PROVIDENCE ST JOSEPH MEDICAL CENTER: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PROVIDENCE ST JOSEPH MEDICAL CENTER (EIN 81-0463482)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-17
- IRS object ID
- 201433219349308348
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-17T14:43:58-06:00 | 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 | 810463482 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Providence St Joseph Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROV | BusinessNameControlTxt |
| Phone | 4255253985 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 Lind Avenue SW No 9016 | AddressLine1 |
| City | Renton | City |
| State | WA | State |
| ZIP Code | 980579016 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Todd Hofheins | PersonNm |
| Person Title | EVP/CFO | PersonTitleTxt |
| Phone | 4255253985 | PhoneNum |
| Signature | 2014-11-17 | 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 | Rod Hochman MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 Lind Avenue SW No 9016 | AddressLine1 |
| City | Renton | City |
| State | WA | State |
| ZIP Code | 980579016 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $27,496,956 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.saintjoes.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | Healthcare with special concern for the poor and vulnerable in Polson, MT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 372 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $214,210 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $114,080 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $506,421 | PYContributionsGrantsAmt |
| CY Contributions Grants | $278,800 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $25,633,598 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $26,106,590 | CYProgramServiceRevenueAmt |
| PY Investment Income | $15,997 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,298 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,241,407 | PYOtherRevenueAmt |
| CY Other Revenue | $1,106,268 | CYOtherRevenueAmt |
| PY Total Revenue | $27,397,423 | PYTotalRevenueAmt |
| CY Total Revenue | $27,496,956 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $77,616 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $12,768 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,520,708 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,217,822 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,110,548 | PYOtherExpensesAmt |
| CY Other Expenses | $14,378,167 | CYOtherExpensesAmt |
| PY Total Expenses | $26,708,872 | PYTotalExpensesAmt |
| CY Total Expenses | $30,608,757 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $688,551 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,111,801 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,386,279 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,765,476 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,646,363 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,140,387 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,739,916 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$1,374,911 | 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.Healthcare w/ special concern for the poor & vulnerable in Polson, MT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,331,959 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,508,900 | RevenueAmt |
| Desc | Acute - Outpatient - 36,842 VisitsSt. Joseph Medical Center is a 22 bed acute care hospital providing a wide range of medical services to the community without regard to the patients ability to pay for these services.OUR MISSION - As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service. OUR CORE VALUES - Respect, Compassion, Justice, Excellence, and Stewardship Providence Cares Whether tenderly holding a special-needs child who requires round-the-clock care, or easing the way for a stroke patient who faces both physical and financial struggles, the people of Providence are called to a mission of service. Our lifework is to provide excellent care for everyone, at all stages of life, regardless of ability to pay. This has been the Providence mission since the Sisters of Providence arrived on the shores of the Columbia River 150 years ago, committed to the care and healing of poor and vulnerable frontier neighbors.On March 13, 1984, after 67 years serving the Polson community so well and lovingly, the Hospitaller Sisters transferred sponsorship of the local hospital to the Presentation Health System. In 1990, St. Joseph Hospital was in dire economic circumstances. The Sisters of Providence assumed responsibility for the hospital on March 1, allowing St. Joseph's to continue providing health care services to the community. Under the sponsorship of Providence Health & Services, St. Joseph Medical Center participates as a member of a system of hospitals and an affiliate of St. Patrick Hospital in Missoula. Expansion of services, shared purchasing and management expertise provide fundamental value to the community through the services St. Joseph Medical Center provides. The Sisters of Providence understand that the hospital is vital to the well being of the community. Indeed, St. Joseph Medical Center belongs to the community. Faced with an old building in need of extensive upgrades to meet standards and maintain its operating license, the St. Joseph Hospital Board of Directors reviewed options and concluded that new construction was the solution. The options included closing St. Joseph Medical, renovating and upgrading the existing facility, joining with St. Luke Community Hospital in Ronan to build a replacement facility in Pablo, or doing nothing. Clearly, closure of St. Joseph Medical Center would deny essential access to excellent health care to the people of Polson. Today, people need to access health care services in ways compatible with their changing lifestyles and the capabilities of the information age. Physicians and patients need modern diagnostic imaging equipment, outpatient surgery, physical therapy, cardiovascular rehabilitation, home health services, and wellness and fitness programs. In short, today's patients need ready access to outpatient services, modern technology, and skilled staff and physicians more than they need long halls of patient rooms. The resulting vision was one of the hospital and doctors working together to continue to provide primary health care services in a state-of-the-art facility, designed to meet the health care needs of the area's growing, diverse and aging population. The plan included replacing the 1933 building with a new structure that includes a modern imaging suite, a new emergency room, a new surgical suite, patient rooms, medical office space and administrative office areas. The cost of the project was estimated at $10 million. The community, combined with donations from foundations, generously contributed $1.6 million. The balance of the project was financed through a Providence Bond Issue. We watched the old building go down and the new one rise in its place with great anticipation. The new building, St. Joseph Medical Center, allows us to have "one-stop-shopping" for medical services; patient convenience for doctor visits, added a complete retail pharmacy, which is available 6 days a week, and closer proximity to testing laboratories so folks don't have to leave the building. We expanded our Family Maternity Center to promote a wonderful experience with closer family interaction. The new hospital takes full advantage of the beautiful views of Flathead Lake and is filled with lots of natural light, which combined with the care, competence and training of our staff, make this a special healing place. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,133,255 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,831,909 | RevenueAmt |
| Desc | Primary Care - 30,444 VisitsSEE PART III, Line 4a. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,842,992 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,508,582 | RevenueAmt |
| Desc | Acute Inpatient - 758 AdmissionsAcute Patient Days - 2,509SEE PART III, Line 4a. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (2 entries)
| ExpenseExpenseAmt | GrantGrantAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|---|
| $1,128,633 | $0 | $1,257,199 | LTC/Hospice/Housing & Assisted Living - 13,194 Days for Long-Term Care/Asst.St. Joseph Assisted Living is the first phase of St. Joseph Retirement Community, a multi-phase senior retirement campus located on the grounds of St. Joseph Hospital in Polson, MT. The Assisted Living Center was thoughtfully designed with the purpose of creating a warm and comfortable atmosphere. The library/living area is an irresistible gathering place where the warmth of fireplaces mingles with beautiful art and furnishings.The centrally located dining room serves nutritious, home cooked meals three times a day in a pleasant and social environment.The Assisted Living Program is based on the principles of choice, dignity, independence, privacy, individuality and homelike surroundings. The program is designed for seniors who desire or need to have some additional personal assistance with managing their daily activities. |
| $12,768 | $12,768 | $0 | Grants & Allocations. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,141,401 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $12,768 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $1,257,199 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $23,449,607 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| 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 | Yes (1) | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| 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 | 372 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Karl E Fritschel CPA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4255253339 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 Lind Ave SW 9016 | AddressLine1 |
| City | Renton | City |
| State | WA | State |
| ZIP Code | 980579016 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (44 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 | |||
| John F Koster MD - Thru 0313 | |||||||||
| President / CEO | 0.10 | 53.90 | Yes (X) | $0 | $3,202,727 | $247,248 | |||
| Rod F Hochman MD - Eff 0413 | |||||||||
| President / CEO | 0.10 | 64.90 | Yes (X) | $0 | $1,402,907 | $515,903 | |||
| Todd Hofheins | |||||||||
| EVP/CFO | 0.10 | 59.90 | Yes (X) | $0 | $570,367 | $90,110 | |||
| 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 | |||
| James R Kiser II | |||||||||
| CEO - PSJMC | 45.00 | 0.00 | Yes (X) | $244,550 | $0 | $27,930 | |||
| Terry L Smith | |||||||||
| SVP/Management Svcs | 0.00 | 60.00 | $0 | $1,612,950 | $226,158 | Yes (X) | |||
| Deborah Burton | |||||||||
| SVP/Chief Nrsg. Officer | 0.00 | 65.00 | $0 | $1,347,109 | $66,039 | Yes (X) | |||
| Michael L Butler | |||||||||
| President/Operations & Services | 0.00 | 60.00 | $0 | $1,272,743 | $742,629 | Yes (X) | |||
| Randy Axelrod MD | |||||||||
| EVP/Clinical & Patient Svcs | 0.00 | 60.00 | $0 | $1,055,259 | $219,690 | Yes (X) | |||
| Janice J Jones | |||||||||
| SVP/CAO | 0.00 | 55.00 | $0 | $999,701 | $159,493 | Yes (X) | |||
| Myron Berdischewsky MD | |||||||||
| SVP/CMQO | 0.00 | 60.00 | $0 | $855,510 | $158,577 | Yes (X) | |||
| Jack Friedman | |||||||||
| SVP/Account Care & Payor Rel. | 0.00 | 55.00 | $0 | $826,281 | $177,752 | Yes (X) | |||
| Ray Williams | |||||||||
| SVP/Physicians Svcs | 0.00 | 55.00 | $0 | $761,267 | $203,589 | Yes (X) | |||
| Cindra R Syverson | |||||||||
| SVP/CHRO | 0.00 | 60.00 | $0 | $717,450 | $292,188 | Yes (X) | |||
| Craig L Wright MD | |||||||||
| SVP/Physicians Svcs | 0.00 | 60.00 | $0 | $708,798 | $451,637 | Yes (X) | |||
| John O Mudd | |||||||||
| SVP/Mission Leadership | 0.00 | 55.00 | $0 | $542,246 | $208,258 | Yes (X) | |||
| Claudia Haglund | |||||||||
| VP/Governance & Sponsorship | 0.00 | 50.00 | $0 | $494,375 | $157,049 | Yes (X) | |||
| Joel S Gilbertson | |||||||||
| VP/Govt. & Public Affairs | 0.00 | 55.00 | $0 | $456,594 | $126,245 | Yes (X) | |||
| David Brown | |||||||||
| VP/Strategy & Innovation | 0.00 | 55.00 | $0 | $434,606 | $168,959 | Yes (X) | |||
| Orest Holubec | |||||||||
| SVP/Marketing & Communications | 0.00 | 60.00 | $0 | $423,960 | $61,310 | Yes (X) | |||
| Gary Flaming | |||||||||
| SVP/Chief Risk Officer | 0.00 | 57.00 | $0 | $381,771 | $94,294 | Yes (X) | |||
| Michael Righetti MD | |||||||||
| Physician | 50.00 | 0.00 | $545,012 | $0 | $31,343 | Yes (X) | |||
| Adam T Smith MD | |||||||||
| Chief of Staff | 50.00 | 0.00 | $335,615 | $0 | $34,771 | Yes (X) | |||
| Jamie Straub MD | |||||||||
| Physician | 50.00 | 0.00 | $270,923 | $0 | $29,199 | Yes (X) | |||
| Amanda Blea MD | |||||||||
| Physician | 50.00 | 0.00 | $249,106 | $0 | $27,233 | Yes (X) | |||
| Kelly G Bagnell MD | |||||||||
| OB/GYN | 50.00 | 0.00 | $248,134 | $0 | $27,447 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,893,340 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $20,365,251 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $4,983,185 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | 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 |
|---|---|---|---|---|---|
| Cross Country Travcor Staffing | |||||
| LA Lockbox File 50941 | Los Angeles | CA | 90074 | Staffing Services | $775,169 |
| Mission Valley Anesthesia Assoc | |||||
| Glacier Bank 49430 Highway 93 | Polson | MT | 59860 | Anesthesiology | $602,308 |
| Alliance Healthcare | |||||
| PO Box 6600 | Newport | CA | 92658 | MRI Services | $280,473 |
| Comphealth | |||||
| PO Box 972651 | Dallas | TX | 75397 | Staffing Services | $216,144 |
| Medical Doctor Associates | |||||
| PO Box 277185 | Atlanta | GA | 30384 | Staffing Services | $176,956 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $79,927 | RelatedOrganizationsAmt |
| Government Grants | $196,147 | GovernmentGrantsAmt |
| All Other Contributions | $2,726 | AllOtherContributionsAmt |
| Total Contributions | $278,800 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Acute - Outpatient | 621400 | $11,508,900 | $11,508,900 |
| Primary Care | 621110 | $6,831,909 | $6,831,909 |
| Acute - Inpatient | 622110 | $6,508,582 | $6,508,582 |
| LTC/Home Care | 621610 | $1,257,199 | $1,257,199 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $26,106,590 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,298 | TotalRevenueColumnAmt |
| Exclusion | $5,298 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $38,215 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $38,215 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,215 | TotalRevenueColumnAmt |
| Exclusion | $38,215 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Pharmacy Revenue | 446110 | $892,543 | $214,210 | $678,333 |
| Dietary | 900099 | $158,387 | $158,387 | |
| Purchase Discounts | 900099 | $6,003 | $6,003 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,120 | TotalRevenueColumnAmt |
| Exclusion | $11,120 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,068,053 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,496,956 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,106,590 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $214,210 | UnrelatedBusinessRevenueAmt |
| Exclusion | $897,356 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,768 | TotalAmt |
| Program Services | $12,768 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,167 | TotalAmt |
| Management And General | $255,167 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,209,343 | TotalAmt |
| Program Services | $10,713,248 | ProgramServicesAmt |
| Management And General | $1,496,095 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $773,640 | TotalAmt |
| Program Services | $674,644 | ProgramServicesAmt |
| Management And General | $98,996 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,101,382 | TotalAmt |
| Program Services | $1,807,678 | ProgramServicesAmt |
| Management And General | $293,704 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $878,290 | TotalAmt |
| Program Services | $755,534 | ProgramServicesAmt |
| Management And General | $122,756 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,343 | TotalAmt |
| Management And General | $18,343 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Management And General | $1,000 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $397 | TotalAmt |
| Management And General | $397 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,967,953 | TotalAmt |
| Program Services | $2,396,220 | ProgramServicesAmt |
| Management And General | $571,733 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,657 | TotalAmt |
| Program Services | $175,657 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,201,478 | TotalAmt |
| Program Services | $778,832 | ProgramServicesAmt |
| Management And General | $422,646 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $630,621 | TotalAmt |
| Program Services | $62,260 | ProgramServicesAmt |
| Management And General | $568,361 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $392,042 | TotalAmt |
| Program Services | $223,464 | ProgramServicesAmt |
| Management And General | $168,578 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192,989 | TotalAmt |
| Program Services | $152,230 | ProgramServicesAmt |
| Management And General | $40,759 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,096 | TotalAmt |
| Program Services | $77,584 | ProgramServicesAmt |
| Management And General | $18,512 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,557 | TotalAmt |
| Program Services | $461,557 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,527,332 | TotalAmt |
| Management And General | $2,527,332 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,013,756 | TotalAmt |
| Program Services | $577,841 | ProgramServicesAmt |
| Management And General | $435,915 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $713,859 | TotalAmt |
| Program Services | $713,859 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $2,472,794 | $2,472,794 | |
| Bad Debts | $1,150,356 | $1,150,356 | |
| Provider Tax | $111,000 | $111,000 | |
| UBI Taxes | $50,900 | $50,900 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,037 | TotalAmt |
| Program Services | $132,081 | ProgramServicesAmt |
| Management And General | $67,956 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,608,757 | TotalAmt |
| Program Services | $23,449,607 | ProgramServicesAmt |
| Management And General | $7,159,150 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,235 | BOYAmt |
| EOY | $1,335 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,888,310 | BOYAmt |
| EOY | $1,183,720 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,668,017 | BOYAmt |
| EOY | $4,560,768 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $629,169 | BOYAmt |
| EOY | $683,408 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,555 | BOYAmt |
| EOY | $49,121 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $23,583,949 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,836,319 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,327,704 | BOYAmt |
| EOY | $8,747,630 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $286,681 | BOYAmt |
| EOY | $1,986,223 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $144,443 | BOYAmt |
| EOY | $215,482 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,288,165 | BOYAmt |
| EOY | $2,337,789 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,386,279 | BOYAmt |
| EOY | $19,765,476 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,581,056 | BOYAmt |
| EOY | $1,872,749 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,262 | BOYAmt |
| EOY | $116,848 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,763,714 | BOYAmt |
| EOY | $9,325,002 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $641,890 | BOYAmt |
| EOY | $1,358 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,558,441 | BOYAmt |
| EOY | $9,824,430 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,646,363 | BOYAmt |
| EOY | $21,140,387 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,579,967 | BOYAmt |
| EOY | -$1,607,155 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,949 | BOYAmt |
| EOY | $232,244 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,739,916 | BOYAmt |
| EOY | -$1,374,911 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,386,279 | BOYAmt |
| EOY | $19,765,476 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,111,801 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $607 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$3,633 | 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 A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $397 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $397 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Payment of dues to MHA to represent healthcare interests with government entities. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $235,295 | OtherCostOrOtherBasisAmt |
| Book Value | $235,295 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,767,003 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,839,730 | DepreciationAmt |
| Book Value | $4,927,273 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $714,150 | OtherCostOrOtherBasisAmt |
| Depreciation | $608,433 | DepreciationAmt |
| Book Value | $105,717 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,864,867 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,388,156 | DepreciationAmt |
| Book Value | $3,476,711 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,634 | OtherCostOrOtherBasisAmt |
| Book Value | $2,634 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,747,630 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (7 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Unamortized Bond Finance Costs | $77,317 |
| Due from Affiliates | $546,216 |
| CSV Life Insurance | $16,852 |
| Third Party Settlements | $1,280,216 |
| Resident Trust Fund | $761 |
| Provider Tax Receivable | $415,560 |
| Cash - Residents | $867 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,337,789 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| Third Party Settlements | $1,006,842 |
| Due to Affiliates | $7,865,226 |
| Bond Premium Discount | $211,777 |
| Capital Lease Obligations | $2,982 |
| Resident Trust Account | $761 |
| SJRC Trust Account | $16,900 |
| Taxable Bond Issue | $664,442 |
| Provider Tax Payable | $55,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,824,430 | 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 H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,114,254 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,114,254 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03780 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $4,576,782 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,232,894 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$656,112 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $700 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $521 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $179 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,691,736 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,233,415 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $458,321 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03780 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $16,702 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,702 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $63,893 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $63,893 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,440 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,440 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $82,035 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $82,035 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,773,771 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,233,415 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $540,356 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,150,356 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $11,533,069 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,473,972 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $1,059,097 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 NONE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Providence St Joseph Medical Center | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 Thirteenth Ave East | AddressLine1 |
| City | Polson | City |
| State | MT | State |
| ZIP Code | 59860 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | montana.providence.org/ | WebsiteAddressTxt |
| State License | 13223 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Providence St Joseph Medical Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://montana.providence.org/hospitals/ | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Providence St. Joseph Medical Center | Part V, Section B, Line 3: The Community Health Assessment workgroup included representatives from the Missoula City-County Health Department, Community Medical Center, St. Patrick Hospital, Partnership Health Center, Air Quality Advisory Council, Curry Health Center, Maternal Child Health Advisory Council, Missoula Aging Services, Missoula Indian Center, Water Quality Advisory Council, WORD, Inc. and the YWCA. |
| Providence St. Joseph Medical Center | Part V, Section B, Line 4: St. Patrick Hospital |
| Providence St. Joseph Medical Center | Part V, Section B, Line 14g: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also, our statements provide information on how to apply by making contact with our business office. |
| Providence St. Joseph Medical Center | Part V, Section B, Line 18e: Financial Assistance information along with payment options are given on each billing statement to the patient. |
| Providence St. Joseph Medical Center | Part V, Section B, Line 20d: The hospital used the average of the largest negotiated commercial insurance rates. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Prov St Joseph Assisted Living Ctr | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 Seventeenth Ave East | AddressLine1 |
| City | Polson | City |
| State | MT | State |
| ZIP Code | 59660 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Assisted Living | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | The PH&S sliding fee scale will be used to determine the amount to be written off as charity care for guarantors with income between 101% and 400% of the current federal poverty level after all funding possibilities available to the guarantor have been exhausted or denied and personal financial resources and assets have been reviewed for possible funding to pay for billing charges. |
| Part I, Line 6a: | In addition to providing its own smaller Community benefit Report, St. Joseph's Community benefit information is included in the consolidated report for Providence Health & Services.Please see: http://montana.providence.org/about/community-benefit/ |
| Part I, Line 7, Column (f): | The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 1,150,356. |
| PART I, LINE 7B | This facility is reimbursed 100% of cost by Medicaid. In addition, they received a sizable Disproportionate Share Hospital bonus to cover the cost of the uninsured. |
| Part II, Community Building Activities: | Medication Assistance: Uninsured patients often do not fill critical prescriptions due to cost and forego care due to lack of coverage, which affects their long term health. This program assists low income and self-pay patients with the assistance they need to access patient assistance programs of pharmaceutical companies and state/federal coverage options. Mental Health Crisis Assessment Services: Due to the lack of adequate mental health and substance abuse services in Lake County, St. Joseph Medical Center collaborates with the Western Montana Mental Health Center to provide assessments in the emergency department on an as needed basis. These assessments help to place patients in the right care setting in a timely manner, while most of those placements are out of county, work is underway to build a short term mental health crisis facility to serve the residents of Lake County.No dollar amounts are presented in Part II since the actual expenses related to these activities are not tracked. |
| Part III, Line 4: | It is Providence's policy to exclude all bad debts from Community benefit information.The Consolidated Audited Financial Statements do not contain a footnote specific to Bad Debt Expense.Bad debt expense is reported in the audited financials as a separate line item within expenses from operations. Bad debt expense represents the amount of gross charges for patients who do not have insurance and which Providence was unable to qualify for assistance under either government programs or our internal charity care policy. |
| Part III, Line 8: | 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: | Billing and Collection PracticesProvidence has written policies about when and under whose authority patient debt is advanced for collection, and uses its best efforts to ensure that patient accounts are processed fairly and consistently.Providence ensures that practices to be used by their outside (non-hospital) collection agencies conform to the standards set forth in this policy, and obtains written commitments from such agencies that they will adhere to those standards. Providence also conducts an assessment of each collection agency's adherence to the policy. Such assessments are conducted at least annually.At time of billing, we provide to all low-income uninsured patients the same information concerning services and charges provided to all other patients who receive care at the hospital.When sending a bill to a patient, Providence includes a) a statement that indicates that if the patient meets certain income requirements the patient may be eligible for a government-sponsored program or for financial assistance from the hospital; and b) a statement that provides the patient with the name and telephone number of a hospital employee or office from whom or which the patient may obtain information about Providence's financial assistance policies for patients and how to apply for such assistance.Any patient seeking financial assistance from Providence (or the patient's legal representative) provides the individual facility with information concerning health benefits coverage, financial status (i.e. income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs.For patients who have an application pending determination for either government-sponsored coverage or for the hospitals own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency.Eligibility for financial assistance will be determined as closely as possible to the date of service. |
| Part VI, Line 2: | We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care. |
| Part VI, Line 3: | Communication to the Public:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients. |
| Part VI, Line 4: | Providence St. Joseph Medical Center is a 22 bed acute care, Joint Commission accredited, critical access hospital located on the Flathead Indian Reservation in Polson, Montana, which is about one and a half hours north of Missoula. Providence St. Joseph Medical Center provides community hospital care for the more than 28,000 residents of Lake County. At Providence St. Joseph Medical Center, 36% of patients are covered by Medicare, another 28% are covered by Medicaid and 5% are self-pay and uninsured. Providence St. Joseph Medical Center serves a higher percentage of older adults, with 14% of the primary service area's population over the age of 65. With approximately 16% of the population living in poverty, the community is characterized by lower income levels than the national average. The service area where Providence St. Joseph Medical Center is located encompasses rural communities from Lake, Lincoln, Flathead and Sanders counties with approximately 147,000 residents living in an area of 12,967 square miles. Each of these counties is designated a Mental Health Professional Shortage Area by the U.S. Department of Health & Human Services. The Median Household Income is $36,232 or 16% below the median for Montana. From the 2009 U.S. Census Quick Facts for Montana, these counties have a higher percentage (17.25%) of residents who are older than 65 living in the four county service area compared with the state (14.6%). |
| Part VI, Line 5: | Providence St. Joseph Medical Center management is directed by a community ministry board which helps direct the hospital in its endeavors. The composition of the community ministry board represents the diversity of the community by having representatives from local government, social service agencies, medical providers, independent business representatives and interested community members. The St. Joseph Medical Center Community Ministry Board of Directors reviews and develops the community benefit plan, providing information and insight into community needs and resources and helping set priorities for what community needs are to be addressed. They also receive regular updates on the overall community benefit strategy and specific programs to assess whether the organization is having an impact on the health of the community. The providers and staff and St. Joseph Medical Center provide education to the broader community on certain health benefits, risks and preventative medicine and is provided at no cost. The hospital has been serving the needs of the community since 1916 and has expanded over the years in response to the growing population and changes in health care. As a ministry of Providence Health & Services, Providence St. Joseph Medical Center participates in shared purchasing, information systems and financial management support that benefits the community hospital. In 2013, the medical center had 758 admissions, 4,814 emergency visits and 67,286 outpatient visits. Providence St. Joseph Medical Center also includes St. Joseph Retirement Community, an assisted living center.Providence Medical Group manages 32 primary care and specialty provider practices, employing 133 total providers. Providence St. Joseph Medical Center and Providence Medical Group collectively build and support coordinated services across the continuum of care to meet regional residents' needs, while mutually supporting organizational, operational, and fiscal health. Joint ventures include research collaborations (cardiac, neuroscience and oncology) with the University of Montana; affiliations with long term care facilities; a community based mental health center and the Indian Health services clinic, among others. |
| Part VI, Line 6: | Providence Health & Services owns or operates 32 general acute care hospitals, three ambulatory care centers, five medical groups, six long-term care facilities, seven homecare and hospice entities, five assisted living facilities, a children's nursing center, 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 22 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; Everett, Seattle, Edmonds, Issaquah, Spokane and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California.Providence St. Joseph Medical Center conducts local assessments to make sure the needs of the community are met. The community ministry board of directors oversees and approves the annual community benefit plan that addresses the health care disparities within the community. The community benefit plan is developed and reviewed annually to ensure that the proposed outcomes are being met. This plan is implemented in concert with others in the community to increase the accountability that we share with them to improve the health of our community and to not duplicate services. Access to mental health services is one of the top priorities of the community and St. Joseph Hospital coordinates the Lake County crisis committee to address both the short and long term solutions. By collaborating with community groups, a new mental health crisis facility is being built, access to tele-psychiatry services in primary care as well as direct services from an LCSW and Advanced practice RN are now in place. Additional efforts are underway to minimize the impact of mothers delivering babies while under the influence of drugs and alcohol through the Best Beginning committee that St. Joseph staff participate on. |
| Part VI, Line 7, Reports Filed With States | MT |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | During 2013, there were no grants made in excess of the $5,000 required reporting threshold. | 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 (27 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| John F Koster MD - Thru 0313 | ||||||||||||||
| President / CEO | $0 | $1,316,766 | $0 | $1,868,461 | $0 | $17,500 | $0 | $215,651 | $0 | $31,597 | $0 | $3,449,975 | $0 | $0 |
| Rod F Hochman MD - Eff 0413 | ||||||||||||||
| President / CEO | $0 | $1,051,406 | $0 | $334,001 | $0 | $17,500 | $0 | $486,988 | $0 | $28,915 | $0 | $1,918,810 | $0 | $0 |
| Todd Hofheins | ||||||||||||||
| EVP/CFO | $0 | $432,363 | $0 | $120,504 | $0 | $17,500 | $0 | $65,303 | $0 | $24,807 | $0 | $660,477 | $0 | $0 |
| 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 |
| James R Kiser II | ||||||||||||||
| CEO - PSJMC | $187,192 | $0 | $39,703 | $0 | $17,655 | $0 | $10,617 | $0 | $17,313 | $0 | $272,480 | $0 | $0 | $0 |
| Terry L Smith | ||||||||||||||
| SVP/Management Svcs | $0 | $639,022 | $0 | $906,428 | $0 | $67,500 | $0 | $202,105 | $0 | $24,053 | $0 | $1,839,108 | $0 | $0 |
| Deborah Burton | ||||||||||||||
| SVP/Chief Nrsg. Officer | $0 | $323,817 | $0 | $1,005,792 | $0 | $17,500 | $0 | $42,736 | $0 | $23,303 | $0 | $1,413,148 | $0 | $296,416 |
| Michael L Butler | ||||||||||||||
| President/Operations & Services | $0 | $954,645 | $0 | $300,598 | $0 | $17,500 | $0 | $713,468 | $0 | $29,161 | $0 | $2,015,372 | $0 | $0 |
| Randy Axelrod MD | ||||||||||||||
| EVP/Clinical & Patient Svcs | $0 | $613,884 | $0 | $315,700 | $0 | $125,675 | $0 | $192,796 | $0 | $26,894 | $0 | $1,274,949 | $0 | $0 |
| Janice J Jones | ||||||||||||||
| SVP/CAO | $0 | $604,348 | $0 | $377,853 | $0 | $17,500 | $0 | $132,205 | $0 | $27,288 | $0 | $1,159,194 | $0 | $0 |
| Myron Berdischewsky MD | ||||||||||||||
| SVP/CMQO | $0 | $527,449 | $0 | $310,561 | $0 | $17,500 | $0 | $134,979 | $0 | $23,598 | $0 | $1,014,087 | $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 |
| Ray Williams | ||||||||||||||
| SVP/Physicians Svcs | $0 | $120,595 | $0 | $200,000 | $0 | $440,672 | $0 | $179,162 | $0 | $24,427 | $0 | $964,856 | $0 | $0 |
| Cindra R Syverson | ||||||||||||||
| SVP/CHRO | $0 | $404,069 | $0 | $312,381 | $0 | $1,000 | $0 | $267,888 | $0 | $24,300 | $0 | $1,009,638 | $0 | $0 |
| Craig L Wright MD | ||||||||||||||
| SVP/Physicians Svcs | $0 | $509,167 | $0 | $128,777 | $0 | $70,854 | $0 | $432,646 | $0 | $18,991 | $0 | $1,160,435 | $0 | $0 |
| John O Mudd | ||||||||||||||
| SVP/Mission Leadership | $0 | $368,604 | $0 | $158,842 | $0 | $14,800 | $0 | $189,558 | $0 | $18,700 | $0 | $750,504 | $0 | $0 |
| Claudia Haglund | ||||||||||||||
| VP/Governance & Sponsorship | $0 | $342,176 | $0 | $134,699 | $0 | $17,500 | $0 | $136,830 | $0 | $20,219 | $0 | $651,424 | $0 | $0 |
| Joel S Gilbertson | ||||||||||||||
| VP/Govt. & Public Affairs | $0 | $354,361 | $0 | $84,733 | $0 | $17,500 | $0 | $103,698 | $0 | $22,547 | $0 | $582,839 | $0 | $0 |
| David Brown | ||||||||||||||
| VP/Strategy & Innovation | $0 | $303,119 | $0 | $131,437 | $0 | $50 | $0 | $146,627 | $0 | $22,332 | $0 | $603,565 | $0 | $0 |
| Orest Holubec | ||||||||||||||
| SVP/Marketing & Communications | $0 | $328,545 | $0 | $77,915 | $0 | $17,500 | $0 | $39,407 | $0 | $21,903 | $0 | $485,270 | $0 | $0 |
| Gary Flaming | ||||||||||||||
| SVP/Chief Risk Officer | $0 | $266,837 | $0 | $97,434 | $0 | $17,500 | $0 | $75,446 | $0 | $18,848 | $0 | $476,065 | $0 | $0 |
| Michael Righetti MD | ||||||||||||||
| Physician | $511,012 | $0 | $34,000 | $0 | $0 | $0 | $11,475 | $0 | $19,868 | $0 | $576,355 | $0 | $0 | $0 |
| Adam T Smith MD | ||||||||||||||
| Chief of Staff | $273,103 | $0 | $56,512 | $0 | $6,000 | $0 | $16,792 | $0 | $17,979 | $0 | $370,386 | $0 | $0 | $0 |
| Jamie Straub MD | ||||||||||||||
| Physician | $266,885 | $0 | $4,000 | $0 | $38 | $0 | $11,475 | $0 | $17,724 | $0 | $300,122 | $0 | $0 | $0 |
| Amanda Blea MD | ||||||||||||||
| Physician | $235,672 | $0 | $13,384 | $0 | $50 | $0 | $10,099 | $0 | $17,134 | $0 | $276,339 | $0 | $0 | $0 |
| Kelly G Bagnell MD | ||||||||||||||
| OB/GYN | $226,634 | $0 | $4,000 | $0 | $17,500 | $0 | $11,507 | $0 | $15,940 | $0 | $275,581 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | The reporting organization did not provide any of the benefits listed in Part I, Line 1a. However, as part of Providence's philosophy of transparency, the narrative that follows relates to the compensation and benefits provided by the related organization. Providence Health & Services Expense Reimbursement Procedures include the following policies: 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 Human Resource 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 2013, none of the Officers, Directors or Key Employees listed on Form 990, Part VII utilized First Class or Companion Travel. Tax Indemnifications or Gross-Up Payments Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2013, the following Key Employee received gross-up payments: Craig Wright, MD - Relocation The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding "rent" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The Executive Vice President/Chief Human Resources Officer may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2013, the following Key Employees received relocation/housing program payments: Craig Wright, MD Ray Williams Terry Smith Randy Axelrod The amounts reported for these relocation/housing payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. |
| Part I, Lines 4a-b | NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan C) ESP = Elective Survivor Plan 1) John F. Koster, MD a) Taxable SERP Earned but not Paid- $350,711 b) SERP Interest Credit - $191,190 2) Rod Hochman, MD a) SERP Earned but not Vested- $444,760 b) SERP Interest Credit - $24,378 3) Todd Hofheins a) SERP Earned but not Vested - $57,974 4) Jeffrey W. Rogers a) Taxable SERP Earned but not Paid - $44,111 b) SERP Interest Credit- $97,420 c) ESP Interest Credit - $7,567 5) Cindy Strauss a) SERP Earned but not Vested - $190,313 b) SERP Interest Credit - $14,149 6) Terry Smith a) Taxable SERP Earned but not Paid - $67,662 b) Taxable CBRP Earned but not Paid - $147 c) Non-Taxable CBRP Earned but not Paid - $353 d) ESP Interest Credit - $5,823 e) SERP Interest Credit - $118,609 7) Debbie Burton a) Taxable SERP Earned but not Paid - $915,149 b) SERP Interest Credit - $20,728 8) Mike Butler a) SERP Earned but not Vested - $478,094 b) SERP Interest Credit - $201,306 9) Randy Axelrod, MD a) SERP Earned but not Vested- $181,321 10) Jan Jones a) Taxable CBRP Earned but not Paid - $84 b) Taxable SERP Earned but not Paid - $148,227 c) Non-Taxable CBRP Earned - $101 d) SERP Interest Credit - $100,997 11) Myron Berdischewsky, MD a) Taxable CBRP Earned but not Paid - $2,548 b) Taxable SERP Earned but not Paid - $108,227 c) Non-Taxable CBRP Earned - $2,060 d) SERP Interest Credit - $105,170 12) Jack Friedman a) Taxable SERP Earned but not Paid - $54,169 b) SERP Interest Credit - $100,470 13) Ray Williams a) SERP Interest Credit - $12,906 b) SERP Earned but not Vested - $153,506 14) Cindra Syverson a) SERP Earned but not Vested - $144,043 b) SERP Interest Credit - $103,147 15) Craig Wright, MD a) SERP Earned but not Vested - $221,797 b) SERP Interest Credit - $181,734 16) Jack Mudd a) Taxable SERP Earned but not Paid - $50,004 b) SERP Interest Credit - $165,857 17) Claudia Haglund a) Taxable SERP Earned but not Paid - $35,007 b) SERP Interest Credit - $70,109 c) ESP Interest Credit - $2,161 18) Joel Gilbertson a) SERP Earned but not Vested - $52,868 b) SERP Interest Credit - $32,392 19) David Brown a) SERP Interest Credit - $39,209 b) SERP Earned but not Vested - $80,917 20) Orest Holubec a) SERP Interest Credit - $6,443 b) SERP Earned but not Vested - $21,490 21) Gary Flaming a) SERP Interest Credit - $4,233 b) Taxable SERP Earned but not Paid - $17,362 c) Taxable CBRP Earned but not Paid - $1,640 d) Non-Taxable CBRP Earned - $4,730 |
| Part I, Lines 4a-b | SEVERANCE 1) Ray Williams - $376,916 |
| 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 K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Montana Facility Finance Authority | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 810302402 | BondIssuerEIN |
| CUSIP | 61204KCB5 | CUSIPNum |
| Bond Issued | 2006-06-22 | BondIssuedDt |
| Issue Price | $10,589,455 | IssuePriceAmt |
| Purpose | Refunded Series 1999 Bonds - 7/20/99; Refunded Series 2002 Bonds - 8/7/02 | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $906,000 | RetiredAmt |
| Total Proceeds | $10,589,455 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $113,191 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $10,474,771 | OtherSpentProceedsAmt |
| Substantial Completion | 2002 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | Yes (1) | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Date Rebate Computation Performed | FormAndLineReferenceDesc |
| Explanation | Issuer Name: Montana Facility Finance Authority Date the Rebate Computation was Performed: 06/22/2011 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The sole Corporate Member of the Corporation is St. Patrick Hospital and Health Sciences Center. |
| 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 with or without cause. Additionally, the Member may appoint and remove the President/CEO with or without cause after consultation with the Board. |
| Form 990, Part VI, Section A, line 7b | The following powers reside with the Member: To adopt or change the mission, philosophy, and values of the Corporation. To amend or repeal the Articles of Incorporation and the Bylaws of the Corporation. To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale, transfer, assignment or encumbering of the assets, in excess of a specified amount. To approve the dissolution and/or liquidation or the consolidation or merger of the Corporation. To approve the annual operating and capital budget and approval any deviations from the budget exceeding a specified amount. To appoint the Corporation's certified public accountants after receiving recommendation of the Board of Directors. To approve the lending of Corporate funds, other than the purchase of publicly traded securities, to unaffiliated organizations. To approve the closure of any institution or major ministry or work within this 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. 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 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. Financial statements are available on our public Internet site www.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 | James R. Kiser II - 6 Thirteenth Ave. E., Polson, MT 59860. |
| Form 990, Part XI, line 9: | Recipient Organization Adjustment 71,039. Expenses paid by Foundation to 3rd Party -75,927. TR Investment Income from Life Insurance 1,256. Rounding -1. |
| 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 System's investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. |
| FORM 990, PART VII, SECTION A - RELATED ORGANIZATION COMPENSATION | Compensation paid by a related organization for those individuals listed on Part VII, was paid by Providence Health & Services - Washington dba Health System Office EIN# 91-0725998 and not by the reporting organization. |
| FORM 990, PART I, LINE 6 - VOLUNTEERS | Gift Shop Volunteers Surgery Reception Oncology Reception/Lab Delivery Medical Records Clerk |
| 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. |
| FORM 990, PART V, LINE 1 - ISSUANCE OF FORM 1099 | All 1099s for 2013 were issued by Providence Health & Services - WA. #51-0216586. Therefore, none are shown for the reporting organization. |
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 Plan Partners | |||||||||||
| 4400 NE Halsey Bldg 2 | Portland | OR | 97213 | 911861964 | Healthcare Services | OR | 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 | 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 | |
| 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 | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | 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 | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |