Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 01-01-2013 , 2013, and ending 12-31-2013
BCheck if applicable:
CName of organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1801 Lind Avenue SW No 9016
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Renton, WA980579016
D Employer identification number

51-0216589
E Telephone number

G Gross receipts $ 1,724,724,506
F Name and address of principal officer:
Rod Hochman MD
1801 Lind Avenue SW No 9016
Renton,WA980579016
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
http://california.providence.org/
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1903
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Healthcare with special concern for the poor & vulnerable in So. California.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 17
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 17
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 11,239
6 Total number of volunteers (estimate if necessary) ............. 6 3,048
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 26,328,334 21,135,287
9 Program service revenue (Part VIII, line 2g) ......... 1,527,531,826 1,508,778,682
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 9,541,035 9,489,475
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 69,246,939 69,834,226
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,632,648,134 1,609,237,670
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 7,504,982 8,334,922
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) 924,318,561 867,419,912
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet461,216    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 739,451,851 788,168,830
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,671,275,394 1,663,923,664
19 Revenue less expenses. Subtract line 18 from line 12....... -38,627,260 -54,685,994
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 4,259,536,833 5,581,007,297
21 Total liabilities (Part X, line 26)............. 3,517,644,082 4,778,524,981
22 Net assets or fund balances. Subtract line 21 from line 20..... 741,892,751 802,482,316
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Healthcare with special concern for the poor & vulnerable in Southern California.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 950,684,491 including grants of $ 0 ) (Revenue $ 1,041,144,011 )
Acute Care - Inpatient Patient Days - 309,991Admissions - 70,537OUR MISSION - As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.OUR CORE VALUES - Respect, Compassion, Justice, Excellence, and StewardshipPROVIDENCE CARESProvidence Health System-Southern California is a not-for-profit network of hospitals, care centers, physicians, clinics, home health services and affiliated services. We continue a tradition of caring that the Sisters of Providence began in the West 150 years ago.There is nothing more valuable than good health. When the unemployment rate in Los Angeles County surpassed 10 percent, many people were in need of help with not only basic healthcare needs, but critical needs.Providence Health & Services Southern California answered needs across the region, contributing nearly $183 million in charity care and in services to the under-served in 2013 through its community benefits program. Providence Cares.We care about school children who've never seen a dentist, about indigent emergency patients who desperately need follow-up care and for the elderly who need a ride to the doctor or just a friendly phone call to say hello.In the South Bay, employees collected many boxes of Christmas gifts for families in need, many for working families who had lost their homes. In the San Fernando Valley, an outbreak of whooping cough prompted our School Nurse Program to provide free vaccinations to children. Providence Cares about the communities we serve.We understand the importance of preventive care and provide several programs aimed at keeping people out of the hospital by meeting their basic healthcare needs, diagnosing chronic illnesses and providing care before treatable conditions become critical.We are driven by a commitment to the Providence Mission of compassionate care for all, especially the poor and vulnerable, and to our core values of Respect, Compassion, Justice, Stewardship and Excellence. Providence honored that tradition in 2012 by providing a total of $250,000 to 14 nonprofit groups in the San Fernando and Santa Clarita valleys that served the homeless, the uninsured in need of medical care, school children in low-income areas and others in need. The money came from the Mother Joseph Fund, which held a portion of proceeds from the Valley Service Area ministries.As part of the South Bay Service Area's community benefits programs, employees of Providence Little Company of Mary Medical Center San Pedro donated children's outfits to Barton School. Nearly 60 percent of the school's 800 children are from lower-income households. The ministry also collected more than 200 pairs of shoes to donate to a project that helped the homeless. Finally, a Christmas appeal drew gifts for 23 families in need. We help our neighbors across Southern California - and the West - because Providence Cares. OUR FACILITIES:Providence Saint Joseph Medical Center in BurbankProvidence Holy Cross Medical Center in Mission HillsProvidence Tarzana Medical Center in TarzanaProvidence Little Company of Mary Medical Center in TorranceProvidence Little Company of Mary Medical Center in San PedroProvidence Health System - Southern California has entered into a joint agreement with the Bioethics Institute at Loyola Marymount University in Westchester, California. Loyola Marymount faculty will now be available to Providence hospitals to assist with bioethics education.
4b (Code:   ) (Expenses $ 360,097,135 including grants of $ 0 ) (Revenue $ 394,361,094 )
Acute Care - Outpatient - including emergency/trauma services. Patient Visits - 750,637San Pedro Peninsula Hospital dba Little Company of Mary-San Pedro Hospital (LCM-SPH) provides care to the sick and dying and their families through the Catholic Health Ministry. In October 1992, LCM-SPH affiliated with Little Company of Mary Health Services (LCMHS) and became part of its integrated system. Due to the changing economic conditions of health care, LCMHS sought a strategic partner to be able to continue its commitment to meet the health needs of the community and remain financially strong. On September 1, 1999 LCMHS affiliated with Providence Health & Services, an exempt 501(c)(3) corporation headquartered in Renton, Washington. Providence Health & Services is a not - for - profit Catholic organization with the same mission and values as LCMHS and its affiliated organizations.LCM-SPH accomplishes its Mission of providing health care services to the community in a variety of hospital and ambulatory settings. LCM-SPH operates an acute general hospital that provides comprehensive inpatient, outpatient and emergency services. Major service areas within the acute hospital include medical/surgical, obstetrics, geropsychiatry, rehabilitation and chemical dependency. The hospital also has an outpatient diagnostic imaging center. In addition to its acute hospital, LCM-SPH provides sub-acute care services to the community .The Mission of Little Company of Mary Sisters and the Sisters of Providence is reflected in the historical significance of their names to continue the healing ministry of Jesus. They are committed to care for the sick, dying and needy.Providence Health & Services Southern California - LCM Services Area is committed to the fulfillment of the Mission of the Sisters through the delivery of expanded charitable services. In keeping with this mission it has established a Social Accountability budget to return the value of the system's tax exemption to the community.Providence Little Company of Mary San Pedro was among the first recipients of Press Ganey's new Best Place to Practice Award which was given to only six hospitals nationwide. This award recognizes hospitals who have reached and sustained the 95th percentile on their physician surveys for two consecutive reporting periods that are not more than twenty-four months apart.HealthGrades recognized Providence Tarzana Medical Center with 5-Star ratings for the treatment of heart attack and heart failure for the sixth consecutive year and Providence Saint Joseph Medical Center with a Maternity Care Excellence Award, ranking Providence Saint Joseph among the top five percent of rated hospitals in the nation for five years.
4c (Code:   ) (Expenses $ 66,899,452 including grants of $ 0 ) (Revenue $ 73,265,068 )
Long-Term Care, Subacute Skilled Nursing & Home Health Programs. Long-Term Care Days - 94,177; Home Health Visits - 59,075.
(Code:   ) (Expenses $ 4,718,726 including grants of $ 0 ) (Revenue $ 6,137,530 )
Providence High School for children of the Northern San Fernando Valley and surrounding area. School Days - 182 Students - 405.Providence High School is a Catholic, accredited, college-preparatory school for young men and women. The School is located in the San Fernando Valley and serves the Greater Los Angeles area. The School offers a challenging college-preparatory academic program, carefully designed to give students opportunities for growth and experience in preparation for university course work. The School has received full accreditation from the Western Association of Schools and Colleges, and the Western Catholic Educational Association.
(Code:   ) (Expenses $ 0 including grants of $ 0 ) (Revenue $ 79,874 )
Health Care Joint Ventures
(Code:   ) (Expenses $ 8,334,922 including grants of $ 8,334,922 ) (Revenue $ 0 )
Grant & Allocations - See Schedule I.
4d Other program services (Describe in Schedule O.)
(Expenses $ 13,053,648 including grants of $ 8,334,922 ) (Revenue $ 6,217,404 )
4e Total program service expensesMediumBullet1,390,734,726
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions).... Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II....................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
2,842
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
11,239
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
17
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
17
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
Yes
 
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletKarl E Fritschel CPA1801 Lind Ave SW 9016RentonWA980579016 (425) 525-3339
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Michael Holcomb........................................................................
Chair of the Board
 .10
.......................8.60 		X   X       0 60,335 0
(2) Lucille Dean SP........................................................................
Director
 .10
.......................9.40 		X           0 0 0
(3) Mary Corita Heid RSM........................................................................
Director
 .10
.......................5.00 		X           0 0 0
(4) Michael A Stein........................................................................
Director
 .10
.......................6.00 		X           0 18,335 0
(5) Eugene Al Parrish........................................................................
Director
 .10
.......................5.00 		X           0 15,335 0
(6) Dana A Rasmussen........................................................................
Director
 .10
.......................4.30 		X           0 18,335 0
(7) James S Roberts MD........................................................................
Director
 .10
.......................9.00 		X           0 30,835 0
(8) Peter J Snow........................................................................
Director
 .10
.......................5.70 		X           0 20,835 0
(9) Bob Wilson........................................................................
Director
 .10
.......................5.00 		X           0 15,335 0
(10) Sallye Liner........................................................................
Director
 .10
.......................4.00 		X           0 15,335 0
(11) Cheryl M Scott........................................................................
Director
 .10
.......................4.60 		X           0 15,335 0
(12) Ellen L Wolf........................................................................
Director
 .10
.......................7.10 		X           0 15,335 0
(13) Isiaah Crawford........................................................................
Director
 .10
.......................4.10 		X           0 15,335 0
(14) Martha Diaz Aszkenazy........................................................................
Director
 .10
.......................7.70 		X           0 15,335 0
(15) Kirby McDonald........................................................................
Director
 .10
.......................4.60 		X           0 15,335 0
(16) Dave Olsen........................................................................
Director
 .10
.......................5.50 		X           0 15,335 0
(17) Charles Chuck Watts........................................................................
Director
 .10
.......................4.60 		X           0 15,335 0
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) John F Koster MD - Thru 0313........................................................................
President / CEO
 8.90
.......................45.10 		    X       0 3,202,727 247,248
(19) Rod F Hochman MD - Eff 0413........................................................................
President / CEO
 10.80
.......................54.20 		    X       0 1,402,907 515,903
(20) Todd Hofheins........................................................................
EVP/CFO
 9.90
.......................50.10 		    X       0 570,367 90,110
(21) Jeffrey W Rogers - Thru 513........................................................................
Corporate Secretary
 8.30
.......................41.70 		    X       0 1,040,781 189,880
(22) Cindy Strauss - Eff 613........................................................................
SVP/Chief Counsel/Corp. Secretary
 9.90
.......................50.10 		    X       0 955,824 248,254
(23) Michael Hunn........................................................................
SVP/CEO - CA. Region
 60.00
.......................0.00 		    X       0 1,050,356 120,379
(24) Dave Mast........................................................................
CFO/CA. Region
 40.00
.......................0.00 		    X       0 434,698 68,853
(25) Terry L Smith........................................................................
SVP/Management Svcs
 .10
.......................59.90 		      X     0 1,612,950 226,158
(26) Deborah Burton........................................................................
SVP/Chief Nrsg. Officer
 .10
.......................64.90 		      X     0 1,347,109 66,039
(27) Michael L Butler........................................................................
President/Operations & Services
 .10
.......................59.90 		      X     0 1,272,743 742,629
(28) Randy Axelrod MD........................................................................
EVP/Clinical & Patient Svcs
 .10
.......................59.90 		      X     0 1,055,259 219,690
(29) Janice J Jones........................................................................
SVP/CAO
 .10
.......................54.90 		      X     0 999,701 159,493
(30) Myron Berdischewsky MD........................................................................
SVP/CMQO
 .10
.......................59.90 		      X     0 855,510 158,577
(31) Jack Friedman........................................................................
SVP/Account Care & Payor Rel.
 .10
.......................54.90 		      X     0 826,281 177,752
(32) Ray Williams........................................................................
SVP/Physicians Svcs
 .10
.......................54.90 		      X     0 761,267 203,589
(33) Cindra R Syverson........................................................................
SVP/CHRO
 .10
.......................59.90 		      X     0 717,450 292,188
(34) Craig L Wright MD........................................................................
SVP/Physicians Svcs
 .10
.......................59.90 		      X     0 708,798 451,637
(35) John O Mudd........................................................................
SVP/Mission Leadership
 .10
.......................54.90 		      X     0 542,246 208,258
(36) Claudia Haglund........................................................................
VP/Governance & Sponsorship
 .10
.......................49.90 		      X     0 494,375 157,049
(37) Joel S Gilbertson........................................................................
SVP/Comm.Ptrshp & External Affairs
 .10
.......................54.90 		      X     0 456,594 126,245
(38) David Brown........................................................................
VP/Strategy & Innovation
 .10
.......................54.90 		      X     0 434,606 168,959
(39) Orest Holubec........................................................................
SVP/Marketing & Communications
 .10
.......................59.90 		      X     0 423,960 61,310
(40) Michael Rembis........................................................................
CEO - PSJMC
 40.00
.......................0.00 		      X     0 608,560 219,669
(41) Elizabeth Dunne........................................................................
CEO - LCMMC - Torrance
 40.00
.......................0.00 		      X     0 587,221 170,390
(42) Nancy Carlson........................................................................
CEO - LCMMC - San Pedro
 50.00
.......................0.00 		      X     0 526,239 183,203
(43) Gerald Clute........................................................................
CEO - PTMC
 40.00
.......................0.00 		      X     0 431,047 140,335
(44) Dale Surowitz........................................................................
CEO - Valley Community
 59.00
.......................0.00 		      X     0 540,243 227,914
(45) Glenn Komatsu........................................................................
CMO - TCH
 40.00
.......................0.00 		        X   432,752 0 40,125
(46) Pat Modrzejewski........................................................................
Chief Development Officer
 1.00
.......................55.00 		        X   393,931 0 34,581
(47) Richard Glimp........................................................................
CMO - LCMH
 40.00
.......................0.00 		        X   393,054 0 30,281
(48) Teresa David........................................................................
COO - Facey Med. Foundation
 0.00
.......................40.00 		        X   389,214 0 28,661
(49) James Corwin........................................................................
CFO - Facey Med. Foundation
 0.00
.......................40.00 		        X   387,903 0 35,066
(50) Karl Carrier........................................................................
Former CFO
 0.00
.......................0.00 		          X 0 181,409 201,988
(51) Kerry Carmody........................................................................
Former COO
 0.00
.......................0.00 		          X 0 757,578 357,950
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,996,854 25,100,831 6,570,363
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet1,395
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Healthcare Partner Inc MED19191 S Vermont Avenue 21FTorranceCA90502 Medical Services 10,060,609
Therapeutic Associates Inc7100 Fort Dent Way Ste 220SeattleWA98188 Physical/Occup. Therapy Svc 5,727,742
Transcend Services IncPO Box 740209AtlantaGA303740209 Medical Records Services 3,313,507
Buena Vista Anesthesia Med Group225 South Lake StreetPasadenaCA91101 Medical Services 2,903,963
Navigant Consulting Inc4511 Paysphere CircleChicagoIL60674 Consulting Services 2,349,564
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet188
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b 5,560
c Fundraising events....1c 4,350
d Related organizations...1d 10,431,626
e Government grants (contributions)1e 10,425,228
f All other contributions, gifts, grants, and
similar amounts not included above1f 		268,523
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 21,135,287
Program Service RevenueAmt Business Code
2a Acute - Inpatient 900099 1,036,865,291 1,036,865,291    
b Acute - Outpatient 621400 392,740,414 392,740,414    
c LTC/HomeCare/Hospice 623000 72,963,975 72,963,975    
d Tuition & Fees 611600 6,129,128 6,129,128    
e Healthcare JVs 900099 79,874 79,874    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 1,508,778,682
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 5,938,354     5,938,354
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 3,445,593  
b Less: rental expenses 2,398,082  
c Rental income or (loss) 1,047,511  
d Net rental income or (loss).......MediumBullet 1,047,511     1,047,511
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 116,191,392 85,899
b Less: cost or other basis and sales expenses 112,726,170 0
c Gain or (loss) 3,465,222 85,899
d Net gain or (loss)..........MediumBullet 3,551,121     3,551,121
8a Gross income from fundraising events (not including
$ 4,350
of contributions reported on line 1c). See Part IV, line 18 ..
a 95,986
b Less: direct expenses ...b 38,967
c Net income or (loss) from fundraising events..MediumBullet 57,019   57,019
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 8,540
b Less: direct expenses ...b 514
c Net income or (loss) from gaming activities...MediumBullet 8,026     8,026
10a Gross sales of inventory, less
returns and allowances .
a 433,620
b Less: cost of goods sold ..b 323,103
c Net income or (loss) from sales of inventory..MediumBullet 110,517     110,517
Miscellaneous Revenue Business Code
11a Cafeteria 722210 5,054,769     5,054,769
b Pharmacy Services 446110 2,514,052     2,514,052
c Laboratory Services 621500 206,716 206,716    
d All other revenue .... 60,835,616 6,002,179   54,833,437
e Total. Add lines 11a–11d ...... MediumBullet 68,611,153
12 Total revenue. See Instructions......MediumBullet 1,609,237,670 1,514,987,577 0 73,114,806
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
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 United States. See Part IV, line 21 7,732,850 7,732,850
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 602,072 602,072
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 5,186,096   5,186,096  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 575,621,992 516,030,015 59,288,210 303,767
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 44,751,865 35,796,268 8,951,418 4,179
9 Other employee benefits ....... 199,178,071 174,723,589 24,428,639 25,843
10 Payroll taxes ........... 42,681,888 38,001,758 4,657,524 22,606
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 3,588,450 314,644 3,273,806  
c Accounting ........... 16,090   16,090  
d Lobbying ........... 16,552   16,552  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 192,223   192,223  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 152,486,428 121,474,676 31,001,759 9,993
12 Advertising and promotion .... 5,955,611 93,043 5,802,466 60,102
13 Office expenses ....... 36,280,920 28,136,535 8,111,512 32,873
14 Information technology ...... 25,321,073 13,960,496 11,360,577  
15 Royalties ..        
16 Occupancy ........... 31,811,022 22,726,982 9,084,040  
17 Travel ............ 1,734,593 892,056 842,537  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 986,835 431,007 554,770 1,058
20 Interest ........... 32,030,201 32,030,201    
21 Payments to affiliates ....... 62,358,273   62,358,273  
22 Depreciation, depletion, and amortization ..... 73,499,787 39,241,636 34,258,151  
23 Insurance .............. 15,069,026 14,075,610 993,416  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a Medical Supplies 188,663,850 188,663,850    
b Healthcare Taxes 66,458,543 66,458,543    
c Bad Debts 45,446,354 45,446,354    
d Provider Taxes 39,875,126 39,875,126    
e All other expenses 6,377,873 4,027,415 2,349,663 795
25 Total functional expenses. Add lines 1 through 24e 1,663,923,664 1,390,734,726 272,727,722 461,216
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 2,241,499 1 2,887,547
2 Savings and temporary cash investments ......... 70,255,720 2 84,812,332
3 Pledges and grants receivable, net ........... 409,030 3 198,749
4 Accounts receivable, net ............. 207,812,822 4 211,635,758
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ............. 51,658,210 7 54,561,675
8 Inventories for sale or use .............. 22,881,102 8 20,278,476
9 Prepaid expenses and deferred charges .......... 16,312,135 9 4,269,617
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,737,693,333
b Less: accumulated depreciation ..... 10b 975,918,649 821,735,067 10c 761,774,684
11 Investments—publicly traded securities .......... 93,667,627 11 130,722,413
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..... 93,078,295 13 102,772,666
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 2,879,485,326 15 4,207,093,380
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 4,259,536,833 16 5,581,007,297
Liabilities 17 Accounts payable and accrued expenses ......... 169,015,012 17 168,306,647
18 Grants payable ................. 13,511 18 22,590
19 Deferred revenue ................ 6,340,155 19 7,277,577
20 Tax-exempt bond liabilities ............. 430,590,000 20 425,700,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other 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 (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 2,911,685,404 25 4,177,218,167
26 Total liabilities. Add lines 17 through 25......... 3,517,644,082 26 4,778,524,981
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 689,287,304 27 745,806,491
28 Temporarily restricted net assets ........... 31,505,699 28 35,132,071
29 Permanently restricted net assets ........... 21,099,748 29 21,543,754
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet 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 ........... 741,892,751 33 802,482,316
34 Total liabilities and net assets/fund balances ........ 4,259,536,833 34 5,581,007,297
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,609,237,670
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,663,923,664
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-54,685,994
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
741,892,751
5
Net unrealized gains (losses) on investments ...............
5
3,768,300
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
40,081,886
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
71,425,373
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
802,482,316
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number

51-0216589
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.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
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.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of 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)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (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 monetary support
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number

51-0216589
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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
Special Rules
......................... 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 on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
  		Employer identification number

51-0216589
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

   
RESTRICTED
RESTRICTED
RESTRICTED, RESTRICTEDRESTRICTED

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
  		Employer identification number

51-0216589
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
  		Employer identification number

51-0216589
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2013)

Additional Data


Software ID:  
Software Version:  
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.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number

51-0216589
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
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 Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(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? ......................................

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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
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)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
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:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
Yes
 
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
16,552
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
16,552
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B, Line 1: Lobbying activities, with the exception of advocacy, are limited to direct contact with government officials and mailings to the general public and legislators for the purpose of expressing opinions on legislative matters. Expenses include employee salaries, postage and incidental traveling expenditures.
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number

51-0216589
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 ........    
5
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? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can 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? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), 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 $  
2
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 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?........
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 373,802 369,341 357,604 104,970 103,609
b Contributions ........ 312 1,000 10,000 238,850  
c Net investment earnings, gains, and losses 19,914 19,389 1,737 13,784 1,361
d Grants or scholarships ..... 16,549 15,928      
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ...... 377,479 373,802 369,341 357,604 104,970
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet0 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   103,140,767 103,140,767
b Buildings ................   837,203,287 356,004,315 481,198,972
c Leasehold improvements ............   28,203,326 21,167,118 7,036,208
d Equipment ................   756,451,443 598,747,216 157,704,227
e Other .................   12,694,510   12,694,510
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 761,774,684
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) Unamortized Bond Financing Costs 6,417,695
(2) Due from Affiliates 4,122,044,675
(3) Miscellaneous Receivables 37,540,901
(4) Library Inventory 13,000
(5) Third Party Settlements 31,659,796
(6) Bond Premium Discount 5,366,891
(7) Trustee Held Funds 1,846,085
(8) Resident Trust Funds 4,881
(9) Acute Medicaid EHR Incent Rec 2,199,456
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 4,207,093,380
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
Due to Affiliates 4,029,083,425
Liability for Risk Sharing 2,780,020
Miscellaneous Other Liabilities 931,782
Capitalized Lease Obligation 4,677,572
LT Asset Retirement Obligation - FIN 47 14,233,927
IBNR Payable 2,540,790
Taxable Bond Issue 106,150,637
Third Party Settlements 14,098,442
Liability for Unpaid Claims 2,721,572
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 4,177,218,167
2. Liability for uncertain tax positions In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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 XIII.) ............ 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 XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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 XIII.) ............ 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 XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Part V, Line 4: Providence High School has one endowment fund established for scholarship purposes that is donor-restricted.
Part X, Line 2: The Health System recognizes the effect of income tax positions only if those positions are more likely than not of being sustained upon an audit by the taxing authority. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number

51-0216589
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

GALA
(event type) 		(b) Event #2

 
(event type) 		(c) Other events

 
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 100,336     100,336
2 Less: Contributions . . 4,350     4,350
3 Gross income (line 1
minus line 2) . . . 		95,986     95,986
VerticalDirectExpenses 4 Cash prizes . . .        
5 Noncash prizes . .        
6 Rent/facility costs . .        
7 Food and beverages . 26,947     26,947
8 Entertainment . . . 1,000     1,000
9 Other direct expenses . 11,020     11,020
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 38,967
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow 57,019
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
%
%
%
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2013
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number

51-0216589
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		0 0 37,679,250   37,679,250 2.330 %
b Medicaid (from Worksheet 3,
column a) .... 		0 0 251,436,862 155,420,723 96,016,139 5.930 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    289,116,112 155,420,723 133,695,389 8.260 %
Other Benefits
 0 0 11,101,522 199,622 10,901,900 0.670 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		0 0 5,244,404 16,625 5,227,779 0.320 %
g Subsidized health services
(from Worksheet 6) .. 		0 0 5,810,831 97,134 5,713,697 0.350 %
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		0 0 1,123,086 0 1,123,086 0.070 %
j Total. Other Benefits ..     23,279,843 313,381 22,966,462 1.410 %
k Total. Add lines 7d and 7j .     312,395,955 155,734,104 156,661,851 9.670 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(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            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
45,446,354
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
385,495,575
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
466,475,427
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-80,979,852
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(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) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?5
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Providence St Joseph Medical Center
501 S Buena Vista St
Burbank,CA91505
california.providence.org
930000159 		X X         X     A
2 Providence LCM Med Ctr - Torrance
4101 Torrance Boulevard
Torrance,CA90505
california.providence.org
930000089 		X X         X     A
3 Providence Holy Cross Medical Center
15031 Rinaldi St
Mission Hills,CA91345
california.providence.org
930000404 		X X     X   X     A
4 Providence Tarzana Medical Center
18321 Clark Street
Tarzana,CA91356
california.providence.org
930000097 		X X         X     A
5 Providence LCM Med Ctr - San Pedro
1300 West Seventh Street
San Pedro,CA90732
california.providence.org
930000142 		X X         X     A
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
PROVIDENCE HEALTH SYSTEM - SOUTHERN CALI
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		 
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 250.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 350.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ............................ 21   No
If "Yes," explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
Part V, Section B Facility Reporting Group A
Facility Reporting Group A consists of: - Facility 3: Providence Holy Cross Medical Center, - Facility 1: Providence St. Joseph Medical Center, - Facility 4: Providence Tarzana Medical Center, - Facility 2: Providence LCM Med. Ctr. - Torrance, - Facility 5: Providence LCM Med. Ctr. - San Pedro
Facility 1 -- Providence St. Joseph Medical Center Part V, Section B, line 14g: Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.
Facility 2 -- Providence LCM Med. Ctr. - Torrance Part V, Section B, line 3: Seeking out special knowledge or expertise about community needs, including health. Staff representing the two Providence Little Company of Mary Medical Centers, San Pedro and Torrance, conducted 19 separate key informant interviews (with 24 individuals) to get their perspective on community health needs. These interviews involved a variety of community sectors, including community leaders of nonprofit organizations, federally qualified health centers, public schools, and faith based organizations, private foundations, elected officials and senior staff from both the Los Angeles County Department of Health and the Los Angeles County Department of Public Health. Due to the size of the Department of Public Health, 4 interviews were conducted across the chronic disease, immunization and maternal child health divisions.In addition, a survey of local community based organizations was prepared and they were asked to rank the highest needs for children, adults and seniors. Responses were received from 46 organizations. The priorities were tallied and summarized and served as the framework from which the Board Committee on Community Benefit, appointed by the joint governing board of both Medical Centers, prepared the final recommended priorities which were sent to the governing board.Finally, telephone surveys of 312 adults were conducted based upon a randomized sample of 10,000 residents to seek their input on the greatest health needs. In addition an August 2013 survey, in collaboration with St. Joseph Church in Hawthorne, located in a high need community resulted in 715 responses about health needs and the prevalence of chronic conditions in a primarily Hispanic population.
Facility 2 -- Providence LCM Med. Ctr. - Torrance Part V, Section B, line 4: The 2013 Joint Community Health Needs Assessment was conducted by Providence Little Company of Mary Medical Center, San Pedro and Providence Little Company of Mary Medical Center, Torrance. The report satisfies all of the required elements for a Joint Community Health Needs Assessment.
Facility 2 -- Providence LCM Med. Ctr. - Torrance Part V, Section B, line 14g: Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.
Facility 3 -- Providence Holy Cross Medical Center Part V, Section B, line 14g: Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.
Facility 4 -- Providence Tarzana Medical Center Part V, Section B, line 14g: Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.
Facility 5 -- Providence LCM Med. Ctr. - San Pedro Part V, Section B, line 3: Seeking out special knowledge or expertise about community needs, including health. Staff representing the two Providence Little Company of Mary Medical Centers, San Pedro and Torrance, conducted 19 separate key informant interviews (with 24 individuals) to get their perspective on community health needs. These interviews involved a variety of community sectors, including community leaders of nonprofit organizations, federally qualified health centers, public schools, and faith based organizations, private foundations, elected officials and senior staff from both the Los Angeles County Department of Health and the Los Angeles County Department of Public Health. Due to the size of the Department of Public Health, 4 interviews were conducted across the chronic disease, immunization and maternal child health divisions.In addition, a survey of local community based organizations was prepared and they were asked to rank the highest needs for children, adults and seniors. Responses were received from 46 organizations. The priorities were tallied and summarized and served as the framework from which the Board Committee on Community Benefit, appointed by the joint governing board of both Medical Centers, prepared the final recommended priorities which were sent to the governing board.Finally, telephone surveys of 312 adults were conducted based upon a randomized sample of 10,000 residents to seek their input on the greatest health needs. In addition an August 2013 survey, in collaboration with St. Joseph Church in Hawthorne, located in a high need community resulted in 715 responses about health needs and the prevalence of chronic conditions in a primarily Hispanic population.
Facility 5 -- Providence LCM Med. Ctr. - San Pedro Part V, Section B, line 4: The 2013 Joint Community Health Needs Assessment was conducted by Providence Little Company of Mary Medical Center, San Pedro and Providence Little Company of Mary Medical Center, Torrance. The report satisfies all of the required elements for a Joint Community Health Needs Assessment.
Facility 5 -- Providence LCM Med. Ctr. - San Pedro Part V, Section B, line 14g: Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?4
Name and address Type of Facility (describe)
1 Providence St Elizabeth Care Center
10425 Magnolia Boulevard
North Hollywood,CA91601 		Skilled Nursing
2 Providence LCM Sub-Acute Care Center
1322 West Sixth Street
San Pedro,CA90732 		Skilled Nursing
3 Providence LCM Transitional Care Ctr
4320 Maricopa Street
Torrance,CA90503 		Transitional Care
4 Facey Medical Foundation
15451 San Fernando Mission Blvd
Mission Hills,CA91345 		Clinical Network
5
6
7
8
9
10
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
Part V, Section B Facility Reporting Group A
Facility Reporting Group A consists of: - Facility 3: Providence Holy Cross Medical Center, - Facility 1: Providence St. Joseph Medical Center, - Facility 4: Providence Tarzana Medical Center, - Facility 2: Providence LCM Med. Ctr. - Torrance, - Facility 5: Providence LCM Med. Ctr. - San Pedro
Facility 1 -- Providence St. Joseph Medical Center Part V, Section B, line 14g: Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.
Facility 2 -- Providence LCM Med. Ctr. - Torrance Part V, Section B, line 3: Seeking out special knowledge or expertise about community needs, including health. Staff representing the two Providence Little Company of Mary Medical Centers, San Pedro and Torrance, conducted 19 separate key informant interviews (with 24 individuals) to get their perspective on community health needs. These interviews involved a variety of community sectors, including community leaders of nonprofit organizations, federally qualified health centers, public schools, and faith based organizations, private foundations, elected officials and senior staff from both the Los Angeles County Department of Health and the Los Angeles County Department of Public Health. Due to the size of the Department of Public Health, 4 interviews were conducted across the chronic disease, immunization and maternal child health divisions.In addition, a survey of local community based organizations was prepared and they were asked to rank the highest needs for children, adults and seniors. Responses were received from 46 organizations. The priorities were tallied and summarized and served as the framework from which the Board Committee on Community Benefit, appointed by the joint governing board of both Medical Centers, prepared the final recommended priorities which were sent to the governing board.Finally, telephone surveys of 312 adults were conducted based upon a randomized sample of 10,000 residents to seek their input on the greatest health needs. In addition an August 2013 survey, in collaboration with St. Joseph Church in Hawthorne, located in a high need community resulted in 715 responses about health needs and the prevalence of chronic conditions in a primarily Hispanic population.
Facility 2 -- Providence LCM Med. Ctr. - Torrance Part V, Section B, line 4: The 2013 Joint Community Health Needs Assessment was conducted by Providence Little Company of Mary Medical Center, San Pedro and Providence Little Company of Mary Medical Center, Torrance. The report satisfies all of the required elements for a Joint Community Health Needs Assessment.
Facility 2 -- Providence LCM Med. Ctr. - Torrance Part V, Section B, line 14g: Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.
Facility 3 -- Providence Holy Cross Medical Center Part V, Section B, line 14g: Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.
Facility 4 -- Providence Tarzana Medical Center Part V, Section B, line 14g: Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.
Facility 5 -- Providence LCM Med. Ctr. - San Pedro Part V, Section B, line 3: Seeking out special knowledge or expertise about community needs, including health. Staff representing the two Providence Little Company of Mary Medical Centers, San Pedro and Torrance, conducted 19 separate key informant interviews (with 24 individuals) to get their perspective on community health needs. These interviews involved a variety of community sectors, including community leaders of nonprofit organizations, federally qualified health centers, public schools, and faith based organizations, private foundations, elected officials and senior staff from both the Los Angeles County Department of Health and the Los Angeles County Department of Public Health. Due to the size of the Department of Public Health, 4 interviews were conducted across the chronic disease, immunization and maternal child health divisions.In addition, a survey of local community based organizations was prepared and they were asked to rank the highest needs for children, adults and seniors. Responses were received from 46 organizations. The priorities were tallied and summarized and served as the framework from which the Board Committee on Community Benefit, appointed by the joint governing board of both Medical Centers, prepared the final recommended priorities which were sent to the governing board.Finally, telephone surveys of 312 adults were conducted based upon a randomized sample of 10,000 residents to seek their input on the greatest health needs. In addition an August 2013 survey, in collaboration with St. Joseph Church in Hawthorne, located in a high need community resulted in 715 responses about health needs and the prevalence of chronic conditions in a primarily Hispanic population.
Facility 5 -- Providence LCM Med. Ctr. - San Pedro Part V, Section B, line 4: The 2013 Joint Community Health Needs Assessment was conducted by Providence Little Company of Mary Medical Center, San Pedro and Providence Little Company of Mary Medical Center, Torrance. The report satisfies all of the required elements for a Joint Community Health Needs Assessment.
Facility 5 -- Providence LCM Med. Ctr. - San Pedro Part V, Section B, line 14g: Charity and Discount policies are posted on the Office of Statewide Health Planning and Development's website as required by California law. Notices of the availability of financial assistance are provided on the hospital's website, in admitting departments, on billing notices and given to the patient at time of admission/registration.
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number
51-0216589
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) Providence Health & Services Foundation
501 S Buena Vista Street
Burbank,CA91505 		95-3544877 501 ( C ) (3) 4,616,759       Operationa Support/Sponsor at special event
(2) Providence Little Company of Mary Foundation
4101 Torrance Blvd
Torrance,CA90503 		51-0224944 501 ( C ) (3) 2,945,631       Operating expenses
(3) Care Harbor LA
8000 McConnell Ave
Los Angeles,CA90045 		95-2138184 501 ( C ) (3) 25,000       Silver level sponsor
(4) National Health Foundation
515 S Figueroa St Ste 1300
Los Angeles,CA90071 		23-7314808 501 ( C ) (3) 20,500       Support tribute awards.
(5) California Institute for Nursing and HealthCare
P O Box 70007
Oakland,CA94612 		82-0570413 501 ( C ) (3) 15,000       Support workforce center
(6) March of Dimes Foundation
700 North Brand Blvd 950
Glendale,CA91203 		13-1846366 501 ( C ) (3) 12,500       Sponsor March for Babies event
(7) LA County Business Federation
1000 N Alameda
Los Angeles,CA90012 		26-0295348 501 ( C ) (6) 10,000       Silver level sponsor
(8) American Cancer Society
500 N Victory Blvd
Burbank,CA91502 		94-1170350 501 ( C ) (3) 7,500       Platinum sponsor for Relay for Life
(9) Cancer Support Community
109 W Torrance Ste 100
Redondo Beach,CA90277 		95-4076131 501 ( C ) (3) 7,110       Sponsor various activities.
(10) Valley Industry and Commerce Association
5121 Van Nuys Blvd Ste 208
Sherman Oaks,CA91403 		23-7182039 501 ( C ) (6) 6,000       Sponsor business organization/Support through Board Fees




2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
8
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
2
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) Family Allowance - 2nd Student 9   13,500 FMV Tuition Reduction
(2) Scholarships 92   160,025 FMV Tuition Reduction
(3) Employee Discount 17   51,000 FMV Tuition Reduction
(4) Financial Aid 136   370,822 FMV Tuition Reduction
(5) Legacy Discount 15   6,725 FMV Tuition Reduction




Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Part I, Line 2: In the application for support/financial aid, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds were used, along with a report of the number of children/families served over the year. Grants made to affiliated foundations are monitored on a monthly basis since the financial statements of these organizations are readily available. Other grants are made that comply with the mission and further the tax exempt purpose of the organization.
Schedule I (Form 990) 2013


Additional Data


Software ID:  
Software Version:  


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, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number

51-0216589
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
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:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
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:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (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 as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)John F Koster MD - Thru 0313President / CEO (i)
(ii)		 0
1,316,766 		0
1,868,461 		0
17,500 		0
215,651 		0
31,597 		0
3,449,975 		0
0
(2)Rod F Hochman MD - Eff 0413President / CEO (i)
(ii)		 0
1,051,406 		0
334,001 		0
17,500 		0
486,988 		0
28,915 		0
1,918,810 		0
0
(3)Todd HofheinsEVP/CFO (i)
(ii)		 0
432,363 		0
120,504 		0
17,500 		0
65,303 		0
24,807 		0
660,477 		0
0
(4)Jeffrey W Rogers - Thru 513Corporate Secretary (i)
(ii)		 0
442,462 		0
529,200 		0
69,119 		0
168,789 		0
21,091 		0
1,230,661 		0
0
(5)Cindy Strauss - Eff 613SVP/Chief Counsel/Corp. Secretary (i)
(ii)		 0
413,323 		0
525,001 		0
17,500 		0
223,587 		0
24,667 		0
1,204,078 		0
0
(6)Michael HunnSVP/CEO - CA. Region (i)
(ii)		 0
536,537 		0
496,319 		0
17,500 		0
93,588 		0
26,791 		0
1,170,735 		0
0
(7)Dave MastCFO/CA. Region (i)
(ii)		 0
351,409 		0
83,289 		0
0 		0
57,321 		0
11,532 		0
503,551 		0
0
(8)Terry L SmithSVP/Management Svcs (i)
(ii)		 0
639,022 		0
906,428 		0
67,500 		0
202,105 		0
24,053 		0
1,839,108 		0
0
(9)Deborah BurtonSVP/Chief Nrsg. Officer (i)
(ii)		 0
323,817 		0
1,005,792 		0
17,500 		0
42,736 		0
23,303 		0
1,413,148 		0
296,416
(10)Michael L ButlerPresident/Operations & Services (i)
(ii)		 0
954,645 		0
300,598 		0
17,500 		0
713,468 		0
29,161 		0
2,015,372 		0
0
(11)Randy Axelrod MDEVP/Clinical & Patient Svcs (i)
(ii)		 0
613,884 		0
315,700 		0
125,675 		0
192,796 		0
26,894 		0
1,274,949 		0
0
(12)Janice J JonesSVP/CAO (i)
(ii)		 0
604,348 		0
377,853 		0
17,500 		0
132,205 		0
27,288 		0
1,159,194 		0
0
(13)Myron Berdischewsky MDSVP/CMQO (i)
(ii)		 0
527,449 		0
310,561 		0
17,500 		0
134,979 		0
23,598 		0
1,014,087 		0
0
(14)Jack FriedmanSVP/Account Care & Payor Rel. (i)
(ii)		 0
508,016 		0
300,765 		0
17,500 		0
151,382 		0
26,370 		0
1,004,033 		0
0
(15)Ray WilliamsSVP/Physicians Svcs (i)
(ii)		 0
120,595 		0
200,000 		0
440,672 		0
179,162 		0
24,427 		0
964,856 		0
0
(16)Cindra R SyversonSVP/CHRO (i)
(ii)		 0
404,069 		0
312,381 		0
1,000 		0
267,888 		0
24,300 		0
1,009,638 		0
0
(17)Craig L Wright MDSVP/Physicians Svcs (i)
(ii)		 0
509,167 		0
128,777 		0
70,854 		0
432,646 		0
18,991 		0
1,160,435 		0
0
(18)John O MuddSVP/Mission Leadership (i)
(ii)		 0
368,604 		0
158,842 		0
14,800 		0
189,558 		0
18,700 		0
750,504 		0
0
(19)Claudia HaglundVP/Governance & Sponsorship (i)
(ii)		 0
342,176 		0
134,699 		0
17,500 		0
136,830 		0
20,219 		0
651,424 		0
0
(20)Joel S GilbertsonSVP/Comm.Ptrshp & External Affairs (i)
(ii)		 0
354,361 		0
84,733 		0
17,500 		0
103,698 		0
22,547 		0
582,839 		0
0
(21)David BrownVP/Strategy & Innovation (i)
(ii)		 0
303,119 		0
131,437 		0
50 		0
146,627 		0
22,332 		0
603,565 		0
0
(22)Orest HolubecSVP/Marketing & Communications (i)
(ii)		 0
328,545 		0
77,915 		0
17,500 		0
39,407 		0
21,903 		0
485,270 		0
0
(23)Michael RembisCEO - PSJMC (i)
(ii)		 0
422,368 		0
186,192 		0
0 		0
195,463 		0
24,206 		0
828,229 		0
0
(24)Elizabeth DunneCEO - LCMMC - Torrance (i)
(ii)		 0
395,185 		0
174,536 		0
17,500 		0
161,791 		0
8,599 		0
757,611 		0
0
(25)Nancy CarlsonCEO - LCMMC - San Pedro (i)
(ii)		 0
356,850 		0
151,889 		0
17,500 		0
159,650 		0
23,553 		0
709,442 		0
0
(26)Gerald CluteCEO - PTMC (i)
(ii)		 0
338,547 		0
75,000 		0
17,500 		0
130,574 		0
9,761 		0
571,382 		0
0
(27)Dale SurowitzCEO - Valley Community (i)
(ii)		 0
456,988 		0
83,255 		0
0 		0
209,345 		0
18,569 		0
768,157 		0
0
(28)Glenn KomatsuCMO - TCH (i)
(ii)		 340,921
0 		74,331
0 		17,500
0 		19,556
0 		20,569
0 		472,877
0 		0
0
(29)Pat ModrzejewskiChief Development Officer (i)
(ii)		 308,595
0 		67,836
0 		17,500
0 		27,682
0 		6,899
0 		428,512
0 		0
0
(30)Richard GlimpCMO - LCMH (i)
(ii)		 324,404
0 		68,650
0 		0
0 		10,156
0 		20,125
0 		423,335
0 		0
0
(31)Teresa DavidCOO - Facey Med. Foundation (i)
(ii)		 300,263
0 		88,951
0 		0
0 		10,525
0 		18,136
0 		417,875
0 		0
0
(32)James CorwinCFO - Facey Med. Foundation (i)
(ii)		 299,408
0 		77,091
0 		11,404
0 		15,164
0 		19,902
0 		422,969
0 		0
0
(33)Karl CarrierFormer CFO (i)
(ii)		 0
5,542 		0
175,407 		0
460 		0
200,502 		0
1,486 		0
383,397 		0
106,408
(34)Kerry CarmodyFormer COO (i)
(ii)		 0
19,669 		0
207,213 		0
530,696 		0
333,783 		0
24,167 		0
1,115,528 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
Part I, Line 1a Providence Health & Services Expense Reimbursement Procedures include the following policies: First Class Travel or Charter Travel or Travel of Companions Air travel is reimbursable for tourist or economy class and should be at the least expensive airfare; which permits departures and arrivals at reasonable times and reasonable distance traveled. Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class air travel will only be reimbursed when tourist or economy class air travel is not available and business travel is mandated by a supervisor. In the rare circumstance that an executive must fly on a first class full fare ticket, their senior level supervisor must approve this expense. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approved by the Executive Vice President, Chief Human Resource Officer. Spouse or Companion Travel. Travel expenses incurred by a PH&S employee's spouse or companion will not be reimbursed by PH&S unless the spouse or companion is required to, or invited to attend a PH&S System-sponsored meeting. These expenses may be considered a taxable benefit by the IRS and if so, will be included on the employee's W- 2. During 2013, none of the Officers, Directors or Key Employees listed on Form 990, Part VII utilized First Class or Companion Travel. Tax Indemnifications or Gross-Up Payments Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2013, the following Key Employee received gross-up payments: Craig Wright, MD - Relocation The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding "rent" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The Executive Vice President/Chief Human Resources Officer may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2013, the following Key Employees received relocation/housing program payments: Craig Wright, MD Ray Williams Terry Smith Randy Axelrod The amounts reported for these relocation/housing payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation.
Part I, Lines 4a-b NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan C) ESP = Elective Survivor Plan 1) John F. Koster, MD a) Taxable SERP Earned but not Paid- $350,711 b) SERP Interest Credit - $191,190 2) Rod Hochman, MD a) SERP Earned but not Vested- $444,760 b) SERP Interest Credit - $24,378 3) Todd Hofheins a) SERP Earned but not Vested - $57,974 4) Jeffrey W. Rogers a) Taxable SERP Earned but not Paid - $44,111 b) SERP Interest Credit- $97,420 c) ESP Interest Credit - $7,567 5) Cindy Strauss a) SERP Earned but not Vested - $190,313 b) SERP Interest Credit - $14,149 6) Terry Smith a) Taxable SERP Earned but not Paid - $67,662 b) Taxable CBRP Earned but not Paid - $147 c) Non-Taxable CBRP Earned but not Paid - $353 d) ESP Interest Credit - $5,823 e) SERP Interest Credit - $118,609 7) Debbie Burton a) Taxable SERP Earned but not Paid - $915,149 b) SERP Interest Credit - $20,728 8) Mike Butler a) SERP Earned but not Vested - $478,094 b) SERP Interest Credit - $201,306 9) Randy Axelrod, MD a) SERP Earned but not Vested- $181,321 10) Jan Jones a) Taxable CBRP Earned but not Paid - $84 b) Taxable SERP Earned but not Paid - $148,227 c) Non-Taxable CBRP Earned - $101 a) SERP Interest Credit - $100,997 11) Myron Berdischewsky, MD a) Taxable CBRP Earned but not Paid - $2,548 b) Taxable SERP Earned but not Paid - $108,227 c) Non-Taxable CBRP Earned - $2,060 d) SERP Interest Credit - $105,170 12) Jack Friedman a) Taxable SERP Earned but not Paid - $54,169 b) SERP Interest Credit - $100,470 13) Ray Williams a) SERP Interest Credit - $12,906 b) SERP Earned but not Vested - $153,506 14) Cindra Syverson a) SERP Earned but not Vested - $144,043 b) SERP Interest Credit - $103,147 15) Craig Wright, MD a) SERP Earned but not Vested - $221,797 b) SERP Interest Credit - $181,734 16) Jack Mudd a) Taxable SERP Earned but not Paid - $50,004 b) SERP Interest Credit - $165,857 17) Claudia Haglund a) Taxable SERP Earned but not Paid - $35,007 b) SERP Interest Credit - $70,109 c) ESP Interest Credit - $2,161 18) Joel Gilbertson a) SERP Earned but not Vested - $52,868 b) SERP Interest Credit - $32,392 19) David Brown a) SERP Interest Credit - $39,209 b) SERP Earned but not Vested - $80,917 20) Orest Holubec a) SERP Interest Credit - $6,443 b) SERP Earned but not Vested - $21,490 21) Gary Flaming a) SERP Interest Credit - $4,233 b) Taxable SERP Earned but not Paid - $17,362 c) Taxable CBRP Earned but not Paid - $1,640 d) Non-Taxable CBRP Earned - $4,730 22) Michael Hunn a) SERP Interest Credit - $ 76,056 b) Taxable SERP Earned but Not Paid - $261,669 23) Dave Mast a) SERP Earned but Not Vested - $43,539 b) SERP Interest Credit - $1,165 24) Dale Surowitz a) SERP Interest Credit - $56,934 b) SERP Earned but Not Vested - $132,731 25) Michael Rembis a) SERP Earned but Not Vested - $183,988 26) Elizabeth Dunne a) SERP Earned but Not Vested - $152,706 27) Nancy Carlson a) SERP Interest Credit - $134,426 b) Taxable SERP Earned but Not Paid - $40,014 c) Taxable CBRP Earned but Not Paid - $190 d) Non-Taxable CBRP Earned but Not Paid - $206 28) Gerald Clute a) SERP Earned but Not Vested - $121,969 29) Karl J. Carrier a) Taxable SERP Earned but Not Paid - $33,144 b) Non-Taxable SERP Earned but Not Paid - 193,497 30) Kerry L. Carmody a) SERP Interest Credit - $47,295 b) Taxable SERP Earned but Not Paid - $67,254 c) Non-Taxable SERP Earned but Not Paid - $250,674 31) Glen Komatsu a) Taxable CBRP Earned but Not Paid - $11,759 b) Non-Taxable CBRP Earned but Not Paid - $716 32) Pat Modrzejewski a) Taxable CBRP Earned but Not Paid - $4,492 b) Non-Taxable CBRP Earned but Not Paid - $511
Part I, Lines 4a-b SEVERANCE 1) Ray Williams - $376,916 2) Kerry L. Carmody - $456,910
FORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS PROGRAM The Providence Executive Incentive Program provides a lump sum award annually as a percent of the executive's base pay. Percent opportunities are aligned with our total compensation philosophy as outlined in Part VI, Section B, Line 15 (Process for determining compensation of top management, officers & key employees). The performance award is based on the level of accomplishment of annual system objectives and personal objectives. In 2013, 50 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's five strategic priorities of: mission driven, financially responsible, people centered, service oriented and EPIC watchlist. In 2013 the percent allocation for each of these strategic priorities was: Mission driven 5% Financially responsible 15% People centered 10% Service oriented 10% EPIC Watchlist 10% To ensure affordability of the program, the organization (system, region or entity) must meet a threshold of 50 percent of budgeted net operating income.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number
51-0216589
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CA Health Facilities Financing Authority
  		52-1643828 13033F7L8 11-06-2008 284,698,621 See PART VI X     X   X
B CA Health Facilities Financing Authority
  		52-1643828 13033LBZ9 07-29-2009 145,060,500 Construct Patient Tower - Holy Cross Med. Ctr.   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 14,400,000      
2 Amount of bonds legally defeased . . . . . . . . . . . 2,070,000      
3 Total proceeds of issue . . . . . . . . . . . . . . 284,698,622 145,228,940    
4 Gross proceeds in reserve funds . . . . . . . . . . . . 8 8    
5 Capitalized interest from proceeds . . . . . . . . . . . 13,434,940 13,434,940    
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 4,582,212 2,072,500    
8 Credit enhancement from proceeds . . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 129,637,276 129,637,276    
11 Other spent proceeds . . . . . . . . . . . . . . 280,116,410 84,216    
12 Other unspent proceeds . . . . . . . . . . . . . . 8 8    
13 Year of substantial completion . . . . . . . . . . . . 2008 2011
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X        
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X        
16 Has the final allocation of proceeds been made? . . . . . . . . X   X          
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X          
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X        
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X     X        
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X        
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X        
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0 %    
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0 %    
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 0 %    
7 Does the bond issue meet the private security or payment test? . . . . .   X   X        
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X        
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X          
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X        
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X X          
b Exception to rebate? . . . . . . . .   X   X        
c No rebate due? . . . . . . . . X     X        
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . .   X   X        
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X        
b Name of provider . . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X        
b Name of provider . . . . . . . . .  
  		 
  		 
  		 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X        
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X          
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X          
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, ISSUE A PART I, QUESTION (F) Refinance bank loan used for acquisition of Providence Tarzana Medical Center, currently call the CHFFA Series 2001 A, B & C (Providence Health System) and CHFFA Series 1998 (Little Company of Mary).
SCHEDULE K, ISSUE A PART IV, QUESTION 2C The most recent rebate computation for the bonds was completed through 12/11/2013.
SCHEDULE K, ISSUE A PART III As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, Line 6. The Organization has not undertaken an analysis of the private security test with respect to the bonds, as the level of private business use and/or unrelated trade or business use reported in Part III, Line 6 is not in excess of amounts permitted under Section 145 of the Code.
SCHEDULE K, ISSUE B PART II - PROCEEDS The amount of the Total Proceeds of Issue are greater than the Issue Price due to Investment Earnings on the proceeds.
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

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.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number

51-0216589
Return Reference Explanation
Form 990, Part VI, Section A, line 6 The sole Member of the Corporation is Providence Health & Services.
Form 990, Part VI, Section A, line 7a The powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause.
Form 990, Part VI, Section A, line 7b The following powers are reserved exclusively to the Corporate Member: A) To adopt and amend the Articles of Incorporation and the Bylaws of the Foundation after consultation with the Foundation's Board of Directors. B) To approve the merger, consolidation, or affiliation of the Foundation with another corporation, organization or program, or the dissolution of the Foundation. C) To approve any strategic plan of the Foundation. D) To approve the annual fundraising plan including special events, annual, capital and planned giving activities. E) To approve the acceptance of any gift that carries conditions or limitations or any gift restricted to services, programs or facilities not currently offered or approved to be offered by the Corporate Member's Board of Directors.
Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS.
Form 990, Part VI, Section B, line 12c Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict.
Form 990, Part VI, Section B, line 15 It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined by the Providence Board's Human Resources Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Board retains an independent consultant each year to review salaries of those in the most significant leadership roles in the organization. Part of the consultant's role is to review an extensive array of compensation surveys of large, not-for-profit health care systems in the United States. Providence is one of the larger health systems in the country, and as such, the Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources Committee. Each year, the Board Chair conducts a formal performance evaluation of the President/CEO that considers input from the other directors and senior leaders reporting to the President. The evaluation is discussed with the Human Resources Committee and then a recommendation is made by the committee to the full Board. The Board Chair and the Chair of the Human Resources Committee also meet with an independent consultant to develop a salary recommendation; which is reviewed and approved first by the committee and then by the Board of Directors. Additionally, the President/CEO utilizes the market information provided by the consultant along with formal performance evaluations, to determine salary recommendations for other senior executives. This process includes a rigorous analysis of those recommendations with the Human Resources Committee as a part of the review and approval process. Performance incentives allow executives to earn additional compensation if they achieve specific organizational and individual goals for furthering Providence operating principles - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated customer satisfaction, meeting employee satisfaction goals and reaching financial performance objectives. The Board of Directors conducts a thorough process to ensure performance incentives are aligned with appropriate practices for not-for-profit health care systems. The Board's process for executive compensation fully complies with IRS standards and mirrors the best practices recommended in the "Report to Congress and the Nonprofit Sector on Governance, Transparency, and Accountability" submitted to the Senate Finance Committee by the Panel on the Nonprofit Sector.
Form 990, Part VI, Section C, line 19 Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon written request. The consolidated Health System financial statements are available on our public Internet site www2.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site.
Form 990, Part VII Michael Hunn - 501 S. Buena Vista Street, Burbank, CA 91505. Dave Mast - 501 S. Buena Vista Street, Burbank, CA 91505. Michael Rembis - 501 S. Buena Vista Street, Burbank, CA 91505. Elizabeth Dunne - 4101 Torrance Boulevard, Torrance, CA 90503. Nancy Carlson - 1300 West 7th Street, San Pedro, CA 90732. Gerald Clute - 18321 Clark Street, Tarzana, CA 91353. Dale Surowitz - 501 S. Buena Vista Street, Burbank, CA 91505.
Form 990, Part XI, line 9: Recipient Organization Adjustment 9,663,896. IAF Consolidated Equity Transfers 62,452,158. Contributions Reclassifications -611,681. SOP Employee Discount 48,000. Auxiliary Adj. Impact -126,999. Rounding -1.
FROM 990, PART XII, LINE 2C - AUDIT & COMPLIANCE The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the System's financial statements and reporting, the audit process and the System's internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the System's internal and external auditors; the System's investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation.
FORM 990, PART I, LINE 6 - VOLUNTEERS Our volunteers provide valuable assistance to all of our ministries through a variety of services. Some specific examples include the following: BEYOND FIFTY VOLUNTEER In conjunction with the Beyond Fifty Program, volunteers may sign up to work on Beyond Fifty projects with the Beyond Fifty Program manager. These projects usually involve mailings and/or filing. CLERICAL VOLUNTEERS Clerical volunteers perform general office work such as filing, mailing, data entry, word processing, answering phones, making charts and copying forms. They work in most of the business and clinical offices throughout the hospital. CLINICAL VOLUNTEERS Clinical volunteers work on the nursing floors in 4 hour shifts. They help with trays and feeding and check on patients to be sure they are comfortable. They also put away clean linens, make beds, run errands for the nurses, keep the nurses' kitchen in order, take patients for wheelchair walks and discharge patients. EMERGENCY ROOM VOLUNTEERS These volunteers work a four hour shift once a week. Duties include making phone calls to recently discharged patients, checking on their condition and asking a few brief questions regarding the care they received while a patient, helping at the registration desk, checking on each patient to see if they need anything, running errands for the staff, answering phones, discharging patients by wheel chair, making beds, etc. INFORMATION DESK They must be able to multi-task: answer phones, direct patients and be willing to walk patients to their destinations. They must have excellent customer relation skills. MESSENGER CENTER Volunteers work a four hour shift answering the messenger phone, carrying lab samples, charts, x-rays, etc. and transporting ambulatory patients by wheel chair within the hospital. The messengers also work on mailing projects for various departments. This is an opportunity for those who like to walk and enjoy a variety of experiences as well as enjoying the constant contact with others. MUSIC PROGRAM Volunteers who sing or play a musical instrument schedule four hours per week to visit patients and sing or play for them. Harpists and guitar players are needed as well as other movable instruments which can be played individually. PATIENT VISITOR These volunteers visit the newly admitted patients to welcome them and provide a friendly ear for requests, complaints or just a brief visit. The volunteer must be outgoing and friendly, able to make easy conversation. PETS WITH A PURPOSE This program is in conjunction with Recreation Therapy. Pet volunteers visit patients with their dogs. The dogs are chosen for their friendly personalities and must pass behavioral tests and training to qualify. Visiting is done on a rotating schedule. All applications must be approved by Recreation Therapy Manager. SPIRITUAL CARE VOLUNTEERS Eucharistic Ministers visit the sick and bring Holy Communion to patients requesting the service. This is done on a rotating basis as the volunteer is available. Other volunteers work on projects such as little gifts and handouts for patients. SURGERY WAITING ROOM DESK Another customer service job places the volunteer in the Surgery Waiting room. He/she must keep track of all patients' family members and other visitors and dispense information regarding the patient in surgery. Duties include keeping the room neat, monitoring the television, making and serving coffee and tea and cleaning up at the end of the shift. The volunteer must also maintain a pleasant, helpful attitude at all times. Volunteers with Providence High School assist in the following capacities: * Meeting Attendance * Preparing special mailings * Laundry * Building Props and making costumes * Supervision of special events * Setting up for special events * Cleaning up after events * Hospitality for events * Video special events * Chaperoning field trips and dances * Courier Service * Traffic Control
FORM 990, PART VII - RELIGIOUS COMMUNITY MEMBERS As members of the Religious Community, each Sister has taken a vow of poverty as a compulsory part of her religious life. Any compensation for services of a Sister inures only for the benefit of the Community, not the individual members. All payments for services are made directly to the Religious Community.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
PROVIDENCE HEALTH SYSTEM -SO CALIFORNIA
 
Employer identification number

51-0216589
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) 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 entity?
Yes No
(1) Providence Health & Services - Washington

1801 Lind Avenue SW 9016

Renton,WA980579016
51-0216586 		Healthcare System WA 501( c)(3) Line 3 Providence Health & Services
 
 
No
(2) Providence Health & Services - Oregon

1801 Lind Avenue SW 9016

Renton,WA980579016
51-0216587 		Healthcare System OR 501( c)(3) Line 3 Providence Health & Services
 
 
No
(3) Everett Transitional Care Services

PO Box 5128

Everett,WA982065128
94-3264605 		Transitional Care WA 501( c)(3) Line 9 N/A
 
No
(4) Providence Oregon Management Corporation

1801 Lind Avenue SW 9016

Renton,WA980579016
93-0813977 		Shell Corporation OR 501( c)(3) Line 1 PH & S - Oregon
 
 
No
(5) Providence Plan Partners

4400 NE Halsey Bldg 2

Portland,OR97213
91-1861964 		Healthcare Services OR 501( c)(4) N/A PH & S - Oregon
 
 
No
(6) Providence Health Plan

4400 NE Halsey Bldg 2

Portland,OR97213
93-0863097 		Health Service Contractor OR 501( c)(4) N/A Providence Plan Partners
 
 
No
(7) Providence Health Assurance

4400 NE Halsey Bldg 2

Portland,OR97213
55-0828701 		Medicaid Healthcare Provider OR 501( c)(4) N/A Providence Health Plan
 
 
No
(8) Providence Medical Institute

4101 Torrance Blvd

Torrance,CA90503
33-0283773 		Healthcare CA 501( c)(3) Line 11/Type I PHS - So California
 
Yes
 
(9) Little Company of Mary Ancillary Services Corporation

4101 Torrance Blvd

Torrance,CA90503
33-0844408 		Imaging Services CA 501( c)(3) Line 9 PHS - So California
 
Yes
 
(10) Providence TrinityCare Hospice

5315 Torrance Blvd Suite B1

Torrance,CA90503
95-3264139 		Hospice CA 501( c)(3) Line 9 PHS - So California
 
Yes
 
(11) Providence Blanchet Association

1700 Providence Pl

Centralia,WA98531
91-1789266 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(12) St Luke Association

350 Washington Ave SE

Chehalis,WA98352
94-3176618 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(13) Providence Rossi Association

1700 Providence Pl

Centralia,WA98531
31-1584166 		Housing WA 501( c)(3) Line 9 PH & S - Washington
 
 
No
(14) Lundberg Association

5921 E Burnside

Portland,OR97215
91-1562797 		Housing OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(15) Providence St Francis Association

3415 12th Avenue NE

Olympia,WA98506
94-3244854 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(16) Providence Peter Claver Association

7101 38th Avenue South

Seattle,WA98118
31-1629656 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(17) Providence St Elizabeth House Association

3201 SW Graham St

Seattle,WA98126
91-2171539 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(18) Providence Gamelin House Association

4515 MLK Jr Way S Ste 200

Seattle,WA98108
31-1744654 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(19) The Gamelin Association

312 North Fourth St

Yakima,WA98901
91-1180824 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(20) The Gamelin Oregon Association

5520 NE Glisan

Portland,OR97213
91-1214491 		Housing OR 501( c)(3) Line 9 PH & S - Oregon
 
 
No
(21) The Gamelin California Association

540 23rd St

Oakland,CA94612
91-1293869 		Housing CA 501( c)(3) Line 9 PHS - So California
 
Yes
 
(22) Gamelin Washington Association

1423 First Avenue

Seattle,WA98101
20-1910170 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(23) Providence Foundation

1801 Lind Avenue SW 9016

Renton,WA980579016
94-3078543 		Support PH&S Institutions WA 501( c)(3) Line 11/Type I PH & S - Washington
 
 
No
(24) Providence Alaska Foundation

3300 Providence Drive - B Tower2

Anchorage,AK99508
92-0093565 		Support PHS-Alaska AK 501( c)(3) Line 11/Type I PH & S - Washington
 
 
No
(25) Providence St Peter Foundation

413 Lilly Road NE

Olympia,WA985065166
91-1097056 		Support Affiliated Tax-Exempt Organization WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(26) Providence Health Care Foundation (Centralia)

914 S Scheuber Road

Centralia,WA98531
91-1433382 		Support Providence Centralia Hospital WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(27) Providence Mount St Vincent Foundation

4831 - 35th Avenue SW

Seattle,WA981262799
91-1188119 		Support Providence Mount St.Vincent WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(28) Providence Marianwood Foundation

3725 Providence Point Drive SE

Issaquah,WA980297219
93-1554288 		Support Providence Marianwood WA 501( c)(3) Line 11/Type I PH & S - Washington
 
 
No
(29) Providence Newberg Health Foundation

1001 Providence Drive

Newberg,OR97132
93-0889144 		Support Providence Newberg Medical Center OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(30) Providence Seaside Hospital Foundation

725 S Wahanna Rd

Seaside,OR97138
93-0927320 		Support Providence Seaside Hospital OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(31) Providence Community Health Foundation

1111 Crater Lake Ave

Medford,OR97504
93-0692907 		Support Providence Medford Medical Center OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(32) Providence Benedictine Nursing Center Foundation

540 South Main St

Mt Angel,OR973629532
91-1940286 		Support Providence Benedictine Nursing Center OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(33) Providence Portland Medical Foundation

4805 NE Glisan St

Portland,OR972132967
93-1231494 		Support Providence Portland Medical Center OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(34) Providence St Vincent Medical Foundation

9205 SW Barnes Rd

Portland,OR97225
93-0575982 		Support Providence St. Vincent Medical Center OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(35) Providence Milwaukie Foundation

10150 SE 32nd

Milwaukie,OR97222
94-3079515 		Support Providence Milwaukie Hospital OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(36) Providence Child Center Foundation

830 NE 47th

Portland,OR97213
93-0800140 		Support Providence Child Center OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(37) Providence TrinityCare Hospice Foundation

5315 Torrance Blvd Suite B1

Torrance,CA90503
33-0261016 		Support TrinityCare Hospice CA 501( c)(3) Line 7 PHS - So California
 
Yes
 
(38) Providence Little Company of Mary Foundation

4101 Torrance Blvd

Torrance,CA90503
51-0224944 		Support Little Company of Mary Service Area CA 501( c)(3) Line 7 PHS - So California
 
Yes
 
(39) PH&S FoundationSFVSA & SCVSA

501 S Buena Vista Street

Burbank,CA91505
95-3544877 		Support Program & Activities of SFVSA & SCVSA CA 501( c)(3) Line 7 PHS - So California
 
Yes
 
(40) Providence Hospice of Seattle Foundation

425 Pontius Avenue North 300

Seattle,WA981095452
91-2077378 		Support Hospice of Seattle WA 501( c)(3) Line 11/Type I PH & S - Washington
 
 
No
(41) Providence Health & Services - Western Washington

1801 Lind Avenue SW 9016

Renton,WA980579016
91-1303277 		Healthcare WA 501( c)(3) Line 3 Providence MinistriesWHC
 
 
No
(42) Providence Health & Services

1801 Lind Avenue SW 9016

Renton,WA980579016
91-1549796 		Shell Corporation WA 501( c)(3) Line 11/Type I N/A
 
No
(43) Providence Health & Services - Montana

500 W Broadway PO Box 4587

Missoula,MT598064587
81-0231793 		Healthcare MT 501( c)(3) Line 3 PH & S - Washington
 
 
No
(44) Providence St Joseph Medical Center

PO Box 1010

Polson,MT598601010
81-0463482 		Healthcare MT 501( c)(3) Line 3 PH & S - Washington
 
 
No
(45) St Thomas Child and Family Center

1710 Benefis Court

Great Falls,MT59405
81-0233495 		Early Childhood Education MT 501( c)(3) Line 1 PH & S - Washington
 
 
No
(46) Sisters of Providence of Montana Corporation

1801 Lind Avenue SW 9016

Renton,WA980579016
26-2612415 		Shell Corporation MT 501( c)(3) Line 1 PH & S - Washington
 
 
No
(47) Providence Health Care Foundation - Eastern Washington

101 W 8th Ave

Spokane,WA99204
32-0014330 		Support PH&S-WA. Ministries in E. WA. WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(48) St Patrick Hospital Foundation

500 West Broadway PO Box 4587

Missoula,MT598064587
23-7056976 		Support Healthcare in W. Montana MT 501( c)(3) Line 7 PH & S - Washington
 
 
No
(49) University of Great Falls

1301 20th Street South

Great Falls,MT59405
81-0231777 		Post Secondary Education MT 501( c)(3) Line 2 PH & S - Washington
 
 
No
(50) E WA & MT Unemployment Compensation Insurance Trust

1801 Lind Avenue SW 9016

Renton,WA980579016
91-1082119 		Unemployment Benefits WA 501( c)(3) Line 11/Type I PH & S - Washington
 
 
No
(51) Providence Willamette Falls Medical Foundation

1500 Division Street

Oregon City,OR97045
93-1003750 		Support Willamette Falls Hospital OR 501( c)(3) Line 11/Type I PH & S - Oregon
 
 
No
(52) Providence Hood River Memorial Hospital Foundation Inc

811 13th St

Hood River,OR97031
93-0921990 		Support Providence Hood River Memorial Hospital OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(53) Providence Hospice and Home Care Foundation

2731 Wetmore Avenue Suite 500

Everett,WA98201
27-2552749 		Support Program & Ministries of PHHC WA 501(c )(3) Line 7 PH & S - Washington
 
 
No
(54) Providence St Mary Foundation

401 W Poplar St

Walla Walla,WA99362
45-2841492 		Support Program & Ministries of SMMC WA 501(c )(3) Line 7 PH & S - Washington
 
 
No
(55) Facey Medical Foundation

15451 San Fernando Mission Blvd 200

Mission Hills,CA913451420
95-4322584 		Support Facey Medical Group CA 501(c )(3) Line 7 PHS - So California
 
Yes
 
(56) Swedish Health Services

747 Broadway

Seattle,WA98122
91-0433740 		Healthcare WA 501(c )(3) Line 3 Western HealthConnect
 
 
No
(57) Swedish Edmonds

21601 76th Ave W

Edmonds,WA98026
27-2305304 		Healthcare WA 501(c )(3) Line 3 Western HealthConnect
 
 
No
(58) Swedish Medical Center Foundation

747 Broadway

Seattle,WA98122
91-0983214 		Support Swedish Health Services WA 501(c )(3) Line 7 Swedish Health Services
 
 
No
(59) Global To Local Health Initiative

747 Broadway

Seattle,WA98122
27-3133200 		Healthcare WA 501(c )(3) Line 7 Swedish Health Services
 
 
No
(60) Swedish MJM Holdings

747 Broadway

Seattle,WA98122
27-3139262 		Holding Company WA 501(c )(3) Line 11/Type I Swedish Health Services
 
 
No
(61) Marsha Rivkin Center for Ovarian Cancer Research

747 Broadway

Seattle,WA98122
91-2054035 		Ovarian Cancer Research WA 501(c )(3) Line 7 Swedish Health Services
 
 
No
(62) Western HealthConnect

747 Broadway

Seattle,WA98122
45-4171900 		Shell Corporation WA 501(c )(3) Line 11/Type I PH&S Western Washington
 
 
No
(63) Inland Northwest Health Services

601 W 1st Avenue

Spokane,WA99201
91-1307555 		Healthcare WA 501( c)(3) Line 3 PH&S - Washington
 
 
No
(64) PHN Holdings

20555 Earl Street

Torrance,CA90503
46-1814184 		Strategic/Planning services for PHN CA 501( c)(4) Pending PHS - So California
 
Yes
 
(65) Providence Health Network

20555 Earl Street

Torrance,CA90503
80-0886966 		Prepaid Healthcare CA 501( c)(4) Pending PHN Holdings
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) Alpha Medical Laboratory LLC

611 N Perry
Spokane,WA99202
91-2017347 		Outpatient Lab ID PAML LLC
  		Related       No     No  
(2) Broadway Imaging LLC

500 W Broadway
Missoula,MT59802
52-2405971 		Medical Imaging MT PH&S - MT
  		Related       No     No  
(3) California Laboratory Associates LLC

501 Buena Vista
Burbank,CA91505
27-3888692 		Outpatient Lab CA PHS - So California
  		Related -829,216 -635,430   No     No 85.900 %
(4) Center for Specialty Surgery LLC

11782 SW Barnes Rd
Portland,OR97225
26-3638838 		Ambulatory Surgery Center OR PH&S - OR
  		Related       No     No  
(5) Clackamas Radiation Oncology Center LLC

4400 NE Halsey St Bldg II 495
Portland,OR97213
26-0381897 		Radiation Oncology OR PH&S - OR
  		Related       No     No  
(6) Ctr for Med Imaging-Bridgeport LLC

4400 NE Halsey St Bldg II 495
Portland,OR97213
26-0796953 		Imaging - Diagnostics OR PH&S - OR
  		Related       No     No  
(7) Ctr for MedImaging-Tanasbourne LLC

4400 NE Halsey St Bldg II 495
Portland,OR97213
20-0477972 		Imaging - Diagnostics OR PH&S - OR
  		Related       No     No  
(8) Greater Valley Medical Building LP

501 S Buena Vista St
Burbank,CA91505
95-4570858 		Real Estate - MOB CA PHS - So California
  		Investment 264,734 4,166,343   No     No 50.000 %
(9) Medalia Healthcare LLC

1801 Lind Ave SW 9016
Renton,WA98057
91-1660459 		Physician Benefits WA PH&S - WA
  		Investment       No     No  
(10) Minor & James Medical PLLC

515 Minor Avenue 200
Seattle,WA98104
91-1340223 		Physician Clinic WA Swedish MJM Holdings Inc
  		N/A       No     No  
(11) Mountainstar Clinical Laboratories LLC

611 N Perry
Spokane,WA99202
26-1345983 		Outpatient Lab MT PAML LLC
  		Related       No     No  
(12) Oregon Advanced Imaging LLC

881 OHare Parkway
Medford,OR97504
45-0471748 		Medical Imaging OR PH&S - OR
  		Related       No     No  
(13) Oregon Outpatient Surgery Center

7300 SW Childs Rd
Tigard,OR97224
22-3883387 		Ambulatory Surgery Center OR PH&S - OR
  		Related       No     No  
(14) PacLab LLC

611 N Perry
Spokane,WA99202
91-1743952 		Outpatient Lab WA PH&S - WA
  		Related       No     No  
(15) Pathology Associates Medical Laboratories LLC

611 N Perry
Spokane,WA99202
27-0943279 		Outpatient Lab WA Bourget Health Services Inc
  		Related       No     No  
(16) PETCT Imaging at Swedish Cancer Institute LLC

1221 Madison Street
Seattle,WA98104
20-3132044 		Medical Imaging WA Swedish Health Services
  		Related       No     No  
(17) Portland Medical Imaging LLC

4400 NE Halsey St Bldg II 495
Portland,OR97213
20-1054971 		Imaging - Diagnostics OR PH&S - OR
  		Related       No     No  
(18) Prov Radiation Oncology Develop Assn LLC

4401 NE Halsey St Bldg II 495
Portland,OR97213
26-0682491 		Real Estate - MOB OR PH&S - OR
  		Investment       No     No  
(19) Providence Imaging Center

3340 Providence Drive
Anchorage,AK99508
92-0118807 		Medical Imaging AK PH&S - WA
  		Related       No     No  
(20) Providence Partners for Health LLC

501 S Buena Vista St
Burbank,CA91505
45-4041798 		Clinical Quality & Integration CA PHS - So California
  		Related -56,410 893,410   No     No 50.000 %
(21) ProvidenceUSP Santa Clarita GP LLC

11550 Indian Hills Road 160
Mission Hills,CA91345
20-2829660 		Ambulatory Surgery Center CA PHS - So California
  		Related 422,940 2,744,191   No     No 51.000 %
(22) ProvidenceUSP Surgery Ctrs LLC

11550 Indian Hills Road 160
Mission Hills,CA91345
20-0905938 		Ambulatory Surgery Center CA PHS - So California
  		Related       No     No  
(23) Southern Idaho Regional Laboratory LLC

611 N Perry
Spokane,WA99202
82-0511819 		Outpatient Lab ID PAML LLC
  		Related       No     No  
(24) Tri-Cities Laboratory LLC

611 N Perry
Spokane,WA99202
91-1773986 		Outpatient Lab WA PAML LLC
  		Related       No     No  
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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Providence Health Ventures Inc

4101 Torrance Blvd
Torrance,CA90503
33-0122216 		Investment CA N/A
 C         No
(2) Caron Health Corporation

510 W Front St
Missoula,MT59802
81-0486082 		Medical Physician Service MT N/A
 C         No
(3) Providence Health Care Ventures Inc

101 W 8th Ave TAF C-9
Spokane,WA99204
90-0155714 		Clinical/Medical Lab WA N/A
 C         No
(4) Providence Physician Services Co

101 W 8th Ave TAF C-9
Spokane,WA99204
91-1216033 		Clinical/Medical Lab WA N/A
 C         No
(5) Yakima Medical Arts Inc

611 N Perry 100
Spokane,WA99202
91-0787963 		Rental Real Estate WA N/A
 C         No
(6) Bourget Health Services Inc

PO Box 2687
Spokane,WA99220
91-1354431 		Clinical/Medical Lab WA N/A
 C         No
(7) 1221 Madison Street Owners Assoc

747 Broadway
Seattle,WA98122
20-1954319 		Owners' Association WA N/A
 C         No
(8) Washington Cancer Centers PC

1560 N 115th G-16
Seattle,WA98133
91-1792791 		Cancer Treatment WA N/A
 C         No
(9) Western HealthConnect Ventures Inc

1801 Lind Ave SW 9016
Renton,WA98057
80-0953654 		Investment WA N/A
 C         No
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) Providence Health & Services Foundation

 C 3,849,224 Cost
(2) Providence Little Company of Mary Foundation

 C 6,579,570 Cost
(3) Providence Little Company of Mary Foundation

 B 2,945,631 Cost
(4) Providence Health & Services Foundation

 B 4,616,759 Cost


Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
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)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V?UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


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