PROVIDENCE PLAN PARTNERS: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PROVIDENCE PLAN PARTNERS (EIN 91-1861964)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-24
- IRS object ID
- 201413289349300116
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-24T10:50:07-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 911194016 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clark Nuber PS | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4th Suite 1700 | AddressLine1 |
| City | Bellevue | City |
| State | WA | State |
| ZIP Code | 98004 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911861964 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE PLAN PARTNERS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROV | BusinessNameControlTxt |
| Phone | 5035746330 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4400 NE Halsey Bldg 2 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 97213 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jeffrey Butcher | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5035746330 | PhoneNum |
| Signature | 2014-11-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Sara Elizabeth J Hyre CPA | PreparerPersonNm |
| PTIN | P00235495 | PTIN |
| Phone | 4254544919 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Jack Friedman | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4400 NE Halsey Bldg 2 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 97213 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,955,380 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | Health Care Services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $12,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,285,943 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,604,122 | CYProgramServiceRevenueAmt |
| PY Investment Income | $851,232 | PYInvestmentIncomeAmt |
| CY Investment Income | $401,793 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $5,149,175 | PYTotalRevenueAmt |
| CY Total Revenue | $4,005,915 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $28,350 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,532,408 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,595,035 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,989,586 | PYOtherExpensesAmt |
| CY Other Expenses | $2,721,567 | CYOtherExpensesAmt |
| PY Total Expenses | $5,521,994 | PYTotalExpensesAmt |
| CY Total Expenses | $5,344,952 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$372,819 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,339,037 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,736,860 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,626,466 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,381,567 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,360,530 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,355,293 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,265,936 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Health Care Services. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,365,431 | ExpenseAmt |
| Grant | $17,276 | GrantAmt |
| Revenue | $3,165,765 | RevenueAmt |
| Desc | Providence Preferred Provider Program (PPO), as part of Providence Plan Partners (PPP), is a network of medical practitioners, hospitals and ancillary medical providers throughout Oregon and southwest Washington designed to manage the cost, delivery, and quality of healthcare in these communities. PPO offers employers, self-insured employers, health and welfare trusts and other healthcare purchasers a program for reducing the cost of healthcare services, while maintaining the quality of medical care to enrollees. PPO acts as a liaison between hospitals and payors by informing payors and enrollees of the agreements entered on their behalf by PPO. PPO neither assumes risk or responsibility for payment to hospitals or providers nor guarantees payment by payors or performance by hospitals or providers of any of the terms of conditions set forth in any payor agreements. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,516,329 | ExpenseAmt |
| Grant | $11,074 | GrantAmt |
| Revenue | $438,357 | RevenueAmt |
| Desc | Providence MCO Program (MCO), as part of Providence Plan Partners (PPP), is an Oregon certified workers' compensation program designed to complement the claims management program of employers. As such, the program aims to provide coordinated, high quality medical care to workers who suffer work-related injuries or illnesses and focuses on early return-to-work strategies that keep employees productive during recovery. The program is functionally and structurally similar to Preferred Provider Program (PPO), although focused on workers' compensation only. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,881,760 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (1) | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jeff Butcher CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5035746390 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4400 NE Halsey Bldg 2 | AddressLine1 |
| City | Portland | City |
| State | OR | State |
| ZIP Code | 97213 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Michael Holcomb | |||||||||
| Chair of the Board | 0.10 | 8.60 | Yes (X) | Yes (X) | $0 | $60,335 | $0 | ||
| Lucille Dean SP | |||||||||
| Director | 0.10 | 9.40 | Yes (X) | $0 | $0 | $0 | |||
| Mary Corita Heid RSM | |||||||||
| Director | 0.10 | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| Michael A Stein | |||||||||
| Director | 0.10 | 6.00 | Yes (X) | $0 | $18,335 | $0 | |||
| Eugene Al Parrish | |||||||||
| Director | 0.10 | 5.00 | Yes (X) | $0 | $15,335 | $0 | |||
| Dana A Rasmussen | |||||||||
| Director | 0.10 | 4.30 | Yes (X) | $0 | $18,335 | $0 | |||
| James S Roberts MD | |||||||||
| Director | 0.10 | 9.00 | Yes (X) | $0 | $30,835 | $0 | |||
| Peter J Snow | |||||||||
| Director | 0.10 | 5.70 | Yes (X) | $0 | $20,835 | $0 | |||
| Bob Wilson | |||||||||
| Director | 0.10 | 5.00 | Yes (X) | $0 | $15,335 | $0 | |||
| Sallye Liner | |||||||||
| Director | 0.10 | 4.00 | Yes (X) | $0 | $15,335 | $0 | |||
| Cheryl M Scott | |||||||||
| Director | 0.10 | 4.60 | Yes (X) | $0 | $15,335 | $0 | |||
| Ellen L Wolf | |||||||||
| Director | 0.10 | 7.10 | Yes (X) | $0 | $15,335 | $0 | |||
| Isiaah Crawford | |||||||||
| Director | 0.10 | 4.10 | Yes (X) | $0 | $15,335 | $0 | |||
| Martha Diaz Aszkenazy | |||||||||
| Director | 0.10 | 7.70 | Yes (X) | $0 | $15,335 | $0 | |||
| Kirby McDonald | |||||||||
| Director | 0.10 | 4.60 | Yes (X) | $0 | $15,335 | $0 | |||
| Dave Olsen | |||||||||
| Director | 0.10 | 5.50 | Yes (X) | $0 | $15,335 | $0 | |||
| Charles Chuck Watts | |||||||||
| Director | 0.10 | 4.60 | Yes (X) | $0 | $15,335 | $0 | |||
| Jeffrey W Rogers - Thru 513 | |||||||||
| Corporate Secretary | 0.10 | 49.90 | Yes (X) | $0 | $1,040,781 | $189,880 | |||
| Cindy Strauss - Eff 613 | |||||||||
| SVP/Chief Counsel/Corp. Secretary | 0.10 | 59.90 | Yes (X) | $0 | $955,824 | $248,254 | |||
| Jack Friedman | |||||||||
| SVP/Account Care & Payor Rel. | 1.00 | 54.00 | Yes (X) | $0 | $826,281 | $177,752 | |||
| Alison S Schrupp | |||||||||
| CSO | 18.00 | 37.00 | Yes (X) | $0 | $487,934 | $106,585 | |||
| Barbara L Christensen | |||||||||
| Chief Sales & Mkt. Officer | 15.00 | 30.00 | Yes (X) | $0 | $355,146 | $76,433 | |||
| Michael G White | |||||||||
| COO | 17.00 | 33.00 | Yes (X) | $0 | $378,050 | $86,302 | |||
| Bruce W Wilkinson | |||||||||
| CIO | 15.00 | 30.00 | Yes (X) | $0 | $384,006 | $102,103 | |||
| Robert A Gluckman | |||||||||
| CMO | 17.00 | 33.00 | Yes (X) | $0 | $431,702 | $144,340 | |||
| Jeffrey Butcher | |||||||||
| CFO | 17.00 | 33.00 | Yes (X) | $0 | $285,033 | $39,452 | |||
| Greg Van Pelt - Thru 413 | |||||||||
| SVP/CEO - OR. Region | 1.00 | 59.00 | $0 | $1,370,941 | $383,928 | Yes (X) | |||
| Dave Underriner - Eff 413 | |||||||||
| SVP/CEO - OR. Region | 1.00 | 59.00 | $0 | $2,910,696 | $106,590 | Yes (X) | |||
| Shelly M Handkins | |||||||||
| CFO - OR. Region | 1.00 | 49.00 | $0 | $502,246 | $368,641 | Yes (X) | |||
| William Olson | |||||||||
| CFO | 1.00 | 49.00 | $0 | $582,354 | $125,398 | Yes (X) | |||
| James H Mackay | |||||||||
| Medical Director | 17.00 | 33.00 | $0 | $306,324 | $85,766 | Yes (X) | |||
| Carrie Smith | |||||||||
| Chief Compliance Officer | 17.00 | 33.00 | $0 | $212,994 | $38,144 | Yes (X) | |||
| Stephanie C Dreyfuss | |||||||||
| Dir. Network Develop. | 13.00 | 27.00 | $0 | $261,560 | $29,418 | Yes (X) | |||
| Susan Abate | |||||||||
| Dir. Quality Med. Mgr. | 13.00 | 27.00 | $0 | $212,592 | $81,105 | Yes (X) | |||
| Katherine L Powell | |||||||||
| CIO | 17.00 | 33.00 | $0 | $254,473 | $34,753 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $12,060,962 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,424,844 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EBS Master LLC | |||||
| PO Box 572490 | Murray | UT | 84157 | Postage & Check Processing Service | $2,205,415 |
| Colibrium Partners LLC | |||||
| 3575 Piedmont Rd NE Ste 1550 | Atlanta | GA | 30305 | Computer Software & Support | $2,065,532 |
| Harrang Long Gary Rudnick PC | |||||
| PO Box 11620 | Eugene | OR | 97440 | Legal Services | $709,235 |
| Edgelink LLC | |||||
| 115 SW Ash Street Suite 321 | Portland | OR | 97204 | Temp Services Agency | $400,478 |
| Payer Connection LLC | |||||
| PO Box 1769 | Lake Oswego | OR | 97035 | Usage of Provider Network | $309,210 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PPO Hospital Fees | 900099 | $1,458,579 | $1,458,579 |
| PPO Admin Fees | 900099 | $1,164,944 | $1,164,944 |
| PPO Physician Fees | 900099 | $542,242 | $542,242 |
| MCO Admin Fees | 900099 | $437,878 | $437,878 |
| MCO Hospital Fees | 900099 | $479 | $479 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,604,122 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $154,302 | TotalRevenueColumnAmt |
| Exclusion | $154,302 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,196,956 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,949,465 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $247,491 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $247,491 | TotalRevenueColumnAmt |
| Exclusion | $247,491 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,005,915 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,604,122 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $401,793 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,350 | TotalAmt |
| Program Services | $28,350 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,845,076 | TotalAmt |
| Program Services | $1,629,094 | ProgramServicesAmt |
| Management And General | $215,982 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $749,959 | TotalAmt |
| Program Services | $660,808 | ProgramServicesAmt |
| Management And General | $89,151 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,263 | TotalAmt |
| Program Services | $10,294 | ProgramServicesAmt |
| Management And General | $23,969 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,634 | TotalAmt |
| Management And General | $13,634 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $715,527 | TotalAmt |
| Program Services | $430,415 | ProgramServicesAmt |
| Management And General | $285,112 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,131 | TotalAmt |
| Program Services | $16,815 | ProgramServicesAmt |
| Management And General | $1,316 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,494 | TotalAmt |
| Program Services | $84,071 | ProgramServicesAmt |
| Management And General | $47,423 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $306,146 | TotalAmt |
| Program Services | $213,966 | ProgramServicesAmt |
| Management And General | $92,180 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $180,282 | TotalAmt |
| Program Services | $162,390 | ProgramServicesAmt |
| Management And General | $17,892 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,617 | TotalAmt |
| Program Services | $25,634 | ProgramServicesAmt |
| Management And General | $2,983 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,067 | TotalAmt |
| Program Services | $2,540 | ProgramServicesAmt |
| Management And General | $1,527 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $677,305 | TotalAmt |
| Program Services | $549,862 | ProgramServicesAmt |
| Management And General | $127,443 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,817 | TotalAmt |
| Program Services | $1,637 | ProgramServicesAmt |
| Management And General | $180 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| Bus. & Ins. Premium Tax | $504,970 | $504,970 | |
| Electronic Claims | $34,306 | $34,306 | |
| Regulatory Fees | $17,685 | $8,842 | $8,843 |
| Dues & Memberships | $12,667 | $2,132 | $10,535 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,656 | TotalAmt |
| Program Services | $12,200 | ProgramServicesAmt |
| Management And General | $28,456 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,344,952 | TotalAmt |
| Program Services | $3,881,760 | ProgramServicesAmt |
| Management And General | $1,463,192 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,675,633 | BOYAmt |
| EOY | $1,936,142 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $362,477 | BOYAmt |
| EOY | $665,052 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,975 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,952,439 | BOYAmt |
| EOY | $2,490,799 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,011,548 | BOYAmt |
| EOY | $8,649,386 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $709,788 | BOYAmt |
| EOY | $3,885,087 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,736,860 | BOYAmt |
| EOY | $17,626,466 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,914,874 | BOYAmt |
| EOY | $5,180,915 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,201 | BOYAmt |
| EOY | $193,404 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,268,492 | BOYAmt |
| EOY | $10,986,211 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,381,567 | BOYAmt |
| EOY | $16,360,530 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,729,010 | BOYAmt |
| EOY | $9,729,010 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$14,413,589 | BOYAmt |
| EOY | -$14,413,589 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,039,872 | BOYAmt |
| EOY | $5,950,515 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,355,293 | BOYAmt |
| EOY | $1,265,936 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,736,860 | BOYAmt |
| EOY | $17,626,466 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,339,037 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $249,680 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due from Affiliates | Desc |
| Book Value | $3,885,087 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,885,087 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Due to Affiliates | Desc |
| Amt | $10,986,211 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,986,211 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Jeffrey W Rogers - Thru 513 | ||||||||||||||
| Corporate Secretary | $0 | $442,462 | $0 | $529,200 | $0 | $69,119 | $0 | $168,789 | $0 | $21,091 | $0 | $1,230,661 | $0 | $0 |
| Cindy Strauss - Eff 613 | ||||||||||||||
| SVP/Chief Counsel/Corp. Secretary | $0 | $413,323 | $0 | $525,001 | $0 | $17,500 | $0 | $223,587 | $0 | $24,667 | $0 | $1,204,078 | $0 | $0 |
| Jack Friedman | ||||||||||||||
| SVP/Account Care & Payor Rel. | $0 | $508,016 | $0 | $300,765 | $0 | $17,500 | $0 | $151,382 | $0 | $26,370 | $0 | $1,004,033 | $0 | $0 |
| Alison S Schrupp | ||||||||||||||
| CSO | $0 | $318,573 | $0 | $155,745 | $0 | $13,616 | $0 | $86,463 | $0 | $20,122 | $0 | $594,519 | $0 | $0 |
| Barbara L Christensen | ||||||||||||||
| Chief Sales & Mkt. Officer | $0 | $268,116 | $0 | $56,567 | $0 | $30,463 | $0 | $56,391 | $0 | $20,042 | $0 | $431,579 | $0 | $0 |
| Michael G White | ||||||||||||||
| COO | $0 | $308,739 | $0 | $51,811 | $0 | $17,500 | $0 | $80,350 | $0 | $5,952 | $0 | $464,352 | $0 | $0 |
| Bruce W Wilkinson | ||||||||||||||
| CIO | $0 | $231,878 | $0 | $134,628 | $0 | $17,500 | $0 | $83,215 | $0 | $18,888 | $0 | $486,109 | $0 | $0 |
| Robert A Gluckman | ||||||||||||||
| CMO | $0 | $378,905 | $0 | $52,797 | $0 | $0 | $0 | $124,125 | $0 | $20,215 | $0 | $576,042 | $0 | $0 |
| Jeffrey Butcher | ||||||||||||||
| CFO | $0 | $247,703 | $0 | $37,330 | $0 | $0 | $0 | $20,530 | $0 | $18,922 | $0 | $324,485 | $0 | $0 |
| Greg Van Pelt - Thru 413 | ||||||||||||||
| SVP/CEO - OR. Region | $0 | $397,517 | $0 | $537,371 | $0 | $436,053 | $0 | $367,609 | $0 | $16,319 | $0 | $1,754,869 | $0 | $0 |
| Dave Underriner - Eff 413 | ||||||||||||||
| SVP/CEO - OR. Region | $0 | $558,191 | $0 | $2,335,005 | $0 | $17,500 | $0 | $80,853 | $0 | $25,737 | $0 | $3,017,286 | $0 | $580,372 |
| Shelly M Handkins | ||||||||||||||
| CFO - OR. Region | $0 | $393,634 | $0 | $108,612 | $0 | $0 | $0 | $345,190 | $0 | $23,451 | $0 | $870,887 | $0 | $0 |
| William Olson | ||||||||||||||
| CFO | $0 | $289,334 | $0 | $293,020 | $0 | $0 | $0 | $104,559 | $0 | $20,839 | $0 | $707,752 | $0 | $0 |
| James H Mackay | ||||||||||||||
| Medical Director | $0 | $288,413 | $0 | $17,911 | $0 | $0 | $0 | $67,253 | $0 | $18,513 | $0 | $392,090 | $0 | $0 |
| Carrie Smith | ||||||||||||||
| Chief Compliance Officer | $0 | $187,424 | $0 | $25,570 | $0 | $0 | $0 | $19,762 | $0 | $18,382 | $0 | $251,138 | $0 | $0 |
| Stephanie C Dreyfuss | ||||||||||||||
| Dir. Network Develop. | $0 | $211,456 | $0 | $34,220 | $0 | $15,884 | $0 | $10,815 | $0 | $18,603 | $0 | $290,978 | $0 | $0 |
| Susan Abate | ||||||||||||||
| Dir. Quality Med. Mgr. | $0 | $192,062 | $0 | $20,530 | $0 | $0 | $0 | $62,750 | $0 | $18,355 | $0 | $293,697 | $0 | $0 |
| Katherine L Powell | ||||||||||||||
| CIO | $0 | $221,837 | $0 | $32,620 | $0 | $16 | $0 | $15,792 | $0 | $18,961 | $0 | $289,226 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Lines 4a-b | NON-QUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan C) ESP = Elective Survivor Plan 1) Jeffrey W. Rogers a) Taxable SERP Earned but not Paid - $44,111 b) SERP Interest Credit- $97,420 c) ESP Interest Credit - $7,567 2) Cindy Strauss a) SERP Earned but not Vested - $190,313 b) SERP Interest Credit - $14,149 3) Jack Friedman a) Taxable SERP Earned but not Paid - $54,169 b) SERP Interest Credit - $100,470 4) Alison S. Schrupp a) SERP Interest Credit - $55,128 b) Taxable SERP Earned but Not Paid - $106,423 c) Taxable CBRP Earned but Not Paid - $1,656 d) ESP Interest Credit - $3,273 5) Barbara L. Christensen a) SERP Interest Credit - $5,276 b) Taxable SERP Earned but Not Paid - $16,237 c) ESP Interest Credit - $2,932 6) Michael G. White a) SERP Interest Credit - $2,741 b) SERP Earned but Not Vested - $52,954 7) Bruce W. Wilkinson a) SERP Interest Credit - $55,949 b) Taxable SERP Earned but Not Paid - $97,368 c) Taxable CBRP Earned but Not Paid - $50 8) Robert A. Gluckman a) SERP Interest Credit - $22,366 b) SERP Earned but not Vested - $69,788 c) Taxable CBRP - $138 9) Jeff Butcher a) SERP Earned but Not Vested - $8,603 b) SERP Interest Credit - $988 10) Greg VanPelt a) Interest Credit - $22,874 b) Taxable SERP Earned but Not Paid - $123,019 c) Non-taxable SERP Earned but Not Paid - $294,235 11) David T. Underriner a) SERP Interest Credit - $22,874 b) Taxable SERP Earned but Not Paid - $2,199,418 c) ESP Interest Credit - $2,998 12) Shelly M. Handkins a) SERP Interest Credit - $92,880 b) SERP Earned but Not Vested - $217,913 13) William Olson a) SERP Interest Credit - $12,401 b) SERP Earned but Not Vested - $56,756 c) Taxable CBRP Earned but Not Paid - $4 d) Taxable SERP Earned but Not Paid - $220,167 14) James H. Mackay a) Taxable CBRP Earned but Not Paid - $9,359 b) Non-Taxable CBRP Earned but Not Paid - $1,311 |
| Part I, Lines 4a-b | Severance Greg Van Pelt - $367,890 |
| FORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS 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). The performance award is based on the level of accomplishment of annual system objectives and personal objectives. In 2013, 50 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's five strategic priorities of: mission driven, financially responsible, people centered, service oriented and EPIC watchlist. In 2013 the percent allocation for each of these strategic priorities was: Mission driven 5% Financially responsible 15% People centered 10% Service oriented 10% EPIC Watchlist 10% To ensure affordability of the program, the organization (system, region or entity) must meet a threshold of 50 percent of budgeted net operating income. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The Member of the Corporation is Providence Health & Services - Oregon. |
| Form 990, Part VI, Section A, line 7a | The Corporate Member has the power to: 1) Fix the number of Directors, select the Directors and to remove such Directors at any time with or without cause. 2) Appoint the Chairperson of the Board of Directors, determine the term of office and to remove such Chairperson with or without cause. |
| Form 990, Part VI, Section A, line 7b | The Corporate Member has the power: 1) To adopt or change the mission, philosophy, and values, including the strategic plan and mission statement. 2) To amend or repeal the Articles of Incorporation or Bylaws. 3) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale transfer, assignment or encumbering of assets exceeding a specified threshold, or the sale or transfer of any property which may have historical or religions significance. 4) To approve the establishment of any new Corporation in which this Corporation has a controlling interest. 5) To approve the dissolution or liquidation. 6) To approve the annual operating and capital budgets. 7) To appoint the certified public accountants. 8) To approve, according to established guidelines, any joint venture of corporate affiliations. 9) To approve lending of corporate funds. 10) To approve the closure of any institution or major ministry or work of the Corporation. |
| Form 990, Part VI, Section B, line 11 | The Form 990 is prepared internally by experienced staff and reviewed by the internal 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 employees, including our senior executives. Salaries for senior executives are determined 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. Performance incentives allow executives to earn additional compensation if they achieve specific organizational and individual goals for furthering Providence operating principles - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated customer 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 written 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 | Michael Holcomb - 1801 Lind Avenue SW, Renton, WA 98057. Lucille Dean, SP - 1801 Lind Avenue SW, Renton, WA 98057. Mary Corita Heid, RSM - 1801 Lind Avenue SW, Renton, WA 98057. Michael A. Stein - 1801 Lind Avenue SW, Renton, WA 98057. Eugene "Al" Parrish - 1801 Lind Avenue SW, Renton, WA 98057. Dana A. Rasmussen - 1801 Lind Avenue SW, Renton, WA 98057. James S. Roberts, MD - 1801 Lind Avenue SW, Renton, WA 98057. Peter J. Snow - 1801 Lind Avenue SW, Renton, WA 98057. Bob Wilson - 1801 Lind Avenue SW, Renton, WA 98057. Sallye Liner - 1801 Lind Avenue SW, Renton, WA 98057. Cheryl M. Scott - 1801 Lind Avenue SW, Renton, WA 98057. Ellen L. Wolf - 1801 Lind Avenue SW, Renton, WA 98057. Isiaah Crawford - 1801 Lind Avenue SW, Renton, WA 98057. Martha Diaz Aszkenazy - 1801 Lind Avenue SW, Renton, WA 98057. Kirby McDonald - 1801 Lind Avenue SW, Renton, WA 98057. Dave Olsen - 1801 Lind Avenue SW, Renton, WA 98057. Charles (Chuck) Watts - 1801 Lind Avenue SW, Renton, WA 98057. Jeffrey W. Rogers - Thru 5/13 - 1801 Lind Avenue SW, Renton, WA 98057. Cindy Strauss - Eff 6/13 - 1801 Lind Avenue SW, Renton, WA 98057. |
| Form 990, Part IX, line 11g | Consulting Fees: Program service expenses 213,525. Management and general expenses 169,907. Fundraising expenses 0. Total expenses 383,432. Network Fees: Program service expenses 81,467. Management and general expenses 0. Fundraising expenses 0. Total expenses 81,467. Other: Program service expenses 62,108. Management and general expenses 62,108. Fundraising expenses 0. Total expenses 124,216. Records Management: Program service expenses 4,970. Management and general expenses 548. Fundraising expenses 0. Total expenses 5,518. Contract Maintenance: Program service expenses 3,058. Management and general expenses 337. Fundraising expenses 0. Total expenses 3,395. Advisors: Program service expenses 2,005. Management and general expenses 19. Fundraising expenses 0. Total expenses 2,024. Professional Fees - Actuarial: Program service expenses 0. Management and general expenses 26,730. Fundraising expenses 0. Total expenses 26,730. Rx Admin Fee: Program service expenses 51,545. Management and general expenses 0. Fundraising expenses 0. Total expenses 51,545. ID Cards: Program service expenses 0. Management and general expenses 11,171. Fundraising expenses 0. Total expenses 11,171. Electronic Data Interchange: Program service expenses 9,850. Management and general expenses 0. Fundraising expenses 0. Total expenses 9,850. On-Line Quoting: Program service expenses 0. Management and general expenses 9,454. Fundraising expenses 0. Total expenses 9,454. Translation: Program service expenses 1,887. Management and general expenses 1,887. Fundraising expenses 0. Total expenses 3,774. Surveys: Program service expenses 0. Management and general expenses 2,951. Fundraising expenses 0. Total expenses 2,951. |
| 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 financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. |
| FORM 990, PART I, LINE 5 & PART V, LINE 2A - EMPLOYEE COMPENSATION | The employees working Providence Plan Partners are paid by Providence Health & Services - Washington dba Health System Office EIN# 91-0725998 or Providence Health & Services - Oregon EIN# 51-0216587. Therefore, no W-2s are issued by the reporting organization. |
| FORM 990, PART VII - RELIGIOUS COMMUNITY MEMBERS | As members of the Religious Community, each Sister has taken a vow of poverty as a compulsory part of her religious life. Any compensation for services of a Sister inures only for the benefit of the Community, not the individual members. All payments for services are made directly to the Religious Community. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (65 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | 0 | N/A | |
| 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 Health Plan | |||||||||||
| 4400 NE Halsey Bldg 2 | Portland | OR | 97213 | 930863097 | Health Service Contractor | OR | 501( c)(4) | N/A | Providence Plan Partners | Yes (1) | |
| Providence Health Assurance | |||||||||||
| 4400 NE Halsey Bldg 2 | Portland | OR | 97213 | 550828701 | Medicaid Healthcare Provider | OR | 501( c)(4) | N/A | Providence Health Plan | Yes (1) | |
| 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 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| St Luke Association | |||||||||||
| 350 Washington Ave SE | Chehalis | WA | 98352 | 943176618 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Rossi Association | |||||||||||
| 1700 Providence Pl | Centralia | WA | 98531 | 311584166 | Housing | WA | 501( c)(3) | Line 9 | PH & S - Washington | 0 | |
| Lundberg Association | |||||||||||
| 5921 E Burnside | Portland | OR | 97215 | 911562797 | Housing | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence St Francis Association | |||||||||||
| 3415 12th Avenue NE | Olympia | WA | 98506 | 943244854 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Peter Claver Association | |||||||||||
| 7101 38th Avenue South | Seattle | WA | 98118 | 311629656 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence St Elizabeth House Association | |||||||||||
| 3201 SW Graham St | Seattle | WA | 98126 | 912171539 | 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 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| The Gamelin Association | |||||||||||
| 312 North Fourth St | Yakima | WA | 98901 | 911180824 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| The Gamelin Oregon Association | |||||||||||
| 5520 NE Glisan | Portland | OR | 97213 | 911214491 | Housing | OR | 501( c)(3) | Line 9 | PH & S - Oregon | 0 | |
| The Gamelin California Association | |||||||||||
| 540 23rd St | Oakland | CA | 94612 | 911293869 | Housing | CA | 501( c)(3) | Line 9 | PHS - So California | 0 | |
| Gamelin Washington Association | |||||||||||
| 1423 First Avenue | Seattle | WA | 98101 | 201910170 | Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Foundation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 943078543 | Support PH&S Institutions | WA | 501( c)(3) | Line 11/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 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 | PHS - So California | 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 I | 0 | N/A | |
| 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 1 | 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 | PH & S - Washington | 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 | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 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 I | 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 | |
| PHN Holdings | |||||||||||
| 20555 Earl Street | Torrance | CA | 90503 | 461814184 | Strategic/Planning services for PHN | CA | 501( c)(4) | Pending | PHS - So California | 0 | |
| Providence Health Network | |||||||||||
| 20555 Earl Street | Torrance | CA | 90503 | 800886966 | Prepaid Healthcare | CA | 501( c)(4) | Pending | PHN Holdings | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (24 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| 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 St Bldg II 495 | Portland | OR | 97213 | 260796953 | Imaging - Diagnostics | OR | N/A |
| Ctr for MedImaging-Tanasbourne LLC | |||||||
| 4400 NE Halsey St Bldg II 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 |
| Medalia Healthcare LLC | |||||||
| 1801 Lind Ave SW 9016 | Renton | WA | 98057 | 911660459 | Physician Benefits | WA | 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 St Bldg II 495 | Portland | OR | 97213 | 201054971 | Imaging - Diagnostics | OR | N/A |
| Prov Radiation Oncology Develop Assn LLC | |||||||
| 4401 NE Halsey St Bldg II 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 |
| 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 |
| Tri-Cities Laboratory LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 911773986 | Outpatient Lab | WA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| 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 |
| Washington Cancer Centers PC | |||||||||
| 1560 N 115th G-16 | Seattle | WA | 98133 | 911792791 | Cancer Treatment | WA | N/A | C | 0 |
| Western HealthConnect Ventures Inc | |||||||||
| 1801 Lind Ave SW 9016 | Renton | WA | 98057 | 800953654 | Investment | WA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Providence Health Plan | ||
| Q | $123,930,197 | Cost |
| Providence Health Assurance | ||
| Q | $5,458,769 | Cost |