2017-11-15T16:44:14-06:00 2016-12-31 911194016 Clark Nuber PS 10900 NE 4th Suite 1400 Bellevue WA 98004 990 2016-01-01 954322584 FACEY MEDICAL FOUNDATION FACE 8183659531 15451 SAN FERNANDO MISSION BLVD MISSION HILLS CA 913451420 Jo Ann Escasa-Haigh EVP/CFO - Operations 4255253985 2017-11-15 1 Sara Elizabeth J Hyre CPA P00235495 4254544919 170.173.0.16 2017-11-15 14:43:56 PS P C5F3CFF4C26DED891B80F887CA75C12EDBBE0CDF C5F3CFF4C26DED891B80F887CA75C12EDBBE0CDF 2016 2017-02-10 21:41:12Z Dave Mast 15451 SAN FERNANDO MISSION BLVD MISSION HILLS CA 913451420 215250692 0 X www.facey.com X 1991 CA Premier healthcare team providing quality medical service in So. California. X 13 13 1392 0 0 0 294224 200165 202505864 202883417 10164140 1019817 143367 425672 213107595 204529071 7800 5000 0 0 58485334 64540428 0 0 0 162257214 170238196 220750348 234783624 -7642753 -30254553 102886557 113002715 61876172 100218640 41010385 12784075 X We are a premier healthcare team dedicated to providing quality medical service in a caring and professional atmosphere. Each of us is committed to service, innovation, and quality care while serving the needs of the community. 0 0 219485620 0 202590263 Direct patient medical care - this includes, but is not limited to, face to face provider appointments, laboratory and x-ray services, physical therapy services, immunizations, provided drugs and medications, procedures in Ophthalmology, OB/GYN, and Gastroenterology. Revenues also include income from Hospital & Health Plan Shared Risk, Health Plan Pay for Performance, Stop Loss Recoveries, and 3rd Party Liens, and Meaningful Use.The following programs and amounts represent the community benefit provided by Facey Medical Foundation and the costs associated with them:Direct Charitable Write-OffsCharity (Indigent Care) $ 55,057Medi-Cal $1,577,519Community Outreach/Education Programs $ 789,816Total Community Benefit Costs thru 12/31/16 $2,422,392 789816 0 0 Patient Education: 184 Health Education classes, serving 5,188 patients.Community Outreach Programs: Over 184 classes were offered at many Facey Locations throughout the year involving over 5,100 attendees.Classes covered numerous topics including blood pressure, cholesterol management, healthy living, memory loss and smoking cessation, to name a few.Additionally, a variety of Health Fairs and Womens' Series were held throughout the year. 619908 0 392810 Clinical Research: Conducted 24 (18 are active) FDA-regulated studies (166 patients and 693 study visits) in various disciplines including Gastroenterology, Endocrinology, Internal Medicine, Oncology, Ophthalmology, and Pulmonology. 5000 5000 0 Facey supports select 501(c)(3) organizations through contributions to their various programs. In 2016 $5,000 was paid to support the 2016 Mathies Award for Vision and Excellence in Healthcare Leadership. 5000 5000 0 220900344 1 1 0 1 0 0 0 0 0 0 1 0 0 0 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 1 0 1 0 0 0 1 X 71 0 1 1392 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 0 0 1 1 CA X Karl E Fritschel CPA 4255253339 1801 Lind Ave SW 9016 Renton WA 980579016 X Richard Blair Chair - Eff. 7/16 0.10 4.60 X X 0 30180 0 Dave Olsen Vice Chair - Eff. 7/16 0.10 5.50 X X 0 24135 0 Dick P Allen Director - Eff. 7/16 0.10 2.00 X 0 15180 0 Isiaah Crawford Director 0.10 4.10 X 0 24360 0 Sister Lucille Dean SP Director - Eff. 7/16 0.10 2.10 X 0 0 0 Sister Diane Hejna CSJ RN Director - Eff. 7/16 0.10 1.90 X 0 0 0 Michael Holcomb Director /Chair Thru 6/16 0.10 5.30 X X 0 45360 0 Phyllis Hughes RSM Director 0.10 5.00 X 0 0 0 Sallye Liner Director 0.10 4.70 X 0 20360 0 Mary Lyons PhD Director - Eff. 7/16 0.10 1.50 X 0 15180 0 Walter Noce Jr Director - Eff. 7/16 0.10 2.00 X 0 15180 0 Carolina Reyes MD Director 0.10 4.60 X 0 22860 0 Phoebe Yang Director - Eff. 7/16 0.10 2.00 X 0 12680 0 Fr Tom Kopfensteiner Director - Res. 12/16 0.10 2.00 X 0 6400 0 Chauncey Boyle SP Director - Thru 6/16 0.10 3.10 X 0 0 0 Marian Schubert CSJ Director - Thru 6/16 0.10 2.80 X 0 0 0 Michael A Stein Director - Thru 6/16 0.10 3.10 X 0 7680 0 Eugene Al Parrish Director - Thru 6/16 0.10 2.80 X 0 7680 0 Bob Wilson Director - Thru 6/16 0.10 2.90 X 0 9120 0 Martha Diaz Aszkenazy Director - Thru 6/16 0.10 3.90 X 0 9180 0 Kirby McDonald Director - Thru 6/16 0.10 2.80 X 0 7680 0 Charles Chuck Watts Director - Thru 6/16 0.10 2.80 X 0 9180 0 Rod F Hochman MD President / CEO - Thru 6/16 0.10 64.90 X 0 4060921 43543 Mike Butler President - Eff. 7/16 0.10 59.90 X 0 6906693 349633 Todd Hofheins EVP/CFO /Treas. Thru 11/16 0.10 59.90 X 0 1571440 60670 Jo Ann Escasa-Haigh EVP/CFO - Operations 0.10 49.90 X 0 755416 168190 Cindy Strauss EVP/Chief Legal Officer 0.10 59.90 X 0 1462780 58266 James Slaggert - Thru 716 President/ CE Medical Foundations 25.00 25.00 X 0 837912 32556 Bill Gil - 816 - 916 President/ CE Medical Foundations 10.00 40.00 X 0 660433 41838 Dave Mast - Eff 1016 President/ CE Medical Foundations 25.00 25.00 X 0 493846 155122 Jim Corwin CFO / Medical Foundation 29.00 31.00 X 0 556281 39811 Debra Canales EVP/CAO 0.10 59.90 X 0 2092357 611609 Janice Newell SVP/Chief Information Officer 0.10 59.90 X 0 1137493 34098 Joel Gilbertson SVP/Community Partnerships 0.10 59.90 X 0 842027 247847 Orest Holubec SVP/Chief Comm./Ext. Affairs Officer 0.10 54.90 X 0 782688 207806 Greg Till VP/Chief Talent Officer 0.10 64.90 X 0 776011 122367 Sharon Toncray SVP / Chief Labor Employee Counsel 0.10 59.90 X 0 764977 243728 Jack Mudd - Thru 316 SVP/Mission Leadership 0.10 28.90 X 0 718728 157778 Paul Stoddart - Thru 916 VP/Marketing 0.10 54.90 X 0 641423 22381 David Brown VP/Strategy & Business Development 0.10 54.90 X 0 700461 226430 Debbie Burton SVP/ Chief Nrsg. Officer 0.10 59.90 X 0 713480 90015 Karl Carrier Interim CE/CA. Region 0.10 59.90 X 0 666411 0 Mary Cranstoun VP/Total Rewards 0.10 59.90 X 0 663031 114417 Aaron Martin SVP/Strategy & Innovation 0.10 69.90 X 0 852934 219285 Tom McDonagh VP/Chief Investment Officer 0.10 57.90 X 0 849462 53521 Rhonda Medows MD EVP/Population Health 0.10 59.90 X 0 1565700 320279 Harvey Smith SVP/Chief Customer Svc. Officer 0.10 49.90 X 0 1226156 23791 Lisa Vance SVP/Clinical Program Services 0.10 59.90 X 0 1220348 125445 Mike Waters VP,CAO/Physician Services 0.10 64.90 X 0 703777 184023 Erik Wexler - Eff 516 CE/CA Region 0.10 64.90 X 0 1358828 359677 Amy Compton-Phillips EVP/Chief Clinical Officer 0.10 54.90 X 0 1113493 278894 Mari Zagrzejewski Admin Dir, Managed Care 40.00 0.00 X 272427 0 20044 Thomas McDevitt Assoc. CFO Med. Foundations 40.00 0.00 X 259683 0 42702 Margie J Melby Admin Dir, Controller 40.00 0.00 X 215521 0 16203 Cathy Hawes Admin Dir, Operations 40.00 0.00 X 187815 0 17327 Susan Slack Admin Dir, Revenue Cycle 40.00 0.00 X 181912 0 14475 Michael Hunn Former /CE / CA. Region 0.00 0.00 X 0 385737 1110 Jack Friedman - Former SVP/Accountable Care & Payor Rel. 0.00 0.00 X 0 299327 0 Randy Axelrod MD - Former EVP/Clinical & Patient Services 0.00 0.00 X 0 1419333 0 1117358 39082299 4704881 69 1 1 0 Facey Medical Group 15451 San Fernando Mission Blvd200 Mission Hills CA 91345 Medical Provider 104384561 Erdman Company PO Box 88670 Milwaukee IL 53288 Construction 3401217 Providence Holy Cross Med Ctr 15031 Rinaldi Street Mission Hills CA 91345 Medical Provider 1745557 Medispec Facility Services Inc 16700 Valley View Ave 130 La Mirada CA 90621 Janitorial Services 1221538 Quest Diagnostics 8401 Fallbrook Ave West Hills CA 91304 Lab Services 1139386 37 190165 10000 200165 Capitation Revenue 621110 153477912 153477912 Primary Care Revenue 621110 48889482 48889482 Clinical Research 621110 392810 392810 HealthCare JVs 900099 123213 123213 202883417 583551 583551 248001 0 248001 248001 248001 11156837 1050 10721621 0 435216 1050 436266 436266 Medical Records 900099 99656 99656 Purchase Discounts 900099 61602 61602 16413 16413 177671 204529071 202983073 0 1345833 X 5000 5000 59812012 55668234 4143778 387984 361104 26880 4340432 4039727 300705 513733 513733 11250 11250 21790 21790 94470 94470 120118191 119288354 829837 414889 332593 82296 2821166 1899190 921976 2027637 1664398 363239 20250491 17691455 2559036 112205 83095 29110 66425 63324 3101 7128550 3570731 3557819 809165 761595 47570 Medical Supplies 12855734 12855734 Bad Debt 2443631 2443631 Bank Charges 347584 347584 Dues & Subscriptions 102660 80146 22514 98625 92033 6592 234783624 220900344 13883280 0 13150 17350 20234661 32021376 11691193 8989471 2050185 1521839 2774340 1742568 66748861 28062628 39837143 38686233 18721421 21648116 378962 415575 7153727 6673129 31775 1287058 102886557 113002715 11312461 12456455 638001 49925710 87762185 61876172 100218640 X 41010385 12784075 41010385 12784075 102886557 113002715 -30254553 2028243 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 21790 21790 0 Part II-B, Line 1: Facey Medical Foundation paid membership dues to the California Association of Physician Groups ("CAPG"). A portion of the dues paid are utilized by that organization for lobbying activities. 25838995 5644438 20194557 35266914 22418190 12848724 5642952 5642952 38686233 Due to Facey Medical Group 9983665 Due To Affiliates 56733210 Deferred Rent Obligation 19305310 Liability for Medical Malpractice 1740000 87762185 X X X X 1 1 0 0 0 0 0 0 0 Rod F Hochman MD President / CEO - Thru 6/16 0 1912650 0 2130271 0 18000 0 25159 0 18384 0 4104464 0 0 Mike Butler President - Eff. 7/16 0 1241463 0 5618732 0 46498 0 324347 0 25286 0 7256326 0 2182191 Todd Hofheins EVP/CFO /Treas. Thru 11/16 0 765052 0 762582 0 43806 0 33684 0 26986 0 1632110 0 0 Jo Ann Escasa-Haigh EVP/CFO - Operations 0 284195 0 465096 0 6125 0 158719 0 9471 0 923606 0 0 Cindy Strauss EVP/Chief Legal Officer 0 657902 0 762672 0 42206 0 35775 0 22491 0 1521046 0 0 James Slaggert - Thru 716 President/ CE Medical Foundations 0 294812 0 238843 0 304257 0 7444 0 25112 0 870468 0 0 Bill Gil - 816 - 916 President/ CE Medical Foundations 0 430420 0 212013 0 18000 0 20736 0 21102 0 702271 0 0 Dave Mast - Eff 1016 President/ CE Medical Foundations 0 376446 0 117400 0 0 0 145708 0 9414 0 648968 0 0 Jim Corwin CFO / Medical Foundation 0 309044 0 229237 0 18000 0 19963 0 19848 0 596092 0 0 Debra Canales EVP/CAO 0 801127 0 1168376 0 122854 0 598119 0 13490 0 2703966 0 0 Janice Newell SVP/Chief Information Officer 0 576214 0 517269 0 44010 0 18550 0 15548 0 1171591 0 0 Joel Gilbertson SVP/Community Partnerships 0 443246 0 350838 0 47943 0 224819 0 23028 0 1089874 0 0 Orest Holubec SVP/Chief Comm./Ext. Affairs Officer 0 396372 0 343782 0 42534 0 185290 0 22516 0 990494 0 0 Greg Till VP/Chief Talent Officer 0 396660 0 378331 0 1020 0 99936 0 22431 0 898378 0 0 Sharon Toncray SVP / Chief Labor Employee Counsel 0 408183 0 308273 0 48521 0 221561 0 22167 0 1008705 0 0 Jack Mudd - Thru 316 SVP/Mission Leadership 0 249590 0 426247 0 42891 0 141404 0 16374 0 876506 0 0 Paul Stoddart - Thru 916 VP/Marketing 0 239356 0 306938 0 95129 0 11537 0 10844 0 663804 0 0 David Brown VP/Strategy & Business Development 0 388819 0 311642 0 0 0 203986 0 22444 0 926891 0 0 Debbie Burton SVP/ Chief Nrsg. Officer 0 355010 0 315852 0 42618 0 66297 0 23718 0 803495 0 0 Karl Carrier Interim CE/CA. Region 0 666411 0 0 0 0 0 0 0 0 0 666411 0 0 Mary Cranstoun VP/Total Rewards 0 372857 0 272174 0 18000 0 91147 0 23270 0 777448 0 0 Aaron Martin SVP/Strategy & Innovation 0 542637 0 292297 0 18000 0 210328 0 8957 0 1072219 0 0 Tom McDonagh VP/Chief Investment Officer 0 478005 0 330119 0 41338 0 28774 0 24747 0 902983 0 0 Rhonda Medows MD EVP/Population Health 0 824899 0 698359 0 42442 0 299110 0 21169 0 1885979 0 0 Harvey Smith SVP/Chief Customer Svc. Officer 0 579168 0 628988 0 18000 0 7950 0 15841 0 1249947 0 0 Lisa Vance SVP/Clinical Program Services 0 571069 0 606964 0 42315 0 110502 0 14943 0 1345793 0 0 Mike Waters VP,CAO/Physician Services 0 426739 0 274903 0 2135 0 172012 0 12011 0 887800 0 0 Erik Wexler - Eff 516 CE/CA Region 0 521453 0 600000 0 237375 0 347285 0 12392 0 1718505 0 0 Amy Compton-Phillips EVP/Chief Clinical Officer 0 713661 0 303268 0 96564 0 251731 0 27163 0 1392387 0 0 Mari Zagrzejewski Admin Dir, Managed Care 139533 0 29072 0 103822 0 8928 0 11116 0 292471 0 0 0 Thomas McDevitt Assoc. CFO Med. Foundations 196328 0 45355 0 18000 0 27226 0 15476 0 302385 0 0 0 Margie J Melby Admin Dir, Controller 160122 0 48158 0 7241 0 7817 0 8386 0 231724 0 0 0 Cathy Hawes Admin Dir, Operations 163473 0 24342 0 0 0 8478 0 8849 0 205142 0 0 0 Susan Slack Admin Dir, Revenue Cycle 159139 0 22773 0 0 0 6780 0 7695 0 196387 0 0 0 Michael Hunn Former /CE / CA. Region 0 0 0 0 0 385737 0 1110 0 0 0 386847 0 0 Jack Friedman - Former SVP/Accountable Care & Payor Rel. 0 0 0 299327 0 0 0 0 0 0 0 299327 0 0 Randy Axelrod MD - Former EVP/Clinical & Patient Services 0 0 0 564384 0 854949 0 0 0 0 0 1419333 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. Facey executives adhere to the Providence Expense Reimbursement Procedures which 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 22 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 5 Key Employees 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 4 Officers, 13 Key Employees and 2 Former Key Employees 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 5 Key Employees 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 NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) DCRP = Defined Contribution Restoration Plan 1) Rod Hochman, MD a) SERP Earned but not Paid - $71,434 2) Cindy Strauss a) SERP Earned but not Paid - $23,073 3) Michael Butler a) SERP Vested but not Paid - $4,194,363 b) SERP Interest Credit - $280,622 4) Jo Ann Escasa-Haigh a) SERP Earned but not Vested - $144,759 5) James Slaggert a) SERP Interest Credit - $3,469 6) Bill Gil a) SERP Paid - $17,850 7) Dave Mast a) SERP Vested but not Paid - $100,675 b) SERP Interest Credit - $15,822 8) Jim Corwin a) Taxable DCRP - $42,791 9) Debra Canales a) SERP Earned but not Vested - $578,244 10) Rhonda Medows, MD a) SERP Earned but not Vested - $267,369 b) SERP Interest Credit - $11,866 11) Erik Wexler a) SERP Earned but not Vested - $339,335 12) Lisa Vance a) SERP Interest Credit - $79,015 13) Janice Newell a) SERP Earned but not Paid - $23,422 14) Amy Compton-Phillips a) SERP Earned but not Vested - $223,438 b) SERP Interest Credit - $8,418 15) Aaron Martin a) SERP Earned but not Vested - $188,376 16) Joel Gilbertson a) SERP Earned but not Vested - $160,455 b) SERP Interest Credit - $39,169 17) Orest Holubec a) SERP Earned but not Vested - $144,707 b) SERP Interest Credit - $19,483 18) Greg Till a) SERP Earned but not Vested - $78,010 b) SERP Interest Credit - $10,002 19) Sharon Toncray a) SERP Earned but not Vested- $172,369 b) SERP Interest Credit - $22,823 20) Jack Mudd a) SERP Earned but not Paid - $5,896 b) SERP Interest Credit - $115,845 21) Debbie Burton a) SERP Earned but not Paid - $16,879 b) SERP Interest Credit - $37,391 22) Mike Waters a) SERP Earned but not Vested - $143,129 b) SERP Interest Credit - $10,334 23) David Brown a) SERP Earned but not Vested - $134,921 b) SERP Interest Credit - $42,528 24) Mary Cranstoun a) SERP Earned but not Vested - $77,234 25) Paul Stoddart a) SERP Interest Credit - $8,530 26) Randy Axelrod, MD a) SERP Paid - $564,384 27) Thomas McDevitt a) Taxable DCRP - $2,828 Part I, Lines 4a-b SEVERANCE 1) James Slaggert - $214,099 2) Paul Stoddart - $77,130 3) Randy Axelrod - $850,776 4) Michael Hunn - $374,738 5) Mari Zagrzejewski - $67,090 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. Expenses in Excess of Revenues 2016-12-31 30254553 Cost 0 0 0 0 SCHEDULE N, PART II - SUBSTANTIAL CONTRACTION Facey Medical Foundation experienced a substantial contraction in Net Assets in 2016 as a result of reduced operating revenues and increased operating expenses.The organization is not ceasing operations. Form 990, Part VI, Section A, line 6 Providence Health System - Southern California, a California nonprofit religious corporation, is the sole corporate member. Form 990, Part VI, Section A, line 7a The Corporate Member may recommend to Providence Health & Services the following actions: A) To fix the number of Directors, appoint the Board of Directors and to remove such Directors of this Corporation at any time. B) To appoint and remove the President/CEO of this Corporation and to remove such President/CEO, with or without cause, after requesting a recommendation from the Board of Directors. Form 990, Part VI, Section A, line 7b The Corporate Member shall have the right to recommend to Providence Health & Services the following actions with respect to this Corporation and of any corporation or other legal entity of which this Corporation is the sole controlling member or shareholder: A) To adopt or change the mission, philosophy, or values. B) To amend or repeal the Articles of Incorporation or the Bylaws. C) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale, transfer, assignment, or encumbering of assets, if the amount involved in any such transaction is in excess of an amount specified from time to time by resolution of the Providence Member and to approve the sale or transfer of other property which may have either historical or religious significance. D) To approve the dissolution, liquidation, consolidation or merger with another corporation or entity. E) To approve on a consolidated system-wide basis the annual operating and capital budgets and approval of any deviations from such budget in excess of an amount or percentage specified from time to time by resolution of Providence Health & Services. F) To appoint the certified public accountants after receiving the recommendation of the Board of Directors and to receive the annual audit report from such accountants. G) To approve the initiation or closure of any major work. 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 single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its 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. Each year, the Board Chair conducts a formal performance evaluation of the President/CEO that considers input from the other directors and senior leaders reporting to the President. The evaluation is discussed with the Executive Compensation Committee and then a recommendation is made by the committee to the full Board. The Board Chair and the Chair of the Executive Compensation Committee also meet with an independent consultant to develop a salary recommendation; which is reviewed and approved first by the committee and then by the Board of Directors. Additionally, 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 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 Richard Blair - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Dave Olsen - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Dick P. Allen - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Isiaah Crawford - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Sister Lucille Dean, SP - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Sister Diane Hejna, CSJ, RN - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Michael Holcomb - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Phyllis Hughes, RSM - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Sallye Liner - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Mary Lyons, Ph.D. - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Walter Noce, Jr. - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Carolina Reyes, MD - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Phoebe Yang - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Fr. Tom Kopfensteiner - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Chauncey Boyle, SP - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Marian Schubert, CSJ - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Kirby McDonald - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Charles (Chuck) Watts - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Rod F. Hochman, MD - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Mike Butler - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Todd Hofheins - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Jo Ann Escasa-Haigh - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Cindy Strauss - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Debra Canales - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Janice Newell - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Joel Gilbertson - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Orest Holubec - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Greg Till - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Sharon Toncray - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Jack Mudd - Thru 3/16 - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Paul Stoddart - Thru 9/16 - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. David Brown - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Debbie Burton - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Mary Cranstoun - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Aaron Martin - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Tom McDonagh - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Rhonda Medows, MD - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Harvey Smith - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Lisa Vance - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Mike Waters - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Amy Compton-Phillips - 1801 Lind Avenue SW, #9016, Renton, WA 98057-9016. Form 990, Part IX, line 11g Medical Fees: Program service expenses 104,384,561. Management and general expenses 0. Fundraising expenses 0. Total expenses 104,384,561. Agency Labor: Program service expenses 386,457. Management and general expenses 61,409. Fundraising expenses 0. Total expenses 447,866. Repairs & Maintenance: Program service expenses 2,185,168. Management and general expenses 328,824. Fundraising expenses 0. Total expenses 2,513,992. Billing & Collections : Program service expenses 0. Management and general expenses 152,742. Fundraising expenses 0. Total expenses 152,742. Security Services: Program service expenses 630,786. Management and general expenses 24,731. Fundraising expenses 0. Total expenses 655,517. Other Patient Services: Program service expenses 11,080,887. Management and general expenses 0. Fundraising expenses 0. Total expenses 11,080,887. Other Departmental Services: Program service expenses 478,958. Management and general expenses 262,131. Fundraising expenses 0. Total expenses 741,089. Record Management: Program service expenses 141,537. Management and general expenses 0. Fundraising expenses 0. Total expenses 141,537. FORM 990, PART XII, LINE 2C - AUDIT & COMPLIANCE The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the System's consolidated financial statements and reporting, the audit process and the System's internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the System's internal and external auditors; the System's investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. FORM 990, SCHEDULE R - RELATED ORGANIZATIONS 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. FORM 990, SCHEDULE A, PART I, Line 3 and SCHEDULE H Although Facey Medical Foundation qualifies for public charity status for Schedule A purposes as an organization providing medical care pursuant to Internal Revenue Code section 170 (b)(1)(A)(iii) and Treasury Regulations Section 1.170A-9(d) (1) (ii), it is not required to file Schedule H with its Form 990 as it does not operate a facility required to be licensed, registered or similarly recognized by a state as a hospital. 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 Plan Partners 4400 NE Halsey Bldg 2 Portland OR 97213 911861964 Healthcare Services WA 501( c)(4) N/A PH & S - Oregon 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 0 Providence Health Assurance 4400 NE Halsey Bldg 2 Portland OR 97213 550828701 Medicaid Healthcare Provider OR 501( c)(4) N/A Providence Health Plan 0 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 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 System 0 St Jude Hospital Inc 101 East Valencia Mesa Drive Fullerton CA 92635 951643324 Healthcare CA 501 (C )(3) Line 3 Covenant Health Network 0 St Mary Medical Center 18300 Highway 18 Apple Valley CA 92307 951914489 Healthcare CA 501 (C )(3) Line 3 Covenant Health Network 0 St Mary Of The Plains Hospital Fdn 4000 24th Street Lubbock TX 79410 751653181 Healthcare TX 501 (C )(3) Line 7 Covenant Health System 0 St Joseph Health Northern California LLC 3345 Michelson Drive Irvine CA 92612 814791043 Healthcare CA 501 (C )(3) Line 3 St Joseph Health System 0 Sisters Of St Joseph Of Orange 480 S Batavia Orange CA 92868 951643383 Religious Org CA 501 (C )(3) Line 1 N/A 0 St Joseph Health Ministry 3345 Michelson Drive Suite 100 Irvine CA 92612 271666576 Religious Org CA 501 (C )(3) Line 1 Sisters of St Joseph of Orange 0 Kadlec Auxiliary Inc 888 Swift Blvd Richland WA 99352 916033089 Support Kadlec Regional Medical Center WA 501 (C )(3) Line 12, Type III Kadlec Regional Medical Center 0 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 Spokane WA 99202 261345983 Outpatient Lab MT N/A Oregon Advanced Imaging LLC 881 OHare Parkway Medford OR 97504 450471748 Medical Imaging OR N/A Oregon Outpatient Surgery Center 7300 SW Childs Rd Tigard OR 97224 223883387 Ambulatory Surgery Center OR N/A PacLab LLC 611 N Perry Spokane WA 99202 911743952 Outpatient Lab WA N/A Pathology Associates Medical Laboratories LLC 611 N Perry Spokane WA 99202 270943279 Outpatient Lab WA N/A PETCT Imaging at Swedish Cancer Institute LLC 1221 Madison Street Seattle WA 98104 203132044 Medical Imaging WA N/A Portland Medical Imaging LLC 4400 NE Halsey 495 Portland OR 97213 201054971 Imaging - Diagnostics OR N/A Prov Radiation Oncology Develop Assn LLC 4400 NE Halsey 495 Portland OR 97213 260682491 Real Estate - MOB OR N/A Providence Imaging Center 3340 Providence Drive Anchorage AK 99508 920118807 Medical Imaging AK N/A Providence Partners for Health LLC 501 S Buena Vista St Burbank CA 91505 454041798 Clinical Quality & Integration CA N/A Providence Surgery Center LLC 902 N Orange St Missoula MT 59802 841401625 Ambulatory Surgery Center MT N/A ProvidenceSilverton Rehab LLC 4400 NE Halsey 425 Portland OR 97213 481287267 Rehab Services OR N/A ProvidenceUSP Santa Clarita GP LLC 11550 Indian Hills Road 160 Mission Hills CA 91345 202829660 Ambulatory Surgery Center CA N/A ProvidenceUSP Surgery Ctrs LLC 11550 Indian Hills Road 160 Mission Hills CA 91345 200905938 Ambulatory Surgery Center CA N/A Southern Idaho Regional Laboratory LLC 611 N Perry Spokane WA 99202 820511819 Outpatient Lab ID N/A The Madison Spokane Inn LLC 15 West Rockwood Blvd Spokane WA 99204 841606484 Hotel Services WA N/A Tri-Cities Laboratory LLC 611 N Perry Spokane WA 99202 911773986 Outpatient Lab WA N/A HCSA Properties LLC 1600 M Street NW Auburn WA 98001 460620892 Real estate rental WA N/A Covenant Long-Term Care LP 4000 24th Street Lubbock TX 79410 205033419 Healthcare TX N/A Heritage Investment Group I LLC 500 S Main Street Ste 1000 Orange CA 92868 271000061 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 90503 461814184 Strategic Planning Services CA N/A C 0 Providence Health Network 20555 Earl Street Torrance CA 90503 800886966 Prepaid Healthcare CA N/A C 0 Pioneer Innovations Inc 800 5th Ave 10th Floor Seattle WA 98104 364818191 Healthcare Innovations WA N/A C 0 Vinserra Inc 1328 22nd Street Santa Monica CA 90404 953943315 Investment CA N/A C 0 American Unity Group Ltd 90 Pitts Bay Road HM08 Pembroke BD Captive Insurance BD N/A C 0 Coastal Management Services Organization 1 Hoag Drive Box 6100 Newport Beach CA 92658 330676831 Healthcare CA N/A C 0 Datu Health Inc 16150 Main Circle Dr Suite 250 Chesterfield MO 63017 463070062 IT Svcs DE N/A C 0 Hoag Management Services Inc 1 Hoag Drive Box 6100 Newport Beach CA 92658 330731587 Healthcare CA N/A C 0 Lubbock Methodist Hosp Practice Mgmt 2107 Oxford Street Ste 300 Lubbock TX 79410 752578995 Inactive TX N/A C 0 Lubbock Methodist Hospital Svcs PO Box 120 Lubbock TX 79410 752118585 Healthcare TX N/A C 0 Mission Viejo Medical Ventures 27800 Medical Center Rd 354 Mission Viejo CA 92691 330212905 Healthcare CA N/A C 0 St Joseph Health 3345 Michelson Drive Suite 100 Irvine CA 92612 462340232 Holding Company CA N/A C 0 St Joseph Health Source Inc 3345 Michelson Drive Suite 100 Irvine CA 92612 461900168 Healthcare CA N/A C 0 St Joseph Prof Svcs Enterprses Inc 3345 Michelson Drive Suite 100 Irvine CA 92612 330155323 Healthcare CA N/A C 0 Ophie Healthcare Services Inc 3345 Michelson Drive Suite 100 Irvine CA 92612 271002825 Healthcare CA N/A C 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 1