2021-11-12T16:42:04-06:00 2020-12-31 346565596 ERNST & YOUNG US LLP 560 MISSION STREET SUITE 1600 SAN FRANCISCO CA 94105 990 2020-01-01 954322584 PROVIDENCE FACEY MEDICAL FOUNDATION PROV 8183659531 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 MELAYNE YOCUM CFO 4255253985 2021-11-12 1 MELAYNE YOCUM 999009999 TAMARA SUGIHARA P01262399 4158948000 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MELAYNE YOCUM 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 365460244 0 X WWW.FACEY.COM X 1991 CA SEE SCHEDULE O.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. 20 14 1318 0 0 0 0 3641476 304279311 353274818 -700284 663529 7827278 7880421 311406305 365460244 0 0 0 0 75003322 72561117 0 0 0 237158071 292497879 312161393 365058996 -755088 401248 213234071 206456570 149739944 169421442 63494127 37035128 X 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. 0 0 347420648 0 360288828 SEE SCHEDULE O.AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE PURSUE INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,085 CLINICS AND A COMPREHENSIVE RANGE OF SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-HOAG MEMORIAL HOSPITAL PRESBYTERIAN IN ORANGE COUNTY, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA2020 - 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. 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; AND4 - INNOVATING FOR THE FUTURE.WE CHOSE THESE FOCUS AREAS BECAUSE THEY ARE ALL FOUNDATIONAL TO HEALTH AND WELL-BEING, REPRESENTING IDENTIFIED NEEDS THAT ARE INTEGRAL TO IMPROVING QUALITY OF LIFE. PROGRAM SERVICE ACCOMPLISHMENTS - DIRECT PATIENT MEDICAL CARE - THIS INCLUDES, BUT IS NOT LIMITED TO, FACE TO FACE PROVIDER APPOINTMENTS, LABORATORY AND X-RAY SERVICES, PHYSICAL THERAPY SERVICES, IMMUNIZATIONS, PROVIDED DRUGS AND MEDICATIONS, PROCEDURES IN OPHTHALMOLOGY, OB/GYN, AND GASTROENTEROLOGY. REVENUES ALSO INCLUDE INCOME FROM HOSPITAL & HEALTH PLAN SHARED RISK, HEALTH PLAN PAY FOR PROVIDENCE FACEY MEDICAL FOUNDATION 95-4322584 PERFORMANCE, STOP LOSS RECOVERIES, AND 3RD PARTY LIENS, AND MEANINGFUL USE.PATIENT EDUCATION: HEALTH EDUCATION CLASSES COVERED NUMEROUS TOPICS, INCLUDING BLOOD PRESSURE MANAGEMENT, CHOLESTEROL MANAGEMENT, HEALTHY LIVING, DEALING WITH MEMORY LOSS, SMOKING CESSATION, PRE-DIABETES, BARIATRIC EDUCATION, TO NAME A FEW. 347420648 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 38 0 1 1318 1 0 0 0 0 0 0 0 0 0 0 0 0 X 20 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 CA X JO ANN ESCASA-HAIGH 9493814000 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 ROD F HOCHMAN MD FORMER OFFICER - PSJH PRESIDENT/CEO 0.00 60.00 X 0 9299594 813801 MIKE BUTLER DIRECTOR 0.10 59.90 X 0 8708237 56431 DEBRA CANALES FORMER KE - PSJH EVP/CAO 0.00 60.00 X 0 2003884 691108 BJ MOORE DIRECTOR 2.00 58.00 X 0 2051691 497009 ERIK WEXLER DIRECTOR 0.10 64.90 X 0 1864281 448015 AMY COMPTON-PHILLIPS MD FORMER KE - PSJH EVP CHF CLIN. OFC. 0.00 55.00 X 0 1709011 533089 RHONDA MEDOWS MD FRMR KE - PSJH PRES. EVP/POP. HEALTH 0.00 60.00 X 0 1814460 328861 VENKAT BHAMIDIPATI FORMER EVP/TREASURER 0.00 60.00 X 0 2084131 22680 CINDY STRAUSS FORMER SECRETARY 0.00 60.00 X 0 1745541 358093 LISA VANCE FORMER KE - PSJH EVP REGIONAL CE OR 0.00 60.00 X 0 1529706 411248 JO ANN ESCASA-HAIGH FORMER EVP/ASSISTANT TREASURER 0.00 60.00 X 0 1311654 434938 GREG TILL FORMER CHIEF PEOPLE OFFICER 0.00 65.00 X 0 1304460 341650 AARON MARTIN FRMR KE - PSJH EVP CHF MKT/DIG INN. 0.00 70.00 X 0 1307753 272343 KEVIN MANEMANN EVP & CE, PHYSICIAN ENTERPRISE 2.00 48.00 X X 0 1249471 299464 MIKE WATERS DIRECTOR 0.10 64.90 X 0 1120486 223207 JOEL GILBERTSON FORMER EVP COMMUNITY PARTNERSHIPS 0.00 60.00 X 0 1107594 226050 OREST HOLUBEC FORMER SVP CHIEF COMMUNICATION OFCR 0.00 55.00 X 0 939380 203274 JOHN WHIPPLE FORMER ASSISTANT SECRETARY 0.00 60.00 X 0 963651 176306 MARY CRANSTOUN FORMER SVP TOTAL REWARDS TALENT ACQ 0.00 60.00 X 0 833682 188693 DOUG KOEKKOEK DIRECTOR 2.00 56.00 X 0 824664 184153 DAVID BROWN FORMER SVP CAO AMBULATORY CARE 0.00 55.00 X 0 708463 156898 JIM WATSON ESQ SECRETARY 2.00 58.00 X 0 744481 120056 DAVID MAST CEO MEDICAL FOUNDATIONS 20.00 20.00 X 0 640050 95760 JILL DUPLECHAN GVP CAO PHYSICIAN ENTERPRISE CA 15.00 40.00 X 0 559261 133506 DEBBIE BURTON FORMER SVP CHIEF NURSING OFFICER 0.00 60.00 X 0 651863 39206 NATHAN HUSMANN CFO 15.00 40.00 X 0 559052 86599 TOM MCDONAGH FORMER VP/CHIEF INVESTMENT OFFICER 0.00 58.00 X 0 485249 30532 TERESA DAVID COO MEDICAL FOUNDATIONS 25.00 25.00 X 497060 0 15058 JAMES A CORWIN CFO LOB PSJH - (PART YEAR) 20.00 40.00 X 0 383778 27235 SHARON TONCRAY FORMER SVP/CHIEF LABOR EE COUNSEL 0.00 60.00 X 0 361654 27461 THOMAS MCDEVITT ASSOC. CFO MED. FOUNDATIONS 40.00 0.00 X 263065 0 27994 CATHY HAWES ADMIN DIR, OPERATIONS 40.00 0.00 X 229337 0 22724 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 0.10 59.90 X 0 228473 22814 LYDIA THANGAIYAN CFO LOB PSJH 20.00 40.00 X 0 223735 24983 TAMMY FISHER REG ADMIN DIR SPEC SERVICES 40.00 0.00 X 219459 0 25130 CAMMIE FLORES REG DIR ACO COMPX CARE MGMT 40.00 0.00 X 207421 0 32659 JACOP JUNG REG DIR MANAGED CARE FINANCE 40.00 0.00 X 225413 0 4946 TAMMY TEODOSIO FORMER ASSISTANT SECRETARY 0.00 60.00 X 0 105105 17660 ANNE FORD MD DIRECTOR 2.00 6.00 X 0 0 0 CONNIE BARTLETT DO DIRECTOR 2.00 6.00 X 0 0 0 DAVID CHENG DIRECTOR 2.00 6.00 X 0 0 0 DONALD PRATT MD DIRECTOR 2.00 6.00 X 0 0 0 ELIZABETH SANDER MD DIRECTOR/CHAIR 2.00 6.00 X 0 0 0 JEANNETTE CURRIE BOARD TRUSTEE (PART YEAR) 2.00 6.00 X 0 0 0 JOHN ARYANPUR MD DIRECTOR - (PART YEAR) 2.00 6.00 X 0 0 0 KEITH MARTON MD DIRECTOR 2.00 6.00 X 0 0 0 MARK NEEDHAM MD DIRECTOR 2.00 6.00 X 0 0 0 MICHAEL SUGARMAN MD DIRECTOR 2.00 6.00 X 0 0 0 ROBERT DEL JUNCO MD DIRECTOR 2.00 6.00 X 0 0 0 ROBERT ROSENBERG MD DIRECTOR 2.00 6.00 X 0 0 0 ROSCOE MARTER MD DIRECTOR 2.00 6.00 X 0 0 0 SISTER JO-ANN EANNARENO DIRECTOR 2.00 6.00 X 0 0 0 1641755 49424495 7621634 118 1 1 0 MEDICAL SPECIALTIES MANAGER 4600 LEBANON ROAD CHARLOTTE NC 28227 MEDICAL CONSULTING 394469 PROVIDENCE MEDICAL FOUNDATION 1801 LIND AVE RENTON WA 98057 MEDICAL SERVICES 246547 PYXIS ASSOCIATES INC 8210 ENRAMADA AVE WHITTIER CA 90605 MEDICAL CONSULTING 220914 TELEMED INC 7117 FLORIDA BLVD BATON ROUGE LA 70806 MEDICAL SERVICES 213691 GENZYME CORPORATION 500 KENDALL STREET CAMBRIDGE MA 02142 MEDICAL CONSULTING 205179 15 3638476 3000 3641476 NET PATIENT REVENUE 621110 310431205 310431205 INTER-AFFILIATE REV. 900099 42872927 42872927 HEALTHCARE JVS 900099 -29314 -29314 353274818 615219 615219 866411 0 866411 866411 866411 48310 0 48310 48310 48310 MISC REVENUE 900099 7003091 7003091 COST RECOVERIES 900099 10919 10919 7014010 365460244 360288828 0 1529940 X 65933411 62504974 3428437 1028812 975315 53497 72638 68861 3777 5526256 5238899 287357 281458 266823 14635 33 31 2 4110 4110 230698070 218702122 11995948 648054 614356 33698 3009371 2852888 156483 151498 143620 7878 21745436 20614707 1130729 38776 36760 2016 38509 36507 2002 6748993 6398056 350937 2479603 2350667 128936 MEDICAL SUPPLIES 25549649 25549649 OTHER DIRECT EXPENSES 459122 435248 23874 LICENSES AND TAXES 375358 375358 SPECIAL EVENTS 180767 171367 9400 89072 84440 4632 365058996 347420648 17638348 0 498541 515120 19036161 18927574 156129 264380 19507501 21833243 2169713 2140737 2123679 5183472 89424493 54766484 38357124 34658009 22594118 25902680 3469234 3198070 5284136 4821139 100037735 89012146 213234071 206456570 38877514 61361252 4268074 110862430 103792116 149739944 169421442 X 63494127 37035128 63494127 37035128 213234071 206456570 X 401248 2689248 -29549495 X 0 1 X 1 0 X 8798599 3050831 5747768 26349530 13077928 13271602 31457247 27765760 3691487 22819117 10871965 11947152 34658009 DUE FROM AFFILIATES 172372 RIGHT OF USE OPERATING LEASES 88252270 OTHER ASSETS 587504 89012146 CAPITAL LEASE OBLIGATIONS 99671005 LIABILITY FOR MEDICAL MALPRACTICE 2190000 OTHER LIABILITIES 666926 DUE TO THIRD PARTY 1264185 103792116 X 1 1 1 1 0 0 0 0 0 1 0 ROD F HOCHMAN MD FORMER OFFICER - PSJH PRESIDENT/CEO 0 1773896 0 6709440 0 816258 0 782925 0 30876 0 10113395 0 751800 MIKE BUTLER DIRECTOR 0 965819 0 3330902 0 4411516 0 34515 0 21916 0 8764668 0 2150861 DEBRA CANALES FORMER KE - PSJH EVP/CAO 0 895727 0 575002 0 533155 0 673455 0 17653 0 2694992 0 487270 BJ MOORE DIRECTOR 0 805013 0 1242064 0 4614 0 465814 0 31195 0 2548700 0 0 ERIK WEXLER DIRECTOR 0 964730 0 573824 0 325727 0 425498 0 22517 0 2312296 0 310110 AMY COMPTON-PHILLIPS MD FORMER KE - PSJH EVP CHF CLIN. OFC. 0 760456 0 519149 0 429406 0 500905 0 32184 0 2242100 0 384671 RHONDA MEDOWS MD FRMR KE - PSJH PRES. EVP/POP. HEALTH 0 897985 0 523880 0 392595 0 308771 0 20090 0 2143321 0 346425 VENKAT BHAMIDIPATI FORMER EVP/TREASURER 0 713471 0 400000 0 970660 0 4275 0 18405 0 2106811 0 184910 CINDY STRAUSS FORMER SECRETARY 0 801070 0 601420 0 343051 0 331005 0 27088 0 2103634 0 299545 LISA VANCE FORMER KE - PSJH EVP REGIONAL CE OR 0 771527 0 511879 0 246300 0 384714 0 26534 0 1940954 0 203441 JO ANN ESCASA-HAIGH FORMER EVP/ASSISTANT TREASURER 0 682465 0 370006 0 259183 0 403809 0 31129 0 1746592 0 218804 GREG TILL FORMER CHIEF PEOPLE OFFICER 0 601238 0 514002 0 189220 0 308738 0 32912 0 1646110 0 152175 AARON MARTIN FRMR KE - PSJH EVP CHF MKT/DIG INN. 0 644818 0 390425 0 272510 0 266627 0 5716 0 1580096 0 249267 KEVIN MANEMANN EVP & CE, PHYSICIAN ENTERPRISE 0 693280 0 447588 0 108603 0 270203 0 29261 0 1548935 0 0 MIKE WATERS DIRECTOR 0 513014 0 313206 0 294266 0 207159 0 16048 0 1343693 0 161221 JOEL GILBERTSON FORMER EVP COMMUNITY PARTNERSHIPS 0 578919 0 305000 0 223675 0 195488 0 30562 0 1333644 0 186629 OREST HOLUBEC FORMER SVP CHIEF COMMUNICATION OFCR 0 472607 0 259999 0 206774 0 173676 0 29598 0 1142654 0 169616 JOHN WHIPPLE FORMER ASSISTANT SECRETARY 0 448628 0 316136 0 198887 0 148450 0 27856 0 1139957 0 169265 MARY CRANSTOUN FORMER SVP TOTAL REWARDS TALENT ACQ 0 450242 0 204417 0 179023 0 163934 0 24759 0 1022375 0 145103 DOUG KOEKKOEK DIRECTOR 0 465468 0 163060 0 196136 0 156746 0 27407 0 1008817 0 178169 DAVID BROWN FORMER SVP CAO AMBULATORY CARE 0 381205 0 143506 0 183752 0 127676 0 29222 0 865361 0 161988 JIM WATSON ESQ SECRETARY 0 437006 0 301877 0 5598 0 84307 0 35749 0 864537 0 0 DAVID MAST CEO MEDICAL FOUNDATIONS 0 389253 0 164386 0 86411 0 76984 0 18776 0 735810 0 82366 JILL DUPLECHAN GVP CAO PHYSICIAN ENTERPRISE CA 0 382562 0 169325 0 7374 0 117383 0 16123 0 692767 0 0 DEBBIE BURTON FORMER SVP CHIEF NURSING OFFICER 0 377566 0 135000 0 139297 0 8252 0 30954 0 691069 0 107362 NATHAN HUSMANN CFO 0 392221 0 161518 0 5313 0 75902 0 10697 0 645651 0 0 TOM MCDONAGH FORMER VP/CHIEF INVESTMENT OFFICER 0 0 0 0 0 485249 0 6415 0 24117 0 515781 0 0 TERESA DAVID COO MEDICAL FOUNDATIONS 339386 0 88544 0 69130 0 5547 0 9511 0 512118 0 14398 0 JAMES A CORWIN CFO LOB PSJH - (PART YEAR) 0 242652 0 78586 0 62540 0 10067 0 17168 0 411013 0 40357 SHARON TONCRAY FORMER SVP/CHIEF LABOR EE COUNSEL 0 0 0 0 0 361654 0 3685 0 23776 0 389115 0 0 THOMAS MCDEVITT ASSOC. CFO MED. FOUNDATIONS 195881 0 41560 0 25624 0 7834 0 20160 0 291059 0 0 0 CATHY HAWES ADMIN DIR, OPERATIONS 196468 0 31083 0 1786 0 12006 0 10718 0 252061 0 0 0 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 0 204368 0 23098 0 1007 0 11841 0 10973 0 251287 0 0 LYDIA THANGAIYAN CFO LOB PSJH 0 174589 0 46871 0 2275 0 19500 0 5483 0 248718 0 0 TAMMY FISHER REG ADMIN DIR SPEC SERVICES 175269 0 30253 0 13937 0 9532 0 15598 0 244589 0 0 0 CAMMIE FLORES REG DIR ACO COMPX CARE MGMT 172002 0 35060 0 359 0 10983 0 21676 0 240080 0 0 0 JACOP JUNG REG DIR MANAGED CARE FINANCE 201971 0 21801 0 1641 0 3372 0 1574 0 230359 0 0 0 TAMMY TEODOSIO FORMER ASSISTANT SECRETARY 0 95587 0 7996 0 1522 0 4335 0 13325 0 122765 0 0 PART I, LINE 1A PROVIDENCE EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: FIRST CLASS TRAVEL OR CHARTER TRAVEL AIR TRAVEL IS GENERALLY REIMBURSABLE AT THE LEAST EXPENSIVE AIRFARE WHICH PERMITS DEPARTURES AND ARRIVALS AT REASONABLE TIMES AND REASONABLE DISTANCE TRAVELED. EMPLOYEES ARE ENCOURAGED TO PLAN IN ADVANCE TO GET AVAILABLE DISCOUNTS. AIRLINE FREQUENT FLYER UPGRADES WILL NEVER BE REIMBURSED. IN LIMITED SITUATIONS, FIRST CLASS TICKETS AND CHARTER MAY BE REIMBURSED WHEN APPROVED BY A SENIOR LEVEL SUPERVISOR. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - 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. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE PROVIDENCE PROVIDES HOUSING ALLOWANCES ONLY FOR PURPOSES OF RELOCATION ASSISTANCE TO A NEWLY HIRED EMPLOYEE. PROVIDENCE MAY PAY TEMPORARY LIVING EXPENSES FOR THE NEWLY HIRED EMPLOYEE UP TO A MAXIMUM OF 90 CALENDAR DAYS. COVERED EXPENSES ARE RENT (EXCLUDING "RENT" WHICH MAY BE PAID IN ORDER TO OCCUPY A NEW PERMANENT RESIDENCE UNTIL THE TITLE CLEARS) AND UTILITIES, INCLUDING HEAT, ELECTRICITY, GAS, WATER, LOCAL INTERNET AND LOCAL TELEPHONE AND GARBAGE SERVICES. THE EXECUTIVE VICE PRESIDENT, CHIEF ADMINISTRATIVE OFFICER OF PROVIDENCE MAY APPROVE TEMPORARY HOUSING ASSISTANCE FOR UP TO SIX MONTHS WHEN FAMILY RELOCATION IS DELAYED TO ACCOMMODATE THE SCHOOL YEAR OR EQUIVALENT CIRCUMSTANCES. ONLY IN EXTENUATING CIRCUMSTANCES IS HOUSING EXTENDED BEYOND THIS SIX-MONTH PERIOD. THE AMOUNTS REPORTED FOR THESE RELOCATION/HOUSING PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE. PART I, LINE 3 DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA, 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 RECEIVED SEVERANCE PAYMENTS DURING 2020: MIKE BUTLER - $507,235 VENKAT BHAMIDIPATI - $750,000 TOM MCDONAGH - $485,032 TERESA DAVID - $29,843 SHARON TONCRAY - $367,774 JACOP JUNG - $1,000 ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(III) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR: ROD F. HOCHMAN, MD - $751,800 MIKE BUTLER - $2,150,861 DEBRA CANALES - $487,270 ERIK WEXLER - $310,110 AMY COMPTON-PHILLIPS, MD - $384,671 RHONDA MEDOWS, MD - $346,425 VENKAT BHAMIDIPATI - $184,910 CINDY STRAUSS - $299,545 LISA VANCE - $203,441 JO ANN ESCASA-HAIGH - $218,804 GREG TILL - $152,175 AARON MARTIN - $249,267 MIKE WATERS - $161,221 JOEL GILBERTSON - $186,629 OREST HOLUBEC - $169,616 JOHN WHIPPLE - $169,265 MARY CRANSTOUN - $145,103 DOUG KOEKKOEK - $178,169 DAVID BROWN - $161,988 DAVID MAST - $82,366 DEBBIE BURTON - $107,362 TERESA DAVID - $14,398 JAMES A. CORWIN - $40,357 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. FORM 990, PART V, LINE 15 INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF THE RELATED ORGANIZATION. IT IS THE INTENTION OF PROVIDENCE AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE EMPLOYEES OF A RELATED ORGANIZATION WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. THE RELATED ORGANIZATION COMMON LAW EMPLOYEES ARE INCLUDED IN THE RELATED ORGANIZATION'S SECTION 4960 TAX ANALYSIS AND REPORTING. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA IS THE SOLE CORPORATE MEMBER OF PROVIDENCE FACEY MEDICAL FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PROVIDENCE FACEY MEDICAL FOUNDATION HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT DIRECTORS TO THE PROVIDENCE FACEY MEDICAL FOUNDATION BOARD. ALL DIRECTOR NOMINATIONS THAT COME FROM THE PROVIDENCE FACEY MEDICAL FOUNDATION BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA, AS THE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE FOLLOWING POWERS RESIDE WITH THE CORPORATE MEMBER: 1) TO ADOPT OR CHANGE THE MISSION, PHILOSOPHY, AND VALUES, INCLUDING THE STRATEGIC PLAN AND MISSION STATEMENT. 2) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS. 3) TO APPROVE THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE TRANSFER, ASSIGNMENT OR ENCUMBERING OF ASSETS EXCEEDING A SPECIFIED THRESHOLD, OR THE SALE OR TRANSFER OF ANY PROPERTY WHICH MAY HAVE HISTORICAL OR RELIGIOUS SIGNIFICANCE. 4) TO APPROVE THE DISSOLUTION OR LIQUIDATION. 5) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS. 6) TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANTS. 7) TO APPROVE THE CLOSURE OF ANY INSTITUTION OR MAJOR ENTITY OR WORK OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY 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 15 PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA, 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 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 852,710. MANAGEMENT AND GENERAL EXPENSES 46,772. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 899,482. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 2,900,151. MANAGEMENT AND GENERAL EXPENSES 159,075. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,059,226. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 4,999,921. MANAGEMENT AND GENERAL EXPENSES 274,249. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,274,170. MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 129,619,135. MANAGEMENT AND GENERAL EXPENSES 7,109,690. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 136,728,825. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 50,436,588. MANAGEMENT AND GENERAL EXPENSES 2,766,478. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 53,203,066. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 381,446. MANAGEMENT AND GENERAL EXPENSES 20,923. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 402,369. MANAGEMENT AND GENERAL EXPENSES: PROGRAM SERVICE EXPENSES 29,512,171. MANAGEMENT AND GENERAL EXPENSES 1,618,761. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,130,932. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS -29,549,495. COVENANT ACO 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 611573313 HEALTHCARE TX 501(C)(3) 12,I CHS 1 COVENANT HEALTH NETWORK INC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 461259908 HEALTHCARE CA 501(C)(3) 12, III SJHS 1 COVENANT HEALTH PARTNERS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 463516417 HEALTHCARE TX 501(C)(3) 12, I CHS 1 COVENANT HEALTH SYSTEM 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS 1 COVENANT HEALTH SYSTEM FOUNDATION 3623 22ND PLACE LUBBOCK TX 79410 752897026 HEALTHCARE TX 501(C)(3) 7 CHS 1 COVENANT HOSPITAL HOBBS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 844273963 HEALTHCARE TX 501(C)(3) 3 CHS 1 COVENANT MEDICAL CENTER 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 822913146 HEALTHCARE TX 501(C)(3) 3 CHS 1 COVENANT MEDICAL GROUP 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 752743883 HEALTHCARE TX 501(C)(3) 3 CHS 1 EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT WA 982065128 943264605 TRANSITIONAL CARE WA 501(C)(3) 10 N/A 0 GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 201910170 SUPPORT WA 501(C)(3) 7 PHS WA 1 GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC WA 98188 273133200 HEALTHCARE WA 501(C)(3) 7 SHS 1 GRACE CLINIC OF LUBBOCK 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 203856995 HEALTHCARE TX 501(C)(3) 3 CHS 1 HMTS INC 1 HOAG DRIVE NEWPORT BEACH CA 92658 453583707 HEALTHCARE CA 501(C)(3) 12, I HMHP 1 HOAG CHARITY SPORTS 2081 BUSINESS CENTER DR STE 195 NEWPORT BEACH CA 92663 452982422 SUPPORT CA 501(C)(3) 7 HHF 1 HOAG CLINIC 1 HOAG DRIVE NEWPORT BEACH CA 92658 330676831 HEALTHCARE CA 501(C)(3) 10 HMHP 1 HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH CA 92663 953222343 FUNDRAISING CA 501(C)(3) 7 HMHP 1 HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG ROAD BOX 6100 NEWPORT BEACH CA 92663 951643327 HEALTHCARE CA 501(C)(3) 3 CHN 1 HOSPICE OF LUBBOCK 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 752133781 HEALTHCARE TX 501(C)(3) 10 CHS 1 INLAND NORTHWEST HEALTH SERVICES 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 911307555 HEALTHCARE WA 501(C)(3) 3 PHS WA 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 1 INSTITUTE FOR SYSTEMS BIOLOGY 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 912003593 HEALTHCARE WA 501(C)(3) 7 WHC 1 KADLEC AUXILIARY INC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 916033089 SUPPORT WA 501(C)(3) 12, III KRMC 1 KADLEC FOUNDATION 888 SWIFT BLVD RICHLAND WA 99352 237005501 SUPPORT WA 501(C)(3) 7 KRMC 1 KADLEC REGIONAL MEDICAL CENTER 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 910655392 HEALTHCARE WA 501(C)(3) 3 WHC 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 1 LUBBOCK HERITAGE HOSPITAL LLC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 264021016 HEALTHCARE TX 501(C)(3) 3 CHS 1 LUNDBERG ASSOCIATION PROVIDENCE HOUSE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 911562797 SUPPORT OR 501(C)(3) 7 PHS OR 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 1 METHODIST CHILDREN'S HOSPITAL 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 752428911 HEALTHCARE TX 501(C)(3) 3 CHS 1 METHODIST HOSPITAL LEVELLAND 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 752246348 HEALTHCARE TX 501(C)(3) 3 CHS 1 METHODIST HOSPITAL PLAINVIEW 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 752426010 HEALTHCARE TX 501(C)(3) 3 CHS 1 MISSION HOSPITAL REGIONAL MEDICAL CTR 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 951643360 HEALTHCARE CA 501(C)(3) 3 CHN 1 NORTHWEST HOPE & HEALING FOUNDATION PO BOX 16069 SEATTLE WA 98116 200799737 SUPPORT WA 501(C)(3) 12, I SHS 1 PACMED CLINICS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 562290878 HEALTHCARE WA 501(C)(3) 10 WHC 1 PH&S FOUNDATIONSFVSA & SCVSA 501 SOUTH BUENA VISTA STREET BURBANK CA 915054809 953544877 HEALTHCARE CA 501(C)(3) 7 PHS SOCAL 1 PROVIDENCE ALASKA FOUNDATION 3760 PIPER STREET SUITE 2021 ANCHORAGE AK 99508 920093565 HEALTHCARE AK 501(C)(3) 7 PHS WA 1 PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION 540 SOUTH MAIN ST MT ANGEL OR 97362 911940286 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE BLANCHET ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 911789266 SUPPORT WA 501(C)(3) 7 PHS WA 1 PROVIDENCE CHILDREN'S HEALTH FOUNDATION 4805 NE GLISAN ST STE 2N35 PORTLAND OR 97213 930800140 SUPPORT OR 501(C)(3) 7 PHS OR 1 PROVIDENCE COMMUNITY HEALTH FOUNDATION 940 ROYAL AVE SUITE 410 MEDFORD OR 97504 930692907 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE DETHMAN HOUSE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 473385506 SUPPORT WA 501(C)(3) 7 N/A 0 PROVIDENCE GAMELIN HOUSE ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 311744654 SUPPORT WA 501(C)(3) 7 PHS WA 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 1 PROVIDENCE HEALTH & SERVICES - OREGON 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 510216587 HEALTHCARE OR 501(C)(3) 3 PHS 1 PROVIDENCE HEALTH & SERVICES - WASHINGTON 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 510216586 HEALTHCARE WA 501(C)(3) 3 PHS 1 PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 911303277 HEALTHCARE WA 501(C)(3) 3 PMWHC 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 1 PROVIDENCE HEALTH CARE FOUNDATION - EASTERN WASHINGTON 101 W 8TH AVE SPOKANE WA 99204 320014330 HEALTHCARE WA 501(C)(3) 7 PHS WA 1 PROVIDENCE HEALTH CARE FOUNDATION (CENTRALIA) 413 LILLY ROAD NE OLYMPIA WA 985065166 911433382 HEALTHCARE WA 501(C)(3) 7 PHS W WA 1 PROVIDENCE HEALTH PLAN 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 930863097 HEALTHCARE OR 501(C)(4) N/A PPP 1 PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 510216589 HEALTHCARE CA 501(C)(3) 3 PHS 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 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 1 PROVIDENCE HOSPICE OF SEATTLE FOUNDATION 2811 SOUTH 102ND NO 220 TUKWILA WA 98168 912077378 HEALTHCARE WA 501(C)(3) 7 PHS W WA 1 PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION 4101 TORRANCE BLVD TORRANCE CA 90503 510224944 HEALTHCARE CA 501(C)(3) 7 PHS SOCAL 1 PROVIDENCE MARIANWOOD FOUNDATION 3725 PROVIDENCE POINT DRIVE SE ISSAQUAH WA 980297219 931554288 HEALTHCARE WA 501(C)(3) 7 PHS W WA 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 1 PROVIDENCE MEDICAL INSTITUTE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 330283773 HEALTHCARE CA 501(C)(3) 12, I PHS SOCAL 1 PROVIDENCE MILWAUKIE FOUNDATION 10150 SE 32ND AVE MILWAUKIE OR 97222 943079515 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE MINISTRIES 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 RELIGIOUS ORG WA 501(C)(3) 1 N/A 0 PROVIDENCE MOUNT ST VINCENT FOUNDATION 4831 35TH AVE SW SEATTLE WA 981262799 911188119 HEALTHCARE WA 501(C)(3) 7 PHS WA 1 PROVIDENCE NEWBERG HEALTH FOUNDATION 1001 PROVIDENCE DRIVE NEWBERG OR 97132 930889144 HEALTHCARE OR 501(C)(3) 7 PHS OR 1 PROVIDENCE PETER CLAVER ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 311629656 SUPPORT WA 501(C)(3) 7 PHS WA 1 PROVIDENCE PLAN PARTNERS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 911861964 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