2012-11-15T14:25:48-06:00 2011-12-31 911194016 Clark Nuber PS 10900 NE 4th Suite 1700 Bellevue WA 98004 990 2011-01-01 510216586 PROVIDENCE HEALTH & SERVICES - WASHINGTON PROV 4255253985 1801 Lind Ave SW No 9016 Renton WA 980579016 Todd Hofheins 4255253985 2012-11-15 1 Sara Elizabeth J Hyre CPA P00235495 4254544919 2011 2016-02-24 21:20:13Z John F Koster MD 1801 Lind Ave SW No 9016 Renton WA 980579016 5363442294 0 X www2.providence.org X 1859 WA Healthcare with special concern for the poor and vulnerable in WA. & AK. 13 13 25449 4763 9411808 2124719 26384935 38316774 3026006930 3118429863 50267367 56985162 341671989 404613548 3444331221 3618345347 13924007 17040598 0 0 1686837618 1840064916 0 0 1498139 1710954254 1655387808 3411715879 3512493322 32615342 105852025 5026204416 5566177800 3395073104 3820671312 1631131312 1745506488 X As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Healthcare with special concern for the poor & vulnerable in WA. & AK. 0 0 1372166829 0 1680350451 Acute Care - Inpatient 520,122 Adult & Pediatric Admissions 113,758 Patient DaysOUR 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. Providence Health & Services - Washington is a not-for-profit network of hospitals, care centers, physicians, clinics, home health services and affiliated services. We continue a tradition of caring that the Sisters of Providence began in the West 150 years ago. 831084184 0 1017742635 Acute Care - Outpatient 1,577,756 Emergency & Ancillary Visits 199511409 0 244320938 LTC/Hospice/Housing & Assisted Living - 410,918 Days for Long-Term Care/Asst. Living; 243,339 Home Health Visits; 325,217 Hospice Days 119045185 0 145782296 Primary Care 993,835 Clinic Visits 38558256 0 47218299 Healthcare Joint Ventures 17040598 17040598 0 Grant & Allocations - See Schedules F & I 174644039 17040598 193000595 2577406461 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 1 2950 0 1 25449 1 1 1 0 0 0 0 1 1 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WA X Karl E Fritschel CPA 4255253339 1801 Lind Ave SW 9016 Renton WA 980579016 X Lucille Dean SP 16.70 X X 0 0 0 M Adrian Davis LCM 5.10 X 0 0 0 Mary Corita Heid RSM 4.70 X 0 0 0 Michael A Stein 6.40 X 19271 0 0 Michael Holcomb 6.50 X 16045 0 0 Dana A Rasmussen 5.50 X 16420 0 0 James S Roberts MD 6.00 X 21564 0 0 Peter J Snow 5.40 X 21643 0 0 Jeffrey B Clode MD 7.40 X 21545 0 0 Sallye Liner 2.60 X 19893 0 0 Owen B Robinson 5.50 X 16065 0 0 Cheryl M Scott 4.70 X 16143 0 0 Ellen L Wolf 9.00 X 16065 0 0 John F Koster MD 54.00 X 4776573 0 1602882 Jeffrey W Rogers 50.00 X 1614579 0 524852 Todd Hofheins 56.00 X 330772 0 44868 Michael L Butler 65.00 X 1162565 0 582548 John V Fletcher 55.00 X 1825505 0 613859 Eugene Al Parrish 50.00 X 1051632 0 489361 Daniel T Harris 50.00 X 515843 0 216022 Anthony J Dorsch 50.00 X 345555 0 66323 Gregory Van Pelt 55.00 X 3311411 0 947178 Arnold R Schaffer 60.00 X 2709303 0 779042 Janice J Jones 55.00 X 2720021 0 566298 John O Mudd 55.00 X 860943 0 408169 Myron Berdischewsky MD 65.00 X 674529 0 464404 Claudia Haglund 50.00 X 1909927 0 456179 Michael Hunn 60.00 X 1319956 0 257022 Cindra R Syverson 60.00 X 494955 0 174335 Joel S Gilbertson 50.00 X 455568 0 74143 David Brown 55.00 X 364226 0 120281 Orest Holubec 50.00 X 313390 0 41419 Terry L Smith 60.00 X 3216132 0 671539 Craig L Wright MD 60.00 X 638787 0 284670 Bruce Lamoureux 60.00 X 599685 0 217743 Andy Agwunobi MD Thru 1130 50.00 X 693875 0 198720 David T Brooks 60.00 X 565551 0 207530 Medrice Coluccio 55.00 X 583584 0 380601 Elaine S Couture 50.00 X 505946 0 158179 Michael Wilson 50.00 X 434191 0 0 Andrew T Howlett 40.00 X 1423471 0 19817 Steven A Burdick 40.00 X 1130093 0 180058 James N Dunlap 40.00 X 1122942 0 19817 Atul Thakker 40.00 X 1059251 0 99042 Thomas Corley 40.00 X 1048313 0 325099 Keith Marton 0.00 X 1234802 0 157078 Russell Danielson 0.00 X 233389 0 0 41431919 0 11349078 2147 1 1 0 M A Mortenson Company 14719 NE 29th Place Bellevue WA 98007 Construction 45643099 Inland NW Health Services PO Box 469 Spokane WA 99210 Staffing 25278877 Health Services NW 2201 Lind Ave Suite 300 Renton WA 98057 AR Collections 12221846 Philips Medical Systems PO Box 100355 Atlanta GA 30384 Technology Support 10013970 GE Healthcare PO Box 843553 Dallas TX 75284 R&M Equipment 9349810 521 67236 763463 7071829 17958333 12455913 19900 38316774 Acute Care/Inpatient 900099 1669167636 1669167636 Acute Care/Outpatient 621400 1010969508 1010969508 LTC/Homecare/Hospice 621610 242694970 242694970 Primary Care 621110 144817070 144812108 4962 Healthcare JVs 900099 46929240 46904059 25181 3851439 3851439 3118429863 40629955 40629955 32280730 20789 15205376 0 17075354 20789 17096143 1405520 15690623 1734064778 9748487 1717163066 10294992 16901712 -546505 16355207 16355207 286768 763463 486754 -199986 -199986 28564 8669 19895 19895 2691271 1938090 753181 753181 Laboratory Revenue 621500 19154203 93340 2156546 16904317 Pharmacy Revenue 446110 17168042 7671823 5034228 4461991 Cafeteria Revenue 722210 15588034 627774 14960260 335034036 9249736 157597 325626703 386944315 3618345347 3135414619 9411808 435202146 15524735 15524735 308532 308532 1207331 1207331 23323413 1686789 21636624 1358220248 1024473963 333034257 712028 135644983 79309702 56148339 186942 220439905 153330185 66934113 175607 102436367 75336939 27033737 65691 29071 29071 5704487 648984 5055503 3115793 3115793 735101 735101 4726208 4726208 401586086 230809359 170726394 50333 7614024 5358867 2245558 9599 104203596 71902906 32151374 149316 44181373 6790188 37390132 1053 73185772 47830750 25349844 5178 12143308 5345938 6778634 18736 9577416 1972739 7589988 14689 37481194 35428174 2053020 2583293 2583293 184562557 110435132 74127425 26248728 18219499 8029229 Medical Supplies 445649212 445263601 385611 Bad Debt Expense 177307478 176869206 408581 29691 Prof. Liab. Trust 33955847 33955847 UBI Taxes 311500 311500 80485764 69323871 11082617 79276 3512493322 2577406461 933588722 1498139 11471118 3215809 432605628 311383408 1250712 3790569 398880521 459916247 30028902 36399969 56491834 56501907 29576566 35990863 4112228897 1811042934 1967752143 2301185963 1073682884 1192019340 88778494 82941176 12189344 17428673 923496270 1065403876 5026204416 5566177800 424425773 478586680 7636121 6346535 737200000 845889999 200322 172499 252924980 252618042 1972685908 2237057557 3395073104 3820671312 X 1577741340 1700467739 43738253 42507244 9651719 2531505 1631131312 1745506488 5026204416 5566177800 X 105852025 8523151 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 1 299000 1 0 1 278357 1 0 1 221456 798813 0 Explanation of Lobbying Activities: Part II-B, Line 1: As a not-for-profit Catholic health care ministry, Providence Health & Services continues to answer the call for greater social justice. We urged Congress to preserve the reforms passed with the Patient Protection and Affordable Care Act and to continue the important work to truly reform our nation's health care system. We must ensure access to those people still uninsured, stabilize and strengthen the Medicaid program and empower a redesign of the delivery of health care to improve quality and efficiency. Providence accepts its role in leading health care reform in the communities we serve. We embrace our accountability as a health care provider to deliver higher quality and lower cost care. A better, more sustainable health care system requires improvements in both care delivery and public policy. The following issues were a priority for 2011. Protect the Poor and Vulnerable If health care reform is to be successful, it is vital that hospitals, physicians and other providers have the resources necessary to meet the increased demand created by millions more insured people after 2014. Continued Medicare payment reductions will undermine access to services for Medicare beneficiaries and others in our communities. We urged Congress to prevent further cuts to the Medicare program so that access to necessary services in our communities is preserved. * Prevent any additional cuts to Medicare providers beyond those included in the Affordable Care Act. * Preserve seniors' ability to access care with a permanent solution for the Medicare physician payment schedule that doesn't finance the solution with cuts to other providers. Remove barriers to coordinate care In order to truly improve quality and make health care more affordable, doctors, hospitals and other providers must change the way they provide care to their patients. This means both changing the practice of medicine and how government and private insurers pay for health care. Patients will receive better care when providers are paid to coordinate and collaborate with each other. We urged Congress and federal regulatory agencies to continue the important work of redesigning how health care is paid for so that providers are rewarded for delivering the right care at the right time, in the right setting. * Eliminate legal barriers to new care models that prevent providers from working together to coordinate care and improve quality. * Create opportunities through the Center for Medicare and Medicaid Innovation for a broad range of payment models that include various types of health care providers and diverse geographic areas, versus limiting experimentation to high-cost areas and narrowly defined participants. * Protect Medicaid and Medicare funding for electronic medical record adoption and ensure regulations empower collaboration and the sharing of information between clinicians. Preserve not-for-profit health care. Providence's tax exempt status represents far more than a legal designation: it is an enduring commitment to not only provide high-quality health care, but to go beyond our care settings and partner with our community to meet the needs of the most vulnerable among us. We urged Congress to recognize and preserve the vital role not-for-profit health care providers play in health care delivery. * Protect local, state and federal tax exemptions that are essential to meet the needs of the communities we serve. * Utilize standards that recognize diverse approaches to delivering community benefit that are based on meeting each community's unique needs for improving health. Ensure everyone has access to health care. We believe access to quality, affordable health care is a basic human right. No one should ever become sick- or worse, lose their life -because they couldn't access health care services. Everyone, whether they are covered by private insurance or a government program, should have a primary care provider and access to necessary specialty care. We urged Congress to ensure everyone has access to affordable, high quality health care services. * Develop federal and state solutions that ensure immigrants, the homeless and other vulnerable people receive needed care. * Provide the necessary funding support for safety net providers and programs, including Medicaid, to ensure appropriate access to health care. Strengthen the health care workforce. Our nation is facing a worsening shortage of health care workers, driven by both an aging workforce and the increased health care needs of an aging baby boomer generation. Federal policy to strengthen and expand the capacity of the health care workforce has the potential to significantly impact the success of implementing the reform legislation. We urged Congress and federal agencies to continue their efforts to meet the demand for health care professionals through reforms that expand education, enrollment and training. * Expand medical education, increase enrollment in nursing programs and increase training of new health care workers through focused funding, grants and other mechanisms. * Streamline the application processes for workforce training grants to encourage the collaboration between health care organizations and educational institutions. 8463851 51311 75538 8107177 483523 7596645 364798 677288 174880 8463851 6401153 106633 1289282 162845 7578 30000 7596645 8854708 287226 -2413940 326841 6401153 0.00000 1.00000 0.00000 0 1 1 39372087 134315860 173687947 195970743 1810959284 783434782 1223495245 104553104 73380916 31172188 51911216 1329430703 954227236 427114683 2707769 443008131 445715900 2301185963 Due From Affiliates 658239657 Trustee Held Funds 220859373 Unamortized Finance Costs 13233155 Assets Held Under Securities Lending 86986894 Other Long-Term Receivables 51649354 Third Party Settlements 27623726 Charitable Trusts & Gift Annuities 572700 CSV of Life Insurance 353586 Deferred Compensation 457F 4477390 Bond Premium Discount 1388041 Chihuly Studio Artwork(glass) 20000 1065403876 Self-Insured Trusts 230639373 Due To Affiliates 666591454 Taxable Bond Issues 250765821 Accrued Pension Costs 909518189 LT Asset Retirement Obligation - FIN 47 18781811 Liabilities Under Securities Lending 89183210 Other Long-Term Payables 21636353 Third Party Settlements 49941346 2237057557 Description of Intended Use of Endowment Funds: Part V, Line 4: The Endowment Funds are intended to be used to support the mission and programs of Providence Sacred Heart Medical Center. Description of Uncertain Tax Positions Under FIN 48: Part X: The Health System recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. 1 Central America and the Caribbean 0 0 Grantmaking 762989 Sub-Saharan Africa 0 0 Grantmaking 61546 South America 0 0 Grantmaking 382796 0 0 0 0 0 0 1207331 0 1207331 Central America and the Caribbean Medical Supplies 212496 Medical Supplies Cost Central America and the Caribbean Medical Supplies 59614 Medical Supplies Cost Central America and the Caribbean Medical Supplies 149653 Medical Supplies Cost Central America and the Caribbean Medical Supplies 189931 Medical Supplies Cost Central America and the Caribbean Medical Supplies 121081 Medical Supplies Cost Sub-Saharan Africa Medical Supplies 61546 Medical Supplies Cost Central America and the Caribbean Medical Supplies 17365 Medical Supplies Cost South America Rebuild Church 382796 Check & Wire Transfer Central America and the Caribbean Post Flood Relief 12849 Wire 9 0 1 0 0 0 0 0 Procedure for Monitoring Grants Outside the U.S.: Schedule F, Part I, Line 2: We only provide grants to non-governmental, charitable organizations that conduct foreign activities. For the donations we require a potential recipient to first complete an application. We have two types of applications; one for donations that will be taken by a person on a plane and part of medical team, the other for container donations that will be shipped. The type of information gathered is different for each application. We always ask for the name of the specific clinic, program or hospital that will be at the clinic. We also ask for information about who will be served/benefit from these donations. We also ask that the recipient provide us feedback on how useful the donations were and what problems they may have encountered. Form 926 is not required to be filed because the transfer to a foreign corporation does not meet the reporting requirements in IRC Section 6038B(a)(1)(A). Providence O'Christmas Trees 828264 593856 234408 30649 102886 251001 The Pour 108627 98102 10525 8359 36499 3242 3 113340 71505 41835 1340 19707 11569 500 21002 1050231 763463 286768 1340 58715 150954 500 275245 486754 -199986 28564 1850 1170 5649 1 1.00000 28564 1850 1170 5649 8669 19895 WA 1 0 0 0 1.00000 Patricia L Szabo 4831 35th Avenue SW Seattle WA 98126 0 Patricia L Szabo 0 Provided oversight of sale of raffle tickets and accounting for proceeds received. X 0 1 1 X 1 X 1 X 1 1 1 0 1 1 80771036 80771036 0.02300 518833553 398547403 120286150 0.03420 9931456 7418320 2513136 0.00070 609536045 405965723 203570322 0.05790 4655667 543714 4111953 0.00120 30780814 9634002 21146812 0.00600 77653508 48195728 29457780 0.00840 2857343 814723 2042620 0.00060 5690432 22654 5667778 0.00160 121637764 59210821 62426943 0.01780 731173809 465176544 265997265 0.07570 18678 18678 0.00000 4500 4500 0.00000 16540 16540 0.00000 31852 31852 0.00000 8582 8582 0.00000 8149 8149 0.00000 88301 88301 0 177307478 0 1047540535 1290330106 -242789571 X 1 1 11 1 Providence Alaska Medical Center

3200 Providence Drive Anchorage AK 99508

X X X X X 2 Providence SHMC & Children's Hospital

101 West 8th Avenue Spokane WA 99204

X X X X 3 Providence St Peter Hospital

413 Lilly Road NE Olympia WA 98506

X X X 4 Providence Regional Med Ctr-Colby

1321 Colby Avenue Everett WA 98201

X X X 5 Providence Regional Med Ctr-Pacific

916 Pacific Avenue Everett WA 98208

X X X 6 Providence Holy Family Hospital

5633 North Lidgerwood Street Spokane WA 99208

X X X 7 Providence Centralia Hospital

914 S Scheuber Road Centralia WA 98531

X X 8 Providence St Mary Medical Center

401 W Poplar St Walla Walla WA 99362

X X X 9 Providence Mt Carmel Hospital

982 East Columbia Colville WA 99114

X X X X 10 Providence St Joseph's Hospital

500 East Webster Street Chewelah WA 99109

X X X 11 Providence Kodiak Is Medical Center

1915 Rezanof Drive Kodiak Island AK 99615

X X Providence Alaska Medical Center 1 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X X X 1 0 1 X 0 1 Providence SHMC & Children's Hopsital 2 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 1 X 0 1 Providence St Peter Hospital 3 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 1 X 0 1 Providence Regional Med Ctr Colby 4 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 1 X 0 1 Providence Regional Med Ctr Pacific 5 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 1 X 0 1 Providence Holy Family Hospital 6 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 1 X 0 1 Providence Centralia Hospital 7 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 1 X 0 1 Providence St Mary Medical Center 8 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 1 0 1 Providence Mt Carmel Hospital 9 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 1 X 0 1 Providence St Joseph's Hospital 10 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X 1 0 1 X 0 1 Providence Kodiak Is Medical Center 11 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X X X 1 0 1 X 0 1 42 Providence Marianwood

3725 Providence Pt Dr SE Issaquah WA 98029

Long-Term Care Providence Elderplace

4515 Martin Luther King Jr Way S Seattle WA 98108

In-Home Service Agency Prov St Peter Chemical Dependency Cter

2505 Olympic Highway N Suite 140 Shelton WA 98584

Chemical Dependency Center Prov St Peter Chemical Dependency Cter

24070 NE Highway 3 Suite A Belfair WA 98528

Chemical Dependency Center Prov St Peter Chemical Dependency Cter

508 1/2 Eighth Street Hoquiam WA 98550

Chemical Dependency Center Prov Internal Medicine Hawks Prairie

8645 Martin Way E Lacey WA 98516

Internal Medicine Clinic Prov South Sound Internal Medicine

3425 Ensign Rd NE Olympia WA 98506

Internal Medicine Clinic Prov Family Medicine West Olympia

1217 Cooper Pt Road SW Olympia WA 98502

Family Medicine Clinic Providence Clinic at Panorama

1450 Northwest Lane SW Olympia WA 98502

Family Medicine Clinic Providence Internal Medicine

1010 S Scheuber Road Centralia WA 98531

Internal Medicine Clinic Providence Imaging Center

908 S Scheuber Road Centralia WA 98531

Patient Diagnostic Imaging Prov Rochester Family Pract Clinic

18313 Paulson St SW Rochester WA 98579

Family Practice Medicine Providence Centralia Womens Center

1000 S Scheuber Road Centralia WA 98531

Comprehensive Women's Health Care Providence Physical Therapy

1809 Cooks Hill Road Centralia WA 98531

Patient Physical Therapy Service Prov Western WA Oncology-Lacey

4525 Third Avenue Suite 200 Lacey WA 98503

Outpatient Oncology Services Prov Western WA Oncology-Aberdeen

954 Anderson St Suite 102 Aberdeen WA 98520

Outpatient Oncology Services Prov Western WA Oncology-Centralia

2015 Cooks Hill Road Suite 200 Centralia WA 98531

Outpatient Oncology Services Providence SoundHomeCare & Hospice

3432 South Bay Road NE Olympia WA 98506

Home Care and Hospice Services Providence Mother Joseph Care Center

3333 Ensign Road NE Olympia WA 98506

Long-Term Care Providence Mount St Vincent

4831 35th Ave SW Seattle WA 98126

Long-Term Care/Assisted Living Prov Infusion & Pharmacy Services

2201 Lind Ave SW Renton WA 98057

Pharmaceutical Services Providence Hospice of Seattle

425 Pontius Avenue North Seattle WA 98109

Hospice Services Providence Home Services

2201 Lind Ave SW Suite 160 Renton WA 98057

Home Health Services Providence Mill Creek Medical Bldg

12800 Bothell-Everett Highway Everett WA 98208

Medical Building Providence Everett Healthcare Clinic

1001 N Broadway Everett WA 98201

Clinic Pavillion for Women & Children

900 Pacific Avenue Everett WA 98201

Clinic Prov Physician Group-Harbour Point

4112 Harbour Pointe Blvd SW Ste 100 Mukilteo WA 98275

Clinic Prov Physician Group-North Everett

1330 Rockefeller Everett WA 98201

Clinic Prov Physician Group-Marysville

11603 State Avenue Suite G Marysville WA 98272

Clinic Prov Physician Group-Monroe

14692 179th Avenue SE Suite 100 Monroe WA 98272

Clinic Millcreek OBGYN

12800 Bothell-Everett Hywy Suite 110 Everett WA 98208

Clinic Pacific Campus OBGYN

900 Pacific Avenue Suite 501 Everett WA 98201

OB/Gyn Services Providence Dominicare

110 South Third Street East Chewelah WA 99109

Home Health Providence VNA Home Health

611 N Perry Bldg 2 Suite 202 Spokane WA 99202

Home Health Prov Emily Court Assisted Living

34 East 8th Avenue Spokane WA 99202

Assisted Living Providence St Joseph Care Center

17 East 8th Avenue Spokane WA 99202

Skilled Nursing Facility Providence Adult Day Health

6018 North Astor Spokane WA 99208

Adult Day Health Providence Extended Care Center

4900 Eagle Street Anchorage AK 99503

Skilled Nursing Facility Providence Alaska Physician Service Org

3200 Providence Drive Anchorage AK 99508

Behavioral & Family Medicine Providence Kodiak Island Counseling Ctr

717 E Rezanof Drive Kodiak Island AK 99615

Behavioral Medicine Providence Residential Treatment Program

3400 E 20th Avenue Anchorage AK 99508

Adolescent Residential Treatment Providence Crisis Recovery Center

3760 Piper Street Anchorage AK 99508

Behavioral Medicine PART I, LINE 7, COL. FOur total expense from Form 990, Part IX, Line 25, column (A) was $3,512,493,322,. The bad debt expense included in this amount was $177,307,478. This left us with total expense of $3,335,185,844 for purposes of calculating line 7, column f. Part II: COMMUNITY BUILDING ACTIVITIES:WESTERN WASHINGTON REGION:In Thurston County, Providence St. Peter Hospital sponsored a program called Grief Works, which assists people who are grieving from the loss of a spouse, child or sibling. The work involves pastoral care support and counseling in both individual and group sessions. In addition, Providence leaders serve on local boards. Examples include the board of Behavioral Health Resources, a not-for-profit mental health provider; CHOICE Regional Health Network; local college boards; service organizations; chamber of commerce boards; school board of directors; and the Hands-On Children's Museum, which promotes healthy family living.SOUTHEAST WASHINGTON REGION:Providence St. Mary Medical Center provides many free, preventative, diagnostic and educational services in the communities it serves. In 2011, it provided free screening mammograms to 66 uninsured and underinsured women, home health visits to 370 insured and underinsured people, and free guest house lodging to 154 cancer patients and their families. The medical center offered a free post-partum clinic to new mothers and babies, which was used by 698 women. Numerous free classes and educational events were offered on topics including child birth, colon cancer awareness, diabetes, smoking cessation and prevention of head and spinal cord injuries among youth. Free screenings were provided for skin cancer, prostate cancer and baseline concussion testing for teen athletes. In collaboration with other community agencies, Providence St. Mary donated funds and supplies to a school-based health clinic, which allowed around 200 high-risk students to receive medical care and mental health counseling at the school throughout the school year. The staff of Providence St. Mary also conducted a project along with several other agencies to provide backpacks full of emergency food and hygiene items for homeless youths and distributed the backpacks through a local school. PROVIDENCE HEALTH CARE/EASTERN WASHINGTON REGION:Many of the activities reported in Part II demonstrate the eastern Washington Providence hospitals' efforts to actively engage and partner with the community to help address specific needs. We collaborate with more than 80 community partners in Spokane and Stevens counties that share our commitment to serving the poor and vulnerable. Together, we are able to maximize resources to reach the greatest number of people, providing needed services such as immunizations, screenings, education, medication, shelter and food. Below is a list of a few of the many organizations Providence hospitals support in eastern Washington: *Catholic Charities*Christ Clinic*Community Detox Services of Spokane*Daybreak (rehabilitation services for adolescents with substance abuse issues)*Life Services of Spokane (support services for pregnant women to help them carry babies to term and provision of parenting education)*Northeast Tri-County Health District (Colville)*Partners with Children and Families*Prescriptions for Life (Chewelah)*Project Access (involves doctors and hospitals in the community volunteering to provide needed health care services and surgeries for patients who cannot pay)*Ronald McDonald House*Rural Resources Family Center (Colville)*Spokane Prescription Access Program*Transitional Programs for Women*Tri-County Community Health Fund (Stevens County)*Second Harvest (food bank)*Community Health Association Spokane dental program (a federally quality health center)*Washington Poison Control CenterIn addition, many Providence Health Care leaders and staff participate in community collaboration efforts through their membership on boards and advisory groups such as the Homeless Coalition and the Spokane Mental Health Advisory Board. Other boards include the United Way, YWCA, Women Helping Women, domestic and family violence organizations, educational boards, stroke conference boards, domestic terrorism training and many more where the expertise of the local hospital staff and administration can offer valuable information to the group for partnership and collaborative efforts in attempts to improve the health and wellbeing of the community. Often the hospital has been asked to provide a representative for the board or advisory group by the community. Providence Sacred Heart, Children's Hospital, and Holy Family also participate as major sponsors of community events that benefit the community at large. Examples include: *American Brain Tumor Association*American Heart Association*American Cancer Society*American Red Cross*Cancer Patient Care*Catholic Charities*Hope House*Inland NW Blood Center*March of Dimes*Special Olympics*Women Helping Women*YWCA Part III, Line 4: The consolidated Health System financial statements do not contain a specific footnote describing bad debt expense. Part III, Line 8: It is Providence's policy to exclude any Medicare shortfall from Community Benefit information.The amount reported on Part III, Section B, Line 6, was determined by applying the Cost-to Charge Ratio to the Medicare revenue. Part III, Line 9b: 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 (or the patient's legal representative) seeking financial assistance from Providence 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 III, SECTION A, LINE 1The reporting entity reports bad debt expense in accordance with HFMA Statement #15 with the exception of the following sections: 8.1(b) and 9.1. PART III, LINE 4It 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. Providence SHMC & Children's Hopsital Part V, Section B, Line 13g: 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. Peter Hospital Part V, Section B, Line 13g: 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 Regional Med. Ctr. Colby Part V, Section B, Line 13g: 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 Regional Med. Ctr. Pacific Part V, Section B, Line 13g: 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 Holy Family Hospital Part V, Section B, Line 13g: 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 Centralia Hospital Part V, Section B, Line 13g: 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. Mary Medical Center Part V, Section B, Line 13g: 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 Mt. Carmel Hospital Part V, Section B, Line 13g: 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's Hospital Part V, Section B, Line 13g: 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 SHMC & Children's Hopsital Part V, Section B, Line 17e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence St. Peter Hospital Part V, Section B, Line 17e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence Regional Med. Ctr. Colby Part V, Section B, Line 17e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence Regional Med. Ctr. Pacific Part V, Section B, Line 17e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence Holy Family Hospital Part V, Section B, Line 17e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence Centralia Hospital Part V, Section B, Line 17e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence St. Mary Medical Center Part V, Section B, Line 17e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence Mt. Carmel Hospital Part V, Section B, Line 17e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence St. Joseph's Hospital Part V, Section B, Line 17e: Financial Assistance information along with payment options are given on each billing statement to the patient. Providence Alaska Medical Center Part V, Section B, Line 19d: All individuals are charged the same rate. Providence SHMC & Children's Hopsital Part V, Section B, Line 19d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family. Providence St. Peter Hospital Part V, Section B, Line 19d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family. Providence Regional Med. Ctr. Colby Part V, Section B, Line 19d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family. Providence Regional Med. Ctr. Pacific Part V, Section B, Line 19d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family. Providence Holy Family Hospital Part V, Section B, Line 19d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family. Providence Centralia Hospital Part V, Section B, Line 19d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family. Providence St. Mary Medical Center Part V, Section B, Line 19d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family. Providence Mt. Carmel Hospital Part V, Section B, Line 19d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family. Providence St. Joseph's Hospital Part V, Section B, Line 19d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family. Providence Kodiak Is. Medical Center Part V, Section B, Line 19d: All individuals are charged the same rate. Providence Alaska Medical Center Part V, Section B, Line 21: Gross charges are the same as the amounts generally billed to those having insurance. Providence SHMC & Children's Hopsital Part V, Section B, Line 21: For non medically necessary services a patient may be charged full billed charges. Providence St. Peter Hospital Part V, Section B, Line 21: For non medically necessary services a patient may be charged full billed charges. Providence Regional Med. Ctr. Colby Part V, Section B, Line 21: For non medically necessary services a patient may be charged full billed charges. Providence Regional Med. Ctr. Pacific Part V, Section B, Line 21: For non medically necessary services a patient may be charged full billed charges. Providence Holy Family Hospital Part V, Section B, Line 21: For non medically necessary services a patient may be charged full billed charges. Providence Centralia Hospital Part V, Section B, Line 21: For non medically necessary services a patient may be charged full billed charges. Providence St. Mary Medical Center Part V, Section B, Line 21: For non medically necessary services a patient may be charged full billed charges. Providence Mt. Carmel Hospital Part V, Section B, Line 21: For non medically necessary services a patient may be charged full billed charges. Providence St. Joseph's Hospital Part V, Section B, Line 21: For non medically necessary services a patient may be charged full billed charges. Providence Kodiak Is. Medical Center Part V, Section B, Line 21: Gross charges are the same as the amounts generally billed to those having insurance. Part VI, Line 2: NEEDS ASSESSMENT: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.These general guidelines are applied across all service areas covered in Providence Health & Services - Washington. These include: Northwest Washington Service Area, Southwest Washington Service Area, Southeast Washington Service Area, Providence Health Care in Eastern Washington and PH & S - WA. in Alaska.Providence Sacred Heart Medical Center and Providence Holy Family Hospital partnered with the Spokane Regional Health District and the Institute for Public Policy and Economic Analysis at Eastern Washington University and their Community Indicators Initiative as part of our comprehensive needs assessment. In addition, focus groups were held to gather information from organizations directly addressing the needs of the low income and uninsured. Quantitative and qualitative data were also used to identify the issues the hospitals should target to address in the Spokane community for the next three years, beginning in 2010.Providence Mount. Carmel Hospital and Providence St. Joseph's Hospital partnered with the Northeast Health District and the Institute for Public Policy and Economic Analysis at Eastern Washington University and their Northeast Trends Initiative. In addition, focus groups were held to gather information from organizations directly addressing the needs of the low income and uninsured. Quantitative and qualitative data were also used to identify the issues the hospitals should target to address in the Stevens County community for the next three years, beginning in 2011.Providence ministries in eastern Washington are governed by a community ministry board. In addition, our foundation boards are composed of community members. The results of our needs assessments are presented to these boards for their review and input. The civic leaders that serve on Providence boards connect the Providence Mission with a local perspective on community needs. The Providence Health Care Eastern Washington Community Ministry Board approves the community needs assessments.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 and broad needs of the community, beyond just the need for free and discounted health care services. 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: COMMUNITY INFORMATION:ALASKA REGION:The geographic difficulties of a vast land mass, relatively undeveloped infrastructure and often extreme weather conditions make meeting the health care needs of Alaskans a unique challenge. Providence Health & Services Alaska serves the health needs of all people across the vast state of Alaska (population of 710,231). Providence Alaska has 15 ministries. Most facilities are located in the Anchorage area, yet Providence Alaska expands it services through a presence in four rural communities as well as telemedicine and electronic intensive care unit (eICU) services extended to communities in Alaska and Oregon. Alaska's population is diverse (28 percent minority) and is widely distributed across great distances (only half the population is accessible by road). Alaska has a significant number of high-need communities as ranked by the Thompson Reuters Community Need Index. Alaska is a demographically young state with 51 percent of the population under age 35, although the fastest growing age group is the over 55 population. Providence Alaska Medical Center (PAMC) is the only comprehensive tertiary referral center serving all Alaskans, regardless of their ability to pay. In addition to PAMC, Providence Alaska has a family practice residency program, a continuum of post-acute care services, and a developing medical group located in Anchorage. Anchorage is the second most-diverse city in the nation with more than 90 languages spoken within the Anchorage school district. Thirty-four percent of the Anchorage community is a minority. While PAMC's primary service area is the Municipality of Anchorage, it serves residents throughout the state. By percentage of gross revenue in 2011, approximately 27.1 percent of revenue was from Medicare, 20.1 percent from Medicaid and the remainder from other payers. The percentage of bad debt, charity care and self pay continues to remain high, at nearly 7.9 percent of gross revenue. While the economic recession has impacted Alaska to a lesser degree than other states, the unemployment rate in Anchorage averaged 6.1 percent in 2011. In 2010, 7.9 percent of Anchorage residents lived below the poverty line, which is lower than the comparable state measure at 9.5 percent.Providence Alaska manages four critical access hospitals located in the remote communities of Cordova, Kodiak, Seward and Valdez, all co-located with skilled nursing facilities. Community mental health centers are operated in Kodiak and Valdez. Each hospital serves as the primary health care provider for their community. Providence Kodiak Island Medical Center serves the Kodiak Island Borough, which has a population of just over 13,000. Geographically isolated, the island can only be accessed by air or sea. More than half of the population on Kodiak Island was white in 2010 (55 percent). The next largest ethnic groups were Asian (20 percent) and then American Indian/Native Alaskan (13 percent). Commercial fishing is of historic and current economic importance and employment swings seasonally - with lower unemployment rates in the summer and higher rates in winter months. For peak employment period in July, the unemployment rate was 6.1 percent in 2011, yet the entire year averaged 6.9 percent. Providence Seward Medical Center serves the communities of Seward and Moose Pass. Seward is located at the head of Resurrection Bay on the Kenai Peninsula. The town is 126 road miles south of Anchorage. The majority of the population in Seward was white in 2010 (76 percent). The next largest ethnic groups were American Indian/Native Alaskan (23 percent) and then black (three percent). The median age was 38 years old. In the 2012 needs assessment, 87% of the respondents needed care in the previous 12 months, yet 10 percent were unable to receive care. When asked, the primary reasons cited from not receiving care were "no insurance/could not afford it" (43%), "services not available" (18%), and "needed a specialist that was not available in Seward" (14%). Although the trends show a decrease by each question, access continues to be an issue and an area of focus for Providence within the community. Providence Valdez Medical Center serves the community of Valdez. Valdez is one of Alaska's most important port cities. It is located approximately 120 air miles and 305 road miles east of Anchorage. The population is close to 4,000 and is located within 222 square miles of land area. According to the 2010 census, the majority (87 percent) of the population in the City of Valdez were white, with 13 percent of the population American Indian/Alaska Native. The median age was 37 years old in Valdez according to the 2010 census, a slightly older median age than its statewide counterpart (34 years old). In the 2011 community health needs assessment, approximately one in 12 community survey respondents reported that they or their family had to go without basic needs in the year prior to the survey. Of those who went without basic needs, almost half said they went without dental care (49 percent) and/or health care (46 percent).Cordova Medical Center is the newest addition to the Providence Alaska family. Providence Alaska began management of the 13-bed critical access hospital and 10-bed long term care center on March 1, 2012. The City of Cordova is a community of about 2,500 people, which swells to 5,000 or more during the summer months. The city of Cordova sits on Prince William Sound and is only accessible by plane or boat (it is a 30 minute commercial flight from Anchorage). Cordova is a community best known for its commercial fishing and has a rich culture of Eyak Athabascan heritage. The median age was 42 years old according to the 2010 census. The majority of the population is white (79 percent) and American Indian/Alaska Native 15.4 percent. A community needs assessment completed in 2010 identified that the people of Cordova had low satisfaction with the availability of health services (54 percent total satisfaction) and physicians (40 percent total satisfaction) in the community. Just under two-thirds (61 percent) of the respondents had traveled outside of Cordova for medical care for themselves (or a household member) in the last five years. Providence has made a long-term commitment to meet the health care needs of the community through periodic formal community needs assessments and program service expansion to meet those needs. WESTERN WASHINGTON REGION - NORTHWEST: The Western Washington Region - Northwest includes Providence Regional Medical Center Everett (PRMCE), which is the only tertiary provider in Snohomish County and is located on two campuses in Everett, Washington. The hospital's primary service area is Snohomish County, with a population of 708,683. Within this geography, the average age is 36.5 years and only 10% of the population is over age 65, although this is estimated to grow to 12.5% by 2016. The average household income is $76,219, and approximately 10% of people are living in poverty in Snohomish County. As of March 2012, 8.4% of Snohomish County residents are unemployed, which is higher than the national unemployment rate. The secondary service area includes Skagit, Island, San Juan and Whatcom counties, totaling an additional 491,631 people. Within this geography, the average age is 39.2 years, with 16% of the population over age 65. The average household income is $63,777. The unemployment rates for the secondary service area include: Skagit (10.2%), Island (9.1%), San Juan (8.5%) and Whatcom (8.1%). In 2011, PRMCE provided almost $65.8 million in charity care and community benefits.WESTERN WASHINGTON REGION - SOUTHWEST: The Western Washington Region - Southwest includes Providence St. Peter Hospital in Olympia, Washington and Providence Centralia Hospital in Centralia, Washington. The hospitals deliver care to a five-county area including Thurston, Mason, Lewis, Grays Harbor and Pacific counties. For Providence St. Peter Hospital, the hospital serves 484,679 people in its primary and secondary service area. The average age of the population in this geography is 39.5 years, with 15.7% of the population over age 65. The average household income is $61,515. Providence Centralia Hospital serves 121,894 people in its service area, and the average age is 39.5 years, with 16.6% of the population over age 65. The average household income is $54,776. Within the Western Washington Region - Southwest, the percentage of people living in poverty includes: Thurston (10.7%), Lewis (16.5%), Mason (16.0%), Grays Harbor (17.9%) and Pacific (17.9%). The unemployment rates for the counties include Thurston (8.4%), Lewis (14.1%), Mason (11.6%), Grays Harbor (14.2%) and Pacific (13.6%). In 2011, the Western Washington Region - Southwest provided more than $51.1 million in charity care and community benefits. (SEE CONTINUATION) Part VI, Line 4: COMMUNITY INFORMATION - CONTINUED:SOUTHEAST WASHINGTON REGION:The Southeast Washington Region includes Providence St. Mary Medical Center in Walla Walla, Washington. The hospital serves a population totaling 78,506 people in its primary service area in Walla Walla County and Columbia County in Washington, and five towns in Umatilla County, Oregon. Within this geography, 15.9% of the population is over age 65 and the average household income is $54,016. The unemployment rate in Walla Walla County is 8.1% and Columbia County is 11.6%. The hospital also serves 92,739 people in its secondary service area, which is comprised of Garfield County, Washington and Union, Wallowa and Umatilla counties in Oregon. Within the secondary market, 14.9% of the population is over age 65 and the average household income is $53,372. In total, 15.7% of people in Walla Walla County are living in poverty, as well as 14.6% in Columbia County. In 2011, the Southeast Washington Region provided almost $8.5 million in charity care and community benefits.PROVIDENCE HEALTH CARE/EASTERN WASHINGTON REGION:Spokane County is the furthest east county along Interstate 90, located on the Idaho border. It is largely urban with the second most populated city in the state, Spokane, with a population of 460,000. Providence Sacred Heart Medical Center & Children's Hospital and Providence Holy Family Hospital are located in Spokane County. About 12.5% of its population is over the age of 65. The leading causes of death in Spokane County are cancer, heart disease and stroke. The maternal smoking rate is two times higher than the state average.Stevens County is a largely rural region in northeast Washington, north of Spokane County with Pend Orielle County to the east and Ferry County to the west. Providence Mount Carmel Hospital in Colville is 75 miles north of Spokane and Providence St. Joseph's Hospital in Chewelah is 25 miles north of Spokane. The Stevens County population is 44,300. A high percentage of the rural population (17%) is over the age of 65. The leading causes of hospitalizations are unintended injury and heart disease, which are above the state average. The drug crime rate has continued to increase and is higher than the state average.The primary service area for these five Providence hospitals is defined as Spokane and Stevens counties. As the region's major quaternary hospital, Providence Sacred Heart Medical Center & Children's Hospital serves a much broader tertiary market which spans eastern Washington, northern Idaho, western Montana and northeastern Oregon, with a population of more than 1.6 million. Approximately 43% of patients are covered by Medicare, 25% are covered by Medicaid and nearly 5% uninsured or self-pay. With approximately 15% of the population for most of the counties served living in poverty, this service area is characterized by lower income levels than the state average. Part VI, Line 5: FURTHERANCE OF EXEMPT PURPOSE:As a not-for-profit Catholic health care ministry, Providence Health & Services embraces its responsibility to provide for the needs of the communities it serves - especially those who are poor and vulnerable. Providence's not-for-profit, tax-exempt status enables Providence to serve its communities, to solicit donations through its foundations and to access capital to respond to community needs that otherwise would go unmet. Health care is fundamentally different from most other goods and services. It is about the most human and intimate needs of people, their families and communities. This critical difference is why we work together with other community organizations to preserve and strengthen the not-for-profit sector in health care.ALASKA REGION:In Alaska, access to health care is one of the most critical community needs. To address this need, Providence Alaska and its local ministries are involved in and supportive of many programs, activities and services. In addition to having 24/7 emergency room care, each community is pursuing trauma designation to ensure every Alaskan receives exemplary and timely care. Providence Alaska is governed by a community ministry board made up of independent community members from across the state. Additionally, each hospital has an advisory board made up of local community members. Providence Alaska Medical Center has an electronic intensive care unit (eICU) that serves communities across Alaska and one community in Oregon. PAMC is also expanding its telemedicine capabilities to provide stroke care to local and distant communities. Within the community of Anchorage, Providence is a long-time partner of Anchorage Project Access (APA). The volunteer network provides medical services, accepting and treating APA-referred patients as any other insured patients. PAMC will continue to provide funding and office space for the program. Providence Senior Care Center and the Pediatric Sub-Specialty Clinic are two more examples of how Providence promotes a healthy, well-cared for community. The Senior Care Center opened in January 2011 with the goal of providing Alaskans 55 and older with whole-health primary care. The program is subsidized by Providence Health & Services Alaska and currently treats more than 1,500 patients. The Pediatric Sub-Specialty Clinic at Providence has served children from birth to the age of 21 since 1998. This clinic is subsidized by the health system to ensure that these children have services and treatment not otherwise available to help them manage chronic illnesses.To address access to health care in Kodiak, Providence Kodiak Island Medical Center is partnering with the Healthy Tomorrows coalition to improve the mental and physical wellness of local youth. Programs include: safe-and-sober activities for students, student skill-building groups, physical activities at schools, Yellow Ribbon suicide prevention and an online "get-fit" challenge.To address access to care in Seward, Providence Seward Medical Center is partnering with the Seward Health and Wellness coalition. Programs include: Free primary care for up to 70 residents, expanding availability of charity care/sliding fee scale in the clinic, expanding the Know Your Numbers campaign and increasing access to dietary support and physical activities.To address access to care in Valdez, Providence Valdez Medical Center is partnering with the Sound Wellness Advisory Network (SWAN) and Valdez Parks and Rec to improve health in Valdez. Programs include: Healthier You Campaign, increased access to healthy activities, wellness education and biometric screenings. WESTERN WASHINGTON REGION - NORTHWEST: In Snohomish County, Providence Regional Medical Center Everett promotes the health of the community in a number of unique ways, one of which is the Providence Everett Healthcare Clinic. Opened in 2004, the clinic serves those with limited financial means and offers medical, dental and mental health care on a sliding fee scale, based on each patient's ability to pay. The clinic came about as the result of what started as a simple conversation between two single moms and a physician. These moms had government coupons to pay for health care, but no clinic or physician was willing to accept the coupons, and as a result, they were denied access. One mom had a son who experienced a simple earache. Because no one would see her son, the earache progressed until his ear drum burst, necessitating an emergency visit to the hospital. Upon hearing this story, the Providence physician realized there had to be a better way to meet the needs of this patient population. He developed a unique care delivery model in which Providence partnered with the schools of nursing at University of Washington Bothell and Everett Community College to deliver care. The clinic has grown in both size and scope several times since opening in 2004. It has expended from initially providing only medical care, to now providing mental and dental care as well. Another example is the community outreach program called Inside Out: The Original Organ Show. This innovative health education program, directed primarily at middle and high-school students, provides audiences with compelling health information - presented in a truly unique way - that empowers them to make informed decisions about behaviors and lifestyle choices that impact their long-term well-being. Inside Out takes viewers on a fantastic voyage through the human body. Actual human organs, such as hearts, lungs, brains, livers, kidneys and aortas are shown. Some are healthy; others have been damaged by substance abuse, poor eating habits and unsafe behaviors. Comparing healthy and cancerous lungs, clinical educators show the effects of smoking. Holding up a heart with a bullet hole through it, they describe the danger of gun violence. Using an aorta covered with hard, jagged plaque, they talk about how high cholesterol can lead to heart attacks. Displaying the shattered remains of a human brain, they talk about the unintended consequences of accidental prescription drug overdose. This program has been offered to the community for more than 20 years and in that time, thousands of people have written to tell how it changed, and possibly saved, their life.WESTERN WASHINGTON REGION - SOUTHWEST: Providence in Southwest Washington provided more than $50 million in total community benefits, including $16 million in charity care and $24 million to cover the difference between the costs of providing care for people insured by government-sponsored programs and the amount paid by the government for those services.Providence Southwest Washington hospitals subsidize a broad range of services that provide health benefits to the community but do not generate enough income to be financially self-sustaining. Examples include more than $5 million in programs such as psychiatry, chemical dependency, a sexual assault clinic and pediatrics.Here is more detail on key subsidized programs:*Providence is proud to collaborate with community partners to offer an intervention program that helps guide treatment decisions for frequent emergency department patients with chronic conditions and, in many cases, an addiction to pain medication. The Emergency Department Consistent Care Program (EDCCP) has assisted more than 1,100 patients, expanded to include five hospitals in a five-county region and dramatically reduced emergency visits. This program helps provide a safety net for patients who would otherwise have nowhere to turn.*Based in Lacey, the Providence St. Peter Chemical Dependency Center offers a complete continuum of treatment options to diagnose, treat and provide ongoing recovery support. Our medically supervised programs offer excellence in clinical counseling, comprehensive education and a safe environment for recovery. In 2011, the Chemical Dependency Center was subsidized with $2.5 million from Providence. This support helped improve the quality of life for more than 4,100 substance abuse inpatients, 16,500 outpatients and their families.*The physicians, nurses, nurse practitioners and social workers at the Sexual Assault Clinic are always there for the victims of sexual abuse. Serving residents of Thurston, Lewis, Mason, Grays Harbor, Pacific and Wahkiakum counties, our specialists are on call 24 hours a day, seven days a week to provide medical evaluations for children, adolescents and adults when they are in crisis. In 2011, the clinic provided nearly $400,000 in subsidized services for 349 patients.(SEE CONTINUATION) Part VI, Line 5: FURTHERANCE OF EXEMPT PURPOSE - CONTINUED: (WESTERN WASHINGTON REGION - SOUTHWEST)*Providence provided more than $1.25 million in non-funded psychiatric services in 2011, including inpatient and outpatient services. The 18-bed voluntary acute care unit housed more than 700 admitted patients. More than 1,700 patients took advantage of the Partial Hospitalization Program. Other Providence psychiatric services include social workers and professional counselors who provide crisis intervention, counseling and support in the Emergency Center; psychiatric nurses who provide home mental health services; specialized services for those 55 and older in our Older Adult Mental Health Program; and psychiatrists and ARNPs who offer treatment in our psychiatric medical clinic.*Providence St. Peter Hospital provided $3.3 million in training support of 18 family medicine physicians, other medical education programs and research.*More than 1,000 people benefited from free blood pressure checks, glucose and cholesterol screenings and low-cost high school sports physicals. Providence also provided free community education events, including "The Flex Diet", "The Smart Women's Guide to Heart Health", "Providence Parenting University", "Cancer Survivors' Celebration", "Harmony and Hope concerts" and "Wellness Roundup".PROVIDENCE HEALTH CARE/EASTERN WASHINGTON REGION:Providence Health Care formed an innovative collaboration 17 years ago with the other local hospital system (then Empire Health System) to better serve the community needs by jointly sponsoring Inland Northwest Health Services (INHS) - a not-for-profit organization that provides vital community services including air ambulance service, inpatient rehabilitation services, community health education, and an extensive medical information system that connects more than 30 hospitals across the inland northwest region. INHS represents a collaborative approach to health care that is unlike any other and brings unique partnerships and innovative technologies and more cost-effective care to Spokane and the Northwest. While the original sponsors have changed following the acquisition of Empire Health Services by a national for-profit system, Providence Health Care has found the ability to continue the community collaborative approach through a new joint sponsorship with the foundation that was formed by the sale of Empire Health Services.The Providence Health Care Community Ministry Board is made up of volunteer community leaders. The Board's primary delegated responsibilities include quality of care and service (including oversight of medical staff privileging), strategic planning and Mission effectiveness. In its role in Mission effectiveness, the Board is responsible for reviewing and approving the community needs assessment and selection of priority community needs. In addition, the Board approves recommendations for financial support of community programs and services (representing a $1.94 million investment in 2011).Providence hospitals in Spokane are also the sole providers of many essential services in Spokane. Many of these services are subsidized as they operate at a loss. For example, Providence Sacred Heart Medical Center is the only inpatient psychiatric program in the region, and Providence Holy Family Hospitals provides the only inpatient detox program in the community. Other unique services include an inpatient maternity clinic for uninsured, low income women located at Sacred Heart, transplant services (heart, kidney, pancreas) and numerous pediatric subspecialties. In addition, all Providence Health Care hospitals operate 24/7 emergency departments that serve all patients, regardless of ability to pay. And, as the only level II trauma center in the inland northwest region, Providence Sacred Heart medical Center serves a unique role of caring for the most critically ill and injured patients from the vast service area. Other examples of how Providence Health Care and its Eastern Washington ministries further its tax exempt status in support of the health of the community include:*Mobile mammography van that provides mammography services to underserved populations in outlying communities.*Tele-medicine and tele-continuing medical education for physicians and nurses throughout the region.*Providing educational opportunities for medical professionals throughout the community, including management oversight and subsidy of the graduate medical education residency programs, including family medicine, internal medicine, radiology and psychiatry, as well as funding for medical research through the Providence Medical Research Center.*Medical staff at Providence hospitals have open privileges across all hospital facilities in the area.*Level I heart attack and level I stroke programs collaborate with rural hospitals throughout the vast inland northwest region to support the delivery of high quality, prompt medical care for patients suffering a stroke or heart attack. Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEM:Providence Health & Services owns and operates 27 general acute care hospitals, six long-term care facilities, seven homecare and hospice entities, five assisted living facilities, a children's nursing center and Montessori school, a high school, a university, 12 low-income housing projects, the Health Plan, a health services contractor, two programs of all inclusive care for the elderly, and 20 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, Spokane and Olympia, Washington; Missoula, Montana; Portland and Medford, OregonThe charitable purpose of Providence Health & Services and each of its ministries is guided by one Mission and set of core values based on Catholic health care and guided by the legacy of the Sisters of Providence. As one system committed to caring for those who are poor and vulnerable, Providence Health & Services has developed a single framework for consistently reporting charity care and community benefit. Our commitment to respect and fairness means Providence has a system-wide compensation policy. Locally, Providence ministries are empowered to apply these policies to meet the local needs of their community. Additionally, Providence ministries conduct local assessments to make sure the needs of the community are met. ALASKA REGION:Providence Alaska has 15 ministries. Most facilities are located in the Anchorage area, yet Providence Alaska expands it services through a presence in three rural communities as well as telemedicine and electronic intensive care unit (eICU) services extended to communities in Alaska and Oregon. The ministries in Providence Alaska work to care for each patient as they need care across the full continuum of health care services. Providence Alaska Medical Center is the only comprehensive tertiary referral center serving all Alaskans. The medical center features the Children's Hospital at Providence (the only one of its kind in Alaska), the states only Level III NICU, Heart and Cancer Centers, the state's largest emergency department, full diagnostic, rehab and surgical services as well as both inpatient and outpatient mental health and substance abuse services for adults and children. Providence Alaska has a family practice residency program that trains physicians in primary care with the intent of increasing providers in distant Alaskan communities. A continuum of post acute care services, including home health, hospice, assisted living and a skilled nursing facility provides care for patients as close to home as possible. A developing medical group provides primary and specialty care in the community. The three critical access hospitals located in the remote communities of Kodiak, Seward, Valdez and Cordova are all co-located with skilled nursing facilities. Community mental health centers are operated in Kodiak and Valdez. These services combined in these communities provide a solid foundation for access to health care. Providence Alaska also partners to provide additional services through five joint ventures including: Providence Imaging Center in both Anchorage and Soldotna, St. Elias Long Term Acute Care Hospital, Imaging Associates of Providence in both Anchorage and Wasilla, LifeMed Alaska (a medical transport / air ambulance service), and Creekside Surgery Center.WESTERN WASHINGTON REGION - NORTHWEST: One example in Snohomish County was the Hands-On Health Fair, a free monthly community health fair. At the health fair, visitors had the chance to learn about and improve their health from all aspects of Providence. From Providence Physician Group primary care, attendees were able to get free heel scans to test for osteoporosis. From Providence Physician Group specialty care, they were able to learn about new treatments for debilitating vein health issues. From Providence Regional Medical Center Everett, they learned about heart and brain health, including exercise, how to perform CPR, and the warning signs of stroke. From the Providence Regional Cancer Partnership, they learned about breast and prostate health. From Providence Hospice and Home Care, they learned about the life-saving benefits of the Lifeline program. From the Providence Health & Services regional Revenue Cycle team, they were able to get information to assist them in paying for medical care. And from the Providence Health Plan, they were informed of new options for Medicare Advantage. Working individually, none of these ministries of Providence could have created or presented a comprehensive health fair. By collaborating, they were able to join together and promote the health of the community in more than 30 individual topic areas to a group of over 500 attendees for the first event alone.PROVIDENCE HEALTH CARE/EASTERN WASHINGTON:In the Eastern Washington Region, Providence Health Care is made up of 11 ministries offering comprehensive, coordinated health care across the full continuum of care. In addition to five hospitals, Providence Health Care includes home health care, skilled nursing/long term care and transitional care, an assisted living facility, home chore services, a physician group with more than 200 physicians, a medical laboratory and the region's only adult day health program. All of these ministries serve the Providence Mission and provide care for all, especially to those who are poor and vulnerable. This coordinated system of care ensures patients receive the right care from the right provider, at the right time, at the right cost. While the Providence physician group is at the core of coordinating patient care, patients may enter the Providence Health Care system at any ministry level depending on need. This comprehensive, open system ensures patients receive a full spectrum of coordinated care, regardless of their ability to pay.WESTERN WASHINGTON REGION - SOUTHWEST: Providence Health & Services in Southwest Washington touches more lives in Thurston, Mason, Lewis, Grays Harbor and Pacific counties than any other health care provider.*Providence St. Peter Hospital is a 390-bed, not-for-profit regional teaching hospital founded by the Sisters of Providence in 1887. Located in Olympia, the hospital offers comprehensive medical, surgical and behavioral health services to residents of Southwest Washington. St. Peter is a regional leader in cardiology, oncology, orthopedics and neuro-sciences. The Joint Commission has designated the hospital a Stroke Center of Excellence since 2007.*Providence Centralia Hospital is a 127-bed, not-for-profit community- based hospital. The services the hospital provides make it the heart of medical care in Lewis County. As a community hospital with outstanding technology, Providence Centralia Hospital is large enough to provide state-of-the-art services such as MRI, 64-slice CT scans and digital mammography. The hospital is also small enough to offer personal, compassionate care to everyone it serves*Providence Medical Group operates more than 20 clinics, with more than 135 specialized providers in Lewis, Thurston and Grays Harbor counties. The group provides primary and specialty care, including family medicine, internal medicine, cardiology, neurosurgery, oncology, diabetes care, general surgery, endocrinology, obstetrics/gynecology, physiatry, psychiatry and urology.*Providence Senior and Community Services provide a full continuum of health care services for those living with chronic and/or life-limiting conditions. Offering access and choice through innovative, customer-centered options, services are provided in the home or in a variety of facility settings including Providence SoundHomeCare and Hospice and Providence Mother Joseph Care Center and through supportive housing, including Providence St. Francis House (Olympia); Providence Blanchet House (Centralia); Providence Rossi House (Centralia) and Providence Place (Chehalis). Reports Filed With States Part VI, Line 7 WA,OR,CA,MT,AK CONTINUATION OF COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 Providence Valdez Medical Center serves the community of Valdez. Valdez is one of Alaska's most important port cities. It is located about 120 air miles and 305 road miles east of Anchorage. The population is close to 4,000 and is located within 222 square miles of land area. In 2010, the majority (79 percent) of the population in the City of Valdez were white, with 8 percent of the population American Indian/Alaska Native. The median age was 37 years old in Valdez according to the 2010 Census, a slightly older median age than its statewide counterpart (34 years old). In the 2011 community health needs assessment, approximately one in 12 community survey respondents reported that they or their family had to go without basic needs in the year prior to the survey. Of those who went without basic needs, almost half said they went without dental care (49 percent) and/or health care (46 percent). CONTINUATION OF PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 In Walla Walla County, Providence St. Mary Medical Center participates with other health, education, governmental and social service agencies in a community health assessment, sponsored by the Walla Walla County Health Department. The assessment identifies the areas of greatest need in the health of the community. Providence St. Mary uses this data in addition to other information to guide its community outreach. In recent years, the most critical need identified through this process is at-risk youth access to health care and services. To meet this need, Providence St. Mary provided funding to establish eastern Washington's first school-based health clinic, which operates as an independent not-for-profit at an alternative high school in Walla Walla. Providence St. Mary now provides annual funding to the clinic. The medical center also donates the use of a building to Trilogy Recovery Community, an independent not-for-profit youth drug and alcohol recovery center.Providence St. Mary utilizes the Providence Telestroke Network, run through the Providence Brain Institute in Portland, Oregon, to ensure that every patient coming into the emergency department with symptoms of stroke can be seen by a neurologist, regardless of the hour. With strokes, the faster a patient is diagnosed and treated, the less damage the stroke can do. Receiving the right treatment quickly can mean the difference between life and death, and between a good recovery and a lifelong disability. In Alaska, access to health care is one of the most critical community needs. To address this need, Providence Alaska and its local ministries are involved in and supportive of many programs, activities and services. In addition to having 24/7 emergency room care, each community is pursuing trauma designation to ensure every Alaskan receives exemplary and timely care. Providence Alaska is governed by a community ministry board made up of independent community members from across the state. Additionally, each hospital has an advisory board made up of local community members. Providence Alaska Medical Center has an electronic intensive care unit (eICU) that serves communities across Alaska and one community in Oregon. PAMC is also expanding its telemedicine capabilities to provide stroke care to local and distant communities. Within the community of Anchorage, Providence is a long-time partner of Anchorage Project Access (APA). The volunteer network provides medical services, accepting and treating APA-referred patients as any other insured patients. PAMC will continue to provide funding and office space for the program. To address access to health care in Kodiak, Providence Kodiak Island Medical Center is partnering with the Healthy Tomorrows (HT) coalition to improve the mental and physical wellness of local youth. Programs include: safe-and-sober activities for students, student skill-building groups, physical activities at schools, Yellow Ribbon suicide prevention and an online "get-fit" challenge.To address access to care in Seward, Providence Seward Medical Center is partnering with the Seward Health and Wellness coalition. Programs include: Free primary care for up to 70 residents, expanding availability of charity care/sliding fee scale in the clinic, expanding the Know Your Numbers campaign and increasing access to dietary support and physical activities.To address access to care in Valdez, Providence Valdez Medical Center is partnering with the Sound Wellness Advisory Network (SWAN) and Valdez Parks and Rec to improve health in Valdez. Programs include: Healthier You Campaign, increased access to healthy activities, wellness education, and biometric screenings. 1 Inland Empire Hospital Services Assoc 104 West Fifth Ave Suite 200W Spokane WA 99204 237385639 501(C )(3) 8156833 Physician Residency Program Providence Alaska Foundtion 3211 Providence Dr K101A Anchorage AK 99508 920093565 501(C )(3) 1178699 Administrative Support of the Foundation Inland Northwest Health Partners PO Box 469 Spokane WA 99210 911307555 501(C )(3) 1021073 Community Health Education Outreach Providence St Peter Foundation 413 Lilly Road NE Olympia WA 98506 911097056 501(C )(3) 752499 Administrative Support of the Foundation University of Washington School of Medicine Box 358047 Seattle WA 98195 916001537 Other 617892 Physician Residency Program Providence Hospice of Seattle Foundation 425 Pontius Ave N 300 Seattle WA 98109 912077378 501(C)(3) 276688 Administrative Support of the Foundation Catholic Relief Services PO Box 17090 Baltimore MD 21203 135563422 501( C)(3) 250000 Community Providence Health Care Foundation 914 S Scheuber Rd Centralia WA 98531 911433382 501(C)(3) 235321 Administrative Support of the Foundation Sacred Heart Children's Foundation 101 W 8th Avenue Spokane WA 99220 320014330 501( C)(3) 206757 Administrative Support of the Foundation Providence Marianwood Foundation 3725 Providence Point Drive SE Issaquah WA 98029 931554288 501(C)(3) 190629 Administrative Support of the Foundation Christ Clinic 914 W Carlisle Spokane WA 99205 911435174 501( C)(3) 165735 Building Expansion Campaign & Psychiatric Nurse Practi. Providence Mount St Vincent Foundation 4831 35th Avenue Southwest Seattle WA 98126 911188119 501(C)(3) 160361 Administrative Support of the Foundation Anchorage Project Access PO Box 196604 Anchorage AK 99519 920152080 501( C)(3) 106300 Community Support Christian Health Associates 1825 Academy Drive Anchorage AK 995075391 920152088 501(C)(3) 106050 Community Support Catholic Charities PO Box 2253 Spokane WA 99210 910569880 501( C)(3) 102205 Donation for Land Purchase & House of Charity Mental Health Partners with Families & Children 613 S Washington St Spokane WA 99204 680576560 501(C)(3) 96786 Monthly Operational Support/Financial Assistance to Families Prescription Drug Assistance Foundation 200 Broadway Suite 100 Seattle WA 98122 331134368 501( C)(3) 71043 Prescription Drug Assistance/Operational Support Choice Regional Health Network 2409 Pacific Avenue SE Olympia WA 98501 911704039 501(C)(3) 60000 Thurston County Project Access Municipality Of Anchorage 715 L St Ste 200 Anchorage AK 995013359 920059987 Government 50875 Community Support Alaska Destination Specialist 639 W International Airport Rd 26 Anchorage AK 99518 920156608 Other 50000 Community Support Alaska Sports Hall of Fame Inc 1415 Echo Canyon Rd Anchorage AK 995166908 810649085 501(C)(3) 50000 Community Support Alaskans For Access To Healthcare 4120 Laurel St Ste 206 Anchorage AK 995085392 202234578 Other 50000 Community Support Lincoln Health Center 342 Catherine Street Walla Walla WA 98362 910793597 501(C)(3) 50000 Community Benefit Donation Project Access Spokane 104 S Freya Street Suite 114 Spokane WA 99202 910827958 501(C)(3) 46000 Operational Support University of Washington 1959 NE Pacific St NW125 Seattle WA 98195 916001537 Other 45000 Financial support Economic Alliance Snohomish County 728 134th Street SW Ste 128 Everett WA 98204 910647005 Other 36210 Donation for the summer networking and roll out event. Community Detox Services of Spokane PO Box 2845 Spokane WA 99220 911108762 501(C)(3) 33000 Operational Support The American Heart Association 3700 Woodland Avenue 700 Anchorage AK 99517 135613797 501(C)(3) 32500 Community Support American Heart Association 140 S Arthur Street Suite 610 Spokane WA 99202 135613797 501(C)(3) 30000 Sponsorship Anchorage School District 1805 Academy Dr Ste 101 Anchorage AK 995075301 928000078 501(C)(3) 27500 Community Support Covenant House Of Alaska PO Box 104640 Anchorage AK 995104640 133419755 501(C)(3) 27241 Community Support Providence Pariseau Corp 1801 Lind Ave SW 9016 Renton WA 98057 911289932 501(C)(3) 25950 Ministry Support/Community Alaska EHR Alliance 4120 Laurel St Ste 206 Anchorage AK 99508 202141045 501(C)(3) 25000 Community Support University of Washington Foundation PO Box 357230 Seattle WA 98195 943079432 501(C)(3) 25000 Leo Greenwalt Professorship Health Pol. University Of Alaska 3211 Providence Dr K101A Anchorage AK 99508 926000147 Other 22500 Community Support Beans Cafe PO Box 100940 Anchorage AK 99510 920072522 501(C)(3) 22270 Community Support Alaska Medicare Clinic 11260 Old Seward Highway Ste 107 Anchorage AK 995153038 270542419 501(C)(3) 20000 Community Support Catholic Cemeteries of Spokane PO Box 18006 Spokane WA 98228 910564968 501(C)(3) 20000 Memorial in Holy Cross Cemetery King County Project Access 1111 Harvard Avenue Seattle WA 98122 204377921 501(C)(3) 20000 Donation to Snohomish County portion of Project Access Northwest United Way of King County 720 2nd Ave Seattle WA 98104 912131783 501(C)(3) 20000 Annual Sponsorship March of Dimes Foundation 1904 Third Aveue Suite 230 Seattle WA 98101 131846366 501(C)(3) 19000 Signature chefs auction-table sponsorship, nurse of the year awards, march for babies. Spokane County Medical Society Foundation 104 S Freya St Suite 114 Spokane WA 99202 911728909 501(C)(3) 18300 Project Access/Patient Transport Alaska State Medical Association PO Box 230630 Anchorage AK 99523 926002176 501(C)(6) 17500 Community Support Rotary Club of Everett PO Box 1225 Everett WA 98201 916032628 501(C)(4) 15100 Student Scholarship Group Health Foundation 320 Westlake Ave N Ste 100 Seattle WA 98109 911246278 501(C)(3) 15000 Gift of Health Gala Sponsorship March of Dimes Foundation 222 W Mission Ave Suite 119 Spokane WA 99201 131846366 501(C)(3) 15000 March for Babies Sponsorship/Event donation Washington State Medical Association 2033 Sixth Ave Suite 1100 Seattle WA 98121 916074463 501(C)(6) 15000 Annual Corporate Sponsorship American Red Cross - Snohomish County Chapter 2530 Lombard Everett WA 98201 910581658 501(C)(3) 13000 Support for the Real Heroes Breakfast and humanitarian efforts such as a CRP event. WSU Extension PO Box 1495 Spokane WA 99210 916001108 Other 13000 Primary Care and Rural Health Sponsorship March of Dime Foundation 255 E Fireweed Ln Ste 102 Anchorage AK 99503 131846366 501(C)(3) 12500 Community Support Rural Resources 956 S Main St Colville WA 99114 910793447 501(C)(3) 12226 Child Protection Resources Providence General Foundation PO Box 1067 Everett WA 98206 911041617 501(C)(3) 11900 Memorial gifts to various PRMCE employees. Catholic Social Services Inc 225 Cordova St Bldg B Anchorage AK 995012409 920037322 501(C)(3) 11300 Community Support Breast Cancer Focus Inc PO Box 242464 Anchorage AK 99524 911842524 501(C)(3) 10600 Community Support Everett Silvertips Hockey Club 2000 Hewitt Avenue Suite 100 Everett WA 98201 980376631 Other 10380 Sponsorship total for hockey club. Bethel Christian Life Center 226 Shiloh Dr Colville WA 99114 943143251 501(C)(3) 10360 Support Hunger Initiative 5 Miler For Mens Cancer Research PO Box 100225 Anchorage AK 995100225 920158284 501(C)(3) 10000 Community Support AK Inaugural Committee PO Box 100719 Anchorage AK 99510 680534095 501(C)(3) 10000 Community Support American College Of Physicians 4120 Laurel St Ste 204 Anchorage AK 99508 920136701 501( C)(3) 10000 Community Support American Heart Association PO Box 4002030 Des Moines IA 50340 135613797 501(C)(3) 10000 Annual Sponsorship Daybreak Youth Services 11711 E Sprague Ave Suite D-4 Spokane Valley WA 99206 911083936 501(C )(3) 10000 Youth Services Program Health For All 25 W Main Ave Suite 310 Spokane WA 99201 911764236 501(C)(3) 10000 Community Services Life Services of Spokane 2659 N Ash Spokane WA 99205 911494402 501(C )(3) 10000 Parenting Support Group Lilac Bloomsday Assoc 1610 W Riverside Spokane WA 99201 911054846 501(C)(3) 10000 Bloomsday Sponsorship Lincoln County Fire Protection PO Box 279 Sprague WA 99032 911542456 Other 10000 Emergency Response Building Expansion Medical Teams International 9680-153rd Ave NE Redmond WA 98052 930878944 501(C)(3) 10000 Donation to support MTI dental Van for visits to Marysville and Everett Gospel Woman's mission. The Foraker Group 161 Klevin St Ste 101 Anchorage AK 995081506 920177787 501(C)(3) 10000 Community Support United Way of Snohomish County 3120 McDougal Avenue Suite 200 Everett WA 98201 910606507 501(C)(3) 10000 Premier sponsorship-year Round United Way events. United Way of Spokane County 920 N Washington St Suite 100 Spokane WA 99201 910606058 501(C)(3) 10000 Our Kids: Our Business Sponsorship YWCA of Spokane 930 N Monroe St Spokane WA 99201 910565025 501(C)(3) 10000 Women of Achievement Sponsorship Big BrothersBig Sisters Inland NW 222 W Mission Ave Suite 40 Spokane WA 99201 916061587 501(C)(3) 9000 Mentoring Program/Sponsorship Oregon Health & Sciences University Foundation Mail Stop 45 PO Box 4000 Portland OR 97208 237083114 501(C)(3) 9000 Community Tri County Comm Health 1200 E Columbia Colville WA 99114 431992627 Government 9000 Operational Support Holy Family Foundation 5633 N Lidgerwood Spokane WA 99028 911107079 501(C)(3) 8750 ER clothing bank program The Anchorage Running Club PO Box 243362 Anchorage AK 995243362 920085126 501(C)(3) 8000 Community Support Alaskan Aids Assistance 1057 W Fireweed Ste 102 Anchorage AK 99503 920113788 501(C)(3) 7550 Community Support Anchorage Economic Development 510 L St Ste 603 Anchorage AK 995011959 920123006 501(C)(3) 7500 Community Support Washington Center for Nursing 1101 Andova Park W Suite 105 Tukwila WA 98188 680568743 501(C)(3) 7500 Annual Sponsorship United Way Of Valdez PO Box 707 Valdez AK 996860707 920090499 501(C)(3) 6034 Community Support Natl Multiple Sclerosis Society 192 Nickerson St Ste 100 Seattle WA 981091632 135661935 501(C)(3) 6000 Community Support St Joseph Family Center 1016 N Superior St Spokane WA 99202 910564989 501(C)(3) 6000 Operational Support Washington Poison Center 155 NE 100th St Suite 100 Seattle WA 98125 943214597 501(C)(3) 6000 Operational Support Sisters of Providence 1801 Lind Ave SW 9016 Renton WA 98057 911549820 501(C)(6) 5600 Annual Sponsorship Alaska Associaton Of Health Underwriters PO Box 244065 Anchorage AK 99524 920165384 501(C)(3) 5500 Community Support American Red Cross 235 E 8TH Avenue Ste 200 Anchorage AK 99501 951643964 501(C)(3) 5366 Community Support Tri County Health District 240 E Dominion Collville WA 99114 911358169 Government 5320 Immunization clinic/program Inland Northwest Blood Center 210 West Cataldo Ave Spokane WA 99201 910499130 501(C)(3) 5186 Sponsorship American Diabetes Association 801 W Fireweed Suite 103 Anchorage AK 99503 131623888 501(C)(3) 5050 Community Support Alaska Pacific University 401 University Dr Anchorage AK 995084625 920023588 501(C)(3) 5000 Community Support Heart to Heart 6033 W Century Blvd Ste 350 Los Angeles CA 90045 043367888 501(C)(3) 5000 Event donation/sponsorship Helps International Inc 15301 Dallas Pkwy Suite 200 Addison TX 75001 751966419 501(C)(3) 5000 Community Housing Hope 5830 Evergreen Way Everett WA 98203 943060709 501(C)(3) 5000 Sponsorship of Housing hope Stone Soup Event Interfaith Hospitality 608 S Richard Allen Ct 5 Spokane WA 99202 911707988 501(C)(3) 5000 Assistance to Families Ride For Life Alaska 2600 Denali St Ste 450 Anchorage AK 99503 562458726 501(C)(3) 5000 Community Support Seattle University 901 12th Avenue PO Box 222000 Seattle WA 98122 910565006 501(C)(3) 5000 Community The Alaska Run For Women PO Box 230929 Anchorage AK 99523 920149312 501(C)(3) 5000 Community Support The Childrens Place PO Box 871788 Wasilla AK 99687 911817911 501(C)(3) 5000 Community Support The Walla Walla Valley Chamber of Commerce 29 E Sumach Walla Walla WA 98362 910457015 501(C)(6) 5000 Community Development Sponsorship Transitions 3104 W Fort George Wright Dr Spokane WA 99204 911307272 501(C)(3) 5000 Transitional program for women Valley General Hospital Foundation PO Box 1522 Monroe WA 98272 943115593 501(C)(3) 5000 Annual Joseph Feek Memorial Golf Tournament 85 15 Patient Transport 3864 56730 FMV Patient Transport Medical Supplies 49 9938 Cost DME Assistance Prescription Medications 217 86207 Cost Medication Housing Assistance 101 9086 Cost Housing Medical Education Assistance 27 32945 Cost Financial Assistance Life Saver Program 66 2720 FMV Mammograms for low-income patients Indigents - Food 1121 11776 Cost Base amount for food plus supply cost used Medical Mission Grants 151 91341 Cost Medical Mission Trips Light of Hope Program 11 4418 Cost Help young mothers with Utility bills & Food Patient other Needs 9 3371 Cost Interpreter for patients & Other Assistance Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: In the application for support, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds were used. X X X X X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 John F Koster MD 1128700 0 3611373 0 36500 0 1585488 0 17394 0 6379455 0 0 0 Jeffrey W Rogers 428372 0 1171207 0 15000 0 505409 0 19443 0 2139431 0 0 0 Todd Hofheins 260430 0 57803 0 12539 0 24688 0 20180 0 375640 0 0 0 Michael L Butler 775091 0 367474 0 20000 0 556768 0 25780 0 1745113 0 0 0 John V Fletcher 534720 0 1150130 0 140655 0 593141 0 20718 0 2439364 0 0 0 Eugene Al Parrish 507395 0 524212 0 20025 0 466528 0 22833 0 1540993 0 0 0 Daniel T Harris 393574 0 107269 0 15000 0 207719 0 8303 0 731865 0 0 0 Anthony J Dorsch 244388 0 86142 0 15025 0 48407 0 17916 0 411878 0 0 0 Gregory Van Pelt 690516 0 2584395 0 36500 0 925680 0 21498 0 4258589 0 0 0 Arnold R Schaffer 667785 0 1931749 0 109769 0 756443 0 22599 0 3488345 0 0 0 Janice J Jones 572386 0 2081316 0 66319 0 542507 0 23791 0 3286319 0 0 0 John O Mudd 336906 0 487537 0 36500 0 389793 0 18376 0 1269112 0 0 0 Myron Berdischewsky MD 477310 0 138533 0 58686 0 442395 0 22009 0 1138933 0 0 0 Claudia Haglund 323326 0 1485333 0 101268 0 438152 0 18027 0 2366106 0 0 0 Michael Hunn 470781 0 829175 0 20000 0 239155 0 17867 0 1576978 0 0 0 Cindra R Syverson 377057 0 102898 0 15000 0 153119 0 21216 0 669290 0 0 0 Joel S Gilbertson 321131 0 102937 0 31500 0 55305 0 18838 0 529711 0 0 0 David Brown 259899 0 89327 0 15000 0 99285 0 20996 0 484507 0 0 0 Orest Holubec 261429 0 29124 0 22837 0 20857 0 20562 0 354809 0 0 0 Terry L Smith 597366 0 2544661 0 74105 0 649540 0 21999 0 3887671 0 0 0 Craig L Wright MD 460242 0 163545 0 15000 0 263284 0 21386 0 923457 0 0 0 Bruce Lamoureux 442134 0 123718 0 33833 0 196191 0 21552 0 817428 0 0 0 Andy Agwunobi MD Thru 1130 473492 0 128430 0 91953 0 178836 0 19884 0 892595 0 0 0 David T Brooks 407789 0 142762 0 15000 0 186874 0 20656 0 773081 0 0 0 Medrice Coluccio 402506 0 149578 0 31500 0 367079 0 13522 0 964185 0 0 0 Elaine S Couture 341676 0 132770 0 31500 0 140485 0 17694 0 664125 0 0 0 Michael Wilson 434191 0 0 0 0 0 0 0 0 0 434191 0 0 0 Andrew T Howlett 896149 0 451946 0 75376 0 9800 0 10017 0 1443288 0 0 0 Steven A Burdick 257739 0 840511 0 31843 0 163874 0 16184 0 1310151 0 0 0 James N Dunlap 524120 0 582427 0 16395 0 9800 0 10017 0 1142759 0 0 0 Atul Thakker 772160 0 249186 0 37905 0 85132 0 13910 0 1158293 0 0 0 Thomas Corley 317469 0 715844 0 15000 0 309447 0 15652 0 1373412 0 0 0 Keith Marton 0 0 786086 0 448716 0 146314 0 10764 0 1391880 0 0 0 Russell Danielson 0 0 108402 0 124987 0 0 0 0 0 233389 0 0 0 Part I, Line 1a Providence Health & Services Expense Reimbursement Procedures include the following policies: First Class Travel or Charter Travel or Travel of Companions Air travel is reimbursable for tourist or economy class and should be at the least expensive airfare; which permits departures and arrivals at reasonable times and reasonable distance traveled. Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class air travel will only be reimbursed when tourist or economy class air travel is not available and business travel is mandated by a supervisor. In the rare circumstance that an executive must fly on a first class full fare ticket, their senior level supervisor must approve this expense. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approval by the VP/Chief Human Resources Officer. During 2011, a total of three first-class tickets were purchased for disclosed personnel. 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 2011, the following Key Employees received gross-up payments: Arnold R. Schaffer Myron Berdischewsky Terry L. Smith Orest Holubec The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Discretionary Spending Account Providence Health & Services provides an executive flex spending allowance per year (paid bi-weekly). This benefit is provided as discretionary spending because the organization does not reimburse for or provide additional executive benefits, such as a car allowance, additional executive life or disability insurance, or other market-based executive benefits practices. 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 VP/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 2011, the following Key Employees received relocation payments: Arnold R. Schaffer Myron Berdischewsky Terry L. Smith Orest Holubec The amounts reported for these relocation payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Part I, Lines 4a-b NONQUALIFIED RETIREMENT PLANS A) DBSERP = Defined Benefit Supplemental Executive Retirement Plan B) DCSERP = Defined Contribution Supplemental Executive Retirement Plan C) DBCBRP = Defined Benefit Cash Balance Restoration Plan D) DCRP = Defined Contribution Restoration Plan E) ESP = Elective Survivor Plan F) SOP = Share Option Plan 1) John F. Koster, MD a) Taxable DBSERP Earned but not Paid- $3,063,813 b) Non-Taxable DBSERP Earned but not Paid - $781,587 c) Non-Taxable DCSERP Earned - $339,126 d) DBSERP Interest Credit - $439,580 2) Jeffrey W. Rogers a) Taxable DBSERP Earned but not Paid - $1,005,741 b) Non-Taxable DBSERP Earned but not Paid - $135,144 c) Taxable DCSERP Earned but not Paid - $8,561 d) Non-Taxable DCSERP Earned - $48,099 e) ESP Interest Credit - $79,952 f) DBSERP Interest Credit - $202,199 3) Todd Hofheins a) Non-Taxable DCRP Earned - $9,603 4) Gregory Van Pelt a) Taxable DBSERP Earned but not Paid - $ 2,008,828 b) Non-Taxable DBSERP Earned but not Paid - $185,993 c) Taxable DCSERP Earned but not Paid - $276,749 d) Non-Taxable DCSERP Earned - $292,233 e) ESP Interest Credit - $88,256 f) DBSERP Interest Credit - $319,032 5) Terry L. Smith a) Taxable DBSERP Earned but not Paid - $2,293,039 b) Non-Taxable DBSERP Earned but not Paid - $236,604 c) Taxable DCSERP Earned but not Paid - $21,722 d) Taxable DBCBRP Earned - $400 e) Non-Taxable DCSERP Earned - $69,165 f) ESP Interest Credit - $61,528 g) DBSERP Interest Credit - $231,388 6) Janice J. Jones a) Taxable DBSERP Earned but not Paid - $ 1,844,829 b) Non-Taxable DBSERP Earned but not Paid - $189,772 c) Taxable DBCBRP Earned but not Paid - $ 142 d) Non-Taxable DCSERP Earned - $154,703 e) SOP Paid - $29,819 f) DBSERP Interest Credit - $184,939 7) Arnold R. Schaffer a) Taxable DBSERP Earned but not Paid - $750,268 b) Non-Taxable DBSERP Earned but not Paid - $33,694 c) Taxable DCSERP Earned but not Paid - $832,896 d) Non-Taxable DCSERP Earned - $630,732 e) DBSERP Interest Credit - $82,122 8) Claudia Haglund a) Taxable DBSERP Earned but not Paid - $1,339,590 b) Non-Taxable DBSERP Earned but not Paid - $195,498 c) Taxable DCSERP Earned but not Paid - $29,245 d) Non-Taxable DCSERP Earned - $37,706 e) ESP Interest Credit - $22,834 f) SOP Paid - $ 69,768 g) DBSERP Interest Credit - $141,491 9) John V. Fletcher a) Taxable DBSERP Earned but not Paid - $648,808 b) Non-Taxable DBSERP Earned but not Paid - $52,905 c) Taxable DCSERP Earned but not Paid - $290,961 d) Non-Taxable DCSERP Earned - $388,497 e) ESP Interest Credit - $46,196 f) SOP Paid - $104,155 g) DBSERP Interest Credit - $86,372 10) Michael Hunn a) Taxable DBSERP Earned but not Paid - $327,914 b) Taxable DCSERP Earned but not Paid - $370,385 c) Non-Taxable DCSERP Earned - $216,958 d) DBSERP Interest Credit - $20,014 11) Michael L. Butler a) Non-Taxable DCSERP Earned - $435,962 b) DBSERP Interest Credit - $95,665 12) Eugene "Al" Parrish a) Taxable DBSERP Earned but not Paid - $346,852 b) Non-Taxable DBSERP Earned but not Paid - $268,971 c) Non-Taxable DCSERP Earned - $56,382 d) DBSERP Interest Credit - $128,312 13) John O. Mudd a) Taxable DBSERP Earned but not Paid - $226,235 b) Non-Taxable DBSERP Earned but not Paid - $71,542 c) Taxable DCSERP Earned but not Paid - $125,304 d) Non-Taxable DCSERP Earned - $254,702 e) DBSERP Interest Credit - $53,501 14) Andrew Agwunobi, MD a) Non-Taxable DCSERP Earned - $158,816 b) DBSERP Interest Credit - $8,147 15) Myron Berdischewsky, MD a) Non-Taxable DCSERP Earned - $404,844 b) DBSERP Interest Credit - $12,137 16) Craig L. Wright, MD a) Non-Taxable DCSERP Earned - $199,302 b) DBSERP Interest Credit - $38,604 17) Bruce Lamoureux a) Taxable DBCBRP Earned - $518 b) Non-Taxable DCSERP Earned - $166,650 c) DBSERP Interest Credit - $22,275 18) Medrice Coluccio a) Non-Taxable DCSERP Earned - $344,898 b) DBSERP Interest Credit - $4,529 19) David T. Brooks a) Non-Taxable DCSERP Earned - $149,660 b) DBSERP Interest Credit - $21,641 20) Cindra R. Syverson a) Non-Taxable DCSERP Earned - $130,173 b) DBSERP Interest Credit - $14,305 21) Joel S. Gilbertson a) Non-Taxable DCSERP Earned - $48,086 22) David S. Brown a) Non-Taxable DCSERP Earned - $74,666 23) Orest Holubec a) Non-Taxable DCSERP Earned - $9,236 24) Keith Marton, MD a) Taxable DBSERP Earned but not Paid - $501,372 b) Taxable DCSERP Earned but not Paid - $284,714 c) Non-Taxable DCSERP Earned - $114,423 d) DBSERP Interest Credit - $30,600 25) Russell Danielson a) Taxable DBSERP Paid - $ 108,402 b) ESP Paid - $57,407 26) Daniel T. Harris a) DBSERP Interest Credit - $22,083 b) Non-Taxable DCSERP Earned - $161,459 27) Anthony J. Dorsch a) Non-Taxable DCSERP Earned - $28,336 28) Elaine S. Couture a) DBSERP Interest Credit - $7,483 b) Taxable DBCBRP Earned but not Paid - $202 c) Non-Taxable DCSERP Earned - $125,652 Part I, Lines 4a-b SEVERANCE 1) Keith Marton, MD - $428,716 Supplemental Information Part III FORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS PROGRAM The Providence Executive Performance Awards 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 2011, 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 quality focused. In 2011 the percent allocation for each of these strategic priorities was: Mission driven 10% Financially responsible 10% People centered 10% Service oriented 10% Quality focused 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. Washington Health Care Facilities Authority 911108929 93978EA77 2006-06-22 208792185 Refund WHCFA Series 1999 & Capital projects in Washinton 1 0 0 Washington Health Care Facilities Authority 911108929 93978EB27 2006-06-22 165050000 Refund WHCFA Series 2002A & B and Series 1994 & 1995 0 0 0 Washington Health Care Facilities Authority 911108929 93978E7V8 2010-07-01 173543991 To Finance a Portion of construction of a Tower in Everett 0 0 0 Washington Health Care Facilities Authority 911108929 93978HDAO 2011-07-13 101296076 Proceeds were used to currently refund all outstanding Series 2001A bonds 0 0 0 1610000 208792185 124 1651096 1980039 3336312 146353342 57929325 2009 0 1 1 1 165050000 108 1660244 2465562 160924194 2002 1 0 1 1 173543991 145 2543991 171000000 2011 0 0 1 1 101296076 64498 1060339 100235737 2004 1 0 1 1 0 0 0 0 0.00010 0.00000 0.00010 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X Alaska Industrial Development and Export 926001185 011903BEO 2003-09-04 37426100 Reimburse Alaska Region for Capital expenditures made in 2002 & 2003 0 0 0 Alaska Industrial Development and Export 926004485 011903CT6 2006-11-30 57177110 Reimburse Alaska Medical Center for portion of costs to construct cancer ctr 0 0 0 Alaska Industrial Development and Export 926004485 011903DZI 2011-11-17 126601436 Fund portion of expansion & renovation at PAMC & Portion of construction 0 0 0 8200000 37426100 156 501778 36924322 2003 0 0 1 1 57177110 37 646775 56530335 2008 0 0 1 1 126601436 1601436 94513131 30515523 0 0 0 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 John F Koster MD Officer 374113813 Purchase of Supplies through cooperative of which Dr. Koster is a Director 0 Form 990, Part VI, Section A, line 6 Providence Health & Services is the sole Corporate Member. 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. Form 990, Part VI, Section A, line 7b Other powers of the Corporate Member include the power: 1) To adopt or change the mission, philosophy, and values, including the strategic plan and mission statement. 2) To amend or repeal the Articles of Incorporation or Bylaws. 3) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale transfer, assignment or encumbering of assets exceeding a specified threshold, or the sale or transfer of any property which may have historical or religions significance. 4) To approve the dissolution or liquidation. 5) To approve the annual operating and capital budgets. 6) To appoint the certified public accountants. 7) To approve the closure of any institution or major ministry or work of the Corporation. Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict. Form 990, Part VI, Section B, line 15 It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined by the Providence Board's Human Resources Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Board retains an independent consultant each year to review salaries of those in the most significant leadership roles in the organization. Part of the consultant's role is to review an extensive array of compensation surveys of large, not-for-profit health care systems in the United States. Providence is one of the larger health systems in the country, and as such, the Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources Committee. 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. The consolidated financial statements are available on our public Internet site www2.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 8,375,520. Investment expenses: 51,860. Prior period adjustments: 37,043. Consolidating Entity Transfers 131,964,438. FAS 136 8,456,973. Net Assets Transferred from Merger -16,237,638. Revenue Reclassifications 446,280. Expense Reclassifications 117,211. Pension Adjustment -124,688,533. Rounding -3. Total to Form 990, Part XI, Line 5: 8,523,151. HOURS WORKED FORM 990, PART VII, LINE 1A The average hours per week reflect hours worked for the entire Providence Health & Services healthcare system and are not allocated to the individual reporting entity. AUDIT & COMPLIANCE FORM 990, PART XII, LINE 2C The Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. VOLUNTEERS FORM 990, PART I, LINE 6 ALASKA REGION: PAMC-Volunteers share their time and talents as they serve patients and their families, as well as staff in one or more of the seventy-plus volunteer opportunities at Providence Alaska Medical Center. Volunteers bring the Providence mission to life everyday; whether it is greeting individuals as they enter the facility, baking cookies for Hickel House guests, rocking a NICU baby, providing warm blankets in the Emergency Department, lending a book to read from the hospitality book cart, or sitting vigil with a patient as a NODA (No One Dies Alone) volunteer. Volunteers enhance the patient experience across the continuum of care at Providence Alaska Medical Center. PKIMC- Volunteers assisted our Extended Care Facility Activities Coordinator, clerical duties, distributing mail, purging medical charts, providing chaplain services, and visiting our Extended Care Center residents. PECC-Volunteers provide valuable services to our residents. Volunteers spend 1:1 time with the residents, assist programs offered through the Activity Therapy Department, operate out gift shop, musical entertainment and provide religious services and programs. HOSPICE OF SEATTLE: Patient Care Volunteers help to support the hospice patient and their family during the course of their illness meeting a variety of needs including respite, companionship, helping with light household tasks and providing personal services such as letter writing, reading and running errands. Transitions Volunteers help to support clients and their family facing a life limiting illness with a prognosis of 12 months or less with a variety of needs. Duties are similar to those of patient care volunteers. Bereavement Volunteers help surviving families/significant others of Hospice patients for up to 15 months following the death of the patient. Safe Crossings Volunteers provide support services to children connected with Providence Hospice of Seattle regarding issues around terminal illness and assist with bereavement support. Complementary therapy volunteers perform the same services as patient care volunteers with the addition of offering a licensed modality such as massage, music therapy or animal-assisted activities (animal/animal handler must be Delta Certified) if requested by the patient, family and care team. Stepping Stones volunteers help support children and their families facing a life limiting illness in a variety of ways. Volunteers may read books, play games or serve as one-to-one support to families. Camp Erin volunteers assist with an annual weekend grief camp sponsored by Providence Hospice and The Moyer Foundation for children ages 5-17. MOTHER JOSEPH CARE CENTER: Assist with resident activities,(Groups, Outings, Special Events, Communion, One to One, Ride along to Doctor appointments), Through Job programs (Morningside, SCSEP), they work closely with staff on Job retraining. PROVIDENCE CENTRALIA HOSPITAL: The regular hospital volunteers fill a variety of job duties that include: Patient Support Services, Hospitality/Guest Services and Clerical Assistance, Information Desk, including "way-finding" for patients and visitors.We also had 90 volunteers, who worked all day to paint 4 homes on September 10,2011 for our annual community service event, Paint the Town, which is administered jointly by Volunteer Services and Foundation, included in the total above. PROVIDENCE HOSPICE & HOMECARE OF SNOHOMISH COUNTY: PHHC Volunteers offer many vital services. Those who provide office help at our agency work in Records & Reimbursement, Home Care, Hospice, Volunteer Services, Lifeline, Finance, and Development. In these roles, the volunteers become our support staff in terms of filing, labeling, keeping documents together, sending out bills to subscribers, addressing envelopes, stuffing envelopes, and numerous other tasks that keep us all so busy. Our Development Volunteers assist us with the fundraisers that sustain our Mission based programs. They are runners at Brunch, traffic-directors during Cruizin' Colby, assemblers for auction baskets, support staff for Angel Ride, and tree decorators for Light up a Life. Sewing volunteers provide us with the tangible mementos and comfort items that we present to our patients and families with: prayer shawls, comfort shawls, decorative hospital gowns, butterfly pillows, memorial pillows, and transfer pads. Patient Care Volunteers are highly trained members of our direct patient care teams. They provide respite for weary caregivers, companionship to patients in facilities, notary services for the housebound, Life Review to capture a lifetime of stories, Tuck-In services for delivery of supplies and / or medications. We also have a volunteer Barber, a Pet Therapy visitor and her 3 dogs, and a volunteer Master Gardener for those special services. Vigil volunteers are patient care volunteers who have additional training in order to be with patients / families within the last 48 hours of the patient's life -often a time of intense emotion. PROVIDENCE MOUNT ST. VINCENT: In 2011, the Mount's volunteer program involved 278 community members, ranging in age from 14 to 93, as official volunteers. Together they contributed 29,447.50 hours of service (up from 27,828.75 in 2010 - an increase of 1,618.75 hours). According to the national volunteer wage, the financial value of these hours is $ 628,998.60. In addition to the gift of their time, volunteers contributed to The Mount community in numerous ways - as donors, as word-of-mouth champions, as genuine friends and good neighbors. Three volunteer groups (the PMSV Auxiliary, Emilie's Treasures, and the Sewing Ladies) raised funds for the PMSV foundation as part of their mission. The Mount also partnered with Our Lady of Guadalupe School to bring the 8th grade class here once a month for visits with residents. PROVIDENCE MARIANWOOD: Departments utilizing and supervising volunteers: *Auxiliary *Dietary *Foundation *Human Resources *Medical Records *Nursing *Pastoral Care *Physical Therapy *Plant Services *Staffing *Therapeutic Recreation *Volunteers PROVIDENCE REGIONAL MEDICAL CENTER EVERETT: CAMP PROV: Volunteers ages 14 and up perform a variety of support activities to special needs children ages 2-10 and their siblings at a day camp located at Forest Park in Everett. Tasks include swimming, art projects, reading, preparing food, singing and fun. Call Volunteer Services to sign up for an information packet. CLERICAL AND OFFICE SUPPORT: Assist staff with clerical and office duties in clinical and administrative departments. Duties may include filing and collating, answering phones, using office machines and using a computer. EXPERIENCE SPECIFIC: Provide Comfort Dog services (if dog is certified by Delta Society); join the Heart to Heart volunteers to talk with others experiencing open heart surgery; personal interactions and clerical work at the Cancer Center & Breast Center regarding cancer survivors and provide an understanding ear for patients fighting cancer. FAMILY CARE AND GUEST SERVICES: Family care volunteers act as a liaison between hospital staff and families in public areas like our surgery waiting lounge and information desks. These volunteers provide information and support to families while a loved one is being cared for. GIFT SHOP: Customer service, cashier duties, and re-stocking merchandise. Minimum age is 18 years or 16 if you work with another 16-year-old friend. PROVIDENCE MEDICAL GROUP: Volunteer assists the Providence Medical Group Midwifery Clinic by compiling information packets, educational material, and forms for distribution to patients. PROVIDENCE SENIOR & COMMUNITY SERVICES: Volunteers helped with the execution of our special events: Providence Golf Classic, O'Christmas Trees Procurement Party, Signature Cocktail Contest, Designer Day, Christmas Carnival, Silver Bells Luncheon, and Gala Dinner & Auction. (SEE CONTINUATION) VOLUNTEERS - CONTINUED FORM 990, PART I, LINE 6 PROVIDENCE SOUND HOMECARE: We have a vibrant volunteer program that serves Thurston, Mason and Lewis counties. Our hospice volunteers provided a variety of services including but not limited to respite, companionship, light housekeeping and gardening for patients and their caregivers. Our volunteers also provided 11th Hour vigiling at the bedside of our patients who were actively dying when caregivers requested a loving, calming presence. We also had volunteers assist with our annual "Coping with the Holidays" and "Light Up A Life" programs for the community. Volunteers made lap quilts and gowns for patients. The quilts and gowns were then disseminated by our Bath Aides to patients in need. Bereavement volunteers made calls to survivors to provide support and information about our grief support services. Volunteers in our children's bereavement program, SoundCareKids, assisted children and adults process their grief. PROVIDENCE ST. PETER HOSPITAL: Volunteer Services Department provides support placing between 300-400 on boarded volunteers up to 51 departments at Providence St. Peters Hospital. Volunteers perform many routine and repetitive tasks that allow paid, licensed, certified, experienced staff to provide more attention to more affordable and comprehensive patient care. The following customer service functions are provided for PSPH and/or the patients and their families: Gift shop clerks, gift grant fundraising, and department volunteer placement in needed areas doing variety of tasks with the most common being: greeters, assisting individuals to get to their desired area in the hospital, delivering flowers, mail, answering phones/taking messages, putting packets together, stocking areas, taking inventory, blowing up balloons, entering non confidential data into computer, filing, mass mailings. PROVIDENCE WASHINGTON/MONTANA REGIONAL SERVICES: Providence Regina House runs both a food and clothing bank which is open twice per week. We not only provide food and clothing, but also household items, bus passes, and many other referrals and resources to our families in need. In 2011, we fulfilled over 90,000 individual requests for food. In 2011, approximately 300 volunteers gave 4,200 hours of their time at Providence Regina House. (SEE CONTINUATION) VOLUNTEERS - CONTINUED FORM 990, PART I, LINE 6 DOMINICARE: The volunteers at Dominicare helped maintain a memorial book, answered phone calls during staff meetings, made satisfaction survey calls once a month, and helped with a December 2011 mailing. EMILIE COURT: Assisted Residents to music in the gardens, and bingo. Assisted with Activities. Pet Therapy Visits. Assisted with Reception. One on one visits. Lead Bible Study every Tuesday. Assisted with Walking Group, Beauty Basket, and medical appointments. AssistED with ice cream social and baking buddies. Assisted with Wii Bowling, Penny Bingo, and Cookies with Santa. Daily Communion and daily rosary. ADULT DAY HEALTH: Volunteers at Adult Day Health work directly with the clients. They help serve lunch and assist the activity director in playing games, doing crafts etc. with our clients. SACRED HEART & HOLY FAMILY: As major medical centers, Sacred Heart and Holy Family have many activities and services needing volunteers. Below is a sampling of the types of services: Children's Hospital Kids need a hospital that understands children and we need volunteers who have a heart for children. Our volunteers in the Sacred Heart Children's Hospital provide comfort and care for children of all ages, from holding and soothing infants and toddlers to simply hanging out with older kids. Volunteers help our staff meet the special needs of our littlest patients and their families. Other opportunities include: Children's Clubhouse: in a special partnership with the Spokane Association of Realtors', realtors and others donate their time to watch over children in the Clubhouse while their parents and/or siblings attend to medical needs. Pediatric Services: Whether on a patient floor or in the pediatric surgery center, you can help ease the way for our youngest patients, whether it be reading to them, volunteering in a play area or sitting by their bedside so they are not alone. Ronald McDonald Family Room: An overnight satellite facility within the Children's Hospital is hosted by the Ronald McDonald House and staffed during the daytime by volunteers. This added benefit provides families with overnight accommodations while they deal with difficult situations with their child who is hospitalized for specialty care. Clerical Services If you have clerical and organizational skills, we have several opportunities for you to help out, whether in medical records, an office setting or our Foundation offices. Family Services Serving as a greeter at any of our information desks requires sensitivity, compassion and hospitality. You'll provide information and assistance to families and friends who have loved ones in the hospital. Various areas available for volunteers include: Greeter / Information Desk, Main Floor Greeter / Information Desk, Heart Institute Greeter / Information Desk, Surgery & Family Waiting Room Greeter / Information Desk, Skybridge Family Waiting Room Concierge, the Madison Inn Gift Shop Become a "retail therapist" by volunteering in one of the best boutique gift shops in the city with unique and unusual gifts and a full-service floral shop. Greet customers and help them shop for that special something. If you like helping people and shopping, you have what it takes! Music Music plays an important part in healing the mind and body, with several programs available. One of the most popular is playing the grand piano in the lobby. Auditions required. Patient Services Cancer Resource Center: Together with the American Cancer Society, you can volunteer in the Cancer Resource Center to help patients navigate their way. Emergency Department: This is a perfect opportunity for those 18 and over who are considering a medical or nursing career. Sacred Heart has the busiest emergency room in the city and is also a level II trauma center and houses the only pediatric trauma care in the region. Errands & Assistants: Enjoy helping people and getting lots of exercise? Then this is the assignment for you! Your shift will include assisting patients and families as they are admitted and discharged, running errands, delivering flowers, plus helping staff by delivering patient records, laboratory specimens and much more. Intensive Care Unit: Another great opportunity for those considering a medical or nursing career is to help in the critical care units by stocking supplies or transporting specimens, X-rays, etc. as directed. Patient Visitation Program: Visit patients who may not have family or friends nearby to provide assistance and a listening ear. Surgery Admit Unit: Volunteers in this busy unit assist clinical staff with various duties to help patients prior to surgery. Pet Visitation (must be Delta-certified dogs) If you love animals and want to experience the special gift a pet visit brings to patients and families in the hospital consider this assignment. Our Pet Visitation Program cannot exist without escorts, who assist the Delta-certified dogs and handlers in making patient visits and brightening the day for patients young and old. Pharmacy Volunteers in the Pharmacy must have a Level B Pharmacy license to assist with prescription drop-offs/pick-ups, sorting and a variety of other duties. It provides a professional environment and exposure to a Pharmacy career in a realistic setting. Retired Physicians and RNs (with current licenses) House of Charity Medical Clinic: If you are a retired physician or nurse, your expertise is needed in providing medical care to the homeless at the House of Charity medical clinic in downtown Spokane. Spiritual Care Eucharistic Ministers: Many of our patients request daily Communion and/or a blessing or prayer while they are in the hospital. Our volunteer Eucharistic ministers work closely with Pastoral Care staff to provide this service as part of their health care ministry. Special Projects Inevitable in a hospital of this size, there are special projects where volunteers can help make a difference! These projects are usually of shorter duration, whether in medical records, radiology or helping with a United Way campaign! Once you are a volunteer, you are eligible to add extra hours by way of a special project as needs are identified! Supply Chain Management From bandages to heart valves, this department makes sure the right item is given to the right caregiver at the right time, every time. Walking is involved, including stocking and delivering items to medical floors. MOUNT CARMEL HOSPITAL Volunteer activities are provided in the following categories: Fund Raisers -Annual Christmas Swag Fund Raiser Gift Shop - operate Vending Machines & purchase and stock Hospital Support- Admitting Desk Volunteer Chart Volunteer Blood Pressure Booth at local fairs Baby T-Shirts Auxiliary Operations ST. JOSEPH HOSPITAL: We have three types of volunteers who serve us including Auxiliary, Support, and Youth. There has been a change in how we label our volunteers. Some of the groups (entertainers, and church groups for example) were previously identified as volunteers, the definition of volunteer has been reassessed and we have determined that these individuals and groups should be termed "facility guests". The reduction in the numbers of our volunteer force reflects this new interpretation of "volunteers". *Assisting Wheel Chair Transport, Crafting, Letter Writing *Companion Visiting, Shopping, Outings, Patio Sitting, Adopt-A-Resident *Creative Nail Painting, Baking Projects, Decorating, Writing *Diversions Reading, Playing Games, Exercise, Coffee Conversation *Entertaining Assisting with Celebrations, Performing, Special Events *Fundraising Gift Shop Attendant, Baking, Organizing, Creating *Leading Horticulture, Sharing Special Talents, Creating Special Interest Groups *Supportive Greeters, Ministry of Presence, Education, Eucharistic Ministry RELIGIOUS COMMUNITY MEMBERS FORM 990, PART VII 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. Providence Assurance Inc 3131 Camelback Road Ste 400 Phoenix AZ 85016 208194071 Insurance Captive AZ 207 27074205 Providence Health & Services - Washington Legacy LLC PO Box 196606 Anchorage AK 99519 320252199 Real Estate AK 4091679 47929510 Providence Health & Services - Washington Health Services Asset Management LLC 1801 Lind Ave SW 9016 Renton WA 98057 271698016 A/R & Collections WA 1763164 581267 Providence Health & Services - Washington 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 1067 Everett WA 982061067 943264605 Transitional Care WA 501( c)(3) Line 9 N/A 0 Providence Oregon Management Corporation 1801 Lind Avenue SW 9016 Renton WA 980579016 930813977 Shell Corporation OR 501( c)(3) Line 1 PH & S - Oregon 0 Providence Plan Partners 3601 SW Murray Blvd 10 Beaverton OR 97005 911861964 Healthcare Services OR 501( c)(4) N/A PH & S - Oregon 0 Providence Health Plan 3601 SW Murray Blvd 10 Beaverton OR 97005 930863097 Health Service Contractor OR 501( c)(4) N/A Providence Plan Partners 0 Providence Health Assurance 3601 SW Murray Blvd 10 Beaverton OR 97005 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 2601 Airport Drive 230 Torrance CA 90505 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 1 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 - 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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 2601 Airport Drive 230 Torrance CA 90505 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 The John Gabriel Ryan Association 1801 Lind Avenue SW 9016 Renton WA 980579016 911303277 Healthcare WA 501( c)(3) Line 3 PH & S - Washington 0 Providence Health & Services 1801 Lind Avenue SW 9016 Renton WA 980579016 911549796 Shell Corporation WA 501( c)(3) Line 11/Type I N/A 0 Providence Health & Services - Montana 500 W Broadway PO Box 4587 Missoula MT 598064587 810231793 Healthcare MT 501( c)(3) Line 3 PH & S - Washington 0 Providence St Joseph Medical Center PO Box 1010 Polson MT 598601010 810463482 Healthcare MT 501( c)(3) Line 3 PH & S - Washington 0 St Thomas Child and Family Center 1710 Benefis Court Great Falls MT 59405 810233495 Early Childhood Education MT 501( c)(3) Line 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 Sacred Heart Children's Foundation PO Box 2555 Spokane WA 99220 320014330 Support Sacred Heart Children's Hospital 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 Willamette Falls Hospital dba Providence Willamette Falls Medical Center 1500 Division Street Oregon City OR 97045 930426018 Healthcare OR 501(c )(3) Line 3 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 & Activities 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 & Activities of SMMC WA 501(c )(3) Line 7 PH & S - Washington 0 Providence Imaging Center 3340 Providence Drive Anchorage AK 99508 920118807 Medical Imaging AK PH&S - WA Related 12379944 20072513 0 0 0.99000 Providence Surgery Centers LLC PO Box 233889 Anchorage AK 99523 203567411 Surgery AK PH&S - WA Related 0 0 Mountainstar Clinical Laboratories LLC 611 N Perry Spokane WA 99202 261345983 Outpatient Lab MT PAML LLC Related 0 0 Broadway Imaging LLC 500 W Broadway Missoula MT 59802 522405971 Medical Imaging MT PH&S - MT Related 0 0 Ctr for MedImaging-Tanasbourne LLC 1235 NE 47th Ave Portland OR 97213 200477972 Imaging - Diagnostics OR PH&S - OR Related 0 0 Ctr for Med Imaging-Bridgeport LLC 1235 NE 47th Ave Portland OR 97213 260796953 Imaging - Diagnostics OR PH&S - OR Related 0 0 Center for Specialty Surgery LLC 11782 SW Barnes Rd Portland OR 97225 263638838 Ambulatory Surgery Center OR PH&S - 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So California Investment 0 0 Pathology Associates Medical Laboratories LLC 611 N Perry Spokane WA 99202 270943279 Outpatient Lab WA Bourget Health Services Inc Related 0 0 Southern Idaho Regional Laboratory LLC 611 N Perry Spokane WA 99202 820511819 Outpatient Lab ID PAML LLC Related 0 0 Tri-Cities Laboratory LLC 611 N Perry Spokane WA 99202 911773986 Outpatient Lab WA PAML LLC Related 0 0 Alpha Medical Laboratory LLC 611 N Perry Spokane WA 99202 912017347 Outpatient Lab ID PAML LLC Related 0 0 PacLab LLC 611 N Perry Spokane WA 99202 911743952 Outpatient Lab WA PH&S - WA Related 0 0 HealthServicesNW LLC PO Box 389672 Seattle WA 98138 311750915 Medical Billing WA PH&S - WA Related -314450 0 0 Medalia Healthcare LLC 1801 Lind Ave SW 9016 Renton WA 98057 911660459 Physician Benefits WA PH&S - WA Investment 711430 0 0 0.51000 Distribution Operations Center LLC 1801 Lind Ave SW 9016 Renton WA 98057 271054858 Supplies Purchasing Agent WA PH&S - WA Related 498460 11475345 0 0 0.40000 Oregon Advanced Imaging LLC 881 OHare Parkway Medford OR 97504 450471748 Medical Imaging OR PH&S - OR Related 0 0 California Laboratory Associates LLC 501 Buena Vista Burbank CA 91505 273888692 Outpatient Lab CA PHS - So California Related 0 0 Canby Medical Center I LLC 2747 Pence Loop SE Salem OR 97302 205470937 Real Estate - MOB OR Willamette Falls Hospital Related 0 0 Providence Health Ventures Inc 4101 Torrance Blvd Torrance CA 90503 330122216 Investment CA N/A C Caron Health Corporation 510 West Front Street Missoula MT 59802 810486082 Medical Physician Service MT N/A C Providence Health Care Ventures Inc 101 West 8th Ave TAF C-9 Spokane WA 99204 900155714 Clinical/Medical Lab WA N/A C Providence Physician Services Co 101 West 8th Ave TAF C-9 Spokane WA 99208 911216033 Clinical/Medical Lab WA N/A C Yakima Medical Arts Inc 611 N Perry Suite 100 Spokane WA 99202 910787963 Rental Real Estate WA N/A C Bourget Health Services Inc PO Box 2687 Spokane WA 99220 911354431 Clinical/Medical Lab WA N/A C 0 1 1 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 Providence Alaska Foundation B 1178699 Cost Providence Alaska Foundation C 2395896 Cost Providence Health Care Foundation B 235321 Cost Providence Health Care Foundation C 205179 Cost Providence Hospice & Home Care Foundation Snohomish County B 2750 Cost Providence Hospice & Home Care Foundation Snohomish County C 425679 Cost Providence Hospice & Home Care Foundation Snohomish County P 307699 Cost Providence Hospice of Seattle Foundation B 276688 Cost Providence Hospice of Seattle Foundation C 859414 Cost Providence Hospice of Seattle Foundation P 207368 Cost Providence Marianwood Foundation B 190629 Cost Providence Marianwood Foundation C 165846 Cost Providence Marianwood Foundation P 166918 Cost Providence Mount St Vincent Foundation B 160361 Cost Providence Mount St Vincent Foundation C 669187 Cost Providence Mount St Vincent Foundation P 510595 Cost Providence St Peter Foundation B 752499 Cost Providence St Peter Foundation C 2044664 Cost Providence St Peter Foundation P 197432 Cost Sacred Heart Children's Foundation B 206757 Cost Sacred Heart Children's Foundation C 127446 Cost Sacred Heart Children's Foundation P 164763 Cost