SRM ALLIANCE HOSPITAL SERVICES: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: SRM ALLIANCE HOSPITAL SERVICES (EIN 68-0395200)
Tax period: 2018-01-01 to 2018-12-31
Filed: 2019-11-15
IRS object ID: 201913199349314326
Schema version: 2018v3.1
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-11-15T15:37:29-06:00	ReturnTs
Tax Period End	2018-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	4365 EXECUTIVE DR STE 1600	AddressLine1Txt
City	SAN DIEGO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92121	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	680395200	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SRM ALLIANCE HOSPITAL SERVICES	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% JONI MURPHY	InCareOfNm
Business Name Control	SRMA	BusinessNameControlTxt
Phone	7075221570	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1801 Lind Ave SW ATTN Tax Dept	AddressLine1Txt
City	RENTON	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	980579016	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JOHN PETERS	PersonNm
Person Title	INTERIM REGIONAL CFO	PersonTitleTxt
Phone	7075255300	PhoneNum
Signature	2019-11-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	RYAN MAYOR	PreparerPersonNm
PTIN	P01650740	PTIN
Phone	8585357200	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	164.57.159.254	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	33577420193195000085	FederalOriginalSubmissionId
Federal Original Submission Id	2019-11-15	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	C8EB7D7F4A43AD7C11A3CC780D94EAED606DA475	AtSubmissionCreationDeviceId
At Submission Filing Device Id	CBBDC42840D8014E8353DD16D453BA683ED30307	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-03-31 21:24:44Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	PETALUMA VALLEY HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	TYLER HEDDEN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 NORTH MCDOWELL BLVD	AddressLine1Txt
City	PETALUMA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94954	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$99,882,337	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.STJOESONOMA.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1996	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	640	TotalEmployeeCnt
Total Volunteers	175	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$9,008	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$240,495	PYContributionsGrantsAmt
CY Contributions Grants	$470,112	CYContributionsGrantsAmt
PY Program Service Revenue	$50,745,394	PYProgramServiceRevenueAmt
CY Program Service Revenue	$97,326,372	CYProgramServiceRevenueAmt
PY Investment Income	$44,777	PYInvestmentIncomeAmt
CY Investment Income	$313,983	CYInvestmentIncomeAmt
PY Other Revenue	$147,049	PYOtherRevenueAmt
CY Other Revenue	$1,771,870	CYOtherRevenueAmt
PY Total Revenue	$51,177,715	PYTotalRevenueAmt
CY Total Revenue	$99,882,337	CYTotalRevenueAmt
PY Grants And Similar Paid	$140,900	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$902,900	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$26,757,697	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$41,351,755	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$137,649	CYTotalFundraisingExpenseAmt
PY Other Expenses	$23,867,923	PYOtherExpensesAmt
CY Other Expenses	$42,564,907	CYOtherExpensesAmt
PY Total Expenses	$50,766,520	PYTotalExpensesAmt
CY Total Expenses	$84,819,562	CYTotalExpensesAmt
PY Revenues Less Expenses	$411,195	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$15,062,775	CYRevenuesLessExpensesAmt
Total Assets BOY	$42,224,019	TotalAssetsBOYAmt
Total Assets EOY	$48,921,351	TotalAssetsEOYAmt
Total Liabilities BOY	$36,604,713	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$34,150,430	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$5,619,306	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$14,770,921	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$81,464,586	ExpenseAmt
Grant	$902,900	GrantAmt
Revenue	$99,098,242	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$81,464,586	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	640	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JONI MURPHY	PersonNm
Phone	7075255300	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	141 STONY CIRCLE SUITE 140	AddressLine1Txt
City	SANTA ROSA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95401	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JIM CARR
BOARD MEMBER	2.0	0.0	Yes (X)	$0	$0	$0
JONATHAN CHOE MD
BOARD MEMBER	2.0	48.0	Yes (X)	$27,000	$0	$0
ROBERT CURRY
BOARD MEMBER, CHAIRPERSON	5.0	0.0	Yes (X)	$0	$0	$0
SISTER PATRICIA HALEY
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$0	$0
KEVIN MANEMANN
BOARD MEMBER	2.0	48.0	Yes (X)	$0	$1,513,161	$47,714
KATHIE POWELL
BOARD MEMBER	2.0	0.0	Yes (X)	$0	$0	$0
SCOTT PRITCHARD
BOARD MEMBER, VICE CHAIRPERSON	4.0	46.0	Yes (X)	$0	$0	$0
RAJESH RANADIVE MD
BOARD MEMBER	2.0	46.0	Yes (X)	$0	$0	$0
TODD SALNAS
BOARD MEMBER/PRESIDENT, SJH-SC	9.0	41.0	Yes (X)	$0	$782,733	$51,792	Yes (X)
SISTER MARIAN SCHUBERT CSJ
BD MEMBER, EVP MISSION INTEG	2.0	48.0	Yes (X)	$0	$0	$0	Yes (X)
JOSEPHINE THORNTON
BOARD MEMBER	2.0	41.0	Yes (X)	$0	$0	$0
MICHAEL TOMASINI
BOARD MEMBER	2.0	2.0	Yes (X)	$0	$0	$0
OLUYEMI ADEYANJU
SECRETARY	4.0	46.0		$0	$408,366	$22,535	Yes (X)
RAJU IYER
REGIONAL CFO, TREASURER	4.0	46.0		$0	$363,872	$33,831	Yes (X)
JOHN PETERS
INTERIM REGIONAL CFO	4.0	46.0		$0	$0	$0	Yes (X)
JOHN BIBBY
REGIONAL VP HR N.CA	4.0	46.0		$0	$364,110	$47,710		Yes (X)
TERRI DENTE
VP-MISSION INTEGRATION	4.0	46.0		$0	$264,599	$42,084		Yes (X)
MAUREEN DISBOT
REG VP, QUALITY & SAFETY-N. CA	4.0	46.0		$0	$327,757	$35,927		Yes (X)
TYLER HEDDEN
COO - SONOMA	4.0	46.0		$0	$352,478	$37,328		Yes (X)
KEVIN KLOCKENGA
REGIONAL PRESIDENT/NCAL	21.0	29.0		$0	$1,182,880	$41,275		Yes (X)
CAROL KOEBLE
CHIEF MEDICAL OFFICER - NCAL	4.0	46.0		$0	$437,819	$13,008		Yes (X)
CHAD KRILICH
CHIEF MEDICAL OFFICER	4.0	46.0		$0	$422,226	$47,112		Yes (X)
ANDREA LEARNED
VP FUND DEVELOPMENT	4.0	46.0		$0	$228,815	$27,048		Yes (X)
CARMELO MOCERI
CHIEF STRATEGY OFFICER - NCAL	4.0	46.0		$0	$333,405	$37,125		Yes (X)
MARK PROVAN
N.CA REG VP-POST ACUTE CARE	4.0	46.0		$0	$326,802	$47,033		Yes (X)
VICKI WHITE
CHIEF NURSING OFFICER	4.0	46.0		$0	$318,501	$33,190		Yes (X)
THELMA COLLINS
HOUSE SUPERVISOR - NE	50.0	0.0		$202,934	$0	$33,993			Yes (X)
HAI GAO
STAFF NURSE IV	50.0	0.0		$185,242	$0	$37,201			Yes (X)
MATT HUDDLESTON
ENGINEER-CHIEF	50.0	0.0		$219,626	$0	$11,473			Yes (X)
ARAM RAHIMI
CLINICAL PHARMACIST	50.0	0.0		$188,587	$0	$41,932			Yes (X)
WENDI THOMAS
DIRECTOR, NURSING	50.0	0.0		$255,455	$0	$47,815			Yes (X)
ROBERT JUST III
FORMER N.CA REGION,COO	0.0	0.0		$0	$403,615	$62,419				Yes (X)
MICHEL RICCIONI
FORMER CFO N. CA	0.0	0.0		$0	$151,400	$0				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,078,844	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$8,182,539	TotReportableCompRltdOrgAmt
Total Other Compensation	$799,545	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	81	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
ALMAZAN FINNEMAN CLIENT TRUST ACCOU
445 S FIGUEROA ST STE 3100	LOS ANGELES	CA	90071	LEGAL SERVICES	$899,998
M ATCHISON CRNA INC
107 MACINNES CT	NAPA	CA	94558	MEDICAL SERVICES	$501,875
PETALUMA SURGICAL ASSOCIATES
1496 PROFESSIONAL DR STE 601	PETALUMA	CA	94954	MEDICAL SERVICES	$492,909
ANESTHESIA AND ANALGESIA MEDICAL GR
2455 BENNETT VALLEY RD SUITE C219	SANTA ROSA	CA	95404	MEDICAL SERVICES	$332,550
ALLIED UNIVERSAL
PO BOX 31001 2374	PASADENA	CA	91110	SECURITY SERVICES	$296,062

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	16	CntrctRcvdGreaterThan100KCnt
Fundraising	$0	FundraisingAmt
Related Organizations	$271,737	RelatedOrganizationsAmt
All Other Contributions	$198,375	AllOtherContributionsAmt
Noncash Contributions	$5,000	NoncashContributionsAmt
Total Contributions	$470,112	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
NET PATIENT REVENUE	622110	$97,229,929	$97,229,929	$0	$0
CAFETERIA	722514	$95,421	$95,421	$0	$0
MEDICAL OFFICER BUILDING RENT REVENUE	531120	$1,022	$1,022	$0	$0

Field	Value	IRS element (for citing)
Total Program Service Revenue	$97,326,372	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$313,983	TotalRevenueColumnAmt
Exclusion	$313,983	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
PVH ADMIN LGL SETTLEMENT	900099	$1,500,000	$1,500,000	$0	$0
REBATES & REFUNDS	900099	$145,325	$145,325	$0	$0
CASH PURCHASES & DISCOUNTS	900099	$126,545	$126,545	$0	$0

Field	Value	IRS element (for citing)
Other Revenue Total	$1,771,870	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$99,882,337	TotalRevenueColumnAmt
Related Or Exempt Func Income	$99,098,242	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$313,983	ExclusionAmt

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

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$902,900	TotalAmt
Program Services	$902,900	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$590,685	TotalAmt
Program Services	$424,601	ProgramServicesAmt
Management And General	$123,252	ManagementAndGeneralAmt
Fundraising	$42,832	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$32,427,498	TotalAmt
Program Services	$31,209,726	ProgramServicesAmt
Management And General	$1,197,842	ManagementAndGeneralAmt
Fundraising	$19,930	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,433,540	TotalAmt
Program Services	$1,355,240	ProgramServicesAmt
Management And General	$76,199	ManagementAndGeneralAmt
Fundraising	$2,101	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,477,564	TotalAmt
Program Services	$4,298,252	ProgramServicesAmt
Management And General	$171,271	ManagementAndGeneralAmt
Fundraising	$8,041	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,422,468	TotalAmt
Program Services	$2,331,616	ProgramServicesAmt
Management And General	$88,488	ManagementAndGeneralAmt
Fundraising	$2,364	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$6,367,976	TotalAmt
Program Services	$6,211,717	ProgramServicesAmt
Management And General	$156,259	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$346,365	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$346,365	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$16,694	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$16,694	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$7,163	TotalAmt
Program Services	$7,163	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$14,286,223	TotalAmt
Program Services	$13,986,678	ProgramServicesAmt
Management And General	$296,763	ManagementAndGeneralAmt
Fundraising	$2,782	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$120,309	TotalAmt
Program Services	$75,869	ProgramServicesAmt
Management And General	$27,902	ManagementAndGeneralAmt
Fundraising	$16,538	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,006,094	TotalAmt
Program Services	$833,899	ProgramServicesAmt
Management And General	$167,274	ManagementAndGeneralAmt
Fundraising	$4,921	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$503,926	TotalAmt
Program Services	$492,697	ProgramServicesAmt
Management And General	$10,396	ManagementAndGeneralAmt
Fundraising	$833	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,134,323	TotalAmt
Program Services	$2,092,677	ProgramServicesAmt
Management And General	$21,702	ManagementAndGeneralAmt
Fundraising	$19,944	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$247,843	TotalAmt
Program Services	$190,275	ProgramServicesAmt
Management And General	$55,083	ManagementAndGeneralAmt
Fundraising	$2,485	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$10,754	TotalAmt
Program Services	$5,747	ProgramServicesAmt
Management And General	$5,007	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$4,554	TotalAmt
Program Services	$4,554	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,629,278	TotalAmt
Program Services	$1,627,064	ProgramServicesAmt
Management And General	$2,214	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Medical Supplies	$7,587,992	$7,576,296	$11,696	$0
CA HOSPITAL FEE PROGRAM	$4,635,630	$4,635,630	$0	$0
REPAIRS & MAINTENANCE	$2,128,047	$2,114,309	$12,819	$919
Other Direct Expenses	$125,022	$125,022	$0	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,406,714	TotalAmt
Program Services	$962,654	ProgramServicesAmt
Management And General	$430,101	ManagementAndGeneralAmt
Fundraising	$13,959	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$84,819,562	TotalAmt
Program Services	$81,464,586	ProgramServicesAmt
Management And General	$3,217,327	ManagementAndGeneralAmt
Fundraising	$137,649	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,059	BOYAmt
EOY	$2,059	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$10,043,074	BOYAmt
EOY	$23,261,429	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$14,165,803	BOYAmt
EOY	$11,676,285	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,385,834	BOYAmt
EOY	$1,564,978	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,746,906	BOYAmt
EOY	$344,335	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$52,371,800	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$40,666,419	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$11,242,056	BOYAmt
EOY	$11,705,381	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$217,503	BOYAmt
EOY	$25,159	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$3,420,784	BOYAmt
EOY	$341,725	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$42,224,019	BOYAmt
EOY	$48,921,351	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$10,222,817	BOYAmt
EOY	$9,011,518	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$26,381,896	BOYAmt
EOY	$25,138,912	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$36,604,713	BOYAmt
EOY	$34,150,430	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,497,606	BOYAmt
EOY	$14,468,388	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,121,700	BOYAmt
EOY	$302,533	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$5,619,306	BOYAmt
EOY	$14,770,921	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$42,224,019	BOYAmt
EOY	$48,921,351	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$15,062,775	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$0	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Investment Expense	$0	InvestmentExpenseAmt
Prior Period Adjustments	$0	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	-$5,911,160	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Media Advertisements	$0	MediaAdvertisementsAmt
Mailings Members	false	MailingsMembersInd
Mailings Members	$0	MailingsMembersAmt
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Publications Or Broadcast	$0	PublicationsOrBroadcastAmt
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Grants Other Organizations	$0	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Direct Contact Legislators	$0	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Rallies Demonstrations	$0	RalliesDemonstrationsAmt
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$7,163	OtherActivitiesAmt
Total Lobbying Expenditures	$7,163	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO SRM ALLIANCE HOSPITAL SERVICES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Book Value	$0	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,800,495	OtherCostOrOtherBasisAmt
Depreciation	$9,368,269	DepreciationAmt
Book Value	$432,226	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,080,085	OtherCostOrOtherBasisAmt
Depreciation	$5,334,226	DepreciationAmt
Book Value	$3,745,859	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$29,773,054	OtherCostOrOtherBasisAmt
Depreciation	$25,963,924	DepreciationAmt
Book Value	$3,809,130	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,718,166	OtherCostOrOtherBasisAmt
Book Value	$3,718,166	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$11,705,381	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
OTHER CURRENT LIABILITIES	$1,383,961
THIRD PARTY PAYABLES	$306,456
DUE TO AFFILIATES	$23,418,869
OTHER LT LIABILITIES	$29,626

Field	Value	IRS element (for citing)
Total Liability	$25,138,912	TotalLiabilityAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	500.	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,645,737	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,645,737	NetCommunityBenefitExpnsAmt
Total Expense	0.01940	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,379,779	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$20,579,186	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,800,593	NetCommunityBenefitExpnsAmt
Total Expense	0.06840	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$68,096	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$43,021	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$25,075	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$28,093,612	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$20,622,207	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,471,405	NetCommunityBenefitExpnsAmt
Total Expense	0.08810	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$256,365	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$47,879	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$208,486	NetCommunityBenefitExpnsAmt
Total Expense	0.00240	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$294,294	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$294,294	NetCommunityBenefitExpnsAmt
Total Expense	0.00350	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$550,659	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$47,879	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$502,780	NetCommunityBenefitExpnsAmt
Total Expense	0.00590	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$28,644,271	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$20,670,086	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,974,185	NetCommunityBenefitExpnsAmt
Total Expense	0.09400	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$51,353	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$51,353	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$51,353	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$51,353	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$1,614,136	BadDebtExpenseAmt
Reimbursed By Medicare	$25,580,475	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$35,631,915	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$10,051,440	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SRM ALLIANCE HOSPITAL SERVICES	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 NORTH MCDOWELL BLVD	AddressLine1Txt
City	PETALUMA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	94954	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.STJOESONOMA.ORG	WebsiteAddressTxt
State License	110000001	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	SRM ALLIANCE HOSPITAL SERVICES	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE SCHEDULE H, PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	17	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE SCHEDULE H, PART V, SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	500.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE PART V, SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE PART V, SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3E	THE 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, LINE 5 OVERVIEW 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 HOSPITALS 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 HOSPITALS 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 6A	MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE HOSPITAL FACILITIES: - SUTTER HEALTH - KAISER PERMANENTE - SONOMA WEST MEDICAL CENTER
SCHEDULE H, PART V, SECTION B, LINE 6B	MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: - SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES - COMMUNITY CHILD CARE COUNCIL (4CS) OF SONOMA COUNTY - FIRST 5 SONOMA COUNTY - BURBANK HOUSING - COMMUNITY FOUNDATION SONOMA COUNTY - SONOMA COUNTY SHERIFF'S OFFICE - CITY OF SANTA ROSA VIOLENCE PREVENTION PARTNERSHIP - COMMUNITY ACTION PARTNERSHIP OF SONOMA - SONOMA COUNTY ACES CONNECTION - SONOMA COUNTY ECONOMIC DEVELOPMENT BOARD - SONOMA COUNTY PERMIT & RESOURCE MANAGEMENT DEPARTMENT - SONOMA COUNTY ENVIRONMENTAL HEALTH & SAFETY - BUCKELEW PROGRAMS - SONOMA COUNTY OFFICE OF EDUCATION - SONOMA COUNTY COMMUNITY DEVELOPMENT COMMISSION - LA LUZ COMMUNITY CENTER - PETALUMA PEOPLE SERVICES CENTER - SANTA ROSA COMMUNITY HEALTH CENTERS - WEST COUNTY HEALTH CENTERS - PETALUMA HEALTH CARE DISTRICT - PETALUMA HEALTH CENTER - ALLIANCE MEDICAL CENTER - PALM DRIVE HEALTH CARE DISTRICT - NORTH SONOMA COUNTY HEALTH CARE DISTRICT - SONOMA VALLEY HEALTH CARE DISTRICT - RUSSIAN RIVER AREA RESOURCES AND ADVOCATES - COMMUNITY HEALTH INITIATIVE OF THE PETALUMA AREA - LATINO SERVICE PROVIDERS - SONOMA COUNTY HUMAN SERVICES DEPARTMENT - SONOMA COUNTY TASK FORCE ON THE HOMELESS - SONOMA COUNTY HEALTH CARE FOR THE HOMELESS COALITION - MENDOCINO COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES - HEALTH MENDOCINO
SCHEDULE H, PART V, SECTION B, LINE 7A	THE WEB ADDRESS IS: HTTPS://WWW.STJOESONOMA.ORG/COMMUNITY-OUTREACH/COMMUNITY-BENEFIT/
SCHEDULE H, PART V, SECTION B, LINE 10A	THE WEB ADDRESS IS: HTTPS://WWW.STJOESONOMA.ORG/COMMUNITY-OUTREACH/COMMUNITY-BENEFIT/
SCHEDULE H, PART V, SECTION B, LINE 11	COMMUNITY 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 COMMUNITYS 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. 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 IMPROVEM
SCHEDULE H, PART V, SECTION B, LINE 13H	THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE.
SCHEDULE H, PART V, SECTION B, LINE 16A	FINANCIAL ASSISTANCE POLICY HTTPS://WWW.STJOESONOMA.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCI AL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16B	FINANCIAL ASSISTANCE APPLICATION HTTPS://WWW.STJOESONOMA.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCI AL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16C	FAP PLAIN LANGUAGE SUMMARY HTTPS://WWW.STJOESONOMA.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINANCI AL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16J	THE ORGANIZATION ADHERES TO STATE REGULATIONS IN PUBLICIZING ITS FINANCIAL ASSISTANCE POLICY. THESE REGULATIONS INCLUDE THE POSTING OF THE FULL POLICY ON THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT (OSHPD) WEBSITE. IN ADDITION, POLICY NOTICES ARE POSTED IN CONSICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS FOR PATIENTS WHO HAVE NOT PROVIDED PROOF OF THIRD-PARTY COVERAGE ALONG WITH CONTACT INFORMATION IN THE EVENT OF ADDITIONAL INQUIRIES. NOTICES OF FINANCIAL ASSISTANCE ARE ALSO PROVIDED UPON INQUIRY. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA.

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
LYNCH CREEK LABORATORY
110 LYNCH CREEK WAY STE B	PETALUMA	CA	94954	LAB OUTREACH
LYNCH CREEK IMAGING
110 LYNCH CREEK WAY STE B	PETALUMA	CA	94954	IMAGING/RADIOLOGY

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3C	IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS.
SCHEDULE H, PART I, LINE 6	PETALUMA VALLEY HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT: https://www.stjoesonoma.org/documents/fy18_cb_report_srmh_final.pdf
SCHEDULE H, PART I, LINES 7A-7I	THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING A COST-TO-CHARGE RATIO USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. SCHEDULE H, PART I, LINES 7G NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.
SCHEDULE H, PART II	COMMUNITY BUILDING ACTIVITIES: NEIGHBORHOOD CARE STAFF (NCS) PROGRAM SERVES AS THE COMMUNITY OUTREACH AND ENGAGEMENT ARM OF THE COMMUNITY BENEFIT DEPARTMENT. NCS STAFF ENGAGE COMMUNITY RESIDENT LEADERS AND AGENCY PARTNERS TO ADDRESS LOCAL COMMUNITY HEALTH AND QUALITY OF LIFE ISSUES, FACILITATE COMMUNITY CONVERSATIONS AND PLANNING, SUPPORT COLLABORATIVE INITIATIVES, AND DRIVE POLICY AND PROGRAM DEVELOPMENTS EMERGING FROM THESE EFFORTS. OUR NCS STAFF ALSO WORK IN TARGET COMMUNITIES OF NEED THROUGHOUT THE COUNTY, ORGANIZING COMMUNITY ENGAGEMENT BY RESIDENTS AT THE NEIGHBORHOOD LEVEL. THESE EFFORTS INCLUDED THE ONGOING COLLECTION OF RESIDENT FEEDBACK IDENTIFYING ISSUES OF CONCERN AND NEED FOR THEM IN THEIR NEIGHBORHOODS AND DEVELOPING STRATEGIES FOR CREATING AND ADVOCATING FOR SOLUTIONS. IN CLOVERDALE, THE "FAMILIAS EN ACCION POSITIVA", THROUGH SUPPORT PROVIDED BY OUR NCS ORGANIZERS, FORMALIZED ITSELF AS AN ONGOING COMMUNITY RESIDENT GROUP WITH AN ESTABLISHED LEADERSHIP STRUCTURE AND BEGAN PARTNERING WITH THE CLOVERDALE COMMUNITY PARTNERSHIP TO FORM A SONOMA COUNTY HEALTH ACTION CHAPTER. IN GUERNEVILLE, THE NCS ORGANIZER HAS ORGANIZED AN ONGOING POETRY GROUP AT WEST COUNTY COMMUNITY SERVICES EMPOWERMENT CENTER, A DROP-IN SITE FOR LOCAL HOMELESS AND MENTALLY ILL RESIDENTS. BUILDING ON THIS, THE LOCAL COMMUNITY HEALTH CENTER HAS PARTNERED WITH THE GROUP IN ORGANIZING AN OPIOID ADDICITON PROJECT. NCS ALSO PROVIDES BILINGUAL LEADERSHIP AND ADVOCACY TRAINING TO COMMUNITY LEADERS IN VULNERABLE NEIGHBORHOODS IN SONOMA COUNTY, AS WELL AS TO MEMBERS OF COMMUNITY GROUPS, LOCAL ORGANIZATIONS, AND ASSOCIATIONS THROUGH THEIR A.C.T.I.O.N. (AGENTS OF CHANGE TRAINING IN OUR NEIGHBORHOODS) TRAINING. THIS INITIATIVE WORKS TO ENGAGE AND TRAIN COMMUNITY LEADERS TO PROACTIVELY RESPOND TO THE NEEDS OF THEIR COMMUNITY. WE ARE ALSO FUNDERS OF A LATINO LEADERSHIP DEVELOPMENT PROGRAM KNOWN AS "ON THE VERGE." THIS IS A YEAR-LONG COHORT MODEL LEADERSHIP DEVELOPMENT PROGRAM AIMED AT EARLY CAREER LATINO PROFESSIONALS. NOW IN ITS SECOND YEAR, THE INITIAL COHORT IS DEVELOPING A BILINGUAL MENTAL HEALTH DROP-IN CENTER OFFERING CULTURALLY APPROPRIATE COUNSELING AND SUPPORT SERVICES. FURTHER SUPPORT FOR THE DEVELOPMENT OF THIS CENTER WILL ALSO INCLUDE LEADERSHIP DEVELOPMENT OPPORTUNITIES FOR LATINO RESIDENTS, PRIMARILY YOUTH.
SCHEDULE H, PART III, SECTION A, LINE 2	COSTING METHODOLOGY THE 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 3	THE 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 IDENTICY AND QUALICY 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 4	FOOTNOTE FROM THE PROVIDENCE ST. JOSEPH HEALTH COMBINED FINANCIAL STATEMENTS FOR THE YEAR ENDED 12/31/2018 THE 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.
CHEDULE H, PART III, SECTION B, LINE 8	COMMUNITY BENEFITS THE 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 PROCESSESS WHICH ARE APPLIED TO CALCULATE ALLOWABLE MEDICARE COSTS.
SCHEDULE H, PART III, SECTION C, LINE 9B	COLLECTION ACTIVITY: PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: 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 FITNESS 2. GAPS IN ACCESS TO PRIMARY CARE 3. ACCESS TO SERVICES FOR SUBSTANCE USE DISORDERS 4. BARRIERS TO HEALTHY AGING 5. ACCESS TO MENTAL HEALTH SERVICES 6. DISPARITIES IN EDUCATIONAL ATTAINMENT 7. CARDIOVASCULAR DISEASE 8. ADVERSE CHILDHOOD EXPERIENCES OR EXPOSURE TO STRESS (ACES) 9. ACCESS TO HEALTH CARE COVERAGE 10. TOBACCO USE 11. COORDINATION AND INTEGRATION OF LOCAL HEALTH CARE SYSTEM 12. DISPARITIES IN ORAL HEALTH 13. LUNG, BREAST, AND COLORECTAL CANCER NEEDS 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 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: ONE WAY PETALUMA VALLEY HOSPITAL (PVH) INFORMS THE PUBLIC OF FAP IS BY POSTING NOTICES. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE PATIENT FINANCIAL ASSISTANCE APPLICATION AND ARE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION: PETALUMA VALLEY HOSPITAL (PVH), FOUNDED BY THE SISTERS OF ST. JOSEPH OF ORANGE, HAS BEEN SERVING THE HEALTHCARE NEEDS OF FAMILIES IN THE COMMUNITY FOR MORE THAN 60 YEARS. DURING THIS TIME, ITS MISSION HAS REMAINED THE SAME: TO CONTINUALLY IMPROVE THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES SERVED. PART OF A LARGER HEALTHCARE SYSTEM KNOWN AS PROVIDENCE ST. JOSEPH HEALTH (PSJH), PVHH IS PART OF A COUNTYWIDE MINISTRY THAT INCLUDES TWO HOSPITALS, URGENT CARE FACILITIES, HOSPICE, HOME HEALTH SERVICES, AND OTHER FACILITIES FOR TREATING THE HEALTHCARE NEEDS OF THE COMMUNITY IN SONOMA COUNTY AND THE REGION. THE MINISTRY'S CORE FACILITIES ARE PETALUMA VALLEY HOSPITAL (PVH), AN 80-BED ACUTE CARE HOSPITAL, AND SRMH, A FULL SERVICE, STATE OF THE ART 330-BED ACUTE CARE HOSPITAL THAT INCLUDES A LEVEL II TRAUMA CENTER FOR THE COASTAL REGION FROM SAN FRANCISCO TO THE OREGON BORDER. MAJOR PROGRAMS AND SERVICES INCLUDE CRITICAL CARE, CARDIOVASCULAR CARE, STROKE CARE, WOMEN'S AND CHILDREN'S SERVICES, CANCER CARE, AND ORTHOPEDICS. SRMH IS HOME TO THE NORMA & EVERT PERSON HEART & VASCULAR INSTITUTE AND THE UCSF NEONATAL INTENSIVE CARE NURSERY. PVH PROVIDES SOUTHERN MENDOCINO, NORTHERN MARIN, AND SONOMA COUNTIES' COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM UKIAH IN THE NORTH, MARSHALL IN THE SOUTH, SONOMA VALLEY IN THE EAST AND BODEGA BAY IN THE WEST. PVH'S TOTAL SERVICE AREA (TSA) INCLUDES THE CITIES OF SANTA ROSA, PETALUMA, SEBASTOPOL, WINDSOR, HEALDSBURG, ROHNERT PARK, COTATI, SONOMA, CLOVERDALE, UKIAH, AND POINT ARENA. DEFINING THE COMMUNITY: SONOMA COUNTY IS A LARGE, URBAN-RURAL COUNTY ENCOMPASSING 1,575 SQUARE MILES. SONOMA COUNTY RESIDENTS INHABIT NINE CITIES AND A LARGE UNINCORPORATED AREA, INCLUDING MANY GEOGRAPHICALLY ISOLATED COMMUNITIES. THE COUNTY'S TOTAL POPULATION WAS ESTIMATED AT 487,011 AT THE TIME OF THE CHNA. SINCE 2006, THE COUNTY POPULATION HAS GROWN AT AN OVERALL RATE OF 1.8% WITH THE CITIES OF SONOMA, SANTA ROSA AND WINDSOR EXPERIENCING THE FASTEST GROWTH RATES. ACCORDING TO PROJECTIONS FROM THE CALIFORNIA DEPARTMENT OF FINANCE, THE COUNTY POPULATION IS PROJECTED TO GROW BY 8.3% TO 546,204 IN 2020. THIS RATE OF GROWTH IS LESS THAN THAT PROJECTED FOR CALIFORNIA AS A WHOLE (10.1%). THE MAJORITY OF THE COUNTY'S POPULATION RESIDES WITHIN ITS CITIES, THE LARGEST OF WHICH ARE CLUSTERED ALONG THE HIGHWAY 101 CORRIDOR. SANTA ROSA IS THE LARGEST CITY WITH A POPULATION ESTIMATED TO BE NEARLY 171,000 IN 2012 AND IS THE SERVICE HUB FOR THE ENTIRE COUNTY AND THE LOCATION OF THE COUNTY'S THREE MAJOR HOSPITALS. AT LEAST PART OF SONOMA COUNTY, CALIFORNIA, IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA). THE AREA IS 0.8 SQUARE MILES AND IS LOCATED NEAR DOWNTOWN SANTA ROSA. THE CLOVERDALE AREA IN SONOMA COUNTY IS A DESIGNATED PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA (PC-HSPA). THERE ARE 6,888 CIVILIAN RESIDENTS IN THIS AREA, WHICH IS 307.5 TOTAL SQUARE MILES. SRMH PROVIDES SONOMA COUNTY COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL IS LOCATED IN DOWNTOWN SANTA ROSA, ABOUT 55 MILES NORTH OF SAN FRANCISCO JUST OFF THE HIGHWAY 101 CORRIDOR IN CENTRAL SONOMA COUNTY. PVH'S PRIMARY SERVICE AREA IS LIMITED TO A TIGHT RADIUS, BUT ITS SECONDARY SERVICE AREA COMPRISES THE ENTIRE COUNTY, PLUS NORTHERN MARIN COUNTY AND SOUTHERN MENDOCINO COUNTY. THE CHNA PROCESS AND DATA GATHERING ADDRESSES SONOMA COUNTY. FOR A COMPLETE COPY OF THE 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 5	PROMOTION OF COMMUNITY HEALTH PETALUMA VALLEY HOSPITAL PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERSINSURED 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 TRUSTEES 2) OPEN MEDICAL STAFF 3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH 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 AND 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.
SCHEDULE H, PART VI, LINE 7	STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ST JOSEPH HEALTH SYSTEM FOUNDATION	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3345 MICHELSON DRIVE SUITE 100	AddressLine1Txt
City	IRVINE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92612	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	330143024	RecipientEIN
IRC Section	501(c)(3)	IRCSectionDesc
Cash Grant	$902,900	CashGrantAmt
Purpose Of Grant	CARE FOR THE POOR	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	DONATIONS TO OTHER ORGANIZATIONS ARE APPROVED BY MANAGEMENT TO ENSURE THEY SUPPORT THE MISSION OF PETALUMA VALLEY HOSPITAL. WE DO NOT MONITOR DONATIONS MADE.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (22 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount
KEVIN MANEMANN
BOARD MEMBER	$613,038	$675,461	$224,662	$19,250	$28,464	$1,560,875
TODD SALNAS
BOARD MEMBER/PRESIDENT, SJH-SC	$460,660	$268,789	$53,284	$13,750	$38,042	$834,525
OLUYEMI ADEYANJU
SECRETARY	$340,587	$37,485	$30,294	$10,939	$11,596	$430,901
RAJU IYER
REGIONAL CFO, TREASURER	$309,613	$50,000	$4,259	$1,096	$32,735	$397,703
JOHN BIBBY
REGIONAL VP HR N.CA	$275,109	$85,403	$3,598	$11,000	$36,710	$411,820
TERRI DENTE
VP-MISSION INTEGRATION	$211,877	$27,010	$25,712	$16,567	$25,517	$306,683
MAUREEN DISBOT
REG VP, QUALITY & SAFETY-N. CA	$268,284	$33,182	$26,291	$9,747	$26,180	$363,684
TYLER HEDDEN
COO - SONOMA	$308,961	$39,625	$3,892	$7,351	$29,977	$389,806
KEVIN KLOCKENGA
REGIONAL PRESIDENT/NCAL	$673,697	$404,136	$105,047	$19,250	$22,025	$1,224,155
CAROL KOEBLE
CHIEF MEDICAL OFFICER - NCAL	$391,704	$35,833	$10,282	$1,103	$11,905	$450,827
CHAD KRILICH
CHIEF MEDICAL OFFICER	$370,832	$47,221	$4,173	$9,380	$37,732	$469,338
ANDREA LEARNED
VP FUND DEVELOPMENT	$177,232	$28,862	$22,721	$14,230	$12,818	$255,863
CARMELO MOCERI
CHIEF STRATEGY OFFICER - NCAL	$310,325	$17,198	$5,882		$37,125	$370,530
MARK PROVAN
N.CA REG VP-POST ACUTE CARE	$260,288	$62,285	$4,229	$10,500	$36,533	$373,835
VICKI WHITE
CHIEF NURSING OFFICER	$275,751	$35,321	$7,429	$11,000	$22,190	$351,691
THELMA COLLINS
HOUSE SUPERVISOR - NE							$183,018	$19,916	$10,093	$23,900	$236,927
HAI GAO
STAFF NURSE IV							$184,967	$275	$12,867	$24,334	$222,443
MATT HUDDLESTON
ENGINEER-CHIEF							$219,601	$25	$10,980	$493	$231,099
ARAM RAHIMI
CLINICAL PHARMACIST							$188,487	$100	$7,610	$34,322	$230,519
WENDI THOMAS
DIRECTOR, NURSING							$200,467	$2,889	$19,347	$28,468	$303,270	$52,099
ROBERT JUST III
FORMER N.CA REGION,COO	$328,917	$32,372	$42,326	$22,000	$40,419	$466,034
MICHEL RICCIONI
FORMER CFO N. CA			$151,400			$151,400

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3	THE ORGANIZATION'S PRESIDENT 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 ST. JOSEPH HEALTH SYSTEM. SCHEDULE J, PART I, LINE 4A THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING THE YEAR: MICHEL RICCIONI - $151,400
SCHEDULE J, PART I, LINE 4B	NONQUALIFIED RETIREMENT PLAN ENTITIES WITHIN THE PSJH 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 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. NO INDIVIDUALS RECEIVED A PAYMENT DURING THE YEAR.
SCHEDULE J, PART I, LINE 7	NON-FIXED PAYMENTS PORTION OF EXECUTIVE SALARIES ARE PLACED AT-RISK AND ARE NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE STRATEGIC OBJECTIVES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4A	PROVIDENCE ST. JOSEPH HEALTH SYSTEM ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH 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, 829 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 & SERVICES IN 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. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON. ST. JOSEPH HEALTH SYSTEM IN 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 MISSION PETALUMA 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: JANUARY 1 - DECEMBER 31, 2018 - PETALUMA VALLEY HOSPITAL CONTINUUM OF ORAL HEALTH SERVICES INCLUDE A FIXED SITE DENTAL CLINIC LOCATED IN SANTA ROSA THAT SERVES CHILDREN FROM THROUGHOUT THE COUNTY, THE MOBILE DENTAL CLINIC, THE MIGHTY MOUTH SCHOOL-BASED DENTAL DISEASE PREVENTION PROGRAM, AND MOMMY AND ME, WHICH TEACHES GOOD DENTAL HEALTH PRACTICES TO VERY YOUNG CHILDREN ZERO TO FIVE YEARS OLD AND THEIR MOTHERS. THE CLINICS PRIORITIZE SERVICE TO CHILDREN AGES 0-16 YEARS, BUT ALSO SERVE ADULTS WITH URGENT NEEDS. THEY PROVIDE BASIC, PREVENTIVE, EMERGENCY AND COMPREHENSIVE DENTAL CARE WITH A STRONG FOCUS ON PREVENTION AND EDUCATION. DURING 2018, 166 PATIENTS WERE SERVED OVER 443 ENCOUNTERS AT THE SJH DENTAL CLINIC. OUR MOBILE DENTAL CLINIC AND MIGHTY MOUTH SCHOOL-BASED PREVENTION PROGRAM SERVED 97 PATIENTS AND COMPLETED 186 ENCOUNTERS COUNTYWIDE. THE OVERALL DECAY RATE FOR ALL PROGRAMS WAS 32%. 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 2018, IN OUR SERVICE AREA, THE CLINIC SERVED 14 PATIENTS OVER 45 ENCOUNTERS 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, PROVIDED SERVICE TO 12 PATIENTS AND COMPLETED OVER 624 ENCOUNTERS COUNTYWIDE, HELPING TO PREVENT UNNECESSARY EMERGENCY DEPARTMENT VISITS AND TO MORE EFFECTIVELY MANAGE CHRONIC DISEASE. FOR MORE INFORMATION ABOUT PETALUMA VALLEY HOSPITAL, PLEASE VISIT WWW.STJOESONOMA.ORG. FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORG FOR MORE INFORMATION ABOUT PROVIDENCE ST. JOSEPH HEALTH, PLEASE VISIT WWW.PSJHEALTH.ORG
FORM 990, PART V, LINE 1A	ST. 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 VI, LINE 6	CLASSES OF MEMBERS OR STOCKHOLDERS SANTA ROSA MEMORIAL HOSPITAL IS THE SOLE CORPORATE MEMBER OF SRM ALLIANCE HOSPITAL SERVICES.
FORM 990, PART VI, LINE 7A	CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS SRM ALLIANCE HOSPITAL SERVICES HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE SRM ALLIANCE HOSPITAL SERVICES BOARD. ALL TRUSTEE NOMINATIONS THAT COME FROM THE SRM ALLIANCE HOSPITAL SERVICES BOARD AS NOMINATIONS MUST BE APPROVED BY SANTA ROSA MEMORIAL HOSPITAL.
FORM 990, PART VI, LINE 7B	CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL AND 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, LINE 11B	PROCESS TO REVIEW 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 COUNSELS 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, LINES 12C	PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY REAL OR POTENTIAL CONFLICT OF INTEREST (COI) IN ACCORDANCE WITH THE PSJH COI POLICY AND IN CONNECTION WITH THAT INDIVIDUAL SATISFYING HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY AND/OR IF AT ANY TIME AN ACTUAL, REAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PSJH CHIEF LEGAL OFFICER AND/OR THE PSJH CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR CONSIDER MATTERS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER. PSJH CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE 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 WHEN ACTION IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF COI DISCLOSURES IS RETAINED PER ORGANIZATION RETENTION POLICY.
FORM 990, PART VI, LINES 15A & 15B	PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE ST. JOSEPH HEALTH'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ST. JOSEPH HEALTH 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 ST. JOSEPH HEALTH HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE ST. JOSEPH HEALTH MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE ST. JOSEPH HEALTH'S LEGAL ENTITIES. PROVIDENCE ST. JOSEPH HEALTH ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE ST. JOSEPH HEALTH HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS OFFICERS, INCLUDING OUR SENIOR EXECUTIVES. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED BY THE PROVIDENCE ST. JOSEPH HEALTH COMMITTEE. THE BOARD 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 ST. JOSEPH HEALTH 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 WHOSE REVENUE IS SIMILAR TO THAT OF PROVIDENCE ST. JOSEPH HEALTH. ADDITIONALLY, PROVIDENCE ST. JOSEPH HEALTHS LABOR MARKET CONTINUES TO SPREAD ACROSS HEALTH CARE AND INTO GENERAL INDUSTRY. BECAUSE OF THIS, PROVIDENCE ST. JOSEPH HEALTH ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY FOR-PROFIT MARKET DATA, WHERE APPLICABLE. BASE SALARIES FOR PROVIDENCE ST. JOSEPH HEALTH EXECUTIVES ARE GENERALLY TARGETED TO THE MEDIAN LEVEL OF THE MARKET, 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. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY ACHIEVE SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE ST. JOSEPH HEALTH 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 EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS AND MIRRORS BEST PRACTICES. THE PROCESS TO REVIEW COMPENSATION WAS LAST COMPLETED MARCH 5, 2019.
FORM 990, PART VI, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE PSJH COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PSJH INTERNET SITE. AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO FORM 990.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS EQUITY TRANSFERS ($3,978,853) TRANSFER OF ASSETS TO SJHC NETWORK FOR PETALUMA HOSPICE ( $920,757) HOSPITAL FEES EQUITY TRANSFER ($1,011,550) ------------ TOTAL ($5,911,160)
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACT SERVICES TOTAL FEES:5957328
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICIAN FEES TOTAL FEES:4256642
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:4072253

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (112 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
COVENANT ACO
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	611573313	HEALTHCARE	TX	501(C)(3)	12, I	CHS	Yes (true)
COVENANT HEALTH NETWORK INC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	461259908	HEALTHCARE	CA	501(C)(3)	12, III	SJHS	Yes (true)
COVENANT HEALTH PARTNERS
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	463516417	HEALTHCARE	TX	501(C)(3)	12, I	CHS	Yes (true)
COVENANT HEALTH SYSTEM
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	752765566	HEALTHCARE	TX	501(C)(3)	3	SJHS	Yes (true)
COVENANT HEALTH SYSTEM FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	752897026	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes (true)
COVENANT MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	822913146	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
COVENANT MEDICAL GROUP
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	752743883	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
E WA & MT UNEMPLOYMENT COMP INSR TRUST
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911082119	UNEMPLOYMENT	WA	501(C)(3)	12, I	PHS WA	Yes (true)
EVERETT TRANSITIONAL CARE SERVICES
PO BOX 5128	EVERETT	WA	982065128	943264605	TRANS. CARE	WA	501(C)(3)	10	NA	false
FACEY MEDICAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	954322584	SUPPORT	CA	501(C)(3)	7	PHS SOCAL	Yes (true)
GAMELIN WASHINGTON ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	201910170	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
GLOBAL TO LOCAL HEALTH INITIATIVE
2800 SOUTH 192ND ST 104	SEATAC	WA	98188	273133200	HEALTHCARE	WA	501(C)(3)	7	SHS	Yes (true)
HMTS INC
1 HOAG DRIVE PO BOX 6100	NEWPORT BEACH	CA	92658	453583707	HEALTHCARE	CA	501(C)(3)	12, I	HMHP	Yes (true)
HOAG CHARITY SPORTS
2081 BUSINESS CTR DR STE 195	IRVINE	CA	92612	452982422	SUPPORT	CA	501(C)(3)	7	HHF	Yes (true)
HOAG CLINIC (FKA COASTAL MGMT SVCS ORG)
1 HOAG DRIVE PO BOX 6100	NEWPORT BEACH	CA	92658	330676831	HEALTHCARE	CA	501(C)(3)	10	HMHP	Yes (true)
HOAG HOSPITAL FOUNDATION
330 PLACENTIA AVE	NEWPORT BEACH	CA	92663	953222343	FUNDRAISING	CA	501(C)(3)	7	HMHP	Yes (true)
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
1 HOAG DRIVE PO BOX 6100	NEWPORT BEACH	CA	92658	951643327	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
HOSPICE OF LUBBOCK
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	752133781	HEALTHCARE	TX	501(C)(3)	10	CHS	Yes (true)
INLAND NORTHWEST HEALTH SERVICES
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911307555	HEALTHCARE	WA	501(C)(3)	3	PHS WA	Yes (true)
INSTITUTE FOR MENTAL HEALTH & WELLNESS
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	814260130	HEALTHCARE	WA	501(C)(3)	7	PHSSJHS	Yes (true)
INSTITUTE FOR SYSTEMS BIOLOGY
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	912003593	HEALTHCARE	WA	501(C)(3)	7	WHC	Yes (true)
JOHN WAYNE CANCER INSTITUTE
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	954291515	HEALTHCARE	CA	501(C)(3)	4	PSJHC	Yes (true)
KADLEC AUXILIARY INC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	916033089	SUPPORT	WA	501(C)(3)	12, III	KRMC	Yes (true)
KADLEC FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	237005501	SUPPORT	WA	501(C)(3)	12, I	KRMC	Yes (true)
KADLEC REGIONAL MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	910655392	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes (true)
LITTLE COMPANY OF MARY ANCILLARY SVCS CO
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	330844408	IMAGING SVCS	CA	501(C)(3)	10	PHS SOCAL	Yes (true)
LUBBOCK METHODIST HOSPITAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	752220963	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes (true)
LUNDBERG ASSOCIATIONPROVIDENCE HOUSE
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911562797	SUPPORT	OR	501(C)(3)	7	PHS OR	Yes (true)
MARSHA RIVKIN CTR FOR OVARIAN CANCER
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	912054035	RESEARCH	WA	501(C)(3)	7	SHS	Yes (true)
METHODIST CHILDREN'S HOSPITAL
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	752428911	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
METHODIST HOSPITAL LEVELLAND
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	752246348	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
METHODIST HOSPITAL PLAINVIEW
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	752426010	HEALTHCARE	TX	501(C)(3)	3	CHS	Yes (true)
MISSION HOSPITAL REGIONAL MEDICAL CTR
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	951643360	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
NORTHWEST HOPE & HEALING FOUNDATION
PO BOX 16069	SEATTLE	WA	98116	200799737	SUPPORT	WA	501(C)(3)	12,I	SHS	Yes (true)
PACMED CLINICS
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	562290878	HEALTHCARE	WA	501(C)(3)	10	WHC	Yes (true)
PH&S FOUNDATIONSFVSA & SCVSA
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	953544877	HEALTHCARE	CA	501(C)(3)	7	PHS SOCAL	Yes (true)
PROVIDENCE ALASKA FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	920093565	HEALTHCARE	AK	501(C)(3)	12, I	PHS WA	Yes (true)
PROVIDENCE BENEDICTINE NURSING CTR FNDN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911940286	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE BLANCHET ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911789266	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE CHILDREN'S HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	930800140	SUPPORT	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE COMMUNITY HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	930692907	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE DETHMAN HOUSE
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	473385506	SUPPORT	WA	501(C)(3)	7	NA	false
PROVIDENCE GAMELIN HOUSE ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	311744654	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE HEALTH & SERVICES
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911549796	HEALTHCARE	WA	501(C)(3)	12, II	PSJH	false
PROVIDENCE HEALTH & SERVICES - MONTANA
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	810231793	HEALTHCARE	MT	501(C)(3)	3	PHS WA	Yes (true)
PROVIDENCE HEALTH & SERVICES - OREGON
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	510216587	HEALTHCARE	OR	501(C)(3)	3	PHS	Yes (true)
PROVIDENCE HEALTH & SERVICES - WA
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	510216586	HEALTHCARE	WA	501(C)(3)	3	PHS	Yes (true)
PROVIDENCE HEALTH & SERVICES - WEST WA
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911303277	HEALTHCARE	WA	501(C)(3)	3	PMWHC	Yes (true)
PROVIDENCE HEALTH ASSURANCE
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	550828701	MEDICAID	OR	501(C)(4)	N/A	PHP	Yes (true)
PROVIDENCE HEALTH CARE FNDN - E WA
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	320014330	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE HEALTH CARE FNDN (CENTRALIA)
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911433382	HEALTHCARE	WA	501(C)(3)	7	PHS W WA	Yes (true)
PROVIDENCE HEALTH PLAN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	930863097	HEALTHCARE	OR	501(C)(4)	N/A	PPP	Yes (true)
PROVIDENCE HEALTH SYSTEM - SO CAL
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	510216589	HEALTHCARE	CA	501(C)(3)	3	PHS	Yes (true)
PROVIDENCE HOOD RIVER MEM HOSP FNDN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	930921990	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE HOSPICE AND HOME CARE FNDN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	272552749	HEALTHCARE	WA	501(C)(3)	7	PHS W WA	Yes (true)
PROVIDENCE HOSPICE OF SEATTLE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	912077378	HEALTHCARE	WA	501(C)(3)	7	PHS W WA	Yes (true)
PROVIDENCE LITTLE COMPANY OF MARY FNDN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	510224944	HEALTHCARE	CA	501(C)(3)	7	PHS SOCAL	Yes (true)
PROVIDENCE MARIANWOOD FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	931554288	HEALTHCARE	WA	501(C)(3)	12, I	PHS W WA	Yes (true)
PROVIDENCE MEDICAL INSTITUTE
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	330283773	HEALTHCARE	CA	501(C)(3)	12, I	PHS SOCAL	Yes (true)
PROVIDENCE MILWAUKIE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	943079515	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE MINISTRIES
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016		RELIGIOUS ORG	WA	501(C)(3)	1	NA	false
PROVIDENCE MOUNT ST VINCENT FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911188119	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE NEWBERG HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	930889144	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE PETER CLAVER ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	311629656	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE PLAN PARTNERS
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911861964	HEALTHCARE	WA	501(C)(4)	N/A	PHS OR	Yes (true)
PROVIDENCE PORTLAND MEDICAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	931231494	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE ROSSI ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	311584166	SUPPORT	WA	501(C)(3)	10	PHS WA	Yes (true)
PROVIDENCE SAINT JOHN'S HEALTH CENTER
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	951684082	HEALTHCARE	CA	501(C)(3)	3	PHS SOCAL	Yes (true)
PROVIDENCE SAINT JOHN'S MEDICAL FNDN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	814542216	HEALTHCARE	CA	501(C)(3)	3	PHS SOCAL	Yes (true)
PROVIDENCE SEASIDE HOSPITAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	930927320	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE ST ELIZABETH HOUSE ASSOC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	912171539	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST FRANCIS ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	943244854	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST JOSEPH HEALTH
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	811244422	HEALTHCARE	WA	501(C)(3)	12, III	NA	false
PROVIDENCE ST JOSEPH HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	943078543	HEALTHCARE	WA	501(C)(3)	12, I	PHS WA	Yes (true)
PROVIDENCE ST JOSEPH MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	810463482	HEALTHCARE	MT	501(C)(3)	3	PHS WA	Yes (true)
PROVIDENCE ST MARY FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	452841492	HEALTHCARE	WA	501(C)(3)	7	PHS WA	Yes (true)
PROVIDENCE ST PETER FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911097056	SUPPORT	WA	501(C)(3)	7	PHS W WA	Yes (true)
PROVIDENCE ST VINCENT MEDICAL FNDN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	930575982	HEALTHCARE	OR	501(C)(3)	7	PHS OR	Yes (true)
PROVIDENCE TRINITYCARE HOSPICE
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	953264139	HEALTHCARE	CA	501(C)(3)	10	PHS SOCAL	Yes (true)
PROVIDENCE TRINITYCARE HOSPICE FNDN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	330261016	HEALTHCARE	CA	501(C)(3)	7	PTCH	Yes (true)
PROVIDENCE WILLAMETTE FALLS MEDICAL FNDN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	931003750	HEALTHCARE	OR	501(C)(3)	12, I	PHS OR	Yes (true)
QUEEN OF THE VALLEY MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	941243669	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
REDWOOD MEMORIAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	942779313	HEALTHCARE	CA	501(C)(3)	7	RMH	Yes (true)
REDWOOD MEMORIAL HOSPITAL
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	941384665	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
SAINT JOHN'S HOSPITALHEALTH CENTER FNDN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	956100079	SUPPORT	CA	501(C)(3)	7	PSJHC	Yes (true)
SANTA ROSA MEMORIAL HOSPITAL
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	941231005	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
SEATTLE SCIENCE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	611502822	PHYSN COLLAB	WA	501(C)(3)	7	WHC	Yes (true)
SISTERS OF PROVIDENCE OF MONTANA CORP
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	262612415	SHELL CORP	MT	501(C)(3)	1	PHS WA	false
SISTERS OF ST JOSEPH OF ORANGE
480 S BATAVIA	ORANGE	CA	92868	951643383	RELIGIOUS ORG	CA	501(C)(3)	1	NA	false
ST JOSEPH HEALTH MINISTRY
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	271666576	RELIGIOUS ORG	CA	501(C)(3)	1	SSJO	false
ST JOSEPH HEALTH N CALIFORNIA LLC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	814791043	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
ST JOSEPH HEALTH SYSTEM
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	953589356	HEALTHCARE	CA	501(C)(3)	12, I	PSJH	false
ST JOSEPH HEALTH SYSTEM FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	330143024	HEALTHCARE	CA	501(C)(3)	7	SJHS	Yes (true)
ST JOSEPH HERITAGE HEALTHCARE
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	330185031	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
ST JOSEPH HOME CARE NETWORK
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	680331084	HEALTHCARE	CA	501(C)(3)	10	SJHS	Yes (true)
ST JOSEPH HOSPITAL OF EUREKA
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	941156596	HEALTHCARE	CA	501(C)(3)	3	SJHS	Yes (true)
ST JOSEPH HOSPITAL OF ORANGE
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	951643359	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
ST JUDE HOSPITAL INC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	951643324	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
ST LUKE ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	943176618	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
ST MARY MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	951914489	HEALTHCARE	CA	501(C)(3)	3	CHN	Yes (true)
ST MARY OF THE PLAINS HOSPITAL FDN
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	751653181	HEALTHCARE	TX	501(C)(3)	7	CHS	Yes (true)
ST PATRICK HOSPITAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	237056976	HEALTHCARE	MT	501(C)(3)	7	PHS WA	Yes (true)
ST THOMAS CHILD AND FAMILY CENTER
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	810233495	EDUCATION	MT	501(C)(3)	10	PHS WA	Yes (true)
SWEDISH EDMONDS
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	272305304	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes (true)
SWEDISH HEALTH SERVICES
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	910433740	HEALTHCARE	WA	501(C)(3)	3	WHC	Yes (true)
SWEDISH MEDICAL CENTER FOUNDATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	910983214	HEALTHCARE	WA	501(C)(3)	7	SHS	Yes (true)
SWEDISH MJM HOLDINGS
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	273139262	HOLDING CO	WA	501(C)(3)	12, I	SHS	Yes (true)
THE GAMELIN ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911180824	SUPPORT	WA	501(C)(3)	7	PHS WA	Yes (true)
THE GAMELIN CALIFORNIA ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911293869	SUPPORT	CA	501(C)(3)	10	PHS SOCAL	Yes (true)
THE GAMELIN OREGON ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	911214491	SUPPORT	OR	501(C)(3)	10	PHS OR	Yes (true)
UNIVERSITY OF PROVIDENCE
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	810231777	EDUCATION	MT	501(C)(3)	2	PHS	Yes (true)
WESTERN HEALTHCONNECT
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	454171900	SHELL CORP	WA	501(C)(3)	12, II	PHS W WA	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (62 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt
20TH STREET SURGERY LLC
1301 20TH STREET STE 140	SANTA MONICA	CA	90404	731735618	AMBULATORY SURG	CA	NA	N/A
BROADWAY IMAGING LLC
500 W BROADWAY	MISSOULA	MT	59802	522405971	MEDICAL IMAGING	MT	NA	N/A
CENTER FOR SPECIALTY SURGERY LLC
11782 SW BARNES RD	PORTLAND	OR	97225	263638838	AMBULATORY SURG	OR	NA	N/A
CLACKAMAS RADIATION ONCOLOGY CENTER LLC
4400 NE HALSEY ST BLDG II 495	PORTLAND	OR	97213	260381897	RADIATION ONCOL	OR	NA	N/A
COASTAL ASC HOLDINGS LLC
ONE HOAG DRIVE PO BOX 6100	NEWPORT BEACH	CA	926586100	810986844	HEALTHCARE	CA	NA	N/A
COVENANT LONG-TERM CARE LP
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	205033419	HEALTHCARE	TX	NA	N/A
CTR FOR MED IMAGING-BRIDGEPORT LLC
4400 NE HALSEY 495	PORTLAND	OR	97213	260796953	IMAGING DIAG.	OR	NA	N/A
CTR FOR MED IMAGING-TANASBOURNE LLC
4400 NE HALSEY 495	PORTLAND	OR	97213	200477972	IMAGING DIAG.	OR	NA	N/A
FULLERTON SURGICAL CENTER LP
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	470927394	AMBULATORY SURG	CA	NA	N/A
GREATER VALLEY MEDICAL BUILDING LP
501 S BUENA VISTA ST	BURBANK	CA	91505	954570858	REAL ESTATE - MOB	CA	NA	N/A
HCSA PROPERTIES LLC
1600 M STREET NW	AUBURN	WA	98001	460620892	REAL ESTATE RENT	WA	NA	N/A
HERITAGE INVESTMENT GROUP I LLC
500 S MAIN STREET STE 1000	ORANGE	CA	92868	271000061	INVESTMENTS	CA	NA	N/A
HOAG ORTHOPEDIC INSTITUTE
ONE HOAG DRIVE PO BOX 6100	NEWPORT BEACH	CA	926586100	611588294	HEALTHCARE	CA	NA	N/A
HOAG OUTPATIENT CENTERS LLC
27271 LAS RAMBLAS 350	MISSION VIEJO	CA	92691	453587572	HEALTHCARE	CA	NA	N/A
INLAND IMAGING LLC
801 S STEVENS ST	SPOKANE	WA	99204	911855796	MEDICAL IMAGING	WA	NA	N/A
LSC REAL PROPERTY LLC
2301 QUAKER AVENUE	LUBBOCK	TX	79410	474646059	REAL ESTATE	TX	NA	N/A
METHODIST DIAGNOSTIC IMAGING
4005 24TH STREET	LUBBOCK	TX	79410	752343261	HEALTHCARE	TX	NA	N/A
NEWPORT BAY SURGERY CENTER LLC
3333 W PACIFIC COAST HWY 100	NEWPORT BEACH	CA	92663	562518360	HEALTHCARE	CA	NA	N/A
NEWPORT BEACH ENDOSCOPY CENTER LLC
27271 LAS RAMBLAS 350	MISSION VIEJO	CA	92691	770368744	HEALTHCARE	CA	NA	N/A
NEWPORT IMAGING CENTER
360 SN MIGUEL	NEWPORT BEACH	CA	92660	330191776	HEALTHCARE	CA	NA	N/A
NEWPORT SURGICAL PARTNERS LLC
27271 LAS RAMBLAS 350	MISSION VIEJO	CA	92691	392060266	HEALTHCARE	CA	NA	N/A
NORTH BAY ENDOSCOPY CENTER
1383 N MCDOWELL BLVD STE 110	PETALUMA	CA	94954	611559876	HEALTHCARE	CA	NA	N/A
OREGON ADVANCED IMAGING LLC
881 OHARE PARKWAY	MEDFORD	OR	97504	450471748	MEDICAL IMAGING	OR	NA	N/A
OREGON OUTPATIENT SURGERY CENTER
7300 SW CHILDS RD	TIGARD	OR	97224	223883387	AMBULATORY SURG	OR	NA	N/A
PETCT IMAGING AT SWEDISH CANCER INSTITU
1221 MADISON STREET	SEATTLE	WA	98104	203132044	MEDICAL IMAGING	WA	NA	N/A
PHS INVESTMENT TRANSITION PORTFOLIO
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472279711	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST 2015 PRIVATE ASSETS
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	473393740	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST 2016 PRIVATE ASSETS
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	811532735	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST 2016 PRIVATE REAL E
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	812960145	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST BANK LOANS PORTFOLI
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472357735	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST COMMODITIES PORTFOL
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472269004	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST HEDGE FUND PORTFOLI
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472293255	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST LDI PORTFOLIO
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472392060	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST LONG TREASURIES POR
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472385238	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST MLP PORTFOLIO
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472367538	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST PUBLIC DEBT PORTFOL
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472353569	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST PUBLIC EQUITY PORTF
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472283974	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST RELATIVE VALUE PORT
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472314743	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST RISK PARITY PORTFOL
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472336377	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST SHORT TERM INVESTME
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	812701056	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST TACTICAL TRADING PO
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472327491	INVESTMENTS	WA	NA	N/A
PHS INVESTMENT TRUST TIPS PORTFOLIO
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	472402609	INVESTMENTS	WA	NA	N/A
PORTLAND MEDICAL IMAGING LLC
4400 NE HALSEY 495	PORTLAND	OR	97213	201054971	IMAGING DIAG.	OR	NA	N/A
PROV RADIATION ONCOLOGY DEVELOP ASSN
4400 NE HALSEY 495	PORTLAND	OR	97213	260682491	REAL ESTATE - MOB	OR	NA	N/A
PROVIDENCE CHILDREN'S NEONATAL SERVICES
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	470918549	NEONATAL CARE	WA	NA	N/A
PROVIDENCE IMAGING CENTER JOINT VENTURE
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	920118807	MEDICAL IMAGING	AK	NA	N/A
PROVIDENCE PARTNERS FOR HEALTH LLC
501 S BUENA VISTA ST	BURBANK	CA	91505	454041798	CLIN QUALITY/INT	CA	NA	N/A
PROVIDENCE ST JOSEPH HEALTH LONG TERM P
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	823190634	INVESTMENTS	WA	NA	N/A
PROVIDENCE SURGERY CENTER LLC
902 N ORANGE ST	MISSOULA	MT	59802	841401625	AMBULATORY SURG	MT	NA	N/A
PROVIDENCESILVERTON REHAB LLC
4400 NE HALSEY 425	PORTLAND	OR	97213	481287267	REHAB SERVICES	OR	NA	N/A
PROVIDENCEUSP SANTA CLARITA GP LLC
11550 INDIAN HILLS ROAD 160	MISSION HILLS	CA	91345	202829660	AMBULATORY SURG	CA	NA	N/A
PROVIDENCEUSP SURGERY CTRS LLC
11550 INDIAN HILLS ROAD 160	MISSION HILLS	CA	91345	200905938	AMBULATORY SURG	CA	NA	N/A
SHA LLC
12940 NORTH HIGHWAY 183	AUSTIN	TX	78750	752569094	HEALTHCARE	TX	NA	N/A
SJO ASC HOLDINGS LLC
1140 W LA VETA AVE	ORANGE	CA	92868	821655501	HEALTHCARE	CA	NA	N/A
ST JOSEPH PHYSICIAN VENTURES I LLC
1100 WEST STEWART DRIVE	ORANGE	CA	92868	454521884	REAL ESTATE	CA	NA	N/A
ST JOSEPHSATELLITE DIALYSIS CENTERS L
300 SANTANA ROW SUITE 300	SAN JOSE	CA	95128	814657391	HEALTHCARE	CA	NA	N/A
ST JUDE SURGICAL CENTERS LLC
1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	823352570	AMBULATORY SURG	CA	NA	N/A
SURGERY CENTER AT TANASBOURNE LLC
11221 ROE AVE STE 300	LEAWOOD	KS	66211	208187971	AMBULATORY SURG	KS	NA	N/A
TARZANA PEDIATRIC VENTURES LLC
18321 CLARK ST TARZANA CA 91356	TARZANA	CA	91356	821308306	HEALTHCARE	CA	NA	N/A
THE MADISON SPOKANE INN LLC
15 WEST ROCKWOOD BLVD	SPOKANE	WA	99204	841606484	HOTEL SERVICES	WA	NA	N/A
TARZANA PEDIATRIC VENTURES LLC
18321 CLARK ST TARZANA CA 91356	TARZANA	CA	91356	821308306	HEALTHCARE	CA	NA	N/A
THE MADISON SPOKANE INN LLC
15 WEST ROCKWOOD BLVD	SPOKANE	WA	99204	841606484	HOTEL SERVICES	WA	NA	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (26 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Legal Domicile StateLegalDomicileStateCd
AMERICAN UNITY GROUP LTD
90 PITTS BAY ROAD	PEMBROKE	BD	HM08	CAPTIVE INSURANCE	BD	NA	C-CORP
1221 MADISON STREET OWNERS ASSOC
				OWNERS' ASSOC.		NA	C-CORP	747 BROADWAY	SEATTLE	WA	98122	201954319	WA
AYIN HEALTH SOLUTIONS INC
				HEALTHCARE		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	833037172	DE
BOURGET HEALTH SERVICES INC
				CLIN/MED LAB		NA	C-CORP	PO BOX 2687	SPOKANE	WA	99220	911354431	WA
CARON HEALTH CORPORATION
				MED PHYS SVCS		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	810486082	MT
DATU HEALTH INC AND SUBSIDIARIES
				IT SVCS		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	463070062	DE
GRACE CLINIC OF LUBBOCK
				HEALTHCARE		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	203856995	TX
GRACE CLINIC SERVICES INC
				HEALTHCARE		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	203857067	TX
HOAG CLINIC (FKA COASTAL MGM SVS ORG)
				HEALTHCARE		NA	C-CORP	1 HOAG DRIVE PO BOX 6100	NEWPORT BEACH	CA	926586100	330676831	CA
HOAG MANAGEMENT SERVICES INC
				HEALTHCARE		NA	C-CORP	1 HOAG DRIVE PO BOX 6100	NEWPORT BEACH	CA	926586100	330731587	CA
LUBBOCK METHODIST HOSP PRACTICE MGMT
				INACTIVE		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	752578995	TX
LUBBOCK METHODIST HOSPITAL SVCS
				HEALTHCARE		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	752118585	TX
LUMEDIC ACQUISITION CO INC
				HEALTHCARE		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	833881097	WA
MISSION VIEJO MEDICAL VENTURES
				HEALTHCARE		NA	C-CORP	27800 MEDICAL CENTER RD 354	MISSION VIEJO	CA	92691	330212905	CA
PHN HOLDINGS
				STRAT PLAN SVCS		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	461814184	CA
PIONEER INNOVATIONS INC
				HEALTH INNOVATNS		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	364818191	WA
PROVIDENCE ASSURANCE INC
				CAPTIVE INSURANCE		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	208194071	AZ
PROVIDENCE HEALTH CARE VENTURES INC
				CLIN/MED LAB		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	900155714	WA
PROVIDENCE HEALTH NETWORK
				PREPAID HEALTH		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	800886966	CA
PROVIDENCE HEALTH VENTURES INC
				INVESTMENT		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	330122216	CA
ST JOSEPH HEALTH
				HOLDING COMPANY		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	462340232	CA
ST JOSEPH HEALTH SOURCE INC
				HEALTHCARE		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	461900168	CA
ST JOSEPH PROF SVCS ENTERPRSES INC
				HEALTHCARE		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	330155323	CA
VINSERRA INC
				INVESTMENT		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	953943315	CA
WESTERN HEALTHCONNECT VENTURES INC
				INVESTMENT		NA	C-CORP	1801 LIND AVE SW ATTN TAX DEPT	RENTON	WA	980579016	800953654	WA
YAKIMA MEDICAL ARTS INC
				RENT REAL ESTATE		NA	C-CORP	611 N PERRY 100	SPOKANE	WA	99202	910787963	WA

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (10 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
ST JOSEPH HOME CARE NETWORK
q	$3,108,571	ACCRUAL
ST JOSEPH HOME CARE NETWORK
p	$54,010	ACCRUAL
ST JOSEPH HOME CARE NETWORK
c	$2,788,718	CASH
ST JOSEPH HOME CARE NETWORK
r	$1,228,101	CASH
SANTA ROSA MEMORIAL HOSPITAL
p	$704,642	ACCRUAL
ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC
p	$5,764,690	ACCRUAL
ST JOSEPH HEALTH FOUNDATION
c	$271,737	CASH
ST JOSEPH HEALTH FOUNDATION
b	$902,900	CASH
ST JOSEPH HEALTH SYSTEM
p	$83,149,214	CASH
ST JOSEPH HEALTH SYSTEM
r	$419,324	CASH

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE R, PART III	FormAndLineReferenceDesc
Explanation	IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP 20TH STREET SURGERY LLC EIN: 73-1735618 ADDRESS: 1301 20TH STREET, STE 140, SANTA MONICA, CA 90404 BROADWAY IMAGING, LLC EIN: 52-2405971 ADDRESS: 500 W. BROADWAY MISSOULA, MT 59802 CENTER FOR SPECIALTY SURGERY, LLC EIN: 26-3638838 ADDRESS: 11782 SW BARNES RD. PORTLAND, OR 97225 CLACKAMAS RADIATION ONCOLOGY CENTER, LLC EIN: 26-0381897 ADDRESS: 4400 NE HALSEY ST., BLDG. II, #495 PORTLAND, OR 97213 COASTAL ASC HOLDINGS LLC EIN: 81-0986844 ADDRESS: ONE HOAG DRIVE, PO BOX 6100, NEWPORT BEACH, CA 92658 COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 CTR. FOR MED. IMAGING-BRIDGEPORT, LLC EIN: 26-0796953 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 CTR. FOR MED. IMAGING-TANASBOURNE, LLC EIN: 20-0477972 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 FULLERTON SURGICAL CENTER LP EIN: 47-0927394 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 GREATER VALLEY MEDICAL BUILDING, L.P. EIN: 95-4570858 ADDRESS: 501 S. BUENA VISTA ST. BURBANK, CA 91505 HCSA PROPERTIES LLC EIN: 46-0620892 ADDRESS: 1600 M STREET NW AUBURN, WA 98001 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 500 S. MAIN STREET, STE 1000, ORANGE, CA 92868 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, PO BOX 6100, NEWPORT BEACH, CA 92658 HOAG OUTPATIENT CENTERS, LLC EIN: 45-3587572 ADDRESS: 27271 LAS RAMBLAS #350, MISSION VIEJO, CA 92691 INLAND IMAGING, LLC EIN: 91-1855796 ADDRESS: 801 S. STEVENS ST., SPOKANE, WA 99204 LSC REAL PROPERTY, LLC EIN: 47-4646059 ADDRESS: 2301 QUAKER AVENUE, LUBBOCK, TX, 79410 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 NEWPORT BAY SURGERY CENTER, LLC EIN: 56-2518360 ADDRESS: 3333 W. PACIFIC COAST HWY, #100 NEWPORT BEACH, CA 92663 NEWPORT BEACH ENDOSCOPY CENTER, LLC EIN: 77-0368744 ADDRESS: 27271 LAS RAMBLAS #350 MISSION VIEJO, CA 92691 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SN MIGUEL, NEWPORT BEACH, CA 92660 NEWPORT SURGICAL PARTNERS, LLC EIN: 39-2060266 ADDRESS: 27271 LAS RAMBLAS #350 MISSION VIEJO, CA 92691 NORTH BAY ENDOSCOPY CENTER EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD, SUITE 110, PETALUMA, CA 94954 OREGON ADVANCED IMAGING, LLC EIN: 45-0471748 ADDRESS: 881 O'HARE PARKWAY, MEDFORD, OR 97504 OREGON OUTPATIENT SURGERY CENTER EIN: 22-3883387 ADDRESS: 7300 SW CHILDS ROAD, TIGARD, OR 97224 PET/CT IMAGING AT SWEDISH CANCER INSTITUTE, LLC EIN: 20-3132044 ADDRESS: 1221 MADISON STREET SEATTLE, WA 98104 PHS INVESTMENT TRANSITION PORTFOLIO EIN: 47-2279711 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST 2015 PRIVATE ASSETS PORTFOLIO EIN: 47-3393740 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST 2016 PRIVATE ASSETS PORTFOLIO EIN: 81-1532735 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST 2016 PRIVATE REAL ESTATE PORTFOLIO EIN: 81-2960145 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST BANK LOANS PORTFOLIO EIN: 47-2357735 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST COMMODITIES PORTFOLIO EIN: 47-2269004 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST HEDGE FUND PORTFOLIO EIN: 47-2293255 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST LDI PORTFOLIO EIN: 47-2392060 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST LONG TREASURIES PORTFOLIO EIN: 47-2385238 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST MLP PORTFOLIO EIN: 47-2367538 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST PUBLIC DEBT PORTFOLIO EIN: 47-2353569 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST PUBLIC EQUITY PORTFOLIO EIN: 47-2283974 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST RELATIVE VALUE PORTFOLIO EIN: 47-2314743 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST RISK PARITY PORTFOLIO EIN: 47-2336377 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO EIN: 81-2701056 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST TACTICAL TRADING PORTFOLIO EIN: 47-2327491 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PHS INVESTMENT TRUST TIPS PORTFOLIO EIN: 47-2402609 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PORTLAND MEDICAL IMAGING, LLC EIN: 20-1054971 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 PROV. RADIATION ONCOLOGY DEVELOP. ASSN., LLC EIN: 26-0682491 ADDRESS: 4400 NE HALSEY, #495 PORTLAND, OR 97213 PROVIDENCE CHILDREN'S NEONATAL SERVICES EIN: 47-0918549 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE IMAGING CENTER JOINT VENTURE EIN: 92-0118807 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE PARTNERS FOR HEALTH, LLC EIN: 45-4041798 ADDRESS: 501 S. BUENA VISTA ST. BURBANK, CA 91505 PROVIDENCE ST. JOSEPH HEALTH LONG TERM PORTFOLIO EIN: 82-3190634 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 PROVIDENCE SURGERY CENTER, LLC EIN: 84-1401625 ADDRESS: 902 N. ORANGE ST MISSOULA, MT 59802 PROVIDENCE/SILVERTON REHAB, LLC EIN: 48-1287267 ADDRESS: 4400 NE HALSEY #425, PORTLAND, OR 97213 PROVIDENCE/USP SANTA CLARITA GP, LLC EIN: 20-2829660 ADDRESS: 11550 INDIAN HILLS ROAD #160, MISSION HILLS, CA 91345 PROVIDENCE/USP SURGERY CENTERS, LLC EIN: 20-0905938 ADDRESS: 11550 INDIAN HILLS ROAD #160, MISSION HILLS, CA 91345 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 SJO ASC HOLDINGS LLC EIN: 82-1655501 ADDRESS: 1140 W. LA VETA AVE ORANGE, CA 92868 ST JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 ST. JOSEPH/SATELLITE DIALYSIS CENTERS, LLC EIN: 81-4657391 ADDRESS: 300 SANTANA ROW, SUITE 300 SAN JOSE, CA 95128 ST. JUDE SURGICAL CENTERS, LLC EIN: 82-3352570 ADDRESS: 1801 LIND AVE. SW, ATTN: TAX DEPARTMENT, RENTON, WA 98057-9016 SURGERY CENTER AT TANASBOURNE, LLC EIN: 20-8187971 ADDRESS: 11221 ROE AVE., STE 300, LEAWOOD, KS 66211 TARZANA PEDIATRIC VENTURES LLC EIN: 82-1308306 ADDRESS: 18321 CLARK ST, TARZANA, CA 91356 THE MADISON SPOKANE INN, LLC EIN: 84-1606484 ADDRESS: 15 WEST ROCKWOOD BLVD. SPOKANE, WA 99204	ExplanationTxt