TY 2015 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) Michael Holcomb...................................................................... Chair of the Board	0.10 ................. 7.60	X	X	60,360	0
(2) Chauncey Boyle SP...................................................................... Director	0.10 ................. 5.50	X		0	0
(3) Marian Schubert CSJ...................................................................... Director	0.10 ................. 4.30	X		0	0
(4) Phyllis Hughes RSM...................................................................... Director	0.10 ................. 5.00	X		0	0
(5) Carolina Reyes MD...................................................................... Director	0.10 ................. 4.60	X		15,360	0
(6) Michael A Stein...................................................................... Director	0.10 ................. 6.00	X		15,360	0
(7) Eugene Al Parrish...................................................................... Director	0.10 ................. 5.00	X		15,360	0
(8) Bob Wilson...................................................................... Director	0.10 ................. 5.00	X		18,360	0
(9) Sallye Liner...................................................................... Director	0.10 ................. 4.30	X		15,360	0
(10) Isiaah Crawford...................................................................... Director	0.10 ................. 4.10	X		18,360	0
(11) Martha Diaz Aszkenazy...................................................................... Director	0.10 ................. 7.70	X		18,360	0
(12) Kirby McDonald...................................................................... Director	0.10 ................. 4.60	X		15,360	0
(13) Dave Olsen...................................................................... Director	0.10 ................. 5.50	X		17,860	0
(14) Charles Chuck Watts...................................................................... Director	0.10 ................. 4.60	X		18,360	0
(15) Jack Friedman Thru 615...................................................................... President/CEO	16.00 ................. 34.00		X	770,782	117,919
(16) Mike Cotton Eff 715...................................................................... President/CEO	16.00 ................. 34.00		X	291,815	57,765
(17) Jeffrey Butcher Thru 915...................................................................... Treasurer / CFO	16.00 ................. 34.00		X	363,146	19,302

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) Cindy Strauss........................................................................ EVP/Chief Legal Officer	0.10 .......................59.90	X		0	1,526,357	64,699
(19) Alison S Schrupp........................................................................ CSO	18.00 .......................37.00	X		0	392,027	58,892
(20) Barbara L Christensen........................................................................ Chief Sales & Mkt. Officer	15.00 .......................30.00	X		0	258,750	69,338
(21) Michael G White........................................................................ COO / Interim CFO	16.00 .......................34.00	X		0	654,462	39,279
(22) Bruce W Wilkinson........................................................................ CIO	15.00 .......................30.00	X		0	300,851	47,448
(23) Robert A Gluckman........................................................................ CMO	16.00 .......................34.00	X		0	837,985	71,296
(24) Carrie Smith........................................................................ Chief Compliance Officer	16.00 .......................34.00	X		0	268,496	39,614
(25) Stephanie C Dreyfuss........................................................................ Dir. Network Develop.	13.00 .......................27.00		X	0	286,497	23,951
(26) Mark A Whitaker........................................................................ Medical Director	13.00 .......................27.00		X	0	287,596	26,525
(27) Rakesh Pai........................................................................ Medical Director	13.00 .......................27.00		X	0	266,680	23,234
(28) Susan Abate........................................................................ Dir. Quality Med. Mgr.	13.00 .......................27.00		X	0	233,129	78,674
(29) Sally Marsh........................................................................ Account Executive	13.00 .......................27.00		X	0	232,521	35,305

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

2015

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH ASSURANCE

Employer identification number

55-0828701

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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 ....

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

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds 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? ............................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

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

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

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

Yes No

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

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

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

Yes No

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" on Form 990, Part IV, line 8.

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.

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 on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2015

Page 2

Part III

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

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	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 ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

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

Yes

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

3a(i)

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

3a(ii)

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

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' on 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 ...
b	Buildings
c	Leasehold improvements
d	Equipment ...
e	Other ...
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..		0

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) Premiums Receivable				681,137
(2) Due from Affiliate				12,624,714
(3) Miscellaneous Receivables				3,958
(4) Healthcare Receivables				949,078
(5) Reinsurance OHP Receivable				188,916
(6) Accrued Investment Income				84,084
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				14,531,887

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Due to Affiliates	3,666,133
Unpaid Claims Liability	10,767,205
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	14,433,338
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	130,746,854
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	2,750
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	2,750
3	Subtract line 2e from line 1..................			3	130,744,104
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	56,708
b	Other (Describe in Part XIII.) ...........	4b	379,442
c	Add lines 4a and 4b....................			4c	436,150
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	131,180,254

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	126,237,410
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	-379,442
e	Add lines 2a through 2d....................			2e	-379,442
3	Subtract line 2e from line 1...................			3	126,616,852
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	56,708
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	56,708
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	126,673,560

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:	PHA's management evaluates tax positions taken by PHA and recognizes a tax liability if PHA has taken an uncertain position that more likely than not would not be sustained upon examination by the IRS. Management has analyzed tax positions taken by PHA and has concluded that as of December 31, 2015, there are no uncertain positions taken or expected to be taken that would require recognition of a liability or disclosure in the financial statements.
Part XI, Line 4b - Other Adjustments:	Statutory Reinsurance reclass 379,442.
Part XII, Line 2d - Other Adjustments:	Statutory Reinsurance reclass -379,442.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

Complete if the organization answered "Yes" on 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

2015

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH ASSURANCE

Employer identification number

55-0828701

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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

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

Any related organization?

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

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

The organization?

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

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

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

Were any amounts reported on 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 .............................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2015

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 on 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 on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Jack Friedman Thru 615President/CEO	(i) (ii)	0 ------------- 364,689	0 ------------- 388,093	0 ------------- 18,000	0 ------------- 103,565	0 ------------- 14,354	0 ------------- 888,701	0 ------------- 0
2Mike Cotton Eff 715President/CEO	(i) (ii)	0 ------------- 115,554	0 ------------- 80,000	0 ------------- 96,261	0 ------------- 53,711	0 ------------- 4,054	0 ------------- 349,580	0 ------------- 0
3Jeffrey Butcher Thru 915Treasurer / CFO	(i) (ii)	0 ------------- 205,762	0 ------------- 35,484	0 ------------- 121,900	0 ------------- 4,630	0 ------------- 14,672	0 ------------- 382,448	0 ------------- 0
4Cindy StraussEVP/Chief Legal Officer	(i) (ii)	0 ------------- 526,875	0 ------------- 981,482	0 ------------- 18,000	0 ------------- 40,075	0 ------------- 24,624	0 ------------- 1,591,056	0 ------------- 524,784
5Alison S SchruppCSO	(i) (ii)	0 ------------- 295,321	0 ------------- 78,852	0 ------------- 17,854	0 ------------- 45,872	0 ------------- 13,020	0 ------------- 450,919	0 ------------- 0
6Barbara L ChristensenChief Sales & Mkt. Officer	(i) (ii)	0 ------------- 126,283	0 ------------- 88,966	0 ------------- 43,501	0 ------------- 60,465	0 ------------- 8,873	0 ------------- 328,088	0 ------------- 0
7Michael G WhiteCOO / Interim CFO	(i) (ii)	0 ------------- 318,290	0 ------------- 318,172	0 ------------- 18,000	0 ------------- 33,663	0 ------------- 5,616	0 ------------- 693,741	0 ------------- 0
8Bruce W WilkinsonCIO	(i) (ii)	0 ------------- 213,666	0 ------------- 67,954	0 ------------- 19,231	0 ------------- 31,381	0 ------------- 16,067	0 ------------- 348,299	0 ------------- 0
9Robert A GluckmanCMO	(i) (ii)	0 ------------- 410,771	0 ------------- 423,187	0 ------------- 4,027	0 ------------- 50,545	0 ------------- 20,751	0 ------------- 909,281	0 ------------- 0
10Carrie SmithChief Compliance Officer	(i) (ii)	0 ------------- 222,393	0 ------------- 29,318	0 ------------- 16,785	0 ------------- 24,958	0 ------------- 14,656	0 ------------- 308,110	0 ------------- 0
11Stephanie C DreyfussDir. Network Develop.	(i) (ii)	0 ------------- 235,989	0 ------------- 32,508	0 ------------- 18,000	0 ------------- 11,050	0 ------------- 12,901	0 ------------- 310,448	0 ------------- 0
12Mark A WhitakerMedical Director	(i) (ii)	0 ------------- 261,209	0 ------------- 9,006	0 ------------- 17,381	0 ------------- 10,965	0 ------------- 15,560	0 ------------- 314,121	0 ------------- 0
13Rakesh PaiMedical Director	(i) (ii)	0 ------------- 247,905	0 ------------- 775	0 ------------- 18,000	0 ------------- 3,842	0 ------------- 19,392	0 ------------- 289,914	0 ------------- 0
14Susan AbateDir. Quality Med. Mgr.	(i) (ii)	0 ------------- 194,533	0 ------------- 26,623	0 ------------- 11,973	0 ------------- 71,089	0 ------------- 7,585	0 ------------- 311,803	0 ------------- 0
15Sally MarshAccount Executive	(i) (ii)	0 ------------- 231,753	0 ------------- 743	0 ------------- 25	0 ------------- 24,133	0 ------------- 11,172	0 ------------- 267,826	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Line 1a	Providence Health & Services Expense Reimbursement Procedures include the following policies: First Class Travel or Charter Travel or Travel of Companions Air travel is reimbursable for tourist or economy class and should be at the least expensive airfare; which permits departures and arrivals at reasonable times and reasonable distance traveled. Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class air travel will only be reimbursed when tourist or economy class air travel is not available and business travel is mandated by a supervisor. In the rare circumstance that an executive must fly on a first class full fare ticket, their senior level supervisor must approve this expense. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approved by the Executive Vice President/Chief 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 2015, there was one First Class ticket 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 2015, the following Listed Persons received gross-up payments: Mike Cotton The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation in the 990. 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/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 2015, the following Listed Persons received relocation/housing program payments: Mike Cotton The amounts reported for these relocation/housing payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation.
Part I, Lines 4a-b	NON-QUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan C) ESP = Elective Survivor Plan 1) Cindy Strauss a) SERP Vested but not Paid - $796,632 b) SERP Interest Credit - $20,200 2) Jack Friedman a) Taxable SERP Earned but not Paid - $69,453 b) SERP Interest Credit - $54,261 3) Alison S. Schrupp a) SERP Interest Credit - $12,791 b) Taxable SERP Earned but Not Paid - $39,857 c) Non Taxable SERP Earned but Not Paid - $57 d) Taxable CBRP Earned but Not Paid - $17 e) ESP Interest Credit - $3,617 4) Barbara L. Christensen a) SERP Interest Credit - $3,249 b) Taxable SERP Earned but Not Paid - $10,344 c) Non Taxable SERP Earned but Not Paid - $5,142 d) ESP Interest Credit - $3,240 5) Michael G. White a) Taxable CBRP Earned but Not Paid - $13,800 b) Taxable SERP Earned but Not Paid - $169,242 6) Bruce W. Wilkinson a) SERP Interest Credit - $20,327 b) Taxable SERP Earned but Not Paid - $31,998 c) Non Taxable SERP Earned but Not Paid - $221 7) Robert A. Gluckman a) SERP Interest Credit - $16,911 b) Taxable SERP Earned but not Paid - $369,027 c) Taxable CBRP Paid - $2 10) Mark Whitaker a) Taxable CBRP Paid - $974
Part I, Lines 4a-b	SEVERANCE 1) Jeffrey Butcher - $80,096
FORM 990, SCHEDULE J, PART II - EXECUTIVE PERFORMANCE AWARDS PROGRAM	The Providence Executive Incentive Program provides a lump sum award annually as a percent of the executive's base pay. Percent opportunities are aligned with our total compensation philosophy as outlined in Part VI, Section B, Line 15 (Process for determining compensation of top management, officers & key employees). The performance award is based on the level of accomplishment of annual system objectives, in combination with personal goals for top executives. In 2015, 50 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. The remaining 50% was based on a robust set of personal goals designed to align critical mission and business drivers, executive team talent development (deepening talent pipeline for top 200+leaders) and professional development. In 2015 the percent allocation for each of these strategic priorities was as outlined below: * Success Measures - System Goals : 50% Community Benefit - 5% Caregiver (Employee) Engagement - 7.5% MyChart Activations - 5% Patient Loyalty Index - 5% Clinical Excellence Index - 7.5% Free Cash Flow - 5% Salary Expense / Net Operating Revenue - 2.5% Primary Care Panel Size - 5% Total Growth in Operating Revenue - 7.5% * Success Measures - Personal Goals : 50% Mission/Business Driver - 15% Exec Talent Development - 20% Professional Development - 15% TOTAL ALLOCATION: 100%

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 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

2015

Open to Public
Inspection

Name of the organization

PROVIDENCE HEALTH ASSURANCE

Employer identification number

55-0828701

Return Reference	Explanation
Form 990, Part VI, Section A, line 6	Providence Health Plan is the Corporate Member.
Form 990, Part VI, Section A, line 7a	The Corporate Member has the power to: 1) Fix the number of Directors, select the Directors and to remove such Directors at any time with or without cause. 2) Appoint the Chair of the Board of directors, determine the term of office, and remove such Chair with or without cause.
Form 990, Part VI, Section A, line 7b	Powers reserved for the Corporate Member include: 1) To adopt or change the mission, philosophy, and values, including the strategic plan and mission statement. 2) To amend or repeal the Articles of Incorporation or Bylaws. 3) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale transfer, assignment or encumbering of assets exceeding a specified threshold, or the sale or transfer of any property which may have historical or religions significance. 4) To approve the establishment of any new Corporation in which this Corporation has a controlling interest. 5) To approve the dissolution or liquidation. 6) To approve the annual operating and capital budgets. 7) To appoint the certified public accountants. 8) To approve, according to established guidelines, any joint venture of corporate affiliations. 9) To approve lending of Corporate funds. 10) To approve the closure of any institution or major ministry or work of the Corporation.
Form 990, Part VI, Section B, line 11	The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS.
Form 990, Part VI, Section B, line 12c	Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict.
Form 990, Part VI, Section B, line 15	It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are 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. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site.
Form 990, Part VII	Michael Holcomb - 1801 Lind Avenue SW , Renton, WA 98057. Chauncey Boyle, SP - 1801 Lind Avenue SW , Renton, WA 98057. Marian Schubert, CSJ - 1801 Lind Avenue SW , Renton, WA 98057. Phyllis Hughes, RSM - 1801 Lind Avenue SW , Renton, WA 98057. Carolina Reyes, MD - 1801 Lind Avenue SW , Renton, WA 98057. Michael A. Stein - 1801 Lind Avenue SW , Renton, WA 98057. Eugene "Al" Parrish - 1801 Lind Avenue SW , Renton, WA 98057. Bob Wilson - 1801 Lind Avenue SW , Renton, WA 98057. Sallye Liner - 1801 Lind Avenue SW , Renton, WA 98057. Isiaah Crawford - 1801 Lind Avenue SW , Renton, WA 98057. Martha Diaz Aszkenazy - 1801 Lind Avenue SW , Renton, WA 98057. Kirby McDonald - 1801 Lind Avenue SW , Renton, WA 98057. Dave Olsen - 1801 Lind Avenue SW , Renton, WA 98057. Charles (Chuck) Watts - 1801 Lind Avenue SW , Renton, WA 98057. Cindy Strauss - 1801 Lind Avenue SW , Renton, WA 98057.
FORM 990, PART XII, LINE 2C - AUDIT & COMPLIANCE	The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation.
FORM 990, PART IV, LINE 12 - AUDITED FINANCIAL STATEMENTS	The audited financial statements of Providence Health Assurance are prepared on a statutory basis in conformity with insurance accounting practices prescribed or permitted by the National Association of Insurance Commissioners and the Insurance Division of the Oregon Department of Consumer and Business Services.
FORM 990, PART I, LINE 5 & PART V, LINE 2A - EMPLOYEE COMPENSATION	The employees working at Providence Health Assurance are paid by Providence Health & Services - Oregon EIN# 51-0216587. Therefore, no W-2s are issued by the reporting organization.
FORM 990, PART VII - RELIGIOUS COMMUNITY MEMBERS	As members of the Religious Community, each Sister has taken a vow of poverty as a compulsory part of her religious life. Any compensation for services of a Sister inures only for the benefit of the Community, not the individual members. All payments for services are made directly to the Religious Community.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH ASSURANCE

Employer identification number

55-0828701

Part I

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

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)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 Bldg 2 Portland,OR97213 91-1861964	Healthcare Services	OR	501( c)(4)	N/A	PH & S - Oregon		No
(7)Providence Health Plan 4400 NE Halsey Bldg 2 Portland,OR97213 93-0863097	Health Service Contractor	OR	501( c)(4)	N/A	Providence Plan Partners		No
(8)Providence Medical Institute 4101 Torrance Blvd Torrance,CA90503 33-0283773	Healthcare	CA	501( c)(3)	Line 11/Type I	PHS - So California		No
(9)Little Company of Mary Ancillary Services Corporation 4101 Torrance Blvd Torrance,CA90503 33-0844408	Imaging Services	CA	501( c)(3)	Line 9	PHS - So California		No
(10)Providence TrinityCare Hospice 5315 Torrance Blvd Suite B1 Torrance,CA90503 95-3264139	Hospice	CA	501( c)(3)	Line 9	PHS - So California		No
(11)Providence Blanchet Association 1700 Providence Pl Centralia,WA98531 91-1789266	Supportive Housing	WA	501( c)(3)	Line 7	PH & S - Washington		No
(12)St Luke Association 350 Washington Ave SE Chehalis,WA98352 94-3176618	Supportive Housing	WA	501( c)(3)	Line 7	PH & S - Washington		No
(13)Providence Rossi Association 1700 Providence Pl Centralia,WA98531 31-1584166	Supportive Housing	WA	501( c)(3)	Line 9	PH & S - Washington		No
(14)Lundberg Association 5921 E Burnside Portland,OR97215 91-1562797	Supportive Housing	OR	501( c)(3)	Line 7	PH & S - Oregon		No
(15)Providence St Francis Association 3415 12th Avenue NE Olympia,WA98506 94-3244854	Supportive Housing	WA	501( c)(3)	Line 7	PH & S - Washington		No
(16)Providence Peter Claver Association 7101 38th Avenue South Seattle,WA98118 31-1629656	Supportive Housing	WA	501( c)(3)	Line 7	PH & S - Washington		No
(17)Providence St Elizabeth House Association 3201 SW Graham St Seattle,WA98126 91-2171539	Supportive Housing	WA	501( c)(3)	Line 7	PH & S - Washington		No
(18)Providence Gamelin House Association 4515 MLK Jr Way S Ste 200 Seattle,WA98108 31-1744654	Supportive Housing	WA	501( c)(3)	Line 7	PH & S - Washington		No
(19)The Gamelin Association 312 North Fourth St Yakima,WA98901 91-1180824	Supportive Housing	WA	501( c)(3)	Line 7	PH & S - Washington		No
(20)The Gamelin Oregon Association 5520 NE Glisan Portland,OR97213 91-1214491	Supportive Housing	OR	501( c)(3)	Line 9	PH & S - Oregon		No
(21)The Gamelin California Association 540 23rd St Oakland,CA94612 91-1293869	Supportive Housing	CA	501( c)(3)	Line 9	PHS - So California		No
(22)Gamelin Washington Association 1423 First Avenue Seattle,WA98101 20-1910170	Supportive Housing	WA	501( c)(3)	Line 7	PH & S - Washington		No
(23)Providence Dethman House 1205 Montello Ave Hood River,OR97031 47-3385506	Supportive Housing	WA	501( c)(3)	Pending	N/A		No
(24)Providence Foundation 1801 Lind Avenue SW 9016 Renton,WA980579016 94-3078543	Support PH&S Institutions	WA	501( c)(3)	Line 11/Type II	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	Providence TrinityCare Hospice		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	Providence Health & Services		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 Regional Medical Center 888 Swift Blvd Richland,WA99352 91-0655392	Healthcare	WA	501(c )(3)	Line 3	Western HealthConnect		No
(66)Kadlec Neurological Resource Center 1268 Lee Blvd Richland,WA99352 91-1266345	Healthcare	WA	501(c )(3)	Line 9	Western HealthConnect		No
(67)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		No
(68)PacMed Clinics 1200 12th Ave S Seattle,WA98144 56-2290878	Healthcare	WA	501(c )(3)	Line 9	Western HealthConnect		No
(69)Seattle Science Foundation 550 17th Ave Seattle,WA98122 61-1502822	Physician Collaboration	WA	501(c )(3)	Line 7	Western HealthConnect		No
(70)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
(71)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
(72)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
(73)Providence St Joseph Health 1801 Lind Avenue SW 9016 Renton,WA98057 81-1244422	Shell Corporation	WA	501(c )(3)	Pending	N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	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 495 Portland,OR97213 26-0796953	Imaging - Diagnostics	OR	N/A
(5) Ctr for Med Imaging-Tanasbourne LLC 4400 NE Halsey 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 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 4400 NE Halsey 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 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	(i) Section 512(b)(13) controlled entity?
(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	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) Western HealthConnect Ventures Inc 1801 Lind Ave SW 9016 Renton,WA98057 80-0953654	Investment	WA	N/A	C				No
(9) PHN Holdings 20555 Earl Street Torrance,CA90503 46-1814184	Strategic Planning Services	CA	N/A	C				No
(10) Providence Health Network 20555 Earl Street Torrance,CA90503 80-0886966	Prepaid Healthcare	CA	N/A	C				No

Schedule R (Form 990) 2015

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

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 .....................

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

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

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

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

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

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

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

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2015

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

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) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Medicaid Health Care Service Contractor in Oregon & Washington.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	0
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

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	118,010,945	131,007,857
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	9,278	172,397
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	118,020,223	131,180,254
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	84,251	424
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)	4,270,019	6,079,744
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	106,037,402	120,593,392
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	110,391,672	126,673,560
19	Revenue less expenses. Subtract line 18 from line 12.......	7,628,551	4,506,694
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	30,180,026	38,334,134
21	Total liabilities (Part X, line 26).............	12,466,946	16,109,814
22	Net assets or fund balances. Subtract line 21 from line 20.....	17,713,080	22,224,320

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 123,674,097 including grants of $ 0 ) (Revenue $ 131,007,857 )
	Providence Health Assurance (PHA) provides coverage for health care services to Medicaid-eligible members of the public in the greater Portland area without regard to race, color, religion, sex or national origin. PHA had approximately 36,500 members as of December 31, 2015. As part of Providence Health Plan (PHP), PHA fulfills its social welfare purpose by furthering the health care services and health education in the community - specifically by committing resources of employee time and ability, as well as a percentage of net income, to benefit the community through agencies established to support the needs of the most vulnerable among us. These include medically fragile and at-risk children; people with mental health needs and issues; people in our communities for whom barriers exist because of language, culture and poverty; and people living in rural areas, for whom access to health care and health promoting activities may be limited.

4b	(Code: ) (Expenses $ 424 including grants of $ 424 ) (Revenue $ 0 )
	Grants and Allocations supporting community health.

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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses123,674,521

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	7,199,554	773,241

(A) Name and business address	(B) Description of services	(C) Compensation





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 0

1a	Federated campaigns..	1a
b	Membership dues..	1b
c	Fundraising events..	1c
d	Related organizations	1d
e	Government grants (contributions)	1e

f	All other contributions, gifts, grants, and similar amounts not included above	1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......

			Business Code
2a	Medicaid Payments	900099	131,007,857	131,007,857
b
c
d
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			131,007,857

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			337,982			337,982
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		54,204,999
b	Less: cost or other basis and sales expenses		54,370,584
c	Gain or (loss)		-165,585
d	Net gain or (loss).....			-165,585			-165,585
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			131,180,254	131,007,857	0	172,397

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	424	424
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....
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	4,434,693	3,867,167	567,526
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	1,645,051	1,512,928	132,123
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	125,374	125,374
c	Accounting ...........	32,465		32,465
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	56,708		56,708
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	2,477,734	1,713,452	764,282
12	Advertising and promotion ....	37,523	33,896	3,627
13	Office expenses .......	398,802	261,679	137,123
14	Information technology ......	980,724	642,756	337,968
15	Royalties ..
16	Occupancy ...........	797,539	400,615	396,924
17	Travel ............	25,874	20,977	4,897
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	14,447	7,300	7,147
20	Interest ...........
21	Payments to affiliates .......	665,414	134,565	530,849
22	Depreciation, depletion, and amortization ..
23	Insurance ...	4,000		4,000
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 Claims	114,833,527	114,833,527
b	Electronic Claims	62,470	62,470
c	Dues & Memberships	19,808	17,191	2,617
d	Regulatory Fines	12,300	12,300
e	All other expenses	48,683	27,900	20,783
25	Total functional expenses. Add lines 1 through 24e	126,673,560	123,674,521	2,999,039	0
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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........		9,182,541	1	6,591,893
2	Savings and temporary cash investments .........			2
3	Pledges and grants receivable, net ......			3
4	Accounts receivable, net .............			4
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
8	Inventories for sale or use ........			8
9	Prepaid expenses and deferred charges ......			9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a
b	Less: accumulated depreciation	10b		10c
11	Investments—publicly traded securities .		13,835,397	11	17,210,354
12	Investments—other securities. See Part IV, line 11 .....			12
13	Investments—program-related. See Part IV, line 11 ..			13
14	Intangible assets ...............			14
15	Other assets. See Part IV, line 11 ...........		7,162,088	15	14,531,887
16	Total assets. Add lines 1 through 15 (must equal line 34)...		30,180,026	16	38,334,134

17	Accounts payable and accrued expenses .....	9,402,814	17	1,676,476
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	3,064,132	25	14,433,338
26	Total liabilities. Add lines 17 through 25..	12,466,946	26	16,109,814

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	17,713,080	27	22,224,320
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	17,713,080	33	22,224,320
34	Total liabilities and net assets/fund balances ........	30,180,026	34	38,334,134