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SRM ALLIANCE HOSPITAL SERVICES: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
SRM ALLIANCE HOSPITAL SERVICES (EIN 68-0395200)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-13
IRS object ID
202003189349309315
Schema version
2019v5.1
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

FieldValueIRS element (for citing)
Return2020-11-13T14:22:24-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN346565596PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14365 EXECUTIVE DRIVE SUITE 1600AddressLine1Txt
CitySAN DIEGOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92121ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN680395200EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SRM ALLIANCE HOSPITAL SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSRMABusinessNameControlTxt
Phone7075221570PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 LIND AVE SW ATTN TAX DEPTAddressLine1Txt
CityRENTONCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98057ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPATTI PILGRIMPersonNm
Person TitleCFOPersonTitleTxt
Phone7075221570PhoneNum
Signature2020-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRYAN MAYORPreparerPersonNm
PTINP01650740PTIN
Phone8585357200PhoneNum
Preparation2020-11-11PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address152.169.64.19IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-13IPDt
IP Tm09:57:50IPTm
IP TimezoneUSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id8C6B038D826617A351DA504230A10C8935A538B8AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1PETALUMA VALLEY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerTYLER HEDDENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 NORTH MCDOWELL BLVDAddressLine1Txt
CityPETALUMACityNm
State AbbreviationCAStateAbbreviationCd
ZIP94954ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$93,507,761GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.STJOESONOMA.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionAS 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 Body11VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee466TotalEmployeeCnt
Total Volunteers87TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$470,112PYContributionsGrantsAmt
CY Contributions Grants$356,365CYContributionsGrantsAmt
PY Program Service Revenue$97,326,372PYProgramServiceRevenueAmt
CY Program Service Revenue$92,637,265CYProgramServiceRevenueAmt
PY Investment Income$313,983PYInvestmentIncomeAmt
CY Investment Income$362,358CYInvestmentIncomeAmt
PY Other Revenue$1,771,870PYOtherRevenueAmt
CY Other Revenue$151,773CYOtherRevenueAmt
PY Total Revenue$99,882,337PYTotalRevenueAmt
CY Total Revenue$93,507,761CYTotalRevenueAmt
PY Grants And Similar Paid$902,900PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$638,748CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$41,351,755PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$36,465,421CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$31,853CYTotalFundraisingExpenseAmt
PY Other Expenses$42,564,907PYOtherExpensesAmt
CY Other Expenses$49,555,372CYOtherExpensesAmt
PY Total Expenses$84,819,562PYTotalExpensesAmt
CY Total Expenses$86,659,541CYTotalExpensesAmt
PY Revenues Less Expenses$15,062,775PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,848,220CYRevenuesLessExpensesAmt
Total Assets BOY$48,921,351TotalAssetsBOYAmt
Total Assets EOY$43,719,964TotalAssetsEOYAmt
Total Liabilities BOY$34,150,430TotalLiabilitiesBOYAmt
Total Liabilities EOY$15,042,483TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$14,770,921NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$28,677,481NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAS 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$82,139,568ExpenseAmt
Grant$638,748GrantAmt
Revenue$92,789,038RevenueAmt
DescSEE SCHEDULE OPROVIDENCEON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT TO FORM PROVIDENCE ST. JOSEPH HEALTH (PROVIDENCE). BY COMING TOGETHER, PROVIDENCE SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 1,085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE - A CHANGING HEALTH CARE ENVIRONMENT - WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE.PROVIDENCE HEALTH & SERVICESIN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. ST. JOSEPH HEALTH SYSTEMIN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK, TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA.REALIZING OUR MISSIONPETALUMA VALLEY HOSPITAL (PVH) HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE LOCAL COMMUNITY FOR OVER 20 YEARS. SERVING THE COMMUNITIES OF SONOMA COUNTY, PVH IS AN ACUTE CARE HOSPITAL THAT PROVIDES QUALITY CARE IN THE AREAS OF CARDIAC CARE, DIAGNOSTIC IMAGING, AND A WIDE RANGE OF SPECIALTY SERVICES, EMERGENCY MEDICINE AND OBSTETRICS. WITH OVER 600 EMPLOYEES COMMITTED TO REALIZING THE MISSION, PETALUMA VALLEY HOSPITAL IS ONE OF THE LARGEST EMPLOYERS IN THE SONOMA COUNTY REGION.PROGRAM SERVICE ACCOMPLISHMENTS - PETALUMA VALLEY HOSPITALCONTINUUM 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. 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 OUR SERVICE AREA, THE CLINIC SERVED PATIENTS AT SEVERAL LOCATIONS, INCLUDING THE CITIES OF SONOMA/BOYES HOT SPRINGS, SANTA ROSA, AND WINDSOR.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, HELPED TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO MORE EFFECTIVELY MANAGE CHRONIC DISEASE.FOR MORE INFORMATION ABOUT PETALUMA VALLEY HOSPITAL, PLEASE VISITWWW.STJOESONOMA.ORG.FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORGFOR MORE INFORMATION ABOUT PROVIDENCE ST. JOSEPH HEALTH, PLEASE VISIT WWW.PSJHEALTH.ORGDesc
Total Program Service Expenses$82,139,568TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee466EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JONI MURPHYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7075255300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1141 STONY CIRCLE SUITE 140AddressLine1Txt
CitySANTA ROSACityNm
State AbbreviationCAStateAbbreviationCd
ZIP95401ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
KEVIN KLOCKENGA
FORMER REG CHIEF EXECUTIVE - NO CA21.0029.00Yes (X)$0$1,144,038$231,217
ROBERT JUST III
FORMER CE - N CA MEDICAL GROUP0.0052.00Yes (X)$0$530,604$147,002
CAROL KOEBLE
FORMER CHIEF MEDICAL OFFICER - NO CA4.0046.00Yes (X)$0$566,793$81,811
OLUYEMI ADEYANJU ESQ
SECRETARY4.0046.00$0$544,043$101,971Yes (X)
CHAD KRILICH
FORMER CMO-CHIEF MEDICAL OFFICER4.0046.00Yes (X)$0$549,953$56,067
CARMELO MOCERI
FORMER CHIEF STRATEGY OFF - NO CA4.0046.00Yes (X)$0$465,044$79,712
VICKI WHITE
FORMER CNO-CHIEF NURSING OFCR4.0046.00Yes (X)$0$494,128$37,692
TYLER HEDDEN
CEO-CHIEF EXEC OFFICER-SONOMA4.0046.00$0$479,748$45,798Yes (X)Yes (X)
JOHN BIBBY
FORMER CHRO, PHYSICIAN ENTERPRISE4.0046.00Yes (X)$0$439,035$74,133
MARK PROVAN
FORMER CHIEF OPS/WORKFORCE INT OFF4.0046.00Yes (X)$0$421,096$56,415
DAVID SOUTHERLAND
INTERIM COO NO CA4.0046.00$197,562$187,584$13,572Yes (X)
TERRI DENTE
FORMER CHIEF MISSION OFF NO CA4.0046.00Yes (X)$0$338,509$52,133
ANDREA LEARNED
FORMER MINISTRY CHIEF, PHILAN OFF4.0046.00Yes (X)$0$305,890$31,458
TODD SALNAS
FORMER CEO-CHIEF EXEC OFFICER-SONOMA9.0041.00Yes (X)$0$290,102$42,415
WENDI THOMAS
DIRECTOR, NURSING50.000.00$232,810$0$49,516Yes (X)
THELMA COLLINS
HOUSE SUPERVISOR - NE50.000.00$240,600$0$35,247Yes (X)
ARAM RAHIMI
CLINICAL PHARMACIST50.000.00$193,807$0$42,182Yes (X)
MATT HUDDLESTON
ENGINEER-CHIEF50.000.00$226,661$0$5,793Yes (X)
MAUREEN DISBOT
FMR REG CHIEF, QUALITY/SAFETY NO CA0.0050.00Yes (X)$0$209,786$13,920
TAMIKO FELICIANO
DIR, NURSING50.000.00$202,161$0$14,568Yes (X)
PJ LALLY MD
EX OFFICIO - CHIEF OF STAFF4.0046.00$0$7,950$0Yes (X)
SCOTT PRITCHARD
BOARD MEMBER, CHAIRPERSON4.0046.00$0$0$0Yes (X)
KATHIE POWELL
BOARD MEMBER, VICE CHAIR2.000.00$0$0$0Yes (X)
DR JEFFREY TOBIAS
PCHD BOARD REP4.0046.00$0$0$0Yes (X)
JOANNE FERRIS
BOARD MEMBER2.000.00$0$0$0Yes (X)
JIM CARR
BOARD MEMBER2.000.00$0$0$0Yes (X)
JOSEPHINE THORNTON
BOARD MEMBER2.0041.00$0$0$0Yes (X)
PAMELA TUFT
BOARD MEMBER2.000.00$0$0$0Yes (X)
RAJESH RANADIVE MD
BOARD MEMBER2.0046.00$0$0$0Yes (X)
SISTER KAREN CLOCK
BOARD MEMBER2.000.00$0$0$0Yes (X)
JOHN PETERS
INTERIM REGIONAL CFO4.0046.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,293,601TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,974,303TotReportableCompRltdOrgAmt
Total Other Compensation$1,212,622TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K105IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PETALUMA SURGICAL ASSOCIATES
1496 PROFESSIONAL DR STE 601PETALUMACA94954MEDICAL SERVICES$745,915
M ATCHISON CRNA INC
107 MACINNES CTNAPACA94558MEDICAL SERVICES$501,875
PETALUMA HEALTHCARE DISTRICT
1425 N MCDOWELL BLVD STE 103PETALUMACA94954MEDICAL SERVICES$433,730
ANESTHESIA & ANALGESIA MED GROUP
2455 BENNETT VALLEY RDSANTA ROSACA95404MEDICAL SERVICES$362,230
COMPHEALTH
PO BOX 972651DALLASTX75397MEDICAL SERVICES$319,644
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K15CntrctRcvdGreaterThan100KCnt
Related Organizations$349,705RelatedOrganizationsAmt
All Other Contributions$6,660AllOtherContributionsAmt
Total Contributions$356,365TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business622110BusinessCd
Total Revenue Column$92,637,265TotalRevenueColumnAmt
Related Or Exempt Func Income$92,637,265RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$92,637,265TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$362,358TotalRevenueColumnAmt
Exclusion$362,358ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA REVENUE900099$78,683$78,683
CASH PURCH & DISCOUNTS900099$51,311$51,311
REBATES & REFUNDS900099$19,934$19,934

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,845TotalRevenueColumnAmt
Related Or Exempt Func Income$1,845RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$151,773OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$93,507,761TotalRevenueColumnAmt
Related Or Exempt Func Income$92,789,038RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$362,358ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$638,748TotalAmt
Program Services$638,748ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,570,278TotalAmt
Program Services$1,509,436ProgramServicesAmt
Management And General$59,720ManagementAndGeneralAmt
Fundraising$1,122FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$30,901,256TotalAmt
Program Services$29,740,800ProgramServicesAmt
Management And General$1,141,464ManagementAndGeneralAmt
Fundraising$18,992FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,345,089TotalAmt
Program Services$1,271,621ProgramServicesAmt
Management And General$71,497ManagementAndGeneralAmt
Fundraising$1,971FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$209,085TotalAmt
Program Services$200,712ProgramServicesAmt
Management And General$7,998ManagementAndGeneralAmt
Fundraising$375FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,439,713TotalAmt
Program Services$2,348,214ProgramServicesAmt
Management And General$89,118ManagementAndGeneralAmt
Fundraising$2,381FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$479,262TotalAmt
Management And General$479,262ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$40,885TotalAmt
Program Services$40,885ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$14,854,093TotalAmt
Program Services$14,242,113ProgramServicesAmt
Management And General$611,162ManagementAndGeneralAmt
Fundraising$818FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,429TotalAmt
Management And General$7,429ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,764,016TotalAmt
Program Services$1,588,087ProgramServicesAmt
Management And General$175,929ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,590,586TotalAmt
Program Services$1,519,056ProgramServicesAmt
Management And General$71,332ManagementAndGeneralAmt
Fundraising$198FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$114,583TotalAmt
Program Services$14,587ProgramServicesAmt
Management And General$99,996ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$13,387TotalAmt
Program Services$9,164ProgramServicesAmt
Management And General$4,223ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,928,532TotalAmt
Program Services$1,727,943ProgramServicesAmt
Management And General$200,589ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SYSTEM COST ALLOCATION$16,311,684$15,460,902$844,786$5,996
MEDICAL SUPPLIES$7,784,206$7,605,195$179,011
CA HOSPITAL FEE PROGRAM$4,095,789$4,095,789
DUES & SUBSCRIPTIONS$85,517$27,808$57,709

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$485,403TotalAmt
Program Services$98,508ProgramServicesAmt
Management And General$386,895ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$86,659,541TotalAmt
Program Services$82,139,568ProgramServicesAmt
Management And General$4,488,120ManagementAndGeneralAmt
Fundraising$31,853FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,059BOYAmt
EOY$2,059EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$23,261,429BOYAmt
EOY$13,606,123EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,676,285BOYAmt
EOY$10,416,558EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,564,978BOYAmt
EOY$1,011,705EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$344,335BOYAmt
EOY$211,608EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$54,640,850LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$42,591,621LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,705,381BOYAmt
EOY$12,049,229EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$25,159BOYAmt
EOY$103,064EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$341,725BOYAmt
EOY$6,319,618EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$48,921,351BOYAmt
EOY$43,719,964EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,011,518BOYAmt
EOY$8,581,045EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$39,707EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$25,138,912BOYAmt
EOY$6,421,731EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$34,150,430BOYAmt
EOY$15,042,483EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,468,388BOYAmt
EOY$28,257,543EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$302,533BOYAmt
EOY$419,938EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,770,921BOYAmt
EOY$28,677,481EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$48,921,351BOYAmt
EOY$43,719,964EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$6,848,220ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$7,058,340OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$8,537OtherActivitiesAmt
Total Lobbying Expenditures$8,537TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO SRM ALLIANCE HOSPITAL SERVICES.ExplanationTxt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,800,495OtherCostOrOtherBasisAmt
Depreciation$9,485,842DepreciationAmt
Book Value$314,653BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,635,993OtherCostOrOtherBasisAmt
Depreciation$6,002,476DepreciationAmt
Book Value$3,633,517BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$30,132,208OtherCostOrOtherBasisAmt
Depreciation$27,103,303DepreciationAmt
Book Value$3,028,905BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,072,154OtherCostOrOtherBasisAmt
Book Value$5,072,154BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,049,229TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
HOSPITAL FEE/PROVIDER TAX RECEIVABLE$5,417,102
OTHER ASSETS$902,516
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,319,618TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
OTHER CURRENT LIABILITIES$955,432
DUE TO AFFILIATES$4,056,813
DUE TO THIRD PARTY-$49,407
HOSPITAL FEE/PROVIDER TAX LIABILITY$1,355,829
ACCRUED RETIREMENT COMPENSATION$103,064
FieldValueIRS element (for citing)
Total Liability$6,421,731TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other500.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,321,917TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,321,917NetCommunityBenefitExpnsAmt
Total Expense0.01530TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,889,250TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,916,174DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$122,763TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,159DirectOffsettingRevenueAmt
Net Community Benefit Expns$107,605NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,333,930TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,931,333DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,429,522NetCommunityBenefitExpnsAmt
Total Expense0.01650TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$298,045TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$68,784DirectOffsettingRevenueAmt
Net Community Benefit Expns$229,261NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$559,005TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$559,005NetCommunityBenefitExpnsAmt
Total Expense0.00650TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$857,050TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$68,784DirectOffsettingRevenueAmt
Net Community Benefit Expns$788,266NetCommunityBenefitExpnsAmt
Total Expense0.00910TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$27,190,980TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,000,117DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,217,788NetCommunityBenefitExpnsAmt
Total Expense0.02560TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Reimbursed By Medicare$25,532,888ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$36,115,156CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$10,582,268MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost Accounting SystemYes (X)CostAccountingSystemInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SRM ALLIANCE HOSPITAL SERVICESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 NORTH MCDOWELL BLVDAddressLine1Txt
CityPETALUMACityNm
State AbbreviationCAStateAbbreviationCd
ZIP94954ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.STJOESONOMA.ORGWebsiteAddressTxt
State License110000001StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SRM ALLIANCE HOSPITAL SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE SCHEDULE H, PART V, SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE SCHEDULE H, PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care500.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE SCHEDULE H, PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE SCHEDULE H, PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.SCHEDULE H, PART V, SECTION B, LINES 4 AND 8:THE FILING ORGANIZATION COMPLETED A CHNA PRIOR TO ITS JUNE 30, 2017 YEAR END. DURING 2017, THE FILING ORGANIZATION CHANGED ITS TAX YEAR END FROM JUNE 30 TO DECEMBER 31 IN 2017. AS A RESULT OF THIS CHANGE, A SHORT PERIOD TAX RETURN WAS FILED FOR THE PERIOD JULY 1, 2017 TO DECEMBER 31, 2017. THE FILING ORGANIZATION ADOPTED A CHNA FOR TAX YEAR 2019 AND WHILE ALL OF THE STEPS WERE COMPLETED PRIOR TO THE FILING OF THIS RETURN, THEY WERE NOT COMPLETED BY DECEMBER 31, 2019. THE COMPLETION OF THE CHNA AFTER DECEMBER 31, 2019 IS NOT AN IRC 501(R) FAILURE PURSUANT TO SECTION 1.501(R)-2(B) OF THE REGULATIONS BECAUSE IT WAS MINOR, INADVERTENT AND DUE TO REASONABLE CAUSE, AND HAS BEEN CORRECTED. IT WAS MINOR BECAUSE IT WAS A SINGLE TIMING ERROR BY A FILING ORGANIZATION OTHERWISE COMPLIANT WITH SECTION 501(R). IT WAS INADVERTENT AND DUE TO REASONABLE CAUSE BECAUSE THE SAME ERROR HAS NOT BEEN MADE PREVIOUSLY AND THE FILING ORGANIZATION HAS AN ESTABLISHED PROCESS FOR COMPLETING CHNAS. THE FILING ORGANIZATION IS AFFILIATED WITH A LARGE HEALTH SYSTEM WHERE THE COMPLETION OF THE CHNA IS COORDINATED ON A SYSTEM-WIDE LEVEL BY A TEAM DEDICATED TO COMMUNITY HEALTH IMPROVEMENT. IT HAS BEEN CORRECTED THROUGH THE COMPLETION OF THE CHNA PRIOR TO FILING THE 2019 FORM 990 AND BY MAKING THE RESULTS OF THE 2019 CHNA WIDELY AVAILABLE.
SCHEDULE H, PART V, SECTION B, LINE 5OVERVIEW AND SUMMARY OF THE HEALTH FRAMEWORK GUIDING THE CHNA:THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS WAS GUIDED BY THE FUNDAMENTAL UNDERSTANDING THAT MUCH OF A PERSON AND COMMUNITY'S HEALTH IS DETERMINED BY THE CONDITIONS IN WHICH THEY LIVE, WORK, PLAY AND PRAY. IN GATHERING INFORMATION ON THE COMMUNITIES WE SERVED BY THE HOSPITAL, WE LOOKED NOT ONLY AT THE HEALTH CONDITIONS OF THE POPULATION, BUT ALSO AT SOCIOECONOMIC FACTORS, THE PHYSICAL ENVIRONMENT, HEALTH BEHAVIORS, AND THE AVAILABILITY OF CLINICAL CARE. THIS FRAMEWORK FOCUSES ATTENTION ON THE SOCIAL DETERMINANTS OF HEALTH TO LEARN MORE ABOUT OPPORTUNITIES FOR INTERVENTION THAT WILL HELP PEOPLE BECOME AND STAY HEALTH WITHIN THEIR COMMUNITY.IN ADDITION, WE RECOGNIZED THAT WHERE PEOPLE LIVE TELLS US A LOT ABOUT THEIR HEALTH AND HEALTH NEEDS, AND THAT THERE CAN BE POCKETS WITHIN COUNTIES AND CITIES WHERE THE CONDITIONS FOR SUPPORTING HEALTH ARE SUBSTANTIALLY WORSE THAN NEARBY AREAS. WHEN DATA WAS PUBLICLY AVAILABLE, IT WAS COLLECTED AT THE ZIP CODE LEVEL TO SHOW THE DISPARITIES IN HEALTH AND THE SOCIAL DETERMINANTS OF HEALTH THAT OCCUR WITHIN THE HOSPITAL SERVICE AREA.THE OLIN GROUP IS A SOCIALLY CONSCIOUS CONSULTING FIRM WORKING ACROSS NONPROFIT, PUBLIC, PRIVATE, AND PHILANTHROPIC SECTORS TO BRING ABOUT COMMUNITY TRANSFORMATION. BASED IN SANTA ANA, CALIFORNIA, THE OLIN GROUP HAS 15 YEARS OF EXPERIENCE WORKING ON EVALUATION, PLANNING, ASSESSMENT, FUNDRAISING, COMMUNICATION, AND OTHER SERVICES FOR NONPROFIT ORGANIZATIONS, AND HAD PREVIOUSLY SUPPORTED THE CHNA PROCESS OF MULTIPLE HOSPITALS IN THE ST. JOSEPH HEALTH SYSTEM. THE OLIN GROUP SERVED AS THE LEAD CONSULTANT IN THE CHNA PROCESSES AND ASSISTING IN THE PRIORITIZATION AND SELECTION OF HEALTH NEEDS.COMMUNITY INPUT:THE PROCESS OF COLLECTING QUALITATIVE COMMUNITY INPUT TOOK THREE MAIN FORMS: COMMUNITY RESIDENT FOCUS GROUPS, A NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, AND A COMMUNITY FORUM. EACH GROUP WAS DESIGNED TO CAPTURE THE COLLECTED KNOWLEDGE AND OPINIONS OF PEOPLE WHO LIVE AND WORK IN THE COMMUNITIES SERVED BY OUR MINISTRY. IN ADDITION, THE FINDINGS FROM THE RECENT SONOMA COUNTY COLLABORATIVE CHNA CONDUCTED IN 2016 AND FROM THE ONGOING COMMUNITY BUILDING INITIATIVE IN THE ROSELAND NEIGHBORHOOD OF SOUTHWEST SANTA ROSA WERE CONSIDERED AS ADDITIONAL SOURCES.INPUT FROM MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS WAS RECEIVED BOTH DIRECTLY AND INDIRECTLY DURING OUR CHNA PROCESS. DIRECTLY, INPUT FROM THESE POPULATIONS WAS RECEIVED THROUGH VARIOUS RESIDENT FOCUS GROUPS AND COMMUNITY FORUMS. RESIDENTS WHO PARTICIPATED IN FOCUS GROUPS AND COMMUNITY FORUMS COMPLETED AN ANONYMOUS SURVEY. INFORMATION GATHERED INCLUDED DEMOGRAPHIC DATA, SOCIOECONOMIC DATA, AND DATA ON CHRONIC CONDITIONS, HEALTH CHALLENGES AND SOCIAL DETERMINANTS OF HEALTH. INDIRECTLY, INPUT FROM THESE POPULATIONS WAS RECEIVED THROUGH NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUPS. ALL NONPROFIT/GOVERNMENT STAKEHOLDERS WERE IDENTIFIED AS REPRESENTING ONE OR MORE OF THE FOLLOWING POPULATIONS: MEDICALLY UNDERSERVED, LOW-INCOME, DIVERSE COMMUNITIES, AND THOSE SUFFERING FROM CHRONIC CONDITIONS. RESIDENT FOCUS GROUPS:FOR COMMUNITY RESIDENT GROUPS, HOSPITAL COMMUNITY BENEFIT STAFF, IN COLLABORATION WITH THEIR COMMUNITY BENEFIT COMMITTEES AND THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIPS DEPARTMENT, IDENTIFIED GEOGRAPHIC AREAS WHERE DATA SUGGESTED THERE WERE SIGNIFICANT HEALTH, PHYSICAL ENVIRONMENT, AND SOCIOECONOMIC CONCERNS. THIS PROCESS ALSO IDENTIFIED THE LANGUAGE NEEDS OF THE COMMUNITY, WHICH DETERMINED THE LANGUAGE IN WHICH EACH FOCUS GROUP WAS CONDUCTED. COMMUNITY BENEFIT STAFF THEN PARTNERED WITH COMMUNITY-BASED ORGANIZATIONS THAT SERVE THOSE AREAS TO RECRUIT FOR AND HOST THE FOCUS GROUPS. THE COMMUNITY-BASED ORGANIZATION DEVELOPED AN INVITATION LIST USING THEIR CONTACTS AND KNOWLEDGE OF THE AREA, AND PARTICIPANTS WERE PROMISED A SMALL INCENTIVE FOR THEIR TIME. TWO CONSULTANTS STAFFED EACH FOCUS GROUP, SERVING AS FACILITATORS AND NOTE TAKERS. THESE CONSULTANTS WERE NOT DIRECTLY AFFILIATED WITH THE MINISTRY TO ENSURE CANDOR FROM THEIR PARTICIPANTS.NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP:FOR THE NONPROFIT AND GOVERNMENT STAKEHOLDER FOCUS GROUP, COMMUNITY BENEFIT STAFF DEVELOPED A LIST OF LEADERS FORM ORGANIZATIONS THAT SERVE DIVERSE CONSTITUENCIES WITHIN THE HOSPITAL'S SERVICE AREA. MINISTRY STAFF SOUGHT TO INVITE ORGANIZATIONS WITH WHICH THEY HAD EXISTING RELATIONSHIPS, BUT ALSO USED THE FOCUS GROUP AS AN OPPORTUNITY TO BUILD NEW RELATIONSHIPS WITH STAKEHOLDERS. PARTICIPANTS WERE NOT GIVEN A MONETARY INCENTIVE FOR ATTENDANCE. AS WITH THE RESIDENT FOCUS GROUPS, THIS GROUP WAS FACILITATED BY OUTSIDE CONSULTANTS WITHOUT A DIRECT LINK TO ST. JOSEPH HEALTH.RESIDENT COMMUNITY FORUM:RECRUITMENT FOR THE COMMUNITY RESIDENT FORUM WAS MUCH BROADER TO ENCOURAGE AS MANY PEOPLE AS POSSIBLE TO ATTEND THE SESSION. COMMUNITY BENEFIT STAFF PUBLICIZED THE EVENT THROUGH FLYERS AND EMAILS USING THEIR EXISTING OUTREACH NETWORKS, AND ALSO ASKED THEIR PARTNER ORGANIZATIONS TO INVITE AND RECRUIT PARTICIPANTS. NO FORMAL INVITATION LIST WAS USED FOR THE FORUM AND ANYONE WHO WISHED TO ATTEND WAS WELCOMED. THE FORUM WAS CONDUCTED BY AN OUTSIDE CONSULTANT IN ENGLISH, WITH SIMULTANEOUS SPANISH LANGUAGE TRANSLATION FOR ANYONE WHO REQUESTED IT. WHILE THE FOCUS GROUPS FOLLOWED A SIMILAR PROTOCOL TO EACH OTHER IN WHICH FIVE TO SIX QUESTIONS WERE ASKED OF THE GROUP, THE FORUM FOLLOWED A DIFFERENT PROCESS. THE LEAD FACILITATOR SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR AND ASKED THE PARTICIPANTS TO COMMENT ON THEM AND ADD ANY OTHER CONCERNS. ONCE THE DISCUSSION WAS COMPLETE, THE PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS PROCESS, THE FORUM SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT PROCESS.COMMUNITY BUILDING INITIATIVE: ROSELAND:IN 2016, THE MINISTRY COLLABORATED WITH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND IN A PROCESS TO IDENTIFY PRESSING COMMUNITY NEEDS IN THE ROSELAND NEIGHBORHOOD OF SANTA ROSA. BECAUSE THIS PROCESS ALSO INVOLVED COMMUNITY MEETINGS, THE HOSPITAL INCORPORATED THE COMMUNITY INPUT FROM THIS PROCESS INTO THE OVERALL DATA CONSIDERATION FOR THIS CHNA.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 HEALTH-RELATED DATA WAS AVAILABLE. AS A RESULT PROXY MEASURES WERE USED WHEN AVAILABLE. FOR EXAMPLE, THERE IS LIMITED COMMUNITY OR ZIP CODE LEVEL DATA ON THE INCIDENCE OF MENTAL HEALTH, OR MANY HEALTH BEHAVIORS SUCH AS SUBSTANCE ABUSE.- DATA THAT IS 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 RATES OF UNINSURED) AND THE MOST RECENT DATA AVAILABLE IS NOT A GOOD REFLECTION OF THE CURRENT STATE.- ZIP CODE AREAS ARE THE SMALLEST GEOGRAPHIC REGIONS FOR WHICH MANY HEALTH OUTCOMES AND HEALTH BEHAVIOR INDICATORS ARE PUBLICLY AVAILABLE. IT IS RECOGNIZED THAT EVEN WITHIN ZIP CODES, THERE CAN BE POPULATIONS THAT ARE DISPROPORTIONATELY WORSE OFF. FOR EXAMPLE, WITHIN SMALLER GEOGRAPHIC AREAS, SUCH AS CENSUS TRACTS, SOCIO-ECONOMIC DATA PROVIDES A MORE GRANULAR UNDERSTANDING OF DISPARITY AT THE NEIGHBORHOOD LEVEL. AS PREVIOUSLY MENTIONED, CENSUS TRACT HEALTH OUTCOME AND HEALTH BEHAVIOR DATA WAS NOT PUBLICLY AVAILABLE TO PAINT A COMPLETE PICTURE OF COMMUNITY LEVEL NEED.- DATA FOR ZIP CODES WITH SMALL POPULATIONS (BELOW 2,000) IS OFTEN UNRELIABLE, ESPECIALLY WHEN THE DATA IS ESTIMATED FROM A SMALL SAMPLE OF THE POPULATION. IN THE TOTAL SERVICE AREA, ANNAPOLIS, BODEGA, BODEGA BAY, CAZADERO, FULTON, GEYSERVILLE, GRATON, HOPLAND, JENNER, KENWOOD, MONTE RIO, OCCIDENTAL, POINT AREA, STEWARTS POINT, AND THE SEA RACH EACH HAD FEWER THAN 2,000 PEOPLE.- INFORMATION GATHER DURING FOCUS GROUPS AND COMMUNITY FORUMS IS DEPENDENT ON WHO WAS INVITED AND WHO SHOWED UP FOR THE EVENT. EFFORTS WERE MADE TO INCLUDE PEOPLE WHO COULD REPRESENT THE BROAD INTERESTS OF THE COMMUNITY AND/OR WERE MEMBERS OF COMMUNITIES OF GREATEST NEED.- FEARS ABOUT DEPORTATION KEPT MANY UNDOCUMENTED IMMIGRANTS FROM PARTICIPATING IN THE FOCUS GROUPS AND COMMUNITY FORUM AND MADE IT MORE DIFFICULT FOR THEIR VOICE TO BE HEARD.
SCHEDULE H, PART V, SECTION B, LINE 6AMANY 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 6BMANY 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 7ATHE WEB ADDRESS IS:HTTPS://WWW.STJOESONOMA.ORG/COMMUNITY-OUTREACH/COMMUNITY-BENEFIT/
SCHEDULE H, PART V, SECTION B, LINE 10ATHE WEB ADDRESS IS: HTTPS://WWW.STJOESONOMA.ORG/COMMUNITY-OUTREACH/COMMUNITY-BENEFIT/
SCHEDULE H, PART V, SECTION B, LINE 11COMMUNITY HEALTH NEEDS PRIORITIZED:ACCESS TO RESOURCES:ENSURING ACCESS TO AFFORDABLE, QUALITY HEALTH CARE SERVICES IS IMPORTANT TO PROTECTING BOTH INDIVIDUAL AND POPULATION HEALTH, ELIMINATING HEALTH DISPARITIES AND PROMOTING OVERALL QUALITY OF LIFE IN THE COMMUNITY. THIS INCLUDES MOST BARRIERS TO ACCESSING HEALTH CARE SERVICES AND OTHER NECESSARY RESOURCES, SUCH AS INCOME, LACK OF ADEQUATE INSURANCE, IMMIGRATION STATUS, TRANSPORTATION, A SHORTAGE OF PROVIDERS AND SPECIALISTS, LANGUAGE BARRIERS, AND RESOURCES BEING UNAVAILABLE OUTSIDE OF WORKING HOURS.THE COMMUNITY BENEFIT COMMITTEE (CBC) NOTED THAT WHILE MANY ADULTS IN SONOMA COUNTY ARE ABLE TO OBTAIN INSURANCE COVERAGE AND ACCESS REGULAR HEALTHCARE IN THE WAKE OF THE IMPLEMENTATION OF THE AFFORDABLE CARE ACT (ACA), DISPARITIES PERSIST. SPECIFICALLY, LOWER INCOME RESIDENTS HAVE DIFFICULTY ACCESSING CARE, AS MANY REMAIN UNINSURED DUE TO HIGH PREMIUM COSTS AND THOSE WITH PUBLIC INSURANCE FACE BARRIERS TO FINDING PROVIDERS WHO ACCEPT MEDI-CAL.FOREIGN-BORN RESIDENTS WHO ARE NOT U.S. CITIZENS ALSO FACE STARK BARRIERS IN OBTAINING INSURANCE COVERAGE AND ACCESSING CARE. AMONG THOSE WHO DO HAVE INSURANCE COVERAGE, PRIMARY DATA IDENTIFIED OTHER BARRIERS TO ACCESSING CARE INCLUDING THAT THERE ARE NOT ENOUGH PRIMARY HEALTHCARE PROVIDERS IN SONOMA COUNTY TO MEET THE HIGH DEMAND. THE CBC RECOGNIZES THIS IS AN ONGOING, HIGH-PRIORITY NEED, AND ONE WHICH, GIVEN THE EXISTING SRMH COMMUNITY BENEFIT PROGRAMS (MOBILE HEALTH AND DENTAL CLINICS, FIXED-SITE DENTAL CLINIC, AND IN-HOME CARE), WE ARE UNIQUELY QUALIFIED WITH APPROPRIATE CAPACITY TO ADDRESS.CARE NETWORK PROVIDES A COMPREHENSIVE TEAM APPROACH TO PROVIDE MEDICAL CARE, CARE COORDINATION, SOCIAL WORK SUPPORTS, AND RESOURCE NAVIGATION TO THE MOST VULNERABLE PATIENT POPULATION. WE ALSO BEGAN TO STRENGTHEN OUR PARTNERSHIPS WITH SANTA ROSA COMMUNITY HEALTH, CATHOLIC CHARITIES, REDWOOD GOSPEL MISSION, THE PALMS AND SAM JONES SHELTER TO PROVIDE SUPPORT SERVICES IN THE COMMUNITY FOR OUR MOST VULNERABLE PATIENTS. THE PROGRAM HAS ALSO INTEGRATED WITH PSYCHIATRIC LIAISONS IN THE EMERGENCY DEPARTMENT TO PROVIDE SERVICES TO BEHAVIORAL HEALTH PATIENTS REQUIRING PSYCHIATRIC CARE OR REFERRALS TO CARE.HOMELESSNESS AND HOUSING CONCERNS:THESE TWO NEEDS WERE COMBINED BY THE CBC IN RECOGNITION OF THE FACT THAT THE TWO ISSUES, WHILE IDENTIFIED SEPARATELY IN THE DATA COLLECTION PROCESS, ARE INEXTRICABLE LINKED AND CANNOT BE EFFECTIVELY ADDRESSED SEPARATELY, AND THAT WHILE HOMELESSNESS IS THE MORE VISIBLE PROBLEM, THE STRESS OF HOUSING INSECURITY AND THE THREAT OF HOMELESSNESS ARE EQUALLY INJURIOUS TO COMMUNITY AND INDIVIDUAL HEALTH. HOUSING IS CONSIDERED A PRIMARY SOCIAL DETERMINANT OF HEALTH, AND THE LACK OF HOUSING OR AFFORDABLE HOUSING CONTRIBUTES TO AND EXACERBATES MULTIPLE ADVERSE HEALTH CONDITIONS.STAKEHOLDERS NOTED THAT 2,835 HOMELESS PERSONS WERE FOUND DURING THE JANUARY 26, 2017 SONOMA COUNTY HOMELESS COUNT. WHILE THIS NUMBER REFLECTS A DECLINING TREND IN HOMELESSNESS IN SONOMA COUNTY OVER THE PAST FIVE YEARS, THE NUMBER IS STILL VERY LARGE. ON ANY GIVEN NIGHT, 5.6 PEOPLE OUT OF EVERY 1,000 RESIDENTS ARE HOMELESS, AND MANY OF THEM IN MUCH MORE VISIBLE LOCATIONS THAN IN PREVIOUS YEARS' COUNTS. THE CBC BELIEVES IT IS IMPERATIVE THAT WE JOIN IN OUR COMMUNITY'S EFFORTS TO COMBAT THESE TRENDS AS WE SEE THIS AS THE MOST PROMINENT SOCIAL DETERMINANT OF HEALTH THAT WE MUST ADDRESS. OUR PRIMARY FOCUS IS ON THE CONDITION OF HOMELESSNESS, INCLUDING THE DEVELOPMENT OF PERMANENT SUPPORTIVE HOUSING, PROVIDING HEALTHCARE TO HOMELESS INDIVIDUALS, PREVENTION OF HOMELESSNESS, AND MITIGATING ITS IMPACT ON COMMUNITIES. WE CONTINUED TO PARTNER WITH OTHER COMMUNITY ORGANIZATIONS TO ADDRESS ISSUES OF HOUSING AFFORDABILITY, AVAILABILITY, OVERCROWDING, AND QUALITY.OUR INTERSECTIONS COALITION LAUNCHED THIS YEAR AND WILL FOCUS ON THE ISSUE OF HOUSING EQUITY. IT CONTAINS AN IMPORTANT COMMUNITY ENGAGEMENT ELEMENT THAT WILL INCLUDE RECRUITMENT AND LEADERSHIP DEVELOPMENT FOR RESIDENTS OF THE MOST VULNERABLE NEIGHBORHOODS IN OUR COMMUNITY. ONE OF THE PRIMARY FOCI OF THE COALITION IS ADVOCACY BY THESE RESIDENTS FOR HOUSING POLICIES THAT WILL PROMOTE EQUITY. WE ARE ALSO A LEADING MEMBER OF THE HEALTH CARE FOR THE HOMELESS COLLABORATIVE FOCUSED ON COORDINATING EXISTING SERVICES AND DEVELOPING NEW HOMELESS HEALTH CARE SERVICES. OUR MOBILE HEALTH CLINIC TEAM HAS ADDED SANTA ROSA HOMELESS SHELTERS TO THEIR ROSTER AND BEGAN PROVIDING SERVICES INSIDE THE SHELTERS, CONTRIBUTING TO A REDUCTION IN UNNECESSARY ER VISITS. WE HAVE ALSO PROVIDED FUNDING TO THE COMMITTEE ON THE SHELTERLESS FOR THE CREATION OF 11 PERMANENT SUPPORTIVE HOUSING UNITS IN THE MARY ISAAC CENTER IN PETALUMA AND PROVIDED FUNDING TO SANTA ROSA COMMUNITY HEALTH IN SUPPORT OF THEIR HOMELESS CARE TRANSITIONS PROGRAM WHICH CONNECTS PATIENTS WITH NEEDED SOCIAL SERVICES.BEHAVIORAL HEALTH:MENTAL HEALTH AND SUBSTANCE USE WERE COMBINED BY THE CBC IN RECOGNITION OF THE FACT THAT MENTAL HEALTH AND SUBSTANCE USE DISORDERS OFTEN GO HAND-IN-HAND AND MORE MANY PATIENTS ARE CO-OCCURRING CONDITIONS. WE PREFER THE TERM BEHAVIORAL HEALTH TO REFER TO THESE CONDITIONS COLLECTIVELY. IN ADDITION, THE CBC NOTED THAT AT THE CONCLUSION OF STEP 3 OF THE PRIORITIZATION PROCESS, THESE WERE THE FIRST AND SECOND HIGHEST RANKED CONCERNS. BOTH CONCERNS WERE RAISED THROUGHOUT THE COMMUNITY INPUT PROCESS AND RECEIVED A HIGH NUMBER OF VOTES AT THE COMMUNITY FORUM.ALTHOUGH THE DATA SHOWS A BETTER RATIO OF POPULATION TO MENTAL HEALTH PROVIDERS IN SONOMA AND MENDOCINO COUNTIES THAT THE STATE, FOCUS GROUP PARTICIPANTS SPOKE OF SHORTAGES OF PROVIDERS AND SERVICES FOR MENTAL HEALTH AND SUBSTANCE USE. IN SONOMA COUNTY, FOR INSTANCE, MANY LOW-INCOME INDIVIDUALS WITH MENTAL HEALTH CONCERNS DO NOT HAVE ACCESS TO THE TREATMENT THEY NEED. INSUFFICIENT PRIVATE INSURANCE COVERAGE FOR MENTAL HEALTH SERVICES AND INSUFFICIENT AVAILABILITY OF PUBLICLY FUNDED TREATMENT SERVICES ARE SIGNIFICANT BARRIERS FOR MANY. FURTHERMORE, LIMITED INTEGRATION OF MENTAL HEALTH SERVICES WITHIN THE HEALTH CARE SYSTEM ALSO LEADS TO MISSED OPPORTUNITIES FOR EARLY PROBLEM IDENTIFICATION AND PREVENTION. MENTAL HEALTH INCLUDES EMOTIONAL, BEHAVIORAL, AND SOCIAL WELL-BEING. POOR MENTAL HEALTH, INCLUDING THE PRESENCE OF CHRONIC TOXIC STRESS OR PSYCHOLOGICAL CONDITIONS SUCH AS ANXIETY, DEPRESSION OR POST-TRAUMATIC STRESS DISORDER, HAS PROFOUND CONSEQUENCES ON HEALTH BEHAVIOR CHOICES AND PHYSICAL HEALTH. AS A RESULT, THE CBC FELT THAT THE FOCUS ON MENTAL HEALTH AND SUBSTANCE USE, I.E. BEHAVIORAL HEALTH, WITH A PARTICULAR FOCUS ON TRAUMA-INFORMED COMMUNITY-BASED PREVENTION AND RESILIENCE IN THE FACE OF ADVERSE COMMUNITY EXPERIENCES, WAS OF PARAMOUNT IMPORTANCE TO OUR MINISTRY AND OUR COMMUNITY.WE ARE A LEADING MEMBER OF THE BEHAVIORAL HEALTH COALITION FOCUSED ON IDENTIFYING, DEVELOPING AND IMPLEMENTING POLICIES AND PRACTICES TO IMPROVE THE COUNTYWIDE BEHAVIORAL HEALTH SYSTEM OF CARE, SOMETHING THAT WAS IDENTIFIED BY SRMH AS THE MOST PRESSING NEED IN THE LOCAL BEHAVIORAL HEALTH COMMUNITY. OUR HEALTHY FOR LIFE PROGRAM IS PARTNERING WITH SCOE, THE SCHOOL DISTRICTS AND OTHER COMMUNITY GROUPS TO PLAN AND IMPLEMENT MORE EXPLICITLY BEHAVIORAL HEALTH ELEMENTS INTO ITS CURRICULA, IN ADDITION TO CONTINUING ITS PHYSICAL FITNESS AND MINDFULNESS EDUCATION. WE ALSO PROVIDED FUNDING TO SANTA ROSA COMMUNITY HEALTH IN SUPPORT OF MENTAL HEALTH SERVICES FOR THEIR LOW-INCOME PATIENTS.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 13HTHE 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/
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - LYNCH CREEK LABORATORY
110 LYNCH CREEK WAY STE BPETALUMACA94954LAB OUTREACH
2 - LYNCH CREEK IMAGING
110 LYNCH CREEK WAY STE BPETALUMACA94954IMAGING/RADIOLOGY

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3CIN 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 6APETALUMA VALLEY HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT: HTTPS://WWW.STJOESONOMA.ORG/DOCUMENTS/FY19_CB_REPORT_SRMH_FINAL.PDF
SCHEDULE H, PART I, LINE 7THE 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 7GNO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.
SCHEDULE H, PART III, SECTION A, LINE 2COSTING METHODOLOGYTHE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE.
SCHEDULE H, PART III, SECTION A, LINE 3THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY.
SCHEDULE H, PART III, SECTION A, LINE 4FOOTNOTE FROM THE PROVIDENCE ST. JOSEPH HEALTH COMBINED FINANCIAL STATEMENTS FOR THE YEAR ENDED 12/31/2019THE HEALTH SYSTEM PROVIDES FOR AN ALLOWANCE AGAINST PATIENT ACCOUNTS RECEIVABLE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE. THE HEALTH SYSTEM ESTIMATES THIS ALLOWANCE BASED ON THE AGING OF ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR, AND OTHER RELEVANT FACTORS. THERE ARE VARIOUS FACTORS THAT CAN IMPACT THE COLLECTION TRENDS, SUCH AS CHANGES IN THE ECONOMY, WHICH IN TURN HAVE AN IMPACT ON UNEMPLOYMENT RATES AND THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE INCREASED BURDEN OF COPAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE COVERAGE AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS USED BY THE HEALTH SYSTEM. THE HEALTH SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICES ON THE BASIS OF PAST EXPERIENCE, WHICH HAS HISTORICALLY INDICATED THAT MANY PATIENTS ARE UNRESPONSIVE OR ARE OTHERWISE UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE.
SCHEDULE H, PART III, SECTION B, LINE 8COMMUNITY 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 9BCOLLECTION 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 2NEEDS ASSESSMENT:THE GOAL OF THE CHNA DATA DEVELOPMENT PROCESS WAS TO GATHER, ANALYZE, AND SUMMARIZE CURRENT LOCAL DATA ON THE RESIDENTS OF SONOMA COUNTY, THEIR HEALTH STATUS AND THE VARIETY OF FEATURES AND CONDITIONS WHICH IMPACT THEIR HEALTH, HEALTHY DEVELOPMENT AND QUALITY OF LIFE. TO ACCOMPLISH THIS, THE CHNA PARTNERS DEVELOPED AND UTILIZED BOTH PRIMARY AND SECONDARY DATA SOURCES. THE PARTNERS CONDUCTED THE FOLLOWING ACTIVITIES TO CREATE THE FY17 SONOMA COUNTY CHNA:- DEMOGRAPHIC SUMMARY: DEVELOPED A DEMOGRAPHIC SUMMARY OF SONOMA COUNTY'S CURRENT POPULATION ALONG WITH POPULATION GROWTH PROJECTIONS WHEN AVAILABLE. INFORMATION IS PROVIDED ON A VARIETY OF DEMOGRAPHIC INDICATORS INCLUDING POPULATION DISTRIBUTION, AGE, ETHNICITY, INCOME, HEALTHCARE COVERAGE, EDUCATION AND EMPLOYMENT.- SECONDARY SOURCES: ASSEMBLED SUMMARY DATA FROM A VARIETY OF SECONDARY SOURCES IDENTIFYING HEALTH BEHAVIORS AND CONDITIONS THAT COMPROMISE THE HEALTH AND HEALTHY DEVELOPMENT OF CHILDREN AND CONTRIBUTE MOST PROMINENTLY TO ILLNESS AND INJURY, DISABILITY AND DEATH FOR SONOMA COUNTY ADULTS AND CHILDREN. WHERE KNOWN, INFORMATION ON CONTRIBUTING FACTORS IS PRESENTED ALONG WITH EACH HEALTH INDICATOR. HEALTH DISPARITIES ARE HIGHLIGHTED.- KEY INFORMANT INTERVIEWS AND FOCUS GROUPS: CONDUCTED KEY INFORMANT INTERVIEWS, COMMUNITY-BASED FOCUS GROUPS AND A COUNTRYWIDE RANDOM TELEPHONE SURVEY TO GATHER DATA ON HEALTH STATUS AND ELICIT INFORMATION ON COMMUNITY HEALTH ISSUES OF GREATEST CONCERN AND PERSPECTIVES ON LOCAL OPPORTUNITIES TO IMPROVE POPULATION HEALTH AND/OR THE HEALTHCARE DELIVERY SYSTEM.PRIORITY COMMUNITY HEALTH NEEDS:THE PRIORITIZED COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE FY17 CHNA PROCESS INCLUDE THE FOLLOWING.1. HEALTHY EATING AND PHYSICAL FITNESS2. GAPS IN ACCESS TO PRIMARY CARE3. ACCESS TO SERVICES FOR SUBSTANCE USE DISORDERS4. BARRIERS TO HEALTHY AGING5. ACCESS TO MENTAL HEALTH SERVICES6. DISPARITIES IN EDUCATIONAL ATTAINMENT7. CARDIOVASCULAR DISEASE8. ADVERSE CHILDHOOD EXPERIENCES OR EXPOSURE TO STRESS (ACES)9. ACCESS TO HEALTH CARE COVERAGE10. TOBACCO USE11. COORDINATION AND INTEGRATION OF LOCAL HEALTH CARE SYSTEM12. DISPARITIES IN ORAL HEALTH13. LUNG, BREAST, AND COLORECTAL CANCERNEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM:NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH COMMUNITY BENEFIT PROGRAMMING AND BY FUNDING OTHER NONPROFIT ORGANIZATIONS THROUGH OUR CARE FOR THE POOR PROGRAM MANAGED BY SRMH.FURTHERMORE, SANTA ROSA MEMORIAL HOSPITAL WILL ENDORSE LOCAL NONPROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES, RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGH ST. JOSEPH HEALTH COMMUNITIES.
SCHEDULE H, PART VI, LINE 4COMMUNITY 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 2017 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 5PROMOTION 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 6ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 1,085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.
SCHEDULE H, PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORTCALIFORNIA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ST JOSEPH HEALTH SYSTEM FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 LIND AVE SWAddressLine1Txt
CityRENTONCityNm
State AbbreviationWAStateAbbreviationCd
ZIP98057ZIPCd
FieldValueIRS element (for citing)
Recipient EIN330143024RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$638,000CashGrantAmt
Purpose Of GrantCARE FOR THE POORPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationDESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT ALONG WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KEVIN KLOCKENGA
FORMER REG CHIEF EXECUTIVE - NO CA$0$696,204$0$440,231$0$7,603$0$195,574$0$35,643$0$1,375,255$0$0
ROBERT JUST III
FORMER CE - N CA MEDICAL GROUP$0$379,432$0$146,304$0$4,868$0$102,360$0$44,642$0$677,606$0$0
CAROL KOEBLE
FORMER CHIEF MEDICAL OFFICER - NO CA$0$429,315$0$127,344$0$10,134$0$75,596$0$6,215$0$648,604$0$0
OLUYEMI ADEYANJU ESQ
SECRETARY$0$352,516$0$187,551$0$3,976$0$88,287$0$13,684$0$646,014$0$0
CHAD KRILICH
FORMER CMO-CHIEF MEDICAL OFFICER$0$423,655$0$121,137$0$5,161$0$11,200$0$44,867$0$606,020$0$0
CARMELO MOCERI
FORMER CHIEF STRATEGY OFF - NO CA$0$336,743$0$87,086$0$41,215$0$38,570$0$41,142$0$544,756$0$0
VICKI WHITE
FORMER CNO-CHIEF NURSING OFCR$0$326,585$0$90,611$0$76,932$0$11,200$0$26,492$0$531,820$0$64,688
TYLER HEDDEN
CEO-CHIEF EXEC OFFICER-SONOMA$0$383,463$0$92,056$0$4,229$0$11,200$0$34,598$0$525,546$0$0
JOHN BIBBY
FORMER CHRO, PHYSICIAN ENTERPRISE$0$305,315$0$130,080$0$3,640$0$38,847$0$35,286$0$513,168$0$0
MARK PROVAN
FORMER CHIEF OPS/WORKFORCE INT OFF$0$300,843$0$115,907$0$4,346$0$52,493$0$3,922$0$477,511$0$0
DAVID SOUTHERLAND
INTERIM COO NO CA$193,049$55,803$0$82,368$4,513$49,413$0$1,382$8,871$3,319$206,433$192,285$0$0
TERRI DENTE
FORMER CHIEF MISSION OFF NO CA$0$269,997$0$62,861$0$5,651$0$24,699$0$27,434$0$390,642$0$0
ANDREA LEARNED
FORMER MINISTRY CHIEF, PHILAN OFF$0$228,304$0$69,632$0$7,954$0$18,226$0$13,232$0$337,348$0$0
TODD SALNAS
FORMER CEO-CHIEF EXEC OFFICER-SONOMA$0$106,882$0$181,835$0$1,385$0$32,452$0$9,963$0$332,517$0$0
WENDI THOMAS
DIRECTOR, NURSING$210,046$0$20,023$0$2,741$0$17,336$0$32,180$0$282,326$0$0$0
THELMA COLLINS
HOUSE SUPERVISOR - NE$218,926$0$100$0$21,574$0$11,383$0$23,864$0$275,847$0$0$0
ARAM RAHIMI
CLINICAL PHARMACIST$193,601$0$100$0$106$0$7,829$0$34,353$0$235,989$0$0$0
MATT HUDDLESTON
ENGINEER-CHIEF$226,636$0$0$0$25$0$5,367$0$426$0$232,454$0$0$0
MAUREEN DISBOT
FMR REG CHIEF, QUALITY/SAFETY NO CA$0$119,853$0$87,200$0$2,733$0$4,854$0$9,066$0$223,706$0$0
TAMIKO FELICIANO
DIR, NURSING$199,474$0$100$0$2,587$0$0$0$14,568$0$216,729$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AFIRST 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 3DESCRIPTION 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-BTHE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN 2019: DAVID SOUTHERLAND - $74,514 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: VICKI WHITE - $64,688
PART I, LINE 7NON-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 (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINE 1AST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR PETALUMA VALLEY HOSPITAL FROM ITS SHARED SERVICES. SJHS ISSUES FORM 1099-MISC UNDER ITS TAX ID NUMBER AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS.
FORM 990, PART V, LINE 15INDIVIDUALS 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 6CLASSES 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 7ACLASSES 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 7BCLASSES 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 11BPROCESS 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 12CPROCESS 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 15BPROCESS 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 19GOVERNING 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 11GAGENCY & CONTRACT LABOR: PROGRAM SERVICE EXPENSES 1,606,767. MANAGEMENT AND GENERAL EXPENSES 229,747. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,836,514. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 300,640. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 300,640. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 4,958,166. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 818. TOTAL EXPENSES 4,958,984. MEDICAL DIRECTOR & MED CONSULTING FEES: PROGRAM SERVICE EXPENSES 4,453,075. MANAGEMENT AND GENERAL EXPENSES 72,969. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,526,044. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 1,231,749. MANAGEMENT AND GENERAL EXPENSES 6,250. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,237,999. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 1,992,356. MANAGEMENT AND GENERAL EXPENSES 1,556. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,993,912.
FORM 990, PART XI, LINE 9:NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS 7,058,340.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (112 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
COVENANT ACO
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016611573313HEALTHCARETX501(C)(3)12,ICHSYes (1)
COVENANT HEALTH NETWORK INC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016461259908HEALTHCARECA501(C)(3)12,IIISJHSYes (1)
COVENANT HEALTH PARTNERS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016463516417HEALTHCARETX501(C)(3)12,ICHSYes (1)
COVENANT HEALTH SYSTEM
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752765566HEALTHCARETX501(C)(3)3SJHSYes (1)
COVENANT HEALTH SYSTEM FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752897026HEALTHCARETX501(C)(3)7CHSYes (1)
COVENANT MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016822913146HEALTHCARETX501(C)(3)3CHSYes (1)
COVENANT MEDICAL GROUP
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752743883HEALTHCARETX501(C)(3)3CHSYes (1)
E WA & MT UNEMPLOYMENT COMPENSATION INSURANCE TRUST
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911082119UNEMPLOYMENTWA501(C)(3)12,IPHS WAYes (1)
EVERETT TRANSITIONAL CARE SERVICES
PO BOX 5128EVERETTWA982065128943264605TRANS. CAREWA501(C)(3)100N/A
FACEY MEDICAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016954322584SUPPORTCA501(C)(3)7PHS SOCALYes (1)
GAMELIN WASHINGTON ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016201910170SUPPORTWA501(C)(3)7PHS WAYes (1)
GLOBAL TO LOCAL HEALTH INITIATIVE
2800 SOUTH 192ND ST 104SEATACWA98188273133200HEALTHCAREWA501(C)(3)7SHSYes (1)
HMTS INC
1 HOAG DRIVE PO BOX 6100NEWPORT BEACHCA926586100453583707HEALTHCARECA501(C)(3)12,IHMHPYes (1)
HOAG CHARITY SPORTS
2081 BUSINESS CENTER DR STE 195IRVINECA92612452982422SUPPORTCA501(C)(3)7HHFYes (1)
HOAG CLINIC
1 HOAG DRIVE PO BOX 6100NEWPORT BEACHCA926586100330676831HEALTHCARECA501(C)(3)10HMHPYes (1)
HOAG HOSPITAL FOUNDATION
330 PLACENTIA AVENEWPORT BEACHCA92663953222343FUNDRAISINGCA501(C)(3)7HMHPYes (1)
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
1 HOAG DRIVE PO BOX 6100NEWPORT BEACHCA926586100951643327HEALTHCARECA501(C)(3)3CHNYes (1)
HOSPICE OF LUBBOCK
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752133781HEALTHCARETX501(C)(3)10CHSYes (1)
INLAND NORTHWEST HEALTH SERVICES
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911307555HEALTHCAREWA501(C)(3)3PHS WAYes (1)
INSTITUTE FOR MENTAL HEALTH & WELLNESS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016814260130HEALTHCAREWA501(C)(3)7PHS SJHSYes (1)
INSTITUTE FOR SYSTEMS BIOLOGY
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016912003593HEALTHCAREWA501(C)(3)7WHCYes (1)
JOHN WAYNE CANCER INSTITUTE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016954291515HEALTHCARECA501(C)(3)4PSJHCYes (1)
KADLEC AUXILIARY INC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016916033089SUPPORTWA501(C)(3)12,IIIKRMCYes (1)
KADLEC FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016237005501SUPPORTWA501(C)(3)12,IKRMCYes (1)
KADLEC REGIONAL MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016910655392HEALTHCAREWA501(C)(3)3WHCYes (1)
LITTLE COMPANY OF MARY ANCILLARY SERVICES CORPORATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330844408IMAGING SVCSCA501(C)(3)10PHS SOCALYes (1)
LUBBOCK METHODIST HOSPITAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752220963HEALTHCARETX501(C)(3)7CHSYes (1)
LUNDBERG ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911562797SUPPORTOR501(C)(3)7PHS ORYes (1)
MARSHA RIVKIN CENTER FOR OVARIAN CANCER RESEARCH
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016912054035RESEARCHWA501(C)(3)7SHSYes (1)
METHODIST CHILDREN'S HOSPITAL
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752428911HEALTHCARETX501(C)(3)3CHSYes (1)
METHODIST HOSPITAL LEVELLAND
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752246348HEALTHCARETX501(C)(3)3CHSYes (1)
METHODIST HOSPITAL PLAINVIEW
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752426010HEALTHCARETX501(C)(3)3CHSYes (1)
MISSION HOSPITAL REGIONAL MEDICAL CTR
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016951643360HEALTHCARECA501(C)(3)3CHNYes (1)
NORTHWEST HOPE & HEALING FOUNDATION
PO BOX 16069SEATTLEWA98116200799737SUPPORTWA501(C)(3)12,ISHSYes (1)
PACMED CLINICS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016562290878HEALTHCAREWA501(C)(3)10WHCYes (1)
PH&S FOUNDATIONSFVSA & SCVSA
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016953544877HEALTHCARECA501(C)(3)7PHS SOCALYes (1)
PROVIDENCE ALASKA FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016920093565HEALTHCAREAK501(C)(3)12,IPHS WAYes (1)
PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911940286HEALTHCAREOR501(C)(3)7PHS ORYes (1)
PROVIDENCE BLANCHET ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911789266SUPPORTWA501(C)(3)7PHS WAYes (1)
PROVIDENCE CHILDREN'S HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930800140SUPPORTOR501(C)(3)7PHS ORYes (1)
PROVIDENCE COMMUNITY HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930692907HEALTHCAREOR501(C)(3)7PHS ORYes (1)
PROVIDENCE DETHMAN HOUSE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016473385506SUPPORTWA501(C)(3)70N/A
PROVIDENCE GAMELIN HOUSE ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016311744654SUPPORTWA501(C)(3)7PHS WAYes (1)
PROVIDENCE HEALTH & SERVICES
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911549796HEALTHCAREWA501(C)(3)12,IIPSJH0
PROVIDENCE HEALTH & SERVICES - MONTANA
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016810231793HEALTHCAREMT501(C)(3)3PHS WAYes (1)
PROVIDENCE HEALTH & SERVICES - OREGON
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016510216587HEALTHCAREOR501(C)(3)3PHSYes (1)
PROVIDENCE HEALTH & SERVICES - WASHINGTON
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016510216586HEALTHCAREWA501(C)(3)3PHSYes (1)
PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911303277HEALTHCAREWA501(C)(3)3PMWHCYes (1)
PROVIDENCE HEALTH ASSURANCE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016550828701MEDICAIDOR501(C)(4)N/APHPYes (1)
PROVIDENCE HEALTH CARE FOUNDATION - EASTERN WASHINGTON
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016320014330HEALTHCAREWA501(C)(3)7PHS WAYes (1)
PROVIDENCE HEALTH CARE FOUNDATION (CENTRALIA)
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911433382HEALTHCAREWA501(C)(3)7PHS W WAYes (1)
PROVIDENCE HEALTH PLAN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930863097HEALTHCAREOR501(C)(4)N/APPPYes (1)
PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016510216589HEALTHCARECA501(C)(3)3PHSYes (1)
PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION INC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930921990HEALTHCAREOR501(C)(3)7PHS ORYes (1)
PROVIDENCE HOSPICE AND HOME CARE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016272552749HEALTHCAREWA501(C)(3)7PHS W WAYes (1)
PROVIDENCE HOSPICE OF SEATTLE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016912077378HEALTHCAREWA501(C)(3)7PHS W WAYes (1)
PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016510224944HEALTHCARECA501(C)(3)7PHS SOCALYes (1)
PROVIDENCE MARIANWOOD FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016931554288HEALTHCAREWA501(C)(3)12,IPHS W WAYes (1)
PROVIDENCE MEDICAL INSTITUTE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330283773HEALTHCARECA501(C)(3)12,IPHS SOCALYes (1)
PROVIDENCE MILWAUKIE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016943079515HEALTHCAREOR501(C)(3)7PHS ORYes (1)
PROVIDENCE MINISTRIES
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016RELIGIOUS ORGWA501(C)(3)10N/A
PROVIDENCE MOUNT ST VINCENT FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911188119HEALTHCAREWA501(C)(3)7PHS WAYes (1)
PROVIDENCE NEWBERG HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930889144HEALTHCAREOR501(C)(3)7PHS ORYes (1)
PROVIDENCE PETER CLAVER ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016311629656SUPPORTWA501(C)(3)7PHS WAYes (1)
PROVIDENCE PLAN PARTNERS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911861964HEALTHCAREWA501(C)(4)N/APHS ORYes (1)
PROVIDENCE PORTLAND MEDICAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016931231494HEALTHCAREOR501(C)(3)7PHS ORYes (1)
PROVIDENCE ROSSI ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016311584166SUPPORTWA501(C)(3)10PHS WAYes (1)
PROVIDENCE SAINT JOHN'S HEALTH CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016951684082HEALTHCARECA501(C)(3)3PHS SOCALYes (1)
PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016814542216HEALTHCARECA501(C)(3)3PHS SOCALYes (1)
PROVIDENCE SEASIDE HOSPITAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930927320HEALTHCAREOR501(C)(3)7PHS ORYes (1)
PROVIDENCE ST ELIZABETH HOUSE ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016912171539SUPPORTWA501(C)(3)7PHS WAYes (1)
PROVIDENCE ST FRANCIS ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016943244854SUPPORTWA501(C)(3)7PHS WAYes (1)
PROVIDENCE ST JOSEPH HEALTH
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016811244422HEALTHCAREWA501(C)(3)12,III0N/A
PROVIDENCE ST JOSEPH HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016943078543HEALTHCAREWA501(C)(3)12,IPHS WAYes (1)
PROVIDENCE ST JOSEPH MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016810463482HEALTHCAREMT501(C)(3)3PHS WAYes (1)
PROVIDENCE ST MARY FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016452841492HEALTHCAREWA501(C)(3)7PHS WAYes (1)
PROVIDENCE ST PETER FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911097056SUPPORTWA501(C)(3)7PHS W WAYes (1)
PROVIDENCE ST VINCENT MEDICAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930575982HEALTHCAREOR501(C)(3)7PHS ORYes (1)
PROVIDENCE TRINITYCARE HOSPICE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016953264139HEALTHCARECA501(C)(3)10PHS SOCALYes (1)
PROVIDENCE TRINITYCARE HOSPICE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330261016HEALTHCARECA501(C)(3)7PTCHYes (1)
PROVIDENCE WILLAMETTE FALLS MEDICAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016931003750HEALTHCAREOR501(C)(3)12, IPHS ORYes (1)
QUEEN OF THE VALLEY MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016941243669HEALTHCARECA501(C)(3)3SJHSYes (1)
REDWOOD MEMORIAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016942779313HEALTHCARECA501(C)(3)7RMHYes (1)
REDWOOD MEMORIAL HOSPITAL
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016941384665HEALTHCARECA501(C)(3)3SJHSYes (1)
SAINT JOHN'S HOSPITALHEALTH CENTER FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016956100079SUPPORTCA501(C)(3)7PSJHCYes (1)
SANTA ROSA MEMORIAL HOSPITAL
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016941231005HEALTHCARECA501(C)(3)3SJHSYes (1)
SEATTLE SCIENCE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016611502822PHYSN COLLABWA501(C)(3)7WHCYes (1)
SISTERS OF PROVIDENCE OF MONTANA CORPORATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016262612415SHELL CORPMT501(C)(3)1PHS WA0
SISTERS OF ST JOSEPH OF ORANGE
480 S BATAVIAORANGECA92868951643383RELIGIOUS ORGCA501(C)(3)10N/A
ST JOSEPH HEALTH MINISTRY
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016271666576RELIGIOUS ORGCA501(C)(3)1SSJO0
ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016814791043HEALTHCARECA501(C)(3)3SJHSYes (1)
ST JOSEPH HEALTH SYSTEM
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016953589356HEALTHCARECA501(C)(3)12,IPSJH0
ST JOSEPH HEALTH SYSTEM FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330143024HEALTHCARECA501(C)(3)7SJHSYes (1)
ST JOSEPH HERITAGE HEALTHCARE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330185031HEALTHCARECA501(C)(3)3SJHSYes (1)
ST JOSEPH HOME CARE NETWORK
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016680331084HEALTHCARECA501(C)(3)10SJHSYes (1)
ST JOSEPH HOSPITAL OF EUREKA
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016941156596HEALTHCARECA501(C)(3)3SJHSYes (1)
ST JOSEPH HOSPITAL OF ORANGE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016951643359HEALTHCARECA501(C)(3)3CHNYes (1)
ST JUDE HOSPITAL INC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016951643324HEALTHCARECA501(C)(3)3CHNYes (1)
ST LUKE ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016943176618SUPPORTWA501(C)(3)7PHS WAYes (1)
ST MARY MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016951914489HEALTHCARECA501(C)(3)3CHNYes (1)
ST MARY OF THE PLAINS HOSPITAL FDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016751653181HEALTHCARETX501(C)(3)7CHSYes (1)
ST PATRICK HOSPITAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016237056976HEALTHCAREMT501(C)(3)7PHS WAYes (1)
ST THOMAS CHILD AND FAMILY CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016810233495EDUCATIONMT501(C)(3)10PHS WAYes (1)
SWEDISH EDMONDS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016272305304HEALTHCAREWA501(C)(3)3WHCYes (1)
SWEDISH HEALTH SERVICES
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016910433740HEALTHCAREWA501(C)(3)3WHCYes (1)
SWEDISH MEDICAL CENTER FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016910983214HEALTHCAREWA501(C)(3)7SHSYes (1)
SWEDISH MJM HOLDINGS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016273139262HOLDING COWA501(C)(3)12,ISHSYes (1)
THE GAMELIN ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911180824SUPPORTWA501(C)(3)7PHS WAYes (1)
THE GAMELIN CALIFORNIA ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911293869SUPPORTCA501(C)(3)10PHS SOCALYes (1)
THE GAMELIN OREGON ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911214491SUPPORTOR501(C)(3)10PHS ORYes (1)
UNIVERSITY OF PROVIDENCE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016810231777EDUCATIONMT501(C)(3)2PHSYes (1)
WESTERN HEALTHCONNECT
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016454171900SHELL CORPORATIONWA501(C)(3)12,IIPHS W WAYes (1)

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Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
ST JOSEPH HOSPITAL IRVINE OFFICE
P$57,505,786CASH
ST JOSEPH HEALTH SYSTEM FOUNDATION
C$349,075CASH
ST JOSEPH
B$638,000CASH