COMMITTEE OF THE PROVIDENCE BOARD CONSISTING ONLY OF OUTSIDE, INDEPENDENT DIRECTORS. THE COMMITTEE MAKES SURE, AT EACH OF ITS MEETINGS, THAT NO MEMBER OF THE COMMITTEE HAS A CONFLICT OF INTEREST AS TO ANY EXECUTIVE WHOSE COMPENSATION IS REVIEWED BY THE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE 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 THAT ARE SUBSTANTIALLY SIMILAR TO PROVIDENCE IN SIZE AND COMPLEXITY (SUCH AS HAVING A SIMILAR AMOUNT OF ANNUAL NET REVENUE). ADDITIONALLY, BECAUSE PROVIDENCE OFTEN LOOKS TO GENERAL INDUSTRY FOR LEADERS IN CERTAIN FUNCTIONAL AREAS, PROVIDENCE ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY MARKET DATA IN THESE SPECIAL SITUATIONS. BASE SALARIES FOR PROVIDENCE EXECUTIVES ARE GENERALLY TARGETED TO THE "MEDIAN" LEVEL OF THE MARKET DATA (WHERE HALF THE SALARIES IN THE DATA ARE LOWER AND HALF THE SALARIES IN THE DATA ARE HIGHER), AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. 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 EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. TOTAL COMPENSATION IS TIED CLOSELY TO PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY HELP LEAD PROVIDENCE IN ACHIEVING SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE'S OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR SETTING, REVIEWING AND APPROVING EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS (TO ASSURE THAT ALL COMPENSATION IS CONSIDERED REASONABLE) AND REFLECTS BEST GOVERNANCE PRACTICES IN THE INDUSTRY. THE PROCESS WAS LAST COMPLETED IN JUNE 2023. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE PROVIDENCE COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, CONSOLIDATED AUDITED FINANCIAL STATEMENTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PROVIDENCE INTERNET SITE. |
| FORM 990, PART XI, LINE 9: | OTHER -65,184. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (111 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| COLLABRIA CARE | |||||||||||
| 414 SOUTH JEFFERSON STREET | NAPA | CA | 94559 | 680393144 | HEALTHCARE | CA | 501(C)(3) | 10 | SJHCN | Yes (1) | |
| COVENANT ACO | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 611573313 | HEALTHCARE | TX | 501(C)(3) | 12, I | CHS | Yes (1) | |
| COVENANT CHILDREN'S PHYSICIANS GROUP | |||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 881290850 | HEALTHCARE | TX | 501(C)(3) | PENDING | CHS | Yes (1) | |
| COVENANT HEALTH NETWORK INC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 461259908 | HEALTHCARE | CA | 501(C)(3) | 12, III | SJHS | Yes (1) | |
| COVENANT HEALTH PARTNERS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 463516417 | HEALTHCARE | TX | 501(C)(3) | 12, I | CHS | Yes (1) | |
| COVENANT HEALTH SYSTEM | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752765566 | HEALTHCARE | TX | 501(C)(3) | 3 | SJHS | Yes (1) | |
| COVENANT HEALTH SYSTEM FOUNDATION | |||||||||||
| 3623 22ND PLACE | LUBBOCK | TX | 79410 | 752897026 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (1) | |
| COVENANT HOME AND COMMUNITY CARE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 920275096 | HEALTHCARE | TX | 501(C)(3) | 10 | CHS | Yes (1) | |
| COVENANT HOSPITAL HOBBS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844273963 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| COVENANT MEDICAL CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 822913146 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| COVENANT MEDICAL GROUP | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752743883 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| EVERETT TRANSITIONAL CARE SERVICES | |||||||||||
| PO BOX 5128 | EVERETT | WA | 982065128 | 943264605 | TRANSITIONAL CARE | WA | 501(C)(3) | 10 | 0 | N/A | |
| GAMELIN WASHINGTON ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 201910170 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| GLOBAL TO LOCAL HEALTH INITIATIVE | |||||||||||
| 2800 SOUTH 192ND ST 104 | SEATAC | WA | 98188 | 273133200 | HEALTHCARE | WA | 501(C)(3) | 7 | SHS | Yes (1) | |
| GRACE CLINIC OF LUBBOCK | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 203856995 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| HMTS INC | |||||||||||
| 1 HOAG DRIVE | NEWPORT BEACH | CA | 92658 | 453583707 | HEALTHCARE | CA | 501(C)(3) | 12, I | HMHP | Yes (1) | |
| HOAG CHARITY SPORTS | |||||||||||
| 2081 BUSINESS CENTER DR STE 195 | NEWPORT BEACH | CA | 92663 | 452982422 | SUPPORT | CA | 501(C)(3) | 7 | HHF | Yes (1) | |
| HOAG CLINIC | |||||||||||
| 1 HOAG DRIVE | NEWPORT BEACH | CA | 92658 | 330676831 | HEALTHCARE | CA | 501(C)(3) | 10 | HMHP | Yes (1) | |
| HOAG HOSPITAL FOUNDATION | |||||||||||
| 330 PLACENTIA AVE | NEWPORT BEACH | CA | 92663 | 953222343 | FUNDRAISING | CA | 501(C)(3) | 7 | HMHP | Yes (1) | |
| HOAG MEMORIAL HOSPITAL PRESBYTERIAN | |||||||||||
| 1 HOAG ROAD BOX 6100 | NEWPORT BEACH | CA | 92663 | 951643327 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| HOSPICE OF LUBBOCK | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752133781 | HEALTHCARE | TX | 501(C)(3) | 10 | CHS | Yes (1) | |
| INSTITUTE FOR MENTAL HEALTH & WELLNESS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814260130 | HEALTHCARE | WA | 501(C)(3) | PF | PHS SJHS | Yes (1) | |
| INSTITUTE FOR SYSTEMS BIOLOGY | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 912003593 | HEALTHCARE | WA | 501(C)(3) | 7 | WHC | Yes (1) | |
| KADLEC AUXILIARY INC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 916033089 | SUPPORT | WA | 501(C)(3) | 12, III | KRMC | Yes (1) | |
| KADLEC FOUNDATION | |||||||||||
| 888 SWIFT BLVD | RICHLAND | WA | 99352 | 237005501 | SUPPORT | WA | 501(C)(3) | 7 | KRMC | Yes (1) | |
| KADLEC REGIONAL MEDICAL CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 910655392 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (1) | |
| LITTLE COMPANY OF MARY ANCILLARY SERVICES CORPORATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330844408 | IMAGING SERVICES | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (1) | |
| LUBBOCK HERITAGE HOSPITAL LLC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 264021016 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| LUNDBERG ASSOCIATION PROVIDENCE HOUSE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911562797 | SUPPORT | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| METHODIST CHILDREN'S HOSPITAL | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752428911 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| METHODIST HOSPITAL LEVELLAND | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752246348 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| METHODIST HOSPITAL PLAINVIEW | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752426010 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (1) | |
| MISSION HOSPITAL REGIONAL MEDICAL CTR | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643360 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| NORTHWEST HOPE & HEALING FOUNDATION | |||||||||||
| PO BOX 16069 | SEATTLE | WA | 98116 | 200799737 | SUPPORT | WA | 501(C)(3) | 12, I | SHS | Yes (1) | |
| OPEN DOOR VENTURES | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911608508 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PACMED CLINICS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 562290878 | HEALTHCARE | WA | 501(C)(3) | 10 | WHC | Yes (1) | |
| PH&S FOUNDATIONSFVSA & SCVSA | |||||||||||
| 501 SOUTH BUENA VISTA STREET | BURBANK | CA | 915054809 | 953544877 | HEALTHCARE | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (1) | |
| PROVIDENCE ALASKA FOUNDATION | |||||||||||
| 3760 PIPER STREET SUITE 2021 | ANCHORAGE | AK | 99508 | 920093565 | HEALTHCARE | AK | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION | |||||||||||
| 540 SOUTH MAIN ST | MT ANGEL | OR | 97362 | 911940286 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE BLANCHET ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911789266 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE CHILDREN'S HEALTH FOUNDATION | |||||||||||
| 4805 NE GLISAN ST STE 2N35 | PORTLAND | OR | 97213 | 930800140 | SUPPORT | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE COMMUNITY HEALTH FOUNDATION | |||||||||||
| 940 ROYAL AVE SUITE 410 | MEDFORD | OR | 97504 | 930692907 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE DETHMAN HOUSE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 473385506 | SUPPORT | WA | 501(C)(3) | 7 | 0 | N/A | |
| PROVIDENCE FACEY MEDICAL FOUNDATION (FKA FACEY MEDICAL FDN) | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 954322584 | SUPPORT | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (1) | |
| PROVIDENCE GAMELIN HOUSE ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 311744654 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911549796 | HEALTHCARE | WA | 501(C)(3) | 12, II | PSJH | 0 | |
| PROVIDENCE HEALTH & SERVICES - MONTANA | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810231793 | HEALTHCARE | MT | 501(C)(3) | 3 | PHS WA | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES - OREGON | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 510216587 | HEALTHCARE | OR | 501(C)(3) | 3 | PHS | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES - WASHINGTON | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 510216586 | HEALTHCARE | WA | 501(C)(3) | 3 | PHS | Yes (1) | |
| PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911303277 | HEALTHCARE | WA | 501(C)(3) | 3 | PMWHC | Yes (1) | |
| PROVIDENCE HEALTH ASSURANCE | |||||||||||
| 4400 NE HALSEY ST STE 609 ATTN ACCO | PORTLAND | OR | 97213 | 550828701 | MEDICAID HEALTHCARE PROVIDER | OR | 501(C)(4) | N/A | PHP | Yes (1) | |
| PROVIDENCE INLAND NORTHWEST FOUNDATION (FKA PROV HC FDN - E WA) | |||||||||||
| 101 W 8TH AVE | SPOKANE | WA | 99204 | 320014330 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE HEALTH PLAN | |||||||||||
| 4400 NE HALSEY ST STE 609 ATTN ACCO | PORTLAND | OR | 97213 | 930863097 | HEALTHCARE | OR | 501(C)(4) | N/A | PPP | Yes (1) | |
| PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 510216589 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS | Yes (1) | |
| PROVIDENCE HOSPICE AND HOME CARE FOUNDATION SNOHOMISH COUNTY | |||||||||||
| 1615 75TH ST SW SUITE 210 | EVERETT | WA | 98203 | 272552749 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE HOSPICE OF SEATTLE FOUNDATION | |||||||||||
| 2811 SOUTH 102ND NO 220 | TUKWILA | WA | 98168 | 912077378 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION | |||||||||||
| 4101 TORRANCE BLVD | TORRANCE | CA | 90503 | 510224944 | HEALTHCARE | CA | 501(C)(3) | 7 | PHS SOCAL | Yes (1) | |
| PROVIDENCE MARIANWOOD FOUNDATION | |||||||||||
| 3725 PROVIDENCE POINT DRIVE SE | ISSAQUAH | WA | 980297219 | 931554288 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE MEDICAL FDN (FKA ST JOSEPH HERITAGE HEALTHCARE) | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330185031 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (1) | |
| PROVIDENCE MEDICAL INSTITUTE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330283773 | HEALTHCARE | CA | 501(C)(3) | 12, I | PHS SOCAL | Yes (1) | |
| PROVIDENCE MILWAUKIE FOUNDATION | |||||||||||
| 10150 SE 32ND AVE | MILWAUKIE | OR | 97222 | 943079515 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE MINISTRIES | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | RELIGIOUS ORG | WA | 501(C)(3) | 1 | 0 | N/A | ||
| PROVIDENCE MOUNT ST VINCENT FOUNDATION | |||||||||||
| 4831 35TH AVE SW | SEATTLE | WA | 981262799 | 911188119 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE NEWBERG HEALTH FOUNDATION | |||||||||||
| 1001 PROVIDENCE DRIVE | NEWBERG | OR | 97132 | 930889144 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE PETER CLAVER ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 311629656 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE PLAN PARTNERS | |||||||||||
| 4400 NE HALSEY ST STE 609 ATTN ACCO | PORTLAND | OR | 97213 | 911861964 | HEALTHCARE | WA | 501(C)(4) | N/A | PHS OR | Yes (1) | |
| PROVIDENCE PORTLAND MEDICAL FOUNDATION | |||||||||||
| 4805 NE GLISAN ST | PORTLAND | OR | 972132967 | 931231494 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE ROSSI ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 311584166 | SUPPORT | WA | 501(C)(3) | 10 | PHS WA | Yes (1) | |
| PROVIDENCE SAINT JOHN'S HEALTH CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951684082 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS SOCAL | Yes (1) | |
| PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814542216 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS SOCAL | Yes (1) | |
| PROVIDENCE SEASIDE HOSPITAL FOUNDATION | |||||||||||
| 725 S WAHANNA ROAD | SEASIDE | OR | 97138 | 930927320 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE SW WASHINGTON FOUNDATION (FKA PROV ST PETER FDN) | |||||||||||
| 413 LILLY ROAD NE | OLYMPIA | WA | 985065166 | 911097056 | SUPPORT | WA | 501(C)(3) | 7 | PHS W WA | Yes (1) | |
| PROVIDENCE ST ELIZABETH HOUSE ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 912171539 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST FRANCIS ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 943244854 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST JOSEPH HEALTH | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 811244422 | HEALTHCARE | WA | 501(C)(3) | 12, III | 0 | N/A | |
| PROVIDENCE ST JOSEPH HEALTH FOUNDATION | |||||||||||
| 4400 NE HALSEY ST STE 599 | PORTLAND | OR | 97213 | 943078543 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST JOSEPH MEDICAL CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810463482 | HEALTHCARE | MT | 501(C)(3) | 3 | PHS WA | Yes (1) | |
| PROVIDENCE ST MARY FOUNDATION | |||||||||||
| 401 W POPLAR STREET | WALLA WALLA | WA | 99362 | 452841492 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| PROVIDENCE ST VINCENT MEDICAL FOUNDATION | |||||||||||
| 9205 SW BARNES ROAD STE MT2111 | PORTLAND | OR | 97225 | 930575982 | HEALTHCARE | OR | 501(C)(3) | 7 | PHS OR | Yes (1) | |
| PROVIDENCE TRINITYCARE HOSPICE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 953264139 | HEALTHCARE | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (1) | |
| PROVIDENCE TRINITYCARE HOSPICE FOUNDATION | |||||||||||
| 5315 TORRANCE BLVD NO B-1 | TORRANCE | CA | 90503 | 330261016 | HEALTHCARE | CA | 501(C)(3) | 7 | PTCH | Yes (1) | |
| PROVIDENCE WILLAMETTE FALLS MEDICAL FOUNDATION | |||||||||||
| 1500 DIVISION STREET | OREGON CITY | OR | 97045 | 931003750 | HEALTHCARE | OR | 501(C)(3) | 12, I | PHS OR | Yes (1) | |
| REDWOOD MEMORIAL FOUNDATION | |||||||||||
| 2700 DOBEER STREET | EUREKA | CA | 95501 | 942779313 | HEALTHCARE | CA | 501(C)(3) | 7 | SJHNC LLC | Yes (1) | |
| SAINT JOHN'S CANCER INSTITUTE (FKA JOHN WAYNE CANCER INST) | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 954291515 | HEALTHCARE | CA | 501(C)(3) | 4 | PSJHC | Yes (1) | |
| SAINT JOHN'S HOSPITALHEALTH CENTER FOUNDATION | |||||||||||
| 2121 SANTA MONICA BLVD | SANTA MONICA | CA | 90404 | 956100079 | SUPPORT SAINT JOHN HEALTH CENTER & JWCI | CA | 501(C)(3) | 7 | PSJHC | Yes (1) | |
| SEATTLE SCIENCE FOUNDATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 611502822 | PHYSICIAN COLLABORATION | WA | 501(C)(3) | 7 | WHC | Yes (1) | |
| SISTERS OF PROVIDENCE OF MONTANA CORPORATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 262612415 | SHELL CORPORATION | MT | 501(C)(3) | 1 | PHS WA | 0 | |
| SISTERS OF ST JOSEPH OF ORANGE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643383 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | 0 | N/A | |
| SRM ALLIANCE HOSPITAL SERVICES (PVH) | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 680395200 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHNC LLC | Yes (1) | |
| ST JOSEPH HEALTH MINISTRY | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 271666576 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | SSJO | 0 | |
| ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814791043 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (1) | |
| ST JOSEPH HEALTH SYSTEM | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 953589356 | HEALTHCARE | CA | 501(C)(3) | 12, I | PSJH | 0 | |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | |||||||||||
| 3345 MICHELSON DRIVE SUITE 100 | IRVINE | CA | 92612 | 330143024 | HEALTHCARE | CA | 501(C)(3) | 10 | SJHS | Yes (1) | |
| ST JOSEPH HOME CARE NETWORK | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 680331084 | HEALTHCARE | CA | 501(C)(3) | 10 | SJHS | Yes (1) | |
| ST JOSEPH HOSPITAL OF ORANGE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643359 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| ST JUDE HOSPITAL INC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951643325 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| ST LUKE ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 943176618 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| ST MARY MEDICAL CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 951914489 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (1) | |
| ST PATRICK HOSPITAL FOUNDATION | |||||||||||
| 502 W SPRUCE STREET | MISSOULA | MT | 59802 | 237056976 | HEALTHCARE | MT | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| ST THOMAS CHILD AND FAMILY CENTER | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810233495 | EDUCATION | MT | 501(C)(3) | 10 | PHS WA | Yes (1) | |
| SWEDISH EDMONDS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 272305304 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (1) | |
| SWEDISH HEALTH SERVICES | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 910433740 | HEALTHCARE | WA | 501(C)(3) | 3 | WHC | Yes (1) | |
| SWEDISH MEDICAL CENTER FOUNDATION | |||||||||||
| 747 BROADWAY | SEATTLE | WA | 98122 | 910983214 | HEALTHCARE | WA | 501(C)(3) | 7 | SHS | Yes (1) | |
| SWEDISH MJM HOLDINGS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 273139262 | HOLDING COMPANY | WA | 501(C)(3) | 12, I | SHS | Yes (1) | |
| TARZANA MEDICAL CENTER LLC | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 833972614 | HEALTHCARE | CA | 501(C)(3) | 3 | PHS SOCAL | Yes (1) | |
| THE GAMELIN ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911180824 | SUPPORT | WA | 501(C)(3) | 7 | PHS WA | Yes (1) | |
| THE GAMELIN CALIFORNIA ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911293869 | SUPPORT | CA | 501(C)(3) | 10 | PHS SOCAL | Yes (1) | |
| THE GAMELIN OREGON ASSOCIATION | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911214491 | SUPPORT | OR | 501(C)(3) | 10 | PHS OR | Yes (1) | |
| TRI-CITIES CANCER CENTER FOUNDATION | |||||||||||
| 7350 W DESCHUTES AVE BUILDING A | KENNEWICK | WA | 99336 | 911739024 | SUPPORT | WA | 501(C)(3) | 7 | KRMC | Yes (1) | |
| UNIVERSITY OF PROVIDENCE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810231777 | EDUCATION | MT | 501(C)(3) | 2 | PHS | Yes (1) | |
| WESTERN HEALTHCONNECT | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 454171900 | SHELL CORPORATION | WA | 501(C)(3) | 12, II | PHS W WA | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (48 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of EOY AssetsShareOfEOYAssetsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 20TH STREET SURGERY LLC | ||||||||||||
| 1301 20TH STREET STE 140 | SANTA MONICA | CA | 90404 | 731735618 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | 0 | |||
| BRIDGEPORT MEDICAL IMAGING LLC (BMI) | ||||||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260796953 | IMAGING - DIAGNOSTICS | OR | N/A | 0 | Yes (1) | |||
| BROADWAY IMAGING LLC | ||||||||||||
| PO BOX 4587 | MISSOULA | MT | 598064587 | 522405971 | MEDICAL IMAGING | MT | N/A | 0 | Yes (1) | |||
| CANBY MEDICAL CENTER I LLC | ||||||||||||
| 4800 SW MACADAM AVE STE 120 | PORTLAND | OR | 97239 | 205470937 | REAL ESTATE - MOB | OR | N/A | 0 | Yes (1) | |||
| CENTER FOR MEDICAL IMAGING LLC (CMI) | ||||||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 200477972 | IMAGING - DIAGNOSTICS | OR | N/A | 0 | Yes (1) | |||
| CLACKAMAS RADIATION ONCOLOGY CENTER LLC | ||||||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260381897 | RADIATION ONCOLOGY | OR | N/A | 0 | Yes (1) | |||
| COASTAL ASC HOLDINGS LLC | ||||||||||||
| ONE HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92663 | 810986844 | HEALTHCARE | CA | N/A | 0 | Yes (1) | |||
| COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY | ||||||||||||
| 1031 W CHAPMAN AVE 101 | ORANGE | CA | 92868 | 264591502 | HEALTHCARE | CA | N/A | 0 | Yes (1) | |||
| COVENANT PARK PHASE I VENTURE LLC | ||||||||||||
| 3615 19TH ST | LUBBOCK | TX | 79410 | 871464045 | REAL ESTATE | TX | N/A | 0 | 0 | |||
| CSS JV LLC | ||||||||||||
| 11782 SW BARNES ROAD STE 200 BLDG C | PORTLAND | OR | 97225 | 263638838 | AMBULATORY SURGERY CENTER | OR | N/A | 0 | 0 | |||
| FIRST HILL SURGERY CENTER LLC | ||||||||||||
| 1101 MADISON STREET STE 200 | SEATTLE | WA | 98104 | 472066485 | AMBULATORY SURGERY CENTER | WA | N/A | 0 | Yes (1) | |||
| FULLERTON SURGICAL CENTER LP | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 470927394 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | Yes (1) | |||
| GREATER VALLEY MEDICAL BUILDING LP | ||||||||||||
| 501 S BUENA VISTA ST | BURBANK | CA | 91505 | 954570858 | REAL ESTATE - MOB | CA | N/A | 0 | Yes (1) | |||
| HCSA PROPERTIES LLC | ||||||||||||
| 1600 M STREET NW | AUBURN | WA | 98001 | 460620892 | REAL ESTATE RENTAL | WA | N/A | 0 | 0 | |||
| HERITAGE INVESTMENT GROUP I LLC | ||||||||||||
| 500 S MAIN STREET STE 1000 | ORANGE | CA | 92868 | 271000061 | INVESTMENTS | CA | N/A | 0 | 0 | |||
| HOAG ORTHOPEDIC INSTITUTE | ||||||||||||
| 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 611588294 | HEALTHCARE | CA | N/A | 0 | 0 | |||
| HOI ASC HOLDINGS LLC | ||||||||||||
| 16250 SAND CANYON AVE | IRVINE | CA | 92618 | 825250937 | INVESTMENTS | CA | N/A | 0 | 0 | |||
| IMAGING ASSOCIATES LLC | ||||||||||||
| 3650 PIPER STREET STE A | ANCHORAGE | AK | 99508 | 203906048 | MEDICAL IMAGING | AK | N/A | 0 | Yes (1) | |||
| LSC REAL PROPERTY LLC | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 474646059 | REAL ESTATE | TX | N/A | 0 | 0 | |||
| METHODIST DIAGNOSTIC IMAGING | ||||||||||||
| 4005 24TH STREET | LUBBOCK | TX | 79410 | 752343261 | HEALTHCARE | TX | N/A | 0 | Yes (1) | |||
| MISSION VIEJO PARTNERS II LLC | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 823943675 | REAL ESTATE - MOB | CA | N/A | 0 | Yes (1) | |||
| NEWPORT IMAGING CENTER | ||||||||||||
| 360 SN MIGUEL | NEWPORT BEACH | CA | 92660 | 330191776 | HEALTHCARE | CA | N/A | 0 | Yes (1) | |||
| NORTH OC IMAGING JV HOLDINGS LLC | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 852444305 | HEALTHCARE | CA | N/A | 0 | 0 | |||
| OREGON ADVANCED IMAGING LLC | ||||||||||||
| 881 OHARE PARKWAY | MEDFORD | OR | 97504 | 450471748 | MEDICAL IMAGING | OR | N/A | 0 | Yes (1) | |||
| PAVILION SURGERY CENTER LLC | ||||||||||||
| 1140 WEST LAVETA AVE | ORANGE | CA | 92868 | 814376492 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | 0 | |||
| PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC | ||||||||||||
| 1221 MADISON STREET | SEATTLE | WA | 98104 | 203132044 | MEDICAL IMAGING | WA | N/A | 0 | Yes (1) | |||
| PERFORMANCE MEDICAL EQUIPMENT & RESPIRATORY SERVICES LLC | ||||||||||||
| 19625 62ND AVENUE SOUTH SUITE 101 | KENT | WA | 98032 | 452901632 | MEDICAL EQUIPMENT | WA | N/A | 0 | Yes (1) | |||
| PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 812701056 | INVESTMENTS | WA | N/A | 0 | 0 | |||
| PROVIDENCE ALASKA HOUSE I OWNER LP | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 882819223 | SUPPORTIVE HOUSING | AK | N/A | 0 | 0 | |||
| PROVIDENCE & SCA OFF-CAMPUS HOLDINGS LLC | ||||||||||||
| 569 BROOKWOOD VILLAGE SUITE 901 | BIRMINGHAM | AL | 35209 | 823765555 | MEDICAL | AL | N/A | 0 | 0 | |||
| PROVIDENCE & SCA ON-CAMPUS HOLDINGS LLC | ||||||||||||
| 569 BROOKWOOD VILLAGE SUITE 901 | BIRMINGHAM | AL | 35209 | 823270499 | MEDICAL | AL | N/A | 0 | Yes (1) | |||
| PROVIDENCE HOUSE OAKLAND LP | ||||||||||||
| 540 23RD ST | OAKLAND | CA | 94612 | 811441264 | SUPPORTIVE HOUSING | CA | N/A | 0 | Yes (1) | |||
| PROVIDENCE IMAGING CENTER JOINT VENTURE | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 920118807 | MEDICAL IMAGING | AK | N/A | 0 | 0 | |||
| PROVIDENCE ST JOSEPH HEALTH LONG TERM PORTFOLIO | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 823190634 | INVESTMENTS | WA | 0 | 0 | PHS WA | EXCLUDED | $75 | |
| PROVIDENCE SURGERY CENTER LLC | ||||||||||||
| 902 N ORANGE ST | MISSOULA | MT | 59802 | 841401625 | AMBULATORY SURGERY CENTER | MT | N/A | 0 | 0 | |||
| PROVIDENCEUSP SPOKANE SURGERY CENTERS LLC | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 881149413 | AMBULATORY SURGERY CENTER | WA | N/A | 0 | 0 | |||
| PROVIDENCEUSP SURGERY CTRS LLC | ||||||||||||
| 11550 INDIAN HILLS ROAD 160 | MISSION HILLS | CA | 91345 | 200684116 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | 0 | |||
| RADIATION THERAPY INNOVATIONS LLC | ||||||||||||
| 1221 MADISON ST 1ST FL | SEATTLE | WA | 98104 | 300553035 | HEALTHCARE | WA | N/A | 0 | Yes (1) | |||
| RIVERSIDE HEALTHCARE | ||||||||||||
| 1107 HAZELTINE BLVD 200 | CHASKA | MN | 55318 | 411594648 | HEALTHCARE | MN | N/A | 0 | Yes (1) | |||
| SJO ASC HOLDINGS LLC | ||||||||||||
| 27401 LOS ALTOS SUITE 200 | MISSION VIEJO | CA | 92691 | 821655501 | HEALTHCARE | CA | N/A | 0 | 0 | |||
| ST JOSEPH PHYSICIAN VENTURES I LLC | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 454521884 | REAL ESTATE | CA | N/A | 0 | Yes (1) | |||
| ST JOSEPHSATELLITE DIALYSIS CENTERS LLC | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814657391 | HEALTHCARE | CA | N/A | 0 | 0 | |||
| ST JUDE SURGICAL CENTERS LLC | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 823352570 | AMBULATORY SURGERY CENTER | CA | N/A | 0 | Yes (1) | |||
| ST MARY MEDICAL CENTER LLC | ||||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | HEALTHCARE | CA | N/A | 0 | 0 | ||||
| ST PETER-SOUTH SOUND REGIONAL MRI CENTER | ||||||||||||
| 3417 ENSIGN RD NE | OLYMPIA | WA | 98506 | 911455338 | MEDICAL IMAGING | WA | N/A | 0 | Yes (1) | |||
| SURGERY CENTER AT TANASBOURNE LLC | ||||||||||||
| 11221 ROE AVE STE 300 | LEAWOOD | KS | 66211 | 208187971 | AMBULATORY SURGERY CENTER | KS | N/A | 0 | Yes (1) | |||
| THE MADISON SPOKANE INN LLC | ||||||||||||
| 15 WEST ROCKWOOD BLVD | SPOKANE | WA | 99204 | 841606484 | HOTEL SERVICES | WA | N/A | 0 | Yes (1) | |||
| WON-ONC LLC | ||||||||||||
| 1900 COOKS HILL RD | CENTRALIA | WA | 98531 | 262181194 | REAL ESTATE - MOB | WA | N/A | 0 | Yes (1) | |||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (47 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1221 MADISON STREET OWNERS ASSOC | ||||||||||||||
| 747 BROADWAY | SEATTLE | WA | 98122 | 201954319 | OWNERS' ASSOCIATION | WA | N/A | C | 0 | |||||
| ACCLARA SOLUTIONS GROUP LLC | ||||||||||||||
| 10713 W SAM HOUSTON PKWY N 500 | HOUSTON | TX | 77064 | 870837184 | HOLDING COMPANY | TX | N/A | C | 0 | |||||
| ACCLARA SOLUTIONS INTERMEDIATE LLC | ||||||||||||||
| 10713 W SAM HOUSTON PKWY N 500 | HOUSTON | TX | 77064 | 371783298 | HEALTHCARE FINANCIAL SERVICES | TX | N/A | C | 0 | |||||
| ADVATA INC (FKA KENSCI INC) | ||||||||||||||
| 615 2ND AVE 700 | SEATTLE | WA | 98104 | 474048082 | HEALTHCARE | WA | N/A | C | 0 | |||||
| AMERICAN UNITY GROUP LTD | ||||||||||||||
| CAPTIVE INSURANCE | N/A | C | 0 | 90 PITTS BAY ROAD | PEMBROKE | BD | HM08 | BD | ||||||
| AYIN HEALTH SOLUTIONS INC | ||||||||||||||
| 4400 NE HALSEY ST STE 609 ATTN ACCO | PORTLAND | OR | 97213 | 833037172 | HEALTHCARE | DE | N/A | C | 0 | |||||
| BOURGET HEALTH SERVICES INC | ||||||||||||||
| 101 W 8TH AVE TAF C-9 | SPOKANE | WA | 99204 | 911354431 | CLINICAL/MEDICAL LAB | WA | N/A | C | 0 | |||||
| CARON CORPORATION | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810486082 | MEDICAL PHYSICIAN SERVICE | MT | N/A | C | 0 | |||||
| CLOUD 21 LIMITED | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | HEALTHCARE | N/A | C | 0 | UK | ||||||
| COLBURN HILL GROUP INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 95057 | 863383433 | HEALTHCARE | DE | N/A | C | 0 | |||||
| ENDOSCOPY CENTER OF SOUTHERN CALIFORNIA | ||||||||||||||
| 1301 20TH ST STE 280 | SANTA MONICA | CA | 90404 | 952880495 | HEALTHCARE | CA | N/A | S | 0 | |||||
| HMR WEIGHT MANAGEMENT SERVICES CORP | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 463598718 | HEALTHCARE | WA | N/A | C | 0 | |||||
| HOAG MANAGEMENT SERVICES INC | ||||||||||||||
| 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 330731587 | HEALTHCARE | CA | N/A | C | 0 | |||||
| HOAG PHYSICIAN PARTNERS | ||||||||||||||
| 16148 SAND CANYON AVE | IRVINE | CA | 92618 | 834276044 | HEALTHCARE | CA | N/A | C | 0 | |||||
| KENSCI TECH INDIA PRIVATE LIMITED | ||||||||||||||
| 615 2ND AVE 700 | SEATTLE | WA | 98104 | HEALTHCARE | N/A | C | 0 | IN | ||||||
| KENSCI ASIA PACIFIC PTE LTD | ||||||||||||||
| 615 2ND AVE 700 | SEATTLE | WA | 98104 | HEALTHCARE | N/A | C | 0 | SN | ||||||
| LUBBOCK METHODIST HOSP PRACTICE MGMT | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752578995 | INACTIVE | TX | N/A | C | 0 | |||||
| LUBBOCK METHODIST HOSPITAL SVCS | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 752118585 | HEALTHCARE | TX | N/A | C | 0 | |||||
| LUMEDIC INC (FKA LUMEDIC ACQ CO INC) | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 833881097 | HEALTHCARE | WA | N/A | C | 0 | |||||
| MEDICAL SPECIALTIES MANAGERS INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330406218 | HEALTHCARE | WA | N/A | C | 0 | |||||
| MISSION VIEJO MEDICAL VENTURES INC | ||||||||||||||
| 27800 MEDICAL CENTER RD 354 | MISSION VIEJO | CA | 92691 | 330212905 | HEALTHCARE | CA | N/A | C | 0 | |||||
| PERFORMANCE HEALTH TECHNOLOGY LTD | ||||||||||||||
| 4400 NE HALSEY ST STE 609 ATTN ACCO | PORTLAND | OR | 97213 | 931211733 | HEALTHCARE | OR | N/A | C | 0 | |||||
| PHN HOLDINGS | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 461814184 | STRATEGIC PLANNING SERVICES | CA | N/A | C | 0 | |||||
| PROVIDENCE ASSURANCE INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 208194071 | CAPTIVE INSURANCE | AZ | N/A | C | 0 | |||||
| PROVIDENCE GLOBAL CENTER LLP | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 981516461 | IT SVCS | N/A | C | 0 | IN | |||||
| PROVIDENCE HEALTH CARE VENTURES INC | ||||||||||||||
| 101 W 8TH AVE TAF C-9 | SPOKANE | WA | 99204 | 900155714 | CLINICAL/MEDICAL LAB | WA | N/A | C | 0 | |||||
| PROVIDENCE HEALTH NETWORK | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 800886966 | PREPAID HEALTHCARE | CA | N/A | C | 0 | |||||
| PROVIDENCE PARTNERS HOLDINGS INC | ||||||||||||||
| 4400 NE HALSEY ST STE 609 ATTN ACCO | PORTLAND | OR | 97213 | 882962549 | INVESTMENT | DE | N/A | C | 0 | |||||
| PROVIDENCE PHYSICIAN SERVICES CO | ||||||||||||||
| 101 W 8TH AVE TAF C-9 | SPOKANE | WA | 99204 | 911216033 | HEALTHCARE | WA | N/A | C | 0 | |||||
| PROVIDENCE RE | ||||||||||||||
| INVESTMENT | N/A | C | 0 | 2ND FLR N BLDG 878 WEST BAY RD P | CJ | CJ | ||||||||
| PROVIDENCE ST JOSEPH HEALTH NETWORK | ||||||||||||||
| 20555 EARL ST | TORRANCE | CA | 90503 | 823771547 | HEALTHCARE | CA | N/A | C | 0 | |||||
| QUIVIQ INC | ||||||||||||||
| 1400-112TH AVENUE ST SUITE 100 | BELLEVUE | WA | 98004 | 833879444 | HEALTHCARE ANALYTICS | WA | N/A | C | 0 | |||||
| ST JOSEPH HEALTH | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 462340232 | HOLDING COMPANY | CA | N/A | C | 0 | |||||
| ST JOSEPH HEALTH SOURCE INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 461900168 | HEALTHCARE | CA | N/A | C | 0 | |||||
| ST JOSEPH MEDICAL PLAZA ASSOCIATION | ||||||||||||||
| 1140 W LA VETA STE 400 | ORANGE | CA | 92868 | 330621539 | CONDO ASSOCIATION | CA | N/A | C | 0 | |||||
| ST JOSEPH PROF SVCS ENTERPRSES INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 330155323 | HEALTHCARE | CA | N/A | C | 0 | |||||
| TEGRIA HOLDINGS LLC (FKA GRADY BLOCKER LLC) | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 842092143 | HOLDING COMPANY | DE | N/A | C | 0 | |||||
| TEGRIA INSIGHTS GROUP HOLDINGS INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 861400769 | HOLDING COMPANY | WA | N/A | C | 0 | |||||
| TEGRIA INSIGHTS GROUP INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 861532593 | HEALTHCARE | WA | N/A | C | 0 | |||||
| TEGRIA PRODUCTS GROUP INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 870995138 | HOLDING COMPANY | DE | N/A | C | 0 | |||||
| TEGRIA RCM GROUP INC (FKA PROV RCM GROUP INC) | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844686520 | HOLDING COMPANY | DE | N/A | C | 0 | |||||
| TEGRIA RCM GROUP US INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 863046450 | HOLDING COMPANY | DE | N/A | C | 0 | |||||
| TEGRIA SERVICES GROUP-CAN INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | HEALTHCARE | N/A | C | 0 | CA | ||||||
| TEGRIA SERVICES GROUP INC (FKA PROVIDENCE SERVICES GROUP) | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844704409 | HOLDING COMPANY | DE | N/A | C | 0 | |||||
| TEGRIA SERVICES GROUP-US INC (FKA BLUETREE NETWORK INC) | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 900872936 | HEALTHCARE | WI | N/A | C | 0 | |||||
| TRUSANA INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 922370159 | HEALTHCARE | DE | N/A | C | 0 | |||||
| VINSERRA INC | ||||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 953943315 | INVESTMENT | CA | N/A | C | 0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PROVIDENCE HEALTH & SERVICES - OREGON | ||
| B | $82,197 | COST |
| PROVIDENCE HEALTH & SERVICES - OREGON | ||
| C | $157,044 | COST |