2017-01-24T14:41:04-06:00 2015-12-31 911194016 Clark Nuber PS 10900 NE 4th Suite 1700 Bellevue WA 98004 990 2015-01-01 911307555 INLAND NORTHWEST HEALTH SERVICES INLA 5092328100 PO BOX 469 SPOKANE WA 992100469 Helen Andrus CFO 5092328100 2017-01-24 1 Sara Elizabeth J Hyre CPA P00235495 4254544919 2015 2021-01-29 14:40:06Z Elaine Couture PO BOX 469 SPOKANE WA 992100469 150484323 0 X www.inhs.info X 1994 WA To provide unique, effective, affordable services using collaborative and innovative approaches for the benefits of the entire health care continuum. 6 3 1281 156 1051837 0 1545773 105432 108420832 117868859 15693 38052 29475464 31279247 139457762 149291590 497374 1262100 0 0 83388653 82548168 0 0 0 49200895 49307404 133086922 133117672 6370840 16173918 120009905 124665190 41612374 28564585 78397531 96100605 X To provide unique, effective, affordable services using collaborative and innovative approaches for the benefits of the entire health care continuum. 0 0 53981086 0 58672087 Inland Northwest Health Services, a not for profit corporation, provides collaborative, community-benefitting health care. With the guidance of its sole Member, Providence Health & Services-Washington, INHS provides unique, affordable services using collaborative and innovative approaches for the benefit of the entire health care continuum. These local, regional and national solutions improve efficiencies and health outcomes in rehabilitation and clinical services, critical care, transportation, information technology, health care education and other health care services, and incorporate the highest ideals from its Member's Christian heritage in the provision of medical care.St. Luke's Rehabilitation Institute specializes in comprehensive inpatient and outpatient therapy sessions for children and adults and provides rehabilitation treatment for stroke, spinal cord injuries, orthopedic issues and brain injuries. Conveniently located in Spokane, Washington, St. Luke's Rehabilitation Institute serves patients throughout the Inland Northwest including patients in central and eastern Washington, northern Idaho and western Montana. Committed to providing hope, quality of care and recovery, St. Luke's is the state's largest provider of rehabilitation services for stroke, spinal cord injury, head injury and injury or diseases to bones, joints or muscles. After illness or injury, there is a need to gain strength, skills and function to allow people to return to the highest quality of life possible. St. Luke's works as a team with patients and their families to achieve this goal. With a main campus located in downtown Spokane, St. Luke's combines compassionate care with expertise to provide inpatient physical rehabilitation services to patients of all ages. In addition to inpatient services at the main campus, St. Luke's also offers high quality outpatient rehabilitation services at several convenient locations.During 2015, St. Luke's Rehabilitation Institute served 30,000 people in acute care, inpatient, outpatient and in-home rehabilitation care settings. St. Luke's is Washington State's #1 rehabilitation provider based on 17,982 inpatient days. Also in 2015, in collaboration with Providence Occupational Medicine, St. Luke's Rehabilitation Institute expanded occupational rehabilitation services with a north Spokane clinic and established an occupational rehabilitation and outpatient therapy location in Spokane Valley.Northwest MedStar is the region's premier critical care transport service dedicated to the safe, compassionate care and transport of critically ill or injured patients to health care facilities throughout the Pacific Northwest. From its bases in Spokane, Tri-Cities, Moses Lake, the Palouse area, Brewster and Missoula, Northwest MedStar provides thousands of helicopter, fixed wing and ground-based transports each year with the highest level of advanced care.With a fleet of helicopters and fixed wing planes, Northwest MedStar is accredited by the Commission on Accreditation of Medical Transport Systems (CAMTS), the "seal of approval" for the air medical industry.During 2015, MedStar provided critical care transports to more than 5,800 adult and pediatric patients from six bases throughout the Northwest. Over 50,000 households are covered with the NW MedStar membership program, bringing financial peace of mind to families should they need to be transported. In addition, through the MedStar Alert mobile and desktop app, Northwest MedStar collaborated with 45 hospitals and 911 centers, and over 1,600 first responders in the field for streamlined access to critical care transports.With the goal of reducing disability and helping injured workers return to work safely while providing occupational health best practices, COHE Community of Eastern Washington is a collaboration between Washington State Department of Labor & Industries and St. Luke's Rehabilitation Institute. In 2015, COHE Community of Eastern Washington served in 19 counties throughout eastern Washington, processing 5,108 injured worker claims for employers in 19 counties while enrolling 302 new health care providers in the program based on best practices.The resource for better health, Community Wellness offers affordable health care coaching, classes, screenings and education both in the community and on the job. Dedicated to health and wellness, a wide variety of services are provided for improved health, well-being and quality of life. In 2015, Community Wellness, recognized as a Center of Disease Control and Prevention program, taught Group Lifestyle Balance to hundreds of people in our community. Additionally, Community Wellness served more than 100 participants with type 2 diabetes with free workshops, Living Well with Diabetes, in 11 community centers in Spokane.INHS Health Training is committed to helping health care professionals maintain and advance skills and stay up-to-date of the latest medical advances that are vital to quality care and improved patient outcomes for healthier communities. In 2015, Health Training's American Heart Association Community Training Center aligned with 1,945 instructors who trained 29,000 community members in the life-saving skill of CPR. Health Training also welcomed its fourth paramedic program class while maintaining a 100 percent pass rate for the National Registry Test (NREMT). They were also awarded a national five-year accreditation for the Emergency Medical Technician (EMT), Advanced Emergency Medical Technician (AEMT), and Paramedic programs by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). In addition, INHS Health Training collaborated with organizations like Central Valley School District and Spokane Valley Fire to hold an emergency medical technician (EMT) training program for high school students enrolled in the Fire Science Program, ensuring these students graduate as certified EMTs.Northwest TeleHealth is a robust video conference network providing a platform for collaborative health care throughout the region. The network delivers secure and confidential connectivity for interaction between two or more locations involved in patient consults, health care administration, medical education, training and other related activities. Improving access to care in 2015, Northwest TeleHealth provided a platform for telemedicine service delivery of behavioral health, wound care, genetics and stroke support to rural patients. 30183149 0 32806089 Acute Inpatient Services - see line 4a. 27026988 0 29375655 Engage, a division of INHS, represents a progression in health care IT that originated from within the environments of 10 competitive hospitals. The company provides a complete solution to IT consulting, implementation and management, and is driven by a passion for embracing the toughest challenges.In 2015, Engage secured 10 percent of the U.S. MEDITECH market share, working with 120 hospitals across the country, 35 new customers in 2015 and became the first vendor in the nation to commercially host and manage MEDITECH's 6.1 electronic medical record software and implement an industry-first EMR cloud backup and archive technology. In addition, Engage fully implemented ICD-10 medical coding for 15 customers, completed Meaningful Use (MU) attestations for 30 hospitals, supported 25 facilities in passing federal MU audits, and assisted in submitting PQRS reports for providers, ensuring that hospitals and providers are meeting requirements for advanced patient care and quality. 1353278 0 1470879 Other Service Revenue - see line 4a. 1262100 1262100 0 Grants & Allocations - See Schedule I. 2615378 1262100 1470879 113806601 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 160 0 1 1281 1 1 1 0 0 0 0 0 0 0 0 0 X 6 3 0 0 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 X Karl E Fritschel CPA 4255253339 2001 Lind Avenue SW 9016 Renton WA 980579016 R Ronald Wells Chair and Treasurer 2.00 0.00 X X 0 0 0 Gary A Livingston PhD Vice Chair & Secretary 2.00 0.00 X X 0 0 0 Mike Reilly Director 2.00 0.00 X 0 0 0 Jeff Collins MD Director 2.00 48.00 X 0 484082 42635 Todd Hofheins Director 0.10 64.90 X 0 970092 295713 Aaron Martin Director 0.10 64.90 X 0 681696 189399 Frederick Lee Galusha Engage Chief Executive 50.00 0.00 X 406362 0 20169 Nancy Vorhees Chief Administrative Officer 50.00 0.00 X 233532 0 15659 Phyllis Anita Gabel Chief Human Resource Officer 50.00 0.00 X 221498 0 2999 Elaine Couture CEO 2.00 58.00 X 0 988860 92132 Helen Andrus CFO 2.00 48.00 X 0 298883 33239 Ulrike Berzau Administrator 40.00 0.00 X 190727 0 2056 Michael Smyly Chief Bus. Dev. Officer 40.00 0.00 X 235009 0 18975 Daniel Engle Senior Director 40.00 0.00 X 201373 0 11747 Nancy Webster Hospital Administrator 40.00 0.00 X 193807 0 14493 Marcia Cheadle Senior Director 40.00 0.00 X 187474 0 13243 Gregory Carter CMO 40.00 0.00 X 337805 0 18973 Vivian M Moise Physiatrist 40.00 0.00 X 271514 0 18253 Roger Stevens Chief Hospital Applications 40.00 0.00 X 214601 0 14098 Mark S Gordon Physiatrist 40.00 0.00 X 286161 0 16930 Patrice Stevenson Physiatrist 40.00 0.00 X 271004 0 12869 Steven Goodman Physiatrist 40.00 0.00 X 182584 0 15381 Tom Fritz Former CEO 0.00 0.00 X 679183 0 6688 John Craig Jr Former CFO 0.00 0.00 X 322448 0 4077 4435082 3423613 859728 147 1 1 0 Metro Aviation Inc 1214 Hawn Avenue Shreveport LA 71107 Aviation Services 12239050 GE Healthcare IITS USA Corp 40 IDX Drive South Burlington VT 05403 Healthcare IT Services 521825 Mediware Information Systems Inc 11711 W 79th Street Lenexa KS 66214 Healthcare IT Services 437798 Cerium Networks Inc 1636 W 1st Avenue Spokane WA 99201 Healthcare IT Services 412329 Health Care Systems Inc 5755 Carmichael Parkway Montgomery AL 36117 Healthcare IT Services 388097 43 92932 12500 105432 Acute Care Outpatient 621400 56534873 56534873 Acute Care Inpatient 900099 31611081 31611081 Info Resource Mgmnt. 541519 28305605 27318741 986864 Other Service Revenue 900099 1417300 1417300 117868859 12152 12152 2037133 1185383 851750 851750 851750 33250 7350 25900 25900 25900 Affil. Info Res. Mgmt. 541519 13124634 13124634 Contract Staff Service 900099 10039657 10039657 MedStar Premiums 900099 2148789 2148789 5114417 2307062 64973 2742382 30427497 149291590 121337846 1051837 26796475 X 1262100 1262100 2304978 558902 1746076 1012241 1012241 64237163 56692900 7544263 3621610 3114463 507147 6504843 5527943 976900 4867333 4139049 728284 154549 154549 5254 5254 20756216 19307997 1448219 304995 261988 43007 6137727 4657640 1480087 1341105 965596 375509 1087793 885060 202733 1327797 1045838 281959 231302 231302 2576942 1974530 602412 4621816 2867452 1754364 392139 339294 52845 Bad Debt 5782527 5782527 Taxes & Licenses 2174011 1861678 312333 Medical Supplies 1493462 1493462 Dues & Subscriptions 202463 174571 27892 717306 662309 54997 133117672 113806601 19311071 0 3294073 3108827 5196076 31744 6948885 9535932 163654 175379 394640 497494 156577025 59606895 95154423 96970130 307334 578304 59866 13687030 8571304 120009905 124665190 20078728 10584422 16482 3078047 3743742 5951284 5633405 12504315 8586534 41612374 28564585 X 77763173 95507924 612788 571111 21570 21570 78397531 96100605 120009905 124665190 X 16173918 1529156 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21570 21570 21570 21570 21570 21570 21570 21570 21570 21570 0.00000 1.00000 0.00000 0 0 1372797 1372797 15873776 54072169 20096594 49849351 63400 12021 51379 24669 77283557 39498280 37809946 7886657 7886657 96970130 Other Miscellaneous Receivables 5516070 Unamortized Finance Costs 55534 Due from Affiliates 2999700 8571304 7105723 Third Party Settlements 1073667 Due to Affiliates 407144 8586534 X Part V, Line 4: Earnings from the Endowment are to be used for Team St. Luke's (Wheelchair Sports) activities. Part X, Line 2: Providence Health & Services, the Health System, recognizes the effect of income tax positions only if those positions are more likely than not of being sustained upon an audit by the taxing authority. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. 1 1 1 X 1 X 1 1 0 1 1 282779 282779 0.00220 4805290 4805290 0.03770 5088069 5088069 0.03990 113193 113193 0.00090 541237 541237 0.00430 45661 45661 0.00040 44905 44905 0.00040 744996 744996 0.00600 5833065 5833065 0.04590 1 5782527 41071705 40422671 649034 X 1 1 1 1 St Luke's Rehabilitation Institute 711 S Cowley Street Spokane WA 99202 www.st-lukes.org 157 X St Luke's Rehabilitation Institute 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X www.st-lukes.org/CHNA/ X 1 13 1 st-lukes.org/uploadedFiles/About_Us/CHNA/CHNA%20Report.pdf 0 0 1 X 150.000000000000 300.000000000000 X X X X X X 1 1 X X X 1 X www.st-lukes.org/Patient-Accounts/ X www.st-lukes.org/Patient-Accounts/ X www.st-lukes.org/Patient-Accounts/ X X X X 1 X 0 X X X X 0 X X 0 0 St. Luke's Rehabilitation Institute Part V, Section B, Line 5: Prioritized needs were presented to the Spokane Regional Community Health Assessment Board on May 8, 2015. This group consists of various agencies interested in coordinating a communitywide needs assessment. Members endorsed the selection of needs that Providence facilities had selected to address.Community Health Assessment Board members:-Adams County Health Department-Better Health Together-Community Health Systems-Rockwood-Eastern Washington University-EWU Institute for Public Policy & Economic Analysis-Empire Health Foundation-Gonzaga University-Spokane Regional Health District-Washington State University-Providence Health Care-St. Luke's Rehabilitation InstitutePrioritized needs were presented to the Spokane Homeless Coalition on July 9, 2015. This group consists of various agencies interested in addressing the needs of the homeless population within Spokane County. Many of the participants at this meeting were interested in how Providence would specifically respond to the need for stable housing. They were in agreement with many of the other needs, but as expected were interested in how Providence interpreted stable housing.Spokane Homeless Coalition members:-Aging and Long Term Care of Eastern Washington-Amerigroup-Center for Justice-Children's Administration-City of Spokane-City of Spokane-Public Defender-Community Health Plan of Washington-Family Promise of Spokane-Frontier Behavior Health-Homeless Outreach-Gathering Place-House of Charity-Martin Luther King Jr. Center-Molina Health Care-NW Justice Project-Priority Spokane-Safe Families for Children-Spokane COPS-Spokane Police Department-Transitional Programs for Women - New Leaf Bakery-Women's Hearth-Worksource-YWCAPrioritized needs were presented to Priority Spokane Steering Committee on July 15, 2015. This group consists of leaders developing and initiating a collective impact model to address high priority needs. Currently, the group is focused on homeless and at-risk youth and how to increase graduation rates for this population. They were in agreement with the use of the community data and how Providence defines its role in addressing these overall community needs.Priority Spokane Steering Committee participants:-Avista-Eastern Washington University-Institute of Public Policy-Whitworth University ESD 101-Gonzaga University-Department of Education-Inland Northwest Community Foundation-Rogers High School-Spokane County-Spokane Housing Authority-Spokane Regional Health District-United Way-Washington State University St. Luke's Rehabilitation Institute Part V, Section B, Line 6a: Providence Health Care St. Luke's Rehabilitation Institute Part V, Section B, Line 11: After prioritizing the top issues from the needs assessments, community surveys and gaps, the local Providence system chose to focus on the following 5 areas in the health improvement plan implementation strategies. With broad community endorsement for the needs identified by Providence to address with implementation strategies, St. Luke's augmented the 2015 Providence CHNA with additional information from further community input on health issues affecting the community that St. Luke's serves and ranked them in the following order:1. Mental Health2. Diabetes3. Immunizations4. Dental Care5. Stable Housing St. Luke's Rehabilitation Institute Part V, Section B, Line 13b: The organization uses FPG to determine the patient's eligibility for free or discounted care. In addition, the organization will review family assets, including bank statements; the patient's future earning capacity; the existence of other extraordinary family expenses, including rent expenses; and the patient's ability to make payments over time, as reflected by a third party credit report or other documentation. St. Luke's Rehabilitation Institute Part V, Section B, Line 22d: The hospitals used the average of the largest negotiated commercial insurance rate. 9 1 - Northwest MedStar 6315 E Rutter Ave Spokane WA 99212 Air and ground ambulance 2 - Occupational Rehabilitation - South 421 South Division St Spokane WA 99202 Outpatient 3 - MUV Fitness - Downtown 809 West Main St Spokane WA 99201 Physical therapy 4 - MUV Fitness - South 5501 South Regal St Spokane WA 99223 Physical therapy 5 - St Luke's North 235 E Rowan Ave Suite 210 Spokane WA 99207 Outpatient 6 - MUV Fitness - North 603 East Holland Ave Spokane WA 99218 Physical therapy 7 - Occupational Rehabilitation - North 551 E Hawthorne Rd Spokane WA 99218 Outpatient 8 - Occupational Rehabilitation Valley 16528 E Desmet Court Suite 1600 Spokane WA 99016 Outpatient 9 - MUV Fitness - Valley 14927 East Sprague Ave Spokane WA 99216 Physical therapy Part I, Line 3c: The organization uses FPG to determine the patient's eligibility for free or discounted care. In addition, the organization will review family assets, including bank statements; the patient's future earning capacity; the existence of other extraordinary family expenses, including rent expenses; and the patient's ability to make payments over time, as reflected by a third party credit report or other documentation. Part I, Ln 7 Col(f): Bad debt expense represents the amount of gross charges for patients who do not have insurance and which INHS was unable to qualify for assistance under either government programs or our internal charity care policy. The Bad Debt expense included on Form 990, Part IX, Line 25(A), but subtracted for purposes of calculating the percentage in this column is $5,782,527. Part II, Community Building Activities: INHS embraces its responsibility to provide for the needs of the communities it serves. Health care is fundamentally different from most other goods and services. It is about the most human and intimate needs of people, their families and communities. This critical difference is why we should work together to preserve and strengthen the not-for-profit sector in health care.INHS is actively involved with public, private and other health systems in working towards better health outcomes for the entire community.The organization did not track or report the financial impact of their community building activities.INHS oversees a variety of health care divisions and services that work together to improve outcomes, lead the way in health care innovation and create healthier communities:-St. Luke's Rehabilitation Institute: Provides accredited inpatient and outpatient physical rehabilitation services at the state's only freestanding hospital.-Engage: Sets the national standard in how health information technology improves a community's patient care and lowers costs.-Northwest MedStar: Provides safe, compassionate care and air transport of critically ill or injured patients to health care facilities throughout the Northwest.Community Wellness: Improves the health of the community through screenings, assessments, involvement and education.-Northwest TeleHealth: Links the region to a variety of resources at 115 locations over a robust telemedicine, video-conferencing network.-Health Training: Provides and coordinates medical training for health care professionals throughout the Inland Northwest.-COHE Community of Eastern Washington: Works cooperatively in developing programs to improve the quality, cost effectiveness and consistency of care for injured workers. Part III, Line 2: Bad debt expense represents the amount of gross charges for patients who do not have insurance and which INHS was unable to qualify for assistance under either government programs or our internal charity care policy. Part III, Line 4: The Health System provides for an allowance against patient accounts receivable for amounts that could become uncollectible. The Health System estimates this allowance based on the aging of accounts receivable, historical collection experience by payor, and other relevant factors. There are various factors that can impact the collection trends, such as changes in the economy, which in turn have an impact on unemployment rates and the number of uninsured and underinsured patients, the increased burden of copayments to be made by patients with insurance coverage and business practices related to collection efforts. These factors continuously change and can have an impact on collection trends and the estimation process used by the Health System. The Health System records a provision for bad debts in the period of services on the basis of past experience, which has historically indicated that many patients are unresponsive or are otherwise unwilling to pay the portion of their bill for which they are financially responsible. Part III, Line 8: It is organization's policy to exclude any Medicare shortfall from Community Benefit information.The amount reported on Part III, Section B, line 6, was determined by applying the Cost-to-Charge Ratio to the Medicare revenue. Part III, Line 9b: INHS follows standard collection practices and complies with governing laws, regulations and authorities, including WAC Title 246 Chapter 453, Hospital Charity Care.Charity is re-screened throughout the revenue cycle when account events, such as patient-initiated contact requesting alternative payment options, trigger review. A guarantor may submit a charity care discount application at any point in the revenue cycle, from pre-admission to final payment of the bill. The patient application process is not a requirement for charity eligibility review of accounts with characteristics identified for charity approval. Part VI, Line 2: In September 2013 a consortium of community partners, including members from the parent organization for St. Luke's, Providence Health Care, met with staff from Priority Spokane and the Spokane Regional Health District to begin planning for a 2015 needs assessment. There is a significant desire for the community to come together for one communitywide needs assessment, in which health would be one factor. Priority Spokane had conducted a community needs assessment at the end of 2013. The community consortium agreed to use this data and enhance it with newer data including preliminary quality of life survey data, hospital homeless and marginalized patient data and the Spokane Counts report.The purpose of the 2013 needs assessment was to prioritize the needs of the community, especially among those living in poverty and with least access to resources, and to promote collaborative opportunities to improve health and well-being in Spokane County. Over 300 email invitations were extended to community members, including the corporation of which St. Luke's is a division, Inland Northwest Health Services, to participate in one of five task force committees: Healthy People; Education; Economic Vitality; Public Safety; and Environment.Using the results from the community vote and grouping similar areas of work, the finalfive priorities for the 2013 CHNA were:-Accelerate to a high-performing economy-Ensure that all our children are ready for kindergarten-Increase the accessibility, resources, and attitudes regarding mental health-Improve educational attainment-Increase the percent of population with healthy weights by among others, promoting walking, biking and transit use.To update this to 2015 data, Providence Health Care, the organization for which St. Luke's is an affiliate, conducted an electronic survey of those individuals and organizations who participated in the task force vote of the top needs for the 2013 CHNA. There was overwhelming support for all of the needs remaining as issues to continue to be addressed. Part VI, Line 3: Information regarding the INHS charity care policy, including the appropriate forms, is posted on the website for patients to access. In addition, hard-copy versions are available at the point of service; information about payment options, scholarships and charity care are included in the information sent to patients regarding their bill and staff members are trained to work with patients who need assistance in determining how they can apply for government assistance, scholarships and/or charity care. Part VI, Line 4: St. Luke's Rehabilitation Institute, located in Spokane, Washington, is a private, not-for-profit, 102-bed postacute care hospital specializing in medical rehabilitation for people with neurological or orthopedic injuries and illnesses. It is the only free-standing inpatient rehabilitation facility in Spokane County, and the region's only Level I trauma rehabilitation hospital.Population and age demographics:The total population of Spokane County is about 485,000, with an annual growth rate of about 0.9 percent in 2014. Age demographics are fairly evenly distributed, with the oldest age group comprising the smallest proportion of the population. Ethnicity:Among Spokane County residents in 2013, 90 percent were white, 2.2 percent African American, 1 percent American Indian, 2.8 percent Asian/Pacific Islander, and 4.5 percent were of two or more races.Income levels and housing:In 2013, the median household income for Spokane County was $47,576, and the county's unemployment rate was 7.8 percent. The share of those with incomes below the federal poverty line for all ages in Spokane County was 15.9 percent in 2012. In the same time frame, 19 percent of Spokane County youth under age 18 were living below the federal poverty line. This represents an increase of 1.6 percent since 2009, and is higher than the state average but lower than the national average.Health care and coverage:The share of Spokane county residents who are ages 64 and younger and uninsured was 16.5 percent in 2012. The top three causes of death in Spokane County were heart disease at 23 percent, cancer at 20.1 percent, and stroke at 4.4 percent. Heart disease and strokes are on a decreasing trend while cancer is increasing. Avoidable hospital admissions in Spokane County have decreased to 8.8 percent in 2012. Part VI, Line 5: INHS provides medical care to the community regardless of the patients' ability to pay. The mission of INHS includes charitable activities such as free care to the needy and care at discounted charges to below cost for Federal and state government sponsored programs. INHS promotes the health of the community by offering many health education programs and support groups. A division of INHS is MedStar which operates an air ambulance service to improve the outcomes of emergency medical situations. Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEM:The Health System owns or operates 34 general acute care hospitals, three ambulatory care centers, six medical groups, six long term care facilities, seven homecare and hospice entities, five assisted living facilities, a high school, a university, 13 low income housing projects, the Health Plan, a health services contractor, two programs of all inclusive care for the elderly, and 23 controlled fundraising foundations.The Health System provides inpatient, outpatient, primary care, and home care services in Alaska, Washington, Montana, Oregon, and Southern California. The Health System operates these businesses primarily in the greater metropolitan areas of Anchorage, Alaska; Seattle, Spokane, Kennewick, and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California Part VI, Line 7, Reports Filed With States WA 1 Providence Health Care Foundation Eastern Washington PO Box 2555 Spokane WA 99220 320014330 501 (c)(3) 1217195 Transfer of IHNS Foundation American Heart Association Inc PO Box 4002030 Des Moines IA 50340 135613797 501 (c)(3) 10000 Support for heart disease and stroke 2 0 Part I, Line 2: In the application for support/financial aid, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds were used, along with a report of the number of children/families served over the year. Grants made to affiliated foundations are monitored on a monthly basis since the financial statements of these organizations are readily available. Other grants are made that comply with the mission and further the tax exempt purpose of the organization X 1 1 1 1 0 0 0 0 0 0 0 Jeff Collins MD Director 0 380093 0 75815 0 28174 0 26276 0 16359 0 526717 0 0 Todd Hofheins Director 0 704452 0 247640 0 18000 0 269139 0 26574 0 1265805 0 0 Aaron Martin Director 0 512696 0 151000 0 18000 0 182349 0 7050 0 871095 0 0 Frederick Lee Galusha Engage Chief Executive 340430 0 63673 0 2259 0 17138 0 3031 0 426531 0 0 0 Nancy Vorhees Chief Administrative Officer 204389 0 17546 0 11597 0 14713 0 946 0 249191 0 0 0 Phyllis Anita Gabel Chief Human Resource Officer 42570 0 29505 0 149423 0 2778 0 221 0 224497 0 0 0 Elaine Couture CEO 0 532389 0 438438 0 18033 0 70753 0 21379 0 1080992 0 0 Helen Andrus CFO 0 236132 0 44751 0 18000 0 20294 0 12945 0 332122 0 0 Ulrike Berzau Administrator 30120 0 34347 0 126260 0 1979 0 77 0 192783 0 0 0 Michael Smyly Chief Bus. Dev. Officer 179609 0 46764 0 8636 0 15316 0 3659 0 253984 0 0 0 Daniel Engle Senior Director 192933 0 65 0 8375 0 7374 0 4373 0 213120 0 0 0 Nancy Webster Hospital Administrator 174354 0 10500 0 8953 0 12939 0 1554 0 208300 0 0 0 Marcia Cheadle Senior Director 176833 0 0 0 10641 0 10802 0 2441 0 200717 0 0 0 Gregory Carter CMO 319830 0 9000 0 8975 0 14351 0 4622 0 356778 0 0 0 Vivian M Moise Physiatrist 248544 0 14000 0 8970 0 15222 0 3031 0 289767 0 0 0 Roger Stevens Chief Hospital Applications 213484 0 259 0 858 0 13157 0 941 0 228699 0 0 0 Mark S Gordon Physiatrist 262097 0 17000 0 7064 0 15760 0 1170 0 303091 0 0 0 Patrice Stevenson Physiatrist 240692 0 21000 0 9312 0 8928 0 3941 0 283873 0 0 0 Steven Goodman Physiatrist 174975 0 0 0 7609 0 12630 0 2751 0 197965 0 0 0 Tom Fritz Former CEO 100820 0 122357 0 456006 0 6533 0 155 0 685871 0 0 0 John Craig Jr Former CFO 62718 0 51767 0 207963 0 4077 0 0 0 326525 0 0 0 Part I, Line 1a Membership fees are paid to The Spokane Club for Key Employees for the sole purpose of holding business meetings with customers, clients and vendors. Amounts are not included as taxable compensation for the Key Employees. Part I, Line 1a Providence Health & Services Expense Reimbursement Procedures include the following policies: First Class Travel or Charter Travel or Travel of Companions Air travel is reimbursable for tourist or economy class 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 air travel will only be reimbursed when tourist or economy class air travel is not available and business travel is mandated by a supervisor. In the rare circumstance that an executive must fly on a first class full fare ticket, their senior level supervisor must approve this expense. 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 People and Experience Officer. 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 2015, there were 3 First Class tickets utilized by Officers, Directors or Key Employees listed on Form 990, Part VII. Part I, Lines 4a-b NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan 1) Todd Hofheins a) SERP Earned but not Vested - $244,283 2) Elaine Couture a) Taxable SERP Earned but not Paid - $179,705 b) SERP Interest Credit - $47,129 c) Taxable CBRP Paid - $3 3) Aaron Martin a) SERP Earned but not Vested - $170,424 4) Jeff Collins a) Taxable CBRP Earned but not Paid - $11,745 b) Non-Taxable CBRP Earned - $234 Part I, Lines 4a-b SEVERANCE 1) Phyllis Gabel - $139,760 2) Ulrike Berzau - $120,781 3) Thomas Fritz - $446,644 4) John Craig, Jr. - $194,126 SCHEDULE J - PART II - COMPENSATION The Officers and Directors shown with compensation from a related organization are paid by Providence Health & Services - Washington for their respective positions at Providence related ministries. None are compensated for their services to INHS. SCHEDULE J, PART I - BONUSES Some Officers and Key Employees of the reporting organization receive bonuses based on the annual performance in meeting goals, overall performance, divisional financial information and community service involvement. SCHEDULE J, PART II, COLUMN B(ii) - EXECUTIVE PERFORMANCE AWARDS 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). The performance award is based on the level of accomplishment of annual system objectives, in combination with personal goals for top executives. In 2015, 50 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's six strategic priorities of: creating healthier communities together, inspire and develop our people, building enduring relationships with consumers, create alignment with clinicians & care teams, develop and thrive under new care delivery & economic models, and grow by optimizing expert-to-expert capabilities. The remaining 50% was based on a robust set of personal goals designed to align critical mission and business drivers, executive team talent development (deepening talent pipeline for top 200+leaders) and professional development. In 2015 the percent allocation for each of these strategic priorities was as outlined below: * Success Measures - System Goals : 50% Community Benefit - 5% Caregiver (Employee) Engagement - 7.5% MyChart Activations - 5% Patient Loyalty Index - 5% Clinical Excellence Index - 7.5% Free Cash Flow - 5% Salary Expense / Net Operating Revenue - 2.5% Primary Care Panel Size - 5% Total Growth in Operating Revenue - 7.5% * Success Measures - Personal Goals : 50% Mission/Business Driver - 15% Exec Talent Development - 20% Professional Development - 15% TOTAL ALLOCATION: 100% A Washington Health Care Facilities Authority 911108929 2009-06-18 7462500 Condominiumized Portion of Building 0 0 0 A 1500000 7462500 7462500 2009 0 0 1 1 A 0 0 0 0 0.01730 0.01730 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 SCHEDULE K, PART IV, LINE 2 Since the proceeds were expended within the first six months and there is no reserve fund, no rebate calculations are required. Form 990, Part VI, Section A, line 6 The sole Corporate Member is Providence Health & Services-Washington, a Washington nonprofit corporation. Form 990, Part VI, Section A, line 7a The powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time. Form 990, Part VI, Section A, line 7b Powers reserved to the Corporate Member: 1) To move the corporation's health care facility. 2) To add one or more Members. 3) To amend or revoke the Articles of Incorporation or to repeal, alter or substitute Bylaws. 4) To sell, lease, transfer, or otherwise dispose of all or substantially all of the assets. 5) To merge or consolidate the Corporation. 6) To dissolve the Corporation. 7) To change the Mission of the Corporation. 8) To approve the acquisition of assets, the incurrence of indebtedness, or the lease, sale, transfer, assignment or encumbering of assets for any transaction in excess of an amount specified by the Member. 9) To undertake any activity or to perform or permit any medical procedure which the Member believes offends the moral or ethical values or directives of the Member. Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by experienced Providence Health & Services staff and reviewed by the internal Director of Taxes of Providence Health & Services 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 Conflict of Interest policies are updated annually at the board level and updated annually for all employees during their evaluation. Form 990, Part VI, Section B, line 15 For officers and key employees paid by INHS, compensation packages are calculated by an outside third party and then reviewed and approved by the Board of Directors. For officers and key employees paid through Providence Health & Services, the following discusses the process utilized. 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 employees, including our senior executives. Salaries for senior executives are reviewed by the Providence Board's Human Resources 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. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources 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 Human Resources Committee and then a recommendation is made by the committee to the full Board. The Board Chair and the Chair of the Human Resources 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 Human Resources 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 - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated patient satisfaction, meeting employee satisfaction goals and reaching financial performance objectives. The Board of Directors conducts a thorough process to ensure performance incentives are aligned with appropriate practices for not-for-profit health care systems. The Board's process for executive compensation fully complies with IRS standards and mirrors the best practices recommended in the "Report to Congress and the Nonprofit Sector on Governance, Transparency, and Accountability" submitted to the Senate Finance Committee by the Panel on the Nonprofit Sector. 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 Todd Hofheins - 1801 Lind Avenue SW, Renton, WA 98057. Aaron Martin - 1801 Lind Avenue SW, Renton, WA 98057. Form 990, Part IX, line 11g Aircraft Services: Program service expenses 13,558,739. Management and general expenses 0. Fundraising expenses 0. Total expenses 13,558,739. Repairs & Maintenance: Program service expenses 2,719,039. Management and general expenses 895,248. Fundraising expenses 0. Total expenses 3,614,287. Other Patient Services: Program service expenses 1,338,332. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,338,332. Consulting Fees: Program service expenses 397,981. Management and general expenses 120,040. Fundraising expenses 0. Total expenses 518,021. Agency/Contract Labor: Program service expenses 596,957. Management and general expenses 68,434. Fundraising expenses 0. Total expenses 665,391. Transportation Services: Program service expenses 696,949. Management and general expenses 0. Fundraising expenses 0. Total expenses 696,949. Billing & Collections: Program service expenses 0. Management and general expenses 122,530. Fundraising expenses 0. Total expenses 122,530. Other Admin Services: Program service expenses 0. Management and general expenses 241,967. Fundraising expenses 0. Total expenses 241,967. Form 990, Part XI, line 9: Income from Recipient Organization 578,061. IAF Transfers 914,210. Assets Released from Restriction 32,278. Net Assets/Liabilities Assumed 72,087. Contributions & Grants Adjustment -67,478. Rounding -2. FORM 990, PART XII, LINE 2C - AUDIT & COMPLIANCE As part of the Consolidated Providence Health & Services Audited Financial Statements, the following applies: 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, PART I, LINE 6 - VOLUNTEERS 1. St. Luke's Volunteers: Mail Delivery, Administrative Support, PBX Reception, 1st Floor Reception, Patient Dining & Care, Warehouse Services, Housekeeping, Food Service, Patient Activity, Patient Companion, Magazine Cart, Skilled Clerical/Data Entry. 2. Patient Escort Volunteers: Prospective therapy school students that volunteered with inpatient therapy. 3. SLRI Community Board: Provided operational and financial oversight. 4. MedStar Volunteers: Serving at Felts Field office as Skilled Clerical/Data Entry or Community Outreach Volunteers representing MedStar at community fairs and functions throughout the service area. 5. TSL: Volunteers for Team St. Luke's. 6. WFB: Volunteers at Wells Fargo Building. Typically, college interns placed in an Administrative Support capacity. IHNS Leasing CO LLC 601 W 1st Avenue Spokane WA 99201 912010377 Leasing of Aircraft to INHS WA 2712608 10926855 INHS 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 9 N/A 0 Providence Oregon Management Corporation 1801 Lind Avenue SW 9016 Renton WA 980579016 930813977 Shell Corporation OR 501( c)(3) Line 1 PH & S - Oregon 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 11/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 9 PHS - So California 0 Providence TrinityCare Hospice 5315 Torrance Blvd Suite B1 Torrance CA 90503 953264139 Hospice CA 501( c)(3) Line 9 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 9 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 9 PH & S - Oregon 0 The Gamelin California Association 540 23rd St Oakland CA 94612 911293869 Supportive Housing CA 501( c)(3) Line 9 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) Pending N/A 0 Providence Foundation 1801 Lind Avenue SW 9016 Renton WA 980579016 943078543 Support PH&S Institutions WA 501( c)(3) Line 11/Type II PH & S - Washington 0 Providence Alaska Foundation 3300 Providence Drive - B Tower2 Anchorage AK 99508 920093565 Support PHS-Alaska AK 501( c)(3) Line 11/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 11/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 11/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 Shell Corporation WA 501( c)(3) Line 11/Type II Providence Ministries 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 9 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 11/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 11/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 11/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 11/Type II PH&S Western 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 9 Western HealthConnect 0 Kadlec Foundation 888 Swift Blvd Richland WA 99352 237005501 Support Kadlec Regional Medical Center WA 501(c )(3) Line 11/Type I Kadlec Regional Medical Center 0 PacMed Clinics 1200 12th Ave S Seattle WA 98144 562290878 Healthcare WA 501(c )(3) Line 9 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 Shell Corporation WA 501(c )(3) Pending N/A 0 Providence Imaging Center 3340 Providence Drive Anchorage AK 99508 920118807 Medical Imaging AK N/A California Laboratory Associates LLC 501 Buena Vista Burbank CA 91505 273888692 Outpatient Lab CA N/A Broadway Imaging LLC 500 W Broadway Missoula MT 59802 522405971 Medical Imaging MT 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 Pathology Associates Medical Laboratories LLC 611 N Perry Spokane WA 99202 270943279 Outpatient Lab WA N/A Portland Medical Imaging LLC 4400 NE Halsey 495 Portland OR 97213 201054971 Imaging - Diagnostics OR N/A Oregon Advanced Imaging LLC 881 OHare Parkway Medford OR 97504 450471748 Medical Imaging OR N/A Minor & James Medical PLLC 515 Minor Avenue 200 Seattle WA 98104 911340223 Physician Clinic WA N/A Providence Surgery Center LLC 902 N Orange St Missoula MT 59802 841401625 Ambulatory Surgery Center MT N/A Clackamas Radiation Oncology Center LLC 4400 NE Halsey St Bldg II 495 Portland OR 97213 260381897 Radiation Oncology OR N/A PETCT Imaging at Swedish Cancer Institute LLC 1221 Madison Street Seattle WA 98104 203132044 Medical Imaging WA N/A PacLab LLC 611 N Perry Spokane WA 99202 911743952 Outpatient Lab WA N/A The Madison Spokane Inn LLC 15 West Rockwood Blvd Spokane WA 99204 841606484 Hotel Services WA N/A Center for Specialty Surgery LLC 11782 SW Barnes Rd Portland OR 97225 263638838 Ambulatory Surgery Center OR N/A Oregon Outpatient Surgery Center 7300 SW Childs Rd Tigard OR 97224 223883387 Ambulatory Surgery Center 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 Alpha Medical Laboratory LLC 611 N Perry Spokane WA 99202 912017347 Outpatient Lab ID N/A Greater Valley Medical Building LP 501 S Buena Vista St Burbank CA 91505 954570858 Real Estate - MOB CA N/A Prov Radiation Oncology Develop Assn LLC 4400 NE Halsey 495 Portland OR 97213 260682491 Real Estate - MOB OR N/A Providence Partners for Health LLC 501 S Buena Vista St Burbank CA 91505 454041798 Clinical Quality & Integration CA N/A ProvidenceSilverton Rehab LLC 4400 NE Halsey 425 Portland OR 97213 481287267 Rehab Services OR N/A Southern Idaho Regional Laboratory LLC 611 N Perry Spokane WA 99202 820511819 Outpatient Lab ID N/A Mountainstar Clinical Laboratories LLC 611 N Perry Spokane WA 99202 261345983 Outpatient Lab MT N/A Tri-Cities Laboratory LLC 611 N Perry Spokane WA 99202 911773986 Outpatient Lab WA 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 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0