WESTERN HEALTHCONNECT: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: WESTERN HEALTHCONNECT (EIN 45-4171900)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-11-15
IRS object ID: 202203199349302345
Schema version: 2021v4.2
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 C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-11-15T07:51:51-06:00	ReturnTs
Tax Period End	2021-12-31	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	2021-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	454171900	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WESTERN HEALTHCONNECT	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	WEST	BusinessNameControlTxt
Phone	4255253985	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1801 LIND AVE SW ATTN TAX DEPT	AddressLine1Txt
City	RENTON	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	98057	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	GREG HOFFMAN	PersonNm
Person Title	PRESIDENT/CEO & TREASURER	PersonTitleTxt
Phone	9493814000	PhoneNum
Signature	2022-11-15	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	GREG	PersonFirstNm
Person Last	HOFFMAN	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	ANDREW JAMESON	PreparerPersonNm
PTIN	P01894820	PTIN
Phone	4158948000	PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	3	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	GREG HOFFMAN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1801 LIND AVE SW ATTN TAX DEPT	AddressLine1Txt
City	RENTON	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	98057	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$179,298,426	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	HTTPS://WWW.PROVIDENCE.ORG/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2011	FormationYr
Legal Domicile State	WA	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE OSUPPORT SIGNIFICANT IMPROVEMENTS IN HEALTH CARE DELIVERY AND OUTCOMES WITHIN THE CONTEXT OF NONPROFIT, CHARITABLE OWNERSHIP.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	797	TotalEmployeeCnt
Total Volunteers	60	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$0	PYContributionsGrantsAmt
CY Contributions Grants	$2,386,528	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$145,007,913	CYProgramServiceRevenueAmt
PY Investment Income	$0	PYInvestmentIncomeAmt
CY Investment Income	$30,424,148	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$1,479,837	CYOtherRevenueAmt
PY Total Revenue	$0	PYTotalRevenueAmt
CY Total Revenue	$179,298,426	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$248	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$0	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$63,883,551	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$0	PYOtherExpensesAmt
CY Other Expenses	$87,237,676	CYOtherExpensesAmt
PY Total Expenses	$0	PYTotalExpensesAmt
CY Total Expenses	$151,121,475	CYTotalExpensesAmt
PY Revenues Less Expenses	$0	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$28,176,951	CYRevenuesLessExpensesAmt
Total Assets BOY	$0	TotalAssetsBOYAmt
Total Assets EOY	$161,037,338	TotalAssetsEOYAmt
Total Liabilities BOY	$5,138	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$28,614,034	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$5,138	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$132,423,304	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SUPPORT SIGNIFICANT IMPROVEMENTS IN HEALTH CARE DELIVERY AND OUTCOMES WITHIN THE CONTEXT OF NONPROFIT, CHARITABLE OWNERSHIP.	MissionDesc
Significant New Program Srvc	Yes (1)	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$136,682,457	ExpenseAmt
Grant	$248	GrantAmt
Revenue	$146,487,750	RevenueAmt
Desc	SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE PURSUE 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 - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF 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-HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA2021 WAS MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORTENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSOVER THE LAST TWO YEARS, PROVIDENCE ADVANCED A SOCIAL RESPONSIBILITY FRAMEWORK THAT INCLUDES A STRONGER COMMITMENT TO DIVERSITY, EQUITY, INCLUSION, AND ENVIRONMENTAL STEWARDSHIP. WE UPDATED OUR INTEGRATED STRATEGIC & FINANCIAL PLAN TO MORE CLEARLY EXPRESS 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. IN 2021, OUR SUSTAINABLE AND INCLUSIVE PURCHASING PROGRAM COMMITTED TO INCREASE OUR SPEND WITH WOMEN AND MINORITY OWNED BUSINESS ENTERPRISES BY OVER $300 MILLION ACROSS THE NEXT FIVE YEARS. WE ALSO DEPLOY AN INVESTING PORTFOLIO WHICH INCLUDES SHAREHOLDER ADVOCACY, IMPACT INVESTING, AND SOCIALLY CONSCIOUS PORTFOLIO SCREENS. IN 2021, PROVIDENCE MADE PROGRESS TOWARDS ITS CLIMATE COMMITMENT TO BECOME CARBON NEGATIVE BY 2030. WE ARE IMPLEMENTING AN ENVIRONMENTAL STEWARDSHIP SYSTEM STRATEGY THAT ENCOURAGES WASTE REDUCTIONS, EFFICIENT ENERGY AND WATER USE, LOCAL AGRICULTURE PARTNERSHIPS, LESS TOXIC AND FEWER CHEMICAL USE, AND A REDUCTION IN CARBON FROM TRAVEL.PETALUMA VALLEY HOSPITAL ("PVH") AND HEALDSBURG HOSPITAL ("HDH")PVH IS A COMMUNITY HOSPITAL FOUNDED IN 1980 BY THE PETALUMA HEALTHCARE DISTRICT, AND IS LOCATED IN PETALUMA, CA AND HAS 80 LICENSED BEDS AND A CAMPUS THAT IS 14.63 ACRES IN SIZE. PVH HAS A STAFF OF 501 EMPLOYEES AND PROFESSIONAL RELATIONS WITH MORE THAN 260 LOCAL PHYSICIANS. HDH IS A COMMUNITY HOSPITAL FOUNDED IN 1905 AND IS LOCATED IN HEALDSBURG, CA. PETALUMA VALLEY HOSPITAL CAME TOGETHER WITH PROVIDENCE HEALDSBURG TO FORM NORCAL HEALTHCONNECT.NORCAL HEALTHCONNECT AGREED TO PURCHASE PVH AND HDH TO ENSURE LOCAL RESIDENTS DO NOT LOSE ACCESS TO THEIR ACUTE CARE HOSPITALS WITH DEDICATED EMERGENCY SERVICES. WHILE NORCAL HEALTHCONNECT IS NEW, PROVIDENCE ST. JOSEPH HEALTH HAS DEEP ROOTS IN THE REGION. PVH HAS BEEN OPERATED BY A SUBSIDIARY OF PROVIDENCE ST. JOSEPH HEALTH FOR MORE THAN 20 YEARS AND HAS BEEN RECOGNIZED FOR ITS AWARD-WINNING CARE. NORCAL HEALTHCONNECT IS COMMITTED TO INVESTING IN THE FUTURE OF PVH AND HDH AND THE DESIRE TO FIND LONG-TERM STABILITY FOR THE SONOMA REGION.2021 PROGRAM SERVICE ACCOMPLISHMENTS: (JANUARY 1 - DECEMBER 31, 2021)CONTINUUM OF ORAL HEALTH SERVICES INCLUDE A FIXED SITE DENTAL CLINIC LOCATED IN SANTA ROSA THAT SERVES CHILDREN FROM THROUGHOUT THE COUNTY, THE MOBILE DENTAL CLINIC, THE MIGHTY MOUTH SCHOOL-BASED DENTAL DISEASE PREVENTION PROGRAM. THE CLINICS PRIORITIZE SERVICE TO CHILDREN AGES 0-16 YEARS, BUT ALSO SERVE ADULTS WITH URGENT NEEDS. THEY PROVIDE BASIC, PREVENTIVE, EMERGENCY AND COMPREHENSIVE DENTAL CARE WITH A STRONG FOCUS ON PREVENTION AND EDUCATION. DURING 2021, PATIENTS WERE SERVED OVER 237 ENCOUNTERS AT THE SJH DENTAL CLINIC. OUR MOBILE DENTAL CLINIC AND MIGHTY MOUTH SCHOOL-BASED PREVENTION PROGRAM COMPLETED 26 ENCOUNTERS.MOBILE MEDICAL CLINIC SERVES PATIENTS IN THEIR COMMUNITIES AT NO COST. THE PROGRAM SEEKS TO PROVIDE CARE TO THOSE WHO FALL THROUGH THE TRADITIONAL PRIMARY CARE SAFETY NET, AND FOR REASONS RELATED TO TRANSPORTATION, POVERTY, OR OTHER FACTORS, FACE INSURMOUNTABLE BARRIERS TO ACCESSING CARE AT COMMUNITY HEALTH CENTERS OR OTHER MEDICAL HOMES. THE CLINIC OFFERS HEALTH SCREENINGS, TREATMENT OF MINOR MEDICAL PROBLEMS, HEALTH AND NUTRITIONAL EDUCATION, AND INFORMATION AND REFERRALS. IN 2021, IN OUR SERVICE AREA, THE CLINIC SERVED PATIENTS OVER 54 ENCOUNTERS AT SEVERAL LOCATIONS, INCLUDING THE CITIES OF SONOMA/BOYES HOT SPRINGS, SANTA ROSA, AND WINDSOR. THE MOBILE HEALTH TEAM ALSO SERVED SEVERAL LOCAL HOMELESS SHELTERS, PROVIDING DIRECT PATIENT CARE IN THE SHELTERS.HOUSE CALLS PROGRAM TENDS TO THE PHYSICAL, SPIRITUAL AND EMOTIONAL NEEDS OF FRAIL ELDERLY SENIORS AND ADULTS WITH CHRONIC DISEASES BY PROVIDING PRIMARY MEDICAL CARE AT HOME. ELIGIBLE SENIORS HAVE LIMITED ACCESS TO CARE DUE TO IMPAIRED MOBILITY, UNDER-INSURANCE, AND LACK OF FUNDS. THE PROGRAM TEAM, WHICH INCLUDES NURSE PRACTICTIONERS, NURSES, CASE MANAGEMENT, AND HOME HEALTH ASSISTANCE, PROVIDED SERVICE TO PATIENTS AND COMPLETED OVER 186 ENCOUNTERS COUNTYWIDE, HELPING TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO EFFECTIVELY MANAGE CHRONIC DISEASE.	Desc
Total Program Service Expenses	$136,682,457	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	0	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	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	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	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	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	198	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	797	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
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	0	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	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JIM MARTIN	PersonNm
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 (29 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Key EmployeeKeyEmployeeInd
ROD F HOCHMAN MD
DIRECTOR	0.50	64.50	Yes (X)	$0	$8,639,819	$840,345
MIKE BUTLER
FORMER PRESIDENT	0.00	2.00		$0	$2,359,254	$7,651	Yes (X)
CINDY STRAUSS
FORMER SECRETARY	0.00	0.00		$0	$1,927,096	$17,855	Yes (X)
JO ANN ESCASA-HAIGH
EVP/ASSISTANT TREASURER	0.50	64.50		$0	$1,456,676	$262,400		Yes (X)
GREG HOFFMAN
PRESIDENT/CEO & TREASURER	0.50	64.50		$0	$1,407,278	$273,342		Yes (X)
JOHN WHIPPLE
SECRETARY	0.50	54.50		$0	$1,038,537	$185,449		Yes (X)
JIM WATSON ESQ
ASSISTANT SECRETARY	0.50	54.50		$0	$760,088	$126,854		Yes (X)
VENKAT BHAMIDIPATI
FORMER EVP/TREASURER	0.00	0.00		$0	$750,000	$0	Yes (X)
MICHAEL BOLLINGER
PHYSICIAN	50.00	0.00		$610,373	$0	$34,370			Yes (X)
VERONA DORCH
SECRETARY - THRU 3/21	1.00	54.00		$0	$515,954	$4,717		Yes (X)
JOSEPH TITO
PHYSICIAN	50.00	0.00		$402,661	$0	$3,674			Yes (X)
WENDI THOMAS
DIR, NURSING	50.00	0.00		$329,218	$0	$38,454			Yes (X)
DARIAN HARRIS
CE PETALUMA & HEALDSBURG	55.00	0.00		$288,685	$0	$23,082				Yes (X)
DAVID SOUTHERLAND
INTERIM COO SONOMA	55.00	0.00		$301,477	$0	$6,021				Yes (X)
BERTA KAEMMERLING
DIR, NURSING	50.00	0.00		$271,002	$0	$18,658			Yes (X)
MELANIE ELLIOTT-ELLER
MGR, QUALITY IMPROV & SAFETY	50.00	0.00		$247,352	$0	$20,856			Yes (X)
DONALD ANDERSON JR
ASSISTANT SECRETARY FOR ENROLLMENT	0.50	54.50		$0	$242,551	$24,080		Yes (X)
KURT MALMGREN
CFO PETALUMA & HEALDSBURG	55.00	0.00		$0	$195,664	$31,189				Yes (X)
RICHARD BLAIR
DIRECTOR	0.50	13.50	Yes (X)	$0	$90,000	$0
DAVE OLSEN
DIRECTOR	0.50	12.50	Yes (X)	$0	$50,000	$0
MARY LYONS PHD
BOARD CHAIR	1.00	25.00	Yes (X)	$0	$48,750	$0
CHARLES SORENSON MD
DIRECTOR	0.50	12.50	Yes (X)	$0	$40,000	$0
ISIAAH CRAWFORD PHD
DIRECTOR	0.50	14.00	Yes (X)	$0	$30,000	$0
MICHAEL MURPHY
DIRECTOR	0.50	12.50	Yes (X)	$0	$30,000	$0
KATHARIN DYER
DIRECTOR - THRU 8/21	0.50	12.50	Yes (X)	$0	$20,000	$0
SISTER CAROL PACINI LCM
DIRECTOR (PART YEAR)	0.50	12.50	Yes (X)	$0	$0	$0
SISTER DIANE HEJNA CSJ RN
DIRECTOR	0.50	12.50	Yes (X)	$0	$0	$0
SISTER LUCILLE DEAN SP
DIRECTOR	0.50	12.50	Yes (X)	$0	$0	$0
SISTER PHYLLIS HUGHES RSM DRPH
DIRECTOR	0.50	12.50	Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,450,768	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$19,601,667	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,918,997	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	195	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
AMN HEALTHCARE INC
2735 COLLECTION CENTER DR	CHICAGO	IL	60693	MEDICAL SERVICES	$4,445,958
MEDLINE INDUSTRIES INC
DEPT LA 21558	PASADENA	CA	91185	MEDICAL SERVICES	$1,771,617
CARDINAL HEALTH 411 INC
CO BANK OF AMERICA PO BOX 56412	LOS ANGELES	CA	90074	MEDICAL SERVICES	$1,522,460
PROVIDENCE MEDICAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	98057	MEDICAL SERVICES	$1,323,034
CASS INFORMATION SYSTEMS INC
12444 POWERSCOURT DR STE 550	ST LOUIS	MO	63131	TECHNOLOGY SERVICES	$888,923

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	53	CntrctRcvdGreaterThan100KCnt
Government Grants	$2,386,528	GovernmentGrantsAmt
Total Contributions	$2,386,528	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT REVENUE	621110	$144,990,983	$144,990,983
MOB RENTAL REVENUE	900099	$16,930	$16,930

Field	Value	IRS element (for citing)
Total Program Service Revenue	$145,007,913	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$30,421,999	TotalRevenueColumnAmt
Exclusion	$30,421,999	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,149	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	$2,149	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,149	TotalRevenueColumnAmt
Exclusion	$2,149	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA REVENUE	722514	$238,262	$238,262
REBATES & REFUNDS	900099	$28,627	$28,627
MEDICAL RECORD REVENUE	900099	$5,365	$5,365

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,207,583	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,207,583	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,479,837	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$179,298,426	TotalRevenueColumnAmt
Related Or Exempt Func Income	$146,487,750	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$30,424,148	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$248	TotalAmt
Program Services	$248	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$619,265	TotalAmt
Program Services	$558,515	ProgramServicesAmt
Management And General	$60,750	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$55,370,062	TotalAmt
Program Services	$49,938,259	ProgramServicesAmt
Management And General	$5,431,803	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,205,101	TotalAmt
Program Services	$1,086,881	ProgramServicesAmt
Management And General	$118,220	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,347,073	TotalAmt
Program Services	$2,116,825	ProgramServicesAmt
Management And General	$230,248	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,342,050	TotalAmt
Program Services	$3,916,095	ProgramServicesAmt
Management And General	$425,955	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,307,140	TotalAmt
Management And General	$1,307,140	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$15,201	TotalAmt
Program Services	$13,710	ProgramServicesAmt
Management And General	$1,491	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$30,176,914	TotalAmt
Program Services	$27,216,559	ProgramServicesAmt
Management And General	$2,960,355	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$18,756	TotalAmt
Program Services	$16,916	ProgramServicesAmt
Management And General	$1,840	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,126,833	TotalAmt
Program Services	$2,820,091	ProgramServicesAmt
Management And General	$306,742	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,685,519	TotalAmt
Program Services	$2,422,070	ProgramServicesAmt
Management And General	$263,449	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$57,565	TotalAmt
Program Services	$51,918	ProgramServicesAmt
Management And General	$5,647	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$35,651	TotalAmt
Program Services	$32,154	ProgramServicesAmt
Management And General	$3,497	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,264	TotalAmt
Program Services	$1,140	ProgramServicesAmt
Management And General	$124	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$8,281,885	TotalAmt
Program Services	$7,469,432	ProgramServicesAmt
Management And General	$812,453	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$274,773	TotalAmt
Program Services	$247,818	ProgramServicesAmt
Management And General	$26,955	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
SYSTEM COST ALLOCATION	$23,696,097	$21,371,510	$2,324,587
MEDICAL SUPPLIES	$11,885,507	$11,885,507
HOSPITAL FEE	$4,066,417	$4,066,417
LICENSES & TAXES	$654,819	$590,581	$64,238

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$953,335	TotalAmt
Program Services	$859,811	ProgramServicesAmt
Management And General	$93,524	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$151,121,475	TotalAmt
Program Services	$136,682,457	ProgramServicesAmt
Management And General	$14,439,018	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
EOY	$127,514	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
EOY	$40,838,894	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
EOY	$40,000	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
EOY	$28,192,117	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
EOY	$2,524,487	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
EOY	$471,586	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$127,406,062	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$52,612,160	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$74,793,902	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
EOY	$246,389	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$13,802,449	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$161,037,338	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
EOY	$12,669,644	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
EOY	$71,014	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,138	BOYAmt
EOY	$15,873,376	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,138	BOYAmt
EOY	$28,614,034	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	-$5,138	BOYAmt
EOY	$131,740,816	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
EOY	$682,488	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$5,138	BOYAmt
EOY	$132,423,304	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$161,037,338	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$28,176,951	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$104,251,491	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)
Hospital	Yes (X)	HospitalInd

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$6,067	OtherActivitiesAmt
Total Lobbying Expenditures	$6,067	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1, LOBBYING ACTIVITIES:	FormAndLineReferenceDesc
Explanation	THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES PAID TO AMERICAN HOSPITAL ASSOCIATION, ALLIANCE OF CATHOLIC HEALTH CARE AND CALIFORNIA HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,147,766	OtherCostOrOtherBasisAmt
Book Value	$3,147,766	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$70,679,672	OtherCostOrOtherBasisAmt
Depreciation	$14,726,680	DepreciationAmt
Book Value	$55,952,992	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$11,776,240	OtherCostOrOtherBasisAmt
Depreciation	$7,728,193	DepreciationAmt
Book Value	$4,048,047	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$37,741,388	OtherCostOrOtherBasisAmt
Depreciation	$30,157,287	DepreciationAmt
Book Value	$7,584,101	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,060,996	OtherCostOrOtherBasisAmt
Book Value	$4,060,996	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$74,793,902	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
HOSPITAL FEE/PROVIDER TAX RECEIVABLE	$12,895,062
RIGHT OF USE OPERATING LEASES	$279,868
OTHER ASSETS	$627,519

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$13,802,449	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
OTHER LIABILITIES	$9,596,499
HOSPITAL FEE/PROVIDER TAX LIABILITY	$3,762,979
DUE TO AFFILIATES	$2,547,632
CAPITAL LEASE OBLIGATIONS	$334,000
ACCRUED RETIREMENT COMPENSATION	$246,389
DUE TO THIRD PARTY	-$614,123

Field	Value	IRS element (for citing)
Total Liability	$15,873,376	TotalLiabilityAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
Indiv Hospital Tailored Policy	Yes (X)	IndivHospitalTailoredPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	300.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent350	Yes (X)	Percent350Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,311,870	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,311,870	NetCommunityBenefitExpnsAmt
Total Expense	0.01530	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$35,754,757	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$27,679,119	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,075,638	NetCommunityBenefitExpnsAmt
Total Expense	0.05340	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$82,469	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$69,485	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,984	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$38,149,096	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$27,748,604	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,400,492	NetCommunityBenefitExpnsAmt
Total Expense	0.06880	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$495,808	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$49,318	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$446,490	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,004,953	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$466,232	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$538,721	NetCommunityBenefitExpnsAmt
Total Expense	0.00360	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$252,448	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$252,448	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,753,209	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$515,550	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,237,659	NetCommunityBenefitExpnsAmt
Total Expense	0.00830	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$39,902,305	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$28,264,154	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,638,151	NetCommunityBenefitExpnsAmt
Total Expense	0.07710	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Reimbursed By Medicare	$29,675,023	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$43,974,189	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$14,299,166	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost Accounting System	Yes (X)	CostAccountingSystemInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Critical Access HospitalCriticalAccessHospitalInd
PETALUMA VALLEY HOSPITAL
1	400 NORTH MCDOWELL BLVD	PETALUMA	CA	94954	WWW.PROVIDENCE.ORG/OBP/NORCAL	110000001	Yes (X)	Yes (X)	Yes (X)
HEALDSBURG HOSPITAL
2	1375 UNIVERSITY AVE	HEALDSBURG	CA	95448	WWW.HEALDSBURGDISTRICTHOSPITAL.ORG/	110000019	Yes (X)	Yes (X)	Yes (X)	Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNum	First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	Prior CHNA ImpactPriorCHNAImpactInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Insurance Status CriteriaInsuranceStatusCriteriaInd	Underinsurance Stat CriteriaUnderinsuranceStatCriteriaInd	Other CriteriaOtherCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP Available On Website URLFAPAvailableOnWebsiteURLTxt	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt	FAP Summary On WebsiteFAPSummaryOnWebsiteInd	FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd	Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd	Communtity Notified FAPCommuntityNotifiedFAPInd	FAP TranslatedFAPTranslatedInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Permit No ActionsPermitNoActionsInd	Collection ActivitiesCollectionActivitiesInd	Provided Written NoticeProvidedWrittenNoticeInd	Made Effort Orally NotifyMadeEffortOrallyNotifyInd	Processed FAP ApplicationProcessedFAPApplicationInd	Made Presumptive Elig DetermMadePresumptiveEligDetermInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Look Back Medicare PrivateLookBackMedicarePrivateInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd	Provided Nonprofit ContactProvidedNonprofitContactInd	Prospective Medicare MedicaidProspectiveMedicareMedicaidInd
PETALUMA VALLEY HOSPITAL
1	0	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	21	Yes (1)	Yes (1)	Yes (1)	Yes (1)	Yes (X)	SEE PART V, SECTION C	Yes (X)	Yes (1)	21	Yes (1)	SEE PART V, SECTION C	0	Yes (1)	Yes (X)	300.000000000000	350.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	SEE PART V, SECTION C	Yes (X)	SEE PART V, SECTION C	Yes (X)	SEE PART V, SECTION C	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (1)
HEALDSBURG HOSPITAL
2	0	Yes (1)	0																						0	Yes (1)	Yes (X)	200.000000000000	500.000000000000	Yes (X)	Yes (X)	Yes (X)	Yes (X)		Yes (1)	Yes (1)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	SEE PART V, SECTION C	Yes (X)	SEE PART V, SECTION C	Yes (X)	SEE PART V, SECTION C	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)	Yes (X)	0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (1)		0	0	Yes (X)	Yes (X)

Supplemental Information SupplementalInformationGrp (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PETALUMA VALLEY HOSPITAL	PART V, SECTION B, LINE 2: NORCAL HEALTHCONNECT LLC, A DISREGARDED ENTITY WHOSE SINGLE MEMBER IS WESTERN HEALTHCONNECT, PURCHASED THE PETALUMA VALLEY HOSPITAL FACILITY, WHICH INCLUDED THE PETALUMA VALLEY HOSPITAL FACILITY HOSPITAL LICENSE.
HEALDSBURG HOSPITAL	PART V, SECTION B, LINE 2: NORCAL HEALTHCONNECT LLC, A DISREGARDED ENTITY WHOSE SINGLE MEMBER IS WESTERN HEALTHCONNECT, PURCHASED THE HEALDSBURG HOSPITAL FACILITY, WHICH INCLUDED THE HEALDSBURG HOSPITAL FACILITY HOSPITAL LICENSE.
PETALUMA VALLEY HOSPITAL	PART V, SECTION B, LINE 3J: PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE PRIORITIZED BASED ON THE METHODOLOGY DESCRIBED IN THE MOST RECENT CHNA SECTION ON SIGNIFICANT HEALTH NEEDS.
PETALUMA VALLEY HOSPITAL	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS IS BASED ON THE UNDERSTANDING THAT HEALTH AND WELLNESS ARE INFLUENCED BY FACTORS WITHIN OUR COMMUNITIES, NOT ONLY WITHIN MEDICAL FACILITIES. IN GATHERING INFORMATION ON THE COMMUNITIES SERVED BY SRMH AND PVH, WE LOOKED NOT ONLY AT THE HEALTH CONDITIONS OF THE POPULATION, BUT ALSO AT SOCIOECONOMIC FACTORS, THE PHYSICAL ENVIRONMENT, AND HEALTH BEHAVIORS. WE ALSO INVITED KEY STAKEHOLDERS AND COMMUNITY MEMBERS TO PROVIDE ADDITIONAL CONTEXT TO THE QUANTITATIVE DATA THROUGH QUALITATIVE DATA IN THE FORM OF INTERVIEWS AND LISTENING SESSIONS. AS OFTEN AS POSSIBLE, EQUITY IS AT THE FOREFRONT OF OUR CONVERSATIONS AND PRESENTATION OF THE DATA, WHICH OFTEN HAVE BIASES BASED ON COLLECTION METHODOLOGY.IN ADDITION, WE RECOGNIZE THAT THERE ARE OFTEN GEOGRAPHIC AREAS WHERE THE CONDITIONS FOR SUPPORTING HEALTH ARE SUBSTANTIALLY POORER THAN NEARBY AREAS. WHENEVER POSSIBLE AND RELIABLE, DATA ARE REPORTED AT THE ZIP CODE OR CENSUS BLOCK GROUP LEVEL. THESE SMALLER GEOGRAPHIC AREAS ALLOW US TO BETTER UNDERSTAND THE NEIGHBORHOOD LEVEL NEEDS OF OUR COMMUNITIES AND BETTER ADDRESS HEALTH DISPARITIES WITHIN AND ACROSS COMMUNITIES.WE REVIEWED DATA FROM THE AMERICAN COMMUNITY SURVEY AND LOCAL PUBLIC HEALTH AUTHORITIES. IN ADDITION, WE INCLUDE HOSPITAL UTILIZATION DATA TO IDENTIFY DISPARITIES IN UTILIZATION BY INCOME AND INSURANCE, GEOGRAPHY, AND RACE/ETHNICITY WHEN RELIABLY COLLECTED.COMMUNITY INPUT:TO BETTER UNDERSTAND THE UNIQUE PERSPECTIVES, OPINIONS, EXPERIENCES, AND KNOWLEDGE OF COMMUNITY MEMBERS, REPRESENTATIVES FROM SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS CONDUCTED 11 STAKEHOLDER INTERVIEWS WITH REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS, INCLUDING 12 PARTICIPANTS FROM JUNE TO JULY 2020. DURING THESE INTERVIEWS, NONPROFIT AND GOVERNMENT STAKEHOLDERS DISCUSSED THE ISSUES AND OPPORTUNITIES OF THE PEOPLE, NEIGHBORHOODS, AND CITIES OF THE SERVICE AREA.THESE 2020 QUALITATIVE FINDINGS SUPPLEMENT THE QUALITATIVE DATA FROM THE 2019 SONOMA COUNTY COLLABORATIVE CHNA COLLECTED FROM AUGUST TO NOVEMBER 2018.OBTAINING ROBUST COMMUNITY INPUT DURING THE COVID-19 PANDEMIC WAS ESPECIALLY CHALLENGING AND PREVENTED SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS FROM COMPLETING ANY IN-PERSON CONVERSATIONS. WHILE STAKEHOLDER INTERVIEWS WERE EASILY ADAPTED TO A VIRTUAL SETTING THROUGH A VIDEO CONFERENCING PLATFORM, IT WAS NOT FEASIBLE TO HOST LISTENING SESSIONS COMPRISED OF COMMUNITY MEMBERS IN THIS SAME WAY. WHILE VIDEO CONFERENCING DOES FACILITATE INFORMATION SHARING, THERE ARE CHALLENGES CREATING THE LEVEL OF DIALOGUE THAT WOULD TAKE PLACE IN PERSON. ADDITIONALLY, DUE TO MANY COMMUNITY ORGANIZATIONS ENGAGING IN COVID-19 RESPONSE, SOME ORGANIZATIONS HAD LIMITED CAPACITY AND WERE NOT ABLE TO PARTICIPATE IN INTERVIEWS.NONPROFIT AND GOVERNMENT STAKEHOLDER INTERVIEWS:A TOTAL OF 11 STAKEHOLDER INTERVIEWS WERE COMPLETED BY REPRESENTATIVES FROM SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS. STAKEHOLDERS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND ENGAGEMENT IN WORK THAT DIRECTLY SERVES PEOPLE WHO HAVE LOW INCOMES, HAVE CHRONIC CONDITIONS, AND/OR ARE MEDICALLY UNDERSERVED. SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS AIMED TO ENGAGE STAKEHOLDERS FROM SOCIAL SERVICE AGENCIES, HEALTH CARE, EDUCATION, HOUSING, AND GOVERNMENT, AMONG OTHERS, TO ENSURE A WIDE RANGE OF PERSPECTIVES. INCLUDED IN THE INTERVIEWS WAS A REPRESENTATIVE FROM THE SONOMA COUNTY HUMAN SERVICES DEPARTMENT.DATA LIMITATIONS AND INFORMATION GAPS:WHILE CARE WAS TAKEN TO SELECT AND GATHER DATA THAT WOULD TELL THE STORY OF THE HOSPITAL'S SERVICE AREA, IT IS IMPORTANT TO RECOGNIZE THE LIMITATIONS AND GAPS IN INFORMATION THAT NATURALLY OCCUR.- NOT ALL DESIRED DATA WERE READILY AVAILABLE, SO SOMETIMES WE HAD TO RELY ON TANGENTIAL OR PROXY MEASURES OR NOT HAVE ANY DATA AT ALL. FOR EXAMPLE, THERE IS LITTLE COMMUNITYLEVEL DATA ON THE INCIDENCE OF MENTAL HEALTH OR SUBSTANCE ABUSE.- DATA THAT ARE GATHERED THROUGH INTERVIEWS AND SURVEYS MAY BE BIASED DEPENDING ON WHO IS WILLING TO RESPOND TO THE QUESTIONS AND WHETHER THEY ARE REPRESENTATIVE OF THE POPULATION AS A WHOLE.- THE ACCURACY OF DATA GATHERED THROUGH INTERVIEWS AND SURVEYS DEPENDS ON HOW CONSISTENTLY THE QUESTIONS ARE INTERPRETED ACROSS ALL RESPONDENTS AND HOW HONEST PEOPLE ARE IN PROVIDING THEIR ANSWERS.- WHILE MOST INDICATORS ARE RELATIVELY CONSISTENT FROM YEAR TO YEAR, OTHER INDICATORS ARE CHANGING QUICKLY (SUCH AS PERCENTAGE OF PEOPLE UNINSURED) AND THE MOST RECENT DATA AVAILABLE ARE NOT A GOOD REFLECTION OF THE CURRENT STATE.- INFORMATION GATHERED DURING STAKEHOLDER INTERVIEWS AND CAREGIVER LISTENING SESSIONS IS DEPENDENT ON WHO WAS INVITED AND WHO PARTICIPATED. EFFORTS WERE MADE TO INCLUDE PEOPLE WHO COULD REPRESENT THE BROAD INTERESTS OF THE COMMUNITY AND/OR WERE REPRESENTATIVE OF COMMUNITIES OF GREATEST NEED.
PETALUMA VALLEY HOSPITAL	PART V, SECTION B, LINE 6A: MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE HOSPITAL FACILITIES:- SUTTER HEALTH- KAISER PERMANENTE- SONOMA WEST MEDICAL CENTER
PETALUMA VALLEY HOSPITAL	PART V, SECTION B, LINE 6B: MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:- SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES- COMMUNITY CHILD CARE COUNCIL (4CS) OF SONOMA COUNTY- FIRST 5 SONOMA COUNTY- BURBANK HOUSING- COMMUNITY FOUNDATION SONOMA COUNTY- SONOMA COUNTY SHERIFF'S OFFICE- CITY OF SANTA ROSA VIOLENCE PREVENTION PARTNERSHIP- COMMUNITY ACTION PARTNERSHIP OF SONOMA- SONOMA COUNTY ACES CONNECTION- SONOMA COUNTY ECONOMIC DEVELOPMENT BOARD- SONOMA COUNTY PERMIT & RESOURCE MANAGEMENT DEPARTMENT- SONOMA COUNTY ENVIRONMENTAL HEALTH & SAFETY- BUCKELEW PROGRAMS- SONOMA COUNTY OFFICE OF EDUCATION- SONOMA COUNTY COMMUNITY DEVELOPMENT COMMISSION- LA LUZ COMMUNITY CENTER- PETALUMA PEOPLE SERVICES CENTER- SANTA ROSA COMMUNITY HEALTH CENTERS- WEST COUNTY HEALTH CENTERS- PETALUMA HEALTH CARE DISTRICT- PETALUMA HEALTH CENTER- ALLIANCE MEDICAL CENTER- PALM DRIVE HEALTH CARE DISTRICT- NORTH SONOMA COUNTY HEALTH CARE DISTRICT- SONOMA VALLEY HEALTH CARE DISTRICT- RUSSIAN RIVER ARE RESOURCES AND ADVOCATES- COMMUNITY HEALTH INITIATIVE OF THE PETALUMA AREA- LATINO SERVICE PROVIDERS- SONOMA COUNTY HUMAN SERVICES DEPARTMENT- SONOMA COUNTY TASK FORCE ON THE HOMELESS- SONOMA COUNTY HEALTH CARE FOR THE HOMELESS COALITION- MENDOCINO COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES- HEALTH MENDOCINO
PETALUMA VALLEY HOSPITAL	PART V, SECTION B, LINE 11: COMMUNITY HEALTH NEEDS PRIORITIZED:1) HOUSING INSTABILITY & HOMELESSNESS2) MENTAL HEALTH & SUBSTANCE USE3) HEALTH EQUITY: RACISM & DISCRIMINATION4) ACCESS TO HEALTH CAREHOUSING INSTABILITY & HOMELESSNESS:THE COST OF LIVING IN SONOMA COUNTY OUTPACES THE INCOME FOR MANY PEOPLE IN THE COMMUNITY, MAKING IT CHALLENGING FOR FAMILIES TO MEET THEIR BASIC NEEDS. HOUSING IS FOUNDATIONAL TO ONE'S HEALTH: PEOPLE WHO ARE STABLY HOUSED ARE BETTER ABLE TO CARE FOR THEIR PHYSICAL AND MENTAL HEALTH. THOSE MOST IMPACTED BY HOUSING STABILITY AND AFFORDABILITY ARE THE LATINO/A COMMUNITY DUE TO INCOME INEQUITIES; YOUTH EXPERIENCING HOMELESSNESS, ESPECIALLY THOSE IDENTIFYING AS LGBTQ+; AND OLDER ADULTS WHOSE FIXED INCOME LIMITS THEIR ABILITY TO AFFORD LOCAL HOUSING PRICES. THERE IS ALSO NEED FOR SUPPORTIVE HOUSING, USING A HOUSING FIRST APPROACH, FOR PEOPLE WITH MENTAL HEALTH CHALLENGES, SUBSTANCE USE DISORDERS, AND OTHER SPECIAL NEEDS. THERE ARE ESPECIALLY FEW RESOURCES FOR PEOPLE WHO ARE UNDOCUMENTED.MENTAL HEALTH & SUBSTANCE USE:ACCESSING QUALITY MENTAL HEALTH AND SUBSTANCE USE SERVICES CAN BE A CHALLENGE FOR MANY. TRAUMA FROM THE RECENT FIRES, COVID-19, AND THE CURRENT POLITICAL CLIMATE CONTRIBUTE TO THE COMMUNITY MENTAL HEALTH NEEDS. THERE IS A PARTICULAR NEED FOR MILD TO MODERATE MENTAL HEALTH SERVICES, PERINATAL MENTAL HEALTH SERVICES, MORE WRAPAROUND CASE MANAGEMENT FOR FAMILIES TO ADDRESS MENTAL HEALTH, AND MORE SUBSTANCE USE DISORDER TREATMENT SERVICES. THERE IS FURTHER NEED FOR MORE BILINGUAL AND BICULTURAL MENTAL HEALTH PROFESSIONALS TO SERVE THE LATINO/A COMMUNITY, INCLUDING THOSE THAT ARE UNDOCUMENTED. SCHOOL-AGE CHILDREN AND OLDER ADULTS ARE TWO ADDITIONAL GROUPS WITH UNMET MENTAL HEALTH NEEDS. MAJOR BARRIERS TO ACCESSING MENTAL HEALTH SERVICES INCLUDE INSURANCE COVERAGE LIMITATIONS, COST OF CARE, AND SHORTAGE OF PROVIDERS RESULTING IN LONG WAIT TIMES FOR APPOINTMENTS.HEALTH EQUITY: RACISM & DISCRIMINATION:STAKEHOLDERS DESCRIBED BEING AT AN "INFLECTION POINT" IN ACKNOWLEDGING AND ADDRESSING RACISM IN THE COMMUNITY, WITH MORE PEOPLE TALKING ABOUT THE ISSUE. THEY SHARED RACISM KEEPS PEOPLE IN POVERTY BY LIMITING EDUCATION AND JOB OPPORTUNITIES, LEADING TO MORE BLACK, INDIGENOUS, AND PEOPLE OF COLOR (BIPOC) WORKING IN LOWER-WAGE JOBS, WITH PARTICULAR EMPHASIS ON THE LATINO/A COMMUNITY IN SONOMA COUNTY. HOUSING DISCRIMINATION PREVENTS THE LATINO/A COMMUNITY FROM ACCESSING GOOD-QUALITY, AFFORDABLE HOUSING. RACISM CONTRIBUTES TO INEQUITIES IN THE WAYS DIFFERENT SCHOOLS ARE FUNDED, CONTRIBUTING TO THE OPPORTUNITY GAP. STAKEHOLDERS SHARED PARTICULAR CONCERN FOR THE WAYS IN WHICH XENOPHOBIA AND RACIST POLICIES NEGATIVELY AFFECT THE MENTAL HEALTH AND ECONOMIC SECURITY OF THE LATINO/A COMMUNITY.ACCESS TO HEALTH CARE:STAKEHOLDERS DISCUSSED THE NEED FOR MORE AFFORDABLE HEALTH CARE, AS WELL AS CHALLENGES ACCESSING PRIMARY AND SPECIALTY CARE. THEY NOTED A PARTICULAR NEED FOR MORE CASE MANAGEMENT AND NAVIGATION RESOURCES, ESPECIALLY FOR SPANISH-SPEAKING PATIENTS AND NEW PARENTS. TRANSPORTATION TO CARE IS A CONSISTENT BARRIER FOR MANY, BUT ESPECIALLY OLDER ADULTS. FEARS OF IMMIGRATION ENFORCEMENT AND CHANGES IN PUBLIC CHARGE RULES MAY PREVENT MIXED STATUS HOUSEHOLDS FROM APPLYING FOR MEDI-CAL. A LACK OF CULTURALLY RESPONSIVE AND LINGUISTICALLY APPROPRIATE HEALTH CARE SERVICES AND DOCUMENTATION STATUS MAY PREVENT THE LATINO/A COMMUNITY FROM RECEIVING THE CARE THEY NEED.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM:NO SINGLE HOSPITAL FACILITY CAN FULLY ADDRESS ALL THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WHILE SANTA ROSA MEMORIAL WILL EMPLOY STRATEGIES TO ADDRESS EACH OF THE FOUR SIGNIFICANT HEALTH NEEDS THAT WERE PRIORITIZED DURING THE CHNA PROCESS, PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS AND GOVERNMENT AGENCIES ARE CRITICAL FOR ACHIEVING THE ESTABLISHED GOALS.PETALUMA VALLEY HOSPITAL WILL COLLABORATE WITH PETALUMA PEOPLE SERVICES CENTER, LA LUZ CENTER, WEST COUNTY COMMUNITY SERVICES, COMMUNITY ACTION PARTNERSHIP OF SONOMA COUNTY, AND A VARIETY OF LOCAL FAMILY RESOURCE CENTERS THAT ADDRESS THE COMMUNITY NEEDS TO COORDINATE CARE AND REFERRALS TO ADDRESS UNMET NEEDS.WITH RESPECT TO SOME OF THE OTHER NEEDS IDENTIFIED IN THE CHNA PROCESS THAT WERE NOT PRIORITIZED FOR ACTION THROUGH THIS PLAN, WE INTEND TO REMAIN ENGAGED IN ADDRESSING: ORAL HEALTH NEEDS THROUGH OUR ONGOING ST. JOSEPH HEALTH COMMUNITY DENTAL CLINIC AND MOBILE DENTAL CLINIC; CRIME AND SAFETY THROUGH OUR CONTINUED INVOLVEMENT ON THE SANTA ROSA VIOLENCE PREVENTION PARTNERSHIP; AND INSURANCE AND COST OF CARE THROUGH OUR CONTINUED INVOLVEMENT ON THE COVERED SONOMA AND SONOMA HEALTH ACTION COMMUNITY HEALTH IMPROVEMENT COMMITTEES. WE ALSO INTEND TO INCORPORATE OTHER ISSUES SUCH AS EARLY CHILDHOOD DEVELOPMENT IN OUR BEHAVIORAL HEALTH STRATEGY AS IT IS SUCH A FUNDAMENTAL DETERMINANT OF MENTAL HEALTH LATER IN LIFE AND ECONOMIC INSECURITY IN OUR HOUSING CONCERNS STRATEGY AS IT IS A NECESSARY INGREDIENT IN HOUSING AFFORDABILITY. SIMILARLY, WITH RESPECT TO IMMIGRATION, WE LACK APPROPRIATE EXPERTISE OR COMPETENCY TO OFFER A PROGRAM. AND WHILE FOOD AND NUTRITION IS NOT TO BE DIRECTLY ADDRESSED BY OUR OWN PROGRAMMING, WE ANTICIPATE THAT OUR ONGOING SUPPORT OF LOCAL INITIATIVES AND ORGANIZATIONS INVOLVED IN CARDIOVASCULAR DISEASE PREVENTION WILL INCLUDES A CONSIDERATION AND INCLUSION OF STRATEGIES TO ADDRESS THIS NEED.FURTHERMORE, WE WILL CONTINUE FUNDING OTHER LOCAL NONPROFIT ORGANIZATIONS THROUGH GRANTS FROM OUR CARE FOR THE POOR PROGRAM MANAGED BY THE SRMH COMMUNITY HEALTH INVESTMENT DEPARTMENT, AND WE WILL ENCOURAGE AND ENDORSE LOCAL NONPROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT THE SRMH SERVICE AREAS.
PETALUMA VALLEY HOSPITAL	PART V, SECTION B, LINE 13H: THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE.
PETALUMA VALLEY HOSPITAL	PART V, SECTION B, LINE 24: FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES.
PART V, SECTION B, LINE 7A:	CHNA REPORT WEBSITEHTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTS
PART V, SECTION B, LINE 10A:	IMPLEMENTATION STRATEGY WEBSITEHTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTS
SCHEDULE H PART V, LINE 13A:	PETALUMA VALLEY HOSPITAL1/1/2021 - 09/17/2021 PETALUMA VALLEY HOSPITAL 100% DISCOUNT WAS UP TO 200% FPL AND 75% DISCOUNT BETWEEN 201% TO 500% FPL.EFFECTIVE 09/18/21 THROUGH 12/31/2021, PETALUMA VALLEY HOSPITAL 100% DISCOUNT WAS UP TO 300% FPL AND 75% DISCOUNT BETWEEN 301% TO 350% FPL.
SCHEDULE H, PART V, SECTION B, LINE 16A:	PETALUMA VALLEY HOSPITALFINANCIAL ASSISTANCE POLICYHTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCEHEALDSBURG HOSPITALFINANCIAL ASSISTANCE POLICYHTTPS://HEALDSBURGDISTRICTHOSPITAL.ORG/PATIENT-SUPPORT/
SCHEDULE H, PART V, SECTION B, LINE 16B:	PETALUMA VALLEY HOSPITALFINANCIAL ASSISTANCE APPLICATIONHTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCEHEALDSBURG HOSPITALFINANCIAL ASSISTANCE APPLICATIONHTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCE
SCHEDULE H, PART V, SECTION B, LINE 16C:	PETALUMA VALLEY HOSPITALFAP PLAIN LANGUAGE SUMMARYHTTPS://WWW.PROVIDENCE.ORG/OBP/NORCAL/FINANCIAL-ASSISTANCEHEALDSBURG HOSPITALFAP PLAIN LANGUAGE SUMMARYHTTPS://HEALDSBURGDISTRICTHOSPITAL.ORG/PATIENT-SUPPORT/
SCHEDULE H PART V, LINE 22A AND 22D:	PETALUMA VALLEY HOSPITALPRIOR TO 9/18/2021 PETALUMA VALLEY HOSPITAL USED THE PROSPECTIVE MEDICARE OR MEDICAID AGB METHOD.EFFECITVE 9/18/2021 PETALUMA VALLEY HOSPITAL WENT LIVE ON EPIC AND MOVED TO THE LOOK BACK METHOD BASED ON CLAIMS ALLOWED BY MEDICARE FEE FOR SERVICE AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO THE HOSPITAL FACILITY DURING A PRIOR 12 MONTH PERIOD.

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS.
PART I, LINE 6A:	PETALUMA VALLEY HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT: HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/NORCAL/PETALUMA-VALLEY-HOSPITAL/ABOUT-US#TABCONTENT-1-COLLAPSE-3
PART I, LINE 7:	THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING A COST-TO-CHARGE RATIO USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
PART I, LINE 7G:	NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIES:CHI SONOMA COUNTY IDENTIFIED THE NEED TO HOLD HEALTHCARE AND COMMUNITY-BASED ORGANIZATIONAL WEEKLY CONVENINGS. THESE MEETINGS INCREASED COMMUNICATIONS BETWEEN HOSPITAL PARTNERS AND ASSISTED WITH THROUGHPUT FOR OUR PATIENTS REENTERING THE COMMUNITY AFTER HOSPITAL ADMISSIONS. PROVIDENCE CHI SONOMA STAFF HAS CONTINUED TO CONVENE AND FACILITATE THESE MEETINGS WHICH HAVE BECOME A STANDARD COMMUNICATION PIPELINE FOR SONOMA COUNTY CLINICIANS AND ORGANIZATIONS.
PART III, LINE 9B:	PETALUMA VALLEY HOSPITALCOLLECTION ACTIVITY:OUR FINANCIAL ASSISTANCE POLICY INCLUDES BILLING AND COLLECTIONS DETAILS. COLLECTION EFFORTS ON UNPAID BALANCES WILL CEASE PENDING FINAL DETERMINATION OF FAP ELIGIBILITY. PROVIDENCE DOES NOT PERFORM, ALLOW, OR ALLOW COLLECTION AGENCIES TO PERFORM ANY EXTRAORDINARY COLLECTION ACTIONS PRIOR TO MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. IT IS STANDARD PRACTICE TO CEASE COLLECTION ACTIVITIES FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THIS INFORMATION IS INCLUDED IN OUR CHARITY POLICY HOWEVER THIS DETAIL IS NOT ADDRESSED IN OUR COLLECTION POLICY.HEALDSBURG HOSPITALCOLLECTION ACTIVITY:PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE.
PART VI, LINE 2:	THROUGH A MIXED-METHODS APPROACH USING QUANTITATIVE AND QUALITATIVE DATA, THE CHNA PROCESS USED SEVERAL SOURCES OF INFORMATION TO IDENTIFY COMMUNITY NEEDS. ACROSS SONOMA COUNTY, INFORMATION COLLECTED INCLUDES PUBLIC HEALTH DATA REGARDING HEALTH BEHAVIORS, MORBIDITY AND MORTALITY, AND HOSPITAL-LEVEL DATA. IN 2019, ST. JOSEPH HEALTH SONOMA PARTNERED WITH SUTTER HEALTH AND KAISER PERMANENTE TO GATHER DATA FROM LISTENING SESSIONS AND INTERVIEWS WITH DIVERSE, LOW-INCOME AND MEDICALLY UNDERSERVED COMMUNITIES IN SONOMA COUNTY. IN 2020, INDIVIDUAL STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH REPRESENTATIVES FROM ORGANIZATIONS THAT SERVE THESE POPULATIONS TO BETTER UNDERSTAND THE IMPACTS OF COVID-19 IN OUR COMMUNITIES.
PART VI, LINE 3:	PETALUMA VALLEY HOSPITALPATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:ONE WAY PETALUMA VALLEY HOSPITAL (PVH) INFORMS THE PUBLIC OF FAP IS BY POSTING NOTICES. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE PATIENT FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE.HEALDSBURG HOSPITALPATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:ONE WAY HEALDSBURG HOSPITAL INFORMS THE PUBLIC OF FAP IS BY POSTING NOTICES. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE PATIENT FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE.
PART VI, LINE 4:	PETALUMA VALLEY HOSPITAL (PVH), FOUNDED BY THE SISTERS OF ST. JOSEPH OF ORANGE, HAS BEEN SERVING THE HEALTHCARE NEEDS OF FAMILIES IN THE COMMUNITY FOR MORE THAN 60 YEARS. DURING THIS TIME, ITS MISSION HAS REMAINED THE SAME: TO CONTINUALLY IMPROVE THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES SERVED. PART OF A LARGER HEALTHCARE SYSTEM KNOWN AS PROVIDENCE ST. JOSEPH HEALTH (PSJH), PVHH IS PART OF A COUNTYWIDE MINISTRY THAT INCLUDES TWO HOSPITALS, URGENT CARE FACILITIES, HOSPICE, HOME HEALTH SERVICES, AND OTHER FACILITIES FOR TREATING THE HEALTHCARE NEEDS OF THE COMMUNITY IN SONOMA COUNTY AND THE REGION. THE MINISTRY'S CORE FACILITIES ARE PETALUMA VALLEY HOSPITAL (PVH), AN 80-BED ACUTE CARE HOSPITAL, AND SRMH, A FULL SERVICE, STATE OF THE ART 330-BED ACUTE CARE HOSPITAL THAT INCLUDES A LEVEL II TRAUMA CENTER FOR THE COASTAL REGION FROM SAN FRANCISCO TO THE OREGON BORDER. MAJOR PROGRAMS AND SERVICES INCLUDE CRITICAL CARE, CARDIOVASCULAR CARE, STROKE CARE, WOMEN'S AND CHILDREN'S SERVICES, CANCER CARE, AND ORTHOPEDICS. SRMH IS HOME TO THE NORMA & EVERT PERSON HEART & VASCULAR INSTITUTE AND THE UCSF NEONATAL INTENSIVE CARE NURSERY. PVH PROVIDES SOUTHERN MENDOCINO, NORTHERN MARIN, AND SONOMA COUNTIES' COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM UKIAH IN THE NORTH, MARSHALL IN THE SOUTH, SONOMA VALLEY IN THE EAST AND BODEGA BAY IN THE WEST. PVH'S TOTAL SERVICE AREA (TSA) INCLUDES THE CITIES OF SANTA ROSA, PETALUMA, SEBASTOPOL, WINDSOR, HEALDSBURG, ROHNERT PARK, COTATI, SONOMA, CLOVERDALE, UKIAH, AND POINT ARENA.DEFINING THE COMMUNITY:SONOMA COUNTY IS A LARGE, URBAN-RURAL COUNTY ENCOMPASSING 1,575 SQUARE MILES. SONOMA COUNTY RESIDENTS INHABIT NINE CITIES AND A LARGE UNINCORPORATED AREA, INCLUDING MANY GEOGRAPHICALLY ISOLATED COMMUNITIES. THE COUNTY'S TOTAL POPULATION WAS ESTIMATED AT 487,011 AT THE TIME OF THE CHNA. SINCE 2006, THE COUNTY POPULATION HAS GROWN AT AN OVERALL RATE OF 1.8% WITH THE CITIES OF SONOMA, SANTA ROSA AND WINDSOR EXPERIENCING THE FASTEST GROWTH RATES. ACCORDING TO PROJECTIONS FROM THE CALIFORNIA DEPARTMENT OF FINANCE, THE COUNTY POPULATION IS PROJECTED TO GROW BY 8.3% TO 546,204 IN 2020. THIS RATE OF GROWTH IS LESS THAN THAT PROJECTED FOR CALIFORNIA AS A WHOLE (10.1%). THE MAJORITY OF THE COUNTY'S POPULATION RESIDES WITHIN ITS CITIES, THE LARGEST OF WHICH ARE CLUSTERED ALONG THE HIGHWAY 101 CORRIDOR. SANTA ROSA IS THE LARGEST CITY WITH A POPULATION ESTIMATED TO BE NEARLY 171,000 IN 2012 AND IS THE SERVICE HUB FOR THE ENTIRE COUNTY AND THE LOCATION OF THE COUNTY'S THREE MAJOR HOSPITALS. AT LEAST PART OF SONOMA COUNTY, CALIFORNIA, IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA). THE AREA IS 0.8 SQUARE MILES AND IS LOCATED NEAR DOWNTOWN SANTA ROSA. THE CLOVERDALE AREA IN SONOMA COUNTY IS A DESIGNATED PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA (PC-HSPA). THERE ARE 6,888 CIVILIAN RESIDENTS IN THIS AREA, WHICH IS 307.5 TOTAL SQUARE MILES. SRMH PROVIDES SONOMA COUNTY COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL IS LOCATED IN DOWNTOWN SANTA ROSA, ABOUT 55 MILES NORTH OF SAN FRANCISCO JUST OFF THE HIGHWAY 101 CORRIDOR IN CENTRAL SONOMA COUNTY. PVH'S PRIMARY SERVICE AREA IS LIMITED TO A TIGHT RADIUS, BUT ITS SECONDARY SERVICE AREA COMPRISES THE ENTIRE COUNTY, PLUS NORTHERN MARIN COUNTY AND SOUTHERN MENDOCINO COUNTY. THE CHNA PROCESS AND DATA GATHERING ADDRESSES SONOMA COUNTY. FOR A COMPLETE COPY OF THE 2017 PVH CHNA SEE: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSSONOMA COUNTY'S UNINCORPORATED AREAS ARE HOME TO 146,739 RESIDENTS, 30.1% OF THE TOTAL POPULATION. A SIGNIFICANT NUMBER OF THESE INDIVIDUALS LIVE IN LOCATIONS THAT ARE VERY RURAL AND GEOGRAPHICALLY REMOTE. RESIDENTS OF THESE AREAS MAY EXPERIENCE SOCIAL ISOLATION AND SIGNIFICANT BARRIERS IN ACCESSING BASIC SERVICES AND SUPPORTS SUCH AS TRANSPORTATION, HEALTH CARE, NUTRITIOUS FOOD AND OPPORTUNITIES TO SOCIALIZE. LOW INCOME AND SENIOR POPULATIONS LIVING IN REMOTE AREAS MAY FACE SPECIAL CHALLENGES IN MAINTAINING HEALTH AND QUALITY OF LIFE. OF THE COUNTY'S TOTAL SENIOR POPULATION, AGE 60 AND OLDER, 12,144 (12%) ARE CONSIDERED "GEOGRAPHICALLY ISOLATED" AS DEFINED BY THE OLDER AMERICANS ACT.PVH TOTAL SERVICE AREA:THE COMMUNITY SERVED BY PVH IS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF PVH'S INPATIENTS. THE PVH TOTAL SERVICE AREA IS COMPRISED OF BOTH THE PRIMARY SERVICE AREA (PSA) AS WELL AS THE SECONDARY SERVICE AREA (SSA) AND IS ESTABLISHED BASED ON THE FOLLOWING CRITERIA:- PSA: 70% OF DISCHARGES (EXCLUDING NORMAL NEWBORNS)- SSA: 71%-85% OF DISCHARGES (DRAW RATES PER ZIP CODE ARE CONSIDERED AND PSA/SSA ARE MODIFIED ACCORDINGLY)- INCLUDES ZIP CODES FOR CONTINUITY- NATURAL BOUNDARIES ARE CONSIDERED (I.E., FREEWAYS, MOUNTAIN RANGES, ETC.)- CITIES ARE PLACED IN PSA OR SSA, BUT NOT BOTH THE PSA IS THE GEOGRAPHIC AREA FROM WHICH THE MAJORITY OF PVH'S PATIENTS ORIGINATE. THE CITIES AND TOWNS IN THE PVH PSA INCLUDE SANTA ROSA, SEBASTOPOL, WINDSOR, FORESTVILLE, ROHNERT PARK AND COTATI/PENNGROVE. THE SSA IS WHERE AN ADDITIONAL POPULATION OF THE HOSPITAL'S INPATIENTS RESIDE. THE SSA INCLUDES ALL OF SONOMA COUNTY, UKIAH TO THE NORTH IN MENDOCINO COUNTY, AND NORTHERN MARIN COUNTY TO THE SOUTH. THE POPULATION OF THE SERVICE AREA IS 835,741, OF WHICH 328,005 ARE IN THE PSA AND 507,736 RESIDE IN THE SSA.COMMUNITY NEED INDEX (ZIP CODE LEVEL) BASED ON NATIONAL NEED:THE COMMUNITY NEED INDEX (CNI) WAS DEVELOPED BY DIGNITY HEALTH AND TRUVEN HEALTH ANALYTICS. THE CNI IDENTIFIES THE SEVERITY OF HEALTH DISPARITY FOR EVERY ZIP CODE IN THE UNITED STATES AND DEMONSTRATES THE LINK BETWEEN COMMUNITY NEED, ACCESS TO CARE, AND PREVENTABLE HOSPITALIZATIONS. CNI AGGREGATES FIVE SOCIOECONOMIC INDICATORS THAT CONTRIBUTE TO HEALTH DISPARITY (ALSO KNOWN AS BARRIERS):- INCOME BARRIERS (ELDER POVERTY, CHILD POVERTY AND SINGLE PARENT POVERTY)- CULTURE BARRIERS (NON-CAUCASIAN LIMITED ENGLISH);- EDUCATIONAL BARRIERS (% POPULATION WITHOUT HS DIPLOMA);- INSURANCE BARRIERS (INSURANCE, UNEMPLOYED AND UNINSURED);- HOUSING BARRIERS (HOUSING, RENTING PERCENTAGE).THIS OBJECTIVE MEASURE IS THE COMBINED EFFECT OF FIVE SOCIOECONOMIC BARRIERS (INCOME, CULTURE, EDUCATION, INSURANCE AND HOUSING). A SCORE OF 1.0 INDICATES A ZIP CODE WITH THE FEWEST SOCIOECONOMIC BARRIERS, WHILE A SCORE OF 5.0 REPRESENTS A ZIP CODE WITH THE MOST SOCIOECONOMIC BARRIERS. RESIDENTS OF COMMUNITIES WITH THE HIGHEST CNI SCORES WERE SHOWN TO BE TWICE AS LIKELY TO EXPERIENCE PREVENTABLE HOSPITALIZATIONS FOR MANAGEABLE CONDITIONS SUCH AS EAR INFECTIONS, PNEUMONIA OR CONGESTIVE HEART FAILURE COMPARED TO COMMUNITIES WITH THE LOWEST CNI SCORES. (REF ROTH R, BARSI E., HEALTH PROG. 2005 JUL-AUG; 86(4):32-8.) THE CNI IS USED TO A DRAW ATTENTION TO AREAS THAT NEED ADDITIONAL INVESTIGATION SO THAT HEALTH POLICY AND PLANNING EXPERTS CAN MORE STRATEGICALLY ALLOCATE RESOURCES. FOR EXAMPLE, THE ZIP CODE 95407 ON THE CNI MAP IS SCORED 4.2, MAKING IT A HIGH NEED COMMUNITY.OTHER HOSPITALS IN SERVICE AREATHE MINISTRY'S SERVICE AREA IS ALSO SERVED BY SUTTER SANTA ROSA REGIONAL HOSPITAL AND KAISER PERMANENTE SANTA ROSA MEDICAL CENTER AND MEDICAL OFFICES.
PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTH:PETALUMA VALLEY HOSPITAL PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. PETALUMA VALLEY HOSPITAL IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES2) OPEN MEDICAL STAFF3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.
PART VI, LINE 6:	AFFILIATED HEALTH CARE SYSTEM:AT 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 HEALTH 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 - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 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, WA.2021 WAS A YEAR MARKED BY THREE MAJOR SURGES IN COVID-19 VOLUMES, A NATIONAL SHORTAGE OF HEALTH CARE PERSONNEL, AS WELL AS DEFERRALS OF NON-EMERGENT CARE. EVEN WITH THESE TREMENDOUS CHALLENGES, THE PROVIDENCE FAMILY OF ORGANIZATIONS CONTINUED TO INVEST IN OUR COMMUNITIES, GUIDED BY OUR STRATEGIC PLAN AND OUR COMMUNITY BENEFIT PRIORITIES. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT
PART VI, LINE 7, REPORTS FILED WITH STATES	CA

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (1)	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 (18 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
ROD F HOCHMAN MD
DIRECTOR	$0	$2,224,561	$0	$5,586,400	$0	$828,858	$0	$810,415	$0	$29,930	$0	$9,480,164	$0	$764,400
MIKE BUTLER
FORMER PRESIDENT	$0	$0	$0	$0	$0	$2,359,254	$0	$7,651	$0	$0	$0	$2,366,905	$0	$0
CINDY STRAUSS
FORMER SECRETARY	$0	$228,582	$0	$263,565	$0	$1,434,949	$0	$6,525	$0	$11,330	$0	$1,944,951	$0	$397,592
JO ANN ESCASA-HAIGH
EVP/ASSISTANT TREASURER	$0	$810,289	$0	$339,019	$0	$307,368	$0	$235,035	$0	$27,365	$0	$1,719,076	$0	$266,274
GREG HOFFMAN
PRESIDENT/CEO & TREASURER	$0	$875,809	$0	$415,999	$0	$115,470	$0	$241,752	$0	$31,590	$0	$1,680,620	$0	$76,348
JOHN WHIPPLE
SECRETARY	$0	$485,477	$0	$301,033	$0	$252,027	$0	$156,256	$0	$29,193	$0	$1,223,986	$0	$180,264
JIM WATSON ESQ
ASSISTANT SECRETARY	$0	$450,443	$0	$287,615	$0	$22,030	$0	$94,222	$0	$32,632	$0	$886,942	$0	$0
VENKAT BHAMIDIPATI
FORMER EVP/TREASURER	$0	$0	$0	$0	$0	$750,000	$0	$0	$0	$0	$0	$750,000	$0	$0
MICHAEL BOLLINGER
PHYSICIAN	$511,143	$0	$99,230	$0	$0	$0	$3,335	$0	$31,035	$0	$644,743	$0	$0	$0
VERONA DORCH
SECRETARY - THRU 3/21	$0	$167,297	$0	$273,000	$0	$75,657	$0	$1,673	$0	$3,044	$0	$520,671	$0	$0
JOSEPH TITO
PHYSICIAN	$401,661	$0	$1,000	$0	$0	$0	$2,735	$0	$939	$0	$406,335	$0	$0	$0
WENDI THOMAS
DIR, NURSING	$224,790	$0	$101,779	$0	$2,649	$0	$6,513	$0	$31,941	$0	$367,672	$0	$0	$0
DARIAN HARRIS
CE PETALUMA & HEALDSBURG	$177,584	$0	$25,000	$0	$86,101	$0	$2,518	$0	$20,564	$0	$311,767	$0	$0	$0
DAVID SOUTHERLAND
INTERIM COO SONOMA	$87,825	$0	$210,584	$0	$3,068	$0	$1,992	$0	$4,029	$0	$307,498	$0	$0	$0
BERTA KAEMMERLING
DIR, NURSING	$220,362	$0	$42,891	$0	$7,749	$0	$3,903	$0	$14,755	$0	$289,660	$0	$0	$0
MELANIE ELLIOTT-ELLER
MGR, QUALITY IMPROV & SAFETY	$202,699	$0	$42,367	$0	$2,286	$0	$3,299	$0	$17,557	$0	$268,208	$0	$0	$0
DONALD ANDERSON JR
ASSISTANT SECRETARY FOR ENROLLMENT	$0	$210,749	$0	$30,761	$0	$1,041	$0	$12,268	$0	$11,812	$0	$266,631	$0	$0
KURT MALMGREN
CFO PETALUMA & HEALDSBURG	$0	$172,487	$0	$1,000	$0	$22,177	$0	$13,271	$0	$17,918	$0	$226,853	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 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, LINES 4A-B	THE FOLLOWING INDIVIDUALS RECIEVED SEVERANCE PAYMENTS DURING 2021: MIKE BUTLER - $2,355,018 VENKAT BHAMIDIPATI - $750,000 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. THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR: ROD F. HOCHMAN, MD - $764,400 CINDY STRAUSS - $397,592 JO ANN ESCASA-HAIGH - $266,274 GREG HOFFMAN - $76,348 JOHN WHIPPLE - $180,264
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 (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 2	NORCAL HEALTHCONNECT LLC, A DISREGARDED ENTITY WHOSE SINGLE MEMBER IS WESTERN HEALTHCONNECT, PURCHASED TWO HOSPITAL FACILITIES, HEALDSBURG HOSPITAL AND PETALUMA VALLEY HOSPITAL. SEE PART III, LINE 4A NARRATIVE IN SCHEDULE O FOR MORE DETAILS OF THE HOSPITALS' 2021 ACTIVITES.
FORM 990, PART V, LINE 15:	INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF THE RELATED ORGANIZATION. IT IS THE INTENTION OF PROVIDENCE AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE EMPLOYEES OF A RELATED ORGANIZATION WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. THE RELATED ORGANIZATION COMMON LAW EMPLOYEES ARE INCLUDED IN THE RELATED ORGANIZATION'S SECTION 4960 TAX ANALYSIS AND REPORTING.
FORM 990, PART VI, SECTION A, LINE 7A	CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS WESTERN HEALTHCONNECT HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT THE WESTERN HEALTHCONNECT'S GOVERNING BOARD. ALL NOMINATIONS THAT COME FROM THE WESTERN HEALTHCONNECT BOARD AS NOMINATIONS MUST BE APPROVED BY ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B	CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, EXEMPT PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE ST. JOSEPH HEALTH SYSTEM, RESERVES THE RIGHT TO APPROVE THE PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS.
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 15B	PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY A RELATED TAX-EXEMPT ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, 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 2021.
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 IX, LINE 11G	AGENCY & CONTRACT LABOUR: PROGRAM SERVICE EXPENSES 7,435,129. MANAGEMENT AND GENERAL EXPENSES 808,722. TOTAL EXPENSES 8,243,851. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 696,407. MANAGEMENT AND GENERAL EXPENSES 75,748. TOTAL EXPENSES 772,155. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 3,488,912. MANAGEMENT AND GENERAL EXPENSES 379,490. TOTAL EXPENSES 3,868,402. MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 8,828,564. MANAGEMENT AND GENERAL EXPENSES 960,286. TOTAL EXPENSES 9,788,850. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 4,603,763. MANAGEMENT AND GENERAL EXPENSES 500,753. TOTAL EXPENSES 5,104,516. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 2,163,784. MANAGEMENT AND GENERAL EXPENSES 235,356. TOTAL EXPENSES 2,399,140.
FORM 990, PART XI, LINE 9:	NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS 69,785,192. NET ASSETS PURCHASED 34,466,299.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NORCAL HEALTHCONNECT LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1801 LIND AVE SW ATTN TAX DEPT	AddressLine1Txt
City	RENTON	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	98057	ZIPCd

Field	Value	IRS element (for citing)
EIN	852390012	EIN
Primary Activities	HEALTHCARE	PrimaryActivitiesTxt
Legal Domicile State	WA	LegalDomicileStateCd
Total Income	$179,298,426	TotalIncomeAmt
End Of Year Assets	$160,790,821	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	WHC	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (110 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 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 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
1801 LIND AVENUE SW ATTN TAX DEPT	RENTON	WA	98057	550828701	MEDICAID HEALTHCARE PROVIDER	OR	501(C)(4)	N/A	PHP	Yes (1)
PROVIDENCE HEALTH CARE FOUNDATION - EASTERN WASHINGTON
101 W 8TH AVE	SPOKANE	WA	99204	320014330	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (1)
PROVIDENCE HEALTH PLAN
1801 LIND AVENUE SW ATTN TAX DEPT	RENTON	WA	98057	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 HOOD RIVER MEMORIAL HOSPITAL FOUNDATION INC
810 12TH STREET PO BOX 149	HOOD RIVER	OR	97031	930921990	HEALTHCARE	OR	501(C)(3)	7	PHS OR	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
1801 LIND AVENUE SW ATTN TAX DEPT	RENTON	WA	98057	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
1801 LIND AVENUE SW ATTN TAX DEPT	RENTON	WA	98057	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
1801 LIND AVENUE SW ATTN TAX DEPT	RENTON	WA	98057	911594526	HEALTHCARE	WA	501(C)(3)	3	KRMC	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)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (50 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
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 MATERNAL NEWBORN AND CHILD HEALTH LLC
1801 LIND AVENUE SW ATTN TAX DEPT	RENTON	WA	98057	813526875	HEALTHCARE	CA	N/A	0	0
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
ONE CITY BLVD W STE 1100	ORANGE	CA	92868	264591502	HEALTHCARE	CA	N/A	0	Yes (1)
COVENANT LONG-TERM CARE LP
1801 LIND AVENUE SW ATTN TAX DEPT	RENTON	WA	98057	205033419	HEALTHCARE	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	0
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	Yes (1)
IMAGING ASSOCIATES LLC
3650 PIPER STREET STE A	ANCHORAGE	AK	99508	203906048	MEDICAL IMAGING	AK	N/A	0	Yes (1)
INLAND IMAGING LLC
801 S STEVENS ST	SPOKANE	WA	99204	911855796	MEDICAL IMAGING	WA	N/A	0	Yes (1)
LSC REAL PROPERTY LLC
2301 QUAKER AVENUE	LUBBOCK	TX	79410	474646059	REAL ESTATE	TX	N/A	0	0
METHODIST DIAGNOSTIC IMAGING
4005 24TH STREET	LUBBOCK	TX	79410	752343261	HEALTHCARE	TX	N/A	0	0
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)
OREGON OUTPATIENT SURGERY CENTER
7300 SW CHILDS RD	TIGARD	OR	97224	223883387	AMBULATORY SURGERY CENTER	OR	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
PROV RADIATION ONCOLOGY DEVELOP ASSN LLC
4400 NE HALSEY 495	PORTLAND	OR	97213	260682491	REAL ESTATE - MOB	OR	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 CHILDREN'S NEONATAL SVCS
1801 LIND AVENUE SW ATTN TAX DEPT	RENTON	WA	98057	470918549	NEONATAL CARE	WA	N/A	0	0
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	N/A	0	0
PROVIDENCE SURGERY CENTER LLC
902 N ORANGE ST	MISSOULA	MT	59802	841401625	AMBULATORY SURGERY CENTER	MT	N/A	0	0
PROVIDENCE UCLA USP SURGERY CENTER JV
14201 DALLAS PARKWAY	DALLAS	TX	75254	320503030	AMBULATORY SURGERY CENTER	CA	N/A	0	0
PROVIDENCEUSP SOUTH BAY SURGERY CENTERS
15305 DALLAS PKWY STE 1600 LB 28	ADDISON	TX	75001	475064486	AMBULATORY SURGERY CENTER	CA	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)
SANTA ANA MOB LLC
1800 QUAIL STREET STE 100	NEWPORT BEACH	CA	92660	753205306	REAL ESTATE - MOB	CA	N/A	0	Yes (1)
SJO ASC HOLDINGS LLC
1140 W LA VETA AVE	ORANGE	CA	92868	821655501	HEALTHCARE	CA	N/A	0	0
ST JOSEPH PHYSICIAN VENTURES I LLC
1100 WEST STEWART DRIVE	ORANGE	CA	92868	454521884	REAL ESTATE	CA	N/A	0	Yes (1)
ST JOSEPHSATELLITE DIALYSIS CENTERS LLC
300 SANTANA ROW SUITE 300	SAN JOSE	CA	95128	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 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)
TARZANA PEDIATRIC VENTURES LLC
18321 CLARK ST	TARZANA	CA	91356	821308306	HEALTHCARE	CA	N/A	0	0
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 (46 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	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	OwnershipOwnershipPct
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
AMERICAN UNITY GROUP LTD
					CAPTIVE INSURANCE		N/A	C	0	90 PITTS BAY ROAD HM08 PEMBROKE	BD	BD
AYIN HEALTH SOLUTIONS INC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	98057	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
COLBURN HILL GROUP INC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	95057	863383433	HEALTHCARE	DE	N/A	C	0
COMMUNITY TECHNOLOGIES INC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	98057	844722399	IT SVCS	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 INC
615 2ND AVE 700	SEATTLE	WA	98104	474048082	HEALTHCARE	WA	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
MEDIREVV INC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	98057	208783763	HEALTHCARE	DE	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
3993 FAIRVIEW INDUSTRIAL DR SE	SALEM	OR	97302	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
PIONEER INNOVATIONS INC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	98057	364818191	HEALTHCARE INNOVATIONS	WA		C	Yes (1)				WHC	1.00000
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 HEALTH VENTURES INC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	98057	330122216	INVESTMENT	CA	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 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 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
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	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	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