TY 2019 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) ROD F HOCHMAN MD...................................................................... FORMER PRESIDENT/CEO	0.00 ................. 60.00			X	9,697,491	1,217,351
(2) MIKE BUTLER...................................................................... PRESIDENT	7.00 ................. 53.00	X			3,421,103	597,820
(3) ERIK WEXLER...................................................................... EVP CHIEF EXECUTIVE PSJH SO CA	8.00 ................. 57.00		X		2,323,821	283,835
(4) DEBRA CANALES...................................................................... FORMER EVP CAO PSJH	0.00 ................. 60.00			X	2,204,087	353,537
(5) RHONDA MEDOWS MD...................................................................... FORMER PRESIDENT POP HEALTH / AYIN	0.00 ................. 60.00			X	1,888,838	274,454
(6) CINDY STRAUSS...................................................................... SECRETARY	7.00 ................. 53.00	X			1,735,009	347,233
(7) AMY COMPTON-PHILLIPS MD...................................................................... FORMER EVP CHIEF CLINICAL OFC PSJH	0.00 ................. 55.00			X	1,701,825	248,465
(8) VENKAT BHAMIDIPATI...................................................................... EVP/TREASURER	7.00 ................. 53.00	X			1,615,492	304,802
(9) DALE SUROWITZ...................................................................... CHIEF EXEC PROV TARZANA MED CN	59.00 ................. 0.00		X		1,510,249	200,905
(10) LISA VANCE...................................................................... FORMER EVP REGIONAL CE OR	0.00 ................. 60.00			X	1,313,995	245,652
(11) JOEL GILBERTSON...................................................................... FORMER EVP COMMUNITY PARTNERSHIPS	0.00 ................. 60.00			X	1,315,140	203,790
(12) AARON MARTIN...................................................................... FORMER EVP CHIEF MKT/DIGITAL INNO OF	0.00 ................. 70.00			X	1,302,273	194,312
(13) VICTOR JORDAN...................................................................... COO SO CA	50.00 ................. 0.00		X		1,211,448	213,793
(14) JO ANN ESCASA-HAIGH...................................................................... EVP/ASSISTANT TREASURER	6.00 ................. 54.00	X			1,188,910	217,824
(15) TOM MCDONAGH...................................................................... FORMER VP/CHIEF INVESTMENT OFFICER	0.00 ................. 58.00			X	1,356,638	46,012
(16) SHARON TONCRAY...................................................................... FORMER SVP/CHIEF LABOR EE COUNSEL	0.00 ................. 60.00			X	1,364,262	36,627
(17) GREG TILL...................................................................... FORMER CHIEF PEOPLE OFFICER	0.00 ................. 65.00			X	1,166,513	196,967

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) BERNIE KLEIN MD........................................................................ CHIEF EXEC PROV HOLY CROSS MC	50.00 .......................0.00			X			0	1,130,832	220,436
(19) MIKE WATERS........................................................................ FORMER EVP AMBULATORY CARE NETWORK	0.00 .......................65.00					X	0	1,049,713	159,733
(20) JOHN WHIPPLE........................................................................ ASSISTANT SECRETARY	7.00 .......................53.00		X				0	905,646	235,831
(21) JANICE NEWELL........................................................................ FORMER SVP/CHIEF INFORMATION OFFCR	0.00 .......................60.00					X	0	1,071,876	18,740
(22) OREST HOLUBEC........................................................................ FORMER SVP CHIEF COMMUNICATION OFCR	0.00 .......................55.00					X	0	891,959	168,978
(23) JIM WATSON ESQ........................................................................ ASSISTANT SECRETARY	6.00 .......................54.00		X				0	843,494	137,810
(24) DAVID BROWN........................................................................ FORMER SVP CAO AMBULATORY CARE	0.00 .......................55.00					X	0	797,114	164,344
(25) DEBBIE BURTON........................................................................ FORMER SVP CHIEF NURSING OFFICER	0.00 .......................60.00					X	0	710,092	170,287
(26) GARRY OLNEY........................................................................ CHIEF EXECUTIVE SOUTH BAY	50.00 .......................0.00			X			0	640,839	176,773
(27) JACK MUDD........................................................................ FORMER SVP/MISSION LEADERSHIP	0.00 .......................29.00					X	0	802,158	6,452
(28) KELLY LINDEN........................................................................ CHIEF EXEC PROV ST JOSEPH MC	50.00 .......................0.00			X			0	646,235	158,364
(29) JIM NOBLE........................................................................ CFO SO CA REGION	50.00 .......................0.00			X			0	620,277	128,524
(30) RICHARD GLIMP........................................................................ CMO TORRANCE	50.00 .......................0.00				X		575,965	0	53,520
(31) GLEN KOMATSU........................................................................ CMO PTCH	0.00 .......................40.00				X		536,834	0	86,225
(32) HOWARD DAVIS........................................................................ CMO TARZANA	50.00 .......................0.00				X		564,567	0	50,912
(33) SUSAN DOLBERT........................................................................ PRESIDENT/CDO	40.00 .......................15.00				X		554,602	0	26,893
(34) NICK LYMBEROPOULOS........................................................................ COO TARZANA	50.00 .......................0.00				X		433,121	0	66,912
(35) STEVEN MOHR........................................................................ FORMER CFO - LA SERVICE AREA	0.00 .......................50.00					X	0	459,400	9,342
(36) DONALD ANDERSON JR........................................................................ ASSISTANT SECRETARY FOR ENROLLMENT	7.00 .......................53.00		X				0	222,743	19,991
(37) TAMMY TEODOSIO........................................................................ FORMER ASSISTANT SECRETARY	7.00 .......................53.00					X	0	133,465	24,894
(38) DAVE OLSEN........................................................................ BOARD CHAIR	0.10 .......................7.00	X					0	65,360	0
(39) RICHARD BLAIR........................................................................ PAST CHAIR	0.10 .......................7.70	X					0	50,360	0
(40) ISIAAH CRAWFORD PHD........................................................................ DIRECTOR	0.10 .......................4.10	X					0	46,550	0
(41) DICK P ALLEN........................................................................ DIRECTOR	0.10 .......................5.00	X					0	40,789	0
(42) MICHAEL HOLCOMB........................................................................ DIRECTOR	0.10 .......................5.50	X					0	40,391	0
(43) MARY LYONS PHD........................................................................ DIRECTOR	0.10 .......................4.60	X					0	40,360	0
(44) CAROLINA REYES MD........................................................................ DIRECTOR	0.10 .......................6.00	X					0	40,360	0
(45) PHOEBE YANG........................................................................ DIRECTOR	0.10 .......................5.50	X					0	30,360	0
(46) CHARLES SORENSON MD........................................................................ DIRECTOR	0.10 .......................5.00	X					0	30,360	0
(47) LYDIA MARSHALL........................................................................ DIRECTOR	0.10 .......................5.00	X					0	22,860	0
(48) SISTER DIANE HEJNA CSJ RN........................................................................ DIRECTOR	0.10 .......................5.30	X					0	0	0
(49) SISTER LUCILLE DEAN SP........................................................................ DIRECTOR	0.10 .......................5.50	X					0	0	0
(50) KATHARIN DYER........................................................................ DIRECTOR	0.10 .......................5.00	X					0	0	0
(51) MICHAEL MURPHY........................................................................ DIRECTOR	0.10 .......................5.00	X					0	0	0
(52) SR PHYLLIS HUGHES RSM DRPH........................................................................ DIRECTOR	0.10 .......................5.00	X					0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
PROVIDENCE MEDICAL ASSOCIATES 3460 TORRANCE BLVD 310 TORRANCE,CA90503	MEDICAL SERVICES	67,536,014
PROVIDENCE SPECIALTY MEDICAL GROUP 5315 TORRANCE BLVD STE A TORRANCE,CA90503	MEDICAL SERVICES	42,066,318
PACIFIC NEUROSCIENCE INSTITUTE MED GROUP 11645 WILSHIRE BLVD LOS ANGELES,CA90025	MEDICAL SERVICES	20,465,319
SANTA MONICA FAMILY PHYSICIANS 261 N BOWLING GREEN WY LOS ANGELES,CA90049	MEDICAL SERVICES	7,227,804
THERAPEUTIC ASSOCIATES INC PO BOX 848289 BOSTON,MA02284	MEDICAL SERVICES	6,042,261
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 245

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA

Employer identification number

51-0216589

Part I

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

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

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

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

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


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) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)..

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

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

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).

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.

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.

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.

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

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) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

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

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA

Employer identification number

51-0216589

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

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

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA		Employer identification number 51-0216589

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA			Employer identification number 51-0216589
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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 SYSTEM - SO
CALIFORNIA

Employer identification number

51-0216589

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
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) 2019

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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)

Yes|No

(b)

Amount

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

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

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

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

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

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

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

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

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

Other activities? ...................................................................................................................

Yes

191,349

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

191,349

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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:	THE LOBBYING EXPENDITURES REPORTED REPRESENT THE PORTION OF DUES PAID TO ALLIANCE OF CATHOLIC HEALTH CARE, AMERICAN HOSPITAL ASSOCIATION AND CALIFORNIA HOSPITAL ASSOCIATION FOR LOBBYING SERVICES.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," 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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA

Employer identification number

51-0216589

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

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

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

1a	Beginning of year balance ....	511,439	497,829	386,035	386,224	380,469
b	Contributions ...	35,929	14,322	108,955	120	178
c	Net investment earnings, gains, and losses	5,182	-712	2,839	-309	32,206
d	Grants or scholarships ...					26,629
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	552,550	511,439	497,829	386,035	386,224

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

0 %

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

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

Yes

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 .....	104,022,161		104,022,161
b	Buildings ....	992,844,265	533,517,456	459,326,809
c	Leasehold improvements	53,778,827	15,482,893	38,295,934
d	Equipment ....	879,224,032	766,359,091	112,864,941
e	Other .....	367,540,089	1,885,026	365,655,063
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,080,164,908

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1)HEALTHCARE JOINT VENTURES	23,913,845	F
(2)BENEFICIAL INTEREST IN FOUNDATION	212,836,562	F
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	236,750,407

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				114,411,273
(2)OTHER LT REC. - PERPETUAL TRUST				1,407,514
(3)DUE FROM THIRD PARTY				10,486,494
(4)HOSPITAL FEE/ PROVIDER TAX RECEIVABLE				110,917,355
(5)OTHER ASSETS				69,156,656
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				306,379,292

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
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	396,902,794
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) 2019

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 V, Line 4:	THE HIGH SCHOOL HAS TWO ENDOWMENT FUNDS ESTABLISHED FOR SCHOLARSHIP PURPOSES AND IS DONOR-RESTRICTED.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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 arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA

Employer identification number

51-0216589

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

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?

YesNo

If "Yes," list the 10 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)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

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) 2019

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.

		(a) Event #1 GALA (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	165,652	165,652
2	Less: Contributions . . . .	77,975	77,975
3	Gross income (line 1 minus line 2) . . . . . .	87,677	87,677

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .	44,700	44,700
8	Entertainment . . . .
9	Other direct expenses . . .	17,416	17,416
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		62,116
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		25,561

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.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

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

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

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2019

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

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? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

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

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

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 provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA

Employer identification number

51-0216589

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

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

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 30000.0000000000 %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

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

Yes

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

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) . . .		21,751	27,691,057	0	27,691,057	1.870 %
b	Medicaid (from Worksheet 3, column a) . . . . .		78,659	424,384,958	368,985,623	55,399,335	3.740 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		100,410	452,076,015	368,985,623	83,090,392	5.610 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	89	68,067	23,045,222	5,391,367	17,653,855	1.190 %
f	Health professions education (from Worksheet 5) . . .	9	2,106	9,205,214	518,691	8,686,523	0.590 %
g	Subsidized health services (from Worksheet 6) . . . .	9	3,750	6,451,402	1,648,999	4,802,403	0.320 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	107	73,923	38,701,838	7,559,057	31,142,781	2.100 %
k	Total. Add lines 7d and 7j .	107	174,333	490,777,853	376,544,680	114,233,173	7.710 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

32,035,111

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. ......

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

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

634,620,587

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

820,090,323

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

-185,469,736

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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

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) 2019

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?5Name, 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)						Facility reporting group
1	PROVIDENCE ST JOSEPH MEDICAL CENTER 501 S BUENA VISTA ST BURBANK,CA91505 CALIFORNIA.PROVIDENCE.ORG 930000159	X	X		X	A
2	PROVIDENCE LCM MED CTR - TORRANCE 4101 TORRANCE BOULEVARD TORRANCE,CA90505 CALIFORNIA.PROVIDENCE.ORG 930000089	X	X		X	B
3	PROVIDENCE HOLY CROSS MEDICAL CENTER 15031 RINALDI ST MISSION HILLS,CA91345 CALIFORNIA.PROVIDENCE.ORG 930000404	X	X	X	X	A
4	PROVIDENCE TARZANA MEDICAL CENTER 18321 CLARK STREET TARZANA,CA91356 CALIFORNIA.PROVIDENCE.ORG 930000097	X	X		X	A
5	PROVIDENCE LCM MED CTR - SAN PEDRO 1300 WEST SEVENTH STREET SAN PEDRO,CA90732 CALIFORNIA.PROVIDENCE.ORG 930000142	X	X		X	B

Schedule H (Form 990) 2019

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)

	PHS - SOUTHERN CALIFORNIA ( GROUP A)
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):

Yes

Community Health Needs Assessment

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?........................

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

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

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

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

Yes

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

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE LINE 10A URL BELOW

Other website (list url): SEE PART V, SECTION C

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	PHS - SOUTHERN CALIFORNIA ( GROUP A)
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.000000000000%
and FPG family income limit for eligibility for discounted care of 350.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	PHS - SOUTHERN CALIFORNIA ( GROUP A)
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	PHS - SOUTHERN CALIFORNIA ( GROUP A)
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

Yes

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

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)

	PHS - SOUTHERN CALIFORNIA ( GROUP B)
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):

Yes

Community Health Needs Assessment

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?........................

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

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

Yes

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

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE LINE 10A URL BELOW

Other website (list url): SEE PART V, SECTION C

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	PHS - SOUTHERN CALIFORNIA ( GROUP B)
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.000000000000%
and FPG family income limit for eligibility for discounted care of 350.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	PHS - SOUTHERN CALIFORNIA ( GROUP B)
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	PHS - SOUTHERN CALIFORNIA ( GROUP B)
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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? ...........................

Yes

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 3: PROVIDENCE HOLY CROSS MEDICAL CENTER, - Facility 1: PROVIDENCE ST. JOSEPH MEDICAL CENTER, - Facility 4: PROVIDENCE TARZANA MEDICAL CENTER
Part V, Section B	Facility Reporting Group B
Facility Reporting Group B consists of:	- Facility 2: PROVIDENCE LCM MED. CTR. - TORRANCE, - Facility 5: PROVIDENCE LCM MED. CTR. - SAN PEDRO
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 3E:	AFTER ALL OF THE PRIMARY AND SECONDARY DATA WAS COLLECTED AND ANALYZED, A GROUP OF 18 COMMUNITY STAKEHOLDERS, 9 FROM PROVIDENCE AND 9 FROM DIFFERENT COMMUNITY SECTORS (PUBLIC SCHOOLS, PUBLIC HEALTH, FEDERALLY QUALIFIED HEALTH CENTERS (FQHC'S), AND COMMUNITY-BASED ORGANIZATIONS) MET ON TWO SEPARATE OCCASIONS TO REVIEW THE FINDINGS. AFTER FACILITATED DISCUSSION, THE GROUP REACHED A CONSENSUS ON THE TOP EIGHT HEALTH NEEDS:- HOMELESSNESS AND HOUSING INSTABILITY,- BEHAVIORAL HEALTH, INCLUDING MENTAL HEALTH AND SUBSTANCE USE,- FOOD INSECURITY,- PREVENTION AND MANAGEMENT OF CHRONIC DISEASES, AND- ACCESS TO HEALTH CARE AND RESOURCES- SENIOR CARE- IMMUNIZATION/SCHOOL HEALTH- VIOLENCE PREVENTION
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 5:	PROVIDENCE CONDUCTED KEY INFORMANT INTERVIEWS WITH INDIVIDUALS WHO REPRESENT A VARIETY OF LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS THROUGHOUT THE HOSPITALS' SERVICE AREA.2019 CHNA KEY INFORMANTS:- 3WINS FITNESS (PROGRAM, PHYSICAL ACTIVITY)- CAL STATE UNIVERSITY, NORTHRIDGE (UNIVERSITY, PHYSICAL ACTIVITY)- ALLIANCE FOR COMMUNITY EMPOWERMENT (COMMUNITY BASED ORGANIZATION, COMMUNITY PROGRAMMING AND EMPOWERMENT)- ALL-INCLUSIVE COMMUNITY HEALTH CENTER (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- BURBANK HOUSING CORPORATION (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS)- CITY OF BURBANK (GOVERNMENT)- EL CENTRO DE AMISTAD (COMMUNITY BASED ORGANIZATION, BEHAVIORAL HEALTH)- EL PROYECTO DEL BARRIO (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- LA FAMILY HOUSING (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS)- LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH (GOVERNMENT, PUBLIC HEALTH)- NORTH VALLEY CARING SERVICES (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS)- NORTHEAST VALLEY HEALTH CORPORATION (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- SAN FERNANDO AND SANTA CLARITA VALLEY HOMELESS COALITION (COALITION, HOUSING/HOMELESSNESS)- NORTHEAST VALLEY HEALTH CORPORATION (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- ONEGENERATION (COMMUNITY BASED ORGANIZATION, AGING SERVICES)- SAN FERNANDO COMMUNITY HEALTH CENTER (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- THE OFFICE OF LAUSD SCHOOL BOARD MEMBER KELLY GONEZ (GOVERNMENT, EDUCATION)- VALLEY CROSSROADS SEVENTH-DAY ADVENTIST CHURCH (FAITH BASED ORGANIZATION)- WEST VALLEY YMCA (NATIONAL ORGANIZATION, HEALTHY LIVING AND YOUTH DEVELOPMENT)IN ADDITION TO CONDUCTING KEY INFORMANT INTERVIEWS AS PART OF ITS PRIMARY DATA COLLECTION, PROVIDENCE ALSO INCLUDED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY AS PART OF ITS CHNA OVERSIGHT COMMITTEE.THE CHNA OVERSIGHT COMMITTEE, AUTHORIZED BY THE GOVERNING BOARDS IN MARCH 2019, MET TWICE IN THE FALL OF 2019 TO PRIORITIZE AND RECOMMEND THE TOP IDENTIFIED HEALTH NEEDS TO BE ADDRESSED OVER THE NEXT THREE YEARS. THE EXTERNAL REPRESENTATIVES INCLUDED THE PERSPECTIVE OF A PEDIATRICIAN, AN FQHC, MENTAL HEALTH SERVICES PROVIDER, AN AFFORDABLE HOUSING ORGANIZATION, SENIOR SERVICES PROVIDER AND THE AREA HEALTH OFFICER FOR THE SAN FERNANDO VALLEY FROM THE DEPARTMENT OF PUBLIC HEALTH. THE GROUP PARTICIPATED IN TWO MEETINGS TO REVIEW THE ASSEMBLED PRIMARY AND SECONDARY DATA FOR EACH IDENTIFIED HEALTH NEED. THE FIRST MEETING INCLUDED DISCUSSIONS ON HOW EACH ISSUE AFFECTED THE COMMUNITIES IN THE REGION, USING THE IDENTIFIED NEED OF HOMELESSNESS AND HOUSING INSTABILITY TO FAMILIARIZE AND PREPARE THE PARTICIPANTS FOR CRITERIA THAT WOULD BE APPLIED DURING THE PRIORITIZATION MEETING. IN THE SECOND MEETING COMMITTEE PARTICIPANTS RECEIVED A QUESTIONNAIRE AT THE START OF THE MEETING AND ASKED TO RATE THE SEVERITY OF EACH IDENTIFIED HEALTH NEED USING THREE CRITERIA: (1) THE CHANGE OVER TIME, (2) THE AVAILABILITY OF COMMUNITY RESOURCES/ASSETS TO ADDRESS THE HEALTH NEED, AND (3) THE COMMUNITY READINESS TO IMPLEMENT/SUPPORT PROGRAMS TO ADDRESS THE HEALTH NEED. OVERSIGHT COMMITTEE MEMBERS WERE THEN ASKED TO CONSIDER THE THREE QUESTIONS BELOW AND GIVEN THREE DOTS, OR "VOTES", TO ASSIGN TO THE IDENTIFIED HEALTH NEEDS, RESULTING IN A LIST OF PRIORITIZED NEEDS.- HOW DOES THIS NEED IMPACT THE WORK OF YOUR ORGANIZATION AND THE CLIENTS YOU SERVE?- WHAT OTHER SERVICE GAPS CURRENTLY EXIST?- WHAT ROLE CAN PROVIDENCE PLAY IN ADDRESSING THIS NEED?
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 6A:	PROVIDENCE HOLY CROSS, PROVIDENCE SAINT JOSEPH AND PROVIDENCE TARZANA MEDICAL CENTERS COLLABORATED TOGETHER TO COMPLETE THEIR JOINT COMMUNITY HEALTH NEEDS ASSESSMENT.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 6B:	THE CHNA WAS CONDUCTED IN PARTNERSHIP WITH THE CENTER FOR NONPROFIT MANAGEMENT (CNM), LOS ANGELES, CA.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, LINE 7B, CHNA REPORT WEBSITE:	HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS?SCREF=GLOBALSEARCH
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 9:	THE HOSPITAL FACILITIES ADOPTED ITS IMPLEMENTATION STRATEGY ASSOCIATED WITH THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT ON APRIL 16, 2020, IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-3(A)(1).
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 11:	IN DEVELOPING THE LIST OF PRIORITY NEEDS, PROVIDENCE LOOKED AT BRINGING ITS EXPERTISE AND RESOURCES TO THOSE ISSUES WHERE IT CAN MAKE POSITIVE CHANGE. AFTER CONSIDERABLE DISCUSSION, THE BOARD COMMITTEE ON COMMUNITY BENEFITS CAME TO A CONSENSUS THAT THE THREE-YEAR COMMUNITY HEALTH IMPROVEMENT PLAN WOULD ADDRESS EACH OF THE EIGHT IDENTIFIED HEALTH NEEDS:1) HOMELESSNESS AND HOUSING INSTABILITY2) BEHAVIORAL HEALTH, INCLUDING MENTAL HEALTH AND SUBSTANCE USE3) FOOD INSECURITY4) PREVENTION AND MANAGEMENT OF CHRONIC DISEASES5) ACCESS TO HEALTH CARE AND RESOURCES6) SENIOR CARE7) IMMUNIZATION/SCHOOL HEALTH8) VIOLENCE PREVENTION THE MOST SIGNIFICANT CHANGE TO THIS LIST (COMPARED TO THE 2016 CHNA) WAS THE ADDITION OF IMMUNIZATION/SCHOOL HEALTH AS AN IDENTIFIED COMMUNITY HEALTH NEED IN THE COMMUNITY.THE IDENTIFIED HEALTH NEEDS WILL BE ADDRESSED WITHIN THE CONTEXT OF FOUR INITIATIVES THAT MAKE UP THE THREE-YEAR IMPLEMENTATION STRATEGY:1) INITIATIVE #1: STRENGTHEN INFRASTRUCTURE OF CONTINUUM OF CARE FOR PATIENTS EXPERIENCING HOMELESSNESS OUR GOAL IS TO PROVIDE ADDITIONAL SUPPORT TO PATIENTS EXPERIENCING HOMELESSNESS AND HOUSING INSTABILITY THROUGH EFFORTS TO STRENGTHEN INFRASTRUCTURE OF CONTINUUM OF CARE. THESE EFFORTS INCLUDE NAVIGATORS, EARLY INTERVENTION FOR INDIVIDUALS WHO ARE AT HIGH RISK OF BECOMING HOMELESS, AND PROVIDING SUPPORT FOR ADDITIONAL TEMPORARY HOUSING AND/OR RECUPERATIVE CARE BEDS IN THE REGION.2) INITIATIVE #2: INCREASE REACH AND UTILIZATION OF COMMUNITY BASED WELLNESS AND ACTIVITY CENTERSOUR GOAL IS TO INCREASE THE REACH AND UTILIZATION OF PROVIDENCE COMMUNITY-BASED WELLNESS AND ACTIVITY CENTERS BY EXPANDING THE SCOPE OF HEALTH AND WELLNESS SERVICES AVAILABLE TO LOCAL RESIDENTS, STRENGTHENING THE INFRASTRUCTURE OF WELLNESS SERVICES IN UNDERSERVED COMMUNITIES AND ENGAGING PUBLIC AND PRIVATE PARTNERS TO WORK ALONGSIDE US IN THE IMPLEMENTATION OF PROGRAM SERVICES.3) INITIATIVE #3: IMPROVE ACCESS TO HEALTHCARE SERVICES AND PREVENTIVE RESOURCESOUR GOAL IS TO IMPROVE ACCESS TO HEALTH CARE AND PREVENTIVE RESOURCES TO THE MOST VULNERABLE COMMUNITIES OF THE REGION ESPECIALLY THE POOR AND UNDERSERVED BY DEPLOYING PROGRAMS TO ASSIST IN THE NAVIGATION OF THE HEALTH CARE SYSTEM, PROVIDE EDUCATION, AND ENROLLMENT ASSISTANCE. 4) INITIATIVE #4: SUPPORT COLLABORATIVE PARTNERSHIPS FOR BETTER HEALTH OUR GOAL IS TO BUILD COLLABORATIVE PARTNERSHIPS WITH NONPROFIT ORGANIZATIONS, COMMUNITY CLINICS, PUBLIC AND PRIVATE SCHOOLS IN THE SAN FERNANDO VALLEY TO ADDRESS THE NEEDS OF CHILDREN TO BECOME UP TO DATE ON AGE-APPROPRIATE IMMUNIZATIONS AND INCREASE FLU SHOT VACCINATIONS FOR CHILDREN, ADULTS AND SENIORS.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 16A:	FAP WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 16B:	FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/FINANCIAL-ASSISTANCE-APPLICATION
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 16C:	FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/PLAIN-LANGUAGE-SUMMARY
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 24:	IF THE SERVICES WERE NOT MEDICALLY NECESSARY OR WERE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY, THEY WERE BILLED AT THE GROSS CHARGE.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 3E:	AFTER ALL OF THE PRIMARY AND SECONDARY DATA WAS COLLECTED AND ANALYZED, A GROUP OF 8 COMMUNITY STAKEHOLDERS, 4 FROM PROVIDENCE AND 4 FROM DIFFERENT COMMUNITY SECTORS (PUBLIC SCHOOLS, PUBLIC HEALTH, FEDERALLY QUALIFIED HEALTH CENTERS (FQHC'S), AND COMMUNITY-BASED ORGANIZATIONS) MET ON TWO SEPARATE OCCASIONS TO REVIEW THE FINDINGS. AFTER FACILITATED DISCUSSION, THE GROUP REACHED A CONSENSUS ON THE TOP TEN HEALTH NEEDS:- HOMELESSNESS AND HOUSING INSTABILITY- ACCESS TO HEALTH CARE- BEHAVIORAL HEALTH- ECONOMIC INSECURITY AND WORKFORCE DEVELOPMENT- FOOD INSECURITY- SERVICES FOR SENIORS- CHRONIC DISEASES- EARLY CHILDHOOD DEVELOPMENT- SOCIAL COHESION- ORAL HEALTH CARE
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 5:	PROVIDENCE CONDUCTED KEY INFORMANT INTERVIEWS WITH INDIVIDUALS WHO REPRESENT A VARIETY OF LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS THROUGHOUT THE HOSPITALS' SERVICE AREA.2019 CHNA KEY INFORMANTS:- BEHAVIORAL HEALTH SERVICES, INC. (COMMUNITY BASED ORGANIZATION, BEHAVIORAL HEALTH)- ST. JOSEPH CHURCH HAWTHORN (RELIGIOUS ORGANIZATION)- LAWNDALE ELEMENTARY SCHOOL DISTRICT (SCHOOL DISTRICT, EDUCATION)- HARBOR COMMUNITY CLINIC (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- BOYS & GIRLS CLUBS OF THE LOS ANGELES HARBOR (NATIONAL ORGANIZATION, YOUTH DEVELOPMENT)- THE VOLUNTEER CENTER SOUTH BAY, HARBOR, LONG BEACH (COMMUNITY BASED ORGANIZATION, MENTAL HEALTH, FOOD INSECURITY, COMMUNITY WELLBEING)- CALIFORNIA ASSOCIATION OF FOOD BANKS (STATE ORGANIZATION, FOOD INSECURITY)- FLYAWAYHOMES (COMMUNITY BASED ORGANIZATION, HOMELESSNESS)- RICHSTONE FAMILY CENTER (COMMUNITY BASED ORGANIZATION, CHILD ABUSE TREATMENT AND PREVENTION)- SOUTH BAY COALITION TO END HOMELESSNESS (COALITION, HOMELESSNESS)IN ADDITION TO CONDUCTING KEY INFORMANT INTERVIEWS AS PART OF ITS PRIMARY DATA COLLECTION, PROVIDENCE ALSO INCLUDED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY AS PART OF ITS CHNA OVERSIGHT COMMITTEE.THE CHNA OVERSIGHT COMMITTEE, AUTHORIZED BY THE GOVERNING BOARD, MET TWICE IN THE FALL OF 2019 TO PRIORITIZE AND RECOMMEND THE TOP IDENTIFIED HEALTH NEEDS TO BE ADDRESSED OVER THE NEXT THREE YEARS. THE EXTERNAL REPRESENTATIVES INCLUDED THE PERSPECTIVE OF A FQHC, NONPROFIT SOCIAL SERVICES AGENCY, PUBLIC SCHOOLS AND THE DIRECTOR OF NUTRITION AND PHYSICAL ACTIVITY PROGRAM FROM THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH. THE GROUP PARTICIPATED IN TWO MEETINGS TO REVIEW THE ASSEMBLED PRIMARY AND SECONDARY DATA FOR EACH IDENTIFIED HEALTH NEED. THE FIRST MEETING INCLUDED DISCUSSIONS ON HOW EACH ISSUE AFFECTED THE COMMUNITIES IN THE REGION, USING THE IDENTIFIED NEEDS OF FOOD INSECURITY AND BEHAVIORAL HEALTH TO FAMILIARIZE AND PREPARE THE PARTICIPANTS FOR CRITERIA THAT WOULD BE APPLIED DURING THE PRIORITIZATION MEETING. IN THE SECOND MEETING COMMITTEE PARTICIPANTS RECEIVED A QUESTIONNAIRE AT THE START OF THE MEETING AND ASKED TO RATE THE SEVERITY OF EACH IDENTIFIED HEALTH NEED USING THREE CRITERIA: (1) THE CHANGE OVER TIME, (2) THE AVAILABILITY OF COMMUNITY RESOURCES/ASSETS TO ADDRESS THE HEALTH NEED, AND (3) THE COMMUNITY READINESS TO IMPLEMENT/SUPPORT PROGRAMS TO ADDRESS THE HEALTH NEED. OVERSIGHT COMMITTEE MEMBERS WERE THEN ASKED TO CONSIDER THE THREE QUESTIONS BELOW AND GIVEN THREE DOTS, OR "VOTES," TO ASSIGN TO THE IDENTIFIED HEALTH NEEDS, RESULTING IN A LIST OF PRIORITIZED NEEDS.- HOW DOES THIS NEED IMPACT THE WORK OF YOUR ORGANIZATION AND THE CLIENTS YOU SERVE?- WHAT OTHER SERVICE GAPS CURRENTLY EXIST?- WHAT ROLE CAN PROVIDENCE PLAY IN ADDRESSING THIS NEED?
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 6A:	PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO AND PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE COLLABORATED TOGETHER TO COMPLETE THEIR JOINT COMMUNITY HEALTH NEEDS ASSESSMENT.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 6B:	THE CHNA WAS CONDUCTED IN PARTNERSHIP WITH THE CENTER FOR NONPROFIT MANAGEMENT (CNM), LOS ANGELES, CA.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, LINE 7B, CHNA REPORT WEBSITE:	HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS?SCREF=GLOBALSEARCH
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 9:	THE HOSPITAL FACILITIES ADOPTED ITS IMPLEMENTATION STRATEGY ASSOCIATED WITH THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT ON MARCH 24, 2020, IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-3(A)(1).
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 11:	IN DEVELOPING THE LIST OF PRIORITY NEEDS, PROVIDENCE LOOKED AT BRINGING ITS EXPERTISE AND RESOURCES TO THOSE ISSUES WHERE IT CAN MAKE POSITIVE CHANGE. AFTER CONSIDERABLE DISCUSSION, THE BOARD COMMITTEE ON COMMUNITY BENEFITS CAME TO A CONSENSUS THAT THE THREE-YEAR COMMUNITY HEALTH IMPROVEMENT PLAN WOULD ADDRESS NINE OF THE TEN IDENTIFIED HEALTH NEEDS:1. HOMELESSNESS AND HOUSING INSTABILITY2. ACCESS TO HEALTH CARE3. BEHAVIORAL HEALTH4. ECONOMIC INSECURITY AND WORKFORCE DEVELOPMENT5. FOOD INSECURITY6. SERVICES FOR SENIORS7. CHRONIC DISEASES8. EARLY CHILDHOOD DEVELOPMENT9. SOCIAL COHESIONNO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. ORAL HEALTH WAS EXCLUDED AS A HEALTH NEED THAT WOULD BE ADDRESSED IN THE THREE-YEAR COMMUNITY HEALTH IMPROVEMENT PLAN. OUR HEALTH FACILITIES DO NOT PROVIDE ORAL HEALTH CARE, AND IT IS NOT OUR AREA OF EXPERTISE WITHIN THE PROVIDENCE HEALTH SYSTEM IN THE LOS ANGELES REGION. HOWEVER, THERE ARE NUMBER OF COMMUNITY PARTNERS INCLUDING LOCAL FEDERALLY QUALIFIED HEALTH CLINICS WHO ARE FOCUSING ON INCREASING ACCESS TO ORAL HEALTH CARE ESPECIALLY FOR THE MEDI-CAL POPULATION. FOR COMMUNITY MEMBERS IN NEED OF THESE SERVICES WE REFER THEM TO THESE PROVIDERS OF LOW-COST DENTAL CARE.THE MOST SIGNIFICANT CHANGE TO THIS LIST (COMPARED TO THE 2016 CHNA) WAS THE ADDITION OF IMMUNIZATION/SCHOOL HEALTH AS AN IDENTIFIED COMMUNITY HEALTH NEED IN THE COMMUNITY.THE NINE PRIORITIZED HEALTH NEEDS WILL BE ADDRESSED WITHIN THE CONTEXT OF FOUR INITIATIVES THAT MAKE UP THE THREE-YEAR IMPLEMENTATION STRATEGY:1) INITIATIVE #1: STRENGTHEN INFRASTRUCTURE OF CONTINUUM OF CARE FOR PATIENTS EXPERIENCING HOMELESSNESSOUR GOAL IS TO PROVIDE ADDITIONAL SUPPORT TO PATIENTS EXPERIENCING HOMELESSNESS AND HOUSING INSTABILITY THROUGH EFFORTS TO STRENGTHEN INFRASTRUCTURE OF CONTINUUM OF CARE. THESE EFFORTS INCLUDE NAVIGATORS, A COORDINATED ENTRY SYSTEM HOSPITAL LIAISON, EARLY INTERVENTION FOR INDIVIDUALS WHO ARE AT HIGH RISK OF BECOMING HOMELESS, AND PROVIDING SUPPORT FOR ADDITIONAL TEMPORARY HOUSING AND/OR RECUPERATIVE CARE BEDS IN THE REGION.2) INITIATIVE #2: IMPROVE ACCESS TO HEALTH CARE SERVICESOUR GOAL IS TO IMPROVE ACCESS TO QUALITY HEALTH CARE SERVICES FOR VULNERABLE POPULATIONS BY:- REDUCING THE UTILIZATION OF EMERGENCY DEPARTMENTS FOR "AVOIDABLE", NON-EMERGENCY VISITS AND IMPROVING LINKAGE TO A MEDICAL HOME.- REDUCING THE RATES OF UNINSURED PEOPLE IN THE COMMUNITY- INCREASING THE PERCENTAGE OF THE POPULATION WHO RECEIVE FLU SHOTS3) INITIATIVE #3: INVEST IN EXPANSION OF COMMUNITY-BASED WELLNESS AND ACTIVITY CENTERSOUR GOAL IS TO INCREASE THE REACH AND UTILIZATION OF PROVIDENCE COMMUNITY-BASED WELLNESS AND ACTIVITY CENTERS BY EXPANDING THE SCOPE OF HEALTH AND WELLNESS SERVICES AVAILABLE TO LOCAL RESIDENTS, STRENGTHENING THE INFRASTRUCTURE OF WELLNESS SERVICES IN UNDERSERVED COMMUNITIES AND ENGAGING PUBLIC AND PRIVATE PARTNERS TO WORK ALONGSIDE US IN THE IMPLEMENTATION OF PROGRAM SERVICES.4) INITIATIVE #4: TRAIN AND DEPLOY A WORKFORCE OF COMMUNITY HEALTH WORKERS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH IN UNDERSERVED POPULATIONSOUR GOAL IS TO INCREASE THE NUMBER OF COMMUNITY HEALTH WORKERS EMPLOYED IN HEALTH CARE SETTINGS IN ROLES THAT ADDRESS SOCIAL DETERMINANTS OF HEALTH- REDUCTION IN THE NUMBER OF PEOPLE WHO ARE UNINSURED- REDUCTION THE IN THE NUMBER OF ELIGIBLE BUT UNENROLLED IN CALFRESH/SNAP BENEFITS
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 16A:	FAP WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 16B:	FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/FINANCIAL-ASSISTANCE-APPLICATION
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 16C:	FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/PLAIN-LANGUAGE-SUMMARY
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 24:	IF THE SERVICES WERE NOT MEDICALLY NECESSARY OR WERE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY, THEY WERE BILLED AT THE GROSS CHARGE.

Schedule H (Form 990) 2019

Page 9

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?43
Name and address		Type of Facility (describe)
1	1 - AMBULATORY SURGERY CENTER 2020 SANTA MONICA BLVD STE 140 SANTA MONICA,CA90404	OUTPATIENT SERVICES
2	2 - BRAIN TUMOR CENTER 2121 SANTA MONICA BOULEVARD SANTA MONICA,CA90404	OUTPATIENT SERVICES
3	3 - CARDIAC AND PULMONARY REHAB 20929 HAWTHORNE BOULEVARD TORRANCE,CA90503	OUTPATIENT SERVICES
4	4 - CARSON PRIMARY CARE NORTH 20401 AVALON BOULEVARD STE B CARSON,CA90746	OUTPATIENT SERVICES
5	5 - CHILD AND FAMILY DEVELOPMENT CENTER 1339 20TH STREET SANTA MONICA,CA90404	OUTPATIENT SERVICES
6	6 - CLEFT PALATE CENTER 2121 SANTA MONICA BOULEVARD SANTA MONICA,CA90404	OUTPATIENT SERVICES
7	7 - COMMUNITY HEALTH 2601 AIRPORT DRIVE STE 220 TORRANCE,CA90505	OUTPATIENT SERVICES
8	8 - CONCUSSION MANAGEMENT 501 S BUENA VISTA STREET BURBANK,CA91505	OUTPATIENT SERVICES
9	9 - DERMATOLOGICAL CENTER FOR SKIN HEALTH 2121 SANTA MONICA BOULEVARD SANTA MONICA,CA90404	OUTPATIENT SERVICES
10	10 - HIP AND PELVIS INSTITUTE 2001 SANTA MONICA BLVD STE 760 SANTA MONICA,CA90404	OUTPATIENT SERVICES
11	11 - HOME HEALTH 2601 AIRPORT DRIVE STE 230 TORRANCE,CA90505	OUTPATIENT SERVICES
12	12 - HOWARD AND HYCY HILL NEUROSCIENCE CENTER 501 S BUENA VISTA STREET BURBANK,CA91505	OUTPATIENT SERVICES
13	13 - IMAGING AND BREAST CENTER 1360 W 6TH STREET SUITE 100 SAN PEDRO,CA90731	OUTPATIENT SERVICES
14	14 - MARGIE PETERSON BREAST CENTER 2121 SANTA MONICA BOULEVARD GARDEN LEVE SANTA MONICA,CA90404	OUTPATIENT SERVICES
15	15 - NUTRITION AND DIABETES EDUCATION DEPARTM 2121 SANTA MONICA BOULEVARD SANTA MONICA,CA90404	OUTPATIENT SERVICES
16	16 - OUTPATIENT DIAGNOSTIC CENTER 11570 INDIAN HILLS ROAD MISSION HILLS,CA91345	OUTPATIENT SERVICES
17	17 - OUTPATIENT REHAB CENTER 21135 HAWTHORNE BOULEVARD TORRANCE,CA90503	OUTPATIENT SERVICES
18	18 - PERFORMANCE THERAPY 2020 SANTA MONICA BLVD STE 401 SANTA MONICA,CA90404	OUTPATIENT SERVICES
19	19 - PROVIDENCE CENTER FOR COMMUNITY IMPROVEM 6801 COLDWATER CANYON AVE NORTH HOLLYWOOD,CA91605	OUTPATIENT SERVICES
20	20 - PROVIDENCE FAMILY MEDICAL CENTER 520 N PROSPECT AVE STE 103 REDONDO BEACH,CA90277	OUTPATIENT SERVICES
21	21 - PROVIDENCE HOLY CROSS CANCER CENTER 15031 RINALDI STREET MISSION HILLS,CA91345	OUTPATIENT SERVICES
22	22 - PROVIDENCE HOLY CROSS HEALTH CENTER AT P 19950 RINALDI STREET PORTER RANCH,CA91326	OUTPATIENT SERVICES
23	23 - PROVIDENCE HOLY CROSS HEALTH CENTER AT S 26357 MCBEAN PARKWAY SANTA CLARITA,CA91355	OUTPATIENT SERVICES
24	24 - PROVIDENCE HOLY CROSS SURGERY CENTER 11550 INDIAN HILLS ROAD MISSION HILLS,CA91345	OUTPATIENT SERVICES
25	25 - PROVIDENCE PLAYA VISTA MEDICAL CENTER 6020 SEA BLUFF DRIVE STE 1 PLAYA VISTA,CA90094	OUTPATIENT SERVICES
26	26 - PROVIDENCE SAINT JOSEPH BREAST HEALTH CE 181 S BUENA VISTA STREET STE 300 BURBANK,CA91505	OUTPATIENT SERVICES
27	27 - PROVIDENCE SAINT JOSEPH DIAGNOSTIC CENTE 201 S BUENA VISTA STREET STE 125 BURBANK,CA91505	OUTPATIENT SERVICES
28	28 - PROVIDENCE SAINT JOSEPH HEALTH CENTER 3413 W PACIFIC AVENUE BURBANK,CA91505	OUTPATIENT SERVICES
29	29 - PROVIDENCE ST ELIZABETH CARE CENTER 10425 MAGNOLIA BLVD NORTH HOLLYWOOD,CA91601	OUTPATIENT SERVICES
30	30 - PROVIDENCE TARZANA MRI CENTER 18321 CLARK STREET TARZANA,CA91356	OUTPATIENT SERVICES
31	31 - PROVIDENCE TARZANA OUTPATIENT IMAGING CE 18344 CLARK STREET STE 101 TARZANA,CA91356	OUTPATIENT SERVICES
32	32 - PROVIDENCE TARZANA OUTPATIENT THERAPY CE 5359 BALBOA BLVD ENCINO,CA91316	OUTPATIENT SERVICES
33	33 - PROVIDENCE TARZANA WOMENS CENTER 18344 CLARK STREET STE 110 TARZANA,CA91356	OUTPATIENT SERVICES
34	34 - PROVIDENCE TARZANA WOUND CARE CENTER 18411 CLARK STREET STE 301 TARZANA,CA91356	OUTPATIENT SERVICES
35	35 - RADIATION ONCOLOGY 3531 FASHION WAY TORRANCE,CA90503	OUTPATIENT SERVICES
36	36 - RECOVERY CENTER 1386 W 7TH STREET SAN PEDRO,CA90732	OUTPATIENT SERVICES
37	37 - ROY AND PATRICIA DISNEY FAMILY CANCER CE 181 S BUENA VISTA STREET BURBANK,CA91505	OUTPATIENT SERVICES
38	38 - SAN FERNANDO VALLEY HEART INSTITUTE 18321 CLARK STREET TARZANA,CA91356	OUTPATIENT SERVICES
39	39 - SOUTH BAY OPHTHALMOLOGY CENTER 4825 TORRANCE BOULEVARD STE 100 TORRANCE,CA90503	OUTPATIENT SERVICES
40	40 - SUB ACUTE CARE CENTER 1322 W 6TH STREET SAN PEDRO,CA90732	OUTPATIENT SERVICES
41	41 - TRANSITIONAL CARE CENTER 4320 MARICOPA STREET TORRANCE,CA90505	OUTPATIENT SERVICES
42	42 - VASEK POLAK HEALTH CLINIC 13355 HAWTHORNE BLVD HAWTHORNE,CA90250	OUTPATIENT SERVICES
43	43 - WOMEN'S IMAGING CENTER 20929 HAWTHORNE BOULEVARD TORRANCE,CA90503	OUTPATIENT SERVICES

Schedule H (Form 990) 2019

Page 10

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:	IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS.
Part I, Line 6a:	PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTP://WWW.PSJHEALTH.ORG/COMMUNITY-BENEFIT/SOUTHERN-CALIFORNIA.
Part I, Line 7:	THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS.
Part I, Line 7g:	NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED ON THIS LINE IN 2019.
Part III, Line 2:	THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE.
Part III, Line 3:	THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY.
Part III, Line 4:	THE HEALTH SYSTEM PROVIDED 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:	THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT.
Part III, Line 9b:	PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE.
Part VI, Line 2:	NEEDS ASSESSMENT:REPORTING GROUP AEVERY THREE YEARS, PROVIDENCE HOLY CROSS, PROVIDENCE SAINT JOSEPH AND PROVIDENCE TARZANA MEDICAL CENTERS CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE COMMUNITIES IN THE SAN FERNANDO VALLEY. PRIOR TO BEGINNING THE PROCESS, THE COMMUNITY HEALTH DEPARTMENT STAFF MAKES A PRESENTATION TO THE SAN FERNANDO VALLEY COMMUNITY MINISTRY BOARD OUTLINING THE FRAMEWORK OF THE CHNA PROCESS AND REQUESTS AUTHORITY FROM THE GOVERNING BOARD TO FORM A BOARD COMMITTEE ON COMMUNITY BENEFIT TO OVERSEE THE CHNA PROCESS. THE COMMITTEE IS COMPOSED OF NINE INTERNAL PROVIDENCE STAFF, AND NINE COMMUNITY STAKEHOLDERS (I.E. PUBLIC SCHOOLS, PUBLIC HEALTH, FEDERALLY QUALIFIED HEALTH CENTERS (FQHC'S), AND COMMUNITY-BASED ORGANIZATIONS). THIS GROUP IS CHARGED WITH REVIEWING THE FINDINGS FROM THE PRIMARY AND SECONDARY DATA COLLECTED AND PRIORITIZING THE IDENTIFIED COMMUNITY NEEDS. THE PRIORITIZED NEEDS IDENTIFIED IN THE 2019 CHNA ARE LISTED ABOVE IN PART V, SECTION B. THESE PRIORITIZED NEEDS BECOME THE BASIS OF THE COMMUNITY HEALTH IMPROVEMENT PLAN/IMPLEMENTATION STRATEGY THAT SETS FORTH OBJECTIVES TO BE ACCOMPLISHED OVER THREE YEARS, UNTIL THE NEXT CHNA IS CONDUCTED.THE COMMITTEE MET TWICE IN THE FALL OF 2019 TO PRIORITIZE AND RECOMMEND THE TOP IDENTIFIED HEALTH NEEDS TO BE ADDRESSED OVER THE NEXT THREE YEARS. FINAL APPROVAL OF THE CHNA BY THE BOARD OF DIRECTORS TOOK PLACE AT THEIR DECEMBER 2019 MEETING.REPORTING GROUP BEVERY THREE YEARS, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTERS, SAN PEDRO AND TORRANCE CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE COMMUNITIES IN THE SOUTH BAY. PRIOR TO BEGINNING THE PROCESS, THE COMMUNITY HEALTH DEPARTMENT STAFF MAKES A PRESENTATION TO THE SOUTH BAY COMMUNITY MINISTRY BOARD OUTLINING THE FRAMEWORK OF THE CHNA PROCESS AND REQUESTS AUTHORITY FROM THE GOVERNING BOARD TO FORM A BOARD COMMITTEE ON COMMUNITY BENEFIT TO OVERSEE THE CHNA PROCESS. THE COMMITTEE IS COMPOSED OF FOUR INTERNAL PROVIDENCE STAFF, AND FOUR COMMUNITY STAKEHOLDERS (I.E. PUBLIC SCHOOLS, PUBLIC HEALTH, FEDERALLY QUALIFIED HEALTH CENTERS (FQHC'S), AND COMMUNITY-BASED ORGANIZATIONS). THIS GROUP IS CHARGED WITH REVIEWING THE FINDINGS FROM THE PRIMARY AND SECONDARY DATA COLLECTED AND PRIORITIZING THE IDENTIFIED COMMUNITY NEEDS. THE PRIORITIZED NEEDS IDENTIFIED IN THE 2019 CHNA ARE LISTED ABOVE IN PART V, SECTION B. THESE PRIORITIZED NEEDS BECOME THE BASIS OF THE COMMUNITY HEALTH IMPROVEMENT PLAN/IMPLEMENTATION STRATEGY THAT SETS FORTH OBJECTIVE TO BE ACCOMPLISHED OVER THREE YEARS, UNTIL THE NEXT CHNA IS CONDUCTED.THE COMMITTEE MET TWICE IN THE FALL OF 2019 TO PRIORITIZE AND RECOMMEND THE TOP IDENTIFIED HEALTH NEEDS TO BE ADDRESSED OVER THE NEXT THREE YEARS. FINAL APPROVAL OF THE CHNA BY THE BOARD OF DIRECTORS TOOK PLACE AT THEIR DECEMBER 2019 MEETING.
Part VI, Line 3:	COMMUNICATION TO THE PUBLIC:REPORTING GROUPS A & BPROVIDENCE HOLY CROSS, PROVIDENCE SAINT JOSEPH AND PROVIDENCE TARZANA MEDICAL CENTERS AS WELL AS PROVIDENCE LITTLE COMPANY OF MARY, SAN PEDRO AND PROVIDENCE LITTLE COMPANY OF MARY, TORRANCE 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:REPORTING GROUP ATHE PROVIDENCE SAN FERNANDO VALLEY SERVICE AREA (SFV SERVICE AREA) IS COMPRISED OF THE SERVICE AREAS OF THREE PROVIDENCE MEDICAL CENTERS INCLUDING PROVIDENCE HOLY CROSS MEDICAL CENTER (PHCMC; MISSION HILLS); PROVIDENCE ST. JOSEPH MEDICAL CENTER (PSJMC; BURBANK); AND PROVIDENCE CEDARS-SINAI TARZANA MEDICAL CENTER (PCSTMC; TARZANA). THE PROVIDENCE SAN FERNANDO VALLEY COMMUNITY BENEFIT SERVICE AREA CONSISTS OF ALL THREE MEDICAL CENTERS' COMMUNITY BENEFIT SERVICE AREAS. SIMILARLY, THE PROVIDENCE SAN FERNANDO VALLEY BROADER SERVICE AREA CONSISTS OF ZIP CODES WITHIN THE SFV SERVICE AREA, BUT OUTSIDE OF THE COMMUNITY BENEFIT SERVICE AREA. COMMUNITIES IN THE BROADER SERVICE AREA ARE MORE RESOURCE-RICH WITH A POPULATION ON THE HIGHER END OF THE SOCIOECONOMIC SPECTRUM. THIS SERVICE AREA ROUGHLY ALIGNS WITH LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH'S SERVICE PLANNING AREA (SPA) 2.POPULATION AND AGE DEMOGRAPHICSTHE TOTAL POPULATION OF THE PROVIDENCE SAN FERNANDO VALLEY (SFV) SERVICE AREA IN 2019 IS 2,225,425 PEOPLE, WHICH REPRESENTS A 0.2% INCREASE COMPARED TO THE 2016 POPULATION, OR APPROXIMATELY 5,000 ADDITIONAL RESIDENTS LIVING IN THE AREA. THE TOTAL POPULATION OF THE SFV COMMUNITY BENEFIT SERVICE AREA IS JUST OVER 52% OF THE TOTAL SERVICE AREA POPULATION, WITH NEARLY 1.2 MILLION PEOPLE. THE MAJORITY OF RESIDENTS IN THE SFV SERVICE AREA ARE BETWEEN 10 AND 39 YEARS OLD. CHILDREN UNDER THE AGE OF 19 MAKE UP 28.2% OF THE POPULATION. THIS IS NOTABLE AND INDICATES A GREATER PROPORTION OF YOUTH THAN ELSEWHERE IN THE STATE, WHERE CHILDREN UNDER THE AGE OF 18 MAKE UP 22.7% OF THE POPULATION. ADULTS 60 YEARS OF AGE AND OLDER MAKE UP 13.9% OF THE TOTAL SERVICE AREA POPULATION, COMPARED TO THE STATE OF CALIFORNIA, ADULTS 65 AND OLDER MAKE UP 14.3% OF THE POPULATION. THE SFV SERVICE AREA, THEREFORE, IS NOTABLY YOUNGER, ON AVERAGE, THAN THE TOTAL POPULATION OF THE STATE OF CALIFORNIA. POPULATION BY RACE AND ETHNICITYAMONG SFV COMMUNITY BENEFIT SERVICE AREA RESIDENTS, IN 2019, 52.3% WERE WHITE, 11.1% WERE ASIAN/PACIFIC ISLANDER/HAWAIIAN, 0.7% WERE ALASKA NATIVE OR AMERICAN INDIAN, 3.6% WERE AFRICAN AMERICAN OR BLACK, AND 5.0% WERE OF TWO OR MORE RACES. APPROXIMATELY 59.0% OF THE RESIDENTS IDENTIFY AS LATINO.INCOME LEVELSIN 2019, THE MEDIAN HOUSEHOLD INCOME OF THE SFV SERVICE AREA VARIED SIGNIFICANTLY FROM A LOW OF $41,053 FOR THE COMMUNITY OF GLENDALE, TO $166,406 FOR THE COMMUNITY OF LA CANADA FLINTRIDGE. THE SFV COMMUNITY BENEFIT SERVICE AREA, COMPARED TO LOS ANGELES COUNTY, IS HOME TO A HIGHER CONCENTRATION OF LOW-INCOME RESIDENTS; APPROXIMATELY 45.4% OF FAMILIES HAVE ANNUAL INCOMES BELOW 200% OF THE FEDERAL POVERTY LEVEL (FPL; $51,500 FOR A FAMILY OF 4) COMPARED TO 39.6% IN LOS ANGELES COUNTY AS A WHOLE.EDUCATION LEVELWHILE MANY OF THE ADULTS LIVING IN THE SFV COMMUNITY BENEFIT SERVICE AREA HAVE AT LEAST A HIGH SCHOOL DIPLOMA (73.2%), THERE WERE SEVERAL ZIP CODES WITH A HIGH CONCENTRATION OF ADULTS WHO HAD NOT COMPLETED HIGH SCHOOL. THESE ZIP CODES INCLUDED PACOIMA (91331; 44.8%), SAN FERNANDO (91340; 39.3%), PANORAMA CITY (91402; 36.4%) AND SUN VALLEY (91352; 34.1%). ECONOMIC INDICATORSTHE PERCENT UNEMPLOYED IN THE SFV AVERAGES 4.9%. NONETHELESS, 35.1% OF THE POPULATION IS EXPERIENCING SEVERE HOUSING COST BURDEN, AND 11.3% OF THE POPULATION IS ENROLLED IN SNAP, OR FOOD ASSISTANCE PROGRAMS.LANGUAGE PROFICIENCYWITHIN LOS ANGELES COUNTY, 56.6% OF RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. FAR FEWER HOUSEHOLDS (AN AVERAGE OF 30.1%) IN THE SFV SERVICE AREA SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, AND INDIVIDUALS SPEAKING LANGUAGES OTHER THAN ENGLISH AT HOME ARE CONCENTRATED IN PANORAMA CITY, PACOIMA, GLENDALE, AND SAN FERNANDO.REPORTING GROUP BTHE TWO PROVIDENCE SOUTH BAY COMMUNITY MEDICAL CENTERS, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO AND PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE (HEREAFTER SOUTH BAY COMMUNITY), SHARE A COMMON GEOGRAPHY BECAUSE OF THEIR CLOSE PROXIMITY TO EACH OTHER. THE SOUTH BAY COMMUNITY SERVICE AREA IS COMPOSED OF 16 DISTINCT MUNICIPALITIES, AND IS A DEMOGRAPHICALLY AND GEOGRAPHICALLY DIVERSE REGION STRETCHING FROM EL SEGUNDO (NORTH), TO CARSON (EAST), TO THE PORT OF LOS ANGELES (SOUTH), TO THE PACIFIC OCEAN (WEST).POPULATION AND AGE DEMOGRAPHICSTHE SOUTH BAY SERVICE AREA IS SLIGHTLY YOUNGER, ON AVERAGE, THAN THE TOTAL POPULATION OF THE STATE OF CALIFORNIA. THE MAJORITY OF RESIDENTS IN THE SERVICE AREA ARE BETWEEN 10 AND 39 YEARS OLD. CHILDREN UNDER THE AGE OF 19 MAKE UP 29.6% OF THE POPULATION, COMPARED TO 22.7% ACROSS THE STATE. ADULTS AGED 60 YEARS AND OLDER MAKE UP 13.7% OF THE TOTAL SERVICE AREA POPULATION, WHICH IS LESS THAN THE STATE POPULATION AGED 65 AND OVER. POPULATION BY RACE AND ETHNICITYOF THE 358,565 RESIDENTS IN THE SOUTH BAY COMMUNITY SERVICE AREA IN 2019, 56.2% IDENTIFIED AS HISPANIC/LATINO. APPROXIMATELY 42% OF RESIDENTS IDENTIFIED AS WHITE, WHILE 28% IDENTIFIED AS ASIAN/PACIFIC ISLANDER, AMERICAN INDIAN/ALASKA NATIVE, OR ANOTHER RACE. APPROXIMATELY 13% IDENTIFIED AS BLACK, AND 12% AS ASIAN.INCOME LEVELSIN 2019, THE MEDIAN HOUSEHOLD INCOME OF THE AREA VARIED SIGNIFICANTLY FROM A LOW OF $43,717 FOR THE COMMUNITY OF WILMINGTON TO $189,068 FOR THE COMMUNITY OF PALOS VERDES PENINSULA. ALTHOUGH THE SOUTH BAY CONTAINS MANY AFFLUENT COMMUNITIES, THE INCOME DATA SHOW THERE ARE AREAS WITHIN THE SERVICE AREA WITH A HIGHER PORTION OF LOW-INCOME HOUSEHOLDS. THE MEDIAN HOUSEHOLD INCOME ($53,598) WITHIN THE BROADER SOUTH BAY SERVICE AREA IS LOWER THAN THE MEDIAN OF LOS ANGELES COUNTY ($62,751). APPROXIMATELY 44.7% OF HOUSEHOLDS HAVE ANNUAL INCOMES BELOW 200% OF THE FEDERAL POVERTY LEVEL ($51,500 FOR A FAMILY OF 4).EDUCATION LEVELWHILE MANY OF THE ADULTS AGE 25+ LIVING IN HOUSEHOLDS IN THE SOUTH BAY HAVE AT LEAST GRADUATED FROM HIGH SCHOOL, THERE WERE SEVERAL ZIP CODES THAT HAD A HIGHER PERCENTAGE OF ADULTS WHO HAD NOT COMPLETED HIGH SCHOOL. THESE ZIP CODES INCLUDED WILMINGTON (90744; 43.3%), LAWNDALE (90260; 24.8%), HAWTHORNE (90250; 24.0%) AND GARDENA (90247; 22.1%).ECONOMIC INDICATORSTHE SOUTH BAY SERVICE AREA HAS SOME NOTABLE ECONOMIC INDICATORS. THE PERCENT UNEMPLOYED IN THE AREA AVERAGES 4.7%.LANGUAGE PROFICIENCYWITHIN LOS ANGELES COUNTY, 56.6% OF RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. SLIGHTLY MORE HOUSEHOLDS (AN AVERAGE OF 58.7%) IN THE BROADER SOUTH BAY COMMUNITY SERVICE AREA SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, AND INDIVIDUALS SPEAKING LANGUAGES OTHER THAN ENGLISH AT HOME ARE CONCENTRATED IN WILMINGTON, CARSON, AND LAWNDALE.
Part VI, Line 5:	PROMOTION OF COMMUNITY HEALTH:REPORTING GROUPS A & BAS A NOT-FOR-PROFIT CATHOLIC HEALTH CARE MINISTRY, PROVIDENCE HEALTH &SERVICES EMBRACES ITS RESPONSIBILITY TO PROVIDE FOR THE NEEDS OF THECOMMUNITIES IT SERVES - ESPECIALLY THE POOR AND VULNERABLE. PROVIDENCE'SNOT-FOR-PROFIT, TAX-EXEMPT STATUS ENABLES PROVIDENCE TO SERVE ITSCOMMUNITIES, TO SOLICIT DONATIONS THROUGH ITS FOUNDATIONS AND TO ACCESSCAPITAL TO RESPOND TO COMMUNITY NEEDS THAT OTHERWISE WOULD GO UNMET. THE CHARITABLE PURPOSE OF PROVIDENCE HEALTH & SERVICES AND EACH OF ITSMINISTRIES IS GUIDED BY ONE MISSION AND SET OF CORE VALUES BASED ONCATHOLIC HEALTH CARE AND GUIDED BY THE LEGACY OF THE SISTERS OFPROVIDENCE.
Part VI, Line 6:	AFFILIATED HEALTH CARE SYSTEM:PROVIDENCE ST. JOSEPH HEALTH SEEKS TO BETTER SERVE ITSCOMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICALCARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEWSERVICES WHERE THEY ARE NEEDED MOST.TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS AND OVER 1085 CLINICS ACROSSALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.
Part VI, Line 7, Reports Filed With States	CA

Schedule H (Form 990) 2019

Additional Data

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- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA

Employer identification number
51-0216589

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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	(h) Purpose of grant or assistance
(1) WILMINGTON COMMUNITY 1009 N AVALON BLVD WILMINGTON,CA90744	95-3137803	501(C)(3)	50,000	OPERATIONAL SUPPORT
(2) MEND - MEET EACH NEED WITH DIGNITY 10641 N SAN FERNANDO RD PACOLMA CITY,CA91331	23-7306337	501(C)(3)	50,000	OPERATIONAL SUPPORT
(3) NORTHEAST VALLEY HEALTH CORP 1172 N MACLAY AVE SAN FERNANDO CITY,CA91340	23-7120632	501(C)(3)	50,000	OPERATIONAL SUPPORT
(4) LOS ANGELES FIRE DEPARTMENT FOUNDATION 1875 CENTURY PARK EAST SUITE 200 LOS ANGELES CITY,CA90051	27-2007326	501(C)(3)	340,000	OPERATIONAL SUPPORT
(5) THE ILLUMINATION FOUNDATION 1090 N BATAVIA ST ORANGE,CA92867	71-1047686	501(C)(3)	393,961	OPERATIONAL SUPPORT
(6) FACEY MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98075	95-4322584	501(C)(3)	478,285	OPERATIONAL SUPPORT
(7) PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98075	81-4542216	501(C)(3)	678,891	OPERATIONAL SUPPORT
(8) PROVIDENCE MEDICAL INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98075	33-0283773	501(C)(3)	1,488,515	OPERATIONAL SUPPORT
(9) PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98075	51-0224944	501(C)(3)	3,795,837	OPERATIONAL SUPPORT
(10) PROVIDENCE HEALTH & SERVICES FOUNDATION VSA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98075	95-3544877	501(C)(3)	6,091,497	OPERATIONAL SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2019

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

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:

DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT ALONG WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION.

Schedule I (Form 990) 2019

Additional Data

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA

Employer identification number

51-0216589

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1ROD F HOCHMAN MD FORMER PRESIDENT/CEO	(i) (ii)	0 ------------- 2,116,529	0 ------------- 6,126,469	0 ------------- 1,454,493	0 ------------- 1,187,824	0 ------------- 29,527	0 ------------- 10,914,842	0 ------------- 3,819,383
2MIKE BUTLER PRESIDENT	(i) (ii)	0 ------------- 1,445,448	0 ------------- 1,133,982	0 ------------- 841,673	0 ------------- 571,275	0 ------------- 26,545	0 ------------- 4,018,923	0 ------------- 1,472,737
3ERIK WEXLER EVP CHIEF EXECUTIVE PSJH SO CA	(i) (ii)	0 ------------- 977,457	0 ------------- 874,244	0 ------------- 472,120	0 ------------- 263,235	0 ------------- 20,600	0 ------------- 2,607,656	0 ------------- 710,614
4DEBRA CANALES FORMER EVP CAO PSJH	(i) (ii)	0 ------------- 893,126	0 ------------- 651,636	0 ------------- 659,325	0 ------------- 336,204	0 ------------- 17,333	0 ------------- 2,557,624	0 ------------- 929,511
5RHONDA MEDOWS MD FORMER PRESIDENT POP HEALTH / AYIN	(i) (ii)	0 ------------- 941,139	0 ------------- 618,340	0 ------------- 329,359	0 ------------- 254,421	0 ------------- 20,033	0 ------------- 2,163,292	0 ------------- 577,152
6CINDY STRAUSS SECRETARY	(i) (ii)	0 ------------- 823,797	0 ------------- 528,043	0 ------------- 383,169	0 ------------- 321,803	0 ------------- 25,430	0 ------------- 2,082,242	0 ------------- 640,817
7AMY COMPTON-PHILLIPS MD FORMER EVP CHIEF CLINICAL OFC PSJH	(i) (ii)	0 ------------- 800,363	0 ------------- 630,228	0 ------------- 271,234	0 ------------- 219,836	0 ------------- 28,629	0 ------------- 1,950,290	0 ------------- 608,504
8VENKAT BHAMIDIPATI EVP/TREASURER	(i) (ii)	0 ------------- 1,050,394	0 ------------- 523,975	0 ------------- 41,123	0 ------------- 280,148	0 ------------- 24,654	0 ------------- 1,920,294	0 ------------- 319,593
9DALE SUROWITZ CHIEF EXEC PROV TARZANA MED CN	(i) (ii)	0 ------------- 628,210	0 ------------- 285,964	0 ------------- 596,075	0 ------------- 182,038	0 ------------- 18,867	0 ------------- 1,711,154	0 ------------- 700,702
10LISA VANCE FORMER EVP REGIONAL CE OR	(i) (ii)	0 ------------- 783,943	0 ------------- 383,946	0 ------------- 146,106	0 ------------- 220,810	0 ------------- 24,842	0 ------------- 1,559,647	0 ------------- 282,049
11JOEL GILBERTSON FORMER EVP COMMUNITY PARTNERSHIPS	(i) (ii)	0 ------------- 556,867	0 ------------- 551,880	0 ------------- 206,393	0 ------------- 175,653	0 ------------- 28,137	0 ------------- 1,518,930	0 ------------- 319,671
12AARON MARTIN FORMER EVP CHIEF MKT/DIGITAL INNO OF	(i) (ii)	0 ------------- 677,199	0 ------------- 396,342	0 ------------- 228,732	0 ------------- 188,750	0 ------------- 5,562	0 ------------- 1,496,585	0 ------------- 430,874
13VICTOR JORDAN COO SO CA	(i) (ii)	0 ------------- 706,823	0 ------------- 199,553	0 ------------- 305,072	0 ------------- 200,339	0 ------------- 13,454	0 ------------- 1,425,241	0 ------------- 134,553
14JO ANN ESCASA-HAIGH EVP/ASSISTANT TREASURER	(i) (ii)	0 ------------- 722,963	0 ------------- 270,658	0 ------------- 195,289	0 ------------- 209,155	0 ------------- 8,669	0 ------------- 1,406,734	0 ------------- 427,495
15TOM MCDONAGH FORMER VP/CHIEF INVESTMENT OFFICER	(i) (ii)	0 ------------- 24,798	0 ------------- 219,548	0 ------------- 1,112,292	0 ------------- 29,571	0 ------------- 16,441	0 ------------- 1,402,650	0 ------------- 644,223
16SHARON TONCRAY FORMER SVP/CHIEF LABOR EE COUNSEL	(i) (ii)	0 ------------- 0	0 ------------- 272,921	0 ------------- 1,091,341	0 ------------- 5,620	0 ------------- 31,007	0 ------------- 1,400,889	0 ------------- 771,066
17GREG TILL FORMER CHIEF PEOPLE OFFICER	(i) (ii)	0 ------------- 588,318	0 ------------- 457,763	0 ------------- 120,432	0 ------------- 169,131	0 ------------- 27,836	0 ------------- 1,363,480	0 ------------- 199,046
18BERNIE KLEIN MD CHIEF EXEC PROV HOLY CROSS MC	(i) (ii)	0 ------------- 625,156	0 ------------- 282,008	0 ------------- 223,668	0 ------------- 194,410	0 ------------- 26,026	0 ------------- 1,351,268	0 ------------- 334,276
19MIKE WATERS FORMER EVP AMBULATORY CARE NETWORK	(i) (ii)	0 ------------- 538,503	0 ------------- 255,592	0 ------------- 255,618	0 ------------- 148,230	0 ------------- 11,503	0 ------------- 1,209,446	0 ------------- 290,614
20JOHN WHIPPLE ASSISTANT SECRETARY	(i) (ii)	0 ------------- 470,433	0 ------------- 259,537	0 ------------- 175,676	0 ------------- 210,397	0 ------------- 25,434	0 ------------- 1,141,477	0 ------------- 300,654
21JANICE NEWELL FORMER SVP/CHIEF INFORMATION OFFCR	(i) (ii)	0 ------------- 0	0 ------------- 325,436	0 ------------- 746,440	0 ------------- 17,430	0 ------------- 1,310	0 ------------- 1,090,616	0 ------------- 426,198
22OREST HOLUBEC FORMER SVP CHIEF COMMUNICATION OFCR	(i) (ii)	0 ------------- 467,371	0 ------------- 231,245	0 ------------- 193,343	0 ------------- 141,823	0 ------------- 27,155	0 ------------- 1,060,937	0 ------------- 260,468
23JIM WATSON ESQ ASSISTANT SECRETARY	(i) (ii)	0 ------------- 467,350	0 ------------- 370,314	0 ------------- 5,830	0 ------------- 103,753	0 ------------- 34,057	0 ------------- 981,304	0 ------------- 0
24DAVID BROWN FORMER SVP CAO AMBULATORY CARE	(i) (ii)	0 ------------- 400,767	0 ------------- 231,141	0 ------------- 165,206	0 ------------- 137,229	0 ------------- 27,115	0 ------------- 961,458	0 ------------- 251,637
25DEBBIE BURTON FORMER SVP CHIEF NURSING OFFICER	(i) (ii)	0 ------------- 397,242	0 ------------- 224,453	0 ------------- 88,397	0 ------------- 141,638	0 ------------- 28,649	0 ------------- 880,379	0 ------------- 158,120
26GARRY OLNEY CHIEF EXECUTIVE SOUTH BAY	(i) (ii)	0 ------------- 520,351	0 ------------- 80,897	0 ------------- 39,591	0 ------------- 148,263	0 ------------- 28,510	0 ------------- 817,612	0 ------------- 96,586
27JACK MUDD FORMER SVP/MISSION LEADERSHIP	(i) (ii)	0 ------------- 6,684	0 ------------- 80,840	0 ------------- 714,634	0 ------------- 5,550	0 ------------- 902	0 ------------- 808,610	0 ------------- 112,956
28KELLY LINDEN CHIEF EXEC PROV ST JOSEPH MC	(i) (ii)	0 ------------- 485,939	0 ------------- 136,426	0 ------------- 23,870	0 ------------- 143,607	0 ------------- 14,757	0 ------------- 804,599	0 ------------- 102,468
29JIM NOBLE CFO SO CA REGION	(i) (ii)	0 ------------- 549,358	0 ------------- 66,017	0 ------------- 4,902	0 ------------- 96,717	0 ------------- 31,807	0 ------------- 748,801	0 ------------- 56,017
30RICHARD GLIMP CMO TORRANCE	(i) (ii)	481,492 ------------- 0	65,855 ------------- 0	28,618 ------------- 0	43,922 ------------- 0	9,598 ------------- 0	629,485 ------------- 0	80,545 ------------- 0
31GLEN KOMATSU CMO PTCH	(i) (ii)	411,029 ------------- 0	72,065 ------------- 0	53,740 ------------- 0	58,658 ------------- 0	27,567 ------------- 0	623,059 ------------- 0	94,089 ------------- 0
32HOWARD DAVIS CMO TARZANA	(i) (ii)	409,460 ------------- 0	60,974 ------------- 0	94,133 ------------- 0	32,152 ------------- 0	18,760 ------------- 0	615,479 ------------- 0	73,199 ------------- 0
33SUSAN DOLBERT PRESIDENT/CDO	(i) (ii)	419,286 ------------- 0	86,118 ------------- 0	49,198 ------------- 0	4,200 ------------- 0	22,693 ------------- 0	581,495 ------------- 0	105,456 ------------- 0
34NICK LYMBEROPOULOS COO TARZANA	(i) (ii)	341,704 ------------- 0	61,935 ------------- 0	29,482 ------------- 0	41,291 ------------- 0	25,621 ------------- 0	500,033 ------------- 0	76,938 ------------- 0
35STEVEN MOHR FORMER CFO - LA SERVICE AREA	(i) (ii)	0 ------------- 53,932	0 ------------- 274,128	0 ------------- 131,340	0 ------------- 5,164	0 ------------- 4,178	0 ------------- 468,742	0 ------------- 225,258
36DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT	(i) (ii)	0 ------------- 200,073	0 ------------- 22,110	0 ------------- 560	0 ------------- 10,673	0 ------------- 9,318	0 ------------- 242,734	0 ------------- 22,110
37TAMMY TEODOSIO FORMER ASSISTANT SECRETARY	(i) (ii)	0 ------------- 115,500	0 ------------- 0	0 ------------- 17,965	0 ------------- 12,772	0 ------------- 12,122	0 ------------- 158,359	0 ------------- 0

Schedule J (Form 990) 2019

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 EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: FIRST CLASS TRAVEL OR CHARTER TRAVEL AIR TRAVEL IS GENERALLY REIMBURSABLE 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. IN LIMITED SITUATIONS FIRST CLASS TICKETS AND CHARTER MAY BE REIMBURSED WHEN APPROVED BY A SENIOR LEVEL SUPERVISOR. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS RELOCATION PROVIDENCE 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 TAXABLE WAGES AND ARE REPORTED AS SUCH. 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 PROVIDES A GROSS-UP FOR THE RELOCATION BENEFITS, SO THAT A PORTION OF THE REIMBURSEMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - FINANCIAL/RETIREMENT PLANNING PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO FINANCIAL AND RETIREMENT PLANNING EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THESE OTHER EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THIS BENEFIT, SO THAT A PORTION OF THE PAYMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE PROVIDENCE PROVIDES HOUSING ALLOWANCES ONLY FOR PURPOSES OF RELOCATION ASSISTANCE TO A NEWLY HIRED EMPLOYEE. PROVIDENCE MAY PAY TEMPORARY LIVING EXPENSES FOR THE NEWLY HIRED 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 ADMINISTRATIVE OFFICER OF PROVIDENCE 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. THE AMOUNTS REPORTED FOR THESE RELOCATION/HOUSING PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE.
Part I, Line 3	DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE ST. JOSEPH HEALTH, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE.
Part I, Lines 4a-b	THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE YEAR: TOM MCDONAGH - $491,471 SHARON TONCRAY - $421,300 JANICE NEWELL - $330,112 ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(iii) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR: ROD F. HOCHMAN, MD - $1,378,122 MIKE BUTLER - $795,755 ERIK WEXLER - $364,484 DEBRA CANALES - $613,775 RHONDA MEDOWS, MD - $283,794 CINDY STRAUSS - $344,018 AMY COMPTON-PHILLIPS, MD - $227,086 DALE SUROWITZ - $572,173 LISA VANCE - $103,747 JOEL GILBERTSON - $169,849 AARON MARTIN - $206,029 JO ANN ESCASA-HAIGH - $156,837 TOM MCDONAGH - $561,877 SHARON TONCRAY - $636,374 GREG TILL - $83,902 BERNIE KLEIN, MD - $199,765 MIKE WATERS - $155,073 JOHN WHIPPLE - $146,592 JANICE NEWELL - $289,417 OREST HOLUBEC - $156,821 DAVID BROWN - $143,978 DEBBIE BURTON - $57,156 GARRY OLNEY - $15,689 JACK MUDD - $32,116 RICHARD GLIMP - $14,690 GLEN KOMATSU - $22,024 HOWARD DAVIS - $12,225 SUSAN DOLBERT - $19,338 NICK LYMBEROPOULOS - $23,885 STEVEN MOHR - $107,880
Part I, Line 7	NON-FIXED PAYMENTS THE PROVIDENCE EXECUTIVE COMPENSATION COMMITTEE (OF THE BOARD) HAS APPROVED AN EXECUTIVE COMPENSATION PHILOSOPHY THAT CLOSELY TIES AN EXECUTIVE'S COMPENSATION TO PERFORMANCE BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE EXECUTIVE. THERE IS NO GUARANTEE THAT THIS PART OF A LEADER'S COMPENSATION WILL BE PAID IF THE PERFORMANCE OF THE ORGANIZATION OR OF THE INDIVIDUAL DOES NOT MEET THE PERFORMANCE STANDARDS FOR PAYMENT, NO PERFORMANCE-BASED PAYMENT IS MADE. THIS APPROACH IS REFLECTED IN PROVIDENCE'S LEADERSHIP ANNUAL INCENTIVE PLAN, WHICH IS A PERFORMANCE-BASED ANNUAL INCENTIVE PLAN THAT AFFORDS PARTICIPATING EXECUTIVES THE OPPORTUNITY TO EARN "AT RISK" COMPENSATION THROUGH PERFORMANCE AGAINST VERY CHALLENGING GOALS. PAYOUTS WILL BE AWARDED BASED ON GOALS RELATED TO STRATEGIC OBJECTIVES, FISCAL STEWARDSHIP AND QUALITY OF CARE THESE GOALS ARE SET BEFORE THE YEAR BEGINS AND ARE VERY CHALLENGING. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S PERFORMANCE GOALS TO MAKE SURE THEY ARE SUFFICIENTLY CHALLENGING, AND TO MAKE SURE THE GOALS ARE DESIGNED TO HELP PROVIDENCE MEET ITS MISSION AND STRATEGIC PURPOSES. EACH YEAR THE PSJH BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE INCENTIVE PERFORMANCE AND MUST CERTIFY THE ACHIEVEMENT OF PERFORMANCE GOALS BEFORE ANY AWARDS ARE PAID OUT. WHEN REVIEWING AND APPROVING TOTAL COMPENSATION FOR EXECUTIVES, THE EXECUTIVE COMPENSATION COMMITTEE INCLUDES INCENTIVE AWARDS, TO MAKE SURE THAT COMPENSATION IS REASONABLE AND WELL-SUPPORTED BY MARKET DATA. THE COMMITTEE CONSISTS ONLY OF DIRECTORS WHO ARE FREE OF CONFLICTS OF INTEREST, AND THE COMMITTEE RELIES ON MARKET SURVEY DATA GATHERED BY AN INDEPENDENT CONSULTANT. THE COMMITTEE CONDUCTS THIS REVIEW AND APPROVAL PROCESS IN A MANNER THAT IS IN ACCORDANCE WITH IRS REQUIREMENTS FOR COMPENSATION OF TAX-EXEMPT ORGANIZATION LEADERS, AND IN ACCORDANCE WITH THE BEST GOVERNANCE PRACTICES IN THE INDUSTRY.

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA

Employer identification number

51-0216589

Return Reference	Explanation
Form 990, Part III, Line 4a, Program Service Accomplishments (Continued):	* FOR MORE THAN 86 YEARS, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO HAS PROVIDED THE SOUTH BAY COMMUNITY WITH CLINICALLY EXCELLENT AND COMPASSIONATE HEALTHCARE AND THE SOUTH BAY'S FIRST CERTIFIED PRIMARY STROKE CENTER. * NATIONALLY RECOGNIZED FOR CLINICAL PERFORMANCE AND TRAUMA CARE, PROVIDENCE HOLY CROSS MEDICAL CENTER IN MISSION HILLS ALSO IS THE ONLY COMMUNITY HOSPITAL IN THE SAN FERNANDO VALLEY TO RECEIVE MAGNET STATUS FOR NURSING EXCELLENCE. IT IS ONE OF ONLY TWO 24/7 TRAUMA CENTERS IN THE SAN FERNANDO VALLEY. PROVIDENCE ST. ELIZABETH CARE CENTER IS A 52-BED SKILLED NURSING FACILITY. EVERY RESIDENT WHO LIVES AT THE CENTER EXPERIENCES A COMPASSIONATE, CARING AND COMFORTABLE ATMOSPHERE. EACH RESIDENT IS TREATED AS A SPECIAL PERSON, GIVING CAREFUL ATTENTION TO HIS OR HER TOTAL WELL-BEING. WE OFFER AN ARRAY OF HEALTH CARE SERVICES FOR RESIDENTS TO ENJOY THEMSELVES WITH FAMILY AND FRIENDS. TO COMPLEMENT OUR REPUTATION FOR CARING, OUR SPECIALLY TRAINED STAFF WORKS IN PARTNERSHIP WITH RESIDENTS, FAMILIES, DOCTORS, REFERRING HOSPITALS, AND HEALTH PROFESSIONALS TO MAKE SURE RESIDENTS' NEEDS ARE MET. WE ALSO PROVIDE FOR RESPIRATORY SERVICES, AS NEEDED. PROVIDENCE LITTLE COMPANY OF MARY TRANSITIONAL CARE CENTER, A SKILLED NURSING FACILITY IN TORRANCE, EARNED FIVE STARS FOR THE FOURTH STRAIGHT YEAR IN THE WEEK'S U.S. NEWS AND WORLD REPORT FEATURE LISTING THE NATION'S TOP NURSING HOMES. THE MAGAZINE'S PRESTIGIOUS RANKINGS WERE BASED ON U.S. CENTERS FOR MEDICARE AND MEDICAID SURVEYS THAT RATED THE 115-BED TRANSITIONAL CARE CENTER AMONG THE BEST CARE HOMES IN THE NATION BASED ON HEALTH INSPECTIONS, NURSE STAFFING, QUALITY MEASURES AND SAFETY. THE CARE CENTER IS AFFILIATED WITH PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE, A 436-BED ACUTE CARE HOSPITAL. PROVIDENCE LITTLE COMPANY OF MARY STANDS OUT AMONG SKILLED NURSING FACILITIES BECAUSE ITS PATIENTS TYPICALLY ARE NOT LONG-TERM. THE AVERAGE LENGTH-OF-STAY IS ABOUT TWO WEEKS, TIME FOR PATIENTS TO REHABILITATE FROM ACUTE-CARE HOSPITAL STAYS BEFORE HEADING HOME. U.S. NEWS EVALUATED MORE THAN 15,000 NURSING HOMES NATIONWIDE AND OVER 2,000 EARNED THE FIVE-STAR RATING. THE STAFF INCLUDES NURSES, PHYSICAL THERAPISTS, OCCUPATIONAL THERAPISTS, SPEECH THERAPISTS, RESPIRATORY THERAPISTS, DIETITIANS AND ADMINISTRATIVE SUPPORT AND THEIR FOCUS IS ALWAYS ON QUALITY CENTERED IN PROVIDENCE CORE VALUES AND OUR MISSION OF COMPASSIONATE SERVICE.
Form 990, Part III, Line 4a, Program Service Accomplishments (Continued):	PROVIDENCE HIGH SCHOOL FOR CHILDREN OF THE NORTHERN SAN FERNANDO VALLEY AND SURROUNDING AREA. PROVIDENCE HIGH SCHOOL WAS FOUNDED IN 1955 BY THE SISTERS OF PROVIDENCE. THIS IS A PRIVATE, CO-EDUCATIONAL, INDEPENDENT, COLLEGE PREPARATORY CATHOLIC HIGH SCHOOL. PROVIDENCE HIGH SCHOOL IS ACCREDITED BY THE WESTERN CATHOLIC EDUCATION ASSOCIATION (WCEA) AND THE WESTERN ASSOCIATION OF SCHOOLS AND COLLEGES (WASC), A MEMBER OF THE CALIFORNIA ASSOCIATION OF INDEPENDENT SCHOOLS (CAIS), AND IT IS A NATIONALLY RECOGNIZED BLUE RIBBON HIGH SCHOOL. PROVIDENCE HIGH SCHOOL INITIALLY STARTED AS AN ALL-GIRLS SCHOOL, BUT IN 1974 THE CAMPUS BECAME CO-EDUCATIONAL. TODAY THE 400+ STUDENTS ENJOY A FULL COLLEGE PREP CURRICULUM AS WELL AS ACCESS TO THREE FOCUS PROGRAMS; MEDICAL, CINEMA ARTS, AND TECHNOLOGY. PROVIDENCE HIGH SCHOOL ALSO OFFER AWARD WINNING PERFORMING ARTS, REWARDING CHRISTIAN SERVICE AND CAMPUS MINISTRY OPPORTUNITIES, COMPETITIVE ATHLETICS AND NUMEROUS CLUBS AND ACTIVITIES. GRANT & ALLOCATIONS - SEE SCHEDULE I.
FORM 990, PART V, LINE 15	INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF THE RELATED ORGANIZATION. IT IS THE INTENTION OF PROVIDENCE AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE EMPLOYEES OF A RELATED ORGANIZATION WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. THE RELATED ORGANIZATION COMMON LAW EMPLOYEES ARE INCLUDED IN THE RELATED ORGANIZATIONS SECTION 4960 TAX ANALYSIS AND REPORTING.
Form 990, Part VI, Section A, line 6	DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS PROVIDENCE HEALTH & SERVICES IS THE SOLE CORPORATE MEMBER OF PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA.
Form 990, Part VI, Section A, line 7a	DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT DIRECTORS TO THE PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA BOARD. ALL DIRECTOR NOMINATIONS THAT COME FROM THE PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE HEALTH & SERVICES, AS THE CORPORATE MEMBER.
Form 990, Part VI, Section A, line 7b	CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL AND TYPE OF VOTING RIGHTS THE FOLLOWING POWERS RESIDE WITH THE CORPORATE MEMBER: 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 RELIGIOUS 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 ENTITY OR WORK OF THE CORPORATION.
Form 990, Part VI, Section B, line 11b	PROCESS TO REVIEW FORM 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES.
Form 990, Part VI, Section B, line 12c	PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE REGULARLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY.
Form 990, Part VI, Section B, line 15	PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY ITS TAX EXEMPT PARENT, PROVIDENCE ST. JOSEPH HEALTH, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. 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 ENTITY 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 SENIOR EXECUTIVES, INCLUDING ALL OFFICERS. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED AT LEAST ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS A COMMITTEE OF THE PROVIDENCE BOARD CONSISTING ONLY OF OUTSIDE, INDEPENDENT DIRECTORS. THE COMMITTEE MAKES SURE, AT EACH OF ITS MEETINGS, THAT NO MEMBER OF THE COMMITTEE HAS A CONFLICT OF INTEREST AS TO ANY EXECUTIVE WHOSE COMPENSATION IS REVIEWED BY THE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE 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 THAT ARE SUBSTANTIALLY SIMILAR TO PROVIDENCE IN SIZE AND COMPLEXITY (SUCH AS HAVING A SIMILAR AMOUNT OF ANNUAL NET REVENUE). ADDITIONALLY, BECAUSE PROVIDENCE OFTEN LOOKS TO GENERAL INDUSTRY FOR LEADERS IN CERTAIN FUNCTIONAL AREAS, PROVIDENCE ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY MARKET DATA IN THESE SPECIAL SITUATIONS. BASE SALARIES FOR PROVIDENCE EXECUTIVES ARE GENERALLY TARGETED TO THE "MEDIAN" LEVEL OF THE MARKET DATA (WHERE HALF THE SALARIES IN THE DATA ARE LOWER AND HALF THE SALARIES IN THE DATA ARE HIGHER), AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. 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 EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. TOTAL COMPENSATION IS TIED CLOSELY TO PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY HELP LEAD PROVIDENCE IN ACHIEVING SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE'S OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR SETTING, REVIEWING AND APPROVING EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS (TO ASSURE THAT ALL COMPENSATION IS CONSIDERED REASONABLE) AND REFLECTS BEST GOVERNANCE PRACTICES IN THE INDUSTRY. THE PROCESS WAS LAST COMPLETED IN 2020.
Form 990, Part VI, Section C, line 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE PROVIDENCE COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, CONSOLIDATED AUDITED FINANCIAL STATEMENTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PROVIDENCE INTERNET SITE.
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.
Form 990, Part IX, line 11g	AGENCY/CONTRACT LABOR: Program service expenses 26,539,937. Management and general expenses 3,215,667. Fundraising expenses 0. Total expenses 29,755,604. MEDICAL DIRECTOR & MED PHYSICIAN FEES: Program service expenses 40,581,898. Management and general expenses 10,175,582. Fundraising expenses 0. Total expenses 50,757,480. REPAIRS & MAINTENANCE: Program service expenses 15,254,574. Management and general expenses 16,328,660. Fundraising expenses 18,630. Total expenses 31,601,864. BILLING & COLLECTIONS: Program service expenses 13,126. Management and general expenses 336,165. Fundraising expenses 0. Total expenses 349,291. OTHER PATIENT SERVICES: Program service expenses 29,754,247. Management and general expenses 927,178. Fundraising expenses 0. Total expenses 30,681,425. GENERAL CONSULTING FEES: Program service expenses 21,850,685. Management and general expenses 30,098,781. Fundraising expenses 48,356. Total expenses 51,997,822.
Form 990, Part XI, line 9:	NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS 764,587,147. FAS 136 - RECIPIENT ORGANIZATION ADJUSTMENT 19,253,241. OTHER -1,164,090.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA

Employer identification number

51-0216589

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) BELL RIVER LLC 20555 EARL ST TORRANCE,CA90503 51-0216589	RENTAL	CA	90,000	77,646	PHS - SO CALIFORNIA
(2) CALIFORNIA LABORATORY ASSOCIATES LLC 501 BUENA VISTA BURBANK,CA91505 27-3888692	OUTPATIENT LAB	CA	0	0	PHS - SO CALIFORNIA
(3) PROVIDENCE PARTNERS FOR HEALTH LLC 20555 EARL ST TORRANCE,CA90503 45-4041798	CLIN QUALITY/INT	CA	0	0	PHS - SO CALIFORNIA

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)COVENANT ACO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 61-1573313	HEALTHCARE	TX	501(c)(3)	12,I	CHS	Yes
(2)COVENANT HEALTH NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 46-1259908	HEALTHCARE	CA	501(c)(3)	12,III	SJHS	Yes
(3)COVENANT HEALTH PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 46-3516417	HEALTHCARE	TX	501(c)(3)	12,I	CHS	Yes
(4)COVENANT HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2765566	HEALTHCARE	TX	501(c)(3)	3	SJHS	Yes
(5)COVENANT HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2897026	HEALTHCARE	TX	501(c)(3)	7	CHS	Yes
(6)COVENANT HOSPITAL HOBBS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 84-4273963	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(7)COVENANT MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 82-2913146	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(8)COVENANT MEDICAL GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2743883	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(9)E WA & MT UNEMPLOYMENT COMPENSATION INSURANCE TRUST 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1082119	UNEMPLOYMENT	WA	501(c)(3)	12,I	PHS WA	Yes
(10)EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT,WA982065128 94-3264605	TRANS. CARE	WA	501(c)(3)	10	N/A		No
(11)FACEY MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-4322584	SUPPORT	CA	501(c)(3)	7	PHS SOCAL	Yes
(12)GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 20-1910170	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(13)GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC,WA98188 27-3133200	HEALTHCARE	WA	501(c)(3)	7	SHS	Yes
(14)GRACE CLINIC OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 20-3856995	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(15)HMTS INC 1 HOAG DRIVE NEWPORT BEACH,CA92658 45-3583707	HEALTHCARE	CA	501(c)(3)	12,I	HMHP	Yes
(16)HOAG CHARITY SPORTS 2081 BUSINESS CENTER DR STE 195 NEWPORT BEACH,CA92663 45-2982422	SUPPORT	CA	501(c)(3)	7	HHF	Yes
(17)HOAG CLINIC 1 HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92658 33-0676831	HEALTHCARE	CA	501(c)(3)	10	HMHP	Yes
(18)HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH,CA92663 95-3222343	FUNDRAISING	CA	501(c)(3)	7	HMHP	Yes
(19)HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG ROAD BOX 6100 NEWPORT BEACH,CA92663 95-1643327	HEALTHCARE	CA	501(c)(3)	3	CHN	Yes
(20)HOSPICE OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2133781	HEALTHCARE	TX	501(c)(3)	10	CHS	Yes
(21)INLAND NORTHWEST HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1307555	HEALTHCARE	WA	501(c)(3)	3	PHS WA	Yes
(22)INSTITUTE FOR MENTAL HEALTH & WELLNESS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-4260130	HEALTHCARE	WA	501(c)(3)	7	PHS SJHS	Yes
(23)INSTITUTE FOR SYSTEMS BIOLOGY 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-2003593	HEALTHCARE	WA	501(c)(3)	7	WHC	Yes
(24)JOHN WAYNE CANCER INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-4291515	HEALTHCARE	CA	501(c)(3)	4	PSJHC	Yes
(25)KADLEC AUXILIARY INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-6033089	SUPPORT	WA	501(c)(3)	12,III	KRMC	Yes
(26)KADLEC FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 23-7005501	SUPPORT	WA	501(c)(3)	7	KRMC	Yes
(27)KADLEC REGIONAL MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-0655392	HEALTHCARE	WA	501(c)(3)	3	WHC	Yes
(28)LITTLE COMPANY OF MARY ANCILLARY SERVICES CORPORATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 33-0844408	IMAGING SVCS	CA	501(c)(3)	10	PHS SOCAL	Yes
(29)LUBBOCK HERITAGE HOSPITAL LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 26-4021016	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(30)LUBBOCK METHODIST HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2220963	HEALTHCARE	TX	501(c)(3)	7	CHS	Yes
(31)LUNDBERG ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1562797	SUPPORT	OR	501(c)(3)	7	PHS OR	Yes
(32)MARSHA RIVKIN CENTER FOR OVARIAN CANCER RESEARCH 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-2054035	RESEARCH	WA	501(c)(3)	7	SHS	Yes
(33)METHODIST CHILDREN'S HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2428911	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(34)METHODIST HOSPITAL LEVELLAND 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2246348	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(35)METHODIST HOSPITAL PLAINVIEW 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2426010	HEALTHCARE	TX	501(c)(3)	3	CHS	Yes
(36)MISSION HOSPITAL REGIONAL MEDICAL CTR 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-1643360	HEALTHCARE	CA	501(c)(3)	3	CHN	Yes
(37)NORTHWEST HOPE & HEALING FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 20-0799737	SUPPORT	WA	501(c)(3)	12,I	SHS	Yes
(38)PACMED CLINICS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 56-2290878	HEALTHCARE	WA	501(c)(3)	10	WHC	Yes
(39)PH&S FOUNDATIONSFVSA & SCVSA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-3544877	HEALTHCARE	CA	501(c)(3)	7	PHS SOCAL	Yes
(40)PROVIDENCE ALASKA FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 92-0093565	HEALTHCARE	AK	501(c)(3)	7	PHS WA	Yes
(41)PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1940286	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(42)PROVIDENCE BLANCHET ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1789266	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(43)PROVIDENCE CHILDREN'S HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 93-0800140	SUPPORT	OR	501(c)(3)	7	PHS OR	Yes
(44)PROVIDENCE COMMUNITY HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 93-0692907	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(45)PROVIDENCE DETHMAN HOUSE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 47-3385506	SUPPORT	WA	501(c)(3)	7	N/A		No
(46)PROVIDENCE GAMELIN HOUSE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 31-1744654	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(47)PROVIDENCE HEALTH & SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1549796	HEALTHCARE	WA	501(c)(3)	12,II	PSJH		No
(48)PROVIDENCE HEALTH & SERVICES - MONTANA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-0231793	HEALTHCARE	MT	501(c)(3)	3	PHS WA	Yes
(49)PROVIDENCE HEALTH & SERVICES - OREGON 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 51-0216587	HEALTHCARE	OR	501(c)(3)	3	PHS	Yes
(50)PROVIDENCE HEALTH & SERVICES - WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 51-0216586	HEALTHCARE	WA	501(c)(3)	3	PHS	Yes
(51)PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1303277	HEALTHCARE	WA	501(c)(3)	3	PMWHC	Yes
(52)PROVIDENCE HEALTH ASSURANCE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 55-0828701	MEDICAID	OR	501(c)(4)	N/A	PHP	Yes
(53)PROVIDENCE HEALTH CARE FOUNDATION - EASTERN WASHINGTON 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 32-0014330	HEALTHCARE	WA	501(c)(3)	7	PHS WA	Yes
(54)PROVIDENCE HEALTH CARE FOUNDATION (CENTRALIA) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1433382	HEALTHCARE	WA	501(c)(3)	7	PHS W WA	Yes
(55)PROVIDENCE HEALTH PLAN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 93-0863097	HEALTHCARE	OR	501(c)(4)	N/A	PPP	Yes
(56)PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 93-0921990	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(57)PROVIDENCE HOSPICE AND HOME CARE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 27-2552749	HEALTHCARE	WA	501(c)(3)	7	PHS W WA	Yes
(58)PROVIDENCE HOSPICE OF SEATTLE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-2077378	HEALTHCARE	WA	501(c)(3)	7	PHS W WA	Yes
(59)PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 51-0224944	HEALTHCARE	CA	501(c)(3)	7	PHS SOCAL	Yes
(60)PROVIDENCE MARIANWOOD FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 93-1554288	HEALTHCARE	WA	501(c)(3)	7	PHS W WA	Yes
(61)PROVIDENCE MEDICAL INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 33-0283773	HEALTHCARE	CA	501(c)(3)	12,I	PHS SOCAL	Yes
(62)PROVIDENCE MILWAUKIE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 94-3079515	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(63)PROVIDENCE MINISTRIES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057	RELIGIOUS ORG	WA	501(c)(3)	1	N/A		No
(64)PROVIDENCE MOUNT ST VINCENT FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1188119	HEALTHCARE	WA	501(c)(3)	7	PHS WA	Yes
(65)PROVIDENCE NEWBERG HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 93-0889144	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(66)PROVIDENCE PETER CLAVER ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 31-1629656	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(67)PROVIDENCE PLAN PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1861964	HEALTHCARE	WA	501(c)(4)	N/A	PHS OR	Yes
(68)PROVIDENCE PORTLAND MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 93-1231494	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(69)PROVIDENCE ROSSI ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 31-1584166	SUPPORT	WA	501(c)(3)	10	PHS WA	Yes
(70)PROVIDENCE SAINT JOHN'S HEALTH CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-1684082	HEALTHCARE	CA	501(c)(3)	3	PHS SOCAL	Yes
(71)PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-4542216	HEALTHCARE	CA	501(c)(3)	3	PHS SOCAL	Yes
(72)PROVIDENCE SEASIDE HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 93-0927320	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(73)PROVIDENCE ST ELIZABETH HOUSE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-2171539	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(74)PROVIDENCE ST FRANCIS ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 94-3244854	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(75)PROVIDENCE ST JOSEPH HEALTH 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-1244422	HEALTHCARE	WA	501(c)(3)	12,III	N/A		No
(76)PROVIDENCE ST JOSEPH HEALTH FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 94-3078543	HEALTHCARE	WA	501(c)(3)	7	PHS WA	Yes
(77)PROVIDENCE ST JOSEPH MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-0463482	HEALTHCARE	MT	501(c)(3)	3	PHS WA	Yes
(78)PROVIDENCE ST MARY FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 45-2841492	HEALTHCARE	WA	501(c)(3)	7	PHS WA	Yes
(79)PROVIDENCE ST PETER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1097056	SUPPORT	WA	501(c)(3)	7	PHS W WA	Yes
(80)PROVIDENCE ST VINCENT MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 93-0575982	HEALTHCARE	OR	501(c)(3)	7	PHS OR	Yes
(81)PROVIDENCE TRINITYCARE HOSPICE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-3264139	HEALTHCARE	CA	501(c)(3)	10	PHS SOCAL	Yes
(82)PROVIDENCE TRINITYCARE HOSPICE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 33-0261016	HEALTHCARE	CA	501(c)(3)	7	PTCH	Yes
(83)PROVIDENCE WILLAMETTE FALLS MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 93-1003750	HEALTHCARE	OR	501(c)(3)	12, I	PHS OR	Yes
(84)QUEEN OF THE VALLEY MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 94-1243669	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(85)REDWOOD MEMORIAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 94-2779313	HEALTHCARE	CA	501(c)(3)	7	RMH	Yes
(86)REDWOOD MEMORIAL HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 94-1384665	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(87)SAINT JOHN'S HOSPITALHEALTH CENTER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-6100079	SUPPORT	CA	501(c)(3)	7	PSJHC	Yes
(88)SANTA ROSA MEMORIAL HOSPITAL 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 94-1231005	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(89)SEATTLE SCIENCE FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 61-1502822	PHYSN COLLAB	WA	501(c)(3)	7	WHC	Yes
(90)SISTERS OF PROVIDENCE OF MONTANA CORPORATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 26-2612415	SHELL CORP	MT	501(c)(3)	1	PHS WA		No
(91)SISTERS OF ST JOSEPH OF ORANGE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-1643383	RELIGIOUS ORG	CA	501(c)(3)	1	N/A		No
(92)SRM ALLIANCE HOSPITAL SERVICES (PVH) 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 68-0395200	HEALTHCARE	CA	501(c)(3)	3	SRMH	Yes
(93)ST JOSEPH HEALTH MINISTRY 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 27-1666576	RELIGIOUS ORG	CA	501(c)(3)	1	SSJO		No
(94)ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-4791043	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(95)ST JOSEPH HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-3589356	HEALTHCARE	CA	501(c)(3)	12,I	PSJH		No
(96)ST JOSEPH HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 33-0143024	HEALTHCARE	CA	501(c)(3)	10	SJHS	Yes
(97)ST JOSEPH HERITAGE HEALTHCARE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 33-0185031	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(98)ST JOSEPH HOME CARE NETWORK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 68-0331084	HEALTHCARE	CA	501(c)(3)	10	SJHS	Yes
(99)ST JOSEPH HOSPITAL OF EUREKA 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 94-1156596	HEALTHCARE	CA	501(c)(3)	3	SJHS	Yes
(100)ST JOSEPH HOSPITAL OF ORANGE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-1643359	HEALTHCARE	CA	501(c)(3)	3	CHN	Yes
(101)ST JUDE HOSPITAL INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-1643324	HEALTHCARE	CA	501(c)(3)	3	CHN	Yes
(102)ST LUKE ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 94-3176618	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(103)ST MARY MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-1914489	HEALTHCARE	CA	501(c)(3)	3	CHN	Yes
(104)ST MARY OF THE PLAINS HOSPITAL FDN 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-1653181	HEALTHCARE	TX	501(c)(3)	7	CHS	Yes
(105)ST PATRICK HOSPITAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 23-7056976	HEALTHCARE	MT	501(c)(3)	7	PHS WA	Yes
(106)ST THOMAS CHILD AND FAMILY CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-0233495	EDUCATION	MT	501(c)(3)	10	PHS WA	Yes
(107)SWEDISH EDMONDS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 27-2305304	HEALTHCARE	WA	501(c)(3)	3	WHC	Yes
(108)SWEDISH HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-0433740	HEALTHCARE	WA	501(c)(3)	3	WHC	Yes
(109)SWEDISH MEDICAL CENTER FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-0983214	HEALTHCARE	WA	501(c)(3)	7	SHS	Yes
(110)SWEDISH MJM HOLDINGS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 27-3139262	HOLDING CO	WA	501(c)(3)	12,I	SHS	Yes
(111)TARZANA MEDICAL CENTER LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 83-3972614	HEALTHCARE	CA	501(c)(3)	3	PHS SOCAL	Yes
(112)THE GAMELIN ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1180824	SUPPORT	WA	501(c)(3)	7	PHS WA	Yes
(113)THE GAMELIN CALIFORNIA ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1293869	SUPPORT	CA	501(c)(3)	10	PHS SOCAL	Yes
(114)THE GAMELIN OREGON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 91-1214491	SUPPORT	OR	501(c)(3)	10	PHS OR	Yes
(115)UNIVERSITY OF PROVIDENCE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-0231777	EDUCATION	MT	501(c)(3)	2	PHS	Yes
(116)WESTERN HEALTHCONNECT 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 45-4171900	SHELL CORPORATION	WA	501(c)(3)	12,II	PHS W WA	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) 20TH STREET SURGERY LLC 1301 20TH STREET STE 140 SANTA MONICA,CA90404 73-1735618	AMBULATORY SURG	CA	N/A
(2) BROADWAY IMAGING LLC 500 W BROADWAY MISSOULA,MT59802 52-2405971	MEDICAL IMAGING	MT	N/A
(3) CENTER FOR MATERNAL NEWBORN AND CHILD 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-3526875	HEALTHCARE	CA	N/A
(4) CLACKAMAS RADIATION ONCOLOGY CENTER LLC 4400 NE HALSEY ST BLDG II 495 PORTLAND,OR97213 26-0381897	RADIATION ONCOL	OR	N/A
(5) COASTAL ASC HOLDINGS LLC ONE HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92663 81-0986844	HEALTHCARE	CA	N/A
(6) COVENANT LONG-TERM CARE LP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 20-5033419	HEALTHCARE	TX	N/A
(7) BRIDGEPORT MEDICAL IMAGING (BMI) 4400 NE HALSEY 495 PORTLAND,OR97213 26-0796953	IMAGING DIAG.	OR	N/A
(8) CENTER FOR MEDICAL IMAGING (CMI) 4400 NE HALSEY 495 PORTLAND,OR97213 20-0477972	IMAGING DIAG.	OR	N/A
(9) FULLERTON SURGICAL CENTER LP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 47-0927394	AMBULATORY SURG	CA	N/A
(10) GREATER VALLEY MEDICAL BUILDING LP 501 S BUENA VISTA ST BURBANK,CA91505 95-4570858	REAL ESTATE - MOB	CA	PHS SOCAL	INVESTMENT	645,858	8,463,120		No		Yes		50.000 %
(11) HCSA PROPERTIES LLC 1600 M STREET NW AUBURN,WA98001 46-0620892	REAL ESTATE RENT	WA	N/A
(12) HERITAGE INVESTMENT GROUP I LLC 500 S MAIN STREET STE 1000 ORANGE,CA92868 27-1000061	INVESTMENTS	CA	N/A
(13) HOAG ORTHOPEDIC INSTITUTE ONE HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92658 61-1588294	HEALTHCARE	CA	N/A
(14) IMAGING ASSOCIATES LLC 3650 PIPER STREET STE A ANCHORAGE,AK99508 20-3906048	MEDICAL IMAGING	AK	N/A
(15) INLAND IMAGING LLC 801 S STEVENS ST SPOKANE,WA99204 91-1855796	MEDICAL IMAGING	WA	N/A
(16) LSC REAL PROPERTY LLC 2301 QUAKER AVENUE LUBBOCK,TX79410 47-4646059	REAL ESTATE	TX	N/A
(17) METHODIST DIAGNOSTIC IMAGING 4005 24TH STREET LUBBOCK,TX79410 75-2343261	HEALTHCARE	TX	N/A
(18) NEWPORT IMAGING CENTER 360 SAN MIGUEL NEWPORT BEACH,CA92660 33-0191776	HEALTHCARE	CA	N/A
(19) NEWPORT SURGICAL PARTNERS LLC 27271 LAS RAMBLAS 350 MISSION VIEJO,CA92691 39-2060266	HEALTHCARE	CA	N/A
(20) OREGON ADVANCED IMAGING LLC 881 OHARE PARKWAY MEDFORD,OR97504 45-0471748	MEDICAL IMAGING	OR	N/A
(21) OREGON OUTPATIENT SURGERY CENTER 7300 SW CHILDS RD TIGARD,OR97224 22-3883387	AMBULATORY SURG	OR	N/A
(22) PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC 1221 MADISON STREET SEATTLE,WA98104 20-3132044	MEDICAL IMAGING	WA	N/A
(23) PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-2701056	INVESTMENTS	WA	N/A
(24) PROV RADIATION ONCOLOGY DEVELOP ASSN 4400 NE HALSEY 495 PORTLAND,OR97213 26-0682491	REAL ESTATE - MOB	OR	N/A
(25) PROVIDENCE CHILDREN'S NEONATAL SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 47-0918549	NEONATAL CARE	WA	N/A
(26) PROVIDENCE HOUSE HEARING HEALTH CENTERS LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057	HEALTHCARE	CA	N/A
(27) PROVIDENCE IMAGING CENTER JOINT VENTURE 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 92-0118807	MEDICAL IMAGING	AK	N/A
(28) PROVIDENCE ST JOSEPH HEALTH LONG TERM PORTFOLIO 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 82-3190634	INVESTMENTS	WA	PHS WA	EXCLUDED	267,251	6,999,121		No			No	0.120 %
(29) PROVIDENCE SURGERY CENTER LLC 902 N ORANGE ST MISSOULA,MT59802 84-1401625	AMBULATORY SURG	MT	N/A
(30) PROVIDENCESILVERTON REHAB LLC 4400 NE HALSEY 425 PORTLAND,OR97213 48-1287267	REHAB SERVICES	OR	N/A
(31) PROVIDENCE UCLA USP SURGERY CENTER JV 15305 DALLAS PKWY STE 1600 LB 28 ADDISON,TX75001 32-0503030	AMBULATORY SURG	CA	PHS SOCAL	RELATED	-1,030,804	4,868,792		No			No	72.200 %
(32) PROVIDENCEUSP SOUTH BAY SURGERY CENTERS 15305 DALLAS PKWY STE 1600 LB 28 ADDISON,TX75001 47-5064486	AMBULATORY SURG	CA	PHS SOCAL	RELATED	129,891	6,913,822		No			No	49.950 %
(33) PROVIDENCEUSP SURGERY CENTERS LLC 11550 INDIAN HILLS ROAD 160 MISSION HILLS,CA91345 20-0684116	AMBULATORY SURG	CA	PHS SOCAL	RELATED	799,650	1,843,454		No			No	49.950 %
(34) RADIATION THERAPY INNOVATIONS LLC 1221 MADISON STREET 1ST FL SEATTLE,WA98104 30-0553035	HEALTHCARE	WA	N/A
(35) REDMOND AMBULATORY SURGERY CENTER LLC 805 MADISON ST STE 901 SEATTLE,WA98104 81-3558711	AMBULATORY SURG	WA	N/A
(36) SANTA ANA MOB LLC 1800 QUAIL STREET STE 100 NEWPORT BEACH,CA92660 75-3205306	REAL ESTATE - MOB	CA	N/A
(37) SHA LLC 12940 NORTH HIGHWAY 183 AUSTIN,TX78750 75-2569094	HEALTHCARE	TX	N/A
(38) SJO ASC HOLDINGS LLC 1140 W LA VETA AVE ORANGE,CA92868 82-1655501	HEALTHCARE	CA	N/A
(39) ST JOSEPH PHYSICIAN VENTURES I LLC 1100 WEST STEWART DRIVE ORANGE,CA92868 45-4521884	REAL ESTATE	CA	N/A
(40) ST JOSEPHSATELLITE DIALYSIS CENTERS LLC 300 SANTANA ROW STE 300 SAN JOSE,CA95128 81-4657391	HEALTHCARE	CA	N/A
(41) ST JUDE SURGICAL CENTERS LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 82-3352570	AMBULATORY SURG	CA	N/A
(42) SURGERY CENTER AT TANASBOURNE LLC 11221 ROE AVE STE 300 LEAWOOD,KS66211 20-8187971	AMBULATORY SURG	KS	N/A
(43) TARZANA PEDIATRIC VENTURES LLC 18321 CLARK ST TARZANA,CA91356 82-1308306	HEALTHCARE	CA	PHS SOCAL	RELATED		-422,803		No			No	50.000 %
(44) THE MADISON SPOKANE INN LLC 15 WEST ROCKWOOD BLVD SPOKANE,WA99204 84-1606484	HOTEL SERVICES	WA	N/A
(45) YELM MEDICAL OFFICE BUILDING 2840 CRITES ST SW STE 104 TUMATER,WA98512 26-3685020	REAL ESTATE - MOB	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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) 1221 MADISON STREET OWNERS ASSOC 747 BROADWAY SEATTLE,WA98122 20-1954319	OWNERS' ASSOC.	WA	N/A	C					No
(2) AMERICAN UNITY GROUP LTD 90 PITTS BAY ROAD PEMBROKE BD	CAPTIVE INSURANCE	BD	N/A	C					No
(3) AYIN HEALTH SOLUTIONS INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 83-3037172	HEALTHCARE	DE	N/A	C					No
(4) BLUETREE NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 90-0872936	HEALTHCARE	WI	N/A	C					No
(5) BOURGET HEALTH SERVICES INC 101 W 8TH AVE TAF C-9 SPOKANE,WA99220 91-1354431	CLIN/MED LAB	WA	N/A	C					No
(6) CARON HEALTH CORPORATION 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 81-0486082	MED PHYS SVCS	MT	N/A	C					No
(7) COMMUNITY TECHNOLOGIES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 84-4722399	IT SVCS	DE	N/A	C					No
(8) DATU HEALTH INC AND SUBSIDIARIES 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 46-3070062	IT SVCS	DE	N/A	C					No
(9) ENGAGE IT SERVICES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 84-4058573	IT SVCS	DE	N/A	C					No
(10) HOAG MANAGEMENT SERVICES INC 1 HOAG DRIVE BOX 6100 NEWPORT BEACH,CA92658 33-0731587	HEALTHCARE	CA	N/A	C					No
(11) HOAG PHYSICIAN PARTNERS 16148 SAND CANYON AVE IRVINE,CA92618 83-4276044	HEALTHCARE	CA	N/A	C					No
(12) LUBBOCK METHODIST HOSP PRACTICE MGMT 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2578995	INACTIVE	TX	N/A	C					No
(13) LUBBOCK METHODIST HOSPITAL SVCS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 75-2118585	HEALTHCARE	TX	N/A	C					No
(14) LUMEDIC ACQUISITION CO INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 83-3881097	HEALTHCARE	WA	N/A	C					No
(15) MISSION VIEJO MEDICAL VENTURES 27800 MEDICAL CENTER RD MISSION VIEJO,CA92691 33-0212905	HEALTHCARE	CA	N/A	C					No
(16) PERFORMANCE HEALTH TECHNOLOGY LTD 3993 FAIRVIEW INDUSTRIAL DR SE SALEM,OR97302 93-1211733	HEALTHCARE	OR	N/A	C					No
(17) MEDIREVV INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 20-8783763	HEALTHCARE	DE	N/A	C					No
(18) PHN HOLDINGS 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 46-1814184	STRAT PLAN SVCS	CA	PHS SOCAL	C		10,000	100.000 %	Yes
(19) PIONEER INNOVATIONS INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 36-4818191	HEALTH INNOVATNS	WA	N/A	C					No
(20) PROVIDENCE ASSURANCE INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 20-8194071	CAPTIVE INSURANCE	AZ	N/A	C					No
(21) PROVIDENCE GLOBAL CENTER LLP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 98-1516461	IT SVCS	IN	N/A	C					No
(22) PROVIDENCE HEALTH CARE VENTURES INC 101 W 8TH AVE TAF C-9 SPOKANE,WA99220 90-0155714	CLIN/MED LAB	WA	N/A	C				Yes
(23) PROVIDENCE HEALTH NETWORK 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 80-0886966	PREPAID HEALTH	CA	N/A	C					No
(24) PROVIDENCE HEALTH VENTURES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 33-0122216	INVESTMENT	CA	PHS SOCAL	C		2,886,525	100.000 %	Yes
(25) PROVIDENCE PHYSICIAN SERVICES CO 101 W 8TH AVE TAF C-9 SPOKANE,WA99220 91-1216033	HEALTHCARE	WA	N/A	C					No
(26) PROVIDENCE RCM GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 84-4686520	HOLDING COMPANY	DE	N/A	C					No
(27) PROVIDENCE SERVICES GROUP INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 84-4704409	HOLDING COMPANY	DE	N/A	C					No
(28) ST JOSEPH HEALTH 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 46-2340232	HOLDING COMPANY	CA	N/A	C					No
(29) ST JOSEPH HEALTH SOURCE INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 46-1900168	HEALTHCARE	CA	N/A	C					No
(30) ST JOSEPH PROF SVCS ENTERPRSES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 33-0155323	HEALTHCARE	CA	N/A	C					No
(31) VINSERRA INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 95-3943315	INVESTMENTS	CA	N/A	C					No
(32) WESTERN HEALTHCONNECT VENTURES INC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 80-0953654	INVESTMENTS	WA	N/A	C					No
(33) ENDOSCOPY CENTER OF SOUTHERN CALIFORNIA 1301 20TH ST STE 280 SANTA MONICA,CA90404 95-2880495	HEALTHCARE	CA	N/A	S					No
(34) GRADY BLOCKER LLC 1801 LIND AVE SW ATTN TAX DEPT RENTON,WA98057 84-2092143	HOLDING COMPANY	DE	N/A	C					No
(35) PROVIDENCE ST JOSEPH HEALTH NETWORK 20555 EARL ST TORRANCE,CA90503 82-3771547	HEALTHCARE	CA	N/A	C					No

Schedule R (Form 990) 2019

Page 3

Part V

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

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

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

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

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

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

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

Yes

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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) GREATER VALLEY MEDICAL BUILDING LP	L	5,413,048	COST
(2) JOHN WAYNE CANCER INSTITUTE	A	3,222	COST
(3) GREATER VALLEY MEDICAL BUILDING LP	J	3,000,000	COST
(4) JOHN WAYNE CANCER INSTITUTE	Q	1,252,092	COST
(5) JOHN WAYNE CANCER INSTITUTE	J	116,159	COST
(6) LCM ANCILLARY SERVICES CORPORATION	L	16,245,869	COST
(7) LCM ANCILLARY SERVICES CORPORATION	J	4,247,710	COST
(8) LCM ANCILLARY SERVICES CORPORATION	R	2,331,121	COST
(9) PROVIDENCE HEALTH & SERVICES WASHINGTON	R	134,585,944	COST
(10) PROVIDENCE HEALTH & SERVICES WASHINGTON	A	38,932,315	COST
(11) PROVIDENCE HEALTH & SERVICES WASHINGTON	L	5,706,399	COST
(12) PROVIDENCE HEALTH & SERVICES WASHINGTON	J	3,259,911	COST
(13) PROVIDENCE HEALTH & SERVICES WASHINGTON	O	180,349	COST
(14) PROVIDENCE HEALTH & SERVICES FOUNDATION VSA	R	772,711	COST
(15) PROVIDENCE HEALTH NETWORK	O	5,823,507	COST
(16) PROVIDENCE HEALTH NETWORK	R	323,844	COST
(17) PROVIDENCE HEALTH NETWORK	A	272,361	COST
(18) PROVIDENCE HEALTH & SERVICES WASHINGTON	S	61,999,285	COST
(19) PROVIDENCE SAINT JOHNS HEALTH CENTER	S	12,651,167	COST
(20) PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION	C	13,105,670	COST
(21) PROVIDENCE HEALTH & SERVICES FOUNDATION VSA	C	13,374,708	COST
(22) PROVIDENCE MEDICAL INSTITUTE	S	7,425,851	COST
(23) PROVIDENCE TRINITYCARE HOSPICE	S	4,116,075	COST
(24) PROVIDENCE MEDICAL INSTITUTE	S	4,018,643	COST
(25) VINSERRA INC	S	2,362,374	COST
(26) PROVIDENCE HEALTH VENTURES INC	S	470,949	COST
(27) PROVIDENCE HEALTH & SERVICES WASHINGTON	S	186,125	COST
(28) LCM ANCILLARY SERVICES CORPORATION	S	156,931	COST
(29) PROVIDENCE HEALTH VENTURES INC	L	141,042	COST
(30) PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION	R	574,515	COST
(31) PROVIDENCE MEDICAL INSTITUTE	R	27,908,132	COST
(32) PROVIDENCE MEDICAL INSTITUTE	J	6,836,787	COST
(33) PROVIDENCE MEDICAL INSTITUTE	L	136,800	COST
(34) PROVIDENCE SAINT JOHNS HEALTH CENTER	R	61,934,343	COST
(35) PROVIDENCE SAINT JOHNS HEALTH CENTER	J	1,502,114	COST
(36) PROVIDENCE SAINT JOHNS HEALTH CENTER	A	451,314	COST
(37) PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION	R	13,588,618	COST
(38) PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION	J	8,738,335	COST
(39) PROVIDENCE TRINITYCARE HOSPICE	R	3,117,054	COST
(40) PROVIDENCE TRINITYCARE HOSPICE	O	2,111,758	COST
(41) PROVIDENCE TRINITYCARE HOSPICE	L	1,714,969	COST
(42) PROVIDENCE TRINITYCARE HOSPICE	Q	426,442	COST
(43) PROVIDENCE TRINITYCARE HOSPICE	J	218,996	COST
(44) ST JOSEPH HEALTH SYSTEM	L	737,984	COST
(45) ST JOSEPH HEALTH SYSTEM	J	188,399	COST
(46) FACEY MEDICAL FOUNDATION	B	478,285	COST
(47) PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION	B	678,891	COST
(48) PROVIDENCE MEDICAL INSTITUTE	B	1,488,515	COST
(49) PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION	B	3,795,837	COST
(50) PROVIDENCE HEALTH & SERVICES FOUNDATION VSA	B	6,091,497	COST

Schedule R (Form 990) 2019

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2019

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) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE OAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	15
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	12,325
6	Total number of volunteers (estimate if necessary) .............	6	3,560
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	230,000
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	204,268

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	19,539,151	27,226,224
9	Program service revenue (Part VIII, line 2g) .........	1,916,992,673	1,906,282,030
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	5,663,886	11,308,442
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	18,229,581	38,291,169
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,960,425,291	1,983,107,865
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,537,545	14,274,746
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)	747,558,304	759,413,409
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 3,501,354
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	703,300,896	706,555,216
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,453,396,745	1,480,243,371
19	Revenue less expenses. Subtract line 18 from line 12.......	507,028,546	502,864,494
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,902,254,815	1,897,782,886
21	Total liabilities (Part X, line 26).............	2,036,467,596	747,132,444
22	Net assets or fund balances. Subtract line 21 from line 20.....	-134,212,781	1,150,650,442

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,231,573,565 including grants of $ 14,274,746 ) (Revenue $ 1,938,077,519 )
	SEE SCHEDULE OPROVIDENCE ST. JOSEPH HEALTH SYSTEMON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 829 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE A CHANGING HEALTH CARE ENVIRONMENT WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE.PROVIDENCE HEALTH & SERVICESIN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. TODAY, PROVIDENCE SERVES ALASKA, CALIFORNIA, MONTANA, OREGON AND WASHINGTON.ST. JOSEPH HEALTH SYSTEMIN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA.OUR CORE VALUES - RESPECT, COMPASSION, JUSTICE, EXCELLENCE, AND STEWARDSHIPOUR COMMITMENT - AS A NOT-FOR-PROFIT HEALTH CARE MINISTRY, PROVIDENCE HEALTH SYSTEM - SO. CALIFORNIA EMBRACES OUR RESPONSIBILITY TO RESPOND TO THE NEEDS OF PEOPLE IN OUR COMMUNITIES, ESPECIALLY THE POOR AND VULNERABLE. THIS COMMITMENT, THIS MISSION ROOTED IN GOD'S LOVE FOR ALL, BEGAN WITH THE SISTERS OF PROVIDENCE MORE THAN 150 YEARS AGO.THE HEART OF OUR MISSION WE FOCUS OUR COMMUNITY BENEFIT OUTREACH ON FOUR SPECIFIC POPULATIONS. THESE ARE LOW-INCOME AND UNINSURED PEOPLE, DIVERSE POPULATIONS, OLDER CITIZENS, AND PEOPLE WITH BEHAVIORAL NEEDS. OUR OUTREACH CAN RANGE FROM COVERING THE MEDICAL BILLS OF A HUSBAND AND FATHER DISABLED BY DIABETES, TO FINANCIALLY SUPPORTING A NONPROFIT THAT EMBRACES OLDER REFUGEES AND IMMIGRANTS. DURING THESE HARD ECONOMIC TIMES IN OUR NEIGHBORHOODS AND OUR NATION, WE REINFORCE OUR COMMITMENTS TO CARING FOR THE POOR AND VULNERABLE. THIS COMPASSIONATE CARING IS, AND ALWAYS HAS BEEN, THE HEART OF OUR MISSION.FROM THE SAN FERNANDO VALLEY TO THE WESTSIDE AND THE SOUTH BAY, SIX EXCEPTIONAL HOSPITALS AND OUR AFFILIATED MEDICAL GROUPS ARE REDEFINING HEALTH CARE IN THE 21ST CENTURY. EVERY DAY, THE MEDICAL CENTERS OF PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA, ARE PROVING IT IS POSSIBLE TO PROVIDE LEADING-EDGE CARE WHILE STAYING TRUE TO A MORE THAN 150-YEAR-OLD MISSION TO SERVE THE POOR AND VULNERABLE.EXCEPTIONAL PROGRAMS AND SERVICES THROUGHOUT LOS ANGELES COUNTY AND BEYOND, WE'RE KNOWN FOR OUR OUTSTANDING PROGRAMS IN CANCER, CARDIOLOGY, NEUROSCIENCES, ORTHOPEDICS, WOMEN'S SERVICES, HOSPICE AND PALLIATIVE CARE, AND MANY OTHER SPECIALTIES. WE CONTINUE TO ADD SERVICES AND TECHNOLOGY TO MEET THE NEEDS OF OUR EVER CHANGING COMMUNITIES. THE ROY AND PATRICIA DISNEY FAMILY CANCER CENTER AT PROVIDENCE SAINT JOSEPH MEDICAL CENTER, IS THE LARGEST, MOST COMPREHENSIVE CANCER CENTER IN THE SAN FERNANDO AND SURROUNDING VALLEYS. PROVIDENCE CONTINUOUSLY INVESTS IN THE LATEST TECHNOLOGY AND SEEKS NEW EVIDENCE-BASED WAYS TO IMPROVE DIAGNOSES, TREATMENTS AND PATIENT SAFETY, ALL IN AN ENVIRONMENT OF COMPASSIONATE CARE. PROVIDENCE PROVIDES CARE ACROSS THE SPECTRUM FROM OUR FAMILY-CENTERED NEONATAL ICUS FOR THE MOST FRAGILE OF INFANTS TO NATIONALLY RECOGNIZE PEDIATRIC, CARDIAC AND CANCER SERVICES TO SPECIALIZED TEAM-BASED CARE FOR THE ELDERLY. THE PRACTICE OF EXPERT-TO-EXPERT COLLABORATION PROVIDES A WEALTH OF EXPERIENCE AND KNOWLEDGE IN MANAGING COMPLEX ILLNESSES BY BRINGING IN A RANGE OF SPECIALISTS TO HELP ENSURE THE BEST POSSIBLE OUTCOMES FOR OUR PATIENTS. PROVIDENCE MEDICAL CENTERS ARE DEDICATED TO IMPROVING UPON EXCELLENCE, AFFILIATING WITH SOME OF THE BEST PHYSICIANS IN SOUTHERN CALIFORNIA, ENCOURAGING NURSES TO SEEK INNOVATION IN PATIENT CARE AND PROVIDING A SHARED ELECTRONIC MEDICAL RECORD TO HELP ENSURE THE BEST CARE FOR EVERY PATIENT, EVERY TIME. FIVE STARS FOR EXCELLENCE PROVIDENCE HEALTH SYSTEM - SO. CALIFORNIA IS THE FIRST AND ONLY HEALTH SYSTEM IN THE STATE TO HAVE ALL OUR ELIGIBLE HOSPITALS RECOGNIZED WITH THE HEALTHGRADES' DISTINGUISHED HOSPITAL AWARD FOR CLINICAL EXCELLENCE. OUR PROVIDENCE MEDICAL CENTERS HAVE WON NATIONAL AWARDS FOR EXCELLENCE AND SAFETY IN NEUROSCIENCES, ORTHOPEDICS, CRITICAL AND CORONARY CARE, WOMEN'S SERVICES, MATERNITY SERVICES, BARIATRICS AND GASTROINTESTINAL TREATMENT. THESE NATIONAL AWARDS RECOGNIZE THE HIGH LEVEL OF CARE AND DEDICATION TO PATIENT SAFETY AND IMPROVED OUTCOMES. GOLD-STANDARD STROKE CARESTROKE IS THE THIRD LEADING CAUSE OF DEATH AND THE LEADING CAUSE OF DISABILITY FOR ALL AMERICANS. WHEN AND WHERE YOU SEEK TREATMENT CAN MAKE A WORLD OF DIFFERENCE. FIVE OF OUR MEDICAL CENTERS ARE CERTIFIED AS ADVANCED PRIMARY STROKE CENTERS, WHERE THE STROKE CARE PROGRAM FOLLOWS NATIONAL STANDARDS AND GUIDELINES THAT CAN SIGNIFICANTLY IMPROVE OUTCOMES FOR STROKE PATIENTS, EARNING THEM THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR ADVANCED PRIMARY STROKE CENTERS AND TOP AWARDS FROM THE AMERICAN HEART/AMERICAN STROKE ASSOCIATIONS. IN ADDITION, PROVIDENCE SAINT JOSEPH MEDICAL CENTER RECEIVED THE HEALTHGRADES STROKE CARE EXCELLENCE AWARD. LEADERS IN HEART ATTACK CARE AND FOR PATIENTS SUFFERING THE MOST SEVERE TYPE OF HEART ATTACK, ALL OF OUR HOSPITALS ARE DESIGNATED STEMI-RECEIVING CENTERS, RECOGNIZED BY LOS ANGELES COUNTY FOR THEIR DEMONSTRATED ABILITIES TO PROVIDE RAPID AND EFFECTIVE CARE FOR THE MOST SERIOUS HEART ATTACKS TO HELP REDUCE LONG-TERM HEART DAMAGE. DIAGNOSIS BEGINS UPON ARRIVAL IN OUR EMERGENCY DEPARTMENTS AND TREATMENT FOLLOWS IMMEDIATELY, WITH A FULL STAFF OF SPECIALISTS, NURSES AND THERAPISTS HIGHLY TRAINED IN CRITICAL CARE. LONG TRADITION OF COMMUNITY SERVICE OUR ROOTS DATE BACK MORE THAN 150 YEARS, WHEN THE SISTERS OF PROVIDENCE AND THE SISTERS OF THE LITTLE COMPANY OF MARY ARRIVED IN THE WEST TO SUPPORT COMMUNITIES IN NEED. TODAY, COMMUNITY SERVICE IS STILL ONE OF OUR HIGHEST PRIORITIES. WE OFFER A WIDE ARRAY OF FREE OR LOW-COST OUTREACH PROGRAMS FOR THOSE IN NEED, FROM PRIMARY CARE CLINICS AND HEALTH SCREENINGS, TO EXERCISE AND HEALTH EDUCATION CLASSES, TO MENTAL HEALTH COUNSELING AND TELEPHONE VISITS FOR SENIORS. IN ALL, PROVIDENCE'S COMMUNITY BENEFIT PROGRAMS TOUCH THE LIVES OF NEARLY A QUARTER MILLION PEOPLE EACH YEAR. FROM SCHOOL CHILDREN TO THE ELDERLY, OUR COMMUNITIES ARE SERVED BY PROGRAMS THAT PROMOTE GOOD HEALTH FOR THE MIND, BODY AND SPIRIT. OUR MISSION TO SERVE IS THE CORNERSTONE OF PROVIDENCE. * PROVIDENCE TARZANA MEDICAL CENTER RECEIVED RECOGNITION AS A DISTINGUISHED HOSPITAL FOR CLINICAL EXCELLENCE RANKING IT AMONG THE TOP 5 PERCENT IN THE NATION FOR PERFORMANCE ON 27 OF THE MOST COMMON DIAGNOSIS AND PROCEDURES. DESIGNATED AS A PEDIATRIC MEDICAL CENTER, PROVIDENCE TARZANA IS CERTIFIED TO INCLUDE TREATING CRITICALLY ILLCHILDREN TRANSPORTED BY THE 9-1-1 EMERGENCY MEDICAL SERVICES SYSTEM. IT HAS ONE OF THE LARGEST AND MOST RENOWNED NEONATAL INTENSIVE CARE UNITS IN THE AREA.* THE AWARD-WINNING PROVIDENCE SAINT JOSEPH MEDICAL CENTER IN BURBANK IS KNOWN FOR ADVANCED TECHNOLOGY, INCLUDING THE USE OF ROBOTICS, TO BOLSTER A TRADITION OF QUALITY CARE. PROVIDENCE SAINT JOSEPH HAS RECEIVED RECOGNITION FOR ORTHOPEDICS, NEUROLOGY, BARIATRICS AND CARDIAC SERVICES.* PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE HAS A REPUTATION FOR CLINICAL EXCELLENCE AND SOPHISTICATED TECHNOLOGY WITH A PERSONAL TOUCH. WINNER OF TRUVEN HEALTH ANALYTICS' 100 TOP HOSPITALS AWARD THREE YEARS IN A ROW.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,231,573,565

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,665,089	47,650,687	7,268,340

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	77,975
d	Related organizations		1d	26,508,702
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	639,547

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		27,226,224

		Business Code
2a	NET PATIENT REVENUE	621110	1,846,678,227	1,846,678,227
b	HOSPITAL FEE	621110	60,927,972	60,927,972
c	JV INCOME	900099	-1,324,169	-1,324,169
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,906,282,030

3 Investment income (including dividends, interest, and othersimilar amounts) ......			2,501,385			2,501,385
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		34,358,038	6a
b	Less: rental expenses		29,436,317	6b
c	Rental income or (loss)		4,921,721	6c
d	Net rental income or (loss).......			4,921,721			4,921,721
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	8,577,215	300,000	7a
b	Less: cost or other basis and sales expenses	0	70,158	7b
c	Gain or (loss)	8,577,215	229,842	7c
d	Net gain or (loss).........			8,807,057			8,807,057
8a	Gross income from fundraising events (not including $ 77,975of contributions reported on line 1c). See Part IV, line 18 ....
			8a	87,677
b	Less: direct expenses ...		8b	62,116
c	Net income or (loss) from fundraising events..			25,561			25,561
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	12,260
b	Less: direct expenses ...		9b	3,420
c	Net income or (loss) from gaming activities..			8,840			8,840
10a	Gross sales of inventory, less returns and allowances ..
			10a	1,509,919
b	Less: cost of goods sold ..		10b	2,400,613
c	Net income or (loss) from sales of inventory..			-890,694			-890,694
Business Code			Miscellaneous Revenue
11a	EDUCATION REVENUE		611710	8,354,896	8,354,896
b	CLINICAL TRIALS		621110	6,628,543	6,628,543
c	CAFETERIA REVENUE		722514	6,099,588			6,099,588
d	All other revenue ....			13,142,714	12,912,714	230,000
e	Total. Add lines 11a–11d ......			34,225,741
12	Total revenue. See instructions.....			1,983,107,865	1,938,077,519	230,000	21,473,458

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	14,274,746	14,274,746
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	691,254,481	605,690,765	82,849,350	2,714,366
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	14,296,634	151,655	14,144,979
9	Other employee benefits .......	2,550,632	339,349	2,211,268	15
10	Payroll taxes ...........	51,311,662	44,454,983	6,664,416	192,263
11	Fees for services (non-employees):
a	Management ......	130,997	433	130,499	65
b	Legal .........	4,912,249	236,642	4,675,607
c	Accounting ...........	30,001	8,801	21,200
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	15,800		15,800
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	195,143,486	133,994,467	61,082,033	66,986
12	Advertising and promotion ....	363,803	8,749	355,054
13	Office expenses .......	36,251,479	26,571,927	9,532,841	146,711
14	Information technology ......	998,264	429,913	567,037	1,314
15	Royalties ..
16	Occupancy ...........	13,215,053	5,815,603	7,354,122	45,328
17	Travel ............	1,212,436	746,918	426,007	39,511
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	1,472,128	364,861	1,084,486	22,781
20	Interest ...........	13,709,207	3,793	13,705,414
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	58,798,876	26,376,276	32,394,172	28,428
23	Insurance ...	200,315	13,303	187,012
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	238,553,602	238,553,602
b	HOSPITAL FEES	129,209,660	129,209,660
c	LICENSES & TAXES	4,324,786	1,376,394	2,948,392
d	DUES & SUBSCRIPTIONS	3,620,122	1,193,759	2,392,852	33,511
e	All other expenses	4,392,952	1,756,966	2,425,911	210,075
25	Total functional expenses. Add lines 1 through 24e	1,480,243,371	1,231,573,565	245,168,452	3,501,354
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			3,075,535	1	8,072,829
2	Savings and temporary cash investments .........			263,638	2
3	Pledges and grants receivable, net ......			924,900	3	4,542,551
4	Accounts receivable, net .............			211,360,020	4	218,963,118
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........			7,123,788	7	8,995,309
8	Inventories for sale or use ............			19,962,358	8	19,228,478
9	Prepaid expenses and deferred charges ......			4,695,258	9	7,976,984
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,397,409,374
b	Less: accumulated depreciation	10b	1,317,244,466	942,450,271	10c	1,080,164,908
11	Investments—publicly traded securities .			6,741,604	11	6,709,010
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			215,985,146	13	236,750,407
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			489,672,297	15	306,379,292
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,902,254,815	16	1,897,782,886

17	Accounts payable and accrued expenses .....	1,120,548,487	17	346,856,868
18	Grants payable ...		18
19	Deferred revenue .........	17,098,891	19	3,372,782
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	898,820,218	25	396,902,794
26	Total liabilities. Add lines 17 through 25..	2,036,467,596	26	747,132,444

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	-250,346,001	27	1,036,781,573
28	Net assets with donor restrictions ...........	116,133,220	28	113,868,869
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	-134,212,781	32	1,150,650,442
33	Total liabilities and net assets/fund balances ........	1,902,254,815	33	1,897,782,886