STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

REDWOOD MEMORIAL HOSPITAL: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
REDWOOD MEMORIAL HOSPITAL (EIN 94-1384665)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-15
IRS object ID
201923199349313997
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 ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-15T15:37:29-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line118101 VON KARMAN AVE SUITE 1700AddressLine1Txt
CityIRVINECityNm
State AbbreviationCAStateAbbreviationCd
ZIP92612ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN941384665EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1REDWOOD MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% JONI MURPHYInCareOfNm
Business Name ControlREDWBusinessNameControlTxt
Phone7072694259PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 LIND AVE SW ATTN TAX DEPTAddressLine1Txt
CityRENTONCityNm
State AbbreviationWAStateAbbreviationCd
ZIP980579016ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN PETERSPersonNm
Person TitleINTERIM REGIONAL CFOPersonTitleTxt
Phone7075255300PhoneNum
Signature2019-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKARA ADAMSPreparerPersonNm
PTINP00023315PTIN
Phone9497942300PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address164.57.159.254IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id33577420193195000090FederalOriginalSubmissionId
Federal Original Submission Id2019-11-15FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdC8EB7D7F4A43AD7C11A3CC780D94EAED606DA475AtSubmissionCreationDeviceId
At Submission Filing Device IdCBBDC42840D8014E8353DD16D453BA683ED30307AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerROBERTA LUSKIN-HAWK MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 RENNER DRIVEAddressLine1Txt
CityFORTUNACityNm
State AbbreviationCAStateAbbreviationCd
ZIP95540ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$31,778,437GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.STJOEHUMBOLDT.ORG/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1954FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.ActivityOrMissionDesc
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee256TotalEmployeeCnt
Total Volunteers27TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$156,845PYContributionsGrantsAmt
CY Contributions Grants$485,436CYContributionsGrantsAmt
PY Program Service Revenue$28,990,957PYProgramServiceRevenueAmt
CY Program Service Revenue$11,916,671CYProgramServiceRevenueAmt
PY Investment Income$2,848,903PYInvestmentIncomeAmt
CY Investment Income$1,544,507CYInvestmentIncomeAmt
PY Other Revenue$13,898PYOtherRevenueAmt
CY Other Revenue$17,831,823CYOtherRevenueAmt
PY Total Revenue$32,010,603PYTotalRevenueAmt
CY Total Revenue$31,778,437CYTotalRevenueAmt
PY Grants And Similar Paid$496,668PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$535,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,325,116PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$23,640,247CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$320,700CYTotalFundraisingExpenseAmt
PY Other Expenses$11,185,315PYOtherExpensesAmt
CY Other Expenses$5,496,104CYOtherExpensesAmt
PY Total Expenses$23,007,099PYTotalExpensesAmt
CY Total Expenses$29,671,351CYTotalExpensesAmt
PY Revenues Less Expenses$9,003,504PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,107,086CYRevenuesLessExpensesAmt
Total Assets BOY$116,810,739TotalAssetsBOYAmt
Total Assets EOY$0TotalAssetsEOYAmt
Total Liabilities BOY$8,137,654TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$108,673,085NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$28,044,301ExpenseAmt
Grant$535,000GrantAmt
Revenue$29,748,494RevenueAmt
DescSEE SCHEDULE ODesc
Total Program Service Expenses$28,044,301TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationYes (true)PartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee256EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJONI MURPHYPersonNm
Phone7075255300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11165 MONTGOMERY DRIVEAddressLine1Txt
CitySANTA ROSACityNm
State AbbreviationCAStateAbbreviationCd
ZIP95405ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (34 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
RICK CENTER
BOARD MEMBER2.04.0Yes (X)$0$0$0
BECKY GIACOMINI
BOARD MEMBER2.02.0Yes (X)$0$0$0
PETER GOLDBERG MD
BOARD MEMBER/CHIEF OF STAFF2.02.0Yes (X)$0$0$0
SISTER PATRICIA HAYHURST CSJ
BOARD MEMBER2.02.0Yes (X)$0$0$0
RON JONES MD
BOARD VICE CHAIR4.06.0Yes (X)$0$0$0
DENNIS LEONARDI
BOARD CHAIR4.05.0Yes (X)$0$0$0
ROBERTA LUSKIN-HAWK MD
BOARD MEMBER/CEO4.046.0Yes (X)$0$467,830$172,231Yes (X)
ELLEN MAHONEY MD
BOARD MEMBER2.02.0Yes (X)$0$33,139$0
JEFF NELSON
BOARD MEMBER2.02.0Yes (X)$0$0$0
PAUL OHTA
BOARD MEMBER2.052.0Yes (X)$0$392,311$152,979
SR MARY THERESE SWEENEY CSJ
BOARD MEMBER2.02.0Yes (X)$0$0$0
SISTER THUY TRAN CSJ
BOARD MEMBER2.02.0Yes (X)$0$0$0
DAVID WELLS
BOARD MEMBER2.02.0Yes (X)$0$0$0
DONALD WHEELER MD
BOARD MEMBER2.02.0Yes (X)$0$0$0
OLUYEMI ADEYANJU
SECRETARY2.052.0$0$408,366$22,535Yes (X)
RAJU IYER
CFO NORTHERN CA2.048.0$0$363,872$33,831Yes (X)
JULIE MALVEY
VP, MISSION INTEGRATION7.045.0$0$197,326$44,060Yes (X)
JOHN PETERS
INTERIM REGIONAL CFO10.010.0$0$0$0Yes (X)
DAVID SOUTHERLAND
INTERIM CHIEF EXECUTIVE7.043.0$0$369,609$23,042Yes (X)
TAMMY BARK
VP, CNO7.043.0$0$279,320$20,964Yes (X)
JOHN BIBBY
REGIONAL VP HR N. CA2.048.0$0$364,110$47,710Yes (X)
MAUREEN DISBOT
VP, QUALITY & SAFETY10.049.0$0$327,757$35,927Yes (X)
KEVIN KLOCKENGA
REGIONAL PRESIDENT/NCAL2.048.0$0$1,182,880$41,275Yes (X)
CAROL KOEBLE
CHIEF MEDICAL OFFICER - NCAL2.048.0$0$437,819$13,008Yes (X)
CARMELO MOCERI
CHIEF STRATEGY OFFICER - NCAL2.048.0$0$333,405$37,125Yes (X)
WILLIAM PARKS
VP, MEDICAL AFFAIRS/CMO7.043.0$0$403,390$53,991Yes (X)
MARK PROVAN
N.CA REG VP-POST ACUTE CARE10.049.0$0$326,802$47,033Yes (X)
LAURIE WATSON-STONE
VP, ANCILLARY & SUPPORT SRVCS7.043.0$0$264,208$41,860Yes (X)
PAMELA CASSADY
ADMINISTRATIVE SUPERVISOR40.00.0$144,808$0$37,360Yes (X)
MARK GARDNER
PHYSICAL THERAPIST40.00.0$164,825$0$28,890Yes (X)
ADAM GLASER
RN CLINICAL COORDINATOR40.00.0$151,875$0$34,075Yes (X)
MAUREEN LYTLE
ADMIN SUPERVISOR40.00.0$156,209$0$32,905Yes (X)
JOHN SELLERS
STAFF RN40.00.0$154,293$0$35,348Yes (X)
MICHEL RICCIONI
FORMER CFO N. CA0.00.0$0$151,400$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$772,010TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,303,544TotReportableCompRltdOrgAmt
Total Other Compensation$956,149TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K20IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AMN HEALTHCARE INC
PO BOX 56157LOS ANGELESCA90074STAFFING SERVICES$1,025,730
PREMIER EMERGENCY PHYSICIANS OF CA
7032 COLLECTION CENTER DRIVECHICAGOIL60693PHYSICIAN SERVICES$151,569
INPATIENT SERVICES OF CALIFORNIA
7032 COLLECTION CENTER DRIVECHICAGOIL60693PHYSICIAN SERVICES$141,301
ST JOSEPH HERITAGE HEALTHCARE
3345 MICHELSON DRIVEIRVINECA92612PHYSICIAN SERVICES$112,072
FASTAFF LLC
PO BOX 91452DENVERCO80291STAFFING SERVICES$107,906
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
Related Organizations$350,000RelatedOrganizationsAmt
Government Grants$89,029GovernmentGrantsAmt
All Other Contributions$46,407AllOtherContributionsAmt
Total Contributions$485,436TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
NET PATIENT REVENUE622110$11,875,479$11,875,479$0$0
CAFETERIA722310$25,722$25,722$0$0
MOB REVENUE531120$15,470$15,470$0$0
FieldValueIRS element (for citing)
Total Program Service Revenue$11,916,671TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,544,507TotalRevenueColumnAmt
Exclusion$1,544,507ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
EMPLOYEE LEASE REIMBURSEMENT-SJHNC, LLC900099$17,828,007$17,828,007$0$0
REBATES & REFUNDS900099$2,794$2,794$0$0
CASH PURCHASES & DISCOUNT900099$740$740$0$0

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$282TotalRevenueColumnAmt
Related Or Exempt Func Income$282RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$17,831,823OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,778,437TotalRevenueColumnAmt
Related Or Exempt Func Income$29,748,494RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,544,507ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$535,000TotalAmt
Program Services$535,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$373,840TotalAmt
Program Services$316,322ProgramServicesAmt
Management And General$57,518ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

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

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$16,302,063TotalAmt
Program Services$15,308,549ProgramServicesAmt
Management And General$759,844ManagementAndGeneralAmt
Fundraising$233,670FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$845,969TotalAmt
Program Services$774,965ProgramServicesAmt
Management And General$56,489ManagementAndGeneralAmt
Fundraising$14,515FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,784,263TotalAmt
Program Services$4,600,908ProgramServicesAmt
Management And General$135,969ManagementAndGeneralAmt
Fundraising$47,386FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,334,112TotalAmt
Program Services$1,266,982ProgramServicesAmt
Management And General$52,075ManagementAndGeneralAmt
Fundraising$15,055FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$684,214TotalAmt
Program Services$674,988ProgramServicesAmt
Management And General$9,226ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$32,453TotalAmt
Program Services$0ProgramServicesAmt
Management And General$32,453ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

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

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$819TotalAmt
Program Services$819ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

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

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,592,850TotalAmt
Program Services$2,489,859ProgramServicesAmt
Management And General$97,835ManagementAndGeneralAmt
Fundraising$5,156FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,765TotalAmt
Program Services$1,870ProgramServicesAmt
Management And General$373ManagementAndGeneralAmt
Fundraising$522FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$98,337TotalAmt
Program Services$91,450ProgramServicesAmt
Management And General$6,861ManagementAndGeneralAmt
Fundraising$26FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$107,173TotalAmt
Program Services$101,560ProgramServicesAmt
Management And General$4,733ManagementAndGeneralAmt
Fundraising$880FundraisingAmt

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$176,964TotalAmt
Program Services$175,548ProgramServicesAmt
Management And General$1,416ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$43,184TotalAmt
Program Services$22,551ProgramServicesAmt
Management And General$18,495ManagementAndGeneralAmt
Fundraising$2,138FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,445TotalAmt
Program Services$1,635ProgramServicesAmt
Management And General$3,015ManagementAndGeneralAmt
Fundraising$795FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$13,221TotalAmt
Program Services$13,221ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$225,596TotalAmt
Program Services$225,240ProgramServicesAmt
Management And General$356ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

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

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES$881,317$880,114$1,203$0
REPAIRS AND MAINTENANCE$107,749$103,692$4,057$0
OTHER DIRECT EXPENSES$65,560$47,922$17,146$492
ALL OTHER EXPENSES$458,457$411,106$47,286$65

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$29,671,351TotalAmt
Program Services$28,044,301ProgramServicesAmt
Management And General$1,306,350ManagementAndGeneralAmt
Fundraising$320,700FundraisingAmt

Total Joint Costs TotalJointCostsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$8,547,721BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,486,524BOYAmt
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$37,620BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$964,240BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$212,278BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$0LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$12,362,461BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$81,025,560BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$7,174,335BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$116,810,739BOYAmt
EOY$0EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,753,572BOYAmt
EOY$0EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,384,082BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,137,654BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$108,510,203BOYAmt
EOY$0EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$162,882BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$108,673,085BOYAmt
EOY$0EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$116,810,739BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,107,086ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$1,392,347NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$109,387,824OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Media Advertisements$0MediaAdvertisementsAmt
Mailings MembersfalseMailingsMembersInd
Mailings Members$0MailingsMembersAmt
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Publications Or Broadcast$0PublicationsOrBroadcastAmt
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Grants Other Organizations$0GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Direct Contact Legislators$0DirectContactLegislatorsAmt
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Rallies Demonstrations$0RalliesDemonstrationsAmt
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$819OtherActivitiesAmt
Total Lobbying Expenditures$819TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1IFormAndLineReferenceDesc
ExplanationDESCRIPTION OF LOBBYING ACTIVITIES THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO REDWOOD MEMORIAL HOSPITAL.ExplanationTxt

Schedule H IRS990ScheduleH

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

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other500.DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$240,626TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$240,626NetCommunityBenefitExpnsAmt
Total Expense0.00810TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,628,278TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,929,764DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,868,904TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,929,764DirectOffsettingRevenueAmt
Net Community Benefit Expns$240,626NetCommunityBenefitExpnsAmt
Total Expense0.00810TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$260,328TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$23,970DirectOffsettingRevenueAmt
Net Community Benefit Expns$236,358NetCommunityBenefitExpnsAmt
Total Expense0.00800TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$60,469TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$60,469NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$320,797TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$23,970DirectOffsettingRevenueAmt
Net Community Benefit Expns$296,827NetCommunityBenefitExpnsAmt
Total Expense0.01000TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,189,701TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,953,734DirectOffsettingRevenueAmt
Net Community Benefit Expns$537,453NetCommunityBenefitExpnsAmt
Total Expense0.01810TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$0BadDebtExpenseAmt
Reimbursed By Medicare$4,971,329ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$4,971,329CostOfCareReimbursedByMedcrAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1REDWOOD MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 RENNER DRIVEAddressLine1Txt
CityFORTUNACityNm
State AbbreviationCAStateAbbreviationCd
ZIP95540ZIPCd
FieldValueIRS element (for citing)
Website Addresshttps://www.stjoehumboldt.org/WebsiteAddressTxt
State LicenseD-0295172StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Redwood Memorial HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE SCHEDULE H, PART V, SECTION COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt17ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE SCHEDULE H, PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care500.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 3ETHE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 5 COLLECTING COMMUNITY INPUT IS AN INTEGRAL PART OF THE NEEDS ASSESSMENT PROCESS. QUANTITATIVE DATA ONLY TELLS PART OF THE STORY, BUT HEARING DIRECTLY FROM RESIDENTS AND STAKEHOLDERS WORKING IN HEALTH-RELATED FIELDS PROVIDES CONTEXT AND FIRST-HAND EXPERIENCE OF THE NEEDS OCCURRING WHERE PEOPLE LIVE, WORK AND PLAY. OVER A TWO WEEK PERIOD IN FEBRUARY 2017 WE HELD THREE RESIDENT FOCUS GROUPS IN DIFFERENT GEOGRAPHIC LOCATIONS OF OUR SERVICE AREA AND WITH POPULATIONS WHO HAVE KNOWN HEALTH DISPARITIES. IN TOTAL, MORE THAN 30 PEOPLE PARTICIPATED. THE FOCUS GROUPS WERE HELD IN FORTUNA AND EUREKA AND INCLUDED SENIORS LIVING IN THE EEL RIVER VALLEY AS WELL AS ELDERS FROM THE TABLE BLUFF RANCHERIA, LOW-INCOME FAMILIES AND SPANISH-SPEAKING COMMUNITY MEMBERS. A FOURTH FOCUS GROUP WITH GOVERNMENT AND NON-PROFIT STAKEHOLDERS WAS ALSO HELD IN EUREKA. ELEVEN REPRESENTATIVES FROM NINE ENTITIES ATTENDED. AT EACH FOCUS GROUP PARTICIPANTS WERE PROVIDED WITH SUMMARY SECONDARY AND PUBLICALLY AVAILABLE DATA HIGHLIGHTING AREAS OF NEED AND ASKED TO PROVIDE FEEDBACK. FOR CONSISTENCY PURPOSES, THE SAME QUESTIONS WERE ASKED AT EACH OF THE FOCUS GROUPS BUT PARTICIPANTS WERE ENCOURAGED TO SHARE THEIR PERSONAL EXPERIENCES ABOUT THE VARIOUS FACTORS INFLUENCING THEIR HEALTH AND THE HEALTH OF THEIR COMMUNITY. THEY WERE ALSO ASKED TO IDENTIFY ANY GAPS OR MISSING INFORMATION. AFTER GATHERING INPUT FROM FOCUS GROUPS, A RESIDENT COMMUNITY FORUM WAS HELD AT THE SEQUOIA CONFERENCE CENTER IN EUREKA. THE FORUM WAS OPEN TO ALL COMMUNITY MEMBERS. CALIFORNIA CENTER FOR RURAL POLICY FACILITATED THE FORUM AND SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR. AFTER ROBUST DISCUSSION, PARTICIPANTS ENGAGED IN A CUMULATIVE VOTING PROCESS USING DOTS TO INDICATE THEIR GREATEST CONCERNS. THROUGH THIS DESIGN, THE FORUM SERVED AS SOMETHING OF A "CAPSTONE" TO THE COMMUNITY INPUT.
SCHEDULE H, PART V, SECTION B, LINES 6A AND 6BCHNA OTHER HOSPITAL FACILITIES: ST. JOSEPH HOSPITAL OF EUREKA CHNA OTHER ORGANIZATIONS INCLUDING COLLABORATIVE AND COMMUNITY PARTNERS: - THE OLIN GROUP - CALIFORNIA CENTER FOR RURAL POLICY - HUMBOLDT COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, PUBLIC HEALTH BRANCH - LIVE WELL HUMBOLDT, COMMUNITY STRATEGIES TEAM - MULTIGENERATIONAL CENTER AND THE FORTUNA SENIOR CENTER - BETTY KWAN CHINN HOMELESS FOUNDATION AND DAY CENTER - ENGLISH EXPRESS - HUMBOLDT COUNTY OFFICE OF EDUCATION - HUMBOLDT SENIOR RESOURCE CENTER - FORTUNA SENIOR CENTER - WESTSIDE COMMUNITY IMPROVEMENT ASSOCIATION AND THE JEFFERSON COMMUNITY CENTER - HUMBOLDT DEL-NORTE MEDICAL SOCIETY - LATINONET AND HUMBOLDT PROMOTORES DE SALUD - REDWOOD COMMUNITY ACTION AGENCY - ALCOHOL AND DRUG CARE SERVICES - EUREKA RESCUE MISSION
SCHEDULE H, PART V, SECTION B, LINE 7ACHNA WEBSITE HTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/
SCHEDULE H, PART V, SECTION B, LINE 10AHTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/
SCHEDULE H, PART V, SECTION B, LINE 11AS A RESULT OF THE FINDINGS OF OUR FY17 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND THROUGH A PRIORITIZATION PROCESS ALIGNED WITH OUR MISSION, RESOURCES AND HOSPITAL STRATEGIC PLAN, REDWOOD MEMORIAL HOSPITAL WILL FOCUS ON THE FOLLOWING AREAS FOR ITS FY18-FY20 COMMUNITY BENEFIT EFFORTS: - HOUSING - MENTAL HEALTH & SUBSTANCE ABUSE - FOOD AND NUTRITION COLLABORATING ORGANIZATIONS REDWOOD MEMORIAL HOSPITAL BELIEVES IN WORKING COLLABORATIVELY TO SOLVE COMMUNITY AND HEALTH-RELATED PROBLEMS. THE SOCIAL AND HEALTH PROBLEMS OUR COMMUNITIES FACE ARE SIGNIFICANT AND COMPLEX; THEY ARE BIGGER THAN ANY ONE ORGANIZATION ALONE. THEREFORE, REDWOOD MEMORIAL HOSPITAL WILL PARTNER WITH GOVERNMENT ENTITIES, NON-PROFIT ORGANIZATIONS, SCHOOLS, THE INTERFAITH COMMUNITY AND THE BUSINESS COMMUNITY IN ORDER TO ACHIEVE THE GOALS AND STRATEGIES OUTLINED IN THIS PLAN. FLEXIBLE APPROACH DUE TO THE FAST PACE AT WHICH THE COMMUNITY AND HEALTH CARE INDUSTRY CHANGE, REDWOOD MEMORIAL HOSPITAL ANTICIPATES THAT IMPLEMENTATION STRATEGIES MAY EVOLVE AND THEREFORE, A FLEXIBLE APPROACH IS BEST SUITED FOR THE DEVELOPMENT OF ITS RESPONSE TO THE REDWOOD MEMORIAL HOSPITAL CHNA. ON AN ANNUAL BASIS REDWOOD MEMORIAL HOSPITAL EVALUATES ITS CB PLAN, SPECIFICALLY ITS STRATEGIES AND RESOURCES; AND MAKES ADJUSTMENTS AS NEEDED TO ACHIEVE ITS GOALS/OUTCOME MEASURES, AND TO ADAPT TO CHANGES IN RESOURCE AVAILABILITY. FOR DETAILED INFORMATION ON HOW REDWOOD MEMORIAL HOSPITAL IS ADDRESSING THE SIGNIFICANT NEED IDENTIFIED IN OUT FY17 CHNA, PLEASE SEE OUR CB IMPLEMENTATION PLAN POSTED TO OUR WEBSITE. HTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/ NEEDS BEYOND THE HOSPITALS SERVICE PROGRAM NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO CONTINUE OUR MISSION THROUGH CORE COMMUNITY BENEFIT PROGRAMING (CARE TRANSITIONS, COMMUNITY RESOURCE CENTERS, PASO A PASO AND HEALTHY KIDS HUMBOLDT) AND BY FUNDING OTHER NON-PROFITS THROUGH OUR CARE FOR THE POOR COMMUNITY GRANTS PROGRAM MANAGED BY THE REDWOOD MEMORIAL HOSPITAL COMMUNITY BENEFIT DEPARTMENT. FURTHERMORE, REDWOOD MEMORIAL HOSPITAL WILL ENDORSE LOCAL NON-PROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT REDWOOD MEMORIAL HOSPITAL SERVICE AREAS. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW: WHILE WE COULD NOT PRIORITIZE ALL OF THE NEEDS IDENTIFIED, WE WILL BE ABLE TO EFFECT MANY OF THE NEEDS BY WORKING ON ROOT CAUSE. FOR EXAMPLE, HEART DISEASE IS NOT A PRIORITY NEED, BUT WE WILL IMPACT THIS HEALTH OUTCOME BY FOCUSING OUR EFFORTS ON PROMOTING GOOD NUTRITION AND FOOD SECURITY. DENTAL CARE IS NOT A PRIORITIZED NEED BUT REDWOOD MEMORIAL HOSPITAL IS COMMITTED TO WORKING WITH PARTNERS ON THE MULTI-YEAR DENTAL TRANSFORMATION GRANT OUR PUBLIC HEALTH DEPARTMENT RECEIVED FROM THE CA DEPARTMENT OF HEALTH CARE SERVICES. ADDITIONALLY, REDWOOD MEMORIAL HOSPITAL DOES NOT HAVE A PROGRAM IN PLACE TO DIRECTLY PREVENT ASTHMA OCCURRENCE IN OUR SERVICE AREA; HOWEVER, WE PARTNER WITH SEVERAL ENTITIES, INCLUDING THE PUBLIC HEALTH DEPARTMENT THAT DO ADDRESS ASTHMA PREVENTION. FURTHERMORE, OUR EFFORTS TO IMPROVE THE QUALITY OF HOUSING IN OUR SERVICE HAS THE POTENTIAL TO IMPACT ASTHMA OCCURRENCE. IN ADDITION, REDWOOD MEMORIAL HOSPITAL WILL COLLABORATE WITH LOCAL ORGANIZATION(S) THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL AND ADDRESS THESE UNMET NEEDS.
SCHEDULE H, PART V, SECTION B, LINE 13HTHE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE.
SCHEDULE H, PART V, SECTION B, LINE 16AFINANCIAL ASSISTANCE POLICY HTTPS://WWW.STJOEHUMBOLDT.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINAN CIAL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16BFINANCIAL ASSISTANCE APPLICATION HTTPS://WWW.STJOEHUMBOLDT.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINAN CIAL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16CPLAIN LANGUAGE SUMMARY HTTPS://WWW.STJOEHUMBOLDT.ORG/PATIENTS-VISITORS/FOR-PATIENTS/PATIENT-FINAN CIAL-ASSISTANCE/
SCHEDULE H, PART V, SECTION B, LINE 16JTHE 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 CONSPICUOUS AREAS SUCH AS EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMISSIONS OFFICES AND OTHER OUTPATIENT SETTINGS. INDIVIDUAL NOTICES OF FINANCIAL ASSISTANCE ARE INCLUDED WITH BILLINGS TO 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 REQUEST. WRITTEN NOTICES ARE PROVIDED IN ALL LANGUAGES SPOKEN BY 5% OR MORE OF THE HOSPITAL'S SERVICE AREA. ADDITIONALLY, A PATIENT INFORMATION BROCHURE THAT DESCRIBES THE FEATURES OF THE SJH FINANCIAL ASSISTANCE PROGRAM WILL BE MADE AVAILABLE TO PATIENT AND MEMBERS OF THE GENERAL PUBLIC.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3CCRITERIA FOR DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE 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 6AREDWOOD MEMORIAL HOSPITAL PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT: HTTPS://WWW.STJOEHUMBOLDT.ORG/FOR-COMMUNITY/COMMUNITY-BENEFIT/
SCHEDULE H, PART I, LINE 7A-ITHE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING WORKSHEET 2, A COST-TO-CHARGE RATIO AND GENERAL LEDGER.
SCHEDULE H, PART III, LINE 2THE 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, LINE 3CRITERIA USED TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE 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 IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY.
SCHEDULE H, PART III, LINE 4FOOTNOTE 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.
SCHEDULE H, PART III, LINE 8THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 9BPATIENT 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 IDENTICY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE.
SCHEDULE H, PART VI, LINE 2NEEDS ASSESSMENT IN ADDITION TO THE CHNA, ADDITIONAL COMMUNITY NEEDS EMERGE OVER TIME. TO ENSURE A CONTINUOUS CONNECTION TO EMERGING COMMUNITY NEEDS, REDWOOD MEMORIAL HOSPITAL COMMUNITY BENEFIT STAFF ARE CORE MEMBERS OF MULTIPLE CROSS-SECTOR COLLABORATIVES INCLUDING LIVE WELL HUMBOLDT (LWH). HUMBOLDT COUNTY PUBLIC HEALTH SERVES AS THE BACKBONE ORGANIZATION OF LWH, AND THIS PUBLIC AND PRIVATE SECTOR COLLABORATIVE CONSISTS OF OVER 20 AGENCIES. FRONTLINE CB CAREGIVERS ALSO PROVIDE ONGOING INFORMATION AND FEEDBACK ABOUT NEEDS THEIR CLIENTS FACE IN REAL TIME. THE ORGANIZATION ALSO PARTNERS WITH HUMBOLDT STATE UNIVERSITY AND OTHER NONPROFITS TO CONDUCT SURVEYS OF VULNERABLE POPULATIONS. IN ADDITION TO LWH, REDWOOD MEMORIAL HOSPITAL STRATEGIC SERVICES CONDUCT ANALYSIS AND REPORT ON COMMUNITY NEEDS AND TRENDS.
SCHEDULE H, PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE ONE WAY RMH 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 4COMMUNITY INFORMATION REDWOOD MEMORIAL HOSPITAL PROVIDES THE RURAL NORTH COAST AND EEL RIVER VALLEY COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITAL'S SERVICE AREA EXTENDS FROM EUREKA IN THE NORTH, REDWAY IN THE SOUTH, BRIDGEVILLE IN THE EAST AND IS BORDERED BY THE PACIFIC OCEAN IN THE WEST. OUR HOSPITAL TOTAL SERVICE AREA INCLUDES THE CITIES OF EUREKA, FORTUNA, FERNDALE, RIO DELL AND THE UNINCORPORATED COMMUNITIES OF LOLETA, HYDESVILLE, CARLOTTA, BRIDGEVILLE, SCOTIA, REDCREST, MYERS FLAT, MIRANDA AND REDWAY. THIS INCLUDES A POPULATION OF APPROXIMATELY 78,428 PEOPLE. HOSPITAL TOTAL SERVICE AREA: THE COMMUNITY SERVED BY THE HOSPITAL IS DEFINED BASED ON THE GEOGRAPHIC ORIGINS OF THE HOSPITALS INPATIENTS. THE HOSPITAL TOTAL SERVICE AREA IS THE 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 PRIMARY SERVICE AREA ("PSA") IS THE GEOGRAPHIC AREA FROM WHICH THE MAJORITY OF THE HOSPITALS PATIENTS ORIGINATE. THE SECONDARY SERVICE AREA ("SSA") IS WHERE AN ADDITIONAL POPULATION OF THE HOSPITAL'S INPATIENTS RESIDE. THE PSA IS COMPRISED OF FORTUNA, RIO DELL, EUREKA, FERNDALE AND LOLETA. THE SSA IS COMPRISED OF HYDESVILLE, SCOTIA, CARLOTTA, REDWAY, MYERS FLAT, BRIDGEVILLE, MIRANDA AND REDCREST. THE TOTAL SERVICE AREA (TSA) OF REDWOOD MEMORIAL HOSPITAL INCLUDES APPROXIMATELY 78,000 PEOPLE, OF WHICH 91% IS IN THE PRIMARY SERVICE AREA (PSA). THE SECONDARY SERVICE AREA CONSISTS ENTIRELY OF SMALLER INLAND COMMUNITIES. THE TSA COMPRISES 57% OF THE POPULATION OF HUMBOLDT COUNTY, INCLUDING THE POPULATION CENTERS OF EUREKA AND FORTUNA, BUT EXCLUDING ARCATA AND MCKINLEYVILLE. THERE ARE NOT SUBSTANTIAL DIFFERENCES BETWEEN THE TSA AND COUNTY, BUT THERE ARE MANY COMPARED TO THE STATE. THE TSA IS WORSE THAN CALIFORNIA ON MEDIAN INCOME, $41,192, BUT SIMILAR TO OR SLIGHTLY BETTER ON POVERTY METRICS. THIS MAY INDICATE THAT REVENUE IS MORE EVENLY DISTRIBUTED ACROSS THE SERVICE AREA. THERE ARE HIGHER PERCENTAGES OF OLDER ADULTS, LOWER PERCENTAGES OF CHILDREN, AND FAR MORE NON-LATINO WHITES IN THE SERVICE AREA THAN IN CALIFORNIA (74% IN HUMBOLDT COUNTY COMPARED TO 37% ACROSS CALIFORNIA). THE RACE/ETHNICTY DATA FOR THE TSA IS PRIMARILY NON-LATINO WHITE AT 74.4%. 12.8% ARE LATINO AND 3.1% ARE AMERICAN INDIAN. THE TSA HAS 9 FEDERALLY RECOGNIZED TRIBAL ENTITIES. THE TSA HAS MANY POCKETS OF HIGH NEED AS IDENTIFIED AS A COMMUNITY NEEDS INDEX SCORE OF BETWEEN 4.2 AND 5.0. THE COMMUNITIES OF EUREKA 95501 AND 95503, RIO DELL 95562, LOLETA 95551, AND FORTUNA 95540 ARE ALL IN THIS HIGHEST NEED CATEGORY. OTHER HOSPITALS IN HUMBOLDT COUNTY INCLUDE ST. JOSEPH HOSPITAL IN EUREKA, MAD RIVER COMMUNITY HOSPITAL IN ARCATA AND JEROLD PHELPS COMMUNITY HOSPITAL IN GARBERVILLE. HEALTH PROFESSIONS SHORTAGE AREA PRIMARY, MENTAL, AND OTHER: THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATES HEALTH PROFESSIONAL SHORTAGE AREAS AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). REDWOOD MEMORIAL HOSPITAL AND ITS SERVICE AREA ARE BOTH LOCATED IN A PRIMARY AND MENTAL HEALTHCARE SHORTAGE AREA. MEDICAL UNDERSERVED AREA/MEDICAL PROFESSIONAL SHORTAGE AREA: MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE DEFINED BY THE FEDERAL GOVERNMENT TO INCLUDE AREAS OR POPULATION GROUPS THAT DEMONSTRATE A SHORTAGE OF HEALTHCARE SERVICES. THIS DESIGNATION PROCESS WAS ORIGINALLY ESTABLISHED TO ASSIST THE GOVERNMENT IN ALLOCATING COMMUNITY HEALTH CENTER GRANT FUNDS TO THE AREAS OF GREATEST NEED. MEDICALLY UNDERSERVED AREAS ARE IDENTIFIED BY CALCULATING A COMPOSITE INDEX OF NEED INDICATORS COMPILED AND COMPARED WITH NATIONAL AVERAGES TO DETERMINE AN AREAS LEVEL OF MEDICAL "UNDER SERVICE." MEDICALLY UNDERSERVED POPULATIONS ARE IDENTIFIED BASED ON DOCUMENTATION OF UNUSUAL LOCAL CONDITIONS THAT RESULT IN ACCESS BARRIERS TO MEDICAL SERVICES. MEDICALLY UNDERSERVED AREAS AND MEDICALLY UNDERSERVED POPULATIONS ARE PERMANENTLY SET, AND NO RENEWAL PROCESS IS NECESSARY. ALTHOUGH REDWOOD MEMORIAL HOSPITAL IS NOT LOCATED IN A MEDICALLY UNDERSERVED AREA/MEDICALLY UNDERSERVED POPULATIONS AREA, LARGE PORTIONS OF THE SERVICE AREA TO THE NORTH, SOUTH AND WEST OF REDWOOD MEMORIAL HOSPITAL ARE DESIGNATED AS SHORTAGE AREAS; AND THERE ARE ALSO 14 FEDERALLY QUALIFIED HEALTH CENTERS WITHIN A 50 MILE RADIUS OF REDWOOD MEMORIAL HOSPITAL. FEDERALLY QUALIFIED HEALTH CENTERS ARE HEALTH CLINICS THAT QUALIFY FOR ENHANCED REIMBURSEMENT FROM MEDICARE AND MEDICAID. THEY MUST PROVIDE PRIMARY CARE SERVICES TO AN UNDERSERVED AREA OR POPULATION, OFFER A SLIDING FEE SCALE, HAVE AN ONGOING QUALITY ASSURANCE PROGRAM, AND HAVE A GOVERNING BOARD OF DIRECTORS. THE ACA INCLUDED PROVISIONS THAT INCREASED FEDERAL FUNDING TO FEDERALLY QUALIFIED HEATH CENTERS TO HELP MEET THE ANTICIPATED DEMAND FOR HEALTHCARE SERVICES BY THOSE INDIVIDUALS WHO GAINED HEALTHCARE COVERAGE THROUGH THE VARIOUS HEALTH EXCHANGES. A LARGE PERCENTAGE OF AREA RESIDENTS DEPEND ON THE FEDERALLY QUALIFIED HEALTH CENTERS TO RECEIVE THEIR HEALTHCARE SERVICES. ADDITIONALLY, MANY OF THE FEDERALLY QUALIFIED HEALTH CENTERS PATIENTS UTILIZE THE SERVICES OF REDWOOD MEMORIAL HOSPITAL.
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH REDWOOD MEMORIAL 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. REDWOOD MEMORIAL 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 6AFFILIATED HEALTH CARE SYSTEM ON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (LEGACY PHS) AND ST. JOSEPH HEALTH SYSTEM (LEGACY 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 OVER 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.
SCHEDULE H, PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORT CALIFORNIA

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
OPEN DOOR COMMUNITY HEALTH CENTERS
1275 8TH STREETARCATACA95521952671433501(c)(3)$300,000PROGRAM SUPPORT
ST JOSEPH HEALTH SYSTEM FOUNDATION
3345 MICHELSON DRIVEIRVINECA92612330143024501(c)(3)$235,000PROGRAM SUPPORT
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationDESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS EACH GRANTEE REPORTS ON THE PROGRESS OF THE FUNDED PROGRAM ON A BIANNUAL BASIS EVERY 6 MONTHS TO THE COMMUNITY BENEFIT COMMITTEE. THE COMMUNITY BENEFIT COMMITTEE REVIEWS DOCUMENTATION TO CONFIRM THAT THE GRANTEE IS COMPATIBLE WITH THE MISSION, VISION, AND VALUES OF ST. JOSEPH HEALTH SYSTEM. ALSO THE GRANTEE MUST DEMONSTRATE COLLABORATION, FLEXIBILITY, AND RESPECT FOR DIVERSE CULTURES WHILE UTILIZING EFFECTIVE STRATEGIES AND OUTCOME MEASURES. THE GRANTEE MUST HAVE AN EXISTING GOVERNING AND/OR ADVISORY BOARD WITH SUFFICIENT EXPERTISE AND FAMILIARITY WITH THE PROPOSED PROGRAM/PROJECT. THE GRANTEE MUST BE A NONPROFIT ORGANIZATION IN CALIFORNIA THAT IS TAX EXEMPT. FUNDS THAT ARE TRANSFERRED TO ST. JOSEPH HEALTH SYSTEM FOUNDATION (CARE FOR THE POOR) ARE MONITORED AND DISTRIBUTED BY THE ST. JOSEPH HEALTH SYSTEM, AND ARE NOT MONITORED ON A HOSPITAL LEVEL ONCE THE FUNDS ARE TRANSFERRED.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (21 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
OLUYEMI ADEYANJU
SECRETARY$0$340,587$0$37,485$0$30,294$0$10,939$0$11,596$0$430,901$0$0
TAMMY BARK
VP, CNO$0$234,301$0$25,549$0$19,470$0$8,397$0$12,567$0$300,284$0$0
JOHN BIBBY
REGIONAL VP HR N. CA$0$275,109$0$85,403$0$3,598$0$11,000$0$36,710$0$411,820$0$0
PAMELA CASSADY
ADMINISTRATIVE SUPERVISOR$141,093$0$650$0$3,065$0$11,691$0$25,669$0$182,168$0$0$0
MAUREEN DISBOT
VP, QUALITY & SAFETY$0$268,284$0$33,182$0$26,291$0$9,747$0$26,180$0$363,684$0$0
MARK GARDNER
PHYSICAL THERAPIST$161,075$0$3,650$0$100$0$11,570$0$17,320$0$193,715$0$0$0
ADAM GLASER
RN CLINICAL COORDINATOR$149,037$0$0$0$2,838$0$7,470$0$26,605$0$185,950$0$0$0
RAJU IYER
CFO NORTHERN CA$0$309,613$0$50,000$0$4,259$0$1,096$0$32,735$0$397,703$0$0
KEVIN KLOCKENGA
REGIONAL PRESIDENT/NCAL$0$673,697$0$404,136$0$105,047$0$19,250$0$22,025$0$1,224,155$0$0
CAROL KOEBLE
CHIEF MEDICAL OFFICER - NCAL$0$391,704$0$35,833$0$10,282$0$1,103$0$11,905$0$450,827$0$0
ROBERTA LUSKIN-HAWK MD
BOARD MEMBER/CEO$0$367,067$0$25,000$0$75,763$0$145,777$0$26,454$0$640,061$0$0
MAUREEN LYTLE
ADMIN SUPERVISOR$153,296$0$650$0$2,263$0$14,017$0$18,888$0$189,114$0$0$0
JULIE MALVEY
VP, MISSION INTEGRATION$0$173,493$0$19,228$0$4,605$0$15,889$0$28,171$0$241,386$0$0
CARMELO MOCERI
CHIEF STRATEGY OFFICER - NCAL$0$310,325$0$17,198$0$5,882$0$0$0$37,125$0$370,530$0$0
PAUL OHTA
BOARD MEMBER$0$296,730$0$37,870$0$57,711$0$141,959$0$11,020$0$545,290$0$34,455
WILLIAM PARKS
VP, MEDICAL AFFAIRS/CMO$0$331,607$0$36,978$0$34,805$0$10,334$0$43,657$0$457,381$0$0
MARK PROVAN
N.CA REG VP-POST ACUTE CARE$0$260,288$0$62,285$0$4,229$0$10,500$0$36,533$0$373,835$0$0
MICHEL RICCIONI
FORMER CFO N. CA$0$0$0$0$0$151,400$0$0$0$0$0$151,400$0$0
JOHN SELLERS
STAFF RN$152,944$0$500$0$849$0$8,681$0$26,667$0$189,641$0$0$0
DAVID SOUTHERLAND
INTERIM CHIEF EXECUTIVE$0$296,028$0$29,562$0$44,019$0$10,732$0$12,310$0$392,651$0$0
LAURIE WATSON-STONE
VP, ANCILLARY & SUPPORT SRVCS$0$214,671$0$25,275$0$24,262$0$19,305$0$22,555$0$306,068$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 3THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY ST. JOSEPH HEALTH SYSTEM.
SCHEDULE J, PART I, LINE 4ASEVERANCE PAYMENTS MICHEL RICCIONI RECEIVED $151,400 IN SEVERANCE.
SCHEDULE J, PART I, LINE 4BNONQUALIFIED 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. EXECUTIVES PREVIOUSLY PARTICIPATED IN ANOTHER NON-QUALIFIED DEFERRED COMPENSATION PLAN THAT WAS FROZEN EFFECTIVE DECEMBER 2007, AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED. THIS FROZEN PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF THE PLAN. CERTAIN EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN PROVIDED BY A RELATED ENTITY. THE AMOUNTS SHOWN IN COLUMN F OF PART II REFLECT CURRENT YEAR PAYOUTS FROM THESE PLANS.
SCHEDULE J, PART I, LINE 7NON-FIXED PAYMENTS A 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 N IRS990ScheduleN

FieldValueIRS element (for citing)
Liquidation Of Assets TableLiquidationOfAssetsTableGrp

Disposition Of Assets Detail DispositionOfAssetsDetail

FieldValueIRS element (for citing)
Assets Distri Or Expnss PaidUNRESTRICTED NET ASSETSAssetsDistriOrExpnssPaidDesc
Distribution2018-03-31DistributionDt
Fair Market Value Of Asset$109,387,824FairMarketValueOfAssetAmt
Method Of FMV DeterminationBOOK VALUEMethodOfFMVDeterminationTxt
EIN814791043EIN
PersonST JOSEPH HEALTH NORTHERN CA LLCPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13345 MICHELSON DRAddressLine1Txt
CityIRVINECityNm
State AbbreviationCAStateAbbreviationCd
ZIP926120693ZIPCd
FieldValueIRS element (for citing)
IRC Section501(c)(3)IRCSectionTxt
FieldValueIRS element (for citing)
Director Of Successor2Yes (true)DirectorOfSuccessor2Ind
Employee Of Successor2Yes (true)EmployeeOfSuccessor2Ind
Owner Of Successor2falseOwnerOfSuccessor2Ind
Receive Compensation2falseReceiveCompensation2Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE N, PART II, LINE 2ATHE FOLLOWING INDIVIDUALS BECAME AN OFFICER OF THE TRANSFEREE ORGANIZATION: OLUYEMI ADEYANJU - OFFICER OF ST. JOSEPH HEALTH NORTHERN CA. LLC RAJU IYER - OFFICER OF ST. JOSEPH HEALTH NORTHERN CA. LLC KEVIN KLOCKENGA - OFFICER OF ST. JOSEPH HEALTH NORTHERN CA. LLC
SCHEDULE N, Part II Line 2BALL EMPLOYEES OF REDWOOD MEMORIAL HOSPITAL WILL TRANSFER TO ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC ON 1/1/2019. ON MARCH 31, 2018, REDWOOD MEMORIAL HOSPITAL, ALONG WITH SANTA ROSA MEMORIAL HOSPITAL, ST. JOSEPH HOSPITAL OF EUREKA, AND QUEEN OF THE VALLEY MEDICAL CENTER, COLLECTIVELY THE "HOSPITALS", TRANSFERRED ALL OF THEIR NET ASSETS TO ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, A RELATED 501(C)(3) ORGANIZATION. ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC WAS CREATED TO CONSOLIDATE AND SIMPLIFY THE CURRENT STRUCTURE BY MOVING THE OPERATIONS OF THE HOSPITALS INTO A SINGLE LEGAL ENTITY. THE OPERATION OF THE HOSPITALS WILL REMAIN THE SAME.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 4APROVIDENCE ST. JOSEPH HEALTH SYSTEM ON JULY 1, 2016, PROVIDENCE HEALTH AND SERVICES (PHS) AND ST. JOSPEH HEALTH SYSTEM (SJHS) FORMED A NEW ORGANIZATION, PROVIDENCE ST. JOSEPH HEALTH, WITH THE GOAL OF IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH HAS THE POTENTIAL TO SEEK GREATER AFFORDABILITY, ACHIEVE OUTSTANDING AND RELIABLE CLINICAL CARE, IMPROVE THE PATIENT EXPERIENCE AND INTRODUCE 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. 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 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. 2018 PROGRAM SERVICE ACCOMPLISHMENTS: (JANUARY 1 - MARCH 31, 2018) ON MARCH 31, 2018, REDWOOD MEMORIAL HOSPITAL, ALONG WITH SANTA ROSA MEMORIAL HOSPITAL, QUEEN OF THE VALLEY MEDICAL CENTER, AND ST. JOSEPH HOSPITAL OF EUREKA, COLLECTIVELY THE "HOSPITALS", TRANSFERRED ALL OF THEIR NET ASSETS TO ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC, A RELATED 501(C)(3) ORGANIZATION. ST. JOSEPH HEALTH NORTHERN CALIFORNIA, LLC WAS CREATED TO CONSOLIDATE AND SIMPLIFY THE CURRENT STRUCTURE BY MOVING THE OPERATIONS OF THE HOSPITALS INTO A SINGLE LEGAL ENTITY. THE OPERATION OF THE HOSPITALS WILL REMAIN THE SAME. COMMUNITY RESOURCE CENTERS THE COMMUNITY RESOURCE CENTERS (CRC) ARE A COMMUNITY BENEFIT PROGRAM OF REDWOOD MEMORIAL HOSPITAL AND PROVIDE RESOURCE AND REFERRAL SERVICES COUNTY-WIDE THROUGH FIVE PLACE-BASED COMMUNITY CENTERS IN DIFFERENT PARTS OF HUMBOLDT COUNTY (WILLOW CREEK, BLUE LAKE, EUREKA, LOLETA AND RIO DELL). THEIR FOCUS IS ON PROVIDING SERVICES FOR LOW-INCOME FAMILIES AND INDIVIDUALS SUCH AS EMERGENCY FOOD PANTRIES, TRANSPORTATION ASSISTANCE, EMPLOYMENT INFORMATION AND ASSISTANCE APPLYING FOR CALFRESH, MEDI-CAL, AND WOMEN INFANT AND CHILDRENS (WIC) AMONG OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THEY ALSO WORK TO BUILD COMMUNITY AND PREVENT SOCIAL ISOLATION IN OUR RURAL SERVICE AREA BY HOSTING COMMUNITY DINNERS AND WELLNESS AND SAFETY EVENTS SUCH AS BICYCLE RODEOS, PLAYGROUPS FOR KIDS AGE 0-5 YEARS OLD AND THEIR CAREGIVERS, AND MENTAL ILLNESS STIGMA REDUCTION SUPPORT GROUPS. EACH RESOURCE CENTER IS SIMILAR IN PURPOSE AND SCOPE, BUT TAILORED TO MEET THE SPECIFIC NEEDS OF THE COMMUNITY IT SERVES. FROM JANUARY TO MARCH 2018, THE CRCs RECORDED OVER 22,500 ENCOUNTERS WITH COMMUNITY MEMBERS. CARE FOR THE POOR COMMUNITY GRANTS THE CARE FOR THE POOR (CFP) COMMUNITY GRANTS ARE AVAILABLE ON AN ANNUAL BASIS TO ALL NONPROFIT CHARITABLE ORGANIZATIONS, PUBLIC SCHOOLS AND GOVERNMENT ENTITIES OR QUALIFIED FISCAL SPONSOR WITHIN THE REDWOOD MEMORIAL HOSPITAL SERVICE AREA. THE PRIORITY AREAS OF FOCUS FOR THE GRANTS ALIGN WITH THE REDWOOD MEMOIRAL HOSPITAL 2017 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA): HOUSING, MENTAL HEALTH AND SUBSTANCE USE, AND FOOD SECURITY. IN JANUARY OF 2018, REDWOOD MEMORIAL HOSPITAL AWARDED $50,000 TO FOUR ORGANIZATIONS THAT SERVE THE ECONOMICALLY POOR (AT OR BELOW 250% OF THE FEDERAL POVERTY LEVEL) AND VULNERABLE IN THE IDENTIFIED AREAS. SPECIAL EMPHASIS WAS PLACED ON POPULATIONS WITH NOTED HEALTH DISPARITIES; AND AN EFFORT WAS MADE TO FUND UPSTREAM PREVENTION AS WELL AS DOWNSTREAM INTERVENTION PROJECTS. GRANTEES INCLUDED THE HEALY SENIOR CENTER OF SOUTHERN HUMBOLDT, THE WIYOT TRIBE, FORTUNA ADVENTIST COMMUNITY SERVICES AND FOOD FOR PEOPLE. PHYSICIAN RECRUITMENT AND RETENTION REDWOOD MEMORIAL HOSPITAL ADMINISTRATION HAS IDENTIFIED PHYSICIAN RECRUITMENT AND RETENTION AS BEING A TOP PRIORITY, A NEED THAT WAS CONFIRMED BY THE CHNA. FULL TIME STAFF ARE DEDICATED TO PHYSICIAN RECRUITMENT NOT ONLY FOR REDWOOD MEMORIAL HOSPITAL, BUT ALSO FOR ST. JOSEPH HEALTH MEDICAL GROUP AND PRIVATE PRACTICES WHEN NEEDED. REDWOOD MEMORIAL HOSPITAL IS LOCATED IN A HEALTH PROFESSIONS SHORTAGE AREA AND A MEDICALLY UNDERSERVED AREA AND IS IN NEED OF PRIMARY CARE PHYSICIANS TO REPLACE AN AGING WORKFORCE OF MEDICAL PROFESSIONALS AS WELL AS PHYSICIANS SPECIALIZING IN MENTAL HEALTH. FURTHERMORE, WE HAVE A LOAN FORGIVENESS PROGRAM THAT IS UTILIZED TO HELP RETAIN PHYSICIANS. FOR MORE INFORMATION ABOUT PROVIDENCE ST. JOSEPH HEALTH, PLEASE VISIT HTTPS://WWW.PSJHEALTH.ORG FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH, PLEASE VISIT WWW.STJHS.ORG FOR MORE INFORMATION ABOUT REDWOOD MEMORIAL HOSPITAL PLEASE VISIT WWW.STJOEHUMBOLDT.ORG.
FORM 990, PART V, LINE 1AST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR SJHS ENTITIES 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 6CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF REDWOOD MEMORIAL HOSPITAL.
FORM 990, PART VI, LINE 7ACLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS REDWOOD MEMORIAL HOSPITAL HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE REDWOOD MEMORIAL HOSPITAL BOARD. ALL TRUSTEE NOMINATIONS THAT COME FROM THE REDWOOD MEMORIAL HOSPITAL BOARD AS NOMINATIONS MUST BE APPROVED BY THE ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER.
FORM 990, PART VI, LINE 7BCLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL AND TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, EXEMPT PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE CORPORATE MEMBER, ST. JOSEPH HEALTH SYSTEM, RESERVES THE RIGHT TO APPROVE THE PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS.
FORM 990, PART VI, LINE 11BPROCESS 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, LINE 12CPROCESS 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 & 15BPROCESS FOR DETERMINING COMPENSATION 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. 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 19GOVERNING 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 9OTHER CHANGES IN NET ASSETS OR FUND BALANCE NET ASSET TRANSFER TO SJHNC, LLC ($5,681,371)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (112 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
COVENANT ACO
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016611573313HEALTHCARETX501(C)(3)12, ICHSYes (true)
COVENANT HEALTH NETWORK INC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016461259908HEALTHCARECA501(C)(3)12, IIISJHSYes (true)
COVENANT HEALTH PARTNERS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016463516417HEALTHCARETX501(C)(3)12, ICHSYes (true)
COVENANT HEALTH SYSTEM
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752765566HEALTHCARETX501(C)(3)3SJHSYes (true)
COVENANT HEALTH SYSTEM FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752897026HEALTHCARETX501(C)(3)7CHSYes (true)
COVENANT MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016822913146HEALTHCARETX501(C)(3)3CHSYes (true)
COVENANT MEDICAL GROUP
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752743883HEALTHCARETX501(C)(3)3CHSYes (true)
E WA & MT UNEMPLOYMENT COMP INSR TRUST
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911082119UNEMPLOYMENTWA501(C)(3)12, IPHS WAYes (true)
EVERETT TRANSITIONAL CARE SERVICES
PO BOX 5128EVERETTWA982065128943264605TRANS. CAREWA501(C)(3)10NAfalse
FACEY MEDICAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016954322584SUPPORTCA501(C)(3)7PHS SOCALYes (true)
GAMELIN WASHINGTON ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016201910170SUPPORTWA501(C)(3)7PHS WAYes (true)
GLOBAL TO LOCAL HEALTH INITIATIVE
2800 SOUTH 192ND ST 104SEATACWA98188273133200HEALTHCAREWA501(C)(3)7SHSYes (true)
HMTS INC
1 HOAG DRIVE PO BOX 6100NEWPORT BEACHCA92658453583707HEALTHCARECA501(C)(3)12, IHMHPYes (true)
HOAG CHARITY SPORTS
2081 BUSINESS CTR DR STE 195IRVINECA92612452982422SUPPORTCA501(C)(3)7HHFYes (true)
HOAG CLINIC (FKA COASTAL MGMT SVCS ORG)
1 HOAG DRIVE PO BOX 6100NEWPORT BEACHCA92658330676831HEALTHCARECA501(C)(3)10HMHPYes (true)
HOAG HOSPITAL FOUNDATION
330 PLACENTIA AVENEWPORT BEACHCA92663953222343FUNDRAISINGCA501(C)(3)7HMHPYes (true)
HOAG MEMORIAL HOSPITAL PRESBYTERIAN
1 HOAG DRIVE PO BOX 6100NEWPORT BEACHCA92658951643327HEALTHCARECA501(C)(3)3CHNYes (true)
HOSPICE OF LUBBOCK
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752133781HEALTHCARETX501(C)(3)10CHSYes (true)
INLAND NORTHWEST HEALTH SERVICES
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911307555HEALTHCAREWA501(C)(3)3PHS WAYes (true)
INSTITUTE FOR MENTAL HEALTH & WELLNESS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016814260130HEALTHCAREWA501(C)(3)7PHSSJHSYes (true)
INSTITUTE FOR SYSTEMS BIOLOGY
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016912003593HEALTHCAREWA501(C)(3)7WHCYes (true)
JOHN WAYNE CANCER INSTITUTE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016954291515HEALTHCARECA501(C)(3)4PSJHCYes (true)
KADLEC AUXILIARY INC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016916033089SUPPORTWA501(C)(3)12, IIIKRMCYes (true)
KADLEC FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016237005501SUPPORTWA501(C)(3)12, IKRMCYes (true)
KADLEC REGIONAL MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016910655392HEALTHCAREWA501(C)(3)3WHCYes (true)
LITTLE COMPANY OF MARY ANCILLARY SVCS CO
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330844408IMAGING SVCSCA501(C)(3)10PHS SOCALYes (true)
LUBBOCK METHODIST HOSPITAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752220963HEALTHCARETX501(C)(3)7CHSYes (true)
LUNDBERG ASSOCIATIONPROVIDENCE HOUSE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911562797SUPPORTOR501(C)(3)7PHS ORYes (true)
MARSHA RIVKIN CTR FOR OVARIAN CANCER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016912054035RESEARCHWA501(C)(3)7SHSYes (true)
METHODIST CHILDREN'S HOSPITAL
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752428911HEALTHCARETX501(C)(3)3CHSYes (true)
METHODIST HOSPITAL LEVELLAND
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752246348HEALTHCARETX501(C)(3)3CHSYes (true)
METHODIST HOSPITAL PLAINVIEW
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752426010HEALTHCARETX501(C)(3)3CHSYes (true)
MISSION HOSPITAL REGIONAL MEDICAL CTR
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016951643360HEALTHCARECA501(C)(3)3CHNYes (true)
NORTHWEST HOPE & HEALING FOUNDATION
PO BOX 16069SEATTLEWA98116200799737SUPPORTWA501(C)(3)12,ISHSYes (true)
PACMED CLINICS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016562290878HEALTHCAREWA501(C)(3)10WHCYes (true)
PH&S FOUNDATIONSFVSA & SCVSA
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016953544877HEALTHCARECA501(C)(3)7PHS SOCALYes (true)
PROVIDENCE ALASKA FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016920093565HEALTHCAREAK501(C)(3)12, IPHS WAYes (true)
PROVIDENCE BENEDICTINE NURSING CTR FNDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911940286HEALTHCAREOR501(C)(3)7PHS ORYes (true)
PROVIDENCE BLANCHET ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911789266SUPPORTWA501(C)(3)7PHS WAYes (true)
PROVIDENCE CHILDREN'S HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930800140SUPPORTOR501(C)(3)7PHS ORYes (true)
PROVIDENCE COMMUNITY HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930692907HEALTHCAREOR501(C)(3)7PHS ORYes (true)
PROVIDENCE DETHMAN HOUSE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016473385506SUPPORTWA501(C)(3)7NAfalse
PROVIDENCE GAMELIN HOUSE ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016311744654SUPPORTWA501(C)(3)7PHS WAYes (true)
PROVIDENCE HEALTH & SERVICES
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911549796HEALTHCAREWA501(C)(3)12, IIPSJHfalse
PROVIDENCE HEALTH & SERVICES - MONTANA
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016810231793HEALTHCAREMT501(C)(3)3PHS WAYes (true)
PROVIDENCE HEALTH & SERVICES - OREGON
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016510216587HEALTHCAREOR501(C)(3)3PHSYes (true)
PROVIDENCE HEALTH & SERVICES - WA
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016510216586HEALTHCAREWA501(C)(3)3PHSYes (true)
PROVIDENCE HEALTH & SERVICES - WEST WA
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911303277HEALTHCAREWA501(C)(3)3PMWHCYes (true)
PROVIDENCE HEALTH ASSURANCE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016550828701MEDICAIDOR501(C)(4)N/APHPYes (true)
PROVIDENCE HEALTH CARE FNDN - E WA
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016320014330HEALTHCAREWA501(C)(3)7PHS WAYes (true)
PROVIDENCE HEALTH CARE FNDN (CENTRALIA)
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911433382HEALTHCAREWA501(C)(3)7PHS W WAYes (true)
PROVIDENCE HEALTH PLAN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930863097HEALTHCAREOR501(C)(4)N/APPPYes (true)
PROVIDENCE HEALTH SYSTEM - SO CAL
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016510216589HEALTHCARECA501(C)(3)3PHSYes (true)
PROVIDENCE HOOD RIVER MEM HOSP FNDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930921990HEALTHCAREOR501(C)(3)7PHS ORYes (true)
PROVIDENCE HOSPICE AND HOME CARE FNDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016272552749HEALTHCAREWA501(C)(3)7PHS W WAYes (true)
PROVIDENCE HOSPICE OF SEATTLE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016912077378HEALTHCAREWA501(C)(3)7PHS W WAYes (true)
PROVIDENCE LITTLE COMPANY OF MARY FNDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016510224944HEALTHCARECA501(C)(3)7PHS SOCALYes (true)
PROVIDENCE MARIANWOOD FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016931554288HEALTHCAREWA501(C)(3)12, IPHS W WAYes (true)
PROVIDENCE MEDICAL INSTITUTE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330283773HEALTHCARECA501(C)(3)12, IPHS SOCALYes (true)
PROVIDENCE MILWAUKIE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016943079515HEALTHCAREOR501(C)(3)7PHS ORYes (true)
PROVIDENCE MINISTRIES
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016RELIGIOUS ORGWA501(C)(3)1NAfalse
PROVIDENCE MOUNT ST VINCENT FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911188119HEALTHCAREWA501(C)(3)7PHS WAYes (true)
PROVIDENCE NEWBERG HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930889144HEALTHCAREOR501(C)(3)7PHS ORYes (true)
PROVIDENCE PETER CLAVER ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016311629656SUPPORTWA501(C)(3)7PHS WAYes (true)
PROVIDENCE PLAN PARTNERS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911861964HEALTHCAREWA501(C)(4)N/APHS ORYes (true)
PROVIDENCE PORTLAND MEDICAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016931231494HEALTHCAREOR501(C)(3)7PHS ORYes (true)
PROVIDENCE ROSSI ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016311584166SUPPORTWA501(C)(3)10PHS WAYes (true)
PROVIDENCE SAINT JOHN'S HEALTH CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016951684082HEALTHCARECA501(C)(3)3PHS SOCALYes (true)
PROVIDENCE SAINT JOHN'S MEDICAL FNDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016814542216HEALTHCARECA501(C)(3)3PHS SOCALYes (true)
PROVIDENCE SEASIDE HOSPITAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930927320HEALTHCAREOR501(C)(3)7PHS ORYes (true)
PROVIDENCE ST ELIZABETH HOUSE ASSOC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016912171539SUPPORTWA501(C)(3)7PHS WAYes (true)
PROVIDENCE ST FRANCIS ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016943244854SUPPORTWA501(C)(3)7PHS WAYes (true)
PROVIDENCE ST JOSEPH HEALTH
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016811244422HEALTHCAREWA501(C)(3)12, IIINAfalse
PROVIDENCE ST JOSEPH HEALTH FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016943078543HEALTHCAREWA501(C)(3)12, IPHS WAYes (true)
PROVIDENCE ST JOSEPH MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016810463482HEALTHCAREMT501(C)(3)3PHS WAYes (true)
PROVIDENCE ST MARY FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016452841492HEALTHCAREWA501(C)(3)7PHS WAYes (true)
PROVIDENCE ST PETER FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911097056SUPPORTWA501(C)(3)7PHS W WAYes (true)
PROVIDENCE ST VINCENT MEDICAL FNDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016930575982HEALTHCAREOR501(C)(3)7PHS ORYes (true)
PROVIDENCE TRINITYCARE HOSPICE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016953264139HEALTHCARECA501(C)(3)10PHS SOCALYes (true)
PROVIDENCE TRINITYCARE HOSPICE FNDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330261016HEALTHCARECA501(C)(3)7PTCHYes (true)
PROVIDENCE WILLAMETTE FALLS MEDICAL FNDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016931003750HEALTHCAREOR501(C)(3)12, IPHS ORYes (true)
QUEEN OF THE VALLEY MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016941243669HEALTHCARECA501(C)(3)3SJHSYes (true)
REDWOOD MEMORIAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016942779313HEALTHCARECA501(C)(3)7RMHYes (true)
SAINT JOHN'S HOSPITALHEALTH CENTER FNDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016956100079SUPPORTCA501(C)(3)7PSJHCYes (true)
SANTA ROSA MEMORIAL HOSPITAL
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016941231005HEALTHCARECA501(C)(3)3SJHSYes (true)
SEATTLE SCIENCE FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016611502822PHYSN COLLABWA501(C)(3)7WHCYes (true)
SISTERS OF PROVIDENCE OF MONTANA CORP
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016262612415SHELL CORPMT501(C)(3)1PHS WAfalse
SISTERS OF ST JOSEPH OF ORANGE
480 S BATAVIAORANGECA92868951643383RELIGIOUS ORGCA501(C)(3)1NAfalse
SRM ALLIANCE HOSPITAL SERVICES (PVH)
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016680395200HEALTHCARECA501(C)(3)3SRMHYes (true)
ST JOSEPH HEALTH MINISTRY
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016271666576RELIGIOUS ORGCA501(C)(3)1SSJOfalse
ST JOSEPH HEALTH N CALIFORNIA LLC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016814791043HEALTHCARECA501(C)(3)3SJHSYes (true)
ST JOSEPH HEALTH SYSTEM
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016953589356HEALTHCARECA501(C)(3)12, IPSJHfalse
ST JOSEPH HEALTH SYSTEM FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330143024HEALTHCARECA501(C)(3)7SJHSYes (true)
ST JOSEPH HERITAGE HEALTHCARE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330185031HEALTHCARECA501(C)(3)3SJHSYes (true)
ST JOSEPH HOME CARE NETWORK
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016680331084HEALTHCARECA501(C)(3)10SJHSYes (true)
ST JOSEPH HOSPITAL OF EUREKA
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016941156596HEALTHCARECA501(C)(3)3SJHSYes (true)
ST JOSEPH HOSPITAL OF ORANGE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016951643359HEALTHCARECA501(C)(3)3CHNYes (true)
ST JUDE HOSPITAL INC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016951643324HEALTHCARECA501(C)(3)3CHNYes (true)
ST LUKE ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016943176618SUPPORTWA501(C)(3)7PHS WAYes (true)
ST MARY MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016951914489HEALTHCARECA501(C)(3)3CHNYes (true)
ST MARY OF THE PLAINS HOSPITAL FDN
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016751653181HEALTHCARETX501(C)(3)7CHSYes (true)
ST PATRICK HOSPITAL FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016237056976HEALTHCAREMT501(C)(3)7PHS WAYes (true)
ST THOMAS CHILD AND FAMILY CENTER
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016810233495EDUCATIONMT501(C)(3)10PHS WAYes (true)
SWEDISH EDMONDS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016272305304HEALTHCAREWA501(C)(3)3WHCYes (true)
SWEDISH HEALTH SERVICES
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016910433740HEALTHCAREWA501(C)(3)3WHCYes (true)
SWEDISH MEDICAL CENTER FOUNDATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016910983214HEALTHCAREWA501(C)(3)7SHSYes (true)
SWEDISH MJM HOLDINGS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016273139262HOLDING COWA501(C)(3)12, ISHSYes (true)
THE GAMELIN ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911180824SUPPORTWA501(C)(3)7PHS WAYes (true)
THE GAMELIN CALIFORNIA ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911293869SUPPORTCA501(C)(3)10PHS SOCALYes (true)
THE GAMELIN OREGON ASSOCIATION
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016911214491SUPPORTOR501(C)(3)10PHS ORYes (true)
UNIVERSITY OF PROVIDENCE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016810231777EDUCATIONMT501(C)(3)2PHSYes (true)
WESTERN HEALTHCONNECT
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016454171900SHELL CORPWA501(C)(3)12, IIPHS W WAYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (62 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
20TH STREET SURGERY LLC
1301 20TH STREET STE 140SANTA MONICACA90404731735618AMBULATORY SURGCANAN/A
BROADWAY IMAGING LLC
500 W BROADWAYMISSOULAMT59802522405971MEDICAL IMAGINGMTNAN/A
CENTER FOR SPECIALTY SURGERY LLC
11782 SW BARNES RDPORTLANDOR97225263638838AMBULATORY SURGORNAN/A
CLACKAMAS RADIATION ONCOLOGY CENTER LLC
4400 NE HALSEY ST BLDG II 495PORTLANDOR97213260381897RADIATION ONCOLORNAN/A
COASTAL ASC HOLDINGS LLC
ONE HOAG DRIVE PO BOX 6100NEWPORT BEACHCA926586100810986844HEALTHCARECANAN/A
COVENANT LONG-TERM CARE LP
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016205033419HEALTHCARETXNAN/A
CTR FOR MED IMAGING-BRIDGEPORT LLC
4400 NE HALSEY 495PORTLANDOR97213260796953IMAGING DIAG.ORNAN/A
CTR FOR MED IMAGING-TANASBOURNE LLC
4400 NE HALSEY 495PORTLANDOR97213200477972IMAGING DIAG.ORNAN/A
FULLERTON SURGICAL CENTER LP
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016470927394AMBULATORY SURGCANAN/A
GREATER VALLEY MEDICAL BUILDING LP
501 S BUENA VISTA STBURBANKCA91505954570858REAL ESTATE - MOBCANAN/A
HCSA PROPERTIES LLC
1600 M STREET NWAUBURNWA98001460620892REAL ESTATE RENTWANAN/A
HERITAGE INVESTMENT GROUP I LLC
500 S MAIN STREET STE 1000ORANGECA92868271000061INVESTMENTSCANAN/A
HOAG ORTHOPEDIC INSTITUTE
ONE HOAG DRIVE PO BOX 6100NEWPORT BEACHCA926586100611588294HEALTHCARECANAN/A
HOAG OUTPATIENT CENTERS LLC
27271 LAS RAMBLAS 350MISSION VIEJOCA92691453587572HEALTHCARECANAN/A
INLAND IMAGING LLC
801 S STEVENS STSPOKANEWA99204911855796MEDICAL IMAGINGWANAN/A
LSC REAL PROPERTY LLC
2301 QUAKER AVENUELUBBOCKTX79410474646059REAL ESTATETXNAN/A
METHODIST DIAGNOSTIC IMAGING
4005 24TH STREETLUBBOCKTX79410752343261HEALTHCARETXNAN/A
NEWPORT BAY SURGERY CENTER LLC
3333 W PACIFIC COAST HWY 100NEWPORT BEACHCA92663562518360HEALTHCARECANAN/A
NEWPORT BEACH ENDOSCOPY CENTER LLC
27271 LAS RAMBLAS 350MISSION VIEJOCA92691770368744HEALTHCARECANAN/A
NEWPORT IMAGING CENTER
360 SN MIGUELNEWPORT BEACHCA92660330191776HEALTHCARECANAN/A
NEWPORT SURGICAL PARTNERS LLC
27271 LAS RAMBLAS 350MISSION VIEJOCA92691392060266HEALTHCARECANAN/A
NORTH BAY ENDOSCOPY CENTER
1383 N MCDOWELL BLVD STE 110PETALUMACA94954611559876HEALTHCARECANAN/A
OREGON ADVANCED IMAGING LLC
881 OHARE PARKWAYMEDFORDOR97504450471748MEDICAL IMAGINGORNAN/A
OREGON OUTPATIENT SURGERY CENTER
7300 SW CHILDS RDTIGARDOR97224223883387AMBULATORY SURGORNAN/A
PETCT IMAGING AT SWEDISH CANCER INSTITU
1221 MADISON STREETSEATTLEWA98104203132044MEDICAL IMAGINGWANAN/A
PHS INVESTMENT TRANSITION PORTFOLIO
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472279711INVESTMENTSWANAN/A
PHS INVESTMENT TRUST 2015 PRIVATE ASSETS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016473393740INVESTMENTSWANAN/A
PHS INVESTMENT TRUST 2016 PRIVATE ASSETS
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016811532735INVESTMENTSWANAN/A
PHS INVESTMENT TRUST 2016 PRIVATE REAL E
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016812960145INVESTMENTSWANAN/A
PHS INVESTMENT TRUST BANK LOANS PORTFOLI
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472357735INVESTMENTSWANAN/A
PHS INVESTMENT TRUST COMMODITIES PORTFOL
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472269004INVESTMENTSWANAN/A
PHS INVESTMENT TRUST HEDGE FUND PORTFOLI
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472293255INVESTMENTSWANAN/A
PHS INVESTMENT TRUST LDI PORTFOLIO
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472392060INVESTMENTSWANAN/A
PHS INVESTMENT TRUST LONG TREASURIES POR
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472385238INVESTMENTSWANAN/A
PHS INVESTMENT TRUST MLP PORTFOLIO
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472367538INVESTMENTSWANAN/A
PHS INVESTMENT TRUST PUBLIC DEBT PORTFOL
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472353569INVESTMENTSWANAN/A
PHS INVESTMENT TRUST PUBLIC EQUITY PORTF
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472283974INVESTMENTSWANAN/A
PHS INVESTMENT TRUST RELATIVE VALUE PORT
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472314743INVESTMENTSWANAN/A
PHS INVESTMENT TRUST RISK PARITY PORTFOL
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472336377INVESTMENTSWANAN/A
PHS INVESTMENT TRUST SHORT TERM INVESTME
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016812701056INVESTMENTSWANAN/A
PHS INVESTMENT TRUST TACTICAL TRADING PO
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472327491INVESTMENTSWANAN/A
PHS INVESTMENT TRUST TIPS PORTFOLIO
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016472402609INVESTMENTSWANAN/A
PORTLAND MEDICAL IMAGING LLC
4400 NE HALSEY 495PORTLANDOR97213201054971IMAGING DIAG.ORNAN/A
PROV RADIATION ONCOLOGY DEVELOP ASSN
4400 NE HALSEY 495PORTLANDOR97213260682491REAL ESTATE - MOBORNAN/A
PROVIDENCE CHILDREN'S NEONATAL SERVICES
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016470918549NEONATAL CAREWANAN/A
PROVIDENCE IMAGING CENTER JOINT VENTURE
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016920118807MEDICAL IMAGINGAKNAN/A
PROVIDENCE PARTNERS FOR HEALTH LLC
501 S BUENA VISTA STBURBANKCA91505454041798CLIN QUALITY/INTCANAN/A
PROVIDENCE ST JOSEPH HEALTH LONG TERM P
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016823190634INVESTMENTSWANAN/A
PROVIDENCE SURGERY CENTER LLC
902 N ORANGE STMISSOULAMT59802841401625AMBULATORY SURGMTNAN/A
PROVIDENCESILVERTON REHAB LLC
4400 NE HALSEY 425PORTLANDOR97213481287267REHAB SERVICESORNAN/A
PROVIDENCEUSP SANTA CLARITA GP LLC
11550 INDIAN HILLS ROAD 160MISSION HILLSCA91345202829660AMBULATORY SURGCANAN/A
PROVIDENCEUSP SURGERY CTRS LLC
11550 INDIAN HILLS ROAD 160MISSION HILLSCA91345200905938AMBULATORY SURGCANAN/A
SHA LLC
12940 NORTH HIGHWAY 183AUSTINTX78750752569094HEALTHCARETXNAN/A
SJO ASC HOLDINGS LLC
1140 W LA VETA AVEORANGECA92868821655501HEALTHCARECANAN/A
ST JOSEPH PHYSICIAN VENTURES I LLC
1100 WEST STEWART DRIVEORANGECA92868454521884REAL ESTATECANAN/A
ST JOSEPHSATELLITE DIALYSIS CENTERS L
300 SANTANA ROW SUITE 300SAN JOSECA95128814657391HEALTHCARECANAN/A
ST JUDE SURGICAL CENTERS LLC
1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016823352570AMBULATORY SURGCANAN/A
SURGERY CENTER AT TANASBOURNE LLC
11221 ROE AVE STE 300LEAWOODKS66211208187971AMBULATORY SURGKSNAN/A
TARZANA PEDIATRIC VENTURES LLC
18321 CLARK ST TARZANA CA 91356TARZANACA91356821308306HEALTHCARECANAN/A
THE MADISON SPOKANE INN LLC
15 WEST ROCKWOOD BLVDSPOKANEWA99204841606484HOTEL SERVICESWANAN/A
TARZANA PEDIATRIC VENTURES LLC
18321 CLARK ST TARZANA CA 91356TARZANACA91356821308306HEALTHCARECANAN/A
THE MADISON SPOKANE INN LLC
15 WEST ROCKWOOD BLVDSPOKANEWA99204841606484HOTEL SERVICESWANAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (26 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINLegal Domicile StateLegalDomicileStateCd
AMERICAN UNITY GROUP LTD
90 PITTS BAY ROADPEMBROKEBDHM08CAPTIVE INSURANCEBDNAC-CORP
1221 MADISON STREET OWNERS ASSOC
OWNERS' ASSOC.NAC-CORP747 BROADWAYSEATTLEWA98122201954319WA
AYIN HEALTH SOLUTIONS INC
HEALTHCARENAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016833037172DE
BOURGET HEALTH SERVICES INC
CLIN/MED LABNAC-CORPPO BOX 2687SPOKANEWA99220911354431WA
CARON HEALTH CORPORATION
MED PHYS SVCSNAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016810486082MT
DATU HEALTH INC AND SUBSIDIARIES
IT SVCSNAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016463070062DE
GRACE CLINIC OF LUBBOCK
HEALTHCARENAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016203856995TX
GRACE CLINIC SERVICES INC
HEALTHCARENAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016203857067TX
HOAG CLINIC (FKA COASTAL MGM SVS ORG)
HEALTHCARENAC-CORP1 HOAG DRIVE PO BOX 6100NEWPORT BEACHCA926586100330676831CA
HOAG MANAGEMENT SERVICES INC
HEALTHCARENAC-CORP1 HOAG DRIVE PO BOX 6100NEWPORT BEACHCA926586100330731587CA
LUBBOCK METHODIST HOSP PRACTICE MGMT
INACTIVENAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752578995TX
LUBBOCK METHODIST HOSPITAL SVCS
HEALTHCARENAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016752118585TX
LUMEDIC ACQUISITION CO INC
HEALTHCARENAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016833881097WA
MISSION VIEJO MEDICAL VENTURES
HEALTHCARENAC-CORP27800 MEDICAL CENTER RD 354MISSION VIEJOCA92691330212905CA
PHN HOLDINGS
STRAT PLAN SVCSNAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016461814184CA
PIONEER INNOVATIONS INC
HEALTH INNOVATNSNAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016364818191WA
PROVIDENCE ASSURANCE INC
CAPTIVE INSURANCENAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016208194071AZ
PROVIDENCE HEALTH CARE VENTURES INC
CLIN/MED LABNAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016900155714WA
PROVIDENCE HEALTH NETWORK
PREPAID HEALTHNAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016800886966CA
PROVIDENCE HEALTH VENTURES INC
INVESTMENTNAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330122216CA
ST JOSEPH HEALTH
HOLDING COMPANYNAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016462340232CA
ST JOSEPH HEALTH SOURCE INC
HEALTHCARENAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016461900168CA
ST JOSEPH PROF SVCS ENTERPRSES INC
HEALTHCARENAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016330155323CA
VINSERRA INC
INVESTMENTNAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016953943315CA
WESTERN HEALTHCONNECT VENTURES INC
INVESTMENTNAC-CORP1801 LIND AVE SW ATTN TAX DEPTRENTONWA980579016800953654WA
YAKIMA MEDICAL ARTS INC
RENT REAL ESTATENAC-CORP611 N PERRY 100SPOKANEWA99202910787963WA
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
ST JOSEPH HEALTH SYSTEM FOUNDATION
C$350,000CASH
ST JOSEPH HEALTH SYSTEM FOUNDATION
B$235,000CASH
ST JOSEPH HEALTH SYSTEM
P$10,661,099CASH
ST JOSEPH HERITAGE HEALTHCARE
B$268,907CASH
SANTA ROSA MEMORIAL HOSPITAL
P$276,683ACCRUAL
ST JOSEPH HOSPITAL EUREKA
P$596,377ACCRUAL

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART IIIFormAndLineReferenceDesc
ExplanationIDENTIFICATION 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 99204ExplanationTxt