SRM ALLIANCE HOSPITAL SERVICES: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- SRM ALLIANCE HOSPITAL SERVICES (EIN 68-0395200)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-15
- IRS object ID
- 202103199349322210
- Schema version
- 2020v4.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-15T15:39:14-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | 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 | 55 IVAN ALLEN JR BLVD NW STE 100 | AddressLine1Txt |
| City | ATLANTA | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 30308 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680395200 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SRM ALLIANCE HOSPITAL SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SRMA | BusinessNameControlTxt |
| Phone | 7075221570 | 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 | PATTI PILGRIM | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7075221570 | PhoneNum |
| Signature | 2021-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PATTI | PersonFirstNm |
| Person Last | PILGRIM | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AERRIAL ORR | PreparerPersonNm |
| PTIN | P01598400 | PTIN |
| Phone | 8585357200 | PhoneNum |
| Preparation | 2021-11-10 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETALUMA VALLEY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TYLER HEDDEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 NORTH MCDOWELL BLVD | AddressLine1Txt |
| City | PETALUMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94954 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $87,761,924 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STJOESONOMA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 433 | TotalEmployeeCnt |
| Total Volunteers | 60 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $356,365 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,005,648 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $92,637,265 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $82,508,754 | CYProgramServiceRevenueAmt |
| PY Investment Income | $362,358 | PYInvestmentIncomeAmt |
| CY Investment Income | $111,134 | CYInvestmentIncomeAmt |
| PY Other Revenue | $151,773 | PYOtherRevenueAmt |
| CY Other Revenue | $136,388 | CYOtherRevenueAmt |
| PY Total Revenue | $93,507,761 | PYTotalRevenueAmt |
| CY Total Revenue | $87,761,924 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $638,748 | 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 | $36,465,421 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,336,279 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $277 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $49,555,372 | PYOtherExpensesAmt |
| CY Other Expenses | $54,087,222 | CYOtherExpensesAmt |
| PY Total Expenses | $86,659,541 | PYTotalExpensesAmt |
| CY Total Expenses | $88,423,749 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,848,220 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$661,825 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $43,719,964 | TotalAssetsBOYAmt |
| Total Assets EOY | $58,532,601 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,042,483 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,066,302 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $28,677,481 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $34,466,299 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $79,747,862 | ExpenseAmt |
| Grant | $248 | GrantAmt |
| Revenue | $82,645,142 | RevenueAmt |
| Desc | SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE 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 51 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. - HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA. - KADLEC IN SOUTHEAST WASHINGTON - PACIFIC MEDICAL CENTERS IN SEATTLE, WA. - SWEDISH HEALTH SERVICES IN SEATTLE, WA. 2020 AN UNPRECEDENTED YEAR OVER THE PAST YEAR, OUR COMMUNITIES HAVE FACED EXTRAORDINARY CHALLENGES. BUT EVEN DURING THE MOST DIFFICULT PUBLIC HEALTH CRISIS OF OUR TIME, COMMUNITIES HAVE ALSO SHOWN REMARKABLE STRENGTH AND RESOLVE. THERE IS SO MUCH GOOD THAT CAN BE ACCOMPLISHED AT THE COMMUNITY LEVEL, ESPECIALLY WHEN LIKE-MINDED ORGANIZATIONS WORK TOGETHER. IN SERVICE TO OUR MISSION, PROVIDENCE PARTNERS WITH COMMUNITY-BASED ORGANIZATIONS TO IDENTIFY URGENT HEALTH NEEDS AND ENVIRONMENTAL FACTORS THAT ARE IMPACTING THE WELL-BEING OF OUR COMMUNITIES. WE ACT TO PROVIDE SHORT-TERM SOLUTIONS AND ENVISION LONG-TERM RESULTS BY WISELY INVESTING IN OUR COMMUNITIES TO HELP BUILD A MORE EQUITABLE AND SUSTAINABLE FUTURE. IN 2020, WE INVESTED $1.7 BILLION IN COMMUNITY BENEFIT ACROSS SEVEN REGIONS, TO SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT CREATE LASTING CHANGE AT THE COMMUNITY LEVEL. THESE EFFORTS SEEK TO MITIGATE IMMEDIATE CHALLENGES WHILE FINDING SOLUTIONS TO DEEP-ROOTED PROBLEMS, IMPROVE ACCESS TO HEALTH CARE, AND ADVANCE INNOVATIVE CARE MODELS TO MEET THE EVOLVING NEEDS OF OUR COMMUNITIES CARING FOR OUR COMMUNITIES HAS NEVER BEEN MORE IMPORTANT. TO ACHIEVE OUR VISION OF HEALTH FOR A BETTER WORLD, OUR PROVIDENCE FAMILY OF ORGANIZATIONS FOCUSED ON FOUR COMMUNITY INITIATIVES IN 2020: 1) FOUNDATIONS OF HEALTH, 2) REMOVING BARRIERS TO CARE, 3) COMMUNITY RESILIENCE, AND 4) INNOVATING FOR THE FUTURE. PETALUMA VALLEY HOSPITALPVH 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. 2020 PROGRAM SERVICE ACCOMPLISHMENTS: (JANUARY 1 - DECEMBER 31, 2020) 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, AND MOMMY AND ME, WHICH TEACHES GOOD DENTAL HEALTH PRACTICES TO VERY YOUNG CHILDREN ZERO TO FIVE YEARS OLD AND THEIR MOTHERS. 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 2020, PATIENTS WERE SERVED OVER 216 ENCOUNTERS AT THE SJH DENTAL CLINIC. OUR MOBILE DENTAL CLINIC AND MIGHTY MOUTH SCHOOL-BASED PREVENTION PROGRAM SERVED COMPLETED 178 ENCOUNTERS COUNTYWIDE.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 2020, IN OUR SERVICE AREA, THE CLINIC SERVED PATIENTS OVER 25 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 98 ENCOUNTERS COUNTYWIDE, HELPING TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO MORE EFFECTIVELY MANAGE CHRONIC DISEASE. | Desc |
| Total Program Service Expenses | $79,747,862 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 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 | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 93 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 433 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JONI MURPHY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7075255300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 141 STONY CIRCLE SUITE 140 | AddressLine1Txt |
| City | SANTA ROSA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95401 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN KLOCKENGA | ||||||||||
| FORMER REG CHIEF EXECUTIVE - NO CA | 0.00 | 50.00 | Yes (X) | $0 | $1,089,812 | $238,293 | ||||
| ROBERT JUST III | ||||||||||
| FORMER CE - N CA MEDICAL GROUP | 0.00 | 52.00 | Yes (X) | $0 | $541,663 | $141,618 | ||||
| CAROL KOEBLE | ||||||||||
| FORMER CHIEF MEDICAL OFFICER - NO CA | 0.00 | 50.00 | Yes (X) | $0 | $670,353 | $4,142 | ||||
| TYLER HEDDEN | ||||||||||
| CEO-CHIEF EXEC OFFICER-SONOMA | 4.00 | 46.00 | $0 | $581,018 | $88,913 | Yes (X) | Yes (X) | |||
| OLUYEMI ADEYANJU ESQ | ||||||||||
| SECRETARY | 4.00 | 46.00 | $0 | $522,340 | $80,333 | Yes (X) | ||||
| JOHN BIBBY | ||||||||||
| FORMER CHRO, PHYSICIAN ENTERPRISE | 0.00 | 50.00 | Yes (X) | $0 | $494,146 | $104,855 | ||||
| CHAD KRILICH | ||||||||||
| FORMER CMO-CHIEF MEDICAL OFFICER | 0.00 | 50.00 | Yes (X) | $0 | $546,902 | $48,953 | ||||
| CARMELO MOCERI | ||||||||||
| FORMER CHIEF STRATEGY OFF - NO CA | 0.00 | 50.00 | Yes (X) | $0 | $563,061 | $25,850 | ||||
| MARK PROVAN | ||||||||||
| FORMER CHIEF OPS/WORKFORCE INT OFF | 0.00 | 50.00 | Yes (X) | $0 | $434,522 | $32,382 | ||||
| VICKI WHITE | ||||||||||
| FORMER CNO-CHIEF NURSING OFCR | 0.00 | 50.00 | Yes (X) | $0 | $430,706 | $29,594 | ||||
| TERRI DENTE | ||||||||||
| FORMER CHIEF MISSION OFF NO CA | 0.00 | 50.00 | Yes (X) | $0 | $365,766 | $39,943 | ||||
| ANDREA LEARNED | ||||||||||
| FORMER MINISTRY CHIEF, PHILAN OFF | 0.00 | 50.00 | Yes (X) | $0 | $325,206 | $16,577 | ||||
| DAVID SOUTHERLAND | ||||||||||
| INTERIM COO SONOMA | 4.00 | 46.00 | $304,102 | $0 | $19,229 | Yes (X) | ||||
| PATTI PILGRIM | ||||||||||
| REGIONAL CFO, TREASURER | 4.00 | 46.00 | $0 | $263,710 | $31,180 | Yes (X) | ||||
| WENDI THOMAS | ||||||||||
| DIRECTOR, NURSING | 50.00 | 0.00 | $254,618 | $0 | $36,292 | Yes (X) | ||||
| THELMA COLLINS | ||||||||||
| HOUSE SUPERVISOR - NE | 50.00 | 0.00 | $244,768 | $0 | $29,259 | Yes (X) | ||||
| MATT HUDDLESTON | ||||||||||
| ENGINEER-CHIEF | 50.00 | 0.00 | $254,958 | $0 | $0 | Yes (X) | ||||
| TAMIKO FELICIANO | ||||||||||
| DIR, NURSING | 50.00 | 0.00 | $216,490 | $0 | $17,613 | Yes (X) | ||||
| ROBERT LOFTON | ||||||||||
| TECH | 40.00 | 0.00 | $201,747 | $0 | $29,541 | Yes (X) | ||||
| PJ LALLY MD | ||||||||||
| CHIEF OF STAFF | 4.00 | 46.00 | $0 | $27,466 | $0 | Yes (X) | ||||
| JEFFREY TOBIAS MD | ||||||||||
| PCHD BOARD REP | 4.00 | 46.00 | $0 | $0 | $0 | Yes (X) | ||||
| JIM CARR | ||||||||||
| BOARD MEMBER | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| JOANNE FERRIS | ||||||||||
| BOARD MEMBER | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| JOSEPHINE THORNTON | ||||||||||
| BOARD MEMBER | 2.00 | 41.00 | $0 | $0 | $0 | Yes (X) | ||||
| KATHIE POWELL | ||||||||||
| BOARD MEMBER, VICE CHAIR | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| PAMELA TUFT | ||||||||||
| BOARD MEMBER | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| RAJESH RANADIVE MD | ||||||||||
| BOARD MEMBER | 2.00 | 46.00 | $0 | $0 | $0 | Yes (X) | ||||
| SCOTT PRITCHARD | ||||||||||
| BOARD MEMBER, CHAIRPERSON | 4.00 | 46.00 | $0 | $0 | $0 | Yes (X) | ||||
| SISTER KAREN CLOCK | ||||||||||
| BOARD MEMBER | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,476,683 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,856,671 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,014,567 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 106 | 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 | $2,325,453 |
| ROSA CONSTRUCTION INC | |||||
| 14272 WICKS BLVD | SAN LEANDRO | CA | 94577 | CONSTRUCTION SERVICES | $1,981,920 |
| MEDLINE INDUSTRIES INC | |||||
| DEPT LA 21558 | PASADENA | CA | 91185 | MEDICAL SERVICES | $1,669,338 |
| CARDINAL HEALTH 411 INC | |||||
| PO BOX 56412 | LOS ANGELES | CA | 90074 | MEDICAL SERVICES | $1,478,944 |
| ST JOSEPH HERITAGE HEALTHCARE | |||||
| 3345 MICHELSON DRIVE STE 200 | IRVINE | CA | 92612 | MEDICAL SERVICES | $961,318 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 50 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,001,964 | GovernmentGrantsAmt |
| All Other Contributions | $3,684 | AllOtherContributionsAmt |
| Total Contributions | $5,005,648 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $82,508,754 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,508,754 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $82,508,754 | TotalProgramServiceRevenueAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $111,134 | TotalRevenueColumnAmt |
| Exclusion | $111,134 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 900099 | $61,119 | $61,119 |
| CASH PURCH & DISCOUNTS | 900099 | $60,072 | $60,072 |
| REBATES & REFUNDS | 900099 | $14,537 | $14,537 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $660 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $660 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $136,388 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $87,761,924 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,645,142 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $111,134 | 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 | $323,331 | TotalAmt |
| Program Services | $291,607 | ProgramServicesAmt |
| Management And General | $31,724 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,086,774 | TotalAmt |
| Program Services | $27,511,204 | ProgramServicesAmt |
| Management And General | $2,575,570 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,195,571 | TotalAmt |
| Program Services | $1,124,601 | ProgramServicesAmt |
| Management And General | $70,970 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $283,961 | TotalAmt |
| Program Services | $244,580 | ProgramServicesAmt |
| Management And General | $39,381 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,446,642 | TotalAmt |
| Program Services | $2,057,639 | ProgramServicesAmt |
| Management And General | $389,003 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $530,424 | TotalAmt |
| Management And General | $530,424 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,923 | TotalAmt |
| Program Services | $56,923 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,435,988 | TotalAmt |
| Program Services | $14,918,279 | ProgramServicesAmt |
| Management And General | $2,517,709 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,371 | TotalAmt |
| Management And General | $5,371 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,991,461 | TotalAmt |
| Program Services | $1,827,877 | ProgramServicesAmt |
| Management And General | $163,584 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,866,983 | TotalAmt |
| Program Services | $1,796,461 | ProgramServicesAmt |
| Management And General | $70,522 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,795 | TotalAmt |
| Program Services | $8,552 | ProgramServicesAmt |
| Management And General | $38,243 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,855 | TotalAmt |
| Program Services | $2,518 | ProgramServicesAmt |
| Management And General | $3,337 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,010,383 | TotalAmt |
| Program Services | $1,825,259 | ProgramServicesAmt |
| Management And General | $185,124 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SYSTEM COST ALLOCATION | $16,253,819 | $14,659,040 | $1,594,779 | |
| MEDICAL SUPPLIES | $7,274,375 | $7,159,735 | $114,363 | $277 |
| CA HOSPITAL FEE PROGRAM | $6,034,125 | $6,034,125 | ||
| OTHER DIRECT EXPENSES | $142,586 | $41,564 | $101,022 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $432,134 | TotalAmt |
| Program Services | $187,650 | ProgramServicesAmt |
| Management And General | $244,484 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,423,749 | TotalAmt |
| Program Services | $79,747,862 | ProgramServicesAmt |
| Management And General | $8,675,610 | ManagementAndGeneralAmt |
| Fundraising | $277 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,059 | BOYAmt |
| EOY | $2,059 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,606,123 | BOYAmt |
| EOY | $25,219,611 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,416,558 | BOYAmt |
| EOY | $8,415,541 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,011,705 | BOYAmt |
| EOY | $1,287,139 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,608 | BOYAmt |
| EOY | $233,114 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,092,076 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $44,598,840 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,049,229 | BOYAmt |
| EOY | $10,493,236 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,064 | BOYAmt |
| EOY | $196,081 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,319,618 | BOYAmt |
| EOY | $12,685,820 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,719,964 | BOYAmt |
| EOY | $58,532,601 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,581,045 | BOYAmt |
| EOY | $7,880,791 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,707 | BOYAmt |
| EOY | $39,707 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,421,731 | BOYAmt |
| EOY | $16,145,804 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,042,483 | BOYAmt |
| EOY | $24,066,302 | 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 | $28,257,543 | BOYAmt |
| EOY | $34,283,637 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $419,938 | BOYAmt |
| EOY | $182,662 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,677,481 | BOYAmt |
| EOY | $34,466,299 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,719,964 | BOYAmt |
| EOY | $58,532,601 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$661,825 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $6,450,643 | 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) |
|---|---|---|
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $7,529 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,529 | 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: | FormAndLineReferenceDesc |
| Explanation | THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO SRM ALLIANCE HOSPITAL SERVICES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,808,832 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,597,235 | DepreciationAmt |
| Book Value | $211,597 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,210,763 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,838,626 | DepreciationAmt |
| Book Value | $3,372,137 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,025,204 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,162,979 | DepreciationAmt |
| Book Value | $2,862,225 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,047,277 | OtherCostOrOtherBasisAmt |
| Book Value | $4,047,277 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,493,236 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| HOSPITAL FEE/PROVIDER TAX RECEIVABLE | $11,875,098 |
| OTHER ASSETS | $810,722 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $12,685,820 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| OTHER CURRENT LIABILITIES | $11,656,882 |
| DUE TO AFFILIATES | $986,764 |
| DUE TO THIRD PARTY | $28,448 |
| HOSPITAL FEE/PROVIDER TAX LIABILITY | $3,277,629 |
| ACCRUED RETIREMENT COMPENSATION | $196,081 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,145,804 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 500.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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) |
|---|---|---|
| Persons Served | 801 | PersonsServedCnt |
| Total Community Benefit Expns | $1,729,809 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,729,809 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01960 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 715 | PersonsServedCnt |
| Total Community Benefit Expns | $29,799,402 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $27,005,848 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,793,554 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03160 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9 | PersonsServedCnt |
| Total Community Benefit Expns | $45,287 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $132 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $45,155 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1525 | PersonsServedCnt |
| Total Community Benefit Expns | $31,574,498 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $27,005,980 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,568,518 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05170 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 7350 | PersonsServedCnt |
| Total Community Benefit Expns | $444,528 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $59,153 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $385,375 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 30 | PersonsServedCnt |
| Total Community Benefit Expns | $545,484 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $394,771 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $150,713 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $25,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 7380 | PersonsServedCnt |
| Total Community Benefit Expns | $1,015,012 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $453,924 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $561,088 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00640 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 8905 | PersonsServedCnt |
| Total Community Benefit Expns | $32,589,510 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $27,459,904 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,129,606 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05810 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Reimbursed By Medicare | $13,925,802 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $33,430,550 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$19,504,748 | 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 | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SRM ALLIANCE HOSPITAL SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 400 NORTH MCDOWELL BLVD | AddressLine1Txt |
| City | PETALUMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94954 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.STJOESONOMA.ORG | WebsiteAddressTxt |
| State License | 110000001 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SRM ALLIANCE HOSPITAL SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SCHEDULE H, PART V, SECTION C | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 20 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SCHEDULE H, PART V, SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 500.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SCHEDULE H, PART V, SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 3E | THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE PRIORITIZED BASED ON THE METHODOLOGY DESCRIBED IN THE MOST RECENT CHNA SECTION ON SIGNIFICANT HEALTH NEEDS. |
| SCHEDULE H, PART V, SECTION B, LINE 5 | OVERVIEW OF CHNA FRAMEWORK AND PROCESS: 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 COMMUNITY LEVEL 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. |
| SCHEDULE H, 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 |
| SCHEDULE H, 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 AREA 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 |
| SCHEDULE H, PART V, SECTION B, LINE 7A | THE WEB ADDRESS IS:HTTPS://WWW.STJOESONOMA.ORG/COMMUNITY-OUTREACH/COMMUNITY-BENEFIT/SCHEDULE H, PART V, SECTION B, LINE 10ATHE WEB ADDRESS IS: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS |
| SCHEDULE H, PART V, SECTION B, LINE 11 | 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, AND MOMMY AND ME, WHICH TEACHES GOOD DENTAL HEALTH PRACTICES TO VERY YOUNG CHILDREN ZERO TO FIVE YEARS OLD AND THEIR MOTHERS. 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 2020, PATIENTS WERE SERVED OVER 216 ENCOUNTERS AT THE SJH DENTAL CLINIC. OUR MOBILE DENTAL CLINIC AND MIGHTY MOUTH SCHOOL-BASED PREVENTION PROGRAM SERVED COMPLETED 178 ENCOUNTERS COUNTYWIDE.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 2020, IN OUR SERVICE AREA, THE CLINIC SERVED PATIENTS OVER 25 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 PRACTITIONERS, NURSES, CASE MANAGEMENT, AND HOME HEALTH ASSISTANCE, PROVIDED SERVICE TO PATIENTS AND COMPLETED OVER 98 ENCOUNTERS COUNTYWIDE, HELPING TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO MORE EFFECTIVELY MANAGE CHRONIC DISEASE.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM:NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE RECOGNIZE THAT IN CHOOSING TO FOCUS ON THE NEEDS WE HAVE PRIORITIZED, WE WILL NOT BE DIRECTLY ADDRESSING OTHER NEEDS THAT ARE ALSO IMPORTANT IN OUR COMMUNITY. FOR INSTANCE, WE RECOGNIZE THAT CARDIOVASCULAR DISEASE IS THE LEADING CAUSE OF DEATH IN OUR COMMUNITY, AND THAT HEART DISEASE, OBESITY, AND DIABETES WERE ALL AMONG THE HIGHEST PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED IN OUR CHNA PROCESS. IN NOT SELECTING ANY OF THESE CHRONIC CONDITIONS AS ONE OF OUR COMMUNITY BENEFIT PRIORITY AREAS, WE ARE AWARE THAT OTHER ONGOING PROGRAMS IN OUR MINISTRY AND IN OUR COMMUNITY ARE FULLY ENGAGED IN ADDRESSING THEM. WE ARE COMMITTED TO CONTINUE OUR INVOLVEMENT WITH COMMUNITY INITIATIVES SUCH AS HEARTS OF SONOMA AND THE CALIFORNIA ACCOUNTABLE COMMUNITIES FOR HEALTH INITIATIVE, FINANCIAL SUPPORT FOR NONPROFIT ORGANIZATIONS SUCH AS THE NORTHERN CALIFORNIA CENTER FOR WELL-BEING, AND THE HEART WORKS CARDIAC REHAB PROGRAM. |
| SCHEDULE H, PART V, SECTION B, LINE 11 (CONTINUED) | 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, BUT WE INTEND TO DEVELOP A MEDICAL LEGAL PARTNERSHIP WITH A LOCAL LEGAL AID ORGANIZATION THAT WILL ASSIST RESIDENTS AND PATIENTS WITH IMMIGRATION ISSUES, AMONG OTHERS. 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 BENEFIT 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. |
| SCHEDULE H, 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.SCHEDULE H, PART V, SECTION B, LINE 16AFINANCIAL ASSISTANCE POLICYHTTPS://WWW.STJOESONOMA.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/SCHEDULE H, PART V, SECTION B, LINE 16BFINANCIAL ASSISTANCE APPLICATIONHTTPS://WWW.STJOESONOMA.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/SCHEDULE H, PART V, SECTION B, LINE 16CFAP PLAIN LANGUAGE SUMMARYHTTPS://WWW.STJOESONOMA.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCIAL-ASSISTANCE/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - LYNCH CREEK LABORATORY | ||||
| 110 LYNCH CREEK WAY STE B | PETALUMA | CA | 94954 | LAB OUTREACH |
| 2 - LYNCH CREEK IMAGING | ||||
| 110 LYNCH CREEK WAY STE B | PETALUMA | CA | 94954 | IMAGING/RADIOLOGY |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, 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. |
| SCHEDULE H, PART I, LINE 6A | PETALUMA VALLEY HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT: HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/NORCAL/SANTA-ROSA-MEMORIAL-HOSPITAL/COMMUNITY-SUPPORT |
| SCHEDULE H, 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. |
| SCHEDULE H, PART I, LINES 7G | NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. |
| SCHEDULE H, PART III, SECTION A, LINE 4 | AS A RESULT OF ADOPTING ASU 2014-09 AS DESCRIBED IN NOTE 1, THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2019. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | COMMUNITY BENEFITSTHE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. MEDICARE COSTS ARE DETERMINED FROM THE MEDICARE COST REPORT USING CMS STANDARD COSTING METHODS. THIS INCLUDES STEP-DOWN ALLOCATION PROCESSES WHICH ARE APPLIED TO CALCULATE ALLOWABLE MEDICARE COSTS. |
| SCHEDULE H, PART III, SECTION C, LINE 9B | COLLECTION 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. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT: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. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT 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. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION: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 2019 PVH CHNA SEE:HTTPS://WWW.STJOESONOMA.ORG/COMMUNITY-OUTREACH/COMMUNITY-BENEFIT/SONOMA 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.THE MINISTRY'S SERVICE AREA IS ALSO SERVED BY SUTTER SANTA ROSA REGIONAL HOSPITAL AND KAISER PERMANENTE SANTA ROSA MEDICAL CENTER AND MEDICAL OFFICES. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTHPETALUMA 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.SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS. |
| SCHEDULE H, 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 51 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 FIVE 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, WA. 2020 AN UNPRECEDENTED YEAROVER THE PAST YEAR, OUR COMMUNITIES HAVE FACED EXTRAORDINARY CHALLENGES. BUT EVEN DURING THE MOST DIFFICULT PUBLIC HEALTH CRISIS OF OUR TIME, COMMUNITIES HAVE ALSO SHOWN REMARKABLE STRENGTH AND RESOLVE. THERE IS SO MUCH GOOD THAT CAN BE ACCOMPLISHED AT THE COMMUNITY LEVEL, ESPECIALLY WHEN LIKE-MINDED ORGANIZATIONS WORK TOGETHER. IN SERVICE TO OUR MISSION, PROVIDENCE PARTNERS WITH COMMUNITY BASED ORGANIZATIONS TO IDENTIFY URGENT HEALTH NEEDS AND ENVIRONMENTAL FACTORS THAT ARE IMPACTING THE WELL-BEING OF OUR COMMUNITIES. WE ACT TO PROVIDE SHORT-TERM SOLUTIONS AND ENVISION LONG-TERM RESULTS BY WISELY INVESTING IN OUR COMMUNITIES TO HELP BUILD A MORE EQUITABLE AND SUSTAINABLE FUTURE. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORTCALIFORNIA |
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 (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN KLOCKENGA | ||||||||||||||
| FORMER REG CHIEF EXECUTIVE - NO CA | $0 | $651,799 | $0 | $428,812 | $0 | $9,201 | $0 | $202,787 | $0 | $35,506 | $0 | $1,328,105 | $0 | $0 |
| ROBERT JUST III | ||||||||||||||
| FORMER CE - N CA MEDICAL GROUP | $0 | $384,084 | $0 | $152,176 | $0 | $5,403 | $0 | $96,790 | $0 | $44,828 | $0 | $683,281 | $0 | $0 |
| CAROL KOEBLE | ||||||||||||||
| FORMER CHIEF MEDICAL OFFICER - NO CA | $0 | $116,772 | $0 | $75,000 | $0 | $478,581 | $0 | $2,627 | $0 | $1,515 | $0 | $674,495 | $0 | $49,336 |
| TYLER HEDDEN | ||||||||||||||
| CEO-CHIEF EXEC OFFICER-SONOMA | $0 | $420,024 | $0 | $155,927 | $0 | $5,067 | $0 | $56,543 | $0 | $32,370 | $0 | $669,931 | $0 | $0 |
| OLUYEMI ADEYANJU ESQ | ||||||||||||||
| SECRETARY | $0 | $339,506 | $0 | $179,007 | $0 | $3,827 | $0 | $66,240 | $0 | $14,093 | $0 | $602,673 | $0 | $0 |
| JOHN BIBBY | ||||||||||||||
| FORMER CHRO, PHYSICIAN ENTERPRISE | $0 | $329,970 | $0 | $151,001 | $0 | $13,175 | $0 | $64,138 | $0 | $40,717 | $0 | $599,001 | $0 | $0 |
| CHAD KRILICH | ||||||||||||||
| FORMER CMO-CHIEF MEDICAL OFFICER | $0 | $449,179 | $0 | $92,466 | $0 | $5,257 | $0 | $3,986 | $0 | $44,967 | $0 | $595,855 | $0 | $0 |
| CARMELO MOCERI | ||||||||||||||
| FORMER CHIEF STRATEGY OFF - NO CA | $0 | $186,900 | $0 | $58,768 | $0 | $317,393 | $0 | $2,489 | $0 | $23,361 | $0 | $588,911 | $0 | $35,531 |
| MARK PROVAN | ||||||||||||||
| FORMER CHIEF OPS/WORKFORCE INT OFF | $0 | $310,448 | $0 | $119,885 | $0 | $4,189 | $0 | $28,446 | $0 | $3,936 | $0 | $466,904 | $0 | $0 |
| VICKI WHITE | ||||||||||||||
| FORMER CNO-CHIEF NURSING OFCR | $0 | $350,073 | $0 | $67,866 | $0 | $12,767 | $0 | $2,976 | $0 | $26,618 | $0 | $460,300 | $0 | $0 |
| TERRI DENTE | ||||||||||||||
| FORMER CHIEF MISSION OFF NO CA | $0 | $271,031 | $0 | $88,367 | $0 | $6,368 | $0 | $7,478 | $0 | $32,465 | $0 | $405,709 | $0 | $0 |
| ANDREA LEARNED | ||||||||||||||
| FORMER MINISTRY CHIEF, PHILAN OFF | $0 | $257,263 | $0 | $58,927 | $0 | $9,016 | $0 | $1,413 | $0 | $15,164 | $0 | $341,783 | $0 | $0 |
| DAVID SOUTHERLAND | ||||||||||||||
| INTERIM COO SONOMA | $293,650 | $0 | $0 | $0 | $10,452 | $0 | $6,412 | $0 | $12,817 | $0 | $323,331 | $0 | $0 | $0 |
| PATTI PILGRIM | ||||||||||||||
| REGIONAL CFO, TREASURER | $0 | $166,643 | $0 | $50,000 | $0 | $47,067 | $0 | $23,061 | $0 | $8,119 | $0 | $294,890 | $0 | $0 |
| WENDI THOMAS | ||||||||||||||
| DIRECTOR, NURSING | $230,361 | $0 | $21,483 | $0 | $2,774 | $0 | $6,621 | $0 | $29,671 | $0 | $290,910 | $0 | $0 | $0 |
| THELMA COLLINS | ||||||||||||||
| HOUSE SUPERVISOR - NE | $221,520 | $0 | $0 | $0 | $23,248 | $0 | $5,365 | $0 | $23,894 | $0 | $274,027 | $0 | $0 | $0 |
| MATT HUDDLESTON | ||||||||||||||
| ENGINEER-CHIEF | $254,933 | $0 | $0 | $0 | $25 | $0 | $0 | $0 | $0 | $0 | $254,958 | $0 | $0 | $0 |
| TAMIKO FELICIANO | ||||||||||||||
| DIR, NURSING | $202,626 | $0 | $11,331 | $0 | $2,533 | $0 | $3,279 | $0 | $14,334 | $0 | $234,103 | $0 | $0 | $0 |
| ROBERT LOFTON | ||||||||||||||
| TECH | $168,631 | $0 | $0 | $0 | $33,116 | $0 | $18,213 | $0 | $11,328 | $0 | $231,288 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | PROVIDENCE EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: FIRST CLASS TRAVEL OR CHARTER TRAVEL AIR TRAVEL IS GENERALLY REIMBURSABLE AT THE LEAST EXPENSIVE AIRFARE WHICH PERMITS DEPARTURES AND ARRIVALS AT REASONABLE TIMES AND REASONABLE DISTANCE TRAVELED. EMPLOYEES ARE ENCOURAGED TO PLAN IN ADVANCE TO GET AVAILABLE DISCOUNTS. AIRLINE FREQUENT FLYER UPGRADES WILL NEVER BE REIMBURSED. IN LIMITED SITUATIONS FIRST CLASS TICKETS AND CHARTER MAY BE REIMBURSED WHEN APPROVED BY A SENIOR LEVEL SUPERVISOR. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - RELOCATION PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO RELOCATION EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THE RELOCATION EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THE RELOCATION BENEFITS, SO THAT A PORTION OF THE REIMBURSEMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - FINANCIAL/RETIREMENT PLANNING PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO FINANCIAL AND RETIREMENT PLANNING EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THESE OTHER EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THIS BENEFIT, SO THAT A PORTION OF THE PAYMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE. |
| PART I, LINE 3 | DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX-EXEMPT PARENT, ST.JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE. |
| PART I, LINES 4A-B | THE FOLLOWING INDIVIDUALS RECIEVED SEVERANCE PAYMENTS DURING 2020: CAROL KOEBLE - $333,728 CARMELO MOCERI - $172,847 NON-QUALIFIED RETIREMENT PLAN 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 INDIVIDUAL RECEIVED A PAYOUT DURING THE CURRENT YEAR: CAROL KOEBLE - $49,336 CARMELO MOCERI - $35,531 |
| 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, WHICH IS A PERFORMANCE-BASED ANNUAL INCENTIVE PLAN THAT AFFORDS 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 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 ORGANIZATIONS SECTION 4960 TAX ANALYSIS AND REPORTING. |
| FORM 990, PART VI, SECTION A, LINE 6 | CLASSES OF MEMBERS OR STOCKHOLDERS SANTA ROSA MEMORIAL HOSPITAL IS THE SOLE CORPORATE MEMBER OF SRM ALLIANCE HOSPITAL SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 7A | CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS SRM ALLIANCE HOSPITAL SERVICES HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE SRM ALLIANCE HOSPITAL SERVICES BOARD. ALL TRUSTEE NOMINATIONS THAT COME FROM THE SRM ALLIANCE HOSPITAL SERVICES BOARD AS NOMINATIONS MUST BE APPROVED BY SANTA ROSA MEMORIAL HOSPITAL, 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 SANTA ROSA MEMORIAL HOSPITAL 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 CORPORATE MEMBER, SANTA ROSA MEMORIAL HOSPITAL, 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 EMPLOYEES 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 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 REGULARLY. 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 ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, 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 2020. |
| 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 LABOR: PROGRAM SERVICE EXPENSES 2,670,745. MANAGEMENT AND GENERAL EXPENSES 443,362. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,114,107. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 313,148. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 313,148. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 2,815,384. MANAGEMENT AND GENERAL EXPENSES 1,687,371. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,502,755. MEDICAL DIRECTOR & MED CONSULTING FEES: PROGRAM SERVICE EXPENSES 4,605,648. MANAGEMENT AND GENERAL EXPENSES 53,314. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,658,962. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 1,181,683. MANAGEMENT AND GENERAL EXPENSES 3,614. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,185,297. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 3,644,819. MANAGEMENT AND GENERAL EXPENSES 16,900. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,661,719. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS -10,298,830. SYSTEM COST ALLOCATION 16,253,819. OTHER 495,654. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (111 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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) | |
| INLAND NORTHWEST HEALTH SERVICES | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 911307555 | HEALTHCARE | WA | 501(C)(3) | 3 | PHS WA | Yes (1) | |
| INSTITUTE FOR MENTAL HEALTH & WELLNESS | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 814260130 | HEALTHCARE | WA | 501(C)(3) | 7 | 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) | |
| MARSHA RIVKIN CENTER FOR OVARIAN CANCER RESEARCH | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 912054035 | RESEARCH | WA | 501(C)(3) | 7 | SHS | 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) | |
| 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 CARE FOUNDATION (CENTRALIA) | |||||||||||
| 413 LILLY ROAD NE | OLYMPIA | WA | 985065166 | 911433382 | HEALTHCARE | WA | 501(C)(3) | 7 | PHS W 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 | |||||||||||
| 2731 WETMORE AVE STE 500 | EVERETT | WA | 98201 | 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 | |||||||||||
| 1801 LIND AVE SW | RENTON | WA | 980579016 | 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 | |||||||||||
| 1025 S 2ND AVENUE | 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 | RMH | 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 | |
| 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 | KADLEC | Yes (1) | |
| TRI-CITIES CANCER CENTER FOUNDATION | |||||||||||
| 7350 W DESCHUTES AVE BUILDING A | KENNEWICK | WA | 99336 | 911739024 | SUPPORT | WA | 501(C)(3) | 12, I | KADLEC | Yes (1) | |
| UNIVERSITY OF PROVIDENCE | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 810231777 | EDUCATION | MT | 501(C)(3) | 2 | PHS | Yes (1) | |
| WESTERN HEALTHCONNECT | |||||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 454171900 | SHELL CORPORATION | WA | 501(C)(3) | 12, II | PHS W WA | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (45 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 (BMI) | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260796953 | IMAGING - DIAGNOSTICS | OR | N/A | 0 | 0 |
| BROADWAY IMAGING LLC | |||||||||
| 500 W BROADWAY | MISSOULA | MT | 59802 | 522405971 | MEDICAL IMAGING | MT | N/A | 0 | 0 |
| CENTER FOR MATERNAL NEWBORN AND CHILD | |||||||||
| 1801 LIND AVENUE SW ATTN TAX DEPT | RENTON | WA | 98057 | 813526875 | HEALTHCARE | CA | N/A | 0 | 0 |
| CENTER FOR MEDICAL IMAGING (CMI) | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 200477972 | IMAGING - DIAGNOSTICS | OR | N/A | 0 | 0 |
| CLACKAMAS RADIATION ONCOLOGY CENTER LLC | |||||||||
| 4400 NE HALSEY 495 | PORTLAND | OR | 97213 | 260381897 | RADIATION ONCOLOGY | OR | N/A | 0 | 0 |
| 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 |
| 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) |
| NEWPORT SURGICAL PARTNERS LLC | |||||||||
| 27271 LAS RAMBLAS 350 | MISSION VIEJO | CA | 92691 | 392060266 | HEALTHCARE | CA | N/A | 0 | Yes (1) |
| OREGON ADVANCED IMAGING LLC | |||||||||
| 881 OHARE PARKWAY | MEDFORD | OR | 97504 | 450471748 | MEDICAL IMAGING | OR | N/A | 0 | 0 |
| 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 | 0 |
| 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 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 |
| PROVIDENCESILVERTON REHAB LLC | |||||||||
| 4400 NE HALSEY 425 | PORTLAND | OR | 97213 | 481287267 | REHAB SERVICES | OR | 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) |
| REDMOND AMBULATORY SURGERY CENTER LLC | |||||||||
| 805 MADISON ST STE 901 | SEATTLE | WA | 98104 | 813558711 | AMBULATORY SURGERY CENTER | 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) |
| SURGERY CENTER AT TANASBOURNE LLC | |||||||||
| 11221 ROE AVE STE 300 | LEAWOOD | KS | 66211 | 208187971 | AMBULATORY SURGERY CENTER | KS | N/A | 0 | 0 |
| 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) |
| YELM MEDICAL OFFICE BUILDING | |||||||||
| 2840 CRITES ST SW STE 104 | TUMATER | WA | 98512 | 263685020 | REAL ESTATE - MOB | WA | N/A | 0 | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (40 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1221 MADISON STREET OWNERS ASSOC | ||||||||||||
| 747 BROADWAY | SEATTLE | WA | 98122 | 201954319 | OWNERS' ASSOCIATION | WA | 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 | |||
| COMMUNITY TECHNOLOGIES INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844722399 | IT SVCS | DE | N/A | C | 0 | |||
| DATU HEALTH INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 463070062 | 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 | |||
| ENGAGE IT SERVICES INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 844058573 | IT SVCS | DE | N/A | C | 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 | |||
| 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 | ||||||||||||
| 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 | N/A | C | 0 | |||
| PROVIDENCE ASSURANCE INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 208194071 | CAPTIVE INSURANCE | AZ | N/A | C | 0 | |||
| PROVIDENCE GLOBAL CENTER LLP | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 981516461 | IT SVCS | N/A | C | 0 | IN | |||
| PROVIDENCE HCC HOLDINGS INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | HOLDING COMPANY | CA | N/A | C | 0 | ||||
| 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 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 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 | |||
| WESTERN HEALTHCONNECT VENTURES INC | ||||||||||||
| 1801 LIND AVE SW ATTN TAX DEPT | RENTON | WA | 98057 | 800953654 | INVESTMENT | WA | N/A | C | 0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||
| S | $349,705 | CASH |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||
| R | $638,000 | CASH |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||
| P | $8,273,880 | CASH |
| ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC | ||
| R | $419,324 | CASH |