Form990
Click to see attachment
Department of the TreasuryInternal 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
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 01-01-2015 , and ending 12-31-2015
BCheck if applicable:
CName of organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1801 Lind Ave SW No 9016
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Renton, WA980579016
D Employer identification number

51-0216586
E Telephone number

G Gross receipts $ 6,999,107,263
F Name and address of principal officer:
Rodney Hochman MD
1801 Lind Ave SW No 9016
Renton,WA980579016
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
washington.providence.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1859
M State of legal domicile: WA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Healthcare with special concern for the poor and vulnerable in WA. & AK.
2 Check this box MediumBullet
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 35,521
6 Total number of volunteers (estimate if necessary) ............. 6 5,617
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 6,457,889
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 1,547,750
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 42,136,077 31,689,985
9 Program service revenue (Part VIII, line 2g) ......... 3,439,886,452 5,630,711,974
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 134,530,104 41,384,593
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,518,048,478 249,644,663
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 5,134,601,111 5,953,431,215
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 13,951,382 22,649,564
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) 2,884,542,505 3,240,863,194
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet255,429    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,936,049,739 3,986,761,788
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 4,834,543,626 7,250,274,546
19 Revenue less expenses. Subtract line 18 from line 12....... 300,057,485 -1,296,843,331
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 10,159,130,383 13,253,167,313
21 Total liabilities (Part X, line 26)............. 7,585,061,893 10,539,077,842
22 Net assets or fund balances. Subtract line 21 from line 20..... 2,574,068,490 2,714,089,471
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 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Healthcare with special concern for the poor & vulnerable in WA. & AK.
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 $ 2,458,214,766 including grants of $ 0 ) (Revenue $ 3,015,096,336 )
Acute Care Inpatient 115,336 Admissions in 2015 with 565,172 Patient DaysOUR MISSION - As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service. OUR CORE VALUES - Respect, Compassion, Justice, Excellence, and Stewardship As a not-for-profit health care ministry, Providence Health & Services - Washington embraces our responsibility to respond to the needs of people in our communities, especially the poor and vulnerable. In the face of rapidly changing health care, our commitment to our Mission to care for everyone remains unchanged. When the Sisters of Providence began our tradition of caring 158 years ago, their ministry greatly depended on partnering with others in the community who were committed to doing good. This same pioneering spirit continues today as our calling and our promise. Some of our 2016 highlights are:The ER at Providence Regional Medical Center's Colby Campus is the only adult Trauma II emergency department in Snohomish County.Providence Mount Carmel Hospital is among the Top 100 Critical Access Hospitals (CAHs) in the United States, according to iVantage Health Analytics, which compares more than 1,300 facilities each year. Critical Access Hospitals have less than 25 inpatient beds, a 96-hour average length of stay, offer 24/7 emergency care, and are 35 miles away from another hospital.The following awards were received in 2015 by Sacred Heart Medical Center & Children's Hospital: Distinguished Hospital Award - Clinical Excellence; America's 100 Best Hospitals for Stroke Care; America's 100 Best Hospitals for Critical Care; Top 5% in the Nation for Neurosciences & Neurosurgery; Top 5% in the Nation for Stroke Care; Top 5% in the Nation for Gastrointestinal Care. Best Regional Hospital in: Cancer, Cardiology & Heart Surgery, Diabetes, ENT, Gastroenterology, Gynecology, Nephrology, Neurology & Neurosurgery, Orthopedics, Pulmonology, Urology; High Performing Hospital in: Hip Replacement Surgery, Knee Replacement Surgery; National Research Corporation Consumer Choice Award; 100 Great Hospitals in America; and Top 100 Neurosurgery and Spine Programs in the Nation. The neonatal intensive care unit (NICU) at Sacred Heart Children's Hospital is a Level IV designation, the highest level of care for premature and critically ill newborns recognized by the American Academy of Pediatrics (AAP). The Level IV status was granted by Washington State, acknowledging that the hospital met all AAP Perinatal and Neonatal Level of Care Guidelines. Sacred Heart Children's Hospital is the second facility in the state to achieve this status.Providence St. Mary Medical Center has expanded its cardiology program to include emergency angioplasty and stents for the treatment of heart attacks 24 hours a day, seven days a week. Providence is the first hospital in Walla Walla to offer emergency percutaneous coronary intervention (angioplasty/stents) every hour of every day. It also is the first to have 24/7 cardiology coverage, which means a cardiologist is available 24-hours a day, seven days a week to provide cardiology consultations.This marks a significant advancement for cardiac care in the community. Until now, interventional cardiology was only available four days a week in Walla Walla at Walla Walla General Hospital. When heart attacks occurred outside of these days, patients had to be transported by ambulance out of the community for care.Providence St. Mary Medical Center has been designated a Level 1 Cardiac Center by Washington State - the only hospital in Walla Walla to hold the state's highest level designation.St Joseph's Hospital recent hospital quality awards: Best Practice in Publicly Reporting Quality of Care - Rural Health Quality Network; Excellence in Clinical Quality of Care for Acute Heart Failure, Pneumonia and Surgical Care Improvement - The Center for Medicare and Medicaid Services and Premier Hospital Quality Incentive Demonstration.Providence Centralia Hospital is one of only 405 U.S. hospitals and critical access hospitals earning the distinction of top performer on key quality measures from The Joint Commission. We understand that what matters most to patients is safe, effective care. That's why we have made a commitment to accreditation and to positive patient outcomes through evidence-based care processes.Providence St. Peter Hospital is proud to be a "Magnet " recognized hospital of 2015.Level II Trauma designation - Providence Alaska Medical Center has been designated as a Level II Trauma Center. The hospital received verification from The American College of Surgeons and certification from the Alaska Department of Health & Social Services.High-Quality care - Mountain-Pacific Quality Health has awarded Providence Alaska Medical Center with its Commitment to Quality Award and Providence Kodiak Island Medical Center with its Quality Achievement Award. This award recognizes hospitals in their dedication to quality care, especially in the clinical areas of heart attack, heart failure, pneumonia and preventing surgical infection. Cardiac care award - Providence Alaska Medical Center has received the American College of Cardiology's NCDR ACTION Registry-GWTG Platinum Performance Achievement Award for 2015. PAMC is one of only 319 hospitals nationwide and the only hospital in the state of Alaska to receive the honor. The award recognizes the hospital's commitment and success in implementing a higher standard of care for heart attack patients and signifies that PAMC has reached an aggressive goal of treating these patients to standard levels of care as outlined by the American College of Cardiology/American Heart Association clinical guidelines and recommendations.
4b (Code:   ) (Expenses $ 1,427,060,776 including grants of $ 0 ) (Revenue $ 1,750,345,729 )
Acute Care - Outpatient 2,384,233 Emergency & Ancillary VisitsCyberKnife, a non-invasive radiation cancer treatment system, is now available to treat patients at the Providence Cancer Center in Anchorage. The Alaska CyberKnife Center at Providence Cancer Center is the first CyberKnife treatment facility in Alaska, providing the only radiation therapy technology that is capable of tracking and automatically correcting for patient and tumor movement. This enables high doses of radiation to be delivered with extreme precision, anywhere in the head and body. The CyberKnife System delivers robotic, non-invasive, non-surgical radiation therapy that's clinically proven to be effective for the treatment of prostate cancer, lung tumors, brain tumors, liver cancer, head and neck cancers, pancreatic tumors, kidney cancers, and other conditions. As a result of the CyberKnife system's sub-millimeter precision, doctors can deliver a much higher dose of radiation during each treatment session. This unique capability allows patients to complete treatment typically within five consecutive daily sessions, compared to the weeks or even months required for treatment with other radiation oncology technologies.Providence Sacred Heart Medical Center - The Northwest Autism Center is recognized as a Center of Excellence ABA (Applied Behavior Analysis) Day Treatment program for children with autism. This unique program serves children with autism ages two through five in an outpatient treatment setting. The intensive treatment includes three hours of parent education and training per week, in addition to care coordination, speech and language therapy, and transition services. Clinic sessions are three hours per day, four days per week for 12 weeks, in alignment with Health Care Authority requirements. Each child receives one-on-one intensive services from a therapy assistant. The program is supervised and coordinated by a Board Certified Behavior Analyst and provides hands-on supervised training opportunities for those seeking Board Certification in ABA, a field of expertise with an extremely limited provider pool in Washington State.Providence St. Peter Hospital - many arriving in the emergency department are in need of psychiatric intervention. At Providence St. Peter Hospital's emergency center, Crisis Services has trained counselors available 24/7 to support patients and families with problems related to psychiatric illness, grief, substance abuse, domestic abuse, homelessness, crime, aging and traumatic injuries. The crisis counselors also provide discharge planning and community resources to best meet the needs of patients and their families. A mental health professional provides face-to-face evaluations to help individuals establish the need for an appropriate level of mental health or substance abuse services. This unique program works within a community collaboration model and has eased the strain on the emergency center by providing on-site assessment, consults and referrals for appropriate placement.
4c (Code:   ) (Expenses $ 406,963,335 including grants of $ 0 ) (Revenue $ 499,156,412 )
LTC/Hospice/Housing & Assisted Living - 318,245 Days for Long-Term Care/Asst. Living; 343,896 Home Health Visits; 401,606 Hospice DaysProvidence Hospice is proud to participate in the We Honor Veterans program, a program of the National Hospice and Palliative Care Organization in collaboration with the Department of Veterans Affairs. Through this program, hospice professionals across the country focus on a single purpose: to provide comfort and support to veterans at the end of their lives.Hospice Care Center is Washington State's first inpatient hospice care center located within a hospital (Providence Regional Medical Center Everett's Colby Campus). It features a calm, home-like setting with family areas, a children's play room and a quiet room for reflection. The Intergenerational Learning Center (ILC) is an award-winning child care program located within Providence Mount St. Vincent in West Seattle. Five days a week, the children and residents come together in a variety of planned activities such as music, dancing, art, lunch, storytelling or just visiting. These activities result in mutual benefits for both generations. All children are welcome.Palliative and Hospice Care is the only Medicare certified hospice in Anchorage that provides primarily a "routine" level of home hospice care. In addition, there are three other levels of care that might be offered, depending on patient and family goals and the hospice team's assessment of need. Those levels are:Continuous care - short term intensive services in the home; General Inpatient - short term acute care under hospice at PAMC; and Respite care - short term care in a designated facility. Providence Hospice is nationally accredited by the Accreditation Commission for Health Care, Inc.Providence ElderPlace is an innovative program of health care and social services for older adults. Our model of care is known as PACE (Program of All Inclusive Care for the Elderly). PACE programs keep older adults as healthy as possible in the community by providing comprehensive health care and social services including: primary and specialty medical care, a day health program, social work services, rehabilitation, housing (if necessary) and much more. Participants attend the Providence ElderPlace Center on a regular basis, and transportation is provided. The ElderPlace team of health care and social service professionals and our affiliates provide comprehensive integrated care to our participants.
(Code:   ) (Expenses $ 393,818,160 including grants of $ 0 ) (Revenue $ 483,033,341 )
Primary Care 1,760,156 Clinic VisitsProvidence St. Mary Medical Center in Walla Walla offered a free drive through flu shot clinic and a free prostate screening clinic during 2015.Providence Medical Group of SW WA - to provide lower-cost diabetes education in rural Southwest Washington, primary care clinics use telehealth secure videoconferencing between a patient and a diabetes educator. Bringing diabetes education directly to patients in rural areas improves patient and provider access to diabetes services, reduces health disparities and costs significantly less than an office visit. Because of a lack of access to primary care, many rural diabetes patients were at greater risk for diabetic complications. The telehealth diabetes education has increased access while serving the Mission.
(Code:   ) (Expenses $ 22,649,564 including grants of $ 22,649,564 ) (Revenue $ 0 )
Grant & Allocations - See Schedules F & I
4d Other program services (Describe in Schedule O.)
(Expenses $ 416,467,724 including grants of $ 22,649,564 ) (Revenue $ 483,033,341 )
4e Total program service expensesMediumBullet4,708,706,601
Form 990 (2015)
Form 990 (2015)
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
Yes
 
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
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.....Click to see attachment
15
Yes
 
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...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....Click to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............ Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................Click to see attachment
19
Yes
 
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 (2015)
Form 990 (2015)
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
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
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
Yes
 
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 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
2,338
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
35,521
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
Yes
 
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
Yes
 
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
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
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 (2015)
Form 990 (2015)
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
14
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
14
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
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 CPA2001 Lind Ave SW   Renton,WA98057 (425) 525-3339
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Michael Holcomb......................................................................
Chair of the Board
7.60
.................
0.10
X   X       60,360 0 0
(2) Chauncey Boyle SP......................................................................
Director
5.50
.................
0.10
X           0 0 0
(3) Marian Schubert CSJ......................................................................
Director
4.30
.................
0.10
X           0 0 0
(4) Phyllis Hughes RSM......................................................................
Director
5.00
.................
0.10
X           0 0 0
(5) Carolina Reyes MD......................................................................
Director
4.60
.................
0.10
X           15,360 0 0
(6) Michael A Stein......................................................................
Director
6.00
.................
0.10
X           15,360 0 0
(7) Eugene Al Parrish......................................................................
Director
5.00
.................
0.10
X           15,360 0 0
(8) Bob Wilson......................................................................
Director
5.00
.................
0.10
X           18,360 0 0
(9) Sallye Liner......................................................................
Director
4.30
.................
0.10
X           15,360 0 0
(10) Isiaah Crawford......................................................................
Director
4.10
.................
0.10
X           18,360 0 0
(11) Martha Diaz Aszkenazy......................................................................
Director
7.70
.................
0.10
X           18,360 0 0
(12) Kirby McDonald......................................................................
Director
4.60
.................
0.10
X           15,360 0 0
(13) Dave Olsen......................................................................
Director
5.50
.................
0.10
X           17,860 0 0
(14) Charles Chuck Watts......................................................................
Director
4.60
.................
0.10
X           18,360 0 0
(15) Rod F Hochman MD......................................................................
President / CEO
25.00
.................
40.00
    X       5,102,809 0 74,417
(16) Todd Hofheins......................................................................
EVP/CFO
25.00
.................
40.00
    X       970,092 0 295,713
(17) Cindy Strauss......................................................................
EVP/Chief Legal Officer
23.00
.................
37.00
    X       1,526,357 0 64,699
Form 990 (2015)
Form 990 (2015)
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) Anthony Dorsch........................................................................
CFO/PSMS Shared Services
21.00
.......................34.00
    X       446,827 0 99,433
(19) Bruce Lamoureux........................................................................
CE/AK. Region
25.00
.......................40.00
    X       1,042,351 0 73,289
(20) Craig Wright MD........................................................................
SVP/Physician Services
23.00
.......................37.00
      X     2,795,040 0 125,380
(21) Randy Axelrod MD Thru 315........................................................................
EVP/Clinical & Patient Services
23.00
.......................37.00
      X     1,416,580 0 35,750
(22) Mike Butler........................................................................
President/Operations & Services
23.00
.......................37.00
      X     1,572,348 0 740,248
(23) Debbie Burton........................................................................
SVP/ Chief Nrsg. Officer
23.00
.......................37.00
      X     683,302 0 55,602
(24) Debra Canales........................................................................
EVP/Chief People & Experience Ofc.
23.00
.......................37.00
      X     1,650,655 0 458,130
(25) Medrice Coluccio........................................................................
CE/Southwest WA. Region
50.00
.......................2.00
      X     990,635 0 132,873
(26) Elaine Couture........................................................................
CE/PHC/Eastern WA. Region
58.00
.......................2.00
      X     988,860 0 92,132
(27) Jack Friedman Thru 615........................................................................
SVP/Accountable Care & Payor Rel.
19.00
.......................31.00
      X     770,782 0 117,919
(28) Mark Gargett........................................................................
VP/Digital Integration
19.00
.......................31.00
      X     632,716 0 82,292
(29) Joel Gilbertson........................................................................
SVP, Comm. Partnrshp. & Ext. Affairs
23.00
.......................37.00
      X     566,699 0 203,896
(30) Aaron Martin........................................................................
SVP/Strategy & Innovation
25.00
.......................40.00
      X     681,696 0 189,399
(31) Tom McDonagh........................................................................
VP/Chief Investment Officer
21.00
.......................37.00
      X     963,343 0 58,116
(32) Rhonda Medows MD........................................................................
EVP/Population Health
23.00
.......................37.00
      X     667,975 0 188,508
(33) Jack Mudd........................................................................
SVP/Mission Leadership
21.00
.......................34.00
      X     632,418 0 88,850
(34) Janice Newell........................................................................
SVP/Chief Information Officer
23.00
.......................37.00
      X     1,535,323 0 37,767
(35) Harvey Smith........................................................................
SVP/Chief Customer Svc. Officer
19.00
.......................31.00
      X     844,548 0 41,905
(36) Teresa Spalding........................................................................
VP/Revenue Cycle
23.00
.......................37.00
      X     691,899 0 45,132
(37) Greg Till........................................................................
VP/Chief Talent Officer
23.00
.......................37.00
      X     534,186 0 99,744
(38) Sharon Toncray........................................................................
SVP/HR Strat. Partners
21.00
.......................37.00
      X     563,982 0 196,084
(39) Lisa Vance........................................................................
SVP/Clinical Program Services
25.00
.......................40.00
      X     786,086 0 51,186
(40) Jason Dryer........................................................................
Neurosurgeon
55.00
.......................0.00
        X   2,986,849 0 37,207
(41) David Yam........................................................................
Neurosurgeon
55.00
.......................0.00
        X   2,042,108 0 32,537
(42) Joseph Gifford........................................................................
VP/CE ACO of WA
55.00
.......................0.00
        X   1,123,101 0 30,430
(43) J Michael Marsh........................................................................
CAO/Western WA
55.00
.......................0.00
        X   1,076,097 0 23,221
(44) James Brevig........................................................................
Cardiothoracic Surgeon
55.00
.......................0.00
        X   1,018,235 0 26,029
(45) John Fletcher........................................................................
Former VP/Operations Support
0.00
.......................0.00
          X 583,850 0 18,778
(46) Jan Jones........................................................................
Former SVP/CAO
0.00
.......................0.00
          X 759,461 0 33,986
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 38,875,670 0 3,850,652
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet5,017
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
Allied Health Group

File 50941
Los Angeles,CA90074
Agency Staffing 31,199,580
The Everett Clinic

3901 Hoyt Avenue
Everett,WA98201
Medical Services 24,716,772
Bouten Construction

627 N Napa Street
Spokane,WA99220
Construction 10,626,575
Howard S Wright Constructors

415 First Avenue N Suite 400
Seattle,WA98109
Construction 9,303,932
Denali Advanced Integration

17735 NE 65th Street Suite 13
Redmond,WA98052
Software Support 8,724,411
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet532
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a 15,905
b Membership dues..1b  
c Fundraising events..1c 876,980
d Related organizations1d 12,163,906
e Government grants (contributions)1e 13,759,408
f All other contributions, gifts, grants, and similar amounts not included above1f 4,873,786
g Noncash contributions included in lines 1a-1f:$  
h Total.Add lines 1a-1f.......MediumBullet 31,689,985
 Program Service RevenueAmt Business Code
2a Acute Care/Inpatient 900099 1,963,292,607 1,963,292,607    
b Acute Care/Outpatient 621400 1,139,744,952 1,139,744,952    
c LTC/Homecare/Hospice 621610 325,027,788 325,027,788    
d Primary Care 621110 314,529,183 314,529,183    
e
f All other program service revenue. 1,888,117,444 1,888,117,444    
g Total.Add lines 2a–2f.....MediumBullet 5,630,711,974
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 33,214,511     33,214,511
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet 600,000     600,000
(ii) Personal (i) Real
6a Gross rents 19,793 30,685,049
b Less: rental expenses 0 13,450,165
c Rental income or (loss) 19,793 17,234,884
d Net rental income or (loss)......MediumBullet 17,254,677   466,310 16,788,367
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 6,972,218 1,031,370,513
b Less: cost or other basis and sales expenses 8,692,444 1,021,480,205
c Gain or (loss) -1,720,226 9,890,308
d Net gain or (loss).....MediumBullet 8,170,082     8,170,082
8a Gross income from fundraising events (not including $ 876,980of contributions reported on line 1c). See Part IV, line 18 ....
a 255,002
b Less: direct expenses ...b 711,668
c Net income or (loss) from fundraising events..MediumBullet -456,666   -456,666
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 28,850
b Less: direct expenses ...b 12,502
c Net income or (loss) from gaming activities..MediumBullet 16,348     16,348
10a Gross sales of inventory, less
returns and allowances ..
a 2,365,899
b Less: cost of goods sold ..b 1,329,064
c Net income or (loss) from sales of inventory..MediumBullet 1,036,835     1,036,835
Business Code Miscellaneous Revenue
11a Healthcare JVs 900099 29,547,370 27,143,021 2,404,349  
b Pharmacy Revenue 446110 27,516,132 24,702,007 2,814,125  
c Cafeteria Revenue 722210 16,883,681   54,905 16,828,776
d All other revenue .... 157,246,286 65,074,816 718,496 91,452,974
e Total. Add lines 11a–11d ...... MediumBullet 231,193,469
12 Total revenue. See Instructions......MediumBullet 5,953,431,215 5,747,631,818 6,458,185 167,651,227
Form 990 (2015)
Form 990 (2015)
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 20,243,288 20,243,288
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 815,359 815,359
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 1,590,917 1,590,917
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 32,436,508 9,248,313 23,188,195  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 1,352,281   1,352,281  
7 Other salaries and wages 2,154,538,525 1,430,288,759 724,138,310 111,456
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 280,310,139 20,808,762 259,499,511 1,866
9 Other employee benefits ....... 620,351,741 10,221,401 610,129,856 484
10 Payroll taxes ........... 151,874,000 95,561,005 56,302,567 10,428
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 10,852,900 353,095 10,499,805  
c Accounting ........... 3,288,868   3,288,868  
d Lobbying ........... 986,176   986,176  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 3,337,625   3,337,625  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 584,828,086 311,224,043 273,592,741 11,302
12 Advertising and promotion .... 19,909,040 1,212,896 18,696,144  
13 Office expenses ....... 131,657,948 65,944,677 65,713,247 24
14 Information technology ...... 144,321,620 2,768,848 141,548,427 4,345
15 Royalties ..        
16 Occupancy ........... 97,941,671 40,151,917 57,789,754  
17 Travel ............ 29,383,566 6,782,766 22,597,858 2,942
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 12,883,546 3,400,155 9,483,391  
20 Interest ........... 69,220,202 69,377,183 -156,981  
21 Payments to affiliates ....... 3,447,474   3,447,474  
22 Depreciation, depletion, and amortization .. 265,917,109 123,896,153 142,020,956  
23 Insurance ... 13,111,321 4,764,987 8,346,334  
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 Claims Expense 1,879,508,787 1,879,508,787    
b Medical Supplies 541,769,153 541,955,780 -186,627  
c Bad Debt Expense 48,825,271 48,254,137 571,134  
d UBI Taxes 478,669   478,669  
e All other expenses 125,092,756 20,333,373 104,646,801 112,582
25 Total functional expenses. Add lines 1 through 24e 7,250,274,546 4,708,706,601 2,541,312,516 255,429
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 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 34,927,355 1 81,934,754
2 Savings and temporary cash investments ......... 583,295,465 2 452,410,656
3 Pledges and grants receivable, net ...... 1,695,261 3 1,220,034
4 Accounts receivable, net ............. 538,713,832 4 538,283,750
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 .... 27,740,380 7 28,671,008
8 Inventories for sale or use ........ 75,925,085 8 75,239,143
9 Prepaid expenses and deferred charges ...... 95,885,053 9 43,779,100
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 5,277,633,055
b Less: accumulated depreciation 10b 2,706,458,927 2,610,683,455 10c 2,571,174,128
11 Investments—publicly traded securities . 1,722,018,012 11 1,851,596,134
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .. 122,203,289 13 137,721,075
14 Intangible assets ............... 33,256,787 14 32,786,682
15 Other assets. See Part IV, line 11 ........... 4,312,786,409 15 7,438,350,849
16 Total assets. Add lines 1 through 15 (must equal line 34)... 10,159,130,383 16 13,253,167,313
Liabilities 17 Accounts payable and accrued expenses ..... 665,592,937 17 623,470,647
18 Grants payable ...   18  
19 Deferred revenue ......... 118,944,216 19 31,130,936
20 Tax-exempt bond liabilities ......... 845,274,482 20 842,079,700
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 .. 769,830,032 23 752,743,268
24 Unsecured notes and loans payable to unrelated third parties .. 13,540,890 24 138,444,900
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 5,171,879,336 25 8,151,208,391
26 Total liabilities. Add lines 17 through 25.. 7,585,061,893 26 10,539,077,842
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 2,524,680,418 27 2,671,478,841
28 Temporarily restricted net assets ........... 35,157,038 28 28,122,202
29 Permanently restricted net assets 14,231,034 29 14,488,428
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 ........... 2,574,068,490 33 2,714,089,471
34 Total liabilities and net assets/fund balances ........ 10,159,130,383 34 13,253,167,313
Form 990 (2015)
Form 990 (2015)
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
5,953,431,215
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
7,250,274,546
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-1,296,843,331
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
2,574,068,490
5
Net unrealized gains (losses) on investments ...............
5
-82,746,619
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
-55,900
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
1,519,666,831
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
2,714,089,471
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2015)
Form 990 (2015)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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
2015
Open to Public
Inspection
Name of the organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number

51-0216586
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
6
7
8
9
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 (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 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2015

Schedule A (Form 990 or 990-EZ) 2015
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 (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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 section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
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 I of Schedule L (Form 990 or 990-EZ).
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 9a) 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 9a) 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 section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b 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
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
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
 
 
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, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) 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) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
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 2015 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-2015
(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2016. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
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) 2015


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
2015
Name of the organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number

51-0216586
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number
51-0216586
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number

51-0216586
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) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number

51-0216586
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) (2015)

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 BulletInformation about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on 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
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number

51-0216586
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-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2015

Schedule C (Form 990 or 990-EZ) 2015
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) 2012 (b) 2013 (c) 2014 (d) 2015 (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) 2015


Schedule C (Form 990 or 990-EZ) 2015
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 on 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)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
Yes
 
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
378,323
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
607,853
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
 
j
Total. Add lines 1c through 1i ....................................................................................................
986,176
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: As part of our nearly 160-year Mission, Providence has long advocated for important health and social programs in our communities. Our special focus on serving those who are poor and vulnerable compels us to advocate for a better and more just health care system. We believe that health care is a basic human right. When individuals and families have access to care, quality of life improves. Policymakers can help us improve the health of entire communities by supporting innovation, integration and evidence-based care. We are creating healthier communities, together. Our 2015 Advocacy Agenda HELP US BUILD HEALTHIER COMMUNITIES The entire landscape of health care is in a dramatic transformation. A digital revolution is making care more personal and available. Technology and medical research are saving lives. At Providence, we are harnessing these advances to design the best possible whole-person care, with a special focus on those who are poor and vulnerable. This is our strategic plan in action - to improve the overall health of entire populations while supporting the health and well-being of each person we serve. Caring for populations requires large-scale collaboration and innovation. To meet these goals, Providence ministries and affiliates are pioneering new models and fostering unique partnerships across regions. In this dynamic environment, we urge our policymakers to build legislative and regulatory pathways that support innovation, integration and evidence-based care. Together, we can help create healthier communities. HELP PROVIDERS TO FULLY REDESIGN CARE AND PAYMENT New models of care have the potential to truly transform delivery by recognizing and rewarding outcomes and allowing providers to be accountable for quality, cost and the overall patient experience. There are many value-based models, both public and private, that can be supported. We asked policymakers to: * Help increase participation in new payment and delivery models, such as the Medicare Shared Savings Program, by offering greater flexibility for provider agreements and the ability to assign patients participating in these models. * Streamline the regulatory framework and state Medicaid waiver process to support greater clinical integration of providers participating in alternative care models. * Reform the Medicare physician payment system with a more stable update mechanism and establish clear incentives for physicians and other providers to participate in alternative payment models. * Support growth and innovation in the Medicare Advantage program while protecting the ability of high-quality plans to grow and serve patients in new markets. * Preserve the 340B Drug Pricing Program by resisting efforts to limit the scope of the program, and ensure it continues as a vital resource for safety net and rural providers serving low-income populations. * Support legislation to update and expand access to telehealth services by eliminating outdated barriers to providing services through commercial insurance and Medicare. * Support the training of new primary care physicians by reauthorizing the Teaching Health Center Graduate Medical Education Program, which expires in 2015. CREATE MORE OPTIONS FOR PALLIATIVE AND END-OF-LIFE CARE Providence honors the dignity of every person we serve by responding to our patients' unique health care needs at every stage of illness. When our patients and their loved ones face a life-threatening illness, we have come to understand that integrated, whole-person care can relieve suffering and enhance quality of life. We asked policymakers to: * Enhance coverage for palliative and end-of-life services in Medicare and Medicaid. * Allow Medicare patients to receive trial treatments as well as hospice care. * Support policy changes that redesign payment to improve care coordination across provider settings for individuals at or near the end of life. * Support provider education to enhance the delivery of palliative care across clinical specialties, and specifically incorporate palliative care as a requirement for graduate medical and continuing education. PRESERVE AND BUILD ON COVERAGE EXPANSION Millions of people are now enrolled in private coverage or Medicaid. Expanded coverage creates the opportunity to advance new systems of care, and by incorporating population health strategies for the newly insured, we can facilitate clinical transformation and payment reform. We asked policymakers to: * Seek sustainable financial solutions for Medicaid to preserve current funding and prevent future budget reductions. * Support expansion of Medicaid coverage in every state to full eligibility levels. * Extend the Medicaid primary care payment increase that expired on Jan. 1, 2015. * Reauthorize the Children's Health Insurance Program. * Protect funding for federal premium subsidies for health insurance exchanges. * Find mechanisms to expand coverage and access for those who remain uninsured. INCREASE ACCESS TO BEHAVIORAL HEALTH CARE AND SERVICES The nation's behavioral health care system has been plagued by gaps in access and funding for many years. As a result, individuals with severe mental health and chemical dependency conditions struggle to receive needed care and medications in their communities. More care options can and should be available, to reduce suffering and unnecessary social, criminal justice and health care costs. We asked policymakers to: * Ensure Medicaid coverage for behavioral health is adequate. * Support important changes to Medicaid and Medicare coverage for behavioral health services, encouraging integration between medical and behavioral health care. * Improve funding to ensure patients have access to inpatient psychiatric and community-based behavioral health services and prevent long, unnecessary acute hospital stays and emergency department holds. * Strengthen public health infrastructure to provide greater access to services for these very vulnerable patients.
Part II-B, Line 1: Costs related to Lines 1d and 1i are included in the costs reported on Line 1g.
Schedule C (Form 990 or 990EZ) 2015


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," 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 & SERVICES -
WASHINGTON
Employer identification number

51-0216586
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 ....    
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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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 on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $ 20,000
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 on 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) 2015

Schedule D (Form 990) 2015
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" on 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" 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 .... 17,766 16,324 15,046 9,052 8,030,149
b Contributions ...       2,500 24,281
c Net investment earnings, gains, and losses   1,442 1,278 3,494 61,799
d Grants or scholarships ...         8,107,177
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ...... 17,766 17,766 16,324 15,046 9,052
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet0 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
No
(ii) related organizations .................
3a(ii)
 
No
b
If "Yes" on 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' 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 ... 31,554,085 129,214,029 160,768,114
b Buildings 209,897,779 2,123,710,919 1,091,333,148 1,242,275,550
c Leasehold improvements   218,887,245 96,023,147 122,864,098
d Equipment ... 51,998,367 2,410,057,317 1,519,102,632 942,953,052
e Other ... 19,217 102,294,097   102,313,314
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 2,571,174,128
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other 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.)Small Bullet  
Part VIII
Investments—Program 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.)Small Bullet  
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) Due From Affiliates 7,089,048,754
(2) Trustee Held Funds 231,212,898
(3) Unamortized Finance Costs 14,826,328
(4) Other Long-Term Receivables 40,799,848
(5) Third Party Settlements 32,178,341
(6) Charitable Trusts & Gift Annuities 253,095
(7) CSV of Life Insurance 78,509
(8) Deferred Compensation 457F 5,181,263
(9) Bond Premium Discount 1,312,676
(10) Donated Assets 20,000
(11) Accrued Rebates 8,361,421
(12) Provider Tax 419,471
(13) Deposits 14,658,245
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 7,438,350,849
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  
Self-Insured Trusts 48,658
Due To Affiliates 6,832,779,073
Non-Trust Workers Comp 281,794,524
Accrued Pension Costs 897,350,572
LT Asset Retirement Obligation - FIN 47 21,164,222
Other Long-Term Payables 81,174,603
Third Party Settlements 36,896,739
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 8,151,208,391
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

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  
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' on 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 III, Line 4: Artwork is received from a local world-renowned glass sculptor Dale Chihuly, and is displayed at Providence Hospice and Home Care of Snohomish County to enhance the environment for the patients and their families.
Part V, Line 4: The Endowment Funds are intended to be used to provide home health services to the poor & vulnerable in Eastern Washington.
Part X, Line 2: The Health System (Providence Health & Services) 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) 2015


Additional Data


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SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (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 & SERVICES -
WASHINGTON
Employer identification number

51-0216586
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region
(f) Total expenditures
for and investments
in region
Middle East and North Africa 0 0 Grantmaking   514,785
Central America and the Caribbean 0 0 Grantmaking   647,528
South Asia 0 0 Grantmaking   268,984
Sub-Saharan Africa 0 0 Grantmaking   144,190
South America 0 0 Grantmaking   3,745
East Asia and the Pacific 0 0 Grantmaking   1,718
North America 0 0 Grantmaking   9,967
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 1,590,917
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 1,590,917
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(a)(c) Region (b)(d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of non-cash
assistance
(h) Description
of non-cash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
Middle East and North Africa Medical Supplies     514,785 Medical Supplies Cost
South Asia Medical Supplies     243,033 Medical Supplies Cost
Central America and the Caribbean Medical Supplies     193,134 Medical Supplies Cost
Sub-Saharan Africa Medical Supplies     88,894 Medical Supplies Cost
Central America and the Caribbean Medical Supplies     30,972 Medical Supplies Cost
Sub-Saharan Africa Medical Supplies     28,837 Medical Supplies Cost
Central America and the Caribbean Medical Supplies     14,151 Medical Supplies Cost
Central America and the Caribbean Medical Supplies     12,426 Medical Supplies Cost
Sub-Saharan Africa Medical Supplies     7,809 Medical Supplies Cost
Sub-Saharan Africa Medical Supplies     5,676 Medical Supplies Cost
Central America and the Caribbean Medical Mission Trips     393,937 Medical Mission Trips Cost
South Asia Disaster Relief 25,000 Check      
North America Medical Mission Trips     9,731 Medical Mission Trips Cost
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
13
3 Enter total number of other organizations or entities .......................MediumBullet
0
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
non-cash
assistance
(g) Description
of non-cash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
Part I, Line 2: We only provide grants to non-governmental, charitable organizations that conduct foreign activities. For the donations we require a potential recipient to first complete an application. We have two types of applications; one for donations that will be taken by a person on a plane and part of medical team, the other for container donations that will be shipped. The type of information gathered is different for each application. We always ask for the name of the specific clinic, program or hospital that will be at the clinic. We also ask for information about who will be served/benefit from these donations. We also ask that the recipient provide us feedback on how useful the donations were and what problems they may have encountered.
Schedule F, Part IV, Line 1 Form 926 is not required to be filed because the transfer to a foreign corporation does not meet the reporting requirements in IRC Section 6038B(a)(1)(A).
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2015
Additional Data


Software ID:  
Software Version:  



SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ.
right arrowInformation about Schedule G (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 & SERVICES -
WASHINGTON
Employer identification number

51-0216586
Part I
Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.


(i) Name and address of individual
or entity (fundraiser)
(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity
(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i)
(vi) Amount paid to
(or retained by)
organization
Yes No
             
             
             
             
             
             
             
             
             
             
Total . . . . . . . . . . . . . . . . . . . . right arrow      
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.




VerticalRevenue
(a) Event #1

Providence O'Christmas Trees
(event type)
(b) Event #2

Golf Classic
(event type)
(c) Other events

 
(total number)
(d) Total events
(add col. (a) through col. (c))

1

Gross receipts . . . . .

1,071,982

60,000

 

1,131,982

2

Less: Contributions . . . .

846,355

30,625

 

876,980
3 Gross income (line 1 minus
line 2) . . . . . .

225,627

29,375

 

255,002



VerticalDirectExpenses
4 Cash prizes . . . . .        
5 Noncash prizes . . . .   300   300
6 Rent/facility costs . . . . 13,990 19,385   33,375
7 Food and beverages . . . 209,407 8,780   218,187
8 Entertainment . . . .        
9 Other direct expenses . . . 446,278 13,528   459,806
10 Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . . right arrow 711,668
11 Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . . right arrow -456,666
Part III
Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue
(a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo
(c) Other gaming (d) Total gaming (add col.(a) through col.(c))

1

Gross revenue . . . . .

 

 

28,850

28,850
VerticalDirectExpenses

2

Cash prizes . . . . .

 

 

 

 

3

Noncash prizes . . . .

 

 

 

 

4

Rent/facility costs . . . .

 

 

1,437

1,437

5

Other direct expenses . . .

446,278

13,528

 

459,806


6


Volunteer labor . . . .
%
%
100.000 %


7

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

12,502

8

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

16,348

9
Enter the state(s) in which the organization conducts gaming activities: WA
a
Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2015
Schedule G (Form 990 or 990-EZ) 2015
Page 3
11
Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? . . . . . . . . . . . . . . . . .
13
Indicate the percentage of gaming activity conducted in:
a
The organization's facility . . . . . . . . . . . . . . . . . .
13a
0 %
b
An outside facility . . . . . . . . . . . . . . . . . . . .
13b
100.000 %
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Patricia L Szabo
Address right arrow
4831 35th Avenue SW
Seattle,WA98126
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? . . . . . . . . . . . . . . . . . . . . . . . .
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Patricia L Szabo
Gaming manager compensation right arrow $ 0
Description of services provided right arrow
Provided oversight of sale of raffle tickets and accounting for proceeds received.
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? . . . . . . . . . . . . . . . . . . .
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
Schedule G (Form 990 or 990-EZ) 2015
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on 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
2015
Open to Public Inspection
Name of the organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number

51-0216586
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) . . .
  18,697 73,500,614   73,500,614 1.010 %
b Medicaid (from Worksheet 3, column a) . . . . .   214,676 921,863,389 751,927,771 169,935,618 2.340 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .   64 239,732 206,216 33,516 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .   233,437 995,603,735 752,133,987 243,469,748 3.350 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).   127,387 9,545,024 124,348 9,420,676 0.130 %
f Health professions education (from Worksheet 5) . . .   7,037 30,710,088 9,816,287 20,893,801 0.290 %
g Subsidized health services (from Worksheet 6) . . . .   5,795 27,382,630 13,814,563 13,568,067 0.190 %
h Research (from Worksheet 7) .     4,243,081 719,301 3,523,780 0.050 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .   9,809 8,769,184 3,524 8,765,660 0.120 %
j Total. Other Benefits . .   150,028 80,650,007 24,478,023 56,171,984 0.780 %
k Total. Add lines 7d and 7j .   383,465 1,076,253,742 776,612,010 299,641,732 4.130 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
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   235 15,943   15,943 0 %
2 Economic development     30,000   30,000 0 %
3 Community support   138 4,550   4,550 0 %
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building   100 90,949   90,949 0 %
7 Community health improvement advocacy            
8 Workforce development     133   133 0 %
9 Other   24 10,285   10,285 0 %
10 Total   497 151,860   151,860  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
48,825,271
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
1,212,805,110
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
1,414,008,083
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-201,202,973
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) 2015
Schedule H (Form 990) 2015
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?13
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 Providence Alaska Medical Center
3200 Providence Drive
Anchorage,AK99508
alaska.providence.org/
GACH-007
X X X X     X      
2 Providence SHMC & Children's Hospital
101 West 8th Avenue
Spokane,WA99204
washington.providence.org/
00000162
X X X       X      
3 Providence St Peter Hospital
413 Lilly Road NE
Olympia,WA98506
washington.providence.org/
00000159
X X         X      
4 Providence Regional Med CtrColby
1321 Colby Avenue
Everett,WA98201
washington.providence.org/
00000084
X X         X      
5 Providence Regional Med CtrPacific
916 Pacific Avenue
Everett,WA98208
washington.providence.org/
00000084
X X         X      
6 Providence Holy Family Hospital
5633 North Lidgerwood Street
Spokane,WA99208
washington.providence.org/
00000139
X X         X      
7 Providence Centralia Hospital
914 S Scheuber Road
Centralia,WA98531
washington.providence.org/
00000191
X           X      
8 Providence St Mary Medical Center
401 W Poplar St
Walla Walla,WA99362
washington.providence.org/
00000050
X X         X      
9 Providence Mt Carmel Hospital
982 East Columbia
Colville,WA99114
washington.providence.org/
00000030
X X     X   X      
10 Providence St Joseph's Hospital
500 East Webster Street
Chewelah,WA99109
washington.providence.org/
00000194
X X         X      
11 Providence Kodiak Is Medical Center
1915 Rezanof Drive
Kodiak Island,AK99615
alaska.providence.org/
GACH-008
X       X          
12 Providence Seward Medical & Care Center
417 1st Avenue
Seward,AK99664
alaska.providence.org/
RPCH-001
X           X      
13 Providence Valdez Medical Center
911 Meals Ave
Valdez,AK99686
alaska.providence.org/
CAH-002
X       X          
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence Alaska 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 15
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  
6 a 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   No
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): communitybenefit.providence.org/community-health-needs-assessments/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence Alaska Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/AK/financial-assistance.html
b
www2.providence.org/obp/states/AK/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence Alaska Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence SHMC & Children's Hospital
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):
2
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 15
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  
6 a 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   No
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 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): communitybenefit.providence.org/community-health-needs-assessments/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence SHMC & Children's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/WA/financial-assistance.html
b
www2.providence.org/obp/states/WA/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence SHMC & Children's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence St Peter Hospital
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):
3
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 14
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  
6 a 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   No
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   No
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence St Peter Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/WA/financial-assistance.html
b
www2.providence.org/obp/states/WA/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence St Peter Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence Regional Med Ctr Colby
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):
4
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  
6 a 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   No
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   No
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): communitybenefit.providence.org/community-health-needs-assessments/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence Regional Med Ctr Colby
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/WA/financial-assistance.html
b
www2.providence.org/obp/states/WA/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence Regional Med Ctr Colby
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence Regional Med Ctr Pacific
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):
5
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  
6 a 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   No
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   No
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): communitybenefit.providence.org/community-health-needs-assessments/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence Regional Med Ctr Pacific
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/WA/financial-assistance.html
b
www2.providence.org/obp/states/WA/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence Regional Med Ctr Pacific
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence Holy Family Hospital
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):
6
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 15
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  
6 a 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   No
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 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): communitybenefit.providence.org/community-health-needs-assessments/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence Holy Family Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/WA/financial-assistance.html
b
www2.providence.org/obp/states/WA/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence Holy Family Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence Centralia Hospital
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):
7
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 14
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  
6 a 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   No
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   No
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence Centralia Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/WA/financial-assistance.html
b
www2.providence.org/obp/states/WA/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence Centralia Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence St Mary 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):
8
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 15
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  
6 a 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   No
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   No
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 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): communitybenefit.providence.org/community-health-needs-assessments/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence St Mary Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/WA/financial-assistance.html
b
www2.providence.org/obp/states/WA/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence St Mary Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence Mt Carmel Hospital
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):
9
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  
6 a 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   No
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): communitybenefit.providence.org/community-health-needs-assessments/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence Mt Carmel Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/WA/financial-assistance.html
b
www2.providence.org/obp/states/WA/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence Mt Carmel Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence St Joseph's Hospital
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):
10
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  
6 a 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   No
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): communitybenefit.providence.org/community-health-needs-assessments/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence St Joseph's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/WA/financial-assistance.html
b
www2.providence.org/obp/states/WA/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence St Joseph's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence Kodiak Is 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):
11
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  
6 a 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   No
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   No
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): communitybenefit.providence.org/community-health-needs-assessments/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence Kodiak Is Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/AK/financial-assistance.html
b
www2.providence.org/obp/states/AK/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence Kodiak Is Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence Seward Medical & Care 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):
12
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 15
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  
6 a 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   No
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   No
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 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): communitybenefit.providence.org/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence Seward Medical & Care Center
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/AK/financial-assistance.html
b
www2.providence.org/obp/states/AK/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence Seward Medical & Care Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Providence Valdez 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):
13
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 14
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  
6 a 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   No
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   No
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 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): communitybenefit.providence.org/
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" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Providence Valdez Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
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
www2.providence.org/obp/states/AK/financial-assistance.html
b
www2.providence.org/obp/states/AK/financial-assistance.html
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) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Providence Valdez Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized 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 19. (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 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 7
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
Providence Alaska Medical Center Part V, Section B, Line 5: PAMC conducts the CHNA in collaboration with a diverse stakeholder group of community partners in order to identify and address the most significant community health need priorities in Anchorage. Representatives from each of the partner organizations comprised the Anchorage CHNA Advisory Group, which directed the assessment process from its inception to completion. These organizations were chosen due to the fact that they serve and represent the broadests interests of the community of Anchorage.The persons consulted in conducting the CHNA to ensure broad community representation and process integrity were:-Lisa Aquino, Catholic Social Services-Michele Brown, United Way-Kathleen Hollis, Providence Health and Services Alaska-Nathan Johnson, Providence Health and Services Alaska-Tari O'Connor, Municipality of Anchorage Public Health-Randi Sweet, United Way-Charles J. Utermohle, Ph.D., State of Alaska Division of Public Health-Jon Zasada, Anchorage Neighborhood Health Center
Providence SHMC & Children's Hospital Part V, Section B, Line 5: Over 70 representatives from various agencies participated. 170 invitations were sent out to community leaders and organization representatives. A complete list of those participating is available in the Community Health Needs Assessment.
Providence St. Peter Hospital Part V, Section B, Line 5: A workgroup was convened to review the content of the community health needs assessment, community benefit plan and identify priority health needs. Workgroup members represented a variety of sectors in our community, including organizations that serve the medically underserved, low-income, or minority populations in our community:-Peter Brennan, Executive Director Providence St. Peter Foundation-Kevin Haughton, MD, United Way, Thurston Thrives, PMG -Dan Keahey, Community Board Member-Allen Rohr, Community Board President-Mercy Mvundura, Board Member, Providence Centralia Foundation-Leslie Torve, Community Board Member-Daidre West, Community Board President-Paul Wilkinson, Chief Operating Officer, PSPHOther partners in the CHIP Committee and Community Assessment Participants included various community based organizations that represent medically underserved, low-income and minority populations:-Lewis County Public Health and Social Services-United Way of Lewis County-Valley View Health Centers-Child and Family Studies at Centralia College-CHOICE regional health network-Lewis County Juvenile Court-Morton Hospital-Lewis County CHIP core partners-Lewis County Community Health Partnership-Lewis County Mental Health Coalition-Lewis County Thrives-Love INC-Lewis County Board of Health-Lewis County Chamber of Commerce-Lewis County Community Development-Community members at large in Pe El and Onalaska
Providence Regional Med. Ctr. Colby Part V, Section B, Line 5: The Providence Mission Committee of the Board, which has broad representation from the community, provides guidance to the CHNA work group as the assessment is developed. Providence is also an active participant in community partnerships in order to create healthier communities together. One such partnership, the Snohomish County Public Health Advisory Council, presented data and obtained input from the community through various venues including a public forum, media releases, posting on the Snohomish Health District web page and distribution through community leaders. Other noteworthy partnerships that enabled Providence to obtain information and input to help inform the community needs assessment include:Providence Regional Medical Center Everett CHNA Work Group (Senior Leadership Team)Providence Mission Committee of the BoardSnohomish County Health Leadership CoalitionSnohomish County Public Health Advisory CouncilSnohomish County Health Policy Group
Providence Regional Med. Ctr. Pacific Part V, Section B, Line 5: The Providence Mission Committee of the Board, which has broad representation from the community, provides guidance to the CHNA work group as the assessment is developed. Providence is also an active participant in community partnerships in order to create healthier communities together. One such partnership, the Snohomish County Public Health Advisory Council, presented data and obtained input from the community through various venues including a public forum, media releases, posting on the Snohomish Health District web page and distribution through community leaders. Other noteworthy partnerships that enabled Providence to obtain information and input to help inform the community needs assessment include:Providence Regional Medical Center Everett CHNA Work Group (Senior Leadership Team)Providence Mission Committee of the BoardSnohomish County Health Leadership CoalitionSnohomish County Public Health Advisory CouncilSnohomish County Health Policy Group
Providence Holy Family Hospital Part V, Section B, Line 5: Over 70 representatives from various agencies participated. 170 invitations were sent out to community leaders and organization representatives. A complete list of those participating is available in the Community Health Needs Assessment.
Providence Centralia Hospital Part V, Section B, Line 5: A workgroup was convened to review the content of the community health needs assessment, community benefit plan and identify priority health needs. Workgroup members represented a variety of sectors in our community, including organizations that serve the medically underserved, low-income, or minority populations in our community:-Peter Brennan, Executive Director Providence St. Peter Foundation-Kevin Haughton, MD, United Way, Thurston Thrives, PMG-Dan Keahey, Community Board Member-Allen Rohr, Community Board President-Mercy Mvundura, Board Member, Providence Centralia Foundation-Leslie Torve, Community Board Member-Daidre West, Community Board President-Paul Wilkinson, Chief Operating Officer, PSPHOther partners in the CHIP Committee and Community Assessment Participants included various community based organizations that represent medically underserved, low-income and minority populations:-Lewis County Public Health and Social Services-United Way of Lewis County-Valley View Health Centers-Child and Family Studies at Centralia College-CHOICE regional health network-Lewis County Juvenile Court-Morton Hospital-Lewis County CHIP core partners-Lewis County Community Health Partnership-Lewis County Mental Health Coalition-Lewis County Thrives-Love INC-Lewis County Board of Health-Lewis County Chamber of Commerce-Lewis County Community Development-Community members at large in Pe El and Onalaska
Providence St. Mary Medical Center Part V, Section B, Line 5: PSMMC participated in a community health needs assessment coalition in 2014 sponsored by Walla Walla County Public Health (Community Health) which included input from stakeholders representing children's and youth services, substance abuse counseling groups, school district officials, health care agencies, local government, and various other social services agencies, including Catholic Charities. This coalition met four times to conduct a SWOT analysis of the healthiness of the community and to prioritize key areas of concern. In addition, data was reviewed from separate interviews conducted by Public Health staff with key informants representing services to vulnerable populations, including:Aging and Long Term Care, Blue Mountain Heart 2 Heart, Children's Resilience Initiative, Commitment to Community, Family Medical Center (federally funded health clinic), the Housing Authority, Snake River Housing (Broetje Orchards), Trilogy Recovery Community, SOS Clinic, Walla Walla Council on Homelessness, Walla Walla County Mental Health, and the Russian community. Information was also reviewed from a survey sent out to the community in 2013 by Public Health on health behaviors and lifestyles. This survey had a response from 742 citizens with representation from City of Walla Walla 69.8%, College Place 17.2%, and other areas of the county 13%.PSMMC representatives also participated in a similar, but smaller start-up coalition in Umatilla County representing the residents of Milton-Freewater, Oregon identified within our hospital service area.
Providence Mt. Carmel Hospital Part V, Section B, Line 5: Survey to community members placed in local newspapers. Over 55 representatives from various agencies participated. A complete list of those participating is available in the Community Health Needs Assessment.
Providence St. Joseph's Hospital Part V, Section B, Line 5: Survey to community members placed in local newspapers. Over 55 representatives from various agencies participated. A complete list of those participating is available in the Community Health Needs Assessment.
Providence Kodiak Is. Medical Center Part V, Section B, Line 5: PKIMC conducts the CHNA in collaboration with a diverse stakeholder group of community partners in order to identify and address the most significant community health need priorities in Kodiak. Representatives from each of the partner organizations comprised the Kodiak CHNA Advisory Group, which directed the assessment process from its inception to completion. These organizations were chosen due to the fact that they serve and represent the broadests interests of the community of Kodiak.The persons consulted in conducting the CHNA to ensure broad community representation and process integrity were:-Donald Rush, CEO, Providence Kodiak Island Medical Center-Bud Cassidy, Manager, Kodiak Island Borough-Carol Juergens, MD, Owner, Kodiak Island Medical Associates-Elsa DeHart, RN, Director, State of Alaska Kodiak Public Health Center-JC Rathje, Executive Director, Kodiak Community Health Center-Julie A. Tierney, Clinic Supervisor, U.S. Coast Guard Rockmore-King Medical Clinic-Mary Guilas Hawver, Director, Providence Kodiak Island Counseling Center (PKICC) and President, Filipino American Association-Pat Branson, Executive Director, Senior Citizens of Kodiak-Stewart McDonald, Superintendent, Kodiak Island Borough School District-Tammy Hansen, Vice President of Health Services, Kodiak Area Native Association-TC Kamai, Kodiak Chief of Police, City of Kodiak
Providence Seward Medical & Care Center Part V, Section B, Line 5: The CHNA Advisory committee was formed by Leadership at PSMCC. The committee was tasked with completing key objectives outlined by the IRS CHNA requirements, including the identification of health issues and prioritized health needs within the community. These partners were selected to ensure the assessment process was guided by community stakeholders that represent the broad interests of the community. As such, the partners represented the public health perspective and the interests of members of medically underserved, low-income, and minority populations, or individuals. The committee consisted of the following members:-Dave Paperman, Lead Department of Residence Life (Alaska's Institute of Technology (AVTEC))-Gertrude (Trudy) Valenza, Tobacco Prevention and Control Program (TPC) Coordinator (Chugachmiut)-Kris Erchinger, MPA, CGFM, Finance Director (City of Seward)-Sarah Spanos, Personnel Officer (City of Seward)-Lois Daubney, RN, BSN (Public Health)-Joe Fong, Administrator (Providence Seward Medical & Care Center)-Doug Capra, Chair and member of the Providence Region Community Ministry Board (Providence Seward Health Advisory Council)-John (Craig) Williamson, EdD, Licensed Alaska Psychologist (Providence Seward Health Advisory Council)-Joe Forscher, MS LPC, Behavioral Health Director (SeaView Community Services)-Patrick Linton, Executive Director (Seward Community Health Center (SCHC))-Maya Moriarty, Manager/Owner (Seward Family Dentistry (Dr. Michael P. Moriarty, P.C.))-Martha Fleming, Counselor/Teacher (Seward High School)-Karen Sturdy, Director (Seward Parks and Recreation Department and Seward Parking Operation)-Katie Cornwell, Seward Prevention Coalition Coordinator (Seward Prevention Coalition)-Dana Paperman, Executive Director (Seward Senior Center)-Jim Doepken, Pastor (United Methodist Churches of Seward and Moose Pass)
Providence Valdez Medical Center Part V, Section B, Line 5: CHNA Advisory Committee was tasked with completing key objectives outlined by the IRS CHNA requirements, including the identification of health issues and prioritized health needs within the community. The committee consisted of the following members:-Barbara Bigelow, Chief Administrative Officer, Providence Valdez Medical Center.-Joshua Buffington, Administrative Coordinator, Valdez Fisheries Development Association, Inc.-John Cullen, MD, General Partner, Valdez Medical Clinic.-Dave Dengel, CEO, Copper Valley Telecom.-Pauline Doucet, Assistant Administrator-Director of Clinical Services, PVMC.-Marianne Freebury, PVMC Health Advisory Council Member.-Joan Heikens, BSN. Care Coordinator, Valdez Senior Center and PVMC Health Advisory Council Member.-Valencia (Val) Hiebert.-Ruth E. Knight, Teacher- Valdez City Schools.-Nancy Lethcoe.-Jeremy O'Neil, CFO - PVMC.-Cindy Rymer, Administration, City of Valdez Public Works Department and PVMC Health Advisory Council Member.-Pam Shirrell, Registered Nurse.-Todd Wegner, Assistant City Manager - City of Valdez.-Tina Fifarek.-Hope Finley, Sound Wellness Alliance Network (SWAN) Coordinator - PVMC.-Jenny Heckathorn, Biology/PE/Health Teacher, Valdez High School.-Sarah Histand, Health & Fitness Center Coordinator, Prince William Sound Community College (PWSCC).-Joe Kuchin, Valdez Operations Business Strategy Manager, Alyeska Pipeline Service Co.-Sara Pullen, Public Health Nurse, State Division of Public Health.-Mo Radotich, Director of Ancillary Services, PVMC.-Captain Darryl P. Verfaillie, USCG (Ret), Director, City of Valdez Parks, Recreation & Cultural Services Department.
Providence SHMC & Children's Hospital Part V, Section B, Line 6a: Providence Holy Family Hospital
Providence St. Peter Hospital Part V, Section B, Line 6a: Providence Centralia Hospital
Providence Holy Family Hospital Part V, Section B, Line 6a: Providence Sacred Heart Medical Center
Providence Centralia Hospital Part V, Section B, Line 6a: Providence St. Peter Hospital
Providence Mt. Carmel Hospital Part V, Section B, Line 6a: Providence St. Joseph Hospital
Providence St. Joseph's Hospital Part V, Section B, Line 6a: Providence Mount Carmel Hospital
Providence Alaska Medical Center Part V, Section B, Line 6b: The CHNA for Providence Alaska Medical Center was prepared in collaboration with United Way of Anchorage, Municipality of Anchorage, Anchorage Neighborhood Health Center, and Catholic Social Services.
Providence Alaska Medical Center Part V, Section B, Line 7d: Although the facility completed the CHNA, as required, before December 31, 2015 and that CHNA was available for public inspection in paper form at the various facilities, the CHNA was inadvertently not posted to the facility websites in a timely manner. This omission was discovered during the first quarter of 2016.The CHNA was posted to the facility websites during February, 2016.An internal system of checks and balances has been established between Community Benefit staff and the on-site web staff to insure that this situation will not occur in the future.
Providence Seward Medical & Care Center Part V, Section B, Line 7d: Although the facility completed the CHNA, as required, before December 31, 2015 and that CHNA was available for public inspection in paper form at the various facilities, the CHNA was inadvertently not posted to the facility websites in a timely manner. This omission was discovered during the first quarter of 2016.The CHNA was posted to the facility websites during March, 2016.
Providence Alaska Medical Center Part V, Section B, Line 11: PAMC developed Anchorage Community Health Improvement Plan in response to the needs identified in the 2015 CHNA. The development process included input from Providence caregivers, community partners and the Providence Health and Services Alaska Community Ministry Board. Great attention has been paid to establishing meaningful measures by which we intend to evaluate the impact of our activities and the activities of our partners. In some cases, our efforts have been confounded by the lack of or limited availability of data. The effort to measure our impact will be an ongoing challenge and journey as we seek to improve the health of our community.Prioritized Community Health Needs:-Poverty: Serving the poor and vulnerable is core to Providence's Mission. However, providing the basic food and shelter needs of the community directly is not within the core competencies or services of Providence. To address this issue, Providence collaborates with, and provides community investment funding support to sister agencies and organizations that directly address the causes and impacts of poverty. -Healthy Behaviors: Continue SQORD pilot partnership with the Anchorage School District in an effort to increase physical activity and reduce overweight and obesity amongst school-age children. The Providence SQORD program leverages technology and social connectivity to create fun - a new way to inspire a life-long habit of healthy behaviors. Providence is providing 10,000 Anchorage students with a durable, 3-axis accelerometer called Boosters that convert intensity and duration of activity into points that are tracked online. In the virtual environment, individuals can customize a PowerMe avatar, check their activity tracker, earn medals and rewards by collecting points, join in friendly challenges, and communicate with others. This unique hardware-software platform is designed to make physical activity more interactive and engaging for kids.-Substance abuse: Continue to add ambulatory psychiatric/substance-abuse detoxification services to the Crisis Recovery Center to help address unmet need in the community for detox services. Continue to provide and expand chemical dependency programs to help address the growing need for substance abuse programs in Anchorage and Alaska. Increase remote and out-of-clinic access to care by piloting two tele-health initiatives. Continue providing this necessary community service to address emergent community need for acute psychiatric and substance abuse care, especially as there is no other provider doing so in the Anchorage community.-Access to affordable care: Continue to provide medically necessary health care services to members of the community who are unable to pay for such services. Increase the service capacity in the Senior Clinic to address the health care needs of the aging by addressing the shortage of providers accepting Medicaid and/or Medicare in the community. Continue to provide primary care services at the Alaska Family Medicine Residency on a sliding fee scale to remove cost as a barrier to needed care. Continue support of the Nurse Family Partnership program, providing education and support services to first-time low-income mothers to improve maternal-child outcomes.There was an extensive list of needs and issues identified through this assessment process and the organization is unable to address all of them, but PH&S-WA will support organizations that are working to address these needs through collaboration, partnerships and in some cases through financial support for community based projects and programs.
Providence SHMC & Children's Hospital Part V, Section B, Line 11: Providence Sacred Heart Medical Center & Children's Hospital has developed a community health improvement plan designed to address key health needs identified in the community health assessment. These are:1. Mental health - Respond to mental health needs by addressing substance abuse, dementia, depression, adverse childhood experiences, including child abuse and child welfare, and access to care.2. Dental - Improve access to providers and resources, prevention education and address substance abuse, nutrition and mental health.3. Diabetes - Prevention, education, treatment and access.4. Immunizations - Increase education about the health benefits of immunizations and increase access to immunizations in rural and low income populations.5. Stable housing - Stability of family and home to aid in physical, mental and emotional health and healing.Needs not directly addressed: accelerate to a high-performing economy. Providence Health Care is one of the largest employers in eastern Washington, and in keeping with our commitment to social justice, pays caregivers (all employees) sustainable wages. Providence Health Care has made significant investments in education and training opportunities to promote the development of its workforce and encourage internal recruitment. In these ways, we have an indirect but important positive impact on our local economy. However, this need is not as pressing as the other identified needs to address at this time and by addressing the other we can inadvertently address this need.
Providence St. Peter Hospital Part V, Section B, Line 11: There was an extensive list of needs and issues identified through this assessment process and the organization is unable to address all of them - social determinants of health such as education, housing, and employment.Advanced Care Planning:Advance Care Planning, following the Respecting Choices principle allows us to impact the community and cost of health care in a large scale. We will be partnering with others in the state and across Providence.Childhood Obesity:Diabetes is becoming an epidemic in this country and in our community. Targeting youth allows us to move upstream and teach healthy habits early to ensure good health and wellness for future generations. This also allows for more purposeful partnering with other organizations in our community.Access to Mental Health Services: Mental Health and Chemical Dependency are a challenge for the entire state. Providence currently provides Psychiatric Services, Chemical Dependency outpatient services to adults and adolescents. The Recovery Care Unit will allow us to provide care to patients who are in need medically as they go through withdrawals and provide a much needed resource for the community.
Providence Regional Med. Ctr. Colby Part V, Section B, Line 11: Access (Primary Care): Funding: 1. Patient Services Representatives initiate financial assistance paperwork and care coordinators directly assist qualified patients with obtaining health insurance. 2. Financial Counseling screening prior to first scheduled visit to Providence Medical Group or post Providence Regional Medical Center visit. 3. Support for Project Access Northwest to provide coordination and referral services for uninsured or underinsured. 4. Providence Everett Healthcare Clinic accepts all patients regardless of their ability to pay. Finding: 5. Community forum with providers to revise structure for patients arriving in the emergency department without an assigned primary care provider. 6. In-person Assistors in collaboration with Whatcom Alliance for Healthcare Advancement to assist the community to learn about, apply for, and enroll in health insurance coverage on the Exchange, including Medicaid, subsidized and non-subsidized qualified health plan. 7. Community Health Fairs to educate the community on value of connecting with a primary care provider. Facilitating: 8. Providence Medical Group Pacific Clinic provides primary care services with a primary focus on Medicaid, uninsured and low-income patients. 9. Providence Everett Healthcare Clinic provides primary care services with a primary focus on the uninsured or underserved. 10. Develop medical home model for Providence Everett Health Care Clinic and Providence Medical Group. Prenatal Care (First Trimester): Funding: 1. Support to DSHS participants to attend Birth/Family education. 2. Support to March of Dimes for "39 Weeks" media campaign. Finding: 3. Centering pregnancy program group based prenatal care. 4. Birth and family education classes. 5. Community education on importance of early prenatal care, how to determine signs of pregnancy, and wellness care processes to help prepare and educate women for timely entry into prenatal care before pregnancy. Facilitating: 6. Providence Maternal Fetal Medicine program provides specialized services for evaluation of high risk pregnancies. 7. Providence Obstetrics and Gynecology provides traditional, routine and high-risk obstetrical services to women of all ages with all forms of insurance. Physical Abuse, Obesity, Suicide and Dental Decay are not areas of emphasis and focus for Providence during this cycle due to funding and resource availability. In addition there are other community organizations focusing on these issues. Providence will be an engaged partner with other community led collaborative efforts.
Providence Regional Med. Ctr. Pacific Part V, Section B, Line 11: Access (Primary Care): Funding: 1. Patient Services Representatives initiate financial assistance paperwork and care coordinators directly assist qualified patients with obtaining health insurance. 2. Financial Counseling screening prior to first scheduled visit to Providence Medical Group or post Providence Regional Medical Center visit. 3. Support for Project Access Northwest to provide coordination and referral services for uninsured or underinsured. 4. Providence Everett Healthcare Clinic accepts all patients regardless of their ability to pay. Finding: 5. Community forum with providers to revise structure for patients arriving in the emergency department without an assigned primary care provider. 6. In-person Assistors in collaboration with Whatcom Alliance for Healthcare Advancement to assist the community to learn about, apply for, and enroll in health insurance coverage on the Exchange, including Medicaid, subsidized and non-subsidized qualified health plan. 7. Community Health Fairs to educate the community on value of connecting with a primary care provider. Facilitating: 8. Providence Medical Group Pacific Clinic provides primary care services with a primary focus on Medicaid, uninsured and low-income patients. 9. Providence Everett Healthcare Clinic provides primary care services with a primary focus on the uninsured or underserved. 10. Develop medical home model for Providence Everett Health Care Clinic and Providence Medical Group. Prenatal Care (First Trimester): Funding: 1. Support to DSHS participants to attend Birth/Family education. 2. Support to March of Dimes for "39 Weeks" media campaign. Finding: 3. Centering pregnancy program group based prenatal care. 4. Birth and family education classes. 5. Community education on importance of early prenatal care, how to determine signs of pregnancy, and wellness care processes to help prepare and educate women for timely entry into prenatal care before pregnancy. Facilitating: 6. Providence Maternal Fetal Medicine program provides specialized services for evaluation of high risk pregnancies. 7. Providence Obstetrics and Gynecology provides traditional, routine and high-risk obstetrical services to women of all ages with all forms of insurance. Physical Abuse, Obesity, Suicide and Dental Decay are not areas of emphasis and focus for Providence during this cycle due to funding and resource availability. In addition there are other community organizations focusing on these issues. Providence will be an engaged partner with other community led collaborative efforts.
Providence Holy Family Hospital Part V, Section B, Line 11: Providence Holy Family Hospital has developed a community health improvement plan designed to address key health needs identified in the community health assessment. These are:1. Mental health - Respond to mental health needs by addressing substance abuse, dementia, depression, adverse childhood experiences, including child abuse and child welfare, and access to care.2. Dental - Improve access to providers and resources, prevention education and address substance abuse, nutrition and mental health.3. Diabetes - Prevention, education, treatment and access.4. Immunizations - Increase education about the health benefits of immunizations and increase access to immunizations in rural and low income populations.5. Stable housing - Stability of family and home to aid in physical, mental and emotional health and healing.Needs not directly addressed: accelerate to a high-performing economy. Providence Health Care is one of the largest employers in eastern Washington, and in keeping with our commitment to social justice, pays caregivers (all employees) sustainable wages. Providence Health Care has made significant investments in education and training opportunities to promote the development of its workforce and encourage internal recruitment. In these ways, we have an indirect but important positive impact on our local economy. However, this need is not as pressing as the other identified needs to address at this time and by addressing the other we can inadvertently address this need.
Providence Centralia Hospital Part V, Section B, Line 11: There was an extensive list of needs and issues identified through this assessment process and the organization is unable to address all of them - social determinants of health such as education, housing, and employment.Advanced Care Planning:Advance Care Planning, following the Respecting Choices principle allows us to impact the community and cost of health care in a large scale. We will be partnering with others in the state and across Providence.Childhood Obesity:Diabetes is becoming an epidemic in this country and in our community. Targeting youth allows us to move upstream and teach healthy habits early to ensure good health and wellness for future generations. This also allows for more purposeful partnering with other organizations in our community.Access to Mental Health Services: Mental Health and Chemical Dependency are a challenge for the entire state. Providence currently provides Psychiatric Services, Chemical Dependency outpatient services to adults and adolescents. The Recovery Care Unit will allow us to provide care to patients who are in need medically as they go through withdrawals and provide a much needed resource for the community.
Providence St. Mary Medical Center Part V, Section B, Line 11: Priorities for implementation strategies for 2016-18 have been developed by the Mission Committee as follows in order of priority:1. Explore new collaborative opportunities for youth at risk with the Walla Walla Youth Alliance and Blue Mountain Action Council for the proposed Teen Center and homeless youth shelter in the planning and funding stages (2016-2017). Consider 1x donation towards youth homeless shelter capital funding and subsequent part-time MSW or other clinical services support to their program needs once established for counseling and health education for at-risk youth.2. Provide monetary and non-monetary support to The Health Center at Lincoln School for youth at risk to help maintain the tremendous gains that have been made in on ]time graduation rates and reduction in absenteeism.3. Collaborate with local schools to assist with obesity reduction and promotion of physical activity through healthy lifestyles.4. To improve immunization rates in our community continue to provide an annual free flu vaccination drive but also explore new strategies with Department of Community Health to address other adult or pediatric vaccination needs within the community going forward with the ending of the public health department fs immunization services (2016).The following needs identified in the 2015 community needs assessment were not identified for specific action planning in the 2016-18 PSMMC community benefit plan, but PH&S-WA will support organizations that are working to address these needs through collaboration, partnerships and in some cases through financial support for community based projects and programs:-Homelessness-Mental Health Access in the Community-Better Integration of Mental Health & Substance Abuse Care-Availability of Family Living-Wage Jobs
Providence Mt. Carmel Hospital Part V, Section B, Line 11: Family mental health and chemical dependency:1. Partnership with Regional Support Network and New Alliance to expand resources in Stevens County2. Continue relationships with Rural ResourcesPromoting health behaviors1. Education and tools for physicians around immunizations2. Continue partnership with Rural Resources to address smoking cessation and breast exams3. Continue partnership with Get Fit Colville to address obesity.Poverty and difficult life circumstances1. Continue relationship with Hunger Coalition to bring food banks together for collaborative efforts to end hunger in Stevens County2. Support efforts of Hunger Coalition to obtain 501(c)(3) status and expanded grant opportunities3. Utilize model from Hunger Coalition to see if the model could be expanded to outreach coordinator efforts The following health needs will not be addressed at this time:Facility for whole person: resources in one place - many services are looking to consolidate in Spokane.Employment Opportunities - this continues to be an issue in this region.
Providence St. Joseph's Hospital Part V, Section B, Line 11: Family mental health and chemical dependency:1. Partnership with Regional Support Network and New Alliance to expand resources in Stevens County2. Continue relationships with Rural ResourcesPromoting health behaviors1. Education and tools for physicians around immunizations2. Continue partnership with Rural Resources to address smoking cessation and breast exams3. Continue partnership with Get Fit Colville to address obesity.Poverty and difficult life circumstances1. Continue relationship with Hunger Coalition to bring food banks together for collaborative efforts to end hunger in Stevens County2. Support efforts of Hunger Coalition to obtain 501(c)(3) status and expanded grant opportunities3. Utilize model from Hunger Coalition to see if the model could be expanded to outreach coordinator efforts The following health needs will not be addressed at this time:Facility for whole person: resources in one place - many services are looking to consolidate in Spokane.Employment Opportunities - this continues to be an issue in this region.
Providence Kodiak Is. Medical Center Part V, Section B, Line 11: In July of 2013, members of the CHNA Advisory Committee were asked to rate the health issues identified previously according to three key criteria, including size, seriousness, and ability to impact. The committee individually rating the health issues and the group convened to identify the top priorities. The CHNA Advisory Committee identified the following two priorities:1. Uninsured and Affordability of Care as Barriers to AccessThe lack of health insurance and the affordability of health care were identified by the community as significant barriers to receiving needed health care services. The impact of these barriers is compounded by the high cost of living in an isolated rural Alaskan community. 28% of Kodiak adults are uninsured which is up from 22% in 2010. 25% of respondents said they did not receive needed health care during the last year due to lack of insurance. Addressing the problem of the uninsured and affordability of health care will help address other problems identified in the needs assessment such as low utilization of preventive care and actively managing chronic conditions.2. Substance AbuseSubstance abuse and the cultural acceptance of substance use were identified as problems in the Kodiak community. 23% of respondents admit binge drinking from one to 28 times(s) in the prior 30 days. This is up from 20% in 2008. The numbers below reflects the percentage of respondents that found it acceptable or acceptable sometimes to use the following substances for recreational or non-medicinal use:-77% Alcohol-37% Marijuana-23% Prescription drugs-2% MethamphetaminesSubstance abuse continues to negatively impact the mental and physical health of the community of Kodiak Island.
Providence Seward Medical & Care Center Part V, Section B, Line 11: In October of 2015, members of the CHNA Advisory Committee were asked to rate the health issues identified previously according to three key variables, including: SIZE, SERIOUSNESS, and ABILITY TO IMPACT. The committee convened after individually rating the health issues to come up with the top priorities as a group. Four priorities were identified by the CHNA Advisory Committee:1. Overweight and lack of physical activitySQORD - Providence intends to continue its SQORD pilot partnership with the Seward Elementary School in an effort to increase physical activity and reduce overweight and obesity amongst school-age children. The Providence SQORD program leverages technology and social connectivity to create fun new way to inspire a life-long habit of healthy behaviors. Providence provided 150 Seward elementary school students with durable, 3-axis accelerometers called Boosters that convert intensity and duration of activity into points that are tracked online. In the virtual environment, individuals can customize a PowerMe avatar, check their activity tracker, earn medals and rewards by collecting points, join in friendly challenges, and communicate with others. This unique hardware-software platform is designed to make physical activity more interactive and engaging for kids.2. Poor mental health and lack of access to mental health servicesTele-health - Providence intends to increase remote and out-of-clinic access to care through piloting two tele-health initiatives. If successful, these two tele-health services could be offered in Seward.3. Alcohol and substance useAlcohol and substance abuse has significant health and social impacts both for individuals and the community. Raising awareness of the impacts of substance abuse, addressing the cultural acceptance of alcohol/substance use and providing healthy alternatives for youth can have a substantial impact on the health of the community.4. Low utilization of preventative care (medical and dental)Emergency Department - Providence will monitor ambulatory sensitive conditions use of the Emergency Department and collaborate with Seward Community Health Center in the effort to get people the care they need at the right time and right setting to avoid unnecessary ED utilization.Duke University - Population Care Coordination Program (PCCP) - Providence will convene a population health steering committee, the members of which will participate in the 12 week PCCP. The Population Care Coordination Process provides a framework for each collaborating provider and organization to deliver more effective multilevel care based on population- and patient-centered principles. The community collaboration will involve Seward Community Health Center and PSMCC, as well as members from clinics and hospitals in Kodiak, Valdez and Anchorage.
Providence Valdez Medical Center Part V, Section B, Line 11: Leveraging community assets through collaborative efforts is the most effective and sustainable way to address community problems. Rather than establish isolated initiatives to address community need, PVMC chose strategies that involved collaboration with other key community stakeholders to address needs identified in the Valdez needs assessment.1. Overweight/Lack of Physical ActivityRoughly 2 out of 3 Valdez adults are either overweight or obese. The obesity rate for Valdez adults is over 3% greater than the rate for Alaskan adults as a whole. Being overweight or obese is directly linked to some of the most life-threatening conditions and diseases, such as diabetes, cancer, coronary heart disease, high blood pressure and stroke. This threat to the health and well being of Valdez residents is compounded by Valdez's remoteness and climate. The remote location of Valdez makes fresh healthy foods costly and its rainy northern climate makes outdoor activity more challenging for during the dark and rainy season.2. Availability and Access to Primary Care ServicesImproved availability and access to primary care services were identified by the community as a significant issue. Nearly 50% of the survey respondents identified "Timely access to care in a physician clinic (appointment in a reasonable timeframe)" as one of the top 3 health care needs in Valdez. According to survey respondents and stakeholder interviews, access to primary care in Valdez has been challenged with issues of clinic through-put, maintaining sufficient physician-to-population ratios, physician recruitment and retention, appointments that are 2-3 weeks out and long wait times. Roughly 1 in 10 respondents indicated they use the emergency room as their main source of healthcare.3. Mental Health/Substance AbusePoor mental health and the related issue of substance abuse were identified as problems in the Valdez community. Rainy climates and long dark winters are known to negatively impact mental health and are frequently associated with increased incidence of substance abuse. Roughly 1 in 7 Valdez adults report needing mental health services in the last 12 months. Thesame number of respondents report having felt so sad or hopeless almost every day for two weeks or more in the last 12 months that they stopped doing some usual activities. Roughly 1 in 20 Valdez adults report having thought about committing suicide ('suicide ideation') during the past 12 months. Drug and alcohol abuse are closely associated with mental illnessand health. Roughly 1 in 20 Valdez residents report having engaged in binge drinking within the past 30 days.PVMC's implementation plan includes elements that address all three of the top health priorities identified by the Valdez CHNA advisory group and the CHNA.
Providence Alaska Medical Center Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence SHMC & Children's Hospital Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence St. Peter Hospital Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence Regional Med. Ctr. Colby Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence Regional Med. Ctr. Pacific Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence Holy Family Hospital Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence Centralia Hospital Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence St. Mary Medical Center Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence Mt. Carmel Hospital Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence St. Joseph's Hospital Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence Kodiak Is. Medical Center Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence Seward Medical & Care Center Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence Valdez Medical Center Part V, Section B, Line 16i: Brochures and cards are available in all access points at our facilities telling a patient how to gain information and apply. Also our statements provide information on how to apply by making contact with our business office.
Providence Alaska Medical Center Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence SHMC & Children's Hospital Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence St. Peter Hospital Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence Regional Med. Ctr. Colby Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence Regional Med. Ctr. Pacific Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence Holy Family Hospital Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence Centralia Hospital Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence St. Mary Medical Center Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence Mt. Carmel Hospital Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence St. Joseph's Hospital Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence Kodiak Is. Medical Center Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence Seward Medical & Care Center Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence Valdez Medical Center Part V, Section B, Line 22d: The hospital uses a sliding scale based on income levels of the federal poverty guidelines based on full billed charges and approves financial assistance based on the scale of the income of the family.
Providence Alaska Medical Center Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence SHMC & Children's Hospital Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence St. Peter Hospital Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence Regional Med. Ctr. Colby Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence Regional Med. Ctr. Pacific Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence Holy Family Hospital Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence Centralia Hospital Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence St. Mary Medical Center Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence Mt. Carmel Hospital Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence St. Joseph's Hospital Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence Kodiak Is. Medical Center Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence Seward Medical & Care Center Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
Providence Valdez Medical Center Part V, Section B, Line 24: For non medically necessary services a patient may be charged full billed charges.
SCHEDULE H, PART V, Line 8 - Providence St. Peter Hospital Although the facility completed the CHNA, as required, in March of 2014 and that CHNA was available for public inspection in paper form at the facility, the community health improvement plan (CHIP) was inadvertently not completed in a timely manner. The facility is in the process of finalizing the CHIP and will make it available on the hospital's website and for public inspection in paper form in the near future.An internal system of checks and balances has been established between the Community Benefit staff and the on-site web staff to insure that this situation will not occur in the future.
SCHEDULE H, PART V, Line 8 - Providence Centralia Hospital Although the facility completed the CHNA, as required, in March of 2014 and that CHNA was available for public inspection in paper form at the facility, the community health improvement plan (CHIP) was inadvertently not completed in a timely manner. The facility is in the process of finalizing the CHIP and will make it available on the hospital's website and for public inspection in paper form in the near future.An internal system of checks and balances has been established between the Community Benefit staff and the on-site web staff to insure that this situation will not occur in the future.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 8
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?198
Name and address Type of Facility (describe)
1 1 - Hospice and Home Care of Snohomish Count
2731 Wetmore Suite 500
Everett,WA98201
In-Home Services
2 2 - Infusion and Pharmacy Services
10807 E Montgomery Suite 8
Spokane Valley,WA99206
In-Home Services
3 3 - Providence DominiCare
110 S 3rd Street East PO Box 1070
Chewelah,WA99109
In-Home Services
4 4 - Providence Home Services King County
2811 S 102nd Street Suite 220
Tukwila,WA98168
In-Home Services
5 5 - Providence Hospice of Seattle
425 Pontius Ave N Ste 300
Seattle,WA98109
In-Home Services
6 6 - Providence Infusion and Pharmacy Service
3333 South 120th Place Suite 100
Tukwila,WA98168
In-Home Services
7 7 - Providence VNA Home Health
1000 N Argonne
Spokane Valley,WA99212
In-Home Services
8 8 - SoundHomeCare and Hospice
3432 South Bay Road NE
Olympia,WA98506
In-Home Services
9 9 - St Mary Home Health
380 Chase Street
Walla Walla,WA99362
In-Home Services
10 10 - Providence Family Medicine Center
1201 East 36th Avenue
Anchorage,AK99508
Primary Care
11 11 - Chehalis Family Medicine
931 S Market Blvd
Chehalis,WA98532
Primary Care
12 12 - East Olympia Family Medicine
525 Lilly Rd NE Suite 250
Olympia,WA98506
Primary Care
13 13 - Family Medicine
2902 164th St SW
Lynnwood,WA98087
Primary Care
14 14 - Family Medicine
4112 Harbour Pointe Blvd SW Suite
100
Mukilteo,WA98275
Primary Care
15 15 - Family Medicine - Indian Trail
5011 W Lowell Ave Suite 100
Spokane,WA99208
Primary Care
16 16 - Family Medicine - Mill Creek Campus
12800 Bothell-Everett Highway Suite
160
Mill Creek,WA98208
Primary Care
17 17 - Family Medicine - Mill Creek Commons
16708 Bothell-Everett Highway Suite
201
Mill Creek,WA98012
Primary Care
18 18 - Family Medicine - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Primary Care
19 19 - Family Medicine - North
212 E Central Ave Suite 440
Spokane,WA99208
Primary Care
20 20 - Family Medicine - Northpointe
9911 N Nevada Street Suite 200
Spokane,WA99218
Primary Care
21 21 - Family Medicine - Spokane Valley
13102 E Mission Avenue
Spokane Valley,WA99216
Primary Care
22 22 - Hawks Prairie Family Medicine
2555 Marvin Rd NE
Lacey,WA98516
Primary Care
23 23 - Northeast Washington Medical Group - Col
1200 East Columbia Ave
Colville,WA99114
Primary Care
24 24 - Northeast Washington Medical Group - Fam
100 W South Ave
Chewelah,WA99109
Primary Care
25 25 - Northeast Washington Medical Group - Gar
143 Garden Homes Drive
Colville,WA99114
Primary Care
26 26 - Northeast Washington Medical Group - Ket
840 S Meyers Street
Kettle Falls,WA99141
Primary Care
27 27 - Providence Family Medicine
380 Chase Avenue
Walla Walla,WA99362
Primary Care
28 28 - Providence Family Medicine Residency Cli
624 E Front Ave
Spokane,WA99202
Primary Care
29 29 - Providence Medical Group-Battle Ground F
101 NW 12th Ave Suite 107
Battle Ground,WA98604
Primary Care
30 30 - Providence Medical Group-Camas
3101 SE 192nd Ave
Vancouver,WA98683
Primary Care
31 31 - Providence Medical Group-Mill Plain
315 SE Stonemill Drive Suite 102
Vancouver,WA98684
Primary Care
32 32 - Rochester Family Medicine
18313 Paulson St SW Ste A
Rochester,WA98579
Primary Care
33 33 - St Peter Family Medicine
525 Lilly Rd NE
Olympia,WA98506
Primary Care
34 34 - Valley Family Physicians
16528 E Desmet Court Suite B3100
Spokane Valley,WA99216
Primary Care
35 35 - West Olympia Family Medicine
1620 Cooper Point Road SW
Olympia,WA98502
Primary Care
36 36 - Providence Rehabilitation Services
4411 Business Park Blvd Building
M-20
Anchorage,AK99503
Rehab & Physical Therapy
37 37 - Centralia Physical Medicine
1800 Cooks Hill Road Suite E
Centralia,WA98531
Rehab & Physical Therapy
38 38 - Centralia Physical Therapy
1900 Cooks Hill Rd
Centralia,WA98531
Rehab & Physical Therapy
39 39 - Olympia Physical Medicine
410 Providence Lane NE Building 2
Olympia,WA98506
Rehab & Physical Therapy
40 40 - Physical and Aquatic Therapy
1809 Cooks Hill Rd
Centralia,WA98531
Rehab & Physical Therapy
41 41 - Providence Chehalis Physical Therapy
91 SW Chehalis Ave Suite 104
Chehalis,WA98532
Rehab & Physical Therapy
42 42 - Providence Physical Medicine and Rehabil
301 W Poplar Street
Walla Walla,WA99362
Rehab & Physical Therapy
43 43 - Tumwater Valley Physical Therapy
4833 Tumwater Valley Dr Ste 150
Tumwater,WA98501
Rehab & Physical Therapy
44 44 - Providence Extended Care
920 Compassion Cir
Anchorage,AK99504
Senior Care
45 45 - Providence Horizon House
4140 Folker Street
Anchorage,AK99508
Senior Care
46 46 - Providence Medical Group Senior Care
3300 Providence Drive B Tower Suite
314
Anchorage,AK99508
Senior Care
47 47 - Providence Transitional Care Center
910 Compassion Circle
Anchorage,AK99504
Senior Care
48 48 - Providence Seward Mountain Haven
2203 Oak Street
Seward,AK99664
Senior Care
49 49 - ElderPlace Full Life
7829 S 180th Street
Kent,WA98032
Senior Care
50 50 - Emilie Court
34 E 8th Avenue
Spokane,WA99202
Senior Care
51 51 - Heritage House at the Market
1533 Western Avenue
Seattle,WA98101
Senior Care
52 52 - Providence Adult Day Health
6018 N Astor Street
Spokane,WA99208
Senior Care
53 53 - Providence ElderPlace
4515 Martin Luther King Jr Way S
Suite 1
Seattle,WA98108
Senior Care
54 54 - Providence ElderPlace West
4831 35th Ave SW
Seattle,WA98126
Senior Care
55 55 - Providence Marianwood
3725 Providence Point Drive SE
Issaquah,WA98029
Senior Care
56 56 - Providence Mother Joseph Care Center
3333 Ensign Road NE
Olympia,WA98506
Senior Care
57 57 - Providence Mount St Vincent
4831 35th Ave SW
Seattle,WA98126
Senior Care
58 58 - Providence St Joseph Care Center
17 E 8th Avenue
Spokane,WA99202
Senior Care
59 59 - Vashon Community Care
15333 Vashon Highway SW
Vashon Island,WA98070
Senior Care
60 60 - Palliative Care Clinic
3851 Piper Street Tower U STE LL002
Anchorage,AK99508
Specialty Clinic
61 61 - Providence Alaska Neuroscience Center
3851 Piper Street
Anchorage,AK99508
Specialty Clinic
62 62 - Providence Medical Group Behavioral Heal
3760 Piper Street Suite 1108
Anchorage,AK99508
Specialty Clinic
63 63 - Providence Medical Group Maternal-Fetal
3260 Providence Drive Suite C-522
Anchorage,AK99508
Specialty Clinic
64 64 - Providence Medical Group Pediatric Gastr
3340 Providence Drive Suite A-567
Anchorage,AK99508
Specialty Clinic
65 65 - Providence Medical Group Pediatric Pulmo
3200 Providence Drive Suite D-338
Anchorage,AK99508
Specialty Clinic
66 66 - Providence Medical Group Pediatric Subsp
3340 Providence Drive Suite A-351
Anchorage,AK99508
Specialty Clinic
67 67 - Providence Medical Group Pediatric Surge
3340 Providence Drive Suite A-565
Anchorage,AK99508
Specialty Clinic
68 68 - Providence Medical Group U-Med
3260 Providence Drive C tower Suite
436
Anchorage,AK99508
Specialty Clinic
69 69 - Providence Pediatric Oncology & Infusion
3851 Piper St Suite U1-213
Anchorage,AK99508
Specialty Clinic
70 70 - Providence Eagle River Medical Office Bu
17101 Snowmobile Lane
Eagle River,AK99577
Specialty Clinic
71 71 - Providence Medical Group Mat-Su Behavior
2250 S Woodworth Loop Suite 202
Palmer,AK99645
Specialty Clinic
72 72 - Providence Medical Office Building Mat-S
2250 South Woodworth Loop
Palmer,AK99645
Specialty Clinic
73 73 - Anticoagulation - Mill Creek Campus
12800 Bothell-Everett Highway Suite
160
Mill Creek,WA98208
Specialty Clinic
74 74 - Anticoagulation - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
75 75 - Audiology - Norton Building
3216 Norton Ave Suite 102
Everett,WA98201
Specialty Clinic
76 76 - Cancer Care - Providence Regional Cancer
1717 13th St
Everett,WA98201
Specialty Clinic
77 77 - Cardiac and Thoracic Surgery - Colby Cam
1330 Rockefeller Suite 400
Everett,WA98201
Specialty Clinic
78 78 - Cardiology - Colby Campus MOB
1330 Rockefeller Suite 310
Everett,WA98201
Specialty Clinic
79 79 - Cardiology - Mill Creek Campus
12800 Bothell-Everett Highway Suite
270
Mill Creek,WA98208
Specialty Clinic
80 80 - Cardiology - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
81 81 - Cardiology Associates - Aberdeen
1921 Sumner Ave
Aberdeen,WA98520
Specialty Clinic
82 82 - Cardiology Associates - Centralia
1800 Cooks Hill Road Suite K
Centralia,WA98531
Specialty Clinic
83 83 - Cardiology Associates - Shelton
939 Mountain View Dr
Shelton,WA98584
Specialty Clinic
84 84 - Cardiology Associates - Yelm
201 Tahoma Blvd SE Suite 204
Yelm,WA98597
Specialty Clinic
85 85 - Centralia General Surgery
1720 Cooks Hill Road
Centralia,WA98531
Specialty Clinic
86 86 - Centralia Internal Medicine
1010 South Scheuber Road
Centralia,WA98531
Specialty Clinic
87 87 - Centralia Urology
1800 Cooks Hill Road Suite F
Centralia,WA98531
Specialty Clinic
88 88 - Centralia Women's Center
1000 S Scheuber Road
Centralia,WA98531
Specialty Clinic
89 89 - Clinic at Panorama
1450 Northwest Lane SE Suite A
Lacey,WA98503
Specialty Clinic
90 90 - Cranial Spine and Joint
1717 13th St Suite 401
Everett,WA98201
Specialty Clinic
91 91 - Ear Nose and Throat - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
92 92 - Ear Nose and Throat - Mill Creek Campu
12800 Bothell-Everett Highway Suite
110
Mill Creek,WA98208
Specialty Clinic
93 93 - Ear Nose and Throat - Norton Building
3216 Norton Ave Suite 102
Everett,WA98201
Specialty Clinic
94 94 - Endocrinology - Colby Campus MOB
1330 Rockefeller Suite 210
Everett,WA98201
Specialty Clinic
95 95 - Endocrinology - Mill Creek Campus
12800 Bothell-Everett Highway Suite
270
Mill Creek,WA98208
Specialty Clinic
96 96 - Endocrinology - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
97 97 - Epilepsy Center - Sacred Heart Doctors B
105 W 8th Ave Suite 318C
Spokane,WA99204
Specialty Clinic
98 98 - Everett Healthcare Clinic
930 North Broadway
Everett,WA98201
Specialty Clinic
99 99 - Family Medicine & Maternity Care South
2020 E 29th Ave
Spokane,WA99203
Specialty Clinic
100 100 - General Surgery - Norton Building
3216 Norton Ave Suite 202
Everett,WA98201
Specialty Clinic
101 101 - Genetics Clinic
105 W 8th Ave Suite 454E
Spokane,WA99204
Specialty Clinic
102 102 - Gynecologic Oncology
1717 13th St Suite 300
Everett,WA98201
Specialty Clinic
103 103 - Hawks Prairie Internal Medicine
2555 Marvin Rd NE
Lacey,WA98516
Specialty Clinic
104 104 - Infectious Disease - Colby Campus MOB
1330 Rockefeller Suite 520
Everett,WA98201
Specialty Clinic
105 105 - Internal Medicine
820 S McClellan Street Suites 200
500
Spokane,WA99204
Specialty Clinic
106 106 - Internal Medicine - Colby Campus MOB
1330 Rockefeller Suite 210
Everett,WA98201
Specialty Clinic
107 107 - Internal Medicine - Fifth Avenue
910 W 5th Ave Suite 701
Spokane,WA99204
Specialty Clinic
108 108 - Internal Medicine - Mill Creek Campus
12800 Bothell-Everett Highway Suite
180
Mill Creek,WA98208
Specialty Clinic
109 109 - Internal Medicine - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
110 110 - Marysville Clinic
11603 State Ave Suite G
Marysville,WA98271
Specialty Clinic
111 111 - Midwifery - Mill Creek Commons
16708 Bothell-Everett Highway Suite
201
Mill Creek,WA98012
Specialty Clinic
112 112 - Midwifery - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
113 113 - Midwifery - Pavilion for Women & Childre
900 Pacific Ave Suite 501
Everett,WA98201
Specialty Clinic
114 114 - Minimally Invasive Heart Surgery
122 W 7th Avenue
Spokane,WA99204
Specialty Clinic
115 115 - Multiple Sclerosis Center
212 E Central Ave Suite 440
Spokane,WA99208
Specialty Clinic
116 116 - Nephrology - Hypertension Kidney Care &
105 W 8th Ave Suite 7060
Spokane,WA99204
Specialty Clinic
117 117 - Neurology Neurosurgery & Spine
105 W 8th Ave Suite 318C
Spokane,WA99204
Specialty Clinic
118 118 - Northwest Heart & Lung Surgical Associat
122 W 7th Ave Suite 110
Spokane,WA99204
Specialty Clinic
119 119 - Obstetrics and Gynecology - Mill Creek C
16708 Bothell-Everett Highway Suite
201
Mill Creek,WA98012
Specialty Clinic
120 120 - Obstetrics and Gynecology - Monroe Clini
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
121 121 - Obstetrics and Gynecology - Pavillion fo
900 Pacific Ave Suite 501
Everett,WA98201
Specialty Clinic
122 122 - Occupational Medicine - Downtown
421 S Division St Suite 2
Spokane,WA99202
Specialty Clinic
123 123 - Occupational Medicine - North
551 E Hawthorne Road
Spokane,WA99218
Specialty Clinic
124 124 - Occupational Medicine - Spokane Valley
16528 E Desmet Court Suite A1600
Spokane Valley,WA99216
Specialty Clinic
125 125 - Olympia Cardiac Surgery
525 Lilly Rd NE Suite 200
Olympia,WA98506
Specialty Clinic
126 126 - Olympia Endocrinology
2555 Marvin Rd NE
Lacey,WA98516
Specialty Clinic
127 127 - Olympia Infectious Disease Clinic
3525 Ensign Rd NE Suite R
Olympia,WA98506
Specialty Clinic
128 128 - Olympia Urology
149 Lilly Road NE
Olympia,WA98506
Specialty Clinic
129 129 - Orthopedics
820 S McClellan St Suite 300
Spokane,WA99204
Specialty Clinic
130 130 - Orthopedics - North
212 E Central Ave Suite 245
Spokane,WA99208
Specialty Clinic
131 131 - Pediatric Associates - Northpointe
9911 N Nevada St Suite 200
Spokane,WA99218
Specialty Clinic
132 132 - Pediatric Gastroenterology - Sacred Hear
105 W 8th Ave Suite 150E
Spokane,WA99204
Specialty Clinic
133 133 - Pediatric Pulmonology & Cystic Fibrosis
105 W 8th Ave Suite 660E
Spokane,WA99204
Specialty Clinic
134 134 - Pediatric Urology
315 W 9th Ave Suite 200
Spokane,WA99204
Specialty Clinic
135 135 - Pediatrics
2902 164th St SW
Lynnwood,WA98087
Specialty Clinic
136 136 - Pediatrics
4112 Harbour Pointe Blvd SW Suite
100
Mukilteo,WA98275
Specialty Clinic
137 137 - Pediatrics - Indian Trail
5011 W Lowell Ave Suite 100
Spokane,WA99208
Specialty Clinic
138 138 - Pediatrics - Mill Creek Campus
12800 Bothell-Everett Highway Suite
190
Mill Creek,WA98208
Specialty Clinic
139 139 - Pediatrics - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
140 140 - Pediatrics - North
212 E Central Ave Suite 440
Spokane,WA99208
Specialty Clinic
141 141 - Physiatry - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
142 142 - Plastic and Reconstructive Surgery - Mil
12800 Bothell-Everett Highway Suite
260
Mill Creek,WA98208
Specialty Clinic
143 143 - Providence Cardiology Associates
500 Lilly Rd NE
Olympia,WA98506
Specialty Clinic
144 144 - Providence Ear Nose & Throat
301 W Poplar Street Suite 210
Walla Walla,WA99362
Specialty Clinic
145 145 - Providence Gastroenterology
212 E Central Ave Suite 440
Spokane,WA99208
Specialty Clinic
146 146 - Providence Gastroenterology
301 W Poplar Street Suite 210
Walla Walla,WA99362
Specialty Clinic
147 147 - Providence General Surgery
380 Chase Ave
Walla Walla,WA99362
Specialty Clinic
148 148 - Providence HIV Clinic
624 E Front Ave
Spokane,WA99202
Specialty Clinic
149 149 - Providence In Home Primary Care
1830 Bickford Avenue
Snohomish,WA98290
Specialty Clinic
150 150 - Providence Internal Medicine
16528 E Desmet Court Suite B2100
Spokane Valley,WA99216
Specialty Clinic
151 151 - Providence Internal Medicine
380 Chase Street
Walla Walla,WA99362
Specialty Clinic
152 152 - Providence Internal Medicine Residency C
624 E Front Ave
Spokane,WA99202
Specialty Clinic
153 153 - Providence Liver and Pancreas
105 W 8th Ave Suite 7050
Spokane,WA99204
Specialty Clinic
154 154 - Providence Medical Park
16528 E Desmet Court
Spokane Valley,WA99216
Specialty Clinic
155 155 - Providence Nephrology
301 W Poplar Street Suite 100
Walla Walla,WA99362
Specialty Clinic
156 156 - Providence Neurology
105 W 8th Ave Suite 318C
Spokane,WA99204
Specialty Clinic
157 157 - Providence Occupational Health
380 Chase Street
Walla Walla,WA99362
Specialty Clinic
158 158 - Providence Orthopedic Surgery
380 Chase Street
Walla Walla,WA99362
Specialty Clinic
159 159 - Providence Orthopedics - Spokane Valley
16528 E Desmet Court Suite A2200
Spokane Valley,WA99216
Specialty Clinic
160 160 - Providence Regional Cancer Center
105 W 8th Ave Suite 550E
Spokane,WA99204
Specialty Clinic
161 161 - Providence Regional Cancer System
4525 Third Avenue SE Ste 200
Lacey,WA98503
Specialty Clinic
162 162 - Providence Regional Cancer System - Aber
954 Anderson Drive Ste 102
Aberdeen,WA98520
Specialty Clinic
163 163 - Providence Regional Cancer System - Cent
2015 Cooks Hill Rd
Centralia,WA98531
Specialty Clinic
164 164 - Providence Regional Cancer System - Shel
2026 Olympic Highway N Suite 203
Shelton,WA98584
Specialty Clinic
165 165 - Providence Regional Cancer System - Yelm
201 Tahoma Blvd SE Ste 204
Yelm,WA98597
Specialty Clinic
166 166 - Providence Spokane Cardiology
122 W 7th Ave Suite 450
Spokane,WA99204
Specialty Clinic
167 167 - Providence Spokane Heart Institute
122 W 7th Avenue
Spokane,WA99204
Specialty Clinic
168 168 - Providence St Peter Chemical Dependency
4800 College Street SE
Lacey,WA98503
Specialty Clinic
169 169 - Providence St Mary Neuroscience Institu
301 W Poplar Street
Walla Walla,WA99362
Specialty Clinic
170 170 - Providence St Peter Outpatient Orthoped
410 Providence Lane NE 2nd Floor
Olympia,WA98506
Specialty Clinic
171 171 - Providence Urology
301 W Poplar Street Suite 50
Walla Walla,WA99362
Specialty Clinic
172 172 - Pulmonary and Sleep Disorder Clinic
212 E Central Ave Suite 315
Spokane,WA99208
Specialty Clinic
173 173 - Pulmonary Oncology - Sacred Heart Doctor
105 W 8th Ave Suite 550E
Spokane,WA99204
Specialty Clinic
174 174 - Sexual Assault Clinic
420 Golf Club Road Suite 203
Lacey,WA98503
Specialty Clinic
175 175 - Sleep Center for Southwest Washington
500 Lilly Rd NE Suite 110
Olympia,WA98605
Specialty Clinic
176 176 - Sleep Health - Mill Creek Campus
12800 Bothell-Everett Highway Suite
160
Mill Creek,WA98208
Specialty Clinic
177 177 - Sleep Health - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
178 178 - Sleep Lab - Pavilion for Women & Childre
900 Pacific Ave 2nd Floor
Everett,WA98201
Specialty Clinic
179 179 - Snohomish Clinic
1830 Bickford Avenue Suite 211
Snohomish,WA98290
Specialty Clinic
180 180 - South Sound Internal Medicine
3425 Ensign Road NE Suite 220
Olympia,WA98506
Specialty Clinic
181 181 - South Sound Pulmonary and Sleep Medicine
500 Lilly Rd NE Suite 201
Olympia,WA98506
Specialty Clinic
182 182 - Southwest Washington Boldt Diabetes & Nu
2555 Marvin Rd NE Lacey
Lacey,WA98516
Specialty Clinic
183 183 - Southwest Washington Boldt Diabetes & Nu
1010 S Scheuber Rd
Centralia,WA98531
Specialty Clinic
184 184 - Southwest Washington Neurosurgery
615 Lilly Road Suite 220
Olympia,WA98506
Specialty Clinic
185 185 - St Peter Outpatient Pediatric Therapies
410 Providence Lane NE 2nd Floor
Olympia,WA98506
Specialty Clinic
186 186 - Travel Medicine Clinic
525 Lilly Road NE
Olympia,WA98506
Specialty Clinic
187 187 - Valley Young People's Clinic
1414 North Vercler Road 1
Spokane Valley,WA99216
Specialty Clinic
188 188 - Vascular Institute - Providence Spokane
122 W 7th Avenue Suite 420
Spokane,WA99204
Specialty Clinic
189 189 - Vascular Surgery - Colby Campus MOB
1330 Rockefeller Ave Suite 520
Everett,WA98201
Specialty Clinic
190 190 - Vein Center
1923 S Grand Blvd
Spokane,WA99203
Specialty Clinic
191 191 - Vein Center - Mill Creek Campus
12800 Bothell-Everett Highway Suite
270
Mill Creek,WA98208
Specialty Clinic
192 192 - Walk-In Care - Mill Creek Campus
12800 Bothell-Everett Highway Suite
110
Mill Creek,WA98208
Specialty Clinic
193 193 - Walk-In Care - Monroe Clinic
19200 North Kelsey Street
Monroe,WA98272
Specialty Clinic
194 194 - Providence Urgent Care
380 Chase Ave
Walla Walla,WA99362
Urgent Care
195 195 - Urgent Care - 5th & Division
421 S Division Street
Spokane,WA99202
Urgent Care
196 196 - Urgent Care - Hawthorne
551 E Hawthorne Road
Spokane,WA99218
Urgent Care
197 197 - Urgent Care - Spokane Valley
16528 E Desmet Court Suite A1200
Spokane Valley,WA99216
Urgent Care
198 198 - West Olympia Immediate Care
1620 Cooper Point Road SW
Olympia,WA98502
Urgent Care
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 9
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 PH&S sliding fee scale will be used to determine the amount to be written off as charity care for guarantors with income between 101% and 400% of the current federal poverty level after all funding possibilities available to the guarantor have been exhausted or denied and personal financial resources and assets have been reviewed for possible funding to pay for billing charges.
Part I, Ln 7 Col(f): 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 $ 48,825,271.
Part II, Community Building Activities: COMMUNITY BUILDING ACTIVITIES:WESTERN WASHINGTON REGION:In Thurston County, Providence St. Peter Hospital sponsored a program called Grief Works, which assists people who are grieving from the loss of a spouse, child or sibling. The work involves pastoral care support and counseling in both individual and group sessions.In addition, Providence leaders serve on local boards. Examples include the board of Behavioral Health Resources, a not-for-profit mental health provider; CHOICE Regional Health Network; local college boards; service organizations; chamber of commerce boards; school board of directors; and the Hands-On Children's Museum, which promotes healthy family living.SOUTHEAST WASHINGTON REGION:Providence St. Mary Medical Center provides many free, preventative, diagnostic and educational services in the communities it serves. In 2015, community members were invited to attend a wide variety of health education classes, talks, screenings and support groups including topics like diabetes, smoking cessation, cardiopulmonary resuscitation, childbirth, breast cancer and sleep disorders. Free screenings also were conducted for skin and prostate cancer in cooperation with Providence Medical Group and an independent clinic, the Walla Walla Clinic. The medical center hosted a free, drive-through community flu clinic in concert with the Walla Walla County Health Department to both prevent the flu, and stem the tide of a whooping cough epidemic. People were able to be vaccinated without leaving their cars, and nearly 600 flu shots were given. The medical center also helped fund research and worked with a consortium of other agencies in Walla Walla County seeking to identify ways to improve access to mental health services. PROVIDENCE HEALTH CARE/EASTERN WASHINGTON REGION:Many of the activities reported in Part II demonstrate the eastern Washington Providence hospitals' efforts to actively engage and partner with the community to help address specific needs. We collaborate with more than 80 community partners in Spokane and Stevens counties that share our commitment to serving the poor and vulnerable. Together, we are able to maximize resources to reach the greatest number of people, providing needed services such as immunizations, screenings, education, medication, shelter and food. Below is a list of a few of the many organizations Providence hospitals support in eastern Washington:*Catholic Charities*Christ Clinic*Community Detox Services of Spokane*Daybreak (rehabilitation services for adolescents with substance abuse issues)*Life Services of Spokane (support services for pregnant women to help them carry babies to term and provision of parenting education)*Northeast Tri-County Health District (Colville)*Partners with Children and Families*Prescriptions for Life (Chewelah)*Project Access (involves doctors and hospitals in the community volunteering to provide needed health care services and surgeries for patients who cannot pay)*Ronald McDonald House*Rural Resources Family Center (Colville)*Spokane Prescription Access Program*Transitional Programs for Women*Tri-County Community Health Fund (Stevens County)*Second Harvest (food bank)*Community Health Association Spokane dental program (a federally quality health center)*Washington Poison Control CenterIn addition, many Providence Health Care leaders and staff participate in community collaboration efforts through their membership on boards and advisory groups such as the Homeless Coalition and the Spokane Mental Health Advisory Board. Other boards include the United Way, YWCA, Women Helping Women, domestic and family violence organizations, educational boards, stroke conference boards, domestic terrorism training and many more where the expertise of the local hospital staff and administration can offer valuable information to the group for partnership and collaborative efforts in attempts to improve the health and wellbeing of the community. Often the hospital has been asked to provide a representative for the board or advisory group by the community.Providence Sacred Heart, Children's Hospital, and Holy Family also participate as major sponsors of community events that benefit the community at large. Examples include:*American Brain Tumor Association*American Heart Association*American Cancer Society*American Red Cross*Cancer Patient Care*Catholic Charities*Hope House*Inland NW Blood Center*March of Dimes*Special Olympics*Women Helping Women*YWCA
Part III, Line 2: Bad debt expense represents the amount of gross charges for patients who do not have insurance and which PH&S-OR 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 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 Providence's policy to exclude any Medicare shortfall from Community Benefit information.The amount reported on Part III, Section B, Line 6, was determined by applying the Cost-to Charge Ratio to the Medicare revenue.
Part III, Line 9b: Billing & Collection PracticesProvidence has written policies about when and under whose authority patient debt is advanced for collection, and uses its best efforts to ensure that patient accounts are processed fairly and consistently.Providence ensures that practices to be used by their outside (non-hospital) collection agencies conform to the standards set forth in this policy, and obtains written commitments from such agencies that they will adhere to those standards. Providence also conducts an assessment of each collection agency's adherence to the policy. Such assessments are conducted at least annually.At time of billing, we provide to all low-income uninsured patients the same information concerning services and charges provided to all other patients who receive care at the hospital.When sending a bill to a patient, Providence includes a) a statement that indicates that if the patient meets certain income requirements the patient may be eligible for a government-sponsored program or for financial assistance from the hospital; and b) a statement that provides the patient with the name and telephone number of a hospital employee or office from whom or which the patient may obtain information about Providence's financial assistance policies for patients and how to apply for such assistance.Any patient (or the patient's legal representative) seeking financial assistance from Providence provides the individual facility with information concerning health benefits coverage, financial status (i.e. income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs.For patients who have an application pending determination for either government-sponsored coverage or for the hospitals' own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency. Eligibility for financial assistance will be determined as closely as possible to the date of service.
SCHEDULE H, PART III, Line 3 It is Providence's policy to exclude all bad debts from Community Benefit information.
Part VI, Line 2: NEEDS ASSESSMENT:We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care.These general guidelines are applied across all service areas covered in Providence Health & Services - Washington. These include: Northwest Washington Service Area, Southwest Washington Service Area, Southeast Washington Service Area, Providence Health Care in Eastern Washington and PH & S - WA. in Alaska.Providence Sacred Heart Medical Center & Children's Hospital and Providence Holy Family Hospital: In September 2014 representatives from Providence Health Care met with staff from Priority Spokane and the Spokane Regional Health District to begin planning for the 2015 needs assessment. There is a significant desire for the community to come together for one communitywide needs assessment, in which health would be one factor. Priority Spokane had conducted a community needs assessment at the end of 2013 with many of the same participants and measures from our 2012 community health needs assessment. We agreed to use this data and enhance it with newer data including preliminary quality of life survey data, hospital homeless and marginalized patient data and the Spokane Counts report. Along with this data we solicited input from external and internal stakeholders in preparation for a communitywide assessment in 2018.Providence Mount Carmel Hospital and Providence St. Joseph's Hospital: The Community Health Needs Assessment for Stevens County was conducted in collaboration among Providence Health Care, North East Washington Health District, Eastern Washington University, and the Empire Health Foundation. The purpose was to prioritize health care needs, especially among the most poor and vulnerable populations, and look for collaborative opportunities to improve the health of the community.Providence ministries in eastern Washington are governed by a community ministry board. In addition, our foundation boards are composed of community members. The results of our needs assessments are presented to these boards for their review and input. The civic leaders that serve on Providence boards connect the Providence Mission with a local perspective on community needs. The Providence Health Care Eastern Washington Community Ministry Board approves the community needs assessments.Every three years, Providence Alaska Medical Center (PAMC) and Providence Kodiak Island Medical Center (PKIMC) conduct a community health needs assessment (CHNA) for the Anchorage and Kodiak communities. The CHNAs are conducted in collaboration with a diverse stakeholder group of community partners in order to identify and address the most significant community health need priorities in Anchorage and Kodiak. In 2015, PAMC conducted a CHNA in partnership with: -United Way of Anchorage, -Anchorage Neighborhood Health Center, -Catholic Social Services-Anchorage Department of Health and Human ServicesIn 2013, PKIMC conducted a CHNA in partnership with: -Providence Kodiak Island Medical Center-Kodiak Island Borough-Kodiak Island Medical Associates-State of Alaska Kodiak Public Health Center-Kodiak Community Health Center-U.S. Coast Guard Rockmore-King Medical Clinic-Providence Kodiak Island Counseling Center -Filipino American Association-Senior Citizens of Kodiak-Kodiak Island Borough School District-Kodiak Area Native Association-City of KodiakRepresentatives from each of the partner organizations comprised the Anchorage CHNA Advisory Group and Kodiak CHNA Advisory Group, which directed the assessment process from its inception to completion. These organizations were chosen due to the fact that they serve and represent the broadests interests of the community of Anchorage and Kodiak.Both groups selected the key indicators that would comprise the data set for the CNHAs. In the process of selecting the final indicators, the advisory group gave consideration to a number of guiding principles for data characteristics, which included: -Integrity of data source-Multi-year availability of data to better understand past and future trends-Broad community representation, especially to ensure inclusion of poor, vulnerable and underserved populations-Continuity with prior assessment and resulting priorities-Alignment with Healthy Alaskans 2020 initiative to the extent possibleThe data was collected from local, state and federal data sources including: -Alaska Bureau of Vital Statistics-Alaska DHSS Obesity Prevention and Control Program-Anchorage Homeless Point in Time Survey-Anchorage School District-Behavioral Risk Factor Surveillance Survey (BRFSS)-Community Commons-Providence Alaska Medical Center Emergency Department utilization data-United States Census Bureau-U.S. Department of Labor -Youth Risk Behavioral Survey (YRBS)Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete and broad needs of the community, beyond just the need for free and discounted health care services.
Part VI, Line 3: COMMUNICATION TO THE PUBLIC:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills.When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients.
Part VI, Line 4: COMMUNITY INFORMATION:ALASKA REGION:Providence Alaska Medical Center serves the Municipality of Anchorage as its primary service area, the Mat-Su borough as its secondary service area and the entirety of the state of Alaska as the tertiary care provider state-wide. the Municipality of Anchorage is the largest community in the state of Alaska and comprises roughly half of the state's population. It is located in Southcentral Alaska along Cook Inlet. Anchorage sits in a bowl with Cook Inlet on one side and Chugach State Park on the other. Home to nearly half the state's residents, Anchorage has a population of 301,010 and includes the communities of Anchorage, Chugiak, Eagle River, Girdwood, and Joint Base Elmendorf-Richardson. It is the hub of Alaska's infrastructure and business community. Ethnically and culturally diverse, three of the top 10 most diverse census tracts in the United States are within Anchorage . Seventeen percent of Anchorage residents speak a language other than English in their homes. The CHNA assessed the broad Anchorage community but did take a special look at a few key subpopulations: youth, and the poor and vulnerable, especially homeless and underserved residents. The purpose of this assessment was to identify the health needs in the Anchorage area, which is Providence Alaska Medical Center's primary service area. The assessment area comprised the communities within the Municipality of Anchorage. Providence Kodiak Island Medical Center serves the Kodiak community which is situated in the Gulf of Alaska and is comprised of 16 major islands with roughly 14,000 residents. The island totals 3,588 square miles and is the second largest island in the United States - second only to Hawaii. Kodiak Island has the largest fishing port in the state and is the third largest fishing port in the country. In addition, Kodiak Island hosts the largest U.S. Coast Guard base. Thus, commercial fishing and the U.S. Coast Guard are the dominant industries followed by retail trade, transportation, utilities and tourism. WESTERN WASHINGTON REGION - NORTHWEST:The Western Washington Region - Northwest includes Providence Regional Medical Center Everett (PRMCE), which is the only tertiary provider in Snohomish County and is located on two campuses in Everett, Washington. The hospital's primary service area is Snohomish County, with a population of 745,913. Within this geography, the average age is 36.5 years and only 12% of the population is over age 65, although this is estimated to grow to 12.5% by 2016. The average household income is $68,338, and approximately 9.8% of people are living below poverty level in Snohomish County. As of December 2013, 5.3% of Snohomish County residents are unemployed, which is higher than the national unemployment rate. The secondary service area includes Skagit, Island, San Juan and Whatcom counties, totaling an additional 491,631 people. Within this geography, the average age is 39.2 years, with 16% of the population over age 65. The average household income is $54,457. The unemployment rates for the secondary service area include: Skagit (7.9%), Island (7.2%), San Juan (5.9%) and Whatcom (6.2%). In 2013, PRMCE provided almost $53.6 million in charity care and community benefits.WESTERN WASHINGTON REGION - SOUTHWEST:The Western Washington Region - Southwest includes Providence St. Peter Hospital in Olympia, Washington and Providence Centralia Hospital in Centralia, Washington. The hospitals deliver care to a five-county area including Thurston, Mason, Lewis, Grays Harbor and Pacific counties. For Providence St. Peter Hospital, the hospital serves 492,300 people in its primary and secondary service area. (SEE CONTINUATION)
Part VI, Line 5: FURTHERANCE OF EXEMPT PURPOSE:As a not-for-profit Catholic health care ministry, Providence Health & Services embraces its responsibility to provide for the needs of the communities it serves - especially the poor and vulnerable. Providence's not-for-profit, tax-exempt status enables Providence to serve its communities, to solicit donations through its foundations and to access capital to respond to community needs that otherwise would go unmet. Health care is fundamentally different from most other goods and services. It is about the most human and intimate needs of people, their families and communities. This critical difference is why we should work together to preserve and strengthen the not-for-profit sector in health care.In Alaska, access to health care is one of the most critical community needs. To address this need, Providence Alaska and its local ministries are involved in and supportive of many programs, activities and services. In addition to having 24/7 emergency room care, both Providence Alaska Medical Center and Providence Kodiak Island Medical Center are level II trauma centers to ensure every Alaskan receives exemplary and timely care. Providence Alaska is governed by a community ministry board made up of independent community members from across the state. Additionally, each hospital has an advisory board made up of local community members. Providence Alaska Medical Center has an electronic intensive care unit (eICU) that serves communities across Alaska and one community in Oregon. PAMC has expanded its telemedicine capabilities to provide stroke care to local and distant communities. Within the community of Anchorage, Providence is a long-time partner of Anchorage Project Access (APA). The volunteer network provides medical services, accepting and treating APA-referred patients as any other insured patients. PAMC continues to provide funding and resources to the program.Providence Senior Care Center and the Pediatric Sub-Specialty Clinic are two more examples of how Providence promotes a healthy, well-cared for community. The Senior Care Center opened in January 2011 with the goal of providing Alaskans 55 and older with whole-health primary care. The program is subsidized by Providence Health and Services Alaska. The Pediatric Sub-Specialty Clinic at Providence has served children from birth to the age of 21 since 1998. This clinic is subsidized by the health system to ensure that children in Alaska have services and treatment not otherwise available to help them manage chronic illnesses. Providence Kodiak Island Medical Center (PKIMC) is the only hospital on island and provides comprehensive health care to residents and visitors of Kodiak. As a critical access hospital (CAH), PKIMC features 25 acute care beds, including four birthing suites, two psychiatric care beds, and two ICU beds. In addition, the Care Center, PKIMC's extended care facility, has 19 long-term care beds.PKIMC provides an extensive array of inpatient and outpatient services, including emergency department, surgery, laboratory services, maternity, general medicine, physical therapy, occupational therapy, respiratory therapy, sleep studies, specialty clinics, diagnostic imaging services, and pharmacy. It is staffed by a mix of primary care physicians, surgeons, and specialists who provide family practice, internal medicine, obstetrics, radiology, and general practice services. The outpatient Specialty Clinic provides additional support services including pediatrics, urology, allergy, dermatology, podiatry, psychiatry, gynecology, audiology and ear, nose, and throat specialists.In Walla Walla County, Providence St. Mary Medical Center participates with other health, education, governmental and social service agencies in a community health assessment, sponsored by the Walla Walla County Health Department. The assessment identifies the areas of greatest need in the health of the community. Providence St. Mary uses this data in addition to other information to guide its community outreach. In recent years, the most critical need identified through this process is at-risk youth access to health care and services. To meet this need, Providence St. Mary provided funding to establish eastern Washington's first school-based health clinic, which operates as an independent not-for-profit at an alternative high school in Walla Walla. Providence St. Mary now provides annual funding to the clinic. The medical center also donates the use of a building to Trilogy Recovery Community, an independent not-for-profit youth drug and alcohol recovery center.Providence St. Mary utilizes the Providence Telestroke Network, run through the Providence Brain Institute in Portland, Oregon, to ensure that every patient coming into the emergency department with symptoms of stroke can be seen by a neurologist, regardless of the hour. With strokes, the faster a patient is diagnosed and treated, the less damage the stroke can do. Receiving the right treatment quickly can mean the difference between life and death, and between a good recovery and a lifelong disability. (SEE CONTINUATION)
Part VI, Line 6: AFFILIATED HEALTH CARE SYSTEM:The Health System owns or operates 34 general acute care hospitals, three ambulatory care centers, six medical groups, six long term care facilities, seven homecare and hospice entities, five assisted living facilities, 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 23 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; Seattle, Spokane, Kennewick, and Olympia, Washington; Missoula, Montana; Portland and Medford, Oregon; and Los Angeles, California.The charitable purpose of Providence Health & Services and each of its ministries is guided by one Mission and set of core values based on Catholic health care and guided by the legacy of the Sisters of Providence. As one system committed to caring for those who are poor and vulnerable, Providence Health & Services has developed a single framework for consistently reporting charity care and community benefit. Our commitment to respect and fairness means Providence has a system-wide compensation policy. Locally, Providence ministries are empowered to apply these policies to meet the local needs of their community. Additionally, Providence ministries conduct local assessments to make sure the needs of the community are met.ALASKA REGION:Providence Alaska has 15 ministries. Most facilities are located in the Anchorage area, yet Providence Alaska expands it services through a presence in three rural communities as well as telemedicine and electronic intensive care unit (eICU) services extended to communities in Alaska and Oregon. The ministries in Providence Alaska work to care for each patient as they need care across the full continuum of health care services. Providence Alaska Medical Center is the only comprehensive tertiary referral center serving all Alaskans. The medical center features the Children's Hospital at Providence (the only one of its kind in Alaska), the state's only Level III NICU, Heart and Cancer Centers, the state's largest emergency department, full diagnostic, rehab and surgical services as well as both inpatient and outpatient mental health and substance abuse services for adults and children. Providence Alaska has a family practice residency program that trains physicians in primary care with the intent of increasing providers in distant Alaskan communities. A continuum of post-acute care services, including home health, hospice, assisted living and a skilled nursing facility provides care for patients as close to home as possible. A developing medical group provides primary and specialty care in the community. The three critical access hospitals located in the remote communities of Kodiak, Seward, Valdez and Cordova are all co-located with skilled nursing facilities. Community mental health centers are operated in Kodiak and Valdez. These services combined in these communities provide a solid foundation for access to health care. Providence Alaska also partners to provide additional services through five joint ventures including: Providence Imaging Center in both Anchorage and Soldotna, St. Elias Long Term Acute Care Hospital, Imaging Associates of Providence in both Anchorage and Wasilla, LifeMed Alaska (a medical transport / air ambulance service), and Creekside Surgery Center.WESTERN WASHINGTON REGION - NORTHWEST:Providence cares for the residents of five Northwest Washington counties through a comprehensive network of facilities and services. Our hospital, Providence Regional Medical Center, contains more than $60 million in some of the world's most advanced medical technology, and is home to the state's busiest emergency room. Our Pavilion for Women & Children houses maternity and newborn intensive care, and offers breast care and other services for women, children and families. Our Providence Medical Group clinics provide a full range of primary and specialty care throughout Snohomish County. The Providence Regional Cancer Partnership is an innovative partnership that offers all aspects of outpatient cancer care under one roof, using some of the world's most sought-after cancer care technology. The Providence Everett Healthcare Clinic provides high-quality care for those who may otherwise not be able to afford it. Providence Hospice & Home Care of Snohomish County delivers compassionate, home-based care to those who are confined to the home. PROVIDENCE HEALTH CARE/EASTERN WASHINGTON:In the Eastern Washington Region, Providence Health Care is made up of 11 ministries offering comprehensive, coordinated health care across the full continuum of care. In addition to five hospitals, Providence Health Care includes home health care, skilled nursing/long term care and transitional care, an assisted living facility, home chore services, a physician group with more than 200 physicians, a medical laboratory and the region's only adult day health program. All of these ministries serve the Providence Mission and provide care for all, especially to those who are poor and vulnerable. This coordinated system of care ensures patients receive the right care from the right provider, at the right time, at the right cost. While the Providence physician group is at the core of coordinating patient care, patients may enter the Providence Health Care system at any ministry level depending on need. This comprehensive, open system ensures patients receive a full spectrum of coordinated care, regardless of their ability to pay.WESTERN WASHINGTON REGION - SOUTHWEST:Providence Health & Services in Southwest Washington touches more lives in Thurston, Mason, Lewis, Grays Harbor and Pacific counties than any other health care provider. *Providence St. Peter Hospital is a 390-bed, not-for-profit regional teaching hospital founded by the Sisters of Providence in 1887. Located in Olympia, the hospital offers comprehensive medical, surgical and behavioral health services to residents of Southwest Washington. St. Peter is a regional leader in cardiology, oncology, orthopedics and neuro-sciences. The Joint Commission has designated the hospital a Stroke Center of Excellence since 2007.*Providence Centralia Hospital is a 102-bed, not-for-profit community based hospital. The services the hospital provides make it the heart of medical care in Lewis County. As a community hospital with outstanding technology, Providence Centralia Hospital is large enough to provide state-of-the-art services such as MRI, 64-slice CT scans and digital mammography. The hospital is also small enough to offer personal, compassionate care to everyone it serves. *Providence Medical Group operates more than 25 clinics, with more than 160 specialized providers in Lewis, Thurston and Grays Harbor counties. The group provides primary and specialty care, including family medicine, internal medicine, cardiology, neurosurgery, oncology, diabetes care, general surgery, endocrinology, obstetrics/gynecology, physiatry, psychiatry and urology.*Providence Senior and Community Services provide a full continuum of health care services for those living with chronic and/or life-limiting conditions. Offering access and choice through innovative, customer-centered options, services are provided in the home or in a variety of facility settings including Providence SoundHomeCare andHospice and Providence Mother Joseph Care Center and through supportive housing, including Providence St. Francis House (Olympia); Providence Blanchet House (Centralia); Providence Rossi House (Centralia) and Providence Place (Chehalis).
Part VI, Line 7, Reports Filed With States WA,OR,CA,MT,AK
PART VI, LINE 4 - COMMUNITY INFORMATION CONTINUED - W. WA. - SOUTHWEST Providence Centralia Hospital and Providence St. Peter Hospital serve 489,000 people with 20% of the population over age 65. The median household income is $47,216. Within the Western Washington Region - Southwest, the percentage of people living in poverty includes: Thurston (11.7%), Lewis (15.4%), Mason (17.3%), Grays Harbor (19.0%) and Pacific (17.2%). The unemployment rates for the counties include Thurston (7.04%), Lewis (11.2%), Mason (9.74%), Grays Harbor (11.82%) and Pacific (10.65%). In 2013, the Western Washington Region - Southwest provided more than $59 million in charity care and community benefitsSOUTHEAST WASHINGTON REGION:The Southeast Washington Region includes Providence St. Mary Medical Center in Walla Walla, Washington. The primary service area for the hospital includes Walla Walla County and five zip codes in Northeast Oregon which include the nearby city of Milton Freewater as well as Columbia County. Within this geography, 16% of the population is over age 65 and the median household income is $39,215. The unemployment rate in Walla Walla County is 5.6%. PROVIDENCE HEALTH CARE/EASTERN WASHINGTON REGION:Spokane County is the furthest east county along Interstate 90, located on the Idaho border. It is largely urban with the second most populated city in the state, Spokane, with a population of 485,000. Providence Sacred Heart Medical Center & Children's Hospital and Providence Holy Family Hospital are located in Spokane County. About 14.1% of its population is over the age of 65. The share of Spokane county residents who are ages 64 and younger and uninsured was 16.5% in 2012. The top three causes of death in Spokane County were heart disease at 23 percent, cancer at 20.1 percent, and stroke at 4.4 percent. Heart disease and strokes are on a decreasing trend while cancer is increasing.Stevens County is a largely rural region in northeast Washington, north of Spokane County with Pend Orielle County to the east and Ferry County to the west. Providence Mount Carmel Hospital in Colville is 75 miles north of Spokane and Providence St. Joseph's Hospital in Chewelah is 25 miles north of Spokane. The Stevens County population is 43,430. A high percentage of the rural population (17%) is over the age of 65. The leading causes of hospitalizations are unintended injury and heart disease, which are above the state average. The drug crime rate has continued to increase and is higher than the state average.The primary service area for these five Providence hospitals is defined as Spokane and Stevens counties. As the region's major quaternary hospital, Providence Sacred Heart Medical Center & Children's Hospital serves a much broader tertiary market which spans eastern Washington, northern Idaho, western Montana and northeastern Oregon, with a population of more than 1.6 million. Approximately 43% of patients are covered by Medicare, 25% are covered by Medicaid and nearly 5% uninsured or self-pay. With approximately 15% of the population for most of the counties served living in poverty, this service area is characterized by lower income levels than the state average.
PART VI, LINE 5 - FURTHERANCE OF EXEMPT PURPOSE CONTINUED WESTERN WASHINGTON REGION - NORTHWEST:In Snohomish County, Providence Regional Medical Center Everett promotes the health of the community in a number of unique ways, one of which is the Providence Everett Healthcare Clinic. Opened in 2004, the clinic serves those with limited financial means and offers medical, dental and mental health care on a sliding fee scale, based on each patient's ability to pay. The clinic came about as the result of what started as a simple conversation between two single moms and a physician. These moms had government coupons to pay for health care, but no clinic or physician was willing to accept the coupons, and as a result, they were denied access. One mom had a son who experienced a simple earache. Because no one would see her son, the earache progressed until his ear drum burst, necessitating an emergency visit to the hospital. Upon hearing this story, the Providence physician realized there had to be a better way to meet the needs of this patient population. He developed a unique care delivery model in which Providence partnered with the schools of nursing at University of Washington Bothell and Everett Community College to deliver care. The clinic has grown in both size and scope several times since opening in 2004. It has expended from initially providing only medical care, to now providing mental and dental care as well.Another example is the community outreach program called Inside Out: The Original Organ Show. This innovative health education program, directed primarily at middle and high-school students, provides audiences with compelling health information - presented in a truly unique way - that empowers them to make informed decisions about behaviors and lifestyle choices that impact their long-term well-being. Inside Out takes viewers on a fantastic voyage through the human body. Actual human organs, such as hearts, lungs, brains, livers, kidneys and aortas are shown. Some are healthy; others have been damaged by substance abuse, poor eating habits and unsafe behaviors. Comparing healthy and cancerous lungs, clinical educators show the effects of smoking. Holding up a heart with a bullet hole through it, they describe the danger of gun violence. Using an aorta covered with hard, jagged plaque, they talk about how high cholesterol can lead to heart attacks. Displaying the shattered remains of a human brain,they talk about the unintended consequences of accidental prescription drug overdose. This program has been offered to the community for more than 20 years and in that time, thousands of people have written to tell how it changed, and possibly saved, their life.WESTERN WASHINGTON REGION - SOUTHWEST:In 2015, the cost of these community benefit services provided by Providence St. Peter Hospital, Providence Centralia Hospital and Providence Medical Group totaled more than $44 million, including more than $7 million in free and discounted care. Providence is invested in creating healthier communities, beyond the need for free and discounted care. Areas of great need included resources to improve the impact of end-of-life decisions, childhood obesity and the epidemic of diabetes. In response, Providence has invested in community benefit programs, including: -Implementing advanced care planning for the five-county area in southwest Washington.-Partnering with local elementary and middle schools to introduce Sqord activity trackers to encourage physical activity.PROVIDENCE HEALTH CARE/EASTERN WASHINGTON REGION:Providence in Eastern Washington provided more than $103 million in total community benefits.Providence Health Care formed an innovative collaboration 17 years ago with the other local hospital system (then Empire Health System) to better serve the community needs by jointly sponsoring Inland Northwest Health Services (INHS) - a not-for-profit organization that provides vital community services including air ambulance service, inpatient rehabilitation services, community health education, and an extensive medical information system that connects more than 30 hospitals across the inland northwest region. INHS represents a collaborative approach to health care that is unlike any other and brings unique partnerships and innovative technologies and more cost-effective care to Spokane and the Northwest. While the original sponsors have changed following the acquisition of Empire Health Services by a national for-profit system, Providence Health Care has found the ability to continue the community collaborative approach through a new joint sponsorship with the foundation that was formed by the sale of Empire Health Services.The Providence Health Care Community Ministry Board is made up of volunteer community leaders. The Board's primary delegated responsibilities include quality of care and service (including oversight of medical staff privileging), strategic planning and Mission effectiveness. In its role in Mission effectiveness, the Board is responsible for reviewing and approving the community needs assessment and selection of priority community needs. (SEE CONTINUATION)
PART VI, LINE 5 - FURTHERANCE OF EXEMPT PURPOSE CONTINUED For example, Providence Sacred Heart Medical Center is the only inpatient psychiatric program in the region, and Providence Holy Family Hospitals provides the only inpatient detox program in the community. Other unique services include an inpatient maternity clinic for uninsured, low income women located at Sacred Heart, transplant services (heart, kidney, pancreas) and numerous pediatric subspecialties.In addition, all Providence Health Care hospitals operate 24/7 emergency departments that serve all patients, regardless of ability to pay. And, as the only level II trauma center in the inland northwest region, Providence Sacred Heart medical Center serves a unique role of caring for the most critically ill and injured patients from the vast service area.Other examples of how Providence Health Care and its Eastern Washington ministries further its tax exempt status in support of the health of the community include:*Tele-medicine and tele-continuing medical education for physicians and nurses throughout the region.*Providing educational opportunities for medical professionals throughout the community, including management oversight and subsidy of the graduate medical education residency programs, including family medicine, internal medicine, radiology and psychiatry, as well as funding for medical research through the Providence Medical Research Center.*Medical staff at Providence hospitals have open privileges across all hospital facilities in the area.
Schedule H (Form 990) 2015
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," on 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
2015
Open to Public
Inspection
Name of the organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number
51-0216586
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" on 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) Providence Alaska Foundation
PO Box 196604
Anchorage,AK99519
92-0093565 501( C) (3) 3,548,277       Community Support
(2) Providence TrinityCare Hospice
5315 Torrance Blvd
Torrance,CA90503
95-3264139 501( C) (3) 3,137,810       Community Support
(3) Catholic Charities
PO Box 2253
Spokane,WA99210
91-0569880 501(c)(3) 1,100,075 3,731 Cost Forgiveness of Debt Operational Support/House of Charity Expansion/CAPA Program & Expansion for Clinic
(4) Providence Health Care Foundation - Eastern Washington
PO Box 2555
Spokane,WA99220
32-0014330 501(c)(3) 953,579       Operational Support/Community Support & Anesthesia Fund
(5) Catholic Social Services Inc
225 Cordova St Bldg B
Anchorage,AK99501
92-0037322 501( C) (3) 801,000       Community Support
(6) Providence St Peter Foundation
413 Lilly Road NE
Olympia,WA98506
91-1097056 501 (c ) (3) 747,865       Administrative support of the Foundation
(7) Covenant House Of Alaska
PO Box 104640
Anchorage,AK99510
13-3419755 501( C) (3) 576,601       Community Support
(8) Providence General Foundation
916 Pacific Avenue
Everett,WA98201
91-1041617 501(c)(3) 558,566       Foundation support
(9) United Way Of Anchorage
701 W 8th Avenue Ste 230
Anchorage,AK99501
92-0027948 501( C) (3) 550,724       Community Support
(10) Providence Hospice of Seattle Foundation
425 Pontius Ave N 300
Seattle,WA98109
91-2077378 501(C)(3) 465,231       Ministry Support
(11) Providence Mount St Vincent Foundation
4831 35th Avenue Southwest
Seattle,WA98126
91-1188119 501(C)(3) 445,109       Ministry Support
(12) Medical Teams International
PO Box 10
Portland,OR97207
93-0878944 501 ( C)(3) 47,280       Community Health
(13) Spokane Teaching Health Center
PO Box 244
Spokane,WA99210
46-4139065 501 (c ) (3) 434,084       Support for Operations
(14) Providence St Mary Foundation
401 W Poplar St
Walla Walla,WA99362
45-2841492 501(c)(3) 411,994       Foundation Charitable Support
(15) University Of Alaska
3211 Providence Dr K101A
Anchorage,AK99508
92-6000147 Government 380,000       Community Support
(16) Wallowa Memorial Hospital
601 Medical Parkway
Enterprise,OR97828
93-6002339 501(c)(3) 293,443       Community Connect Program
(17) Best Beginnings
3550 Commercial Drive Ste 104A
Anchorage,AK99501
45-5066055 501( C) (3) 250,000       Community Support
(18) City of Seward
PO Box 167
Seward,AK99664
92-6000086 Government 250,000       Community Support
(19) Global To Local Health Initiative
2800 South 192nd Street
SeaTac,WA98188
27-3133200 501 ( C)(3) 250,000       2015 Prov Hospital Community Contribution
(20) Providence Hospice and Home Care Foundation Snohomish County
2731 Wetmore Suite 500
Everett,WA98201
27-2552749 501(c)(3) 237,317       Subsidize Foundation Expenses
(21) Beans Cafe
PO Box 100940
Anchorage,AK99510
92-0072522 501( C) (3) 210,300       Community Support
(22) Alaska Sports Hall of Fame Inc
14815 Echo Canyon Rd
Anchorage,AK99516
81-0649085 501( C) (3) 200,000       Community Support
(23) Providence Marianwood Foundation
3725 Providence PT Dr SE
Issaquah,WA98029
93-1554288 501(C)(3) 183,903       Ministry Support
(24) Community Detox Services of Spokane
PO Box 2845
Spokane,WA99220
91-1108762 501(c)(3) 160,000       Community Detox Enhancement Program
(25) Stone Soup Group
307 East Northern Lights Blvd
Anchorage,AK99503
92-0149995 501( C) (3) 150,000       Community Support
(26) Partners with Families and Children
PO Box 248
Spokane,WA99210
68-0576560 501(c)(3) 141,000       Operational Support
(27) Christ Clinic
914 W Carlisle
Spokane,WA99204
91-1435174 501(c)(3) 125,000       Psychiatric Nurse Practitioner Program
(28) Better Health Together
PO Box 271
Spokane,WA99210
90-0997482 501(c)(3) 120,000       Community Health Education Outreach
(29) Anchorage Park Foundation
3201 C St
Anchorage,AK99503
41-2205907 501( C) (3) 117,803       Community Support
(30) Faith In Practice
7500 Beechnut Street Suite 208
Houston,TX77074
76-0415986 501 ( C)(3) 115,219       Trip Payment Share the mission
(31) Innovate Washington Foundation
714 N Iron Bridge Way Suite 203
Spokane,WA99202
91-1726442 501( C) (3) 112,500       Pledge
(32) Christian Health Associates
1825 Academy Drive
Anchorage,AK99507
92-0152088 501( C) (3) 106,000       Community Support
(33) Providence Health Care Foundation
914 S Scheuber Rd
Centralia,WA98531
91-1433382 501(c)(3) 101,896       Subsidize Foundation Expenses
(34) Anchorage Neighborhood Health Center Inc
4951 Business Park Blvd
Anchorage,AK99503
92-0047965 501( C) (3) 100,000       Community Support
(35) Food Bank of Alaska Inc
2121 Spar Avenue
Anchorage,AK99501
92-0073175 501( C) (3) 100,000       Community Support
(36) Lutheran Social Services of Alaska
1303 W 33rd
Anchorage,AK99503
94-3055592 501( C) (3) 100,000       Community Support
(37) Ronald McDonald House
1015 W 5th Ave
Spokane,WA99204
91-1176115 501(c)(3) 100,000       Operational Support
(38) Sultana New Ventures LLC
16 Klevin Street Ste 101
Anchorage,AK99508
47-0966637 Other 100,000       Community Support
(39) University Of Alaska Foundation
PO Box 755120
Fairbanks,AK99775
23-7394620 501( C) (3) 90,000       Community Support
(40) Prescription Drug Assistance Program
1111 Harvard Ave
Seattle,WA98122
33-1134368 501(c)(3) 75,000       Medication access to underinsured / Grant to support ongoing efforts.
(41) Kodiak Island Health Care Foundation
1911 E Rezanof Drive
Kodiak,AK99615
92-0146203 501( C) (3) 62,500       Community Support
(42) Young Men's Christian Association
2720 Rockefeller Ave
Everett,WA98206
91-0565561 501(c)(3) 60,360       Support for Health Leadership Coalition
(43) American National Red Cross
PO Box 3097
Seattle,WA98114
53-0196605 501 ( C)(3) 60,000       Community Health
(44) Hospice And Palliative Care Of Kodiak Inc
PO Box 8682
Kodiak,AK99615
45-2208200 501( C) (3) 60,000       Community Support
(45) Lutheran Community Services
210 W Sprague Ave
Spokane,WA99201
93-0386860 501(c)(3) 55,340       Outreach Program
(46) Inland Northwest Health Services
PO Box 469
Spokane,WA99210
91-1307555 501(c)(3) 54,568       Community Health Education Outreach
(47) Alaskan Dental Society Charitable Activities Fund
9170 Jewel Lake Rd
Anchorage,AK99502
20-8435454 501( C) (3) 50,000       Community Support
(48) APCA Inc
903 W Northern Lights Blvd Ste 200
Anchorage,AK99503
92-0154822 501( C) (3) 50,000       Community Support
(49) Daybreak Youth Services
11711 E Sprague Ave Suite D-4
Spokane Valley,WA99206
91-1083936 501(c)(3) 50,000       Youth Services Program
(50) Healthcare Info & Management System Society
6923 Eagle Way
Chicago,IL60678
36-3906745 501 ( C)(6) 50,000       Innovation Challenge Sponsor
(51) Spokane Guilds' School & Neuromuscular Center
2118 W Garland Ave
Spokane,WA99205
91-0863163 501(c)(3) 50,000       Community Benefit
(52) United States Figure Skating Association
20 First St
Colorado Springs,CO80906
84-0768715 501(c)(3) 50,000       Sponsor
(53) United Way of Valdez
PO Box 707
Valdez,AK99686
92-0090499 501( C) (3) 50,000       Community Support
(54) Emergency Assistance and Food Bank of Valdez
PO Box 848
Valdez,AK99686
34-1986012 501( C) (3) 45,000       Community Support
(55) Kodiak Baptist Mission Inc
1944 E Rezanof Drive
Kodiak,AK99615
92-0071967 501( C) (3) 40,000       Community Support
(56) Northport School District
PO Box 1280
Northport,WA99157
91-1086089 Government 40,000       Putting Kid's First Program
(57) Alaska Literacy Program Inc
1345 Rudakof Circle
Anchorage,AK99508
23-7451172 501( C) (3) 35,000       Community Support
(58) Washington Poison Center
155 NE 100th Street 100
Seattle,WA98125
94-3214597 501(c)(3) 35,000       2016 Community Benefit for Washington.
(59) Stevens County
215 S Oak Street
Colville,WA99114
91-6001372 Government 33,800       Regional Food HUB
(60) Providence Northeast
986 S Main Street
Colville,WA99114
46-3051292 501(c)(3) 32,700       Program development; food bank
(61) YearUp Inc
93 Summer Street
Boston,MA02110
04-3534407 501 (C ) (3) 30,095       Internship Support
(62) Brother Francis Shelter Kodiak Inc
PO Box 670
Kodiak,AK99615
20-8594266 501( C) (3) 30,000       Community Support
(63) Economic Alliance of Snohomish County
808 134th Street SW Ste 101
Everett,WA98204
91-0647005 501(c)(3) 30,000       Community Support
(64) Kodiak Women's Resource and Crisis Center
PO Box 2122
Kodiak,AK99615
92-0070130 501( C) (3) 30,000       Community Support
(65) The Alaska Community Foundation
3201 C Street 110
Anchorage,AK99503
92-0155067 501( C) (3) 30,000       Community Support
(66) The Health Center at Lincoln
534 So 3rd Ave Suite 16
Walla Walla,WA99362
27-0401462 501(c)(3) 30,000       Health Center Support
(67) United Way of Spokane County
920 N Washington St Suite 100
Spokane,WA99201
91-0606058 501(c)(3) 27,500       Employee Campaign
(68) Diocese of Spokane - Nazareth Guild
PO Box 1453
Spokane,WA99210
91-0564957 501(c)(3) 25,000       Operational Support
(69) Inner Pacific Alliance for Cancer Care
1204 N Vercler Rd Suite 101
Spokane Valley,WA99216
47-1917726 Other 25,000       Community Cancer Fund
(70) John Wayne Cancer Institute Auxiliary
5670 Wilshire Boulevard
Los Angeles,CA90036
95-4291515 501 ( C)(3) 25,000       Cancer Institute Support/Donation
(71) Jubilee Women's Center
620 18th Avenue E
Seattle,WA98112
91-1539920 501 ( C)(3) 25,000       18th Annual Jubilee/2015 Sponsorship
(72) Project Access Northwest
1111 Harvard Avenue
Seattle,WA98122
20-4377921 501(c)(3) 25,000       2016 Sponsorship.
(73) Providence High School
511 S Buena Vista Street
Burbank,CA91505
51-0216589 501 ( C)(3) 25,000       Platinum Sponsor
(74) St Joseph Family Center
1016 N Superior St
Spokane,WA99202
91-0564989 501(c)(3) 25,000       Operational Support
(75) Swedish Medical Center Foundation
747 Broadway
Seattle,WA98122
91-0983214 501 ( C)(3) 25,000       Sponsorship
(76) Providence Portland Medical Foundation
4805 NE Glisan Street
Portland,OR97213
93-1231494 501 ( C)(3) 21,000       Hood to Coast Donation from PH&S-WA
(77) Let Every Woman know Alaska
3851 Piper St Suite U264
Anchorage,AK99508
46-1861913 501( C) (3) 20,000       Sponsorship
(78) Second Harvest
1234 E Front Ave
Spokane,WA99202
23-7173826 501(c)(3) 20,000       Community Benefit
(79) The Waterfall Foundation
PO Box 70049
Fairbanks,AK99707
54-1980898 501 ( C)(3) 16,000 4,000 FMV Item Metal Artwork - SALMON 2015 WATERFALL Charity Auction
(80) United Way of King County
720 2nd Avenue
Seattle,WA98104
91-0565555 501 ( C)(3) 20,000       Sponsorship/Gift Support
(81) Valdez Senior Citizens Center
PO Box 1635
Valdez,AK99686
92-0082275 501( C) (3) 20,000       Community Support
(82) Big Tosi Management LLC
3101 Penland Parkway
Anchorage,AK99508
45-0635206 Other 15,000       Community Support
(83) NEW STEVENS PASS LLC
PO Box 609
Leavenworth,WA98826
45-3587615 Other 15,000       Stevens Pass Sponsorship.
(84) Providence St Joseph Foundation
501 South Buena Vista Street
Burbank,CA91505
95-3544877 501 ( C)(3) 15,000       An Evening to Remember Gala
(85) Senior Citizens of Kodiak Inc
302 Erskine Drive
Kodiak,AK99615
23-7348249 501( C) (3) 15,000       Community Support
(86) United Way of Snohomish County
3120 McDougal Avenue Suite 200
Everett,WA98201
91-0606507 501(c)(3) 15,000       Premier Sponsorship level.
(87) Advocates for Victims of Violence Inc
PO Box 524
Valdez,AK99686
92-0083034 501( C) (3) 12,500       Community Support
(88) Valdez Arts Council
PO Box 3138
Valdez,AK99686
23-7328616 501( C) (3) 12,500       Community Support
(89) Seattle University
901 12th Avenue Box 222000
Seattle,WA98122
91-0565006 501 ( C)(3) 10,500       Gala Scholarship Fund/Prize Award Winner
(90) American Heart Association Inc
816 Figueroa Street
Los Angeles,CA90017
13-5613797 501 ( C)(3) 10,000       2016 An Evening with Heart
(91) American Red Cross Everett
2530 Lombard Avenue
Everett,WA98201
53-0196605 501(c)(3) 10,000       Sponsorship for Real Heroes breakfast.
(92) Commonwealth North Inc
711 M Street Ste 104
Anchorage,AK99501
92-0073333 501( C) (3) 10,000       Community Support
(93) NCSL Washington State Host Committee
712 35th Avenue
Seattle,WA98122
84-0772595 501 ( C)(3) 10,000       2015 Sponsorship
(94) Safe Crossing Foundation
1402 3rd Avenue Suite 1430
Seattle,WA98101
75-2992774 501 ( C)(3) 10,000       Corporate Sponsorship
(95) Seattle Children's
PO Box 5371
Seattle,WA98105
91-0564748 501(c)(3) 10,000       Partnership contribution to safe gun storage giveaway event.
(96) The Foraker Group
161 Klevin St Ste 101
Anchorage,AK99508
92-0177787 501( C) (3) 10,000       Community Support
(97) University of Washington Foundation
Mackenzie Hall Box 3532000
Seattle,WA98195
94-3079432 501 (C ) (3) 12,500       Sponsorship
(98) March of Dimes
904 3rd Avenue Suite 230
Seattle,WA98101
13-1846366 501(c)(3) 9,000       Sponsorship
(99) Providence Joseph House
11215 5th Ave SW
Seattle,WA98146
27-3678314 501(C)(3) 8,613       Ministry Support
(100) American Cancer Society
250 Williams St NW
Atlanta,GA30303
13-1788491 501(c)(3) 8,500       Support Relay for Life / Cancer Research Support
(101) Providence NEW Hunger Coalition
PO Box 46
Loon Lake,WA99148
46-3051292 501(c)(3) 8,000       Hunger Collaborative in Stevens County
(102) Greater Trinity Academy
11229 4th Avenue West
Everett,WA98204
91-1872298 501 ( C)(3) 7,500       Sponsorship
(103) Life Support
PO Box 264
South Cle Elum,WA98943
20-0413954 501 ( C)(3) 7,500       Sponsorship
(104) The Friendship Circle of Washington
2737 77th Avenue SE Suite 101
Mercer Island,WA98040
91-2173196 501 ( C)(3) 7,500       Sponsorship
(105) Valdez Community Hospital Auxiliary
PO Box 94
Valdez,AK99686
92-0096062 501( C) (3) 7,500       Community Support
(106) Valdez Museum & Historical Archive Association Inc
PO Box 8
Valdez,AK99686
92-0159463 501( C) (3) 7,500       Community Support
(107) D and F Consulting
520 South Pines Ste 4
Spokane Valley,WA99206
47-3240506 Other 7,452       Community benefit, IDI training
(108) Health point - Community Health Centers
955 Powell Avenue SW
Renton,WA98057
91-0884412 501 ( C)(3) 6,500       2015 Annual Dinner Service Sponsorship
(109) Blue Mountain Community Foundation
8 So 2nd St Suite 618
Walla Walla,WA99362
91-1250104 501(c)(3) 6,000       Community Health Support
(110) Abuse Recovery Ministry
5285 NE Elam Young Rd Pkwy B-600
Hillsboro,OR97124
93-1270845 501(c)(3) 5,000       ManKind Program
(111) Alaska Association of Health Underwriters
PO Box 244065
Anchorage,AK99524
92-0165384 501( C) (3) 5,000       Annual Luncheon Sponsorship
(112) Blood Bank of Alaska Inc
4000 Laurel Street
Anchorage,AK99508
92-6002175 501( C) (3) 5,000       Community Support
(113) Civic Alliance a Sound Economy
1301 5th Avenue 5th Avenue Suite
1500
Seattle,WA98101
45-2431884 501 ( C)(3) 5,000       Sponsorship
(114) Connecting Ties Inc
PO Box 2017
Valdez,AK99686
92-0150429 501( C) (3) 5,000       Community Support
(115) Copper River Basin Child Advocacy Center
PO Box 103
Gakona,AK99586
26-1108855 501( C) (3) 5,000       Community Support
(116) Everett Public Schools
PO Box 2098
Everett,WA98213
91-6001542 Government 5,000       Community Support
(117) Frontier Community Services
43335 Kalifornsky Beach Rd 36
Soldotna,AK99669
92-0114675 501( C) (3) 5,000       Community Support
(118) Gamelin Washington Association
1423 First Ave
Seattle,WA98101
20-1910170 501(C)(3) 5,000       Ministry Support
(119) Herman Hutchens Elementary PTA
PO Box 398
Valdez,AK99686
92-0127918 501( C) (3) 5,000       Community Support
(120) Let's Move Seattle
119 1st Avenue S Ste 320
Seattle,WA98104
47-4420751 Other 5,000       Community Health
(121) Providence Gamelin House Association
4515 MLK Jr Way South 200
Seattle,WA98108
31-1744654 501(C)(3) 5,000       Ministry Support
(122) Providence Peter Claver Association
7101 38th Avenue South
Seattle,WA98118
31-1629656 501(C)(3) 5,000       Ministry Support
(123) Providence St Elizabeth House Association
3201 SW Graham Street
Seattle,WA98126
91-2171539 501(C)(3) 5,000       Ministry Support
(124) Saint Martins University
5000 Abbey Way SE
Lacey,WA98503
91-0564993 501 (c ) (3) 5,000       Sponsorship
(125) SOS Clinic
1200 SE 12th St
College Place,WA99362
73-1626280 501(c)(3) 5,000       Health Center Support
(126) Street Wise
733 W Garland Ave
Spokane,WA99205
80-0726907 501(c)(3) 5,000       Community Benefit
(127) Union Gospel Mission
413 Franklin St NE
Olympia,WA98501
91-0613587 501 (c ) (3) 5,000       Donation
(128) Volunteers of America
2802 Broadway Avenue
Everett,WA98201
91-0577129 501(c)(3) 5,000       Sponsorship
(129) Woman Making A Difference
956 S Main
Colville,WA99114
37-1412015 501(c)(3) 5,000       Community Benefit support
(130) NW Furniture Bank
117 Puyallup Avenue
Tacoma,WA98421
22-3939593 501 ( C)(3)   138,663 FMV Medical Supplies Medical Equipment & Supplies
(131) Thurston County Medical Equipment Bank
c/o Senior News 112 East 4th Avenue
Olympia,WA98501
91-0821977 501 ( C)(3)   30,038 FMV Medical Supplies Medical Equipment & Supplies
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
122
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
7
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
non-cash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of non-cash assistance
(1) Prescription Medication Assistance 6111 0 85,820 Cost Medications for uninsured & indigent patients
(2) Transportation Assistance 7341 0 152,047 Cost Medical Transport & Gas assistance
(3) Housing Assistance 14   391 Cost Short - term housing assistance
(4) Meals/Food 487   4,911 Cost Meals/Food Gift Card for Needy Patients
(5) Personal Care items 155   6,954 Cost Assistance for indigent patients
(6) School Tuition 99   562,810 Cost University of Great Falls
(7) Utilities 4   354 Cost Utilities Payment for Needy Patients
(8) Wigs/Scarves for Cancer Patients 11   2,072 Cost Wigs/Scarves for Female Cancer Patients
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Part I, Line 2: In the application for support, we request a detailed explanation of the kind of services provided to the community along with specific financial data. If the application for support is approved, we send a letter indicating the amount of the support along with a request for documentation of how the funds were used.
Schedule I (Form 990) 2015



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" 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 & SERVICES -
WASHINGTON
Employer identification number

51-0216586
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 on 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 on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
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:
a
The organization? ...........................
5a
 
No
b
Any related organization?
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization?
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
 
No
8
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 .............................
8
 
No
9
If "Yes" on 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) 2015

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
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1Rod F Hochman MDPresident / CEO (i)

(ii)
1,562,459
-------------
0
3,522,350
-------------
0
18,000
-------------
0
49,002
-------------
0
25,415
-------------
0
5,177,226
-------------
0
1,152,963
-------------
0
2Todd HofheinsEVP/CFO (i)

(ii)
704,452
-------------
0
247,640
-------------
0
18,000
-------------
0
269,139
-------------
0
26,574
-------------
0
1,265,805
-------------
0
0
-------------
0
3Cindy StraussEVP/Chief Legal Officer (i)

(ii)
526,875
-------------
0
981,482
-------------
0
18,000
-------------
0
40,075
-------------
0
24,624
-------------
0
1,591,056
-------------
0
524,784
-------------
0
4Anthony DorschCFO/PSMS Shared Services (i)

(ii)
344,037
-------------
0
102,790
-------------
0
0
-------------
0
77,263
-------------
0
22,170
-------------
0
546,260
-------------
0
0
-------------
0
5Bruce LamoureuxCE/AK. Region (i)

(ii)
531,298
-------------
0
493,053
-------------
0
18,000
-------------
0
46,631
-------------
0
26,658
-------------
0
1,115,640
-------------
0
0
-------------
0
6Craig Wright MDSVP/Physician Services (i)

(ii)
552,895
-------------
0
2,237,145
-------------
0
5,000
-------------
0
105,811
-------------
0
19,569
-------------
0
2,920,420
-------------
0
835,177
-------------
0
7Randy Axelrod MD Thru 315EVP/Clinical & Patient Services (i)

(ii)
190,509
-------------
0
679,339
-------------
0
546,732
-------------
0
11,925
-------------
0
23,825
-------------
0
1,452,330
-------------
0
0
-------------
0
8Mike ButlerPresident/Operations & Services (i)

(ii)
1,151,688
-------------
0
402,660
-------------
0
18,000
-------------
0
710,959
-------------
0
29,289
-------------
0
2,312,596
-------------
0
0
-------------
0
9Debbie BurtonSVP/ Chief Nrsg. Officer (i)

(ii)
365,287
-------------
0
300,015
-------------
0
18,000
-------------
0
31,695
-------------
0
23,907
-------------
0
738,904
-------------
0
0
-------------
0
10Debra CanalesEVP/Chief People & Experience Ofc. (i)

(ii)
772,941
-------------
0
715,960
-------------
0
161,754
-------------
0
444,164
-------------
0
13,966
-------------
0
2,108,785
-------------
0
0
-------------
0
11Medrice ColuccioCE/Southwest WA. Region (i)

(ii)
462,426
-------------
0
480,209
-------------
0
48,000
-------------
0
118,356
-------------
0
14,517
-------------
0
1,123,508
-------------
0
0
-------------
0
12Elaine CoutureCE/PHC/Eastern WA. Region (i)

(ii)
532,389
-------------
0
438,438
-------------
0
18,033
-------------
0
70,753
-------------
0
21,379
-------------
0
1,080,992
-------------
0
0
-------------
0
13Jack Friedman Thru 615SVP/Accountable Care & Payor Rel. (i)

(ii)
364,689
-------------
0
388,093
-------------
0
18,000
-------------
0
103,565
-------------
0
14,354
-------------
0
888,701
-------------
0
0
-------------
0
14Mark GargettVP/Digital Integration (i)

(ii)
387,625
-------------
0
245,091
-------------
0
0
-------------
0
58,688
-------------
0
23,604
-------------
0
715,008
-------------
0
0
-------------
0
15Joel GilbertsonSVP, Comm. Partnrshp. & Ext. Affairs (i)

(ii)
421,859
-------------
0
126,840
-------------
0
18,000
-------------
0
181,114
-------------
0
22,782
-------------
0
770,595
-------------
0
0
-------------
0
16Aaron MartinSVP/Strategy & Innovation (i)

(ii)
512,696
-------------
0
151,000
-------------
0
18,000
-------------
0
182,349
-------------
0
7,050
-------------
0
871,095
-------------
0
0
-------------
0
17Tom McDonaghVP/Chief Investment Officer (i)

(ii)
451,242
-------------
0
512,101
-------------
0
0
-------------
0
34,150
-------------
0
23,966
-------------
0
1,021,459
-------------
0
0
-------------
0
18Rhonda Medows MDEVP/Population Health (i)

(ii)
524,152
-------------
0
100,000
-------------
0
43,823
-------------
0
176,410
-------------
0
12,098
-------------
0
856,483
-------------
0
0
-------------
0
19Jack MuddSVP/Mission Leadership (i)

(ii)
394,530
-------------
0
220,747
-------------
0
17,141
-------------
0
70,632
-------------
0
18,218
-------------
0
721,268
-------------
0
0
-------------
0
20Janice NewellSVP/Chief Information Officer (i)

(ii)
578,517
-------------
0
938,806
-------------
0
18,000
-------------
0
23,307
-------------
0
14,460
-------------
0
1,573,090
-------------
0
185,427
-------------
0
21Harvey SmithSVP/Chief Customer Svc. Officer (i)

(ii)
591,345
-------------
0
235,203
-------------
0
18,000
-------------
0
23,818
-------------
0
18,087
-------------
0
886,453
-------------
0
0
-------------
0
22Teresa SpaldingVP/Revenue Cycle (i)

(ii)
328,808
-------------
0
345,091
-------------
0
18,000
-------------
0
32,190
-------------
0
12,942
-------------
0
737,031
-------------
0
0
-------------
0
23Greg TillVP/Chief Talent Officer (i)

(ii)
374,064
-------------
0
159,900
-------------
0
222
-------------
0
77,595
-------------
0
22,149
-------------
0
633,930
-------------
0
0
-------------
0
24Sharon ToncraySVP/HR Strat. Partners (i)

(ii)
413,272
-------------
0
132,710
-------------
0
18,000
-------------
0
173,585
-------------
0
22,499
-------------
0
760,066
-------------
0
0
-------------
0
25Lisa VanceSVP/Clinical Program Services (i)

(ii)
479,541
-------------
0
203,545
-------------
0
103,000
-------------
0
37,359
-------------
0
13,827
-------------
0
837,272
-------------
0
0
-------------
0
26Jason DryerNeurosurgeon (i)

(ii)
668,874
-------------
0
2,317,975
-------------
0
0
-------------
0
11,925
-------------
0
25,282
-------------
0
3,024,056
-------------
0
0
-------------
0
27David YamNeurosurgeon (i)

(ii)
637,458
-------------
0
1,336,150
-------------
0
68,500
-------------
0
13,912
-------------
0
18,625
-------------
0
2,074,645
-------------
0
0
-------------
0
28Joseph GiffordVP/CE ACO of WA (i)

(ii)
424,769
-------------
0
680,332
-------------
0
18,000
-------------
0
11,813
-------------
0
18,617
-------------
0
1,153,531
-------------
0
0
-------------
0
29J Michael MarshCAO/Western WA (i)

(ii)
0
-------------
0
966,160
-------------
0
109,937
-------------
0
19,587
-------------
0
3,634
-------------
0
1,099,318
-------------
0
349,894
-------------
0
30James BrevigCardiothoracic Surgeon (i)

(ii)
737,465
-------------
0
262,770
-------------
0
18,000
-------------
0
11,925
-------------
0
14,104
-------------
0
1,044,264
-------------
0
0
-------------
0
31John FletcherFormer VP/Operations Support (i)

(ii)
0
-------------
0
102,560
-------------
0
481,290
-------------
0
773
-------------
0
18,005
-------------
0
602,628
-------------
0
0
-------------
0
32Jan JonesFormer SVP/CAO (i)

(ii)
0
-------------
0
106,169
-------------
0
653,292
-------------
0
8,197
-------------
0
25,789
-------------
0
793,447
-------------
0
0
-------------
0
Schedule J (Form 990) 2015

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/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 were 13 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 2015, the following Listed Persons received gross-up payments: Debra Canales Rhonda Medows, MD Greg Till 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: Debra Canales Rhonda Medows, MD Greg Till The amounts reported for these relocation/housing payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation.
Part I, Lines 4a-b NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) CBRP = Cash Balance Restoration Plan C) ESP = Elective Survivor Plan 1) Rod Hochman, MD a) SERP Vested but not Paid - $1,918,360 b) SERP Interest Credit - $32,014 2) Todd Hofheins a) SERP Earned but not Vested - $244,283 3) Cindy Strauss a) SERP Vested but not Paid - $796,632 b) SERP Interest Credit - $20,200 4) Bruce Lamoureux a) Taxable CBRP Paid - $7 b) Taxable SERP Earned but not Paid - $223,706 c) SERP Interest Credit - $22,489 5) Anthony Dorsch a) SERP Earned but not Vested - $45,065 b) SERP Interest Credit - $6,775 6) Craig Wright, MD a) SERP Vested but not Paid - $2,047,185 b) SERP Interest Credit - $75,356 7) Debra Canales a) SERP Earned but not Vested - $432,239 8) Michael Butler a) SERP Earned but not Vested - $590,423 b) SERP Interest Credit - $84,804 9) Janice Newell a) SERP Vested but not Paid - $772,706 b) SERP Interest Credit - $4,758 10) Medrice Coluccio a) Taxable SERP Earned but not Paid - $345,799 b) Non-Taxable SERP Earned but not Paid - $6,226 c) SERP Interest Credit - $85,153 11) Elaine Couture a) Taxable SERP Earned but not Paid - $179,705 b) SERP Interest Credit - $47,129 c) Taxable CBRP Paid - $3 12) Tom McDonagh a) SERP Vested but not Paid - $323,732 b) SERP Interest Credit - $5,950 c) Taxable CBRP Paid - $5,569 13) Lisa Vance a) SERP Earned but not Paid - $22,291 b) SERP Interest Credit - $5,164 c) Taxable CBRP Earned - $63 d) Non-Taxable CBRP Earned - $2 14) Jack Friedman a) Taxable SERP Earned but not Paid - $69,453 b) SERP Interest Credit - $54,261 15) Teresa Spalding a) Taxable SERP Earned but not Paid - $245,180 b) Taxable CBRP Paid - $2 16) Debbie Burton a) SERP Earned but not Paid - $191,285 b) SERP Interest Credit - $5,020 17) Aaron Martin a) SERP Earned but not Vested - $170,424 18) Rhonda Medows a) SERP Earned but not Vested - $164,484 19) Mark Gargett a) Taxable SERP Earned but not Paid - $136,029 b) Taxable CBRP Paid - $42 c) SERP Interest Credit - $22,957 20) Jack Mudd a) SERP Earned but not Paid - $67,957 b) SERP Interest Credit - $42,960 21) Joel Gilbertson a) SERP Earned but not Vested - $143,438 b) SERP Interest Credit - $13,113 22) Sharon Toncray a) SERP Earned but not Vested- $135,371 b) SERP Interest Credit - $11,848 23) Greg Till a) SERP Earned but not Vested - $65,670 24) John Fletcher a) Taxable SERP Paid - $102,560 b) Non-Taxable SERP Paid - $773 25) Jan Jones a) Taxable SERP Paid - $106,169 b) SERP Interest Credit - $8,197
Part I, Lines 4a-b SEVERANCE 1) Randy Axelrod - $ 515,897 2) John Fletcher - $ 476,515 3) Jan Jones - $ 653,292
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:  
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
2015
Open to Public
Inspection
Name of the organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number
51-0216586
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 93978EA77 06-22-2006 208,792,185 Refund WHCFA Series 1999 & Capital projects in Washington X     X   X
B Washington Health Care Facilities Authority
 
91-1108929 93978EA93 06-22-2006 165,050,000 Refund WHCFA Series 2002A & B and Series 1994 & 1995   X   X   X
C Washington Health Care Facilities Authority
 
91-1108929 93978E7V8 07-01-2010 173,543,991 To Finance a Portion of construction of a Tower in Everett   X   X   X
D Washington Health Care Facilities Authority
 
91-1108929 93978HDAO 07-13-2011 101,296,076 Proceeds were used to currently refund all outstanding Series 2001A Bonds   X   X   X
Alaska Industrial Development and Export
 
92-6001185 011903CT6 11-30-2006 57,177,110 Reimburse Alaska Med Ctr for portion of costs to construct cancer ctr X     X   X
Alaska Industrial Development and Export
 
92-6001185 011903DZI 11-17-2011 126,601,436 Fund portion of expansion at PAMC & construct LTC facility   X   X   X
Washington Health Care Facilities Authority
 
91-1108929 93978HKL8 09-10-2014 50,064,724 Partial refinance of taxable issue - Providence Regional Med. Ctr. Everett   X   X   X
Washington Health Care Facilities Authority
 
91-1108929 93978HQU2 08-12-2015 12,250,803 Capital expenditures for Sacred Heart Medical Center   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired ..................       32,175,000
2 Amount of bonds legally defeased .............. 1,610,000      
3 Total proceeds of issue .................. 215,938,735 165,050,000 173,548,413 101,296,076
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,980,039 1,660,244 2,543,941 1,060,339
8 Credit enhancement from proceeds ............. 3,336,312 2,465,562    
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 146,353,342 125,017,295 171,004,472 2,993,212
11 Other spent proceeds ............. 64,269,042 160,924,194   100,235,737
12 Other unspent proceeds .............       9,084,611
13 Year of substantial completion ............. 2009 2002 2011 2004
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? ....   X X     X X  
15 Were the bonds issued as part of an advance refunding issue? ..... X     X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X     X X     X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X       X   X  
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?............. X     X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0.600 %      
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? ............. X              
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X X  
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X     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   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
ENTITY 1- ISSUE A - PART IV, Question 2c The most recent rebate computation for the bonds was completed through 6/22/2011.
ENTITY 1- ISSUE B - PART IV, Question 2c The most recent rebate computation for the bonds was completed through 6/22/2011.
ENTITY 2 - ISSUE A - PART IV, Question 2c The most recent rebate computation for the bonds was completed through 07/20/2015.
ENTITY 2 - ISSUE B - PART IV, Question 2c The most recent rebate computation for the bonds was completed through 12/01/2011.
ENTITY 2 - PART I & II - BOND ISSUE C The 2014C Series issued by the Washington Health Care Facilities Authority was issued to cover both the construction of ambulatory services at Swedish Edmonds as well as to partially refinance a taxable financing of Providence Health & Services - Washington dba Providence Regional Medical Center Everett. Since this bond issue is spread across two separate legal entities, the amounts shown only reflect the portion directly related to the taxable financing of Providence Health & Services - Washington dba Providence Regional Medical Center Everett.
ENTITY 2 - PART I & II - BOND ISSUE D The 2015 Series issued by the Washington Health Care Facilities Authority was issued to cover capital expenditures for both Providence Health & Services - Washington dba Providence Sacred Heart Medical Center and Kadlec Regional Medical Center . Since this bond issue is spread across two separate legal entities, the amounts shown only reflect the portion directly related to Providence Health & Services - Washington dba Providence Sacred Heart Medical Center.
ENTITY 1- ISSUE A - PART II - TOTAL PROCEEDS The amount of Total Proceeds on Part II, Line 3 differs from the Issue Price due to Credit Enhancements, Issuance Costs and Investment Earnings.
Schedule K (Form 990) 2015

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
2015
Open to Public
Inspection
Name of the organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number
51-0216586
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 93978EA77 06-22-2006 208,792,185 Refund WHCFA Series 1999 & Capital projects in Washington X     X   X
B Washington Health Care Facilities Authority
 
91-1108929 93978EA93 06-22-2006 165,050,000 Refund WHCFA Series 2002A & B and Series 1994 & 1995   X   X   X
C Washington Health Care Facilities Authority
 
91-1108929 93978E7V8 07-01-2010 173,543,991 To Finance a Portion of construction of a Tower in Everett   X   X   X
D Washington Health Care Facilities Authority
 
91-1108929 93978HDAO 07-13-2011 101,296,076 Proceeds were used to currently refund all outstanding Series 2001A Bonds   X   X   X
Alaska Industrial Development and Export
 
92-6001185 011903CT6 11-30-2006 57,177,110 Reimburse Alaska Med Ctr for portion of costs to construct cancer ctr X     X   X
Alaska Industrial Development and Export
 
92-6001185 011903DZI 11-17-2011 126,601,436 Fund portion of expansion at PAMC & construct LTC facility   X   X   X
Washington Health Care Facilities Authority
 
91-1108929 93978HKL8 09-10-2014 50,064,724 Partial refinance of taxable issue - Providence Regional Med. Ctr. Everett   X   X   X
Washington Health Care Facilities Authority
 
91-1108929 93978HQU2 08-12-2015 12,250,803 Capital expenditures for Sacred Heart Medical Center   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired ..................       32,175,000
2 Amount of bonds legally defeased .............. 1,610,000      
3 Total proceeds of issue .................. 215,938,735 165,050,000 173,548,413 101,296,076
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,980,039 1,660,244 2,543,941 1,060,339
8 Credit enhancement from proceeds ............. 3,336,312 2,465,562    
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 146,353,342 125,017,295 171,004,472 2,993,212
11 Other spent proceeds ............. 64,269,042 160,924,194   100,235,737
12 Other unspent proceeds .............       9,084,611
13 Year of substantial completion ............. 2009 2002 2011 2004
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? ....   X X     X X  
15 Were the bonds issued as part of an advance refunding issue? ..... X     X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X     X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X     X X     X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X       X   X  
c Are there any research agreements that may result in private business use of bond-financed property? .............   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?............. X     X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0.600 %      
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? ............. X              
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X X  
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X     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   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
ENTITY 1- ISSUE A - PART IV, Question 2c The most recent rebate computation for the bonds was completed through 6/22/2011.
ENTITY 1- ISSUE B - PART IV, Question 2c The most recent rebate computation for the bonds was completed through 6/22/2011.
ENTITY 2 - ISSUE A - PART IV, Question 2c The most recent rebate computation for the bonds was completed through 07/20/2015.
ENTITY 2 - ISSUE B - PART IV, Question 2c The most recent rebate computation for the bonds was completed through 12/01/2011.
ENTITY 2 - PART I & II - BOND ISSUE C The 2014C Series issued by the Washington Health Care Facilities Authority was issued to cover both the construction of ambulatory services at Swedish Edmonds as well as to partially refinance a taxable financing of Providence Health & Services - Washington dba Providence Regional Medical Center Everett. Since this bond issue is spread across two separate legal entities, the amounts shown only reflect the portion directly related to the taxable financing of Providence Health & Services - Washington dba Providence Regional Medical Center Everett.
ENTITY 2 - PART I & II - BOND ISSUE D The 2015 Series issued by the Washington Health Care Facilities Authority was issued to cover capital expenditures for both Providence Health & Services - Washington dba Providence Sacred Heart Medical Center and Kadlec Regional Medical Center . Since this bond issue is spread across two separate legal entities, the amounts shown only reflect the portion directly related to Providence Health & Services - Washington dba Providence Sacred Heart Medical Center.
ENTITY 1- ISSUE A - PART II - TOTAL PROCEEDS The amount of Total Proceeds on Part II, Line 3 differs from the Issue Price due to Credit Enhancements, Issuance Costs and Investment Earnings.
Schedule K (Form 990) 2015

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
2015
Open to Public
Inspection
Name of the organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number

51-0216586
Return Reference Explanation
Form 990, Part VI, Section A, line 6 Providence Health & Services is the sole Corporate Member.
Form 990, Part VI, Section A, line 7a The powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause.
Form 990, Part VI, Section A, line 7b Other powers of the Corporate Member include the power: 1) To adopt or change the mission, philosophy, and values, including the strategic plan and mission statement. 2) To amend or repeal the Articles of Incorporation or Bylaws. 3) To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale transfer, assignment or encumbering of assets exceeding a specified threshold, or the sale or transfer of any property which may have historical or religions significance. 4) To approve the dissolution or liquidation. 5) To approve the annual operating and capital budgets. 6) To appoint the certified public accountants. 7) To approve the closure of any institution or major ministry or work of the Corporation.
Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by experienced Providence Health & Services staff and reviewed by the PH&S 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 XI, line 9: Interaffiliate Transactions 1,704,538,344. Recipient Organization Adjustments -1,416,854. Revenue Reclassifications 24,157. Expense Reclassifications -22,624. Pension Adjustment -9,218,868. Net Assets Transfers -176,631,686. Distribution to Foundation recorded as Net Asset Transfer 2,394,400. Rounding -38.
FORM 990, PART XII, LINE 2C - AUDIT & COMPLIANCE The Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation.
FORM 990, PART I, LINE 6 - VOLUNTEERS Hospital volunteers fill a variety of job duties. Many of these routine and repetitive tasks allow paid, licensed, certified and experienced staff to provide more attention to more affordable and comprehensive patient care. The following examples of customer service functions are provided for patients and their families: Comfort Volunteers - offer comfort items to patients including blankets, pillows and magazines, place the telephone and remote within reach, visit with patients, stock supplies and assist staff with errands. Emergency Department Liaison - greet visitors and patients, escort visitors to patient rooms, provide some comfort measures, such as blankets, pillows and magazines, stock supplies, run errands, assist with miscellaneous clerical projects. Women's Services - assist with newborn care, provide comfort services to new moms and visitors, stock supplies, assist staff with errands. Cuddle Corps - assist in the NICU providing a soothing touch to medically fragile infants when their parents are unable to care for them at that time. Same Day Surgery Liaison - serve as a "go-between" the reception and pre-operative areas, update family on the location of their loved one and teach them to use the OR tracker board, offer comfort measures, preparing supplies and assist with errands. Cancer Center - taking orders and delivering meals to patients, stocking supplies, making coffee, cleaning and tidying, transporting charts from main desk to nurse's station, transporting specimens, running errands to/from the Pharmacy. Gift Shop - ringing up purchases, providing excellent customer service, keeping shelves stocked with product, answering the telephone, delivering Gift Shop flowers to patient rooms. Emergency Room - stocking supplies, bring patients warm blankets, assisting with errands, other misc. tasks as assigned by nursing/physician staff. Information Desk/Errand-answering the Errand Desk telephone, transporting specimens, delivering flowers and mail, preparing various mailings, as directed by staff, making coffee, tidying the waiting area, making reminder calls for the Cancer Center. Cardiac Rehabilitation - assist staff in Rehab department with filing and tidying, assisting with recording results for exercise equipment, explaining how to properly use exercise equipment. Dietary - washing and stocking dishes, stocking juices, milk and ready-to-eat foods, tidying the Dining Room area, assisting with other tasks, as directed by Kitchen staff. Pet Therapy - limited to dogs and their owners. Visits patients and other visitors in waiting areas, and, with permission of nursing staff, in the Medical and Surgical Units. Must have proof of immunizations and letter of good behavior prior to volunteering. Examples of Hospice volunteer duties: Patient Care volunteers help to support the hospice patient and their family during the course of their illness through a variety of roles - including companionship, providing respite to the family caregiver, helping with light housekeeping tasks, assisting with errands and transportation, Life Review (recording of patient's voice on CD provided to family), handiwork (comfort pillows, prayer shawls, lap robes, etc. made and given to patients), and assist with correspondence or other activities for which the patient may need assistance. Animal-assisted activities/therapy (AAA/T) volunteer teams (handlers and their dogs) visit patients and families in skilled nursing facilities, assisted living facilities, adult family homes, and private residences. AAA/T volunteers must complete core training and patient care volunteer training. Complementary therapy volunteers are licensed and/or certified professionals who provide massage, music therapy, hypnotherapy, and other approved services to hospice patients. Services are provided in the patient's residence. Complementary therapy volunteers must complete core training and patient care volunteer training, and they must currently be licensed and/or certified by the state of Washington. Stepping Stones volunteers work with patients in our pediatric hospice and palliative care program and their families. They may play games or read books with patients, participate in outings, or provide practical and emotional support to siblings and other family members. Stepping Stones volunteers must complete our core training and patient care volunteer training, as well as a specialized four-hour training for working with pediatric patients. Transitions volunteers provide practical and emotional support to people with life-limiting illness who are not yet eligible or otherwise ready for hospice. Bereavement volunteers provide regular contact (through telephone calls and/or one-on-one visits) to adult clients who have experienced the death of a loved one. They may also help facilitate grief support groups Camp Erin volunteers provide support to kids at camp, serving as Big Buddies or helping to plan and organize camp activities. Camp Erin is an annual weekend camp for children and teenagers in King County who've lost a loved one. Administrative volunteers perform the administrative tasks necessary to support hospice office operations. These tasks may include filing, copying, word processing, collating, and notary, data entry, assembling mailings, and making phone calls, as well as working on special projects. Administrative volunteers must complete our core training. On-the-job training is also provided at the hospice office. Examples of Long-term Care, Assisted Living, Home Health, Nursing Homes/Transitional, and Home Infusion care volunteers: Volunteers donate their time and talents in a wide variety of ways. The largest group of volunteers worked directly with residents. This includes volunteers who provide one-on-one visits, assist with recreational groups (art class, field trips, spiritual services, Intergenerational Learning Center with children, dining services, the hair salon, laundry and housekeeping, etc), collaborate with staff to put on large special events (summer concert series, Valentine's Day dance), provide entertainment, assist in the Rehab Department, and NODA program, and serve as "Fresh Air Friends", providing one-on-one visits to escort residents outdoors on pleasant days. Administrative departments - including human resources, admissions, resident records, and other (stuffing envelopes and review charts to insure the required paperwork is present). Volunteers help with all aspects of support for Providence Senior and Community Services Special events such as print production and special events, i.e. greeters, spotters, runners, financial, set-up, tear down.
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:  
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
2015
Open to Public Inspection
Name of the organization
PROVIDENCE HEALTH & SERVICES -
WASHINGTON
Employer identification number

51-0216586
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) Providence Assurance Inc
3131 Camelback Road Ste 400
Phoenix,AZ85016
20-8194071
Insurance Captive AZ 261 30,013,878 Providence Health & Services - Washington
 
(2) Legacy LLC
PO Box 196606
Anchorage,AK99519
32-0252199
Real Estate AK 3,065,163 44,900,003 Providence Health & Services - Washington
 
(3) Health Services Asset Management LLC
1801 Lind Ave SW 9016
Renton,WA98057
27-1698016
A/R & Collections WA 52 400,538 Providence Health & Services - Washington
 
(4) Auxillium LLC
1801 Lind Ave SW 9016
Renton,WA98057
31-1750915
Nurse Staffing WA 0 0 Providence Health & Services - Washington
 
(5) Providence Joseph House GP LLC
1801 Lind Ave SW 9016
Renton,WA98057
27-3678218
Supportive Housing WA 47,489 8,356,619 Providence Health & Services - Washington
 


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 - Oregon
1801 Lind Avenue SW 9016

Renton,WA980579016
51-0216587
Healthcare System WA 501( c)(3) Line 3 Providence Health & Services
 
 
No
(2)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
(3)Everett Transitional Care Services
PO Box 5128

Everett,WA982065128
94-3264605
Transitional Care WA 501( c)(3) Line 9 N/A
 
No
(4)Providence Oregon Management Corporation
1801 Lind Avenue SW 9016

Renton,WA980579016
93-0813977
Shell Corporation OR 501( c)(3) Line 1 PH & S - Oregon
 
 
No
(5)Providence Plan Partners
4400 NE Halsey Bldg 2

Portland,OR97213
91-1861964
Healthcare Services OR 501( c)(4) N/A PH & S - Oregon
 
 
No
(6)Providence Health Plan
4400 NE Halsey Bldg 2

Portland,OR97213
93-0863097
Health Service Contractor OR 501( c)(4) N/A Providence Plan Partners
 
 
No
(7)Providence Health Assurance
4400 NE Halsey Bldg 2

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

Torrance,CA90503
33-0283773
Healthcare CA 501( c)(3) Line 11/Type I PHS - So California
 
 
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
 
Yes
 
(12)St Luke Association
350 Washington Ave SE

Chehalis,WA98352
94-3176618
Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington
 
Yes
 
(13)Providence Rossi Association
1700 Providence Pl

Centralia,WA98531
31-1584166
Supportive Housing WA 501( c)(3) Line 9 PH & S - Washington
 
Yes
 
(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
 
Yes
 
(16)Providence Peter Claver Association
7101 38th Avenue South

Seattle,WA98118
31-1629656
Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(19)The Gamelin Association
312 North Fourth St

Yakima,WA98901
91-1180824
Supportive Housing WA 501( c)(3) Line 7 PH & S - Washington
 
Yes
 
(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
 
Yes
 
(23)Providence Dethman House
1205 Montello Ave

Hood River,OR97031
47-3385506
Supportive Housing WA 501( c)(3) Line 7 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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(45)Providence St Joseph Medical Center
PO Box 1010

Polson,MT598601010
81-0463482
Healthcare MT 501( c)(3) Line 3 PH & S - Washington
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
 
Yes
 
(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
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



(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 PH&S - WA
 
Related 11,253,639 12,370,238   No   Yes   99.000 %
(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 PH&S - WA
 
Related -277,191 1,798,542   No     No 61.000 %
(14) The Madison Spokane Inn LLC

15 West Rockwood Blvd
Spokane,WA99204
84-1606484
Hotel Services WA PH&S - WA
 
Rental 185,937 887,688   No   Yes   56.530 %
(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
(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) 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
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
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
Yes
 
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
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) Providence Alaska Foundation

B 3,548,277 Cost
(2) Providence Alaska Foundation

C 1,361,062 Cost
(3) Providence Health Care Foundation

B 101,896 Cost
(4) Providence Health Care Foundation

C 202,435 Cost
(5) Providence Health Care Foundation - Eastern Washington

B 953,579 Cost
(6) Providence Health Care Foundation - Eastern Washington

C 3,216,459 Cost
(7) Providence Hospice & Home Care Foundation Snohomish County

B 237,317 Cost
(8) Providence Hospice & Home Care Foundation Snohomish County

C 2,567,638 Cost
(9) Providence Hospice of Seattle Foundation

B 465,231 Cost
(10) Providence Hospice of Seattle Foundation

C 1,059,896 Cost
(11) Providence Marianwood Foundation

B 183,903 Cost
(12) Providence Marianwood Foundation

C 393,600 Cost
(13) Providence Mount St Vincent Foundation

B 445,109 Cost
(14) Providence Mount St Vincent Foundation

C 1,406,154 Cost
(15) Providence St Mary Foundation

B 411,994 Cost
(16) Providence St Mary Foundation

C 393,514 Cost
(17) Providence St Mary Foundation

Q 170,727 Cost
(18) Providence St Peter Foundation

B 747,865 Cost
(19) Providence St Peter Foundation

C 1,285,726 Cost
Schedule R (Form 990) 2015
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)
(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) 2015
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


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