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.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
KADLEC REGIONAL MEDICAL CENTER
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
888 SWIFT BLVD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
RICHLAND, WA993523583
D Employer identification number

91-0655392
E Telephone number

G Gross receipts $ 442,282,017
F Name and address of principal officer:
Lane Savitch
888 SWIFT BLVD
RICHLAND,WA993523583
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.kadlec.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: 1947
M State of legal domicile: WA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: The mission of Kadlec Regional Medical Center is to provide quality health care to every patient.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 16
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 16
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 3,231
6 Total number of volunteers (estimate if necessary) ............. 6 483
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) ......... 1,547,709 3,082,689
9 Program service revenue (Part VIII, line 2g) ......... 384,778,671 296,970,742
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 3,724,851 5,899,402
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 52,915 135,732,798
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 390,104,146 441,685,631
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 18,257,275
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) 196,012,072 232,751,762
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet586,951    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 178,947,836 227,174,180
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 374,959,908 478,183,217
19 Revenue less expenses. Subtract line 18 from line 12....... 15,144,238 -36,497,586
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 434,880,580 480,145,478
21 Total liabilities (Part X, line 26)............. 257,365,650 302,326,276
22 Net assets or fund balances. Subtract line 21 from line 20..... 177,514,930 177,819,202
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 (2014)
Form 990 (2014)
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: The mission of Kadlec Regional Medical Center is to provide quality health care to every patient.
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 $ 204,945,755 including grants of $   ) (Revenue $ 167,391,778 )
When Kadlec opened its doors in 1944, the hospital was established to care for the Hanford area workers and their families. Since then, we have grown to a regional medical center providing care for the people throughout the Mid-Columbia.As a not-for-profit, private corporation governed by local volunteer trustees, our decisions are made with our community's best interest in mind. We are dedicated to bringing you and your family not only some of the latest high-tech medical equipment but our staff is committed to providing all our patients with compassionate, high quality care. The Medical Center is a licensed 200+ bed acute-care facility providing both inpatient and outpatient medical services for citizens of Richland, Kennewick, and Pasco, Washington as well as surrounding communities and Northeast Oregon.Kadlec is the home to a growing open heart surgery and interventional cardiology program, the region's only level III Neonatal Intensive Care Unit, a world-class all digital outpatient imaging center as well as a number of other innovative services and programs. Outpatient care: Kadlec introduced a new concept in outpatient care with the opening of its Healthplex in 2014. It is the home to over 20 outpatient services and programs. The 50,000 square-foot facility located in Richland also includes a health library, meeting space, a demonstration kitchen, indoor and outdoor walking paths and a retail shop with difficult-to-find specialty medical equipmentt. Also in 2014, Kadlec announced its accreditation by the Accreditation Council for Graduate Medical Education for a new Family Medicine Residency Program. The first class of six residents was announced in the spring of 2015, with the program getting underway that summer. The program will add six residents a year to the three-year program.In 2014, Kadlec was recognized as a Top Performer on Key Quality Measures by The Joint Commission. Kadlec was one of 17 hospitals in the state to receive this distinction, and one of nine in the four core measures of heart attack, heart failure, pneumonia and surgical care. Kadlec was also the first hospital in the area to receive The Joint Commission's Gold Seal of Approval for hip and knee replacement. Total Admissions: 14,796ER Admissions: 11,881Operating Room Cases: 8,938Births: 2,762Physician Clinic Visits: 350,051
4b (Code:   ) (Expenses $ 139,056,427 including grants of $   ) (Revenue $ 113,575,919 )
Inpatient Care - see line 4a
4c (Code:   ) (Expenses $ 18,902,053 including grants of $   ) (Revenue $ 15,438,467 )
Primary Care - see line 4a
(Code:   ) (Expenses $ 18,257,275 including grants of $ 18,257,275 ) (Revenue $   )
Grants and Allocations to community organizations
(Code:   ) (Expenses $ 1,271,798 including grants of $   ) (Revenue $ 1,038,756 )
Healthcare Joint Ventures - see line 4a
4d Other program services (Describe in Schedule O.)
(Expenses $ 19,529,073 including grants of $ 18,257,275 ) (Revenue $ 1,038,756 )
4e Total program service expensesMediumBullet382,433,308
Form 990 (2014)
Form 990 (2014)
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
 
No
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) ....
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............
18
 
No
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...................
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? Click to see attachment
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
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 domestic 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 or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
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), 501(c)(4), and 501(c)(29) 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 "Yes," 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 (2014)
Form 990 (2014)
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
388
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
3,231
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 FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
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.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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 (2014)
Form 990 (2014)
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
16
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
16
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
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
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
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
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
WA
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, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletKarl E Fritschel CPA

2001 Lind Ave SW 9016
Renton,WA980579016 (425) 525-3339
Form 990 (2014)
Form 990 (2014)
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) Susan Kreid Thru 61214........................................................................
Chair
 2.00
.......................1.00 		X   X       0 0 0
(2) Tom Cowan Thru 61214........................................................................
Vice Chair
 2.00
.......................1.00 		X   X       0 0 0
(3) David Merkley MD Thru 61214........................................................................
Secretary
 2.00
.......................1.00 		X   X       0 0 0
(4) Sandra Gamble Thru 61214........................................................................
Treasurer
 2.00
.......................1.00 		X   X       0 0 0
(5) Steve King Thru 61214........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(6) David Lippes Thru 61214........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(7) Wayne Martin PhD Thru 61214........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(8) Thomas Rado MD Thru 61214........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(9) John Samsell MD Thru 61214........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(10) Ronald Schwartz MD Thru 314........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(11) Sam Volpentest Thru 61214........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(12) Jerry Roach Thru 61214........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(13) Mark Gehlen Thru 61214........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(14) Larry Jecha MD Thru 61214........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(15) Michele Dickinson Thru 61214........................................................................
Member
 2.00
.......................1.00 		X           0 0 0
(16) Michael Holcomb Eff 61314........................................................................
Chair of the Board
 0.10
.......................7.30 		X   X       0 60,360 0
(17) Chauncey Boyle SP Eff 61314........................................................................
Director
 0.10
.......................5.50 		X           0 0 0
Form 990 (2014)
Form 990 (2014)
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) Marian Schubert CSJ -Eff914........................................................................
Director
 0.10
.......................4.50 		X           0 0 0
(19) Phyllis Hughes RSM Eff 61314........................................................................
Director
 0.10
.......................5.00 		X           0 0 0
(20) Carolina Reyes MD Eff 61314........................................................................
Director
 0.10
.......................4.20 		X           0 15,360 0
(21) Michael A Stein Eff 61314........................................................................
Director
 0.10
.......................6.00 		X           0 15,360 0
(22) Eugene Al Parrish Eff 61314........................................................................
Director
 0.10
.......................5.00 		X           0 15,360 0
(23) Peter J Snow Eff 61314........................................................................
Director
 0.10
.......................5.70 		X           0 20,860 0
(24) Bob Wilson Eff 61314........................................................................
Director
 0.10
.......................5.00 		X           0 18,360 0
(25) Sallye Liner Eff 61314........................................................................
Director
 0.10
.......................4.20 		X           0 15,360 0
(26) Ellen L Wolf Eff 61314........................................................................
Director
 0.10
.......................7.10 		X           0 15,360 0
(27) Isiaah Crawford Eff 61314........................................................................
Director
 0.10
.......................4.10 		X           0 15,360 0
(28) Martha Diaz Aszkenazy Eff 61314........................................................................
Director
 0.10
.......................7.70 		X           0 18,360 0
(29) Kirby McDonald Eff 61314........................................................................
Director
 0.10
.......................4.60 		X           0 15,360 0
(30) Dave Olsen Eff 61314........................................................................
Director
 0.10
.......................5.50 		X           0 17,860 0
(31) Charles Chuck Watts Eff 61314........................................................................
Director
 0.10
.......................4.60 		X           0 15,360 0
(32) Rand Wortman........................................................................
President/CEO - KRMC
 56.00
.......................0.00 		    X       0 0 0
(33) Julie Meek........................................................................
VP Finance/CFO - KRMC
 50.00
.......................0.00 		    X       560,919 0 18,399
(34) Joel Gilbertson Eff 61314........................................................................
President
 1.00
.......................59.00 		    X       0 419,681 103,211
(35) Dan Harris Eff 61314........................................................................
VP/Treasurer
 1.00
.......................59.00 		    X       0 576,901 48,417
(36) Cindy Strauss Eff 61314........................................................................
Corp. Secretary
 1.00
.......................59.00 		    X       0 488,042 234,850
(37) Jeffrey Clark........................................................................
VP/Support Services
 50.00
.......................0.00 		    X       426,001 0 18,792
(38) Kirk Harper........................................................................
VP/CNO
 50.00
.......................0.00 		    X       351,047 0 11,426
(39) Dale Hoekema........................................................................
VP/CMO
 50.00
.......................0.00 		    X       592,897 0 24,539
(40) Ken Lester........................................................................
President/Kadlec Clinic
 50.00
.......................0.00 		    X       522,337 0 36,256
(41) David Roach........................................................................
VP/CIO
 50.00
.......................0.00 		    X       444,130 0 17,056
(42) Lane Savitch........................................................................
President/ CEO
 50.00
.......................0.00 		    X       635,947 0 12,349
(43) Glenn Welch........................................................................
VP/Foundation Develop. Dir.
 6.00
.......................40.00 		    X       313,510 0 3,889
(44) William Wingo........................................................................
VP/Corporate Counsel
 50.00
.......................0.00 		    X       476,263 0 18,399
(45) Mike Butler........................................................................
President/Operations & Services
 1.00
.......................59.00 		      X     0 1,540,500 492,128
(46) Debra Canales........................................................................
EVP/Chief People & Experience Ofc.
 1.00
.......................55.00 		      X     0 1,076,219 23,317
(47) Lisa Vance........................................................................
SVP/Clinical Program Services
 1.00
.......................59.00 		      X     0 709,715 58,431
(48) Randy Axelrod MD........................................................................
EVP/Clinical & Patient Svcs
 1.00
.......................59.00 		      X     0 701,506 245,640
(49) Jack Friedman........................................................................
SVP/Account Care & Payor Rel.
 1.00
.......................49.00 		      X     0 596,381 177,566
(50) Aaron Martin........................................................................
SVP/Strategy & Innovation
 1.00
.......................64.00 		      X     0 563,108 18,041
(51) Craig L Wright MD........................................................................
SVP/Physician Svcs
 1.00
.......................59.00 		      X     0 549,952 312,082
(52) Janice Newell........................................................................
SVP/Chief Information Officer
 1.00
.......................54.00 		      X     0 529,442 220,834
(53) Deborah Burton........................................................................
SVP/Chief Nrsg. Officer
 1.00
.......................59.00 		      X     0 519,689 55,382
(54) David Brown........................................................................
VP/Strategy & Business Development
 1.00
.......................54.00 		      X     0 493,612 143,130
(55) Orest Holubec........................................................................
SVP/Marketing & Communications
 1.00
.......................54.00 		      X     0 486,207 53,563
(56) Mark Gargett........................................................................
VP/Digital Integration
 1.00
.......................49.00 		      X     0 476,541 80,347
(57) Gary Flaming........................................................................
SVP/Chief Risk Officer
 1.00
.......................54.00 		      X     0 415,719 89,217
(58) Teresa Spalding........................................................................
VP/Revenue Cycle
 1.00
.......................59.00 		      X     0 414,859 44,903
(59) Mike Waters........................................................................
VP,CAO/Physician Services
 1.00
.......................64.00 		      X     0 354,643 38,345
(60) Dave Hunter........................................................................
VP/Supply Chain Management
 1.00
.......................54.00 		      X     0 351,919 68,009
(61) Steve Burdick........................................................................
CE/Southeast WA. Region
 1.00
.......................59.00 		      X     0 306,230 98,428
(62) Dana White........................................................................
VP/Real Estate & Construction
 1.00
.......................54.00 		      X     0 287,642 64,743
(63) Hannan Chaugle........................................................................
Physician
 50.00
.......................0.00 		        X   1,122,697 0 18,425
(64) Iyad Jamall........................................................................
Physician
 50.00
.......................0.00 		        X   965,750 0 4,000
(65) Dae Young Lee........................................................................
Physician
 50.00
.......................0.00 		        X   882,189 0 11,693
(66) Fadi Thabit Abdallah AlQaisi........................................................................
Physician
 50.00
.......................0.00 		        X   867,381 0 15,262
(67) Matthew Fewel........................................................................
Neurosurgeon
 50.00
.......................0.00 		        X   831,598 0 20,993
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 8,992,666 12,117,188 2,902,062
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet361
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
 
No
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
Bouten Construction

PO Box 3507
Spokane,WA99220 		Construction Services 12,207,441
Premier Anesthesia of Richland

2655 Northwinds Pkwy
Alpharetta,GA30009 		Medical Services 4,515,925
Xtend Healthcare

500 W Main St Ste 14
Hendersonville,TN37075 		Medical Services 2,483,477
Davis Partnership Architects

2301 Blake St Ste 100
Denver,CO80205 		Architectural Services 1,859,342
Quorum Health Resources

105 Continental Place
Brentwood,TN37027 		Consulting Services 1,842,199
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet91
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 78,814
e Government grants (contributions)1e 3,003,875
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 3,082,689
Program Service RevenueAmt Business Code
2a Outpatient Revenue 621400 167,124,927 167,124,927    
b Inpatient Revenue 900099 113,394,860 113,394,860    
c Primary Care 621110 15,413,855 15,413,855    
d Healthcare JVs 900099 1,037,100 1,037,100    
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 296,970,742
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 5,783,847     5,783,847
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 975,451  
b Less: rental expenses 562,403  
c Rental income or (loss) 413,048  
d Net rental income or (loss).......MediumBullet 413,048     413,048
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   149,538
b Less: cost or other basis and sales expenses   33,983
c Gain or (loss)   115,555
d Net gain or (loss)..........MediumBullet 115,555     115,555
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a Pharmacy 446110 75,397,866     75,397,866
b Lab 621500 55,253,693     55,253,693
c Cost Recovery 900099 2,622,091 474,178   2,147,913
d All other revenue .... 2,046,100     2,046,100
e Total. Add lines 11a–11d ...... MediumBullet 135,319,750
12 Total revenue. See Instructions......MediumBullet 441,685,631 297,444,920 0 141,158,022
Form 990 (2014)
Form 990 (2014)
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 domestic organizations and domestic governments. See Part IV, line 21 .... 18,257,275 18,257,275
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ....    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............    
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 4,399,482   4,085,972 313,510
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 .... 188,856,004 144,611,758 44,186,750 57,496
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 5,080,138 3,860,152 1,210,083 9,903
9 Other employee benefits ....... 20,926,056 15,665,020 5,220,847 40,189
10 Payroll taxes ........... 13,490,082 10,098,530 3,365,644 25,908
11 Fees for services (non-employees):        
a Management ...... 1,842,199   1,842,199  
b Legal ......... 1,518,025 486 1,488,646 28,893
c Accounting ........... 62,053   62,053  
d Lobbying ........... 100,366   100,366  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 38,082,738 22,772,806 15,306,270 3,662
12 Advertising and promotion .... 1,281,668 959,443 319,764 2,461
13 Office expenses ....... 10,814,870 7,251,112 3,545,404 18,354
14 Information technology ...... 2,431,849 1,820,456 606,723 4,670
15 Royalties ..        
16 Occupancy ........... 11,360,079 8,504,033 2,834,229 21,817
17 Travel ............ 1,355,754 658,215 697,539  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 432,438 323,718 107,889 831
20 Interest ........... 9,699,252 8,921,289 777,963  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 21,527,455 16,115,221 5,370,890 41,344
23 Insurance .............. 3,115,500 2,237,319 878,181  
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 65,812,544 65,812,544    
b Loss on Refinancing 30,127,682 30,127,682    
c Bad Debt 8,907,244 8,907,244    
d Dues, Licenses & Fees 7,202,461 5,473,346 1,715,140 13,975
e All other expenses 11,500,003 10,055,659 1,440,406 3,938
25 Total functional expenses. Add lines 1 through 24e 478,183,217 382,433,308 95,162,958 586,951
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 (2014)
Form 990 (2014)
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 ............. 29,179,320 1 23,865,386
2 Savings and temporary cash investments ......... 491,411 2 73,810
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 59,207,385 4 58,125,188
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 .............   7 1,428,950
8 Inventories for sale or use .............. 2,016,782 8 2,562,515
9 Prepaid expenses and deferred charges .......... 1,660,479 9 2,360,376
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 280,031,868
b Less: accumulated depreciation ..... 10b 12,717,812 210,083,584 10c 267,314,056
11 Investments—publicly traded securities .......... 111,641,008 11 65,366,455
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .....   13 4,645,170
14 Intangible assets ............... 952,000 14 20,820,461
15 Other assets. See Part IV, line 11 ........... 19,648,611 15 33,583,111
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 434,880,580 16 480,145,478
Liabilities 17 Accounts payable and accrued expenses ......... 47,876,041 17 39,168,546
18 Grants payable .................   18  
19 Deferred revenue ................   19 215,591
20 Tax-exempt bond liabilities ............. 185,750,000 20 178,770,000
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 .. 3,429,497 23 11,314,775
24 Unsecured notes and loans payable to unrelated third parties .... 2,079,646 24 4,607,934
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.................... 18,230,466 25 68,249,430
26 Total liabilities. Add lines 17 through 25......... 257,365,650 26 302,326,276
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 .............. 174,252,159 27 177,618,805
28 Temporarily restricted net assets ........... 3,262,771 28 200,397
29 Permanently restricted net assets ...........   29  
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 ........... 177,514,930 33 177,819,202
34 Total liabilities and net assets/fund balances ........ 434,880,580 34 480,145,478
Form 990 (2014)
Form 990 (2014)
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
441,685,631
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
478,183,217
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-36,497,586
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
177,514,930
5
Net unrealized gains (losses) on investments ...............
5
-2,603,565
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
39,405,423
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
177,819,202
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
 
No
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
 
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
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 Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
KADLEC REGIONAL MEDICAL CENTER
 
Employer identification number

91-0655392
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
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
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 listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.)..            
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 section 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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.) ..            
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2014 		(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2015. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

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
2014
Name of the organization
KADLEC REGIONAL MEDICAL CENTER
 
Employer identification number

91-0655392
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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
KADLEC REGIONAL MEDICAL CENTER
  		Employer identification number

91-0655392
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


(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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
KADLEC REGIONAL MEDICAL CENTER
  		Employer identification number

91-0655392
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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
KADLEC REGIONAL MEDICAL CENTER
  		Employer identification number

91-0655392
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. 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) (2014)

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 Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
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) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
KADLEC REGIONAL MEDICAL CENTER
 
Employer identification number

91-0655392
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) 2014

Schedule C (Form 990 or 990-EZ) 2014
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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2011 (b) 2012 (c) 2013 (d) 2014 (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) 2014


Schedule C (Form 990 or 990-EZ) 2014
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? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
100,366
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
100,366
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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Part II-B, Line 1: Dues to AHA and WSHA; payment to Keller McIntyre for Government relations & strategic development for policies and government funding.
Schedule C (Form 990 or 990EZ) 2014

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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
KADLEC REGIONAL MEDICAL CENTER
 
Employer identification number

91-0655392
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 value of contributions to (during year)    
3 Aggregate value of 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)
Revenue 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
Revenue 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) 2014

Schedule D (Form 990) 2014
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, for escrow or custodial account liability?
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 ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
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)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
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 .................   13,605,108 13,605,108
b Buildings ................   194,935,588 3,100,104 191,835,484
c Leasehold improvements ............   1,482,823 213,082 1,269,741
d Equipment ................   66,318,499 9,404,626 56,913,873
e Other .................   3,689,850   3,689,850
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 267,314,056
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
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) Due from Affiliates 669,303
(2) Miscellaneous Receivables 12,525,546
(3) Trustee Held Funds 9,749,005
(4) 457B Contributions 4,916,420
(5) Unamortized Bond Financing Costs 1,725,920
(6) Deposits 490,456
(7) Professional Liability Trust 3,506,461


Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 33,583,111
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  
Bond Premium 21,194,040
457B Contributions 4,916,420
Malpractice Insurance 4,664,999
Due to Affiliates 12,500,000
Third Party Settlements 17,051,787
Miscellaneous Payables 4,809,964
Employee Medical 3,112,220


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 68,249,430
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) 2014

Schedule D (Form 990) 2014
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 (losses) 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 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) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
KADLEC REGIONAL MEDICAL CENTER
 
Employer identification number

91-0655392
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 criteria used 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) .. 		  703 3,210,741   3,210,741 0.680 %
b Medicaid (from Worksheet 3,
column a) .... 		  11,628 53,119,310 32,262,852 20,856,458 4.440 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		  12,331 56,330,051 32,262,852 24,067,199 5.120 %
Other Benefits
            
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		           
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		           
j Total. Other Benefits ..            
k Total. Add lines 7d and 7j .   12,331 56,330,051 32,262,852 24,067,199 5.120 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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
 
No
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
8,907,244
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
79,363,853
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
96,359,028
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-16,995,175
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) 2014
Schedule H (Form 990) 2014
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?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 Kadlec Regional Medical Center
888 Swift Blvd
Richland,WA99352
www.kadlec.org/
HAC.FS.161 		X X         X   Inpatient Rehab  
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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)
Kadlec Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): www.kadlec.org/uploads/CHIP_FINAL_edKWjz.pdf
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Kadlec Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Kadlec Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Kadlec Regional Medical Center Part V, Section B, Line 5: Community Health Needs Assessment was conducted by the Benton Franklin Community Health Alliance (BFCHA). Kadlec is proud to partner with other local health agencies to continue to assess and address community needs through programs and activities that provide treatment and promote health and wellness. Members of the BFCHA and various key partners have worked together to better understand current and future health needs of Benton and Franklin Counties. This process of assessing, prioritizing and addressing health needs in the region was facilitated by local hospitals and public health. It is a strategic, county-wide, community-based approach for creating and maintaining healthy communities. A steering committee of 20+ members representing diverse organizations from across the counties provided oversight and guidance and worked together to better align efforts among community partners and create a more strategic framework for local healthimprovement activities.
Kadlec Regional Medical Center Part V, Section B, Line 6a: Kennewick General Hospital, Lourdes Health Network, and PMH Medical Center
Kadlec Regional Medical Center Part V, Section B, Line 11: See "Community Health Improvement Plan For the People of Benton and Franklin Counties" located at www.kadlec.org/uploads/CHIP_FINAL_edKWjz.pdf
Kadlec Regional Medical Center Part V, Section B, Line 22d: Medicare cost-to-charge ratio.
Part V, Section B, Line 16 Financial Assistance Policy Website Availability
Kadlec Regional Medical Center Part V, Section B, line 16a website: www.kadlec.org/patients-and-visitors/billing-assistance
Kadlec Regional Medical Center Part V, Section B, line 16b website: kadlec.org/uploads/Kadlec_Financial_Assistance_Form_English.pdf
Kadlec Regional Medical Center Part V, Section B, line 16c website: kadlec.org/patients-and-visitors/billing-assistance
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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 I, Line 3c: The organization uses FPG to determine the patient's eligibility for free or discounted care. In addition, the organization will review family assets, including bank statements; the patient's future earning capacity; the existence of other extraordinary family expenses, including rent expenses; and the patient's ability to make payments over time, as reflected by a third party credit report or other documentation.
Part I, Ln 7 Col(f): Bad debt expense represents the amount of gross charges for patients who do not have insurance and which Kadlec was unable to qualify for assistance under either government programs or our internal charity care policy. The Bad Debt expense included on Form 990, Part IX, Line 25(A), but subtracted for purposes of calculating the percentage in this column is $8,907,244.
Part II, Community Building Activities: Kadlec embraces its responsibility to provide for the needs of the communities it serves. Health care is fundamentally different from most other goods and services. It is about the most human and intimate needs of people, their families and communities. This critical difference is why we should work together to preserve and strengthen the not-for-profit sector in health care.Kadlec is actively involved with public, private and other health systems in working towards better health outcomes for the entire community.The organization did not track or report the financial impact of their community building activities.
Part III, Line 2: Bad debt expense represents the amount of gross charges for patients who do not have insurance and which Providence was unable to qualify for assistance under either government programs or our internal charity care policy.
Part III, Line 4: The Health System provides for an allowance against patient accounts receivable for amounts that could become uncollectible. The Health System estimates this allowance based on the aging of accounts receivable, historical collection experience by payor, and other relevant factors. There are various factors that can impact the collection trends, such as changes in the economy, which in turn have an impact on unemployment rates and the number of uninsured and underinsured patients, the increased burden of copayments to be made by patients with insurance coverage and business practices related to collection efforts. These factors continuously change and can have an impact on collection trends and the estimation process used by the Health System. The provision for bad debts in 2014 has decreased from 2013 as a result of the expansion of Medicaid programs and initiatives to assist patients in their Medicaid enrollment. The Health System records a provision for bad debts in the period of services on the basis of past experience, which has historically indicated that many patients are unresponsive or are otherwise unwilling to pay the portion of their bill for which they are financially responsible.
Part III, Line 8: It is Kadlec's policy to exclude any Medicare shortfall from Community Benefit information. The amount reported on Part III, Section B, line 6, was determined by applying the Cost-to-Charge Ratio to the Medicare revenue.
Part III, Line 9b: Billing and Collection Practices1. Kadlec makes all reasonable attempts to confirm that patients are not eligible for assistance programs prior to collection agency assignment.2. Kadlec activity prior to transferring an account - Prior to transfer to a collection agency, Kadlec will send a minimum of 3 statements and make two phone attempts to the patient at the address and phone number provided by the patient. Statements and communications will inform the patient of their financial responsibility and of Financial Assistance.3. In cases where a voluntary trust deed has secured a Kadlec debt, Kadlec does not execute a lien that forces the sale, vacancy or foreclosure of an assistance patient's primary residence to pay for outstanding medical bills.
Part VI, Line 2: The Strategic issues were identified through a process called compression planning. The committee found consensus around two strategic issues: How to promote healthy weight and reduce obesity, and how to improve access to health care services.These issues were identified as having the greatest feasibility based on the available resources, the potential for change,alignment with the community vision, and overlapped in all four assessments. As the core team examined the evidence, it became clear that root-cause analysis was necessary to identify the factors that resulted in the health issues.For example, mental illness and prenatal care were both identified as top concerns. Through dialogue, the committee discovered that both fit well within the access to health care services strategic issue.Cultural differences, both racial and economic, were discussed as having a potential role in contributing to an increasedincidence of obesity and a higher propensity for emergency room use. These and other factors frequently have causal relationships associated with both strategic issues.Those connections will become more apparent as specific objectives for access and obesity are developed in the next phase of the assessment process. Communication and education will play an important role in implementing the strategies and activities to work towards community improvement.How to PROMOTE HEALTHY WEIGHT AND REDUCE OBESITYGoal #1: Community members will make more healthy food choicesGoal #2: Community members will be more physically activeGoal #3: Mothers will breastfeed their infants (when possible)How to improve ACCESS TO HEALTH CARE SERVICESGoal #1: Resources will be identified to lessen the barriers and costs of healthcareGoal #2: The community will experience coordinated health care.Goal #3: The health system will have the capacity to meet the needs of the community
Part VI, Line 3: Kadlec posts notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings. Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Kadlec ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Kadlec attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations. Kadlec shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients.
Part VI, Line 4: Benton and Franklin Counties contain the metropolitan areas of three neighboring cities: Kennewick, Pasco and Richland (commonly called the Tri-Cities). These cities are located at the confluence of the Yakima, Snake, and Columbia Rivers in the semi-arid region of southeastern Washington. Other cities situated within the area include Benton City, Connell, Kahlotus, Patterson, Prosser, and West Richland. Located approximately 20 miles from TriCities, Prosser is the county seat for Benton County and is home to several of the area's largest wineries. Pasco is the county seat for Franklin County and is home to large agricultural processors.The total population of Benton and Franklin Counties was 253,340 (2010 Census) and the TriCities is the fourth-largest metropolitan area in Washington State. According to the US Census Bureau, the Kennewick-Pasco-Richland metropolitan area was the fastest growing in the nation from April 1, 2010 to July 1, 2011. Franklin County experienced an average growth rate of 4.8% per year over the past 10 years and Benton County has seen an average growth of 2.0% per year during the same time frame. In 2012, according to the U.S. Census, the area population grew to an estimated 262,500 people.The median age of each county is younger than Washington State at 37.3; Benton County has a median age of 35.6 years; Franklin County has a median age of 28.4 years. In 2010, the median household income was $57,603 in Benton County and $47,719 in Franklin County, compared to $58,890 in Washington State and $52,762 in the U.S.According to the Washington State Office of Financial Management, the 2011 unemployment rate for Washington State was 9.2%, which was higher than Benton (7.6%) and Franklin (8.8%) Counties. In Benton County, 78% of 9th grade students graduate high school in four years, and 63% of adults age 25-44 have attended college. In Franklin County, 68% of 9th grade students graduate high school within 4 years and 40% of adults aged 25-44 have attended college. According to the U.S. Census Bureau, Benton County's 2011 population was estimated to be 80.8% Caucasian, and 18.8% of Hispanic/Latino ethnicity. Franklin County's population was 53.3% Caucasian, and approximately 50.5% was Hispanic/Latino.
Part VI, Line 6: During 2014, Kadlec celebrated its 70th anniversary, reflecting on how it changed the lives of so many it has served through the years. But, 2014 was also a year Kadlec looked forward with the announcement of its affiliation with the not-for-profit health system Providence Health & Services. The Providence affiliation brought important support to Kadlec as it continues to meet the growing medical needs of the region. It also helped jump-start projects including:Construction of the final four-story of the River Pavilion, which includes a new Intensive Care Unit and additional patient roomsConstruction of the long-awaited 600-space parking garage on the Kadlec campusConstruction of a dedicated electrophysiology lab to support Kadlec's growing cardiac servicesCommitment of $3 million to Columbia Basin College for a second health science centerKadlec's affiliation with Providence also allowed Kadlec and Washington State University Tri-Cities to team together to improve the future of health care in the region with the establishment of an $18-million endowment through Kadlec Foundation. Earnings on the endowment will fund five doctoral facility positions at WSU Tri-Cities to increase the number of nurses earning a Doctor of Nursing Practice (DNP) degree in the region.Providence Health & Services owns or operates 32 general acute care hospitals, three ambulatory care centers, five medical groups, six long-term care facilities, seven homecare and hospice entities, five assisted living facilities, a children's nursing center, a high school, a university, 13 low-income housing projects, the Health Plan, a health services contractor, two programs of all inclusive care for the elderly, and 22 controlled fundraising foundations.The Health System provides inpatient, outpatient, primary care, and home care services in Alaska, Washington, Montana, Oregon and Southern California. The Health System operates these businesses primarily in the greater metropolitan areas of Anchorage, Alaska; Everett, Seattle, Edmonds, Issaquah, Spokane and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California.
Part VI, Line 7, Reports Filed With States WA
Schedule H (Form 990) 2014
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
2014
Open to Public
Inspection
Name of the organization
KADLEC REGIONAL MEDICAL CENTER
 
Employer identification number
91-0655392
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 Domestic Organizations and Domestic Governments. 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 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) Kadlec Foundation
800 Swift Blvd
Richland,WA99352 		23-7005501 501(c)(3) 18,000,000       Community health support
(2) Washington State University Foundation
255 E Main Street 201
Pullman,WA99163 		91-1075542 501(c)(3) 54,800       Support of nursing program
(3) Grace Clinic
800 W Canal Drive
Kennewick,WA99336 		77-0592408 501(c)(3) 52,500       Community health support
(4) March of Dimes Foundation
1275 Mamaroneck Avenue
White Plains,NY10605 		13-1846366 501(c)(3) 20,000       Community health support
(5) Children's Developmental Center
1549 Georgia Ave SE
Richland,WA99352 		91-0876634 501(c)(3) 11,500       Community health support
(6) American Heart Association Inc
7272 Greenville Ave
Dallas,TX75231 		13-5613797 501(c)(3) 10,000       2014 Heart Chase
(7) Girls on the Run Southeast WA
1307 Goethals Dr
Richland,WA99354 		46-3677125 501(c)(3) 10,000       Community health support
(8) Tri-Cities Cancer Center
7350 W Deschutes Ave No A
Kennewick,WA99336 		91-1594526 501(c)(3) 10,000       2014 Umbrella support
(9) Leadership Tri-Cities
1110 N Center Parkway
Kennewick,WA99336 		91-1723036 501(c)(3) 7,000       Community health support
(10) American Diabetes Association
1701 N Beauregard St
Alexandria,VA22311 		13-1623888 501(c)(3) 6,000       Walk to Fight Diabetes




2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
10
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. 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












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: Kadlec provides grants and support to organizations that have a current 501(C)(3) exempt status and whose mission is consistent with the exempt purpose of Kadlec Regional Medical Center.
Schedule I (Form 990) 2014


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 Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
KADLEC REGIONAL MEDICAL CENTER
 
Employer identification number

91-0655392
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
Yes
 
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
Yes
 
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
 
No
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), 501(c)(4), and 501(c)(29) organizations 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) 2014

Schedule J (Form 990) 2014
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 in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1Julie MeekVP Finance/CFO - KRMC (i)
(ii)		 318,178
...............................
0 		225,241
...............................
0 		17,500
...............................
0 		14,300
...............................
0 		4,099
...............................
0 		579,318
...............................
0 		0
...............................
0
2Joel Gilbertson Eff 61314President (i)
(ii)		 0
...............................
402,181 		0
...............................
0 		0
...............................
17,500 		0
...............................
81,301 		0
...............................
21,910 		0
...............................
522,892 		0
...............................
0
3Dan Harris Eff 61314VP/Treasurer (i)
(ii)		 0
...............................
429,749 		0
...............................
147,152 		0
...............................
0 		0
...............................
37,904 		0
...............................
10,513 		0
...............................
625,318 		0
...............................
0
4Cindy Strauss Eff 61314Corp. Secretary (i)
(ii)		 0
...............................
470,542 		0
...............................
0 		0
...............................
17,500 		0
...............................
212,878 		0
...............................
21,972 		0
...............................
722,892 		0
...............................
0
5Jeffrey ClarkVP/Support Services (i)
(ii)		 235,011
...............................
0 		173,490
...............................
0 		17,500
...............................
0 		12,783
...............................
0 		6,009
...............................
0 		444,793
...............................
0 		0
...............................
0
6Kirk HarperVP/CNO (i)
(ii)		 211,811
...............................
0 		139,236
...............................
0 		0
...............................
0 		9,742
...............................
0 		1,684
...............................
0 		362,473
...............................
0 		0
...............................
0
7Dale HoekemaVP/CMO (i)
(ii)		 356,297
...............................
0 		219,100
...............................
0 		17,500
...............................
0 		14,300
...............................
0 		10,239
...............................
0 		617,436
...............................
0 		0
...............................
0
8Ken LesterPresident/Kadlec Clinic (i)
(ii)		 301,487
...............................
0 		220,850
...............................
0 		0
...............................
0 		0
...............................
0 		36,256
...............................
0 		558,593
...............................
0 		0
...............................
0
9David RoachVP/CIO (i)
(ii)		 262,140
...............................
0 		181,990
...............................
0 		0
...............................
0 		12,957
...............................
0 		4,099
...............................
0 		461,186
...............................
0 		0
...............................
0
10Lane SavitchPresident/ CEO (i)
(ii)		 343,328
...............................
0 		275,119
...............................
0 		17,500
...............................
0 		8,250
...............................
0 		4,099
...............................
0 		648,296
...............................
0 		0
...............................
0
11Glenn WelchVP/Foundation Develop. Dir. (i)
(ii)		 208,647
...............................
0 		104,863
...............................
0 		0
...............................
0 		0
...............................
0 		3,889
...............................
0 		317,399
...............................
0 		0
...............................
0
12William WingoVP/Corporate Counsel (i)
(ii)		 262,256
...............................
0 		196,507
...............................
0 		17,500
...............................
0 		14,300
...............................
0 		4,099
...............................
0 		494,662
...............................
0 		0
...............................
0
13Mike ButlerPresident/Operations & Services (i)
(ii)		 0
...............................
983,000 		0
...............................
540,000 		0
...............................
17,500 		0
...............................
466,289 		0
...............................
25,839 		0
...............................
2,032,628 		0
...............................
0
14Debra CanalesEVP/Chief People & Experience Ofc. (i)
(ii)		 0
...............................
706,646 		0
...............................
265,000 		0
...............................
104,573 		0
...............................
11,700 		0
...............................
11,617 		0
...............................
1,099,536 		0
...............................
0
15Lisa VanceSVP/Clinical Program Services (i)
(ii)		 0
...............................
434,708 		0
...............................
246,809 		0
...............................
28,198 		0
...............................
38,628 		0
...............................
19,803 		0
...............................
768,146 		0
...............................
0
16Randy Axelrod MDEVP/Clinical & Patient Svcs (i)
(ii)		 0
...............................
681,191 		0
...............................
0 		0
...............................
20,315 		0
...............................
222,505 		0
...............................
23,135 		0
...............................
947,146 		0
...............................
0
17Jack FriedmanSVP/Account Care & Payor Rel. (i)
(ii)		 0
...............................
531,342 		0
...............................
47,539 		0
...............................
17,500 		0
...............................
151,650 		0
...............................
25,916 		0
...............................
773,947 		0
...............................
0
18Aaron MartinSVP/Strategy & Innovation (i)
(ii)		 0
...............................
463,108 		0
...............................
100,000 		0
...............................
0 		0
...............................
11,700 		0
...............................
6,341 		0
...............................
581,149 		0
...............................
0
19Craig L Wright MDSVP/Physician Svcs (i)
(ii)		 0
...............................
519,920 		0
...............................
0 		0
...............................
30,032 		0
...............................
293,065 		0
...............................
19,017 		0
...............................
862,034 		0
...............................
0
20Janice NewellSVP/Chief Information Officer (i)
(ii)		 0
...............................
511,942 		0
...............................
0 		0
...............................
17,500 		0
...............................
208,385 		0
...............................
12,449 		0
...............................
750,276 		0
...............................
0
21Deborah BurtonSVP/Chief Nrsg. Officer (i)
(ii)		 0
...............................
346,075 		0
...............................
156,114 		0
...............................
17,500 		0
...............................
31,767 		0
...............................
23,615 		0
...............................
575,071 		0
...............................
0
22David BrownVP/Strategy & Business Development (i)
(ii)		 0
...............................
354,112 		0
...............................
139,500 		0
...............................
0 		0
...............................
121,500 		0
...............................
21,630 		0
...............................
636,742 		0
...............................
0
23Orest HolubecSVP/Marketing & Communications (i)
(ii)		 0
...............................
348,449 		0
...............................
120,258 		0
...............................
17,500 		0
...............................
31,673 		0
...............................
21,890 		0
...............................
539,770 		0
...............................
0
24Mark GargettVP/Digital Integration (i)
(ii)		 0
...............................
360,689 		0
...............................
115,852 		0
...............................
0 		0
...............................
57,037 		0
...............................
23,310 		0
...............................
556,888 		0
...............................
0
25Gary FlamingSVP/Chief Risk Officer (i)
(ii)		 0
...............................
264,317 		0
...............................
133,902 		0
...............................
17,500 		0
...............................
70,770 		0
...............................
18,447 		0
...............................
504,936 		0
...............................
0
26Teresa SpaldingVP/Revenue Cycle (i)
(ii)		 0
...............................
312,558 		0
...............................
84,801 		0
...............................
17,500 		0
...............................
32,445 		0
...............................
12,458 		0
...............................
459,762 		0
...............................
0
27Mike WatersVP,CAO/Physician Services (i)
(ii)		 0
...............................
324,643 		0
...............................
30,000 		0
...............................
0 		0
...............................
28,185 		0
...............................
10,160 		0
...............................
392,988 		0
...............................
0
28Dave HunterVP/Supply Chain Management (i)
(ii)		 0
...............................
300,714 		0
...............................
33,705 		0
...............................
17,500 		0
...............................
49,466 		0
...............................
18,543 		0
...............................
419,928 		0
...............................
0
29Steve BurdickCE/Southeast WA. Region (i)
(ii)		 0
...............................
264,563 		0
...............................
24,668 		0
...............................
16,999 		0
...............................
76,395 		0
...............................
22,033 		0
...............................
404,658 		0
...............................
0
30Dana WhiteVP/Real Estate & Construction (i)
(ii)		 0
...............................
270,802 		0
...............................
0 		0
...............................
16,840 		0
...............................
43,097 		0
...............................
21,646 		0
...............................
352,385 		0
...............................
0
31Hannan ChauglePhysician (i)
(ii)		 618,065
...............................
0 		487,132
...............................
0 		17,500
...............................
0 		14,300
...............................
0 		4,125
...............................
0 		1,141,122
...............................
0 		0
...............................
0
32Iyad JamallPhysician (i)
(ii)		 636,575
...............................
0 		329,175
...............................
0 		0
...............................
0 		0
...............................
0 		4,000
...............................
0 		969,750
...............................
0 		0
...............................
0
33Dae Young LeePhysician (i)
(ii)		 453,123
...............................
0 		411,566
...............................
0 		17,500
...............................
0 		5,285
...............................
0 		6,408
...............................
0 		893,882
...............................
0 		0
...............................
0
34Fadi Thabit Abdallah AlQaisiPhysician (i)
(ii)		 669,727
...............................
0 		180,154
...............................
0 		17,500
...............................
0 		11,239
...............................
0 		4,023
...............................
0 		882,643
...............................
0 		0
...............................
0
35Matthew FewelNeurosurgeon (i)
(ii)		 831,598
...............................
0 		0
...............................
0 		0
...............................
0 		14,250
...............................
0 		6,743
...............................
0 		852,591
...............................
0 		0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
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 PRE-AFFILIATION (Through 6/12/14): The Board is allowed to take their companion on the annual Board Retreat. The Travel Policy states that it will only reimburse unpaid Board members for spouse's meals and baggage fees. Meadow Springs Country Club dues are paid by the Medical Center. Country club dues are a bona fide business expense and are not reported as taxable income. POST AFFILIATION: 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 People and Experience 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 2014, there were three First Class tickets utilized by Officers, Directors or Key Employees listed on Form 990, Part VII. 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 2014, the following Listed Persons received gross-up payments: Debra Canales Lisa Vance Craig Wright, MD 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 People and Experience 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 2014, the following Listed Persons received relocation/housing program payments: Debra Canales Lisa Vance Craig Wright, MD The amounts reported for these relocation/housing payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation.
Part I, Line 3 PRE-AFFILIATION: The reporting organization uses an independent third party to determine appropriate compensation. These recommendations are reviewed and approved by the Compensation Committee.
Part I, Line 4b NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan 1) Joel Gilbertson a) SERP Earned but not Vested- $48,936 b) SERP Interest Credit - $13,976 2) Dan Harris a) Taxable CBRP Earned but not Paid - $1,363 b) Taxable SERP Earned but not Paid - $145,789 c) SERP Interest Credit - $5,721 3) Cindy Strauss a) SERP Earned but not Vested - $173,177 b) SERP Interest Credit - $20,200 4) Mike Butler a) SERP Earned but not Vested - $375,980 b) SERP Interest Credit - $55,936 5) Lisa Vance a) Taxable CBRP Paid - $65 b) Taxable SERP Earned but not Paid - $246,744 c) SERP Interest Credit - $5,405 6) Randy Axelrod a) SERP Earned but not Vested - $210,806 7) Jack Friedman a) Taxable SERP Earned but not Paid - $47,539 b) SERP Interest Credit - $100,696 8) Craig Wright, MD a) SERP Earned but not Vested - $172,424 b) SERP Interest Credit - $91,172 9) Janice Newell a) SERP Earned but not Vested - $185,427 b) SERP Interest Credit - $4,758 10) Deborah Burton a) Taxable SERP Earned but not Paid - $156,114 b) SERP Interest Credit - $4,843 11) David Brown a) SERP Earned but not Vested - $74,010 b) SERP Interest Credit - $19,770 12) Orest Holubec a) SERP Earned but not Vested - $18,642 b) SERP Interest Credit - $1,332 13) Mark Gargett a) Taxable SERP Earned but not Paid - $111,973 b) Taxable CBRP Paid - $3,879 c) SERP Interest Credit - $22,957 15) Gary Flaming a) Taxable SERP Earned but not Paid - $127,565 b) Taxable CBRP Paid - $6,338 c) SERP Interest Credit - $1,640 16) Teresa Spalding a) Taxable SERP Earned but not Paid - $84,574 b) Taxable CBRP Paid - $227 17) Mike Waters a) SERP Earned but not Vested - $9,742 b) SER Interest Credit - $243 18) Dave Hunter a) Taxable SERP Earned but not Paid - $33,139 b) Taxable CBRP Paid - $566 c) SERP Interest Credit - $19,890 19) Steve Burdick a) Taxable SERP Earned but not Paid - $24,668 b) SERP Interest Credit - $39,558 c) ESP Interest Credit - $2,889 20) Dana White a) SERP Earned but not Vested - $14,595
EXECUTIVE PERFORMANCE AWARDS - POST-AFFILIATION 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. In 2014, 100 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's six strategic priorities of: creating healthier communities together, inspire and develop our people, building enduring relationships with consumers, create alignment with clinicians & care teams, develop and thrive under new care delivery & economic models, and grow by optimizing expert-to-expert capabilities. For 2014, the percent allocation for each of these strategic priorities is outlined below: * Creating Healthier Communities, Together Community Benefit: 10% System Leadership Council - 10% System Role including Providence Senior & Community Services (PSCS) - 10% Region Role Regional Chief Executives (RCEs) and Reports * Inspire and Develop Our People Core Leader Engagement: 10% System Leadership Council - 10% Providence Strategic and Management Services (PSMS) System Role including PSCS - 10% Region Role RCEs and Reports Employee Health Index: 5% System Leadership Council - 5% System Role including PSCS - 5% System Region Role RCEs and Reports * Building Enduring Relationships with Consumers MyChart Activations: 5% System Leadership Council - 5% System Role including PSCS - 5% Region Role RCEs and Reports Patient Loyalty Index: 5% System Leadership Council - 5% System Role including PSCS - 5% Region Role RCEs and Reports * Create Alignment with Clinicians & Care Teams Clinical Excellence Index: 10% System Leadership Council - 10% System Role including PSCS - 10% Region Role RCEs and Reports * Develop and Thrive Under New Care Delivery & Economic Models Salary Expense as % of Net Service Revenue: 10% System Leadership Council - 10% PSMS System Role including PSCS - 10% Region Role RCEs and Reports Supply Expense as % of Net Service Revenue: 5% System Leadership Council - 5% System Role including PSCS - 5% Region Role RCEs and Reports Primary Care Panel Size: 5% System Leadership Council - 5% System Role including PSCS - 5% Region Role RCEs and Reports Clinical Network Performance: 10% System Leadership Council - 10% System Role including PSCS - 10% System Region Role RCEs and Reports * Grow by Optimizing Expert-to-Expert Capabilities Free Cash Flow: 15% System Leadership Council - 15% System Role including PSCS - 15% Region Role RCEs and Reports Unduplicated Patient Count: 10% System Leadership Council - 10% System Role including PSCS - 10% Region Role RCEs and Reports TOTAL ALLOCATION: 100% Leadership Council - 100% System Role including PSCS - 100% Region Role RCEs and Reports
Schedule J (Form 990) 2014

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.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
KADLEC REGIONAL MEDICAL CENTER
 
Employer identification number
91-0655392
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 Washington Health Care Facilities Authority
  		91-1108929 93978HKM6 11-06-2014 200,084,061 Refinance outstanding bonds to bring into the Providence Obligated Group   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . .        
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 200,084,061      
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 1,674,013      
8 Credit enhancement from proceeds . . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 198,347,949      
11 Other spent proceeds . . . . . . . . . . . . . .        
12 Other unspent proceeds . . . . . . . . . . . . . . 62,099      
13 Year of substantial completion . . . . . . . . . . . . 2014
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X            
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X            
16 Has the final allocation of proceeds been made? . . . . . . . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . 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            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X            
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
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              
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? X              
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   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 %      
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 %      
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 %      
7 Does the bond issue meet the private security or payment test? . . . . .   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            
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              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X            
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . . X              
b Exception to rebate? . . . . . . . .   X            
c No rebate due? . . . . . . . .   X            
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X            
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider . . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
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            
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            
7 Has the organization established written procedures to monitor the requirements of section 148? . . . 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              
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Schedule K (Form 990) 2014

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 990-EZ 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
2014
Open to Public
Inspection
Name of the organization
KADLEC REGIONAL MEDICAL CENTER
 
Employer identification number

91-0655392
Return Reference Explanation
Form 990, Part VI, Section A, line 3 The Pre-Affiliation Board of Directors hired Quorum Health Resources as a Management Company to oversee day to day operations of the Medical Center. Rand Wortman (President & CEO) was compensated by Quorum for his services related to the Medical Center. Total payments for services in 2014 were $1,238,551.
Form 990, Part VI, Section A, line 4 The organizing documents were amended to reflect the new Sole Corporate Member as Western HealthConnect.
Form 990, Part VI, Section A, line 6 The sole Corporate Member is Western HealthConnect, a Washington nonprofit corporation.
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 to and exercised exclusively by the Corporate Member: 1) To amend or repeal the Articles of Incorporation or Bylaws. 2) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale, transfer, assignment or encumbering of the assets. 3) To approve the dissolution, liquidation, consolidation or merger with another corporation or entity with concurrence of the Kadlec Community Board. 4) To approve the annual operating and capital budgets. 5) To appoint certified public accountants and receive the annual audit report from such accountants.
Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by experienced staff and reviewed by the Director of Taxes for Providence Health & Services 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 As a result of Kadlec's affiliation with Providence Health & Services, Kadlec adopted new policies and procedures. 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 PRE-AFFILIATION: An independent third party is used to determine appropriate compensation for the Executive Team. The compensation packages are reviewed and approved by the Compensation Committee of the Board. POST-AFFILIATION: Process for determining compensation of top management, officers & key employees: 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 reviewed 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 goals for furthering Providence operating commitments and strategic objectives - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated patient 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 request. The consolidated financial statements are available on our public Internet site www2.providence.org.
Form 990, Part VII Joel Gilbertson (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Dan Harris (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Cindy Strauss (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Michael Holcomb (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Chauncey Boyle, SP (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Marian Schubert, CSJ -(Eff.9/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Phyllis Hughes, RSM (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Carolina Reyes, MD (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Michael A. Stein (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Eugene "Al" Parrish (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Peter J. Snow (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Bob Wilson (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Sallye Liner (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Ellen L. Wolf (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Isiaah Crawford (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Martha Diaz Aszkenazy (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Kirby McDonald (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Dave Olsen (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Charles (Chuck) Watts (Eff. 6/13/14) - 1801 Lind Ave SW #9016, Renton, WA 98057. Mike Butler - 1801 Lind Ave SW #9016, Renton, WA 98057. Debra Canales - 1801 Lind Ave SW #9016, Renton, WA 98057. Lisa Vance - 1801 Lind Ave SW #9016, Renton, WA 98057. Randy Axelrod, MD - 1801 Lind Ave SW #9016, Renton, WA 98057. Jack Friedman - 1801 Lind Ave SW #9016, Renton, WA 98057. Aaron Martin - 1801 Lind Ave SW #9016, Renton, WA 98057. Craig L. Wright, MD - 1801 Lind Ave SW #9016, Renton, WA 98057. Janice Newell - 1801 Lind Ave SW #9016, Renton, WA 98057. Deborah Burton - 1801 Lind Ave SW #9016, Renton, WA 98057. David Brown - 1801 Lind Ave SW #9016, Renton, WA 98057. Orest Holubec - 1801 Lind Ave SW #9016, Renton, WA 98057. Mark Gargett - 1801 Lind Ave SW #9016, Renton, WA 98057. Gary Flaming - 1801 Lind Ave SW #9016, Renton, WA 98057. Teresa Spalding - 1801 Lind Ave SW #9016, Renton, WA 98057. Mike Waters - 1801 Lind Ave SW #9016, Renton, WA 98057. Dave Hunter - 1801 Lind Ave SW #9016, Renton, WA 98057. Steve Burdick - 1801 Lind Ave SW #9016, Renton, WA 98057. Dana White - 1801 Lind Ave SW #9016, Renton, WA 98057.
Form 990, Part XI, line 9: Affiliation Valuation Adjustment -195,752,474. Contributions from Kadlec Foundation not on GL -22,640. Grants to Kadlec Foundation not on GL 18,000,000. Gain on Affiliation Valuation 217,760,030. Book/Tax difference - Investment in Cancer Center -579,493.
FORM 990. SCHEDULE R - RELATED ORGANIZATIONS AFFILIATION AGREEMENTS Effective March 1, 2014, Providence Health & Services ,the Health System, entered into an affiliation agreement with Sisters of Charity of Leavenworth Health System (SCL) to transfer sponsorship of Saint John's Health Center (Saint John's) to the Health System. Saint John's operates a nonprofit medical center, a cancer institute, and physician clinics to serve the Santa Monica, California community and surrounding area. Effective May 1, 2014, the Health System entered into an affiliation agreement with PacMed Clinics (PacMed). PacMed is a private, nonprofit, multi-specialty medical group with nine clinics in the Puget Sound area and more than 150 primary care and specialty providers at the date of affiliation. Pursuant to the affiliation agreement, Western HealthConnect became PacMed's sole corporate Member. No cash or other purchase consideration was transferred to effect the affiliation. Effective June 13, 2014, the Health System entered into an affiliation agreement with Kadlec Health System (Kadlec). Kadlec operates a nonprofit medical center, a neurological resource center, a supporting foundation, and physician clinics to serve the tri-cities area of Kennewick, Pasco, and Richland, Washington. Pursuant to the affiliation agreement, Western HealthConnect became the sole member of Kadlec. No cash or other purchase consideration was transferred to effect the affiliation.
FORM 990, PART I, LINE 6 - VOLUNTEERS Anyone over the age of 15 can volunteer at Kadlec Regional Medical Center. You can become a member of the Auxiliary or work under the direction of the volunteer coordinator and unit managers in specific areas, including Education and Rehabilitation. All volunteers undergo orientation and take a TB test before they begin their service. The Auxiliary: Each year over 200 members of the Kadlec Auxiliary assist in over 30 different areas ranging from clerical work to mail delivery, from the Critical Care Unit to the Birth Center, from staffing the Information Desk to operating the Gift Shop and from escorting patients and families around the medical center to two sewing groups making important items for use with the medical center. Junior Volunteer Program: Kadlec Regional Medical Center offers opportunities for students aged 15 years and above to volunteer in the Junior Volunteer Program. You may remain a Junior Volunteer through the summer following high school graduation. Services that Junior Volunteers take part in include Nutrition Services, Magazine Cart, Information Desk, Patient Escort, Gift Shop and Education. Junior Volunteers usually work one service a week for 1-3 hours. Pet Partner Program: Pet visitation is a valuable service to those who are missing family, friends and pets during their stay in the hospital. Upon completion of orientation, Kadlec Regional Medical Center allows members of the Delta Society an opportunity to bring their dogs to visit patients. The Delta Society is a Washington-based group that selects and trains pets to become pet partners. Kadlec Music Program: Kadlec's Music Program is another way to volunteer at the medical center. Over 20 musical volunteers play a Baby Grand Piano in the Main Lobby or walk the halls playing their instruments. The musicians range from age 10 to over 70. They provide music throughout the week which can be heard not only in the lobby, but also in the Critical Care Waiting Area.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

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 Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
KADLEC REGIONAL MEDICAL CENTER
 
Employer identification number

91-0655392
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
(1) Kadlec Clinic LLC
945 Goethals Ste 220
Richland,WA99352
20-4265899 		Primary Care Physician Services WA     Kadlec Health System
 
(2) Kadlec Neuroscience Center LLC
888 Swift Blvd Ste 300
Richland,WA99352
20-1613946 		Neurological Related Physician Services WA     Kadlec Health System
 
(3) TriCities Nephrology LLC
309 Bradley Ste 109
Richland,WA99352
27-1041915 		Nephrology Physician Services WA     Kadlec Health System
 






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) Providence Health System - So California
1801 Lind Avenue SW 9016

Renton,WA980579016
51-0216589 		Healthcare System CA 501( c)(3) Line 3 Providence Health & Services
 
 
No
(4) Everett Transitional Care Services
PO Box 5128

Everett,WA982065128
94-3264605 		Transitional Care WA 501( c)(3) Line 9 N/A
 
No
(5) 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
(6) Providence Plan Partners
4400 NE Halsey

Portland,OR97213
91-1861964 		Healthcare Services OR 501( c)(4) N/A PH & S - Oregon
 
 
No
(7) Providence Health Plan
4400 NE Halsey

Portland,OR97213
93-0863097 		Health Service Contractor OR 501( c)(4) N/A Providence Plan Partners
 
 
No
(8) Providence Health Assurance
4400 NE Halsey

Portland,OR97213
55-0828701 		Medicaid Healthcare Provider OR 501( c)(4) N/A Providence Health Plan
 
 
No
(9) Providence Medical Institute
4101 Torrance Blvd

Torrance,CA90503
33-0283773 		Healthcare CA 501( c)(3) Line 11/Type I PHS - So California
 
 
No
(10) 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
 
 
No
(11) Providence TrinityCare Hospice
5315 Torrance Blvd Suite B1

Torrance,CA90503
95-3264139 		Hospice CA 501( c)(3) Line 9 PHS - So California
 
 
No
(12) Providence Blanchet Association
1700 Providence Pl

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

Chehalis,WA98352
94-3176618 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(14) Providence Rossi Association
1700 Providence Pl

Centralia,WA98531
31-1584166 		Housing WA 501( c)(3) Line 9 PH & S - Washington
 
 
No
(15) Lundberg Association
5921 E Burnside

Portland,OR97215
91-1562797 		Housing OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(16) Providence St Francis Association
3415 12th Avenue NE

Olympia,WA98506
94-3244854 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(17) Providence Peter Claver Association
7101 38th Avenue South

Seattle,WA98118
31-1629656 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(18) Providence St Elizabeth House Association
3201 SW Graham St

Seattle,WA98126
91-2171539 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(19) 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
(20) The Gamelin Association
312 North Fourth St

Yakima,WA98901
91-1180824 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(21) The Gamelin Oregon Association
5520 NE Glisan

Portland,OR97213
91-1214491 		Housing OR 501( c)(3) Line 9 PH & S - Oregon
 
 
No
(22) The Gamelin California Association
540 23rd St

Oakland,CA94612
91-1293869 		Housing CA 501( c)(3) Line 9 PHS - So California
 
 
No
(23) Gamelin Washington Association
1423 First Avenue

Seattle,WA98101
20-1910170 		Housing WA 501( c)(3) Line 7 PH & S - Washington
 
 
No
(24) 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
(25) 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
(26) 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
(27) 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
(28) 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
(29) 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
(30) 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
(31) 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
(32) 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
(33) 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
(34) 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
(35) 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
(36) Providence Milwaukie Foundation
10150 SE 32nd

Milwaukie,OR97222
94-3079515 		Support Providence Milwaukie Hospital OR 501( c)(3) Line 7 PH & S - Oregon
 
 
No
(37) 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
(38) 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
 
 
No
(39) 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
 
 
No
(40) 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
 
 
No
(41) 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
(42) Providence Health & Services - Western Washington
1801 Lind Avenue SW 9016

Renton,WA980579016
91-1303277 		Healthcare WA 501( c)(3) Line 3 Providence MinistriesWHC
 
 
No
(43) Providence Health & Services
1801 Lind Avenue SW 9016

Renton,WA980579016
91-1549796 		Shell Corporation WA 501( c)(3) Line 11/Type II Providence Ministries
 
 
No
(44) 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
(45) Providence St Joseph Medical Center
PO Box 1010

Polson,MT598601010
81-0463482 		Healthcare MT 501( c)(3) Line 3 PH & S - Washington
 
 
No
(46) St Thomas Child and Family Center
1710 Benefis Court

Great Falls,MT59405
81-0233495 		Early Childhood Education MT 501( c)(3) Line 9 PH & S - Washington
 
 
No
(47) 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
(48) 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
(49) 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
(50) 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
(51) 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
(52) 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
(53) 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
(54) 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
(55) 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
(56) 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
 
 
No
(57) Swedish Health Services
747 Broadway

Seattle,WA98122
91-0433740 		Healthcare WA 501(c )(3) Line 3 Western HealthConnect
 
 
No
(58) Swedish Edmonds
21601 76th Ave W

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

Seattle,WA98122
91-0983214 		Support Swedish Health Services WA 501(c )(3) Line 7 Swedish Health Services
 
 
No
(60) Global To Local Health Initiative
2800 South 192nd St 104

SeaTac,WA98188
27-3133200 		Healthcare WA 501(c )(3) Line 7 Swedish Health Services
 
 
No
(61) Swedish MJM Holdings
747 Broadway

Seattle,WA98122
27-3139262 		Holding Company WA 501(c )(3) Line 11/Type I Swedish Health Services
 
 
No
(62) 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
(63) Western HealthConnect
747 Broadway

Seattle,WA98122
45-4171900 		Shell Corporation WA 501(c )(3) Line 11/Type II PH&S Western Washington
 
 
No
(64) Inland Northwest Health Services
601 W 1st Avenue

Spokane,WA99201
91-1307555 		Healthcare WA 501( c)(3) Line 3 PH&S - Washington
 
 
No
(65) Kadlec Neurological Resource Center
1268 Lee Blvd

Richland,WA99352
91-1266345 		Healthcare WA 501(c )(3) Line 9 Kadlec Regional Medical Center
 
Yes
 
(66) Kadlec Foundation
888 Swift Blvd

Richland,WA99352
23-7005501 		Support Kadlec Regional Medical Center WA 501(c )(3) Line 11/Type I Kadlec Regional Medical Center
 
Yes
 
(67) PacMed Clinics
1200 12th Ave S

Seattle,WA98144
56-2290878 		Healthcare WA 501(c )(3) Line 9 Western HealthConnect
 
 
No
(68) Providence Saint John's Health Center
2121 Santa Monica Blvd

Santa Monica,CA90404
95-1684082 		Healthcare CA 501(c )(3) Line 3 PHS - So California
 
 
No
(69) John Wayne Cancer Institute
2200 Santa Monica Blvd

Santa Monica,CA90404
95-4291515 		Cancer Treatment CA 501(c )(3) Line 4 Providence Saint John's Health Center
 
 
No
(70) Saint John's HospitalHealth Center Foundation
2121 Santa Monica Blvd

Santa Monica,CA90404
95-6100079 		Support Saint John Health Center & JWCI CA 501(c )(3) Line 7 Providence Saint John's Health Center
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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) Providence Imaging Center

3340 Providence Drive
Anchorage,AK99508
92-0118807 		Medical Imaging AK N/A
                  
(2) California Laboratory Associates LLC

501 Buena Vista
Burbank,CA91505
27-3888692 		Outpatient Lab CA N/A
                  
(3) Broadway Imaging LLC

500 W Broadway
Missoula,MT59802
52-2405971 		Medical Imaging MT N/A
                  
(4) Ctr for Med Imaging-Bridgeport LLC

4400 NE Halsey St Bldg II 495
Portland,OR97213
26-0796953 		Imaging - Diagnostics OR N/A
                  
(5) Ctr for MedImaging-Tanasbourne LLC

4400 NE Halsey St Bldg II 495
Portland,OR97213
20-0477972 		Imaging - Diagnostics OR N/A
                  
(6) Pathology Associates Medical Laboratories LLC

611 N Perry
Spokane,WA99202
27-0943279 		Outpatient Lab WA N/A
                  
(7) Portland Medical Imaging LLC

4400 NE Halsey St Bldg II 495
Portland,OR97213
20-1054971 		Imaging - Diagnostics OR N/A
                  
(8) Oregon Advanced Imaging LLC

881 OHare Parkway
Medford,OR97504
45-0471748 		Medical Imaging OR N/A
                  
(9) Minor & James Medical PLLC

515 Minor Avenue 200
Seattle,WA98104
91-1340223 		Physician Clinic WA N/A
                  
(10) Providence Surgery Center LLC

902 N Orange St
Missoula,MT59802
84-1401625 		Ambulatory Surgery Center MT N/A
                  
(11) Clackamas Radiation Oncology Center LLC

4400 NE Halsey St Bldg II 495
Portland,OR97213
26-0381897 		Radiation Oncology OR N/A
                  
(12) PETCT Imaging at Swedish Cancer Institute LLC

1221 Madison Street
Seattle,WA98104
20-3132044 		Medical Imaging WA N/A
                  
(13) PacLab LLC

611 N Perry
Spokane,WA99202
91-1743952 		Outpatient Lab WA N/A
                  
(14) The Madison Spokane Inn LLC

15 West Rockwood Blvd
Spokane,WA99204
84-1606484 		Hotel Services WA N/A
                  
(15) Center for Specialty Surgery LLC

11782 SW Barnes Rd
Portland,OR97225
26-3638838 		Ambulatory Surgery Center OR N/A
                  
(16) Oregon Outpatient Surgery Center

7300 SW Childs Rd
Tigard,OR97224
22-3883387 		Ambulatory Surgery Center OR N/A
                  
(17) ProvidenceUSP Santa Clarita GP LLC

11550 Indian Hills Road 160
Mission Hills,CA91345
20-2829660 		Ambulatory Surgery Center CA N/A
                  
(18) ProvidenceUSP Surgery Ctrs LLC

11550 Indian Hills Road 160
Mission Hills,CA91345
20-0905938 		Ambulatory Surgery Center CA N/A
                  
(19) Alpha Medical Laboratory LLC

611 N Perry
Spokane,WA99202
91-2017347 		Outpatient Lab ID N/A
                  
(20) Greater Valley Medical Building LP

501 S Buena Vista St
Burbank,CA91505
95-4570858 		Real Estate - MOB CA N/A
                  
(21) Prov Radiation Oncology Develop Assn LLC

4401 NE Halsey St Bldg II 495
Portland,OR97213
26-0682491 		Real Estate - MOB OR N/A
                  
(22) Providence Partners for Health LLC

501 S Buena Vista St
Burbank,CA91505
45-4041798 		Clinical Quality & Integration CA N/A
                  
(23) ProvidenceSilverton Rehab LLC

4400 NE Halsey Bldg III 425
Portland,OR97213
48-1287267 		Rehab Services OR N/A
                  
(24) Southern Idaho Regional Laboratory LLC

611 N Perry
Spokane,WA99202
82-0511819 		Outpatient Lab ID N/A
                  
(25) Mountainstar Clinical Laboratories LLC

611 N Perry
Spokane,WA99202
26-1345983 		Outpatient Lab MT N/A
                  
(26) Tri-Cities Laboratory LLC

611 N Perry
Spokane,WA99202
91-1773986 		Outpatient Lab WA N/A
                  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(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
(10) PHN Holdings

20555 Earl Street
Torrance,CA90503
46-1814184 		Strategic Planning Services for PHN CA N/A
 C         No
(11) Providence Health Network

20555 Earl Street
Torrance,CA90503
80-0886966 		Prepaid Healthcare CA N/A
 C         No
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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
 
No
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
 
No
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) Kadlec Foundation

 B 18,000,000 Cost
(2) Kadlec Foundation

 C 78,814 Cost
(3) Kadlec Neurological Resource Center

 O 215,479 Cost



Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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) 2014
Schedule R (Form 990) 2014
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) 2014
Additional Data


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