TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Bill Cox Chairman	1.00	X			0	0
(2) Karen N Walker Esq Secretary	1.00	X			0	0
(3) Steve Strazzella Treasurer	1.00	X			0	0
(4) Sister Mary Bader Director	1.00	X			0	0
(5) Nalini N Jairath Director	1.00	X			0	0
(6) Rex P Killian Director (start 7/10)	1.00	X			0	0
(7) Derek Leebaert D Phil Director	1.00	X			0	0
(8) Sr Elizabeth Ann Lingg Director	1.00	X			0	0
(9) Marie E Michnich DrPH Director (start 7/10)	1.00	X			0	0
(10) Joseph A Quash MD Director	1.00	X			0	0
(11) Sister Elyse Staab Director	1.00	X			0	0
(12) Judi Teske Director	1.00	X			0	0
(13) Roderic L Woodson Esq Director (start 7/10)	1.00	X			0	0
(14) Amy E Freeman President & CEO	40.00	X	X		365,260	12,587
(15) Cheryl A Sadro Sr. VP Finance & CFO (end 10/11)	40.00		X		275,226	76,019
(16) Mariea R Cromer VP-Gen'l. Counsel (end 7/10)	40.00			X	352,392	5,992
(17) Matthew R Lukasiak VP Mission	40.00			X	182,762	8,217

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Deborah A Morrison VP QI/Risk Management	40.00	X			203,200	0	14,435
(19) Robert L Simmons MD Sr. VP Medical Affairs	40.00	X			467,074	0	21,400
(20) Robert K Snyder VP Corp. Controller (end 4/11)	40.00	X			202,412	0	17,984
(21) Michael D Thompson VP Mktg/Bus Development	40.00	X			178,729	0	7,993
(22) Gary A Coke MD Anesthesiologist	40.00		X		365,603	0	11,470
(23) Cezar A Koev MD Director Anesthesiology	40.00		X		469,752	0	10,420
(24) Andreas Kotzur MD Anesthesiologist	40.00		X		405,556	0	6,560
(25) Tahir Manzoor MD Anesthesiologist	40.00		X		450,119	0	8,704
(26) Mina Nakbeen MD Anesthesiologist	40.00		X		342,689	0	38,163
(27) Julius D Spears Jr Former President & CEO (end 10/09)	0.00			X	463,914	0	12,530
(28) Paul R Grenaldo Former Exec VP/COO (end 3/10)	0.00			X	593,778	0	8,117
(29) Allen Dorsey Jr Former VP-Revenue Cycle (end 12/09)	0.00			X	98,360	0	1,264

(A) Name and business address	(B) Description of services	(C) Compensation
Inova Health System 45745 Nokes Blvd Suite 160 Sterling,VA20166	Blood Service	1,759,742
Advanta Medical Solutions 5800 Silent Sun Place Clarksville,MD21029	Professional Services	406,003
Gallagher Evelius & Jones 218 North Charles St Suite 400 Baltimore,MD21201	Legal Services	282,956
Tatum PO Box 847872 Dallas,TX752847872	Professional Services	270,480
Keith Hunter MD 4221 Argyle Terrace NW Washington,DC20011	Professional Services	248,560
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 17

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	1,812,902	1,714,464	98,438
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	1,756,743	1,668,906	87,837
7	Other salaries and wages	95,059,094	85,382,495	9,676,599
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	7,351,551	6,616,396	735,155
9	Other employee benefits .......	6,280,117	5,652,105	628,012
10	Payroll taxes ...........	8,470,331	7,623,298	847,033
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	628,641	597,209	31,432
c	Accounting ...........	566,372	509,735	56,637
d	Lobbying ...........
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......
g	Other ..........	20,283,544	20,283,544
12	Advertising and promotion ....	107,907	75,535	32,372
13	Office expenses .......	579,510	434,632	144,878
14	Information technology ......	8,605,868	6,884,694	1,721,174
15	Royalties ..
16	Occupancy ...........	5,347,018	4,544,965	802,053
17	Travel ............	171,508	120,056	51,452
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	73,788	36,894	36,894
20	Interest ...........	2,406,823	2,365,380	41,443
21	Payments to affiliates .......	1,390,789	1,390,789
22	Depreciation, depletion, and amortization .....	6,448,752	6,448,752
23	Insurance ..............	3,426,060	3,319,477	106,583
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	Supplies	33,846,903	33,169,965	676,938
b	Bad Debts	6,836,635	6,836,635
c	Agency Staff	3,165,831	3,007,539	158,292
d	Maintenance	2,294,742	2,065,268	229,474
e	DC Provider Tax	2,139,550	2,139,550
f	All other expenses	1,949,266	1,949,266
25	Total functional expenses. Add lines 1 through 24f	221,000,245	204,837,549	16,162,696	0
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	356,349	1	267,835
2	Savings and temporary cash investments .......	4,370,003	2	14,985,871
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	31,859,958	4	27,667,554
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	2,885,068	8	2,579,965
9	Prepaid expenses and deferred charges ............	751,714	9	257,402
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	188,757,622
b	Less: accumulated depreciation. .....	10b	138,205,228	50,634,136	10c	50,552,394
11	Investments—publicly traded securities ..........		11
12	Investments—other securities. See Part IV, line 11 ......		12
13	Investments—program-related. See Part IV, line 11 ..	2,901,944	13	3,498,947
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	94,615,261	15	94,532,551
16	Total assets. Add lines 1 through 15 (must equal line 34)...	188,374,433	16	194,342,519
	17	Accounts payable and accrued expenses .	26,646,540	17	31,980,839
18	Grants payable ..........		18
19	Deferred revenue ..........	152,809	19	103,298
20	Tax-exempt bond liabilities ..........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	91,241,177	25	77,761,943
26	Total liabilities. Add lines 17 through 25.....	118,040,526	26	109,846,080
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	70,155,864	27	84,318,396
28	Temporarily restricted net assets .....	178,043	28	178,043
29	Permanently restricted net assets .....		29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	70,333,907	33	84,496,439
34	Total liabilities and net assets/fund balances .....	188,374,433	34	194,342,519

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

Providence Hospital

Employer identification number

53-0196636

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

Providence Hospital

Employer identification number

53-0196636

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization Providence Hospital
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization Providence Hospital
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
Providence Hospital

Employer identification number

53-0196636

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below.
SchCMd Bullet

Attach to Form 990 or Form 990-EZ. SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Providence Hospital

Employer identification number

53-0196636

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities .................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2010

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check if the filing organization belongs to an affiliated group.
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated Group Totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots non-taxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2010

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? If "Yes," describe in Part IV ..........................

Yes

21,939

Total. lines 1c through 1i ...................................

21,939

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
Explanation of Other Lobbying Activities:	Part II-B, Line 1i:	Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying.

Schedule C (Form 990 or 990EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Providence Hospital

Employer identification number

53-0196636

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year	(c)Two Years Back	(d)Three Years Back	(e)Four Years Back
1a	Beginning of year balance ....
b	Contributions ........
c	Investment earnings or losses ...
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

Permanent endowment: SchDMd Bullet

Term endowment: SchDMd Bullet

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	2,585,094		2,585,094
b	Buildings ................	128,489,790	96,722,487	31,767,303
c	Leasehold improvements ............	25,249	25,249	0
d	Equipment ................	55,030,273	39,247,288	15,782,985
e	Other .................	2,627,216	2,210,204	417,012
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				50,552,394

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) Advances to Affiliates				40,312,586
(2) Other Current Assets				1,624,012
(3) Restricted Assets				178,043
(4) Other Miscellaneous Assets				8,728,584
(5) Health System Depository Account				61,070,238
(6) Third Party Settlements				1,201,495
(7) Contruction-In-Progress				3,918,728
(8) Other Investments - Long Term				-22,501,135

Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........				94,532,551

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes
Third Party Settlement		4,182,717
Self Insurance Liability		2,561,845
Deferred Compensation		4,365,324
Pension Refunding Payable		16,108,228
Ascension Health Pension Restoration		155,850
Deferred Gain or Loss on Sale of Assets		362,906
Intercompany Debt to Ascension Health		49,111,248
Noncurrent Asset Retirement		913,825

Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		77,761,943
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3
4	Net unrealized gains (losses) on investments ..........................	4
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8
9	Total adjustments (net). Add lines 4 - 8 .............................	9
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......		5

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......		5

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Providence Hospital

Employer identification number

53-0196636

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

Yes

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

Yes

If "Yes," does the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..	3,382,635		3,382,635	1.580 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .	65,064,417	62,053,583	3,010,834	1.410 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....	68,447,052	62,053,583	6,393,469	2.990 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	6,272,321		6,272,321	2.930 %
f Health professions education (from Worksheet 5) ..	1,960,471		1,960,471	0.920 %
g Subsidized health services (from Worksheet 6) ..
h Research (from Worksheet 7)
i Cash and in-kind contributions to community groups (from Worksheet 8) ..
jTotal Other Benefits ...	8,232,792		8,232,792	3.850 %
kTotal. Add lines 7d and 7j. ..	76,679,844	62,053,583	14,626,261	6.840 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	64,508	64,508	0.030 %
8	Workforce development
9	Other
10	Total	64,508	64,508	0.030 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense (at cost).....

6,836,635

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

1,070,317

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

70,692,221

Enter Medicare allowable costs of care relating to payments on line 5.....

60,043,319

Subtract line 6 from line 5. This is the surplus or (shortfall)........

10,648,902

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Yes

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?2 Name and address		Other (Describe)
1	Providence Hospital 1150 Varnum Street NE Washington,DC20017	X	X	X	X
2	Carroll Manor Nursing & Rehab Center 1150 Varnum Street NE Washington,DC20017					Skilled Nursing & Rehabilitation Center

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:NA

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?6
Name and address		Type of Facility (Describe)
1	Seton House 1053 Buchanan Street NE Washington,DC20017	Skilled Nursing & Rehabilitation Center
2	Seton House 1053 Buchanan Street NE Washington,DC20017	Skilled Nursing & Rehabilitation Center
3	Seton House 1053 Buchanan Street NE Washington,DC20017	Skilled Nursing & Rehabilitation Center
4	Seton House 1053 Buchanan Street NE Washington,DC20017	Skilled Nursing & Rehabilitation Center
5	Seton House 1053 Buchanan Street NE Washington,DC20017	Skilled Nursing & Rehabilitation Center
6	Seton House 1053 Buchanan Street NE Washington,DC20017	Skilled Nursing & Rehabilitation Center
7
8
9
10

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
		Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with the Catholic Health Association (CHA) guidelines. The organization uses a cost accounting system that addresses all patient segments, i.e. inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, and uninsured (self-pay). The best available data was used to calculate the amounts reported in the table. As applicable for information in the table, cost-to-charge ratios were calculated and applied.
		Part I, Line 7g: Providence Hospital has not included costs attributable to a physician clinic, as part of subsidized health services.
		Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 6836635.
		Part II: Providence Hospital's Wellness Institute provides community health improvement advocacy in a variety of settings and in numerous ways. The Wellness Institute is the primary provider of breast cancer programs and senior citizen health and wellness programs. In addition, the Wellness Institute provides health screenings at various locations, participates in "Take a Loved One to the Doctor" day, promotes and participates in the Komen Walk for the Cure, provides health screening to local high school students who plan to participate in sports programs, plus so many other programs and educational offerings to the public. Overall the costs to operate the Wellness Institute in 2011 totalled $1,461,421 with additional costs of $64,508 specific to Medicaid eligibility education offered to the local community.
		Part III, Line 4: The provision for bad debts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of allowance for uncollectible accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for bad debts to establish an appropriate allowance for uncollectible accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the organization follows established guidelines for placing certain past due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts, as determined by the organization. Accounts receivable are written-off after collection efforts have been followed in accordance with the Organization's policies.
		Part III, Line 8: Providence Hospital follows the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit.
		Part III, Line 9b: Providence Hospital has a written debt collection policy that also includes a provision to address the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity care or financial assistance, certain collection practices do not apply.
		Part V: Providence Hospital has two senior citizen health centers and one family medicine health center. Providence Hospital's skilled nursing facility (listed on Form 990, Schedule H, Part V, Line 2) is required by District of Columbia law to be licensed.
		Part VI, Line 2: See Schedule O, Community Benefit Report Section "Overview of the Community Assessment."
		Part VI, Line 3: In all of the Providence Hospital Community Benefit Programs, education is a primary focus. See Schedule O, Community Benefit Report Section "Other Programs for the Poor."
		Part VI, Line 4: The Washington D.C. metropolitan area encompasses a broad and diverse area that includes the District of Columbia, communities in suburban Northern Virginia, and Maryland counties North and East of the District of Columbia. The 2010 Census Bureau recorded counts of 601,723 residents in the city of Washington, DC, with 5.4 million residents in the immediate surrounding metropolitan area. The Hospital's diverse population community includes people and cultures from all over the world, with some living here temporarily and others moving back and forth within the region. Among the diverse population, there is a substantial population of African-Americans and Latin-Americans that reside in the Washington, DC metropolitan area. Located in Ward 5 of Washington, D.C. and in the Catholic University/Brookland neighborhood, the patient population served by Providence Hospital consists primarily of District of Columbia residents and residents of Prince George's County, Maryland.
		Part VI, Line 6: The Hospital manages Seton House which provides Behavioral Health Services including community outreach. Providence Hospital's community based Perry Health Center and Fort Lincoln Medicine Center provides a full range of primary care and specialty health services for every member of the family. Providence Hospital operates Senior Wellness Centers in Congress Heights and Model cities providing services to DC seniors promoting healthy lifestyles to members, which is free to all DC residents who are 60 years of age or older. The DC Police & Fire Clinic represents a joint venture of Providence Hospital and the Washington Hospital Center providing occupational and preventive medical services to DC's more than 5,000 police officers, fire fighters, US Park Police and US Secret Service agents.
		Part VI, Line 7: Providence Hospital is a member of Ascension Health. Ascension Health is a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 20 of the United States and the District of Columbia. Ascension Health is sponsored by the Northeast, Southeast, East Central, and West Central Provinces of the Daughters of Charity of St. Vincent de Paul, the Congregation of St. Joseph, and the Sisters of St. Joseph of Carondelet (CSJ).Providence Hospital, located in Washington D.C., is a nonprofit acute care hospital. The Medical Center provides inpatient, outpatient, and emergency care services for the residents of Washington D.C. and Prince Georges County, Maryland. Admitting physicians are primarily practitioners in the local area. Providence Hospital is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of Ascension Health and its sponsored organizations are related to providing health care services.Mission:Ascension Health directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with Ascension Health's mission of service to those who are poor and vulnerable, each Health Ministry accepts patients regardless of their ability to pay. Ascension Health uses four categories to identify the resources utilized for the care of persons who are poor and community benefit programs:-Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured.-Unpaid cost of public programs represents the unpaid cost of services provided to persons covered by public programs for the poor.-Cost of other programs for the poor includes unreimbursed costs of programs intentionally designed to serve the poor and vulnerable of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome.-Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the poor, including health promotion and education, health clinics and screenings, and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons who are poor and community benefit programs. The cost of providing care of persons who are poor and community benefit programs is estimated using internal cost data.

Schedule H (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Providence Hospital

Employer identification number

53-0196636

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) Amy E Freeman	(i) (ii)	314,231 0	50,000 0	1,029 0	4,580 0	8,007 0	377,847 0	0 0
(2) Cheryl A Sadro	(i) (ii)	254,576 0	20,000 0	650 0	4,900 0	71,119 0	351,245 0	0 0
(3) Mariea R Cromer	(i) (ii)	119,375 0	0 0	233,017 0	2,400 0	3,592 0	358,384 0	0 0
(4) Matthew R Lukasiak	(i) (ii)	172,446 0	10,000 0	316 0	3,458 0	4,759 0	190,979 0	0 0
(5) Deborah A Morrison	(i) (ii)	192,860 0	10,000 0	340 0	3,603 0	10,832 0	217,635 0	0 0
(6) Robert L Simmons MD	(i) (ii)	392,856 0	66,367 0	7,851 0	21,400 0	0 0	488,474 0	61,533 0
(7) Robert K Snyder	(i) (ii)	201,654 0	0 0	758 0	4,071 0	13,913 0	220,396 0	0 0
(8) Michael D Thompson	(i) (ii)	174,363 0	4,069 0	297 0	3,259 0	4,734 0	186,722 0	0 0
(9) Gary A Coke MD	(i) (ii)	365,319 0	0 0	284 0	4,900 0	6,570 0	377,073 0	0 0
(10) Cezar A Koev MD	(i) (ii)	467,319 0	0 0	2,433 0	3,860 0	6,560 0	480,172 0	0 0
(11) Andreas Kotzur MD	(i) (ii)	405,271 0	0 0	285 0	0 0	6,560 0	412,116 0	0 0
(12) Tahir Manzoor MD	(i) (ii)	449,645 0	0 0	474 0	1,964 0	6,740 0	458,823 0	0 0
(13) Mina Nakbeen MD	(i) (ii)	342,317 0	0 0	372 0	21,400 0	16,763 0	380,852 0	0 0
(14) Julius D Spears Jr	(i) (ii)	0 0	0 0	463,914 0	0 0	12,530 0	476,444 0	0 0
(15) Paul R Grenaldo	(i) (ii)	61,453 0	0 0	532,325 0	4,179 0	3,938 0	601,895 0	0 0
(16) Allen Dorsey Jr	(i) (ii)	0 0	0 0	98,360 0	1,264 0	0 0	99,624 0	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
Supplemental Information	Part III	Part I, Line 4a: Severance Payments: Mariea R. Cromer - $208,013 Allen Dorsey, Jr. - $84,864 Julius D. Spears, Jr. - $457,600 Paul R. Grenaldo - $469,664 Part I, Line 4b: Executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. Neither contributions to nor distributions from the supplemental nonqualifed retirement plan were made in the current year.

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

Providence Hospital

Employer identification number

53-0196636

Identifier	Return Reference	Explanation
Form 990, Part VI, Section A, line 6		Providence Hospital has a single corporate member, Ascension Health.
Form 990, Part VI, Section A, line 7a		Providence Hospital has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of Providence Hospital.
Form 990, Part VI, Section A, line 7b		Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix.
Form 990, Part VI, Section B, line 11		Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, to review and answer any questions. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions.
	Form 990, Part VI, Section B, line 12c	Providence Hospital regularly & consistently monitors and enforces compliance with the conflict of interest policy, in that any director, principal officer, or member of a committee with governing board delegated powers, who has direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee meeting will decide if conflicts of interest exist. Each director, principal officer & member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflict of interest policy, and understands that the organization is charitable & in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
	Form 990, Part VI, Section B, line 15	In determining compensation of Providence Hospital's President & CEO, the process included a review and approval by independent persons, comparability data & contemporaneous substantiation of the deliberation and decision. The Executive/Compensation Committee reviewed & approved the compensation. In the review of compensation, the President & CEO was compared to individuals at other organizations in the area who hold the same title. During the review & approval of the compensation, documentation of the decision was recorded in the Executive Committee minutes. The individual was not present when her compensation was decided. In determining compensation of other officers or key employees of Providence Hospital, the process included a review & approval by independent persons, comparability data, & contemporaneous substantiation of the deliberation and decision. The Executive/Compensation Committee reviewed & approved the compensation. In the review of compensation, the other officers & key employees of Providence Hospital were compared to individuals at other organizations in the area who hold the same titles. During the review & approval of the compensation, documentation of the decision was recorded in the Executive Committee minutes.
	Form 990, Part VI, Section C, line 19	The organization will provide any documents open to public inspection upon request.
Changes in Net Assets or Fund Balances:	Form 990, Part XI, line 5:	Net unrealized gains on investments: 4,447,858. Transfers to Ascension Health -4,002,450. Pension Adjustment, Restoration, & Other Adjustment-FAS 158 23,780,041. Capital Transfers from DePaul Foundation, Inc. -19,197,720. Capital Transfers from Providence Health Foundation, Inc. 426,361. Total to Form 990, Part XI, Line 5: 5,454,090.
Explanation of Attached Audited Financial Statements:	Form 990, Part IV, Line 20b:	The financial statements of Providence Hospital and its subsidiaries fall under a limited scope audit. The activity of Providence Hospital and its subsidiaries is reported in the consolidated financial statements of Ascension Health. No individual audit for Providence Hospital is completed. Therefore, the attached audited financial statements are of Ascension Health and affiliates (which include the activity of Providence Hospital).
Community Benefit Report:	Form 990, Part III, Line 4a:	For the Fiscal Year 2011 Executive Summary This report illustrates the significant degree to which Providence Hospital contributes to the positive health status of the communities it serves. As a member of Ascension Health, the nation's largest Catholic healthcare system, Providence Hospital continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of Providence Hospital is to continue the healing mission of the church, recognizing and serving the particular needs of those who are poor and vulnerable. Providence Hospital serves its community through the delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community, and the conduct of health research. The Hospital's concern for all human life and the dignity of each person is the basis for the organization's pledge to provide medical services to all people in the community without regard to the patient's ability to pay. Ascension Health directs its governance and management activities toward strong, vibrant, Catholic health ministries that are united in service and healing and that are dedicated to employing its resources toward spiritually centered care, because it is spiritually centered care that sustains and improves the health of the individuals and the community served by the Hospital. Providence Hospital provides many services and conducts many projects that benefit the community, and the following sections of this report highlight many of those services and endeavors: - HIV/AIDS Routine Testing in the Emergency Department - Cancer Outreach and Screening - Senior Care - Neonatal Health and the Center for Life - Community-Based Primary Healthcare Clinics Providence Hospital Background Chartered by President Abraham Lincoln in 1861, Providence Hospital is the longest continuously-operating hospital in Washington, DC and will celebrated its 150th anniversary in June of 2011. Providence Hospital is a 408 licensed bed acute care hospital that also operates Carroll Manor Nursing and Rehabilitation Center, a separate 252 bed hospital-based skilled nursing facility. Both facilities are located in the Northeast metropolitan Washington, DC area which borders Prince George's County, Maryland. Providence Hospital serves its community by providing a 24-hour emergency department; a wide spectrum of diagnostic services that include CT scans, MRI imaging, and cardiac catheterization; a comprehensive list of offered outpatient services that include outpatient surgeries, physical medicine, and rehabilitation medicine; and obstetric services to low-income patients through its Center for Life. Providence Hospital is also committed to setting the standard for quality, holistic care with uncomplicated access to Hospital services for the public it serves. Providence Hospital shares the spirit of its founders, the Daughters of Charity, and all who serve in Ascension Health, caring for those most in need through the following mission and core values: Mission: Rooted in the loving ministry of Jesus as healer, we serve all persons with joy, care, and respect, giving special attention to persons who are poor and vulnerable. Our Catholic health ministry improves the health of individuals and our community with compassion and justice. Core Values - Service to those who are poor-generosity of spirit, especially for those in need - Reverence-respect and compassion for the dignity and diversity of life - Integrity-inspiring trust through personal leadership - Wisdom-integrating excellence and stewardship - Creativity-courageous innovation - Dedication-affirming the hope and joy of our ministry Organizational Commitment to Community The Washington DC metropolitan area encompasses a broad and diverse area that includes the District of Columbia, communities in suburban Northern Virginia, and Maryland counties North and East of the District of Columbia. The 2010 US Census Bureau recorded 601,723 residents in the city of Washington, with 5.4 million residents in the immediate surrounding metropolitan area. The Hospital's diverse population community includes people and cultures from all over the world, with some living here temporarily and others moving back and forth within the region. Among the diverse population, there is a substantial population of African-Americans and Latin-Americans that reside in the Washington DC metropolitan area. Located in Ward 5 of Washington DC and in the Catholic University/Brookland neighborhood, the patient population served by Providence Hospital consists primarily of District of Columbia residents and residents of Prince George's County, Maryland. During the Hospital's 2011 fiscal year, 14,265 patients were admitted to the Hospital, and 651 individuals became residents at the Hospital's Carroll Manor Nursing & Rehabilitation Center; these admissions resulted in 153,022 patient days of care provided during the year. The Hospital also performed 3,385 inpatient surgical procedures and 7,335 outpatient surgical procedures during the 2011 fiscal year. Overview of the Community Assessment While Providence Hospital's community assessment has cited specific areas of need that are currently addressed through existing programs, the Hospital also draws upon the expertise of national organizations that have conducted their own community assessments of the metropolitan Washington, DC area. Organizations, such as The Susan G. Komen for the Cure, the DC Department of Health in its annual Medicaid Report, and the US Census provide a wealth of information about the Washington, DC metropolitan area population demographics, the population's health needs, and the availability of health care services. The District of Columbia is home to recognized Federal health care resources and organizations, such as the National Institutes of Health and the Centers for Medicaid and Medicare Services. In addition, Washington, DC is home to leading health associations and organizations, including the Institute of Medicine, the American Red Cross, and the American Public Health Association. The presence of numerous hospitals and primary care facilities throughout the metropolitan area portray an image of widespread access to health care for all residents; and further supporting that image of far-reaching access to health care, Washington, DC boasts the second highest level of insurance coverage among its residents, second only to Massachusetts. However, there is a 6.2% uninsured rate that exists among residents in the metropolitan Washington, DC area, which belies this image. For the uninsured population, particularly those who are poor or who are among the working-poor, reasonable and affordable access to health care related services is difficult to obtain, or in many instances, it simply does not exist. District of Columbia area residents, particularly the poor and those who are vulnerable, rely on state and city sponsored aid or charity care for their health care needs. In the District of Columbia and in nearby Prince George's County, Maryland, the statistical data illustrates the obvious needs of the community and illustrates the wide-spread disparities that exist and persist in a deep-rooted poverty level that exists among the uninsured segment of the area's residents. - The percentage of the population enrolled in Medicaid is higher in the District of Columbia than in any state. - 61% of the District of Columbia children rely on the DC Medicaid program for their health insurance coverage. - In 2009, 30% of the District of Columbia children lived in poverty. Among African American children, the rate increased to 43%, which was an increase of 8% from just one year previously - the 2008 level. For those District of Columbia residents who are uninsured, the options for health services coverage are limited to DC Medicaid for the very low income residents and DC Health Care Alliance for the working poor--those who are employed but who do not have employer-sponsored health insurance coverage or sufficient financial means of obtaining other health care coverage. In addition, there is a portion of the working poor that do not qualify for either DC Medicaid or the DC Medical Alliance program. While other District of Columbia hospitals have discontinued their acceptance of Alliance patients, Providence Hospital has remained steadfast in its commitment to accepting the Alliance patients. An assessment of potential community benefit areas was performed, and certain priority areas of need have been identified:
		- HIV/AIDS - According to the District of Columbia, 2008 HIV/AIDS Epidemiology Update, 3 % of all District of Columbia residents are currently "known" to be living with HIV/AIDS; and a 3% level of infection in any population center is considered to be of epidemic proportions, according to the US Centers for Disease Control and Prevention. - Breast Cancer - The 2007 Susan G. Komen for the Cure community assessment, which set the stage for the 2010 Community Action Plan, stated that "special attention must be paid to reaching the underserved populations that may face various and unique barriers, such as language, legal status, income or economic status, lack of health care coverage, and cultural myths about breast cancer." - Senior Care - In a city where disparities are known to exist between the rates at which Caucasian and African-Americans are affected by chronic illnesses, such as hypertension and diabetes, the statistical evidence of those disparities becomes more substantially evident as populations age. - Neonatal Health Issues - Too often because of their economic status and/or their lack of insurance coverage, too many women receive their prenatal care too late. Some women even consciously attempt to control the financial impact of their pregnancy by scheduling a limited number of prenatal care appointments or skipping appointments, which leads to inconsistent prenatal care. Whether it is prenatal care that is too late or prenatal care that is inconsistent because of an individual's choice, those courses of action make a critical difference for those women in maintaining their own health, while also adversely affecting the duration of their pregnancy and the health of their newborn. The resulting impact of their lack of quality prenatal care or inconsistent prenatal care often results in pre-term birth and sub-optimal birth weight. The District of Columbia received a failing grade from March of Dimes because of their high rates of pre-term deliveries and low birth weights. Providence Hospital has identified the following areas of potential community building needs. - Infant Mortality - The District of Columbia's 2008 infant mortality rate was 10.9 deaths per 1,000 live births, which was more than two (2) times the national average of 6.5 deaths per 1,000 live births. The need has emerged for a city-wide effort to define and focus the goals and plans to reduce this infant mortality rate. - Primary Care Physician Shortage - The need to recruit and retain primary care physicians in the metropolitan Washington, DC area has been identified, and a strategic goal of Providence Hospital is to recruit and retain physicians in the primary care field of medicine, as well as to recruit and retain physicians in a variety of specialty services. Community Benefit Programs -- HIV/AIDS Testing Needs Assessment The District of Columbia's health statistics have documented the prevalence of HIV/AIDS diagnoses throughout the community that have risen to a level that surpasses the threshold of an epidemic level. Among those statistics that document the rates of infection are the following observations and facts: - There is a cumulative estimate of 19,864 diagnosed cases of HIV/AIDS in the District of Columbia - The annual diagnosis rate of HIV/AIDS is more than seven (7) times the national rate - More than 3% of the total District of Columbia population over the age of 12 is infected with HIV/AIDS, including the following segments of the population: - 7.1% of African-American males - 3.4% of Hispanic males - 2.9% of Caucasian males A particular group of HIV/SIDS-infected persons, known as "late testers," is comprised of individuals who are of special concern, because these individuals progress from an initial HIV diagnosis to a full AIDS presentation in less than twelve (12) months after their initial diagnosis date. Of the 3,143 AIDS cases diagnosed between 2004 and 2008, 61% of those cases were late testers. While it often the circumstances that the "late testers" are very sexually active; they are, therefore, most likely to be infecting others. Providence Hospital Response to the Need Providence Hospital has developed several approaches to address the AIDS epidemic in Washington, DC. There is a special focus on prevention through the screening of pregnant women. Providence Hospital delivered 1,933 newborn infants in the 2011 fiscal year, and the Hospital's Center for Life encountered 17,776 visits. Pregnant, women who are seen in the Hospital's Center for Life, where prenatal care is the focus, and/or seen in its Maternal Infant Health Unit, where labor and delivery occur, are tested in their 1st and 3rd trimesters, using the rapid results screening method. This course of therapeutic care identifies infected mothers at an optimal stage in the progression of their infection to initiate a regimen of medication treatments to lower their viral load, and thereby, reduce the probability of infecting their baby. Approximately 1,500 such screenings are conducted annually at Providence Hospital. In the 2011 fiscal year, Providence Hospital's Emergency Department continued with its' HIV/AIDS Testing Program in the Emergency Department that was initially supported with funds received from the District of Columbia Department of Health and later expanded through additional grants. This program informs the patient that he/she will receive an HIV/AIDS test unless the patient objects or opts out. During the 2011 fiscal year, the Hospital's Emergency Department encountered 46,563 emergency visits, which provides a substantial population of individuals that could be tested for HIV/AIDS under this program. Outcome to the Response to the Need During the period July 2010 through June 2011, over 2,570 HIV/AIDS tests were performed. There are 16 positive, confirm cases. When positive results from the test procedures do present in an individual, the Emergency Department's established protocols necessitate that direct educational counseling with an appropriate referral for care is provided to the individual. CASE STUDY: Deana, a pregnant African American woman, presented to the Emergency Room with a sore throat. With our HIV/AIDS policy in place, Deana was notified that, she would be tested for the virus, unless she opted out. The test was performed and Deana had a reactive HIV test that was later confirmed. This young mother was understandably distraught and did not want her unborn child to have the disease. She considered an abortion. After counseling, she was referred to the Center for Life and was immediately started on an anti retro viral regimen. Her baby was born healthy, HIV free. Besides the obvious benefit to the community provided by Providence Hospital's HIV/AIDS testing program in the Emergency Department, the District of Columbia Department of Health's Program has acknowledged an additional benefit of this program that has resulted from the training of Public Health students from the University of the District of Columbia as program interns. These interns have been adequately prepared to address issues related to this epidemic and are passionate about their work having taken the importance of knowing one's HIV/AIDS status back to their campus.
		Community Benefit Programs - Breast Cancer Needs Assessment Approximately one (1) in every eight (8) woman in America will develop breast cancer, according to statistical data issued by the American Cancer Society, but the rate of developing breast cancer among women in the District of Columbia is even higher. According to the 2007 Komen Community Profile for the National Capital Area, Washington, DC has the highest breast cancer mortality rate in the United States. Additionally, a considerable disparity in diagnosis and mortality exists between African-American and Caucasian residents in the District of Columbia. While breast cancer diagnoses in Washington, DC for Caucasian women are 200.3 out of 100,000 and only 147.9 out of 100,000 for African-American women, the mortality rates are inverted with 25.6 out of 100,000 Caucasian women dying as a result of breast cancer, while as many as 33.5 out of 100,000 African-American women succumb to breast cancer. Providence Hospital Response to the Need The Wellness Institute's Breast Cancer Patient Navigation Program at Providence Hospital provides comprehensive, patient-centered breast health services, which specifically address outreach for prevention and improving access to care. The Breast Cancer Navigation Program focuses on all women over the age of forty (40) with "first time" screenings, who have been called back for more intensive diagnostic screenings or procedures. The program also focuses on the newly-diagnosed patient who is often vulnerable and may easily be lost in the follow-up process. Developed and implemented under Providence Hospital's Wellness Institute and Mammography Center, the program provides a continuum of care from prevention to early detection to navigation through the many patient-perceived "system" obstacles to ensure accurate diagnosis and appropriate treatment. Trained Navigators have been essential in supplying the needed support and advocacy for women affected by breast cancer. Too frequently, because of misunderstandings about insurance coverage, pre-authorization obstacles, or confusion regarding the health care system, the patient experiences a time can lag between the initial tests that are critical to establishing an accurate diagnosis and the initiation of treatment. The hiring, training, and deployment of these Navigators was funded through the Ralph Lauren Center for Cancer Cure and Prevention and has made a significant difference for women who fear for their health and are confused by the health care system. Outcome to the Response to the Need - The City-Wide Patient Navigator Research Program - Providence Hospital's Wellness Institute partnered with George Washington University Cancer Institute to participate in the District of Columbia City-Wide Patient Navigator Research Program, sponsored by the National Cancer Institute. The primary goal of this program has been to evaluate the timeliness and cost-effectiveness of patient navigation in order to reduce the incidence of women in the Washington DC population from experiencing a delay in diagnosis and treatment of breast cancer. Providence Hospital served as a recruitment site in offering patient navigation to women who presented with a suspicious mammography finding or with suspicious physical symptoms. Women were entered into the program at the time of an abnormal finding were followed through to the resolution of the finding. For those women who were diagnosed with breast cancer, their patient navigation continued through their primary treatment. The women who enrolled in the program completed questionnaires and satisfaction surveys at different stages of their participation in the program. - Faith-Based Breast Cancer Health Ministry - Funded by a grant from Susan G. Komen for the Cure, Providence Hospital developed and implemented a Faith-Based Breast Cancer Health Ministry program. The goal of this program was to engage the Washington, DC communities in Wards 5, 7, and 8, which were previously identified as high-need areas, to support breast cancer education, to support breast screening, and to offer encouragement and support for breast cancer survivors. With the specific goal of imbedding breast cancer advocates in the community, Providence Hospital was able to identify fourteen (14) churches within these wards where advocate church members were trained to discuss, address, or promote breast cancer awareness and prevention. In addition, these advocates were trained to conduct outreach activities, such as health fairs and breast cancer awareness presentations, and were instructed on the most effective and constructive ways to distribute educational materials to the members of their respective churches. - Breast Cancer Patient Navigation Program - The DC City-wide Patient Navigation Network program was created to fulfill "Priority One" of the DC Cancer Consortium Cancer Control Plan, which is, improving access to care. The George Washington University Cancer Institute was given the mandate to implement this program due to its past city-wide navigation network which include "an even more comprehensive system of community health organizations, screening sites, and comprehensive medical centers with a longitudinal approach to patient navigation". "The goal is to ensure that DC residents are assisted with accessing appropriate screening services and that those with a suspicious finding, or a confirmed diagnosis of cancer, are able to access timely, coordinated, standard-of-care treatment and appropriate support services throughout the cancer continuum in order to improve health outcomes, particularly for those populations are currently experiencing disparities in cancer care". Providence Hospital Wellness Institute has 2 CPNN navigators, who to date have assisted patients with varying cancers; with a focus on patients with breast and prostate cancers. Patients are referred to the navigators through their physicians, the Infusion Treatment Center, The Mammography Department and Health fairs; as well as from navigators from within network. - Breast Cancer Symposium - As a member of the American College of Surgeons Commission on Cancer, Providence Hospital sponsored its annual Breast Cancer Symposium in collaboration with the American Cancer Society's Faith-Based Partnership Program. The theme of the symposium was "Living with Faith" James 5:14-15: "Is any sick among you? Let him call for the elders of the church; and let him pray for him, anointing him with oil in the name of Lord; And the prayer of faith shall save the sick, and the Lord shall raise up; and if he have committed sins, they shall be forgiven him" - KJV. Providence Hospital and the American Cancer Society have once again joined together presenting an informative and spiritually uplifting program to raise awareness and educate community about breast cancer. The speakers took thee audience on a journey from surgery to the first encounter with the patient navigator; then on the adjuvant therapy and calling the American Cancer Society for services along the way. Then the room was filled with inspirational music guiding them to the Spiritual message of the day. - Cancer Awareness Symposium - As a member of the American College of Surgeons Commission on Cancer, Providence Hospital sponsored its annual Cancer Awareness Symposium in collaboration with the American Cancer Society. The theme of the symposium was "Survive and Thrive: Arm Yourself with the Shield of Knowledge," which provided participants with both educational and spiritual support, as well as advice regarding nutritional issues related. The speakers shared the latest guidelines regarding cancer screening and detection, as well as treatment options for the uninsured and underinsured. - Take Your Loved One to the Doctor Day - Providence Hospital hosted "Take Your Loved One to the Doctor Day" on September 28, 2010 which is promoted by nationally-renown, Tom Joyner, as part of the nationwide initiative to increase access to medical services. On this day, numerous health screenings were performed for participants, including clinical breast exams for women attendees. - Breast Cancer Support Group - Providence Hospital also sponsors a Breast Cancer Support Group that provides an environment where women, who are living with breast cancer, come together to share information, to receive further education, and to encourage each other.
		CASE STUDY: Abike is a 31-year-old Nigerian-born woman who had just started a new job in early 2010 as an RN; she found that she related well with cancer patients, especially since she had survived a rare form of uterine cancer. Not long after beginning this new phase of her life as a nurse, she noticed an abnormality during a routine self-examination of her breast. Her subsequent appointments with physicians and diagnostic tests confirmed her worst fear - she had cancer again. A mastectomy was recommended and performed, with chemotherapy and radiation that followed. The chemotherapy was especially difficult, resulting in Abike having to resign from her new job, because she required repeated hospitalizations for severe nausea and other side-effects. As a result of having resigned from her nursing position and with the additional financial obligations related to her numerous hospitalizations, Abike began to experience extensive high levels of stress and depression. A Breast Health Navigator with the Wellness Institute and Mammography Center at Providence Hospital provided effectual emotional support for Abike and provided her with multiple sources of potential financial assistance, including the Paul Carey Quality of Life Fund and the Eagle Bank Foundation. In addition, the Breast Health Navigator offered kind and sincere reassurance that she would heal and that she would have so much to look forward to in her life ahead. With the support Abike received, her physical well-being and psychological state of mind began to reverse themselves from their obvious "low". Her cancer was eradicated, as indicated by an Oncotype report, and her depression began to become far less of a daily experience and more of something that occurred in her past. She began job hunting, and the Breast Health Navigator observed that she was receiving fewer and fewer telephone calls from Abike. Reconstructive surgery was recommended for Abike, and she begun this next stage of recovery with abundant evidence of her fortified resilience to face and successfully address the challenges that lie ahead. Clearly, the Breast Health Navigator truly made a difference an Abike's healing and successful outcome.
		Community Benefit Programs - Community-Based Primary Care Needs Assessment Disparities in health care persist for African-Americans and Hispanics in Washington, DC, particularly in Wards 5, 7, and 8. The ethnic and racial groups in these Wards are disproportionately overrepresented in the poverty level of the Wards and have numerous and various obstacles to receiving adequate health care. Residents of low-income areas of Washington, DC have poorer health-related outcomes, because they lack access to affordable or available health care resources. Such conditions and issues have even more of an adverse affect on the health of the District of Columbia's children, who live in the poverty areas of the city. Too often, these children go without needed care even when parents are employed, because health insurance may not be offered where the parents work or the health insurance may be prohibitively expensive. Inadequate health insurance has been associated with a reduced number of well-child visits, as well as incomplete immunizations that become evident when schools require evidence of required immunizations. Providence Hospital Response to Need Perry Family Health Center (PFHC) is one of two (2) community-based primary care clinics operated by Providence Hospital. PHFC is located on "M" Street in a historic building that previously served as a Washington, DC public school. Pediatric health needs are addressed at Perry Family Health Center through its Children's Health Promotion Program, which is devoted entirely to the care of children. The Children's Health Promotion Program provides a full range of health care services that include prenatal care, immunizations, nutrition education, and the diagnosis and treatment of serious illnesses. The comprehensive primary health care and preventive health care for children includes telephone accessibility to health advice, on site laboratory tests, and free pharmaceutical services when needed. Health education and promotion and chronic disease management for obesity, depression, asthma, and diabetes are available on site. Coordination for support services, such as transportation and interpretive services, are also available. Free transportation is provided by Providence Hospital so families with young children can access routine appointments, outpatient diagnostics, radiology, surgical services, and specialty physicians. Extended services include resources for food, housing, child-care, and parenting training. This multicultural community requires culturally diverse outreach that engages families. PFHC has patients with many special concerns, such as health care for homeless families and support for non-English speaking immigrant parents of adolescents. Access to the Children's Health Promotion Program's comprehensive primary care is essential to this community. Teen mothers and recent immigrants often come to PFHC with their young children, having no family support and little knowledge of child care. PFHC provides them with the extra information and support that allows for positive healthy outcomes for their children. Providers at PHFC have a mutual responsibility and trust among the child, family, and medical home physician. Communication between the health care provider and the family is clear, unbiased, and complete. The medical home private practice model at PFHC utilizes a multi-disciplinary team approach that employs the use of Family Nurse Practitioners as a "bridge" between the disciplines and the family unit, beginning at birth. The medical home private practice team includes the following disciplines: - A Pediatrician, in collaboration with Children's Hospital National Medical Center, provides primary care and coordinates specialty care and surgeries at Children's Hospital. - An ENT Specialist is available three (3) days a week. - A Pediatric Clinical Specialist and an RN Clinical Coordinator manage the chronically-ill pediatric patients who present with diseases such as juvenile diabetes and asthma. - A Nutritionist is available weekly, providing medical nutrition therapy. - A Psychiatric Clinical Nurse Specialist provides support to the Pediatrician for those families requiring additional behavioral health services. - A Community Outreach Worker assists young mothers with external referral arrangements to community specialists and coordinates transportation, completes applications for free prescription medications, and assists with enrollment in DC Medicaid and DC Healthcare Alliance. Outcome to the Response to the Need Perry Family Health Center is known in the Washington, DC metropolitan area as a provider for the underserved and "a safety net within the safety net" that turns no one away. Many families have reported that they learned about PFHC through "word of mouth" from friends and family. Providers throughout the city refer uninsured low-income families to PFHC for prenatal care and well-child visits. Each year nearly 300 newborns delivered at Providence Hospital receive their "first week of life" visit at PFHC. Approximately 6,200 individuals were treated during the 2010 fiscal year at Perry Family Health Center as it encountered a total of 15,933 patient visits. Many of those visits provided well-baby care, immunizations, diabetes checks, and other prevention-oriented health care services. CASE STUDY: Ms. Brown, a single mother who had seven (7) children ranging in ages from four (4) years to fifteen (15) years, utilized the Perry Family Health Center for her family's medical needs for years. Her children were healthy but experienced a variety of difficulties at school and in the community. Ms. Brown worked as a janitor at a downtown DC office building but started to miss work because of stress-related migraines. Her employer was forced to threaten her job status if she continued to have so many absences. Ms. Brown came to Perry Family Health Center (PHFC) for help, where she was seen by a family physician that knew the Brown family and had observed Ms. Brown's struggles with her children. The physician listened as the over-stressed and hard-working woman talked about her current life conditions and environment. The physician treated Ms. Brown for her migraines and referred the family to PHFC Community Health Worker for assistance. The PHFC Community Health Worker interviewed Ms. Brown and observed that she needed help with structure and discipline in the home. The Community Health Worker also noted that two (2) of the older children needed to have follow-up school vision screenings that had not been completed. The Community Health Worker referred Ms. Brown to a YMCA-sponsored class on parenting adolescents, encouraged her to not be afraid to set rules and boundaries, and helped Ms. Brown make the appropriate calls for eye exam follow-ups. As a result of the whole-family treatment and assistance, Ms. Brown gained some much-needed parenting skills, and the children attracted less negative attention in the school and community settings. Community Benefit Programs - Senior Care Needs Assessment Life expectancy in the United States has been increasing steadily for many years, with healthy individuals, who reach the age of sixty-five (65), living vitally and productively into their eighties. With the increase in life expectancy, however, comes an increase in the incidences of individuals developing a chronic disability. In today's health care environment, the good news is that health care resources are available to individuals with a chronic or serious illness so they may regain their health. In the District of Columbia, 17% of the population is over the age of sixty (60), or approximately one (1) out of every six (6) residents. This number will continue to increase dramatically with each wave of baby boomers reaching sixty (60) years of age in the coming years.
		Heart disease, cancer, and hypertension are the three (3) leading causes of death in the District of Columbia, and their overall negative impact on the community has been made worse because of the well-documented historical lack of access to primary care for the uninsured and underinsured. The District of Columbia's health indicators reveal an alarming incidence of death rates from cancer, diabetes, and heart disease that are much higher than the national average in the United States. The high number of occurrences of cancer, diabetes, and heart disease diagnoses and correspondingly high number of related deaths have contributed to the marked differences in life expectancy at birth by race and gender for District of Columbia residents compared to the total population of the United States. According to recent census data, the life expectancy of Washington, DC residents is lower than all the states in the US, with the District of Columbia residents dying eight (8) years younger than the general US population. The District of Columbia's population includes 60% African American and 10% other minorities, and 11.8% of all African Americans and 10.4% of Latinos have diabetes; however, among the African American women of the District of Columbia, 25% if those who are over the age of 55, has diabetes. A substantial number of the District of Columbia's African American population experience complications that result from diabetes, including blindness, amputation, and end-stage renal disease. African American adults are less likely to be diagnosed with heart disease in the District of Columbia, but are 30% more likely to die from heart disease. Although the District of Columbia's African American adults are 40% more likely to have high blood pressure than others in the same population, they are 10% less likely to have their blood pressure under control. Providence Hospital Response to the Need In partnership with the District of Columbia Office on Aging, Providence Hospital sponsors and manages two (2) Senior Wellness Centers for residents of the District of Columbia, who are sixty (60) years of age and older. Research suggests that exercise and physical activity are two important ingredients for older individuals to engage in on a regular basis in order to maintain or partly restore health in four (4) major areas - strength, balance, flexibility, and endurance. Providence Hospital's Wellness Institute designed, developed, and implemented a comprehensive wellness program for senior citizens. Designed to improve the health, well-being, and longevity of the senior population in the District of Columbia and specifically targeting Wards 5 and 8, the program's objectives include increasing the number of participating members in wellness activities, improving upon the access to health care, and offering evidenced-based health promotion, exercise, and quality of life activities. Providence Hospital conducts open dialogue with Senior Wellness Center members and listens to their advice and contributions for continually expanding, supporting, and refining the wellness program. The Senior Wellness Program activities include: - Health promotion activities, including nutrition activities and workshops - Cancer awareness seminars and screenings - Healthy cooking classes and nutrition related field trips - Medication management sessions utilizing pharmacists - "Brown Bag Review" - Diabetes Support Group - Diverse exercise programs to accommodate different exercise levels of its members, i.e., Tai Chi, line dancing, chair exercise, Pilates, ballet, yoga The Geriatric Clinic Without Walls ( informally known as "Medical House Cells") Program was developed as an extension of the Center for Geriatric Medicine ro serve patients over 65 years of age, who are homebound and would otherwise not have access to medical care. This program provides primary care and social work services in the patients' home. The aim of the program is to not only provide primary health care including vaccinations and monthly visits by a physician or nurse practitioner and /or social worker, but also to facilitate patients remaining healthy in the community and preventing hospitalizations and readmissions by urgent visits to the patient's home, rather than an emergency room visit when avoidable. Hospice and end of life care are also provided in collaboration with Hospice agencies. Medical services are extended to persons of all wards of the District of Columbia as well as areas of Maryland within ten miles of the hospital.
		Outcome to the Response to the Need Approximately 77% of participants surveyed reported that health promotion activities increased their awareness of positive health behaviors; led them to adopt one or more positive health habits; and has had a positive impact on their lives. On an average there are 170 active patients who meet Medicare's homebound criteria. At any given time, there is waiting list of patients requesting information about the program. Improved transitions of care are maintained as patients are visited by a health care provider within one day to one week of discharge from the ER or hospital, patients are able to be maintained in their homes and access medical care which would otherwise not be possible. CASE STUDY: 96 year old Mrs. S lived in the same house for seventy five years and died there which was her wish. Mrs. S's daughter has Multiple Sclerosis and had been home bound for the past twenty years herself. They took care of each other and supported each other, and when Mrs. S started developing dimentia and was declining in her physical and cognitive functions, so too was her daughter's MS to that point that she has significant ambulatory dysfunction and was wheelchair bound. Her role evolved from daughter to sole caregiver and called the Geriatric Clinic Without Walls (GCWW) for help as she was no longer able to leave the house to take her mom for medical care. About 1 year ago, Mrs. S was too debilitated and had recurrent falls and took to her bad. The GCWW team provided medical care to Mrs. S in collaboration with a community Visiting Nurses agency and provided emotional support to her daughter in her role caregiver. Hospice was also called in and teams supported them both and Mrs. S has a peaceful death in her home with her daughter at her side which is just the way they wanted it. The teams also continued to provide bereavement services to her daughter and she then herself became a patient of the GCWW. Community Benefit Programs - Improved Birth Outcomes/Healthy Babies Needs Assessment As noted previously in this report, Washington DC has an infant mortality rate that is more than two (2) times the national average in the United States. With 10.9 infants out of 1,000 dying before their first birthday, it is apparent that far too many mothers of newborn in the District of Columbia lack quality, consistent prenatal care, adequate nutrition, and a fundamental education about keeping their newborn safe and well-tended. The presence of these substandard conditions within a segment of the District of Columbia resident population has created the environment that results in high levels of premature birth, low birth weight, or a live birth that ends in tragedy with the subsequent occurrence of Sudden Infant Death Syndrome (SIDS). Providence Hospital Response to the Need The Maternal and Infant Health (MIH) Unit at Providence Hospital has delivered 1,952 babies in the 2011 fiscal year and has cared for a number of women who required hospitalization at varying stages of their pregnancy. The MIH Unit serves all pregnant women, regardless of economic status, with joy, care, and respect; and because the Maternal and Infant Health Unit has Certified Nurse Midwives on staff, a strong influence of the midwife philosophy exists for a natural birthing process that is very supportive of the laboring mother. The influence of the Nurse Midwives natural birthing process integrates very well with the American College of Gynecology guidelines. The result of this collaborative merge of care standards is the establishment of enhanced patient safety standards, a higher quality of care, and a greater flexibility in meeting differing needs the mothers and their newborn infants. For more than thirty-three (33) years, Providence Hospital has provided significant maternity health care for mothers served by its OB/GYN Center for Life (CFL). The Center for Life provides quality prenatal care and specialty gynecological care to disadvantaged women from vulnerable and medically-underserved diverse populations. The majority of these mothers are "working poor" women from families who are employed but cannot afford medical insurance or do not have access to it. The Center for Life developed a special program for teen mothers, who accounted for an important % of the births at Providence Hospital in the 2011 fiscal year. This program includes health assessments, social services, referral services, one-on-one mentoring, and any other necessary follow-up services for one year after their delivery. This Teen Program is well known in the metropolitan Washington, DC area as a quality resource for pregnant teens and new teenage mothers.
		The Center for Life also offers the Centering Pregnancy Program, which is a nationally-recognized program of the Centering Healthcare Institute. The Centering Pregnancy model of health care delivery integrates the provision of health assessment, education, and support within a group format. The primary difference with this program is that the women are assembled into groups led by a nurse-midwife. This program replaces what had been exclusively the traditional ten (10) minute prenatal examination with a comprehensive two (2) hour education and support session in a group format in addition to a prenatal examination. The Center for Life has held Centering Model training sessions for area health care providers and continues to provide technical assistance to the neighboring institutions as the initiate their planning stages for Centering Pregnancy Programs. Outcome to the Response to the Need Positive results have been observed among Providence Hospital's Center for Life (CFL) patients, particularly those patients who are Centering Pregnancy patients. It has been observed and documented that Centering Pregnancy mothers-to-be keep their appointments more consistently than other prenatal patients. Centering Pregnancy patients have also been observed to be developing supportive relationships with other mothers who have due dates approximating their own due date. Additionally, the labor and delivery nurses have observed and reported that the Centering Pregnancy mothers are better prepared for delivery than women receiving traditional prenatal care. Of those newborns of women who completed the CFL Centering Pregnancy program in the 2011 fiscal year and who delivered their babies at Providence Hospital, only 5% were born prematurely compared to the national pre-term delivery rate. Centering Pregnancy program women are receiving more education and their health care providers are able to support them more closely, with nearly 87% of the women who completed the Centering Pregnancy program returning for their six (6) week post-partum visit. In fact, 89% of those women are initiating breastfeeding at delivery compared to 74.6% for the US average. The majority of these women who were surveyed described their high level of satisfaction with their prenatal care and stated that they would be staying in contact with their group. This increased social support and sharing has been shown to be indicative of readiness for infant care and effective parenting skills. Providence Hospital's Centering Program has received extensive media coverage, with stories appearing in the Washington Post, on the Washington, DC CBS television affiliate, and on the World Wide Web. CASE STUDY: Quanesha, 18, was born and raised in the District of Columbia's 5th Ward and quickly learned that she had little in common with her housemates upon learning that she was pregnant. No one provided any words of comfort or wisdom regarding her pregnancy; and too often her friends told her horror stories about pregnancy and about raising a child as a single parent. It was Quanesha's sister who urged her to try Providence Hospital's Centering Pregnancy program; so Quanesha did register to begin the program but was skeptical about how such a program could help her. Quanesha experienced an abundance of the typical pre-first-appointment jitters, stating, "I thought I would freak out that first day." However, she soon relaxed after getting to know others in her group who were experiencing similar circumstances to her own and after realizing that she was receiving both useful and sound educational information from a Certified Nurse Midwife/Facilitator. In Quanesha's group, like most Centering Pregnancy groups at their initial appointments, everyone was quiet. Within a short time, however, the group members relaxed and became willful and active participants who displayed an eagerness to learn and to share with others. At their scheduled appointments, Quanesha and the other mothers-to-be in her group obtained and recorded each other's weights, measurements, and other vital statistics such as blood pressure readings. Quanesha had high praise for the Nurse Midwife, who answered all of her questions, and helped her to more fully understand her body. Quanesha noted that the Nurse Midwife treated everyone in the group with respect and helped them to realize the enormity of the parenting task ahead. As the group's time together progressed, individuals became even more relaxed in asking questions and sharing experiences. Many specific questions about the labor and delivery processes were answered during a tour of Labor and Delivery Department. Detailed descriptions of the birthing process were answered, as the group progressed on their tour from room to room, which greatly reduced the anxiety levels of the group members. Like Quanesha, members of the group all found the tour to be very helpful and comforting. Now feeling more relaxed, better prepared, and even excited about the impending birth of her son, Quanesha is already looking forward to the reunion of her Centering Pregnancy group in a few months. She expects that she'll remain friends with several of the other mothers in her group, and she is especially grateful to her sister who steered her toward Providence Hospital's Center for Life Centering Pregnancy program. Community Benefit Programs - Infant Mortality Needs Assessment Infant mortality is an important indicator of the health of a nation, state, and city. Despite the dramatic decline in infant mortality during the 20th century, the US infant mortality rate is higher than rates in most other developed countries. According to the most current Center for Disease Control data, the United States infant mortality rate has fallen from 12th in the world in 1960 to thirtieth in 2005. As the U.S. infant mortality rate falls further behind other developed nations, the District of Columbia and Maryland's Prince George's County lag even further behind other states and cities. So the ultimate goal is to reach the 2020 Healthy People goal of 6 infant deaths per 1,000 live births. The District of Columbia's infant mortality rate data was presented previously in this report and was documented to be more than twice the national average, while Maryland has shown a decrease in the state's infant mortality rate from 8.0 per 1,000 live births in 2008 to 7.2 in 2009, which is the lowest overall infant mortality rate ever recorded in Maryland. Through its resolute efforts applied toward reducing all infant mortality throughout the state, Maryland's infant mortality rate among Caucasian infants decreased by 20.6 percent; however, the overall infant mortality rate for African American infants increased. Infant mortality statistical trends tracked by District of Columbia Wards over the last five years reveal a great disparity between neighborhoods. For example, in 2008 the infant mortality rate in Ward 2 was 2.9 deaths per 1,000 live births, which meets the People 2020 goal of 6 deaths per 1,000 live births. However, in the same year, the infant mortality rate in Ward 4 was 10.2 deaths per 1,000 live births; the infant mortality rate in Ward 5 was 12.9 deaths per 1,000 live births; the infant mortality rate in Ward 7 was 17.2 deaths per 1,000 live births, and in Ward 8, the infant mortality rate in 2008 was 17.7 deaths per 1,000 live births.
		Providence Hospital Response to the Need In March of 2010, the Center for Perinatal Advocacy at Providence Hospital was created to establish programs to improve both maternal and child health. The Center's mission is to develop and implement programs and services for the community it serves in order to decrease infant mortality in the Washington, DC metropolitan area. The District of Columbia has also established a mission to develop and provide leadership that strengthens the families is serves by providing education, advocacy, and service to safeguard the health and well being of mothers and their infants. Finding ways to decrease infant mortality is a critical step in improving maternal and infant health. The Center is dedicated to promoting desired health outcomes for all mothers, their infants and their families. Outcome to the Response to the Need The Center for Perinatal Advocacy at Providence has several activities to address infant mortality during fiscal year 2011 including hosting and convening the Mayor's Infant Mortality Committee and establishing a car seat instillation station on the grounds of Providence. The car seat station is a partnership between the Center, Providence, the Fire/EMS Department and the Police Department. During fiscal year 2011, approximately 150 car seats were installed for patients and members of the community. The center for Perinatal Advocacy will continue to serve as a convener on maternal and child health and establish best practice programs that meet the needs of the community. In fact, it was recently announced (April 26, 2012) by the DC Department of Health that infant mortality rate in the District declined to a historic low of 8 infant deaths per 1,000 live births. Other Community Programs and Services Besides the programs and services offered by Providence Hospital that have been described previously in this report, there are many types of community services provided by Providence Hospital and its subsidiaries that are described more fully below. In addition, the estimated unreimbursed cost of providing these services is summarized at the end of this Section of the Report. Charity Care Charity care is defined as free or discounted healthcare services provided to persons who cannot afford to pay. Providence Hospital provides charity care in accordance with its policies, which ensure access to medically-necessary care for all individuals. These policies include the following key provisions: - Emergency care provided to all persons, regardless of their ability to pay or regardless of their place of residence. - Non-emergency, medically necessary care (except for certain specialty or referral programs), is provided to medically indigent patients. In fiscal year 2011 the unreimbursed cost of traditional charity care was $2,487,741, including free and discount services. This amount does not include the cost of care provided to the medically indigent through participation in governmental programs, which is described below. Participation in Programs for Uninsured or Underinsured A variety of government programs provide for the indigent, including Medicaid and the District of Columbia's Alliance program. These programs do provide payments for medical care services provided to qualifying patients, but the payments are virtually always well below the cost of providing those services. Medicaid, established under Title XIX of the Social Security Act, provides assistance for the medically indigent, including those who cannot afford to pay for medical care despite being able to afford other living expenses. This assistance also covers the blind and the disabled of any age. The reimbursement that Providence Hospital receives from the Medicaid program is routinely well below the actual cost of services provided. Providence Hospital also provides services to indigent patients who are covered by other Hospital-sponsored programs. For example, the program for Persons Who are Poor provided $4,158,697 worth of free care in fiscal year 2011 while the program for the General Community provided $4,138,603 worth of free care. Other Programs for the Poor Providence Hospital's Perry Family Health Center, Center for Life, and its two (2) senior wellness centers - Model Cities' Wellness Center and Congress Heights Senior Medical Center have been described previously in this report. However, Providence Hospital provides other programs and services to aid and assist those who are in need of medical care but are without financial resources. Two (2) such services are described below. - Medicare Eligibility - Providence Hospital provides a staff of individuals to assist patients in completing Medicaid applications at no cost to the individuals; the cost of this program to Providence Hospital in the 2011 fiscal year was $64,508. - Transportation Service - The Transportation Services Department was started in the 1980s and has grown from a two-vehicle service to a fleet of twelve (12) vehicles that serve the needs of patients, clinic patients, nursing home residents, and physicians. The Transportation Department provided transport rides in the 2011 fiscal year at an unreimbursed cost of $961,029. The Department provides free services to the patients, clients, or residents of Carroll Manor Nursing & Rehab Center, the Geriatric Clinic, Perry School Family Health Center, Congress Heights Senior Medical Center, Model Cities' Wellness Center, Providence Hospital Senior Connection, Seton House, the Emergency Department, Case Management services, outpatient rehabilitation, surgery, outpatient infusion center, nursing units, and the Mission Council. Community Health Education and Promotion As part of Providence Hospital's overall health promotion effort in the community, the Hospital sponsors numerous programs, activities, and services designed to improve the health of the community's residents and designed to prevent the onset of illness or disease among the community. - Providence Hospital produces and distributes a number of community health newsletters and other publications, as well as provides the Hospital's website that includes articles on specific health topics and provides information on health services and classes offered to the community. Providence Hospital provides a number of health classes and support groups to its patients, their family members, and community residents on a wide variety of health topics. - Providence Hospital provides other community health education and promotion services, such as health information and healthcare screenings that are provided at Providence Hospital or are provided at local health fairs and other community events. Medical Community Education In keeping with its goal of continually improving patient care, Providence Hospital provides a variety of medical education and training programs for medical residents, students, and physicians. - Providence Hospital's medical education programs offer a variety of clinical settings for training medical residents, nursing students, and other medical students. The residency program at Providence Hospital has approximately sixty (60) residents (medical student graduates). The medical residents and students are primarily from Georgetown and Howard Universities. - As a teaching hospital, Providence Hospital incurs typical, additional costs associated with teaching facilities. Such additional costs include physician teaching fees, resident salaries, and the cost of additional medical diagnostic tests that are ordered in connection with the education and training of residents. During 2011, the total cost associated with the medical education programs at Providence Hospital was $1,960,471. In order to provide the best health care to the community, Providence Hospital provides its clinical staff with the opportunity to receive ongoing medical education. Therefore, Providence Hospital provides the medical residents and staff with a number of sponsored classes and the opportunity and resources to attend seminars throughout the year.
		Medical Research Providence Hospital provides a variety of essential services to support health-related scientific research. Physicians and other health professionals participate in clinical investigations that lead to advances in medical treatment and patient care. Investigators and sponsors are provided access to a range of facilities and clinical specialties in a hospital setting. The Hospital provides technical and administrative support in the design, conduct, and administration of clinical investigational studies, as well as support in the management of contracts or grants. Other Community Activities Providence Hospital provided a variety of other community services in the 2011 fiscal year. On an ongoing basis, Providence makes available its facilities and resources to benefit the community it serves. - The Meals on Wheels program prepares and delivers meals to area residents who cannot prepare their own meals because of a medical condition. - Providence Hospital provides palliative care throughout the community to those individuals with life-ending medical conditions. This support provides emotional and medical end-of-life comfort to the medically ill and also provides much-needed support to their relative care-takers and other family members of the patient. - Providence Hospital promotes employee volunteerism through its employee volunteer program (232 in 2011). The Hospital donates staff salaries, benefits, and other expenses for the administration and collection of funds and goods for sponsored community programs. Providence employees donate their time, personal funds, and other items to sponsored organizations. During 2011, Providence employees participated in the Adopt a Family Christmas Program, clothes and food drives, school partnerships, and a number of other community service programs. - Providence Hospital provides the use of its meeting room spaces and other services to community groups; the Hospital also provides contributions, in-kind donations, and services. The unreimbursed cost of a meeting space includes prorated rental expense, where applicable, and the cost of setup, cleanup, and refreshments in some instances. - Meals are prepared at Providence Hospital and distributed to local agencies, such as Christ House. - During the summer months, Providence Hospital offers job opportunities to District of Columbia high school students through its Summer Intern Program. This program encourages the students to prepare for a work environment that will come later in their lives; it provides the students with first-hand experience what it takes to care for the ill and aged individuals in their community; and it provides positive opportunities for the students to display their talents and work ethic, while making an impressive contribution to society. Through the combination of all the programs and services described in this report and still others that have not been highlighted, Providence Hospital has demonstrated its commitment to serving the Washington, DC metropolitan area community in order to improve the quality of life in its residents with joy, care, and respect for everyone it serves, regardless of their ability to pay.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

Providence Hospital

Employer identification number

53-0196636

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) Ascension Health PO Box 45998 St Louis,MO63145 31-1662309	National Health System	MO	Section 501(c)(3)	Schedule A, Line 11a	N/A		No
(2) Providence Health Services Inc 1150 Varnum Street NE Washington,DC20017 52-1275587	Physician Practices	DC	Section 501(c)(3)	Schedule A, Line 11a	Providence Hospital	Yes
(3) Providence Health Foundation Inc 1150 Varnum Street NE Washington,DC20017 52-1275583	Fundraising Organization	DC	Section 501(c)(3)	Schedule A, Line 11a	Providence Hospital	Yes

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Providence Medical Building General Partnership 1140 Varnum Street NE Washington,DC20017 52-1129539	Rental Property	DC	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership
(1) Mission Resources Inc 1150 Varnum Street NE Washington,DC20017 52-1347248	Holding Company	DC	N/A	C
(2) Resource Pharmacies Inc 1150 Varnum Street NE Washington,DC20017 52-1410076	Retail Pharmacy	DC	Providence Hospital	C	26,668	456,231	100.000 %

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1) Providence Health Services Inc	P	19,900,000	Fair Value
(2) Resource Pharmacies Inc	P	2,254,970	Fair Value
(3) Providence Health Foundation Inc	P	1,781,650	Fair Value
(4) Providence Health Foundation Inc	C	1,238,119	Fair Value
(5) Ascension Health	Q	4,002,450	Fair Value
(6)

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Inpatient & outpatient health care services to the community.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	13
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	4,770
6	Total number of volunteers (estimate if necessary) ....	6	232
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	9,430
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,055,422	1,238,119
9	Program service revenue (Part VIII, line 2g) .........	225,542,101	217,469,685
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,945,177	5,223,184
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	3,582,183	5,777,699
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	235,124,883	229,708,687
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	127,285,898	120,730,738
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	99,710,101	100,269,507
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	226,995,999	221,000,245
19	Revenue less expenses. Subtract line 18 from line 12......	8,128,884	8,708,442
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	188,374,433	194,342,519
21	Total liabilities (Part X, line 26)............	118,040,526	109,846,080
22	Net assets or fund balances. Subtract line 21 from line 20 .....	70,333,907	84,496,439

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	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 204,837,549 including grants of $ ) (Revenue $ 219,162,415 )
	Providence Hospital is a 408 licensed bed acute care hospital with a 252 bed hospital-based skilled nursing home. During 2011, the Hospital had 14,265 admissions, 63,882 patient days, 46,563 Emergency Room visits, delivered 1,933 newborn infants, and performed 7,854 outpatient surgical procedures and 3,384 inpatient surgical procedures. The unreimbursed cost of traditional charity care was $2,487,741, including free and discounted services. Providence Hospital provided care to: Medicaid patients at an unreimbursed cost of $2,987,795; patients covered by other Hospital-sponsored programs that provided $4,158,697 in free care; the program for the General Community that provided $4,138,603 in free care; and the program to cover Medicare Shortfalls that provided $1,619,352. See Schedule H for Community Benefit Report.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services. (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 204,837,549

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	5,416,826	0	261,855

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		1,238,119
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			1,238,119
			Business Code
2a	Hospital Net Revenue		622,110	188,368,627	188,368,627
b	Nursing Home Net Rev.		623,110	29,101,058	29,101,058
c
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			217,469,685
3	Investment income (including dividends, interest
	and other similar amounts).....			5,223,184			5,223,184
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents	1,407,448
b	Less: rental expenses
c	Rental income or (loss)	1,407,448
d	Net rental income or (loss).......			1,407,448			1,407,448
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss)..........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	Cafeteria Revenue		722,320	1,471,088			1,471,088
b	Income from JVs		523,000	1,197,003			1,197,003
c
d	All other revenue ....			1,702,160	1,692,730	9,430
e	Total. Add lines 11a–11d ......			4,370,251
12	Total revenue. See Instructions....			229,708,687	219,162,415	9,430	9,298,723


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			356,349	1	267,835
2	Savings and temporary cash investments .......			4,370,003	2	14,985,871
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			31,859,958	4	27,667,554
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			2,885,068	8	2,579,965
9	Prepaid expenses and deferred charges ............			751,714	9	257,402
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	188,757,622
b	Less: accumulated depreciation. .....	10b	138,205,228	50,634,136	10c	50,552,394
11	Investments—publicly traded securities ..........				11
12	Investments—other securities. See Part IV, line 11 ......				12
13	Investments—program-related. See Part IV, line 11 ..			2,901,944	13	3,498,947
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			94,615,261	15	94,532,551
16	Total assets. Add lines 1 through 15 (must equal line 34)...			188,374,433	16	194,342,519
17	Accounts payable and accrued expenses .			26,646,540	17	31,980,839
18	Grants payable ..........				18
19	Deferred revenue ..........			152,809	19	103,298
20	Tax-exempt bond liabilities ..........				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			91,241,177	25	77,761,943
26	Total liabilities. Add lines 17 through 25.....			118,040,526	26	109,846,080
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			70,155,864	27	84,318,396
28	Temporarily restricted net assets .....			178,043	28	178,043
29	Permanently restricted net assets .....				29
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			70,333,907	33	84,496,439
34	Total liabilities and net assets/fund balances .....			188,374,433	34	194,342,519