2017-11-02T15:16:34-05:00 2016-12-31 911194016 Clark Nuber PS 10900 NE 4th Suite 1400 Bellevue WA 98004 990 2016-01-01 911861964 PROVIDENCE PLAN PARTNERS PROV 5035746330 4400 NE Halsey Bldg 2 Portland OR 97213 Michael White CFO/Treasurer 5035746330 2017-11-02 1 Sara Elizabeth J Hyre CPA P00235495 4254544919 170.173.0.16 2017-11-02 13:16:15 PD P C5F3CFF4C26DED891B80F887CA75C12EDBBE0CDF C5F3CFF4C26DED891B80F887CA75C12EDBBE0CDF 2016 2018-03-14 21:41:22Z Mike Cotton 4400 NE Halsey Bldg 2 Portland OR 97213 3297831 0 X N/A X 1997 WA To promote and foster improved health status in the communities served by this Corporation. 7 3 0 0 0 0 0 0 3150567 3297831 30580 0 0 0 3181147 3297831 189 0 0 0 3251547 2521465 0 0 0 2517148 436166 5768884 2957631 -2587737 340200 30798720 26472821 33822318 29156217 -3023598 -2683396 X As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.To promote and foster improved health status in the communities served by this Corporation. 0 0 2223855 0 2786292 Providence Preferred Provider Program (PPO), as part of Providence Plan Partners (PPP), is a network of medical practitioners, hospitals and ancillary medical providers throughout Oregon and southwest Washington designed to manage the cost, delivery, and quality of healthcare in these communities. PPO offers employers, self-insured employers, health and welfare trusts and other healthcare purchasers a program for reducing the cost of healthcare services, while maintaining the quality of medical care to enrollees. PPO acts as a liaison between hospitals and payors by informing payors and enrollees of the agreements entered on their behalf by PPO. PPO neither assumes risk or responsibility for payment to hospitals or providers nor guarantees payment by payors or performance by hospitals or providers of any of the terms of conditions set forth in any payor agreements. 408281 0 511539 Providence MCO Program (MCO), as part of Providence Plan Partners (PPP), is an Oregon certified workers' compensation program designed to complement the claims management program of employers. As such, the program aims to provide coordinated, high quality medical care to workers who suffer work-related injuries or illnesses and focuses on early return-to-work strategies that keep employees productive during recovery. The program is functionally and structurally similar to Preferred Provider Program (PPO), although focused on workers' compensation only. During 2016, there were 377,495 individuals that were eligible to use the Providence MCO program. 2632136 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 X 61 0 1 0 0 0 0 0 0 0 X 7 3 0 0 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 0 0 0 OR X Karl E Fritschel CPA 4255253339 1801 Lind Ave SW 9016 Renton WA 980579016 X Dave Olsen Vice Chair - Thru 3/16 0.10 5.50 X X 0 24135 0 Michael Holcomb Director /Chair Thru 3/16 0.10 5.30 X X 0 45360 0 Phyllis Hughes RSM Director - Thru 3/16 0.10 5.00 X 0 0 0 Sallye Liner Director - Thru 3/16 0.10 4.70 X 0 20360 0 Carolina Reyes MD Director - Thru 3/16 0.10 4.60 X 0 22860 0 Chauncey Boyle SP Director - Thru 3/16 0.10 3.10 X 0 0 0 Marian Schubert CSJ Director - Thru 3/16 0.10 2.80 X 0 0 0 Michael A Stein Director - Thru 3/16 0.10 3.10 X 0 7680 0 Eugene Al Parrish Director - Thru 3/16 0.10 2.80 X 0 7680 0 Bob Wilson Director - Thru 3/16 0.10 2.90 X 0 9120 0 Martha Diaz Aszkenazy Director - Thru 3/16 0.10 3.90 X 0 9180 0 Kirby McDonald Director - Thru 3/16 0.10 2.80 X 0 7680 0 Charles Chuck Watts Director - Thru 3/16 0.10 2.80 X 0 9180 0 Isiaah Crawford Director 0.10 4.10 X 0 24360 0 Debra A Canales - Eff 416 Director 0.10 59.90 X 0 2092357 611609 Gilbert Rodriguez MD- Eff 416 Director 0.50 4.50 X 0 0 0 Heath Schiesser - Eff 416 Director 0.50 4.50 X 0 0 0 Todd Hofheins - Eff 416 Director 0.10 59.90 X 0 1571440 60670 Mike Cotton President / CEO 0.50 49.50 X X 0 758611 213000 Rhonda Medows MD - Eff 416 Chair 0.25 59.75 X X 0 1565700 320279 Cindy Strauss - Thru 616 Secretary 0.10 59.90 X 0 1462780 58266 Greg Zamudio - Eff 716 Secretary 1.00 49.00 X 0 233530 68176 Michael G White CFO/Treasurer 0.50 49.50 X 0 508242 143828 Alison S Schrupp Chief Admin. Officer 0.60 54.40 X 0 345840 75560 Jon McAnnis Chief Info. Officer 0.50 49.50 X 0 177614 17286 Brad Garrigues Chief Marketing Officer 0.50 49.50 X 0 246160 30958 Robert A Gluckman Chief Medical Officer 0.50 49.50 X 0 488746 48242 Mark Jensen Chief Services Officer 0.50 49.50 X 0 233645 42178 Carrie Smith Chief Compliance Officer 0.50 49.50 X 0 285616 40018 Stephanie C Dreyfuss Dir. Network Develop. 0.40 39.60 X 0 304985 27282 Sally Marsh Account Executive 0.40 39.60 X 0 318596 36770 Gregory Barkee Director of Technology 0.40 39.60 X 0 297544 13061 Mark A Whitaker Medical Director 0.40 39.60 X 0 284049 27475 Susan Abate Dir. Quality Med. Mgr. 0.40 39.60 X 0 244496 25563 Andrew Tarab AVP Informatics 0.40 39.60 X 0 243484 22562 Jack Friedman Former President / CEO 0.00 0.00 X 0 299327 0 0 12150357 1882783 0 1 1 0 Multiplan Inc 115 Fifth Ave New York NY 10003 Healthcare Cost Mgmnt 7863689 Deloitte Consulting LLP 2 Braxton Way Glen Mills PA 19342 Consulting 7081142 Change Healthcare Solutions 3055 Lebanon Pike Nashville TN 37214 Billing Services 3373739 American Specialty Health Fitness Inc 10221 Wateridge Circle San Diego CA 92121 Healthcare Cost Mgmnt 2507052 Clarity Siftware Solutions 92 Wall St 1 Madison CT 06443 ACA Reporting Services 2116506 40 PPO Admin Fees 900099 2786292 2786292 MCO Admin Fees 900099 511539 511539 3297831 3297831 3297831 0 0 X 1972885 1743389 229496 548580 486749 61831 413 413 178364 171770 6594 168 168 81451 78914 2537 5828 3806 2022 12612 8146 4466 5186 5073 113 1035 631 404 12500 12500 87 87 Electronic Claims 111456 111456 Subscriptions 7204 7081 123 Dues & Memberships 5891 5835 56 Licensing 2140 2086 54 11831 7032 4799 2957631 2632136 325495 0 754883 2988758 201047 178233 1603 405 3697239 2905133 26143948 20400292 30798720 26472821 22194838 2702266 200138 200454 11427342 26253497 33822318 29156217 X 9729010 9729010 -14413589 -14413589 1660981 2001183 -3023598 -2683396 30798720 26472821 X 340200 2 X X 0 1 X 1 0 0 Due from Affiliates 20400292 20400292 Due to Affiliates 15181458 Other Payables 11072039 26253497 1 1 0 0 0 0 0 0 0 Debra A Canales - Eff 416 Director 0 801127 0 1168376 0 122854 0 598119 0 13490 0 2703966 0 0 Todd Hofheins - Eff 416 Director 0 765052 0 762582 0 43806 0 33684 0 26986 0 1632110 0 0 Mike Cotton President / CEO 0 611800 0 89981 0 56830 0 187528 0 25472 0 971611 0 0 Rhonda Medows MD - Eff 416 Chair 0 824899 0 698359 0 42442 0 299110 0 21169 0 1885979 0 0 Cindy Strauss - Thru 616 Secretary 0 657902 0 762672 0 42206 0 35775 0 22491 0 1521046 0 0 Greg Zamudio - Eff 716 Secretary 0 215030 0 18500 0 0 0 45508 0 22668 0 301706 0 0 Michael G White CFO/Treasurer 0 315975 0 174267 0 18000 0 138631 0 5197 0 652070 0 0 Alison S Schrupp Chief Admin. Officer 0 280254 0 48181 0 17405 0 62571 0 12989 0 421400 0 0 Jon McAnnis Chief Info. Officer 0 176757 0 0 0 857 0 8020 0 9266 0 194900 0 0 Brad Garrigues Chief Marketing Officer 0 211522 0 16638 0 18000 0 23425 0 7533 0 277118 0 0 Robert A Gluckman Chief Medical Officer 0 396572 0 73346 0 18828 0 28190 0 20052 0 536988 0 0 Mark Jensen Chief Services Officer 0 201187 0 32458 0 0 0 23664 0 18514 0 275823 0 0 Carrie Smith Chief Compliance Officer 0 247715 0 37901 0 0 0 25497 0 14521 0 325634 0 0 Stephanie C Dreyfuss Dir. Network Develop. 0 245718 0 41457 0 17810 0 13913 0 13369 0 332267 0 0 Sally Marsh Account Executive 0 318596 0 0 0 0 0 25235 0 11535 0 355366 0 0 Gregory Barkee Director of Technology 0 157256 0 0 0 140288 0 1377 0 11684 0 310605 0 0 Mark A Whitaker Medical Director 0 263877 0 2172 0 18000 0 11925 0 15550 0 311524 0 0 Susan Abate Dir. Quality Med. Mgr. 0 211307 0 33189 0 0 0 16855 0 8708 0 270059 0 0 Andrew Tarab AVP Informatics 0 213721 0 29763 0 0 0 11115 0 11447 0 266046 0 0 Jack Friedman Former President / CEO 0 0 0 299327 0 0 0 0 0 0 0 299327 0 0 Part I, Line 1a The reporting organization did not provide any of the benefits listed in Part I, Line 1a. However, as part of the related organization's philosophy of transparency, the narrative that follows relates to the compensation and benefits provided by the related organization. Providence Health & Services Expense Reimbursement Procedures include the following policies: Travel or Charter Travel or Travel of Companions Air travel is reimbursable and should be at the least expensive airfare; which permits departures and arrivals at reasonable times and reasonable distance traveled. Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class full fare tickets and charter must be approved by a senior level supervisor. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approved by the Executive Vice President, Chief Administrative Officer (EVP, CAO) of Providence St. Joseph Health. Spouse or Companion Travel. Travel expenses incurred by a PH&S employee's spouse or companion will not be reimbursed by PH&S unless the spouse or companion is required to, or invited to attend a PH&S System-sponsored meeting. These expenses may be considered a taxable benefit by the IRS and if so, will be included on the employee's W- 2. During 2016, there were 11 First Class tickets utilized by Officers, Directors or Key Employees listed on Form 990, Part VII. Tax Indemnifications or Gross-Up Payments - Relocation Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2016, there were 2 Officers and 1 Director receiving gross-up payments. The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation on the Form 990. Tax Indemnifications or Gross-Up Payments - Financial/Retirement Planning Providence Health & Services follows the federal and state taxation laws related to other expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay these other expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the financial/retirement planning benefits, during 2016 only, to offset the personal tax burden to the employee for IRS allowable expenses. During 2016, there were 2 Officers and 2 Directors receiving this type of gross-up payment. The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation on the Form 990. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding "rent" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The EVP, CAO PSJH may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2016, there were 2 Officers and 1 Director receiving relocation/housing program payments. The amounts reported for these relocation/housing payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation on the Form 990. Part I, Lines 4a-b NON-QUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) ESP = Elective Survivor Plan C) DCRP = Defined Contribution Restoration Plan 1) Mike Cotton a) SERP Earned but not Vested - $171,778 b) SERP Interest Credit - $3,825 2) Cindy Strauss a) SERP Earned but not Paid - $23,073 3) Greg Zamudio a) SERP Earned but not Vested - $34,074 b) SERP Interest Credit - $379 4) Michael White a) SERP Earned but not Vested - $111,399 5) Rhonda Medows, MD a) SERP Earned but not Vested - $267,369 b) SERP Interest Credit - $11,866 6)Alison Schrupp a) SERP Earned but not Paid - $2,527 b) SERP Interest Credit - $34,919 c) ESP Interest Credit - $3,802 7) Robert Gluckman, MD a) SERP Earned but not Paid - $7,652 8) Carrie Smith a) DCRP Earned but not Paid - $489 9) Mark Whitaker a) DCRP Earned but not Paid - $2,172 Part I, Lines 4a-b SEVERANCE Gregory Barkee - $113,270 FORM 990, SCHEDULE J, PART II - EXECUTIVE INCENTIVE PROGRAM The Providence Executive Incentive Program provides a lump sum award annually as a percent of the executive's base pay. Percent opportunities are aligned with our total compensation philosophy as outlined in Part VI, Section B, Line 15 (Process for determining compensation of top management, officers & key employees). For Providence leaders, the performance award is based on the level of accomplishment of annual system and functional (or market) objectives. In 2016, 60 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's strategic priorities. In 2016 the percent allocation for each of these strategic priorities was as outlined below: System Goals: First-year Turnover - 10% Inpatient Experience - 5% Patient Experience - 5% Medical Group Patient Experience - 5% Community Benefit - 10% Clinical Excellence - 15% Free Cash Flow - 10% The remaining 40% was based on a robust set of function specific goals designed to align critical mission and business drivers. Form 990, Part VI, Section A, line 4 The Articles of Incorporation and Bylaws of Providence Health Plan, Providence Health Assurance, and Providence Plan Partners were restated in 2016 to facilitate: 1) the creation of "mirror" boards of directors for the three entities that are comprised of individuals who are elected via a process independent from the election of the Board of Directors for Providence Health & Services - Oregon (Providence Plan Partner's sole corporate member). No changes were made to the general purposes or to the powers reserved by the sole corporate members of each of the three entities. Form 990, Part VI, Section A, line 6 The Member of the Corporation is Providence Health & Services - Oregon. Form 990, Part VI, Section A, line 7a The Corporate Member has the power to: 1) Fix the number of Directors, select the Directors and to remove such Directors at any time with or without cause. 2) Appoint the Chairperson of the Board of Directors, determine the term of office and to remove such Chairperson with or without cause. Form 990, Part VI, Section A, line 7b The Corporate Member has the power: 1) To adopt or change the mission, philosophy, and values, including the strategic plan and mission statement. 2) To amend or repeal the Articles of Incorporation or Bylaws. 3) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale transfer, assignment or encumbering of assets exceeding a specified threshold, or the sale or transfer of any property which may have historical or religious significance. 4) To approve the establishment of any new Corporation in which this Corporation has a controlling interest. 5) To approve the dissolution or liquidation. 6) To approve the annual operating and capital budgets. 7) To appoint the certified public accountants. 8) To approve, according to established guidelines, any joint venture of corporate affiliations. 9) To approve lending of corporate funds. 10) To approve the closure of any institution or major ministry or work of the Corporation. Form 990, Part VI, Section B, line 11b The Form 990 is prepared internally by experienced Providence Health & Services staff and reviewed by the internal PH&S Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict. Form 990, Part VI, Section B, line 15 It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a 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 and approved by the full Board of Directors, none of whom is a Providence employee. 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 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. Additionally, Providence's labor market continues to spread across health care and into general industry. Because of this, Providence also takes into consideration general industry for-profit market data, where applicable. Base salaries for Providence executives are generally targeted to the median level of the market, as identified by the independent consultant and reviewed with the Executive Compensation Committee. Performance incentives allow executives to earn additional compensation if they achieve specific organizational goals for furthering Providence operating commitments and strategic objectives. The Board of Directors conducts a thorough 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. Form 990, Part VI, Section C, line 19 Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon request. The consolidated financial statements are available on our public Internet site www2.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site. Form 990, Part VII Contact Addresses for Officers, Directors, Etc Dave Olsen - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Michael Holcomb - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Phyllis Hughes, RSM - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Sallye Liner - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Carolina Reyes, MD - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Chauncey Boyle, SP - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Marian Schubert, CSJ - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Michael A. Stein - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Eugene "Al" Parrish - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Bob Wilson - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Martha Diaz Aszkenazy - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Kirby McDonald - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Charles (Chuck) Watts - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Todd Hofheins - Eff. 4/16 - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Cindy Strauss - Thru 6/16 - 1801 Lind Ave. SW #9016, Renton, WA 98057-9016. Form 990, Part XI, line 9: Rounding 2. FORM 990, PART XII, LINE 2C - FINANCE & AUDIT COMMITTEE The Providence Plan Partners Finance and Audit Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. FORM 990, PART VII, SECTION B - INDEPENDENT CONTRACTORS All payments to operational expense vendors are made by Providence Plan Partners. Shared expenses are internally allocated between Providence Plan Partners, Providence Health Plan and Providence Health Assurance. All vendor 1099s are issued by Providence Plan Partners. FORM 990, PART I, LINE 5 & PART V, LINE 2A - EMPLOYEE COMPENSATION The employees working at Providence Plan Partners are paid by Providence Health & Services - Washington dba Health System Office EIN# 91-0725998 or Providence Health & Services - Oregon EIN# 51-0216587. Therefore, no W-2s are issued by the reporting organization. FORM 990, SCHEDULE R - RELATED ORGANIZATIONS AFFILIATION AGREEMENTS Effective April 1, 2016, the Health System (Providence Health & Services) entered into a business combination agreement with the Institute for Systems Biology (ISB). The transaction was accounted for as an acquisition under ASC 958-805. On July 1, 2016, Providence Health & Services (PHS) and St. Joseph Health System (SJHS) entered into a business combination agreement, the purpose of which was to better serve both organizations' communities, maintain strong traditions of Catholic healthcare, and provide greater affordability and access to healthcare services. As part of the business combination, PHS and SJHS aligned under a single parent corporation, Providence St. Joseph Health, with a consolidated board of directors and cosponsorship from the public juridic persons Providence Ministries and St. Joseph Health Ministry. SJHS provides a full range of care facilities including 16 acute care hospitals, home health agencies, hospice care, outpatient services, skilled nursing facilities, community clinics, and physician groups spanning California, west Texas, and eastern New Mexico. The results of operations of these entities have been included in the combined statements of operations of the Health System since July 1, 2016, the effective date of the business combination. Providence Health & Services - Washington 1801 Lind Avenue SW 9016 Renton WA 980579016 510216586 Healthcare System WA 501( c)(3) Line 3 Providence Health & Services 0 Providence Health & Services - Oregon 1801 Lind Avenue SW 9016 Renton WA 980579016 510216587 Healthcare System OR 501( c)(3) Line 3 Providence Health & Services 0 Providence Health System - So California 1801 Lind Avenue SW 9016 Renton WA 980579016 510216589 Healthcare System CA 501( c)(3) Line 3 Providence Health & Services 0 Everett Transitional Care Services PO Box 5128 Everett WA 982065128 943264605 Transitional Care WA 501( c)(3) Line 10 N/A 0 Providence Health Plan 4400 NE Halsey Bldg 2 Portland OR 97213 930863097 Health Service Contractor OR 501( c)(4) N/A Providence Plan Partners 1 Providence Health Assurance 4400 NE Halsey Bldg 2 Portland OR 97213 550828701 Healthcare Provider OR 501( c)(4) N/A Providence Health Plan 1 Providence Medical Institute 4101 Torrance Blvd Torrance CA 90503 330283773 Healthcare CA 501( c)(3) Line 12/Type I PHS - So California 0 Little Company of Mary Ancillary Services Corporation 4101 Torrance Blvd Torrance CA 90503 330844408 Imaging Services CA 501( c)(3) Line 10 PHS - So California 0 Providence TrinityCare Hospice 5315 Torrance Blvd Suite B1 Torrance CA 90503 953264139 Hospice CA 501( c)(3) Line 10 PHS - So California 0 Providence Blanchet Association 1700 Providence Pl Centralia WA 98531 911789266 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 St Luke Association 350 Washington Ave SE Chehalis WA 98352 943176618 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Rossi Association 1700 Providence Pl Centralia WA 98531 311584166 Supportive Housing WA 501( c)(3) Line 10 PH & S - Washington 0 Lundberg Association 5921 E Burnside Portland OR 97215 911562797 Supportive Housing OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence St Francis Association 3415 12th Avenue NE Olympia WA 98506 943244854 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Peter Claver Association 7101 38th Avenue South Seattle WA 98118 311629656 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence St Elizabeth House Association 3201 SW Graham St Seattle WA 98126 912171539 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Gamelin House Association 4515 MLK Jr Way S Ste 200 Seattle WA 98108 311744654 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 The Gamelin Association 312 North Fourth St Yakima WA 98901 911180824 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 The Gamelin Oregon Association 5520 NE Glisan Portland OR 97213 911214491 Supportive Housing OR 501( c)(3) Line 10 PH & S - Oregon 0 The Gamelin California Association 540 23rd St Oakland CA 94612 911293869 Supportive Housing CA 501( c)(3) Line 10 PHS - So California 0 Gamelin Washington Association 1423 First Avenue Seattle WA 98101 201910170 Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Dethman House 1205 Montello Ave Hood River OR 97031 473385506 Supportive Housing WA 501( c)(3) Line 7 N/A 0 Providence Foundation 1801 Lind Avenue SW 9016 Renton WA 980579016 943078543 Support PH&S and W. HealthConnect WA 501( c)(3) Line 12/Type I PH & S - Washington 0 Providence Alaska Foundation 3300 Providence Drive - B Tower2 Anchorage AK 99508 920093565 Support PHS-Alaska AK 501( c)(3) Line 12/Type I PH & S - Washington 0 Providence St Peter Foundation 413 Lilly Road NE Olympia WA 985065166 911097056 Support Affiliated Tax-Exempt Organization WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Health Care Foundation (Centralia) 914 S Scheuber Road Centralia WA 98531 911433382 Support Providence Centralia Hospital WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Mount St Vincent Foundation 4831 - 35th Avenue SW Seattle WA 981262799 911188119 Support Providence Mount St.Vincent WA 501( c)(3) Line 7 PH & S - Washington 0 Providence Marianwood Foundation 3725 Providence Point Drive SE Issaquah WA 980297219 931554288 Support Providence Marianwood WA 501( c)(3) Line 12/Type I PH & S - Washington 0 Providence Newberg Health Foundation 1001 Providence Drive Newberg OR 97132 930889144 Support Providence Newberg Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Seaside Hospital Foundation 725 S Wahanna Rd Seaside OR 97138 930927320 Support Providence Seaside Hospital OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Community Health Foundation 1111 Crater Lake Ave Medford OR 97504 930692907 Support Providence Medford Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Benedictine Nursing Center Foundation 540 South Main St Mt Angel OR 973629532 911940286 Support Providence Benedictine Nursing Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Portland Medical Foundation 4805 NE Glisan St Portland OR 972132967 931231494 Support Providence Portland Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence St Vincent Medical Foundation 9205 SW Barnes Rd Portland OR 97225 930575982 Support Providence St. Vincent Medical Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Milwaukie Foundation 10150 SE 32nd Milwaukie OR 97222 943079515 Support Providence Milwaukie Hospital OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Child Center Foundation 830 NE 47th Portland OR 97213 930800140 Support Providence Child Center OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence TrinityCare Hospice Foundation 5315 Torrance Blvd Suite B1 Torrance CA 90503 330261016 Support TrinityCare Hospice CA 501( c)(3) Line 7 Providence TrinityCare Hospice 0 Providence Little Company of Mary Foundation 4101 Torrance Blvd Torrance CA 90503 510224944 Support Little Company of Mary Service Area CA 501( c)(3) Line 7 PHS - So California 0 PH&S FoundationSFVSA & SCVSA 501 S Buena Vista Street Burbank CA 91505 953544877 Support Program & Activities of SFVSA & SCVSA CA 501( c)(3) Line 7 PHS - So California 0 Providence Hospice of Seattle Foundation 425 Pontius Avenue North 300 Seattle WA 981095452 912077378 Support Hospice of Seattle WA 501( c)(3) Line 12/Type I PH & S - Washington 0 Providence Health & Services - Western Washington 1801 Lind Avenue SW 9016 Renton WA 980579016 911303277 Healthcare WA 501( c)(3) Line 3 Providence MinistriesWHC 0 Providence Health & Services 1801 Lind Avenue SW 9016 Renton WA 980579016 911549796 Support Providence Institutions WA 501( c)(3) Line 12/Type II Providence St Joseph Health 0 Providence Health & Services - Montana 500 W Broadway PO Box 4587 Missoula MT 598064587 810231793 Healthcare MT 501( c)(3) Line 3 PH & S - Washington 0 Providence St Joseph Medical Center PO Box 1010 Polson MT 598601010 810463482 Healthcare MT 501( c)(3) Line 3 PH & S - Washington 0 St Thomas Child and Family Center 1710 Benefis Court Great Falls MT 59405 810233495 Early Childhood Education MT 501( c)(3) Line 10 PH & S - Washington 0 Sisters of Providence of Montana Corporation 1801 Lind Avenue SW 9016 Renton WA 980579016 262612415 Shell Corporation MT 501( c)(3) Line 1 PH & S - Washington 0 Providence Health Care Foundation - Eastern Washington 101 W 8th Ave Spokane WA 99204 320014330 Support PH&S-WA. Ministries in E. WA. WA 501( c)(3) Line 7 PH & S - Washington 0 St Patrick Hospital Foundation 500 West Broadway PO Box 4587 Missoula MT 598064587 237056976 Support Healthcare in W. Montana MT 501( c)(3) Line 7 PH & S - Washington 0 University of Great Falls 1301 20th Street South Great Falls MT 59405 810231777 Post Secondary Education MT 501( c)(3) Line 2 Providence Health & Services 0 E WA & MT Unemployment Compensation Insurance Trust 1801 Lind Avenue SW 9016 Renton WA 980579016 911082119 Unemployment Benefits WA 501( c)(3) Line 12/Type I PH & S - Washington 0 Providence Willamette Falls Medical Foundation 1500 Division Street Oregon City OR 97045 931003750 Support Willamette Falls Hospital OR 501( c)(3) Line 12/Type I PH & S - Oregon 0 Providence Hood River Memorial Hospital Foundation Inc 811 13th St Hood River OR 97031 930921990 Support Providence Hood River Memorial Hospital OR 501( c)(3) Line 7 PH & S - Oregon 0 Providence Hospice and Home Care Foundation 2731 Wetmore Avenue Suite 500 Everett WA 98201 272552749 Support Program & Ministries of PHHC WA 501(c )(3) Line 7 PH & S - Washington 0 Providence St Mary Foundation 401 W Poplar St Walla Walla WA 99362 452841492 Support Program & Ministries of SMMC WA 501(c )(3) Line 7 PH & S - Washington 0 Facey Medical Foundation 15451 San Fernando Mission Blvd 200 Mission Hills CA 913451420 954322584 Support Facey Medical Group CA 501(c )(3) Line 7 PHS - So California 0 Swedish Health Services 747 Broadway Seattle WA 98122 910433740 Healthcare WA 501(c )(3) Line 3 Western HealthConnect 0 Swedish Edmonds 21601 76th Ave W Edmonds WA 98026 272305304 Healthcare WA 501(c )(3) Line 3 Western HealthConnect 0 Swedish Medical Center Foundation 747 Broadway Seattle WA 98122 910983214 Support Swedish Health Services WA 501(c )(3) Line 7 Swedish Health Services 0 Global To Local Health Initiative 2800 South 192nd St 104 SeaTac WA 98188 273133200 Healthcare WA 501(c )(3) Line 7 Swedish Health Services 0 Swedish MJM Holdings 747 Broadway Seattle WA 98122 273139262 Holding Company WA 501(c )(3) Line 12/Type I Swedish Health Services 0 Marsha Rivkin Center for Ovarian Cancer Research 747 Broadway Seattle WA 98122 912054035 Ovarian Cancer Research WA 501(c )(3) Line 7 Swedish Health Services 0 Western HealthConnect 747 Broadway Seattle WA 98122 454171900 Shell Corporation WA 501(c )(3) Line 12/Type II PH&S Western Washington 0 Inland Northwest Health Services 601 W 1st Avenue Spokane WA 99201 911307555 Healthcare WA 501( c)(3) Line 3 PH&S - Washington 0 Kadlec Regional Medical Center 888 Swift Blvd Richland WA 99352 910655392 Healthcare WA 501(c )(3) Line 3 Western HealthConnect 0 Kadlec Neurological Resource Center 1268 Lee Blvd Richland WA 99352 911266345 Healthcare WA 501(c )(3) Line 10 Western HealthConnect 0 Kadlec Foundation 888 Swift Blvd Richland WA 99352 237005501 Support Kadlec Regional Medical Center WA 501(c )(3) Line 12/Type I Kadlec Regional Medical Center 0 PacMed Clinics 1200 12th Ave S Seattle WA 98144 562290878 Healthcare WA 501(c )(3) Line 10 Western HealthConnect 0 Seattle Science Foundation 550 17th Ave Seattle WA 98122 611502822 Physician Collaboration WA 501(c )(3) Line 7 Western HealthConnect 0 Providence Saint John's Health Center 2121 Santa Monica Blvd Santa Monica CA 90404 951684082 Healthcare CA 501(c )(3) Line 3 PHS - So California 0 John Wayne Cancer Institute 2200 Santa Monica Blvd Santa Monica CA 90404 954291515 Cancer Treatment CA 501(c )(3) Line 4 Providence Saint John's Health Center 0 Saint John's HospitalHealth Center Foundation 2121 Santa Monica Blvd Santa Monica CA 90404 956100079 Support Saint John Health Center & JWCI CA 501(c )(3) Line 7 Providence Saint John's Health Center 0 Providence St Joseph Health 1801 Lind Avenue SW 9016 Renton WA 98057 811244422 Support PH&S and St. Joseph Health System WA 501(c )(3) Line 12, Type III N/A 0 Institute for Systems Biology 401 Terry Ave N Seattle WA 98109 912003593 Predict, prevent & cure disease WA 501(c )(3) Line 7 Western HealthConnect 0 Providence Saint John's Medical Foundation 20555 Earl St Torrance CA 90503 814542216 Healthcare CA 501(c )(3) Pending PHS - So California 0 Institute for Mental Health & Wellness 1801 Lind Avenue SW 9016 Renton WA 98057 814260130 Mental Healthcare WA 501(c )(3) Line 7 PH&SSt Joseph Health System 0 Covenant Health Network Inc 3345 Michelson Drive Suite 100 Irvine CA 92612 461259908 Healthcare CA 501 (C )(3) Line 12, Type III St Joseph Health System 0 Covenant ACO 3615 19th Street Lubbock TX 79410 611573313 Healthcare TX 501 (C )(3) Line 12, Type I Covenant Health System 0 Covenant Health System 3615 19th Street Lubbock TX 79410 752765566 Healthcare TX 501 (C )(3) Line 3 St Joseph Health System 0 Covenant Health System Foundation 3623 22nd Place Lubbock TX 79410 752897026 Healthcare TX 501 (C )(3) Line 7 Covenant Health System 0 Covenant Medical Group 3420 22nd Place Lubbock TX 79410 752743883 Healthcare TX 501 (C )(3) Line 3 Covenant Health System 0 Covenant Health Partners 3615 19Th Street Lubbock TX 79410 463516417 Healthcare TX 501 (C )(3) Line 12, Type I Covenant Health System 0 HMTS Inc 1 Hoag Drive Newport Beach CA 92658 453583707 Healthcare CA 501 (C )(3) Line 12, Type I Hoag Memorial Hospital Presbyterian 0 Hoag Charity Sports 330 Placentia Ave Newport Beach CA 92663 452982422 Support CA 501 (C )(3) Line 7 Hoag Hospital Foundation 0 Hoag Hospital Foundation 330 Placentia Ave Newport Beach CA 92663 953222343 Fundraising CA 501 (C )(3) Line 7 Hoag Memorial Hospital Presbyterian 0 Hoag Memorial Hospital Presbyterian 1 Hoag Road Box 6100 Newport Beach CA 92663 951643327 Healthcare CA 501 (C )(3) Line 3 Covenant Health Network 0 Home Care Partners 1165 Montgomery Dr Santa Rosa CA 95405 680318656 Inactive CA 501 (C )(3) Line 3 Santa Rosa Memorial Hospital 0 Hospice Of Lubbock 3702 21st Street Lubbock TX 79410 752133781 Healthcare TX 501 (C )(3) Line 10 Covenant Health System 0 Lubbock Methodist Hospital Foundation 3615 19th Street Lubbock TX 79410 752220963 Healthcare TX 501 (C )(3) Line 7 Covenant Health System 0 Methodist Children's Hospital 3610 21st Street Lubbock TX 79410 752428911 Healthcare TX 501 (C )(3) Line 3 Covenant Health System 0 Methodist Hospital Levelland 1900 College Avenue Levelland TX 79336 752246348 Healthcare TX 501 (C )(3) Line 3 Covenant Health System 0 Methodist Hospital Plainview 2601 Dimmitt Road Plainview TX 79072 752426010 Healthcare TX 501 (C )(3) Line 3 Covenant Health System 0 Mission Hospital Regional Medical Ctr 27700 Medical Center Road Mission Viejo CA 92691 951643360 Healthcare CA 501 (C )(3) Line 3 Covenant Health Network 0 Queen Of The Valley Medical Center 1000 Trancas Street Napa CA 94558 941243669 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 Redwood Memorial Foundation 3300 Renner Drive Fortuna CA 95540 942779313 Healthcare CA 501 (C )(3) Line 7 Redwood Memorial Hospital 0 Redwood Memorial Hospital 3300 Renner Drive Fortuna CA 95540 941384665 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 Santa Rosa Memorial Hospital 1165 Montgomery Dr Santa Rosa CA 95405 941231005 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 SRM Alliance Hospital Services (Pvh) 400 North McDowell Blvd Petaluma CA 94954 680395200 Healthcare CA 501 (C )(3) Line 3 Santa Rosa Memorial Hospital 0 St Joseph Health System 3345 Michelson Drive Suite 100 Irvine CA 92612 953589356 Healthcare CA 501 (C )(3) Line 12, Type I Providence St Joseph Health 0 St Joseph Health System Foundation 3345 Michelson Drive Suite 100 Irvine CA 92612 330143024 Healthcare CA 501 (C )(3) Line 7 St Joseph Health System 0 St Joseph Home Care Network 1111 Sonoma Ste 308 Santa Rosa CA 95405 680331084 Healthcare CA 501 (C )(3) Line 10 St Joseph Health System 0 St Joseph Hospital Of Eureka 2700 Dolbeer Street Eureka CA 95501 941156596 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 St Joseph Hospital Of Orange 1100 West Stewart Drive Orange CA 92868 951643359 Healthcare CA 501 (C )(3) Line 3 Covenant Health Network 0 St Jude Hospital Yorba Linda 200 West Center St Promenade Anaheim CA 92805 330185031 Healthcare CA 501 (C )(3) Line 3 St Joseph Health 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Alpha Medical Laboratory LLC 611 N Perry Spokane WA 99202 912017347 Outpatient Lab ID N/A Broadway Imaging LLC 500 W Broadway Missoula MT 59802 522405971 Medical Imaging MT N/A California Laboratory Associates LLC 501 Buena Vista Burbank CA 91505 273888692 Outpatient Lab CA N/A Center for Specialty Surgery LLC 11782 SW Barnes Rd Portland OR 97225 263638838 Ambulatory Surgery Center OR N/A Clackamas Radiation Oncology Center LLC 4400 NE Halsey St Bldg II 495 Portland OR 97213 260381897 Radiation Oncology OR N/A Ctr for Med Imaging-Bridgeport LLC 4400 NE Halsey 495 Portland OR 97213 260796953 Imaging - Diagnostics OR N/A Ctr for Med Imaging-Tanasbourne LLC 4400 NE Halsey 495 Portland OR 97213 200477972 Imaging - Diagnostics OR N/A Greater Valley Medical Building LP 501 S Buena Vista St Burbank CA 91505 954570858 Real Estate - MOB CA N/A Minor & James Medical PLLC 515 Minor Avenue 200 Seattle WA 98104 911340223 Physician Clinic WA N/A Mountainstar Clinical Laboratories LLC 611 N Perry 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Investments CA N/A Hoag Orthopedic Institute 1 Hoag Drive Box 6100 Newport Beach CA 92658 611588294 Healthcare CA N/A Lubbock Surgery Center Ltd 4000 24th Street Lubbock TX 79410 752177401 Healthcare TX N/A Methodist Diagnostic Imaging 4000 24th Street Lubbock TX 79410 752343261 Healthcare TX N/A Mission Ambulatory Surgicenter Ltd 27800 Medical Center Road Ste 362 Mission Viejo CA 92691 330355575 Healthcare CA N/A Newport Imaging Center 360 San Miguel Newport Beach CA 92660 330191776 Healthcare CA N/A SHA LLC 12940 North Highway 183 Austin TX 78750 752569094 Healthcare TX N/A St Joseph Physician Ventures I LLC 1100 West Stewart Drive Orange CA 92868 454521884 Real Estate CA N/A North Bay Endoscopy Center 1383 N McDowell Blvd Suite 110 Petaluma CA 94954 611559876 Healthcare CA N/A Southern California Surgery Center LLC 18321 Ventura Blvd Ste 740 Tarzana CA 91356 330939000 Healthcare CA N/A Mission Viejo Physician Partners I LLC 27700 Medical Center Road Mission Viejo CA 92691 471559873 Healthcare CA N/A Advanced Surgery Institute LLC 1739 4th Street Santa Rosa CA 95404 262299255 Healthcare CA N/A Providence Health Ventures Inc 4101 Torrance Blvd Torrance CA 90503 330122216 Investment CA N/A C 0 Caron Health Corporation 510 W Front St Missoula MT 59802 810486082 Medical Physician Service MT N/A C 0 Providence Health Care Ventures Inc 101 W 8th Ave TAF C-9 Spokane WA 99204 900155714 Clinical/Medical Lab WA N/A C 0 Providence Physician Services Co 101 W 8th Ave TAF C-9 Spokane WA 99204 911216033 Clinical/Medical Lab WA N/A C 0 Yakima Medical Arts Inc 611 N Perry 100 Spokane WA 99202 910787963 Rental Real Estate WA N/A C 0 Bourget Health Services Inc PO Box 2687 Spokane WA 99220 911354431 Clinical/Medical Lab WA N/A C 0 1221 Madison Street Owners Assoc 747 Broadway Seattle WA 98122 201954319 Owners' Association WA N/A C 0 Western HealthConnect Ventures Inc 1801 Lind Ave SW 9016 Renton WA 98057 800953654 Investment WA N/A C 0 PHN Holdings 20555 Earl Street Torrance CA 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