Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
Do not enter social security numbers on this form as it may be made public.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
A For the 2023 calendar year, or tax year beginning 01-01-2023 , and ending 12-31-2023
BCheck if applicable:
CName of organization
WESTERN HEALTHCONNECT
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1801 LIND AVE SW ATTN TAX DEPT
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
RENTON, WA98057
D Employer identification number

45-4171900
E Telephone number

G Gross receipts $ 149,574,122
F Name and address of principal officer:
ERIK WEXLER
1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
I
Tax-exempt status: (   ) (insert no.) or
J
Website:
HTTPS://WWW.PROVIDENCE.ORG/
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number  
K Form of organization:  
L Year of formation: 2011
M State of legal domicile: WA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE OSUPPORT SIGNIFICANT IMPROVEMENTS IN HEALTH CARE DELIVERY AND OUTCOMES WITHIN THE CONTEXT OF NONPROFIT, CHARITABLE OWNERSHIP.
2 Check this box
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 11
5 Total number of individuals employed in calendar year 2023 (Part V, line 2a) ...... 5 841
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 519,777 793,872
9 Program service revenue (Part VIII, line 2g) ......... 137,394,916 144,785,596
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,591,863 179,908
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,198,132 3,793,506
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 143,704,688 149,552,882
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,442,003 1,565,694
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) 69,932,604 66,791,719
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) 0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 87,558,656 96,876,721
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 158,933,263 165,234,134
19 Revenue less expenses. Subtract line 18 from line 12....... -15,228,575 -15,681,252
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 154,222,926 150,412,730
21 Total liabilities (Part X, line 26)............. 31,669,866 80,127,810
22 Net assets or fund balances. Subtract line 21 from line 20..... 122,553,060 70,284,920
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
Signature of officer Date
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name

Firm's EIN
Firm's address



Phone no.
May the IRS discuss this return with the preparer shown above? See Instructions. ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2023)
Form 990 (2023)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: SUPPORT SIGNIFICANT IMPROVEMENTS IN HEALTH CARE DELIVERY AND OUTCOMES WITHIN THE CONTEXT OF NONPROFIT, CHARITABLE OWNERSHIP.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 152,326,213 including grants of $ 1,565,694 ) (Revenue $ 148,579,102 )
SEE SCHEDULE OAT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 117,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,000 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA AS A COMPREHENSIVE HEALTH CARE ORGANIZATION, WE ARE SERVING MORE PEOPLE, ADVANCING BEST PRACTICES AND CONTINUING OUR MORE THAN 100-YEAR TRADITION OF SERVING THE POOR AND VULNERABLE. DELIVERING SERVICES ACROSS SEVEN STATES, PROVIDENCE IS COMMITTED TO TOUCHING MILLIONS OF MORE LIVES AND ENHANCING THE HEALTH OF THE AMERICAN WEST TO TRANSFORM CARE FOR THE NEXT GENERATION AND BEYOND.THROUGH COMMUNITY BENEFIT PROGRAMS AND OTHER HIGH-IMPACT INVESTMENTS, WE WORK TO ENSURE BASIC HEALTH NEEDS ARE MET AND SERVE TO REMOVE BARRIERS TO CARE, BUILD COMMUNITY RESILIENCE AND INNOVATE FOR THE FUTURE. MINISTRIES AND AFFILIATES SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT IMPROVE HEALTH AND WELL-BEING AND INCREASE EQUITABLE ACCESS TO QUALITY CARE AT THE COMMUNITY LEVEL AND AT SCALE ACROSS SEVEN STATES.WE ARE PROUD OF OUR HISTORY AND CONTINUED COMMITMENT TO HELPING BUILD A MORE EQUITABLE, SUSTAINABLE FUTURE. OUR STEADFAST COMMITMENT TO RESPONDING TO COMMUNITY NEED IS ONE OF THE MANY WAYS MINISTRIES, AFFILIATES AND CAREGIVERS LIVE OUT OUR SHARED MISSION AND CONTINUE TO SERVE AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORTENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSPROVIDENCE CONTINUES TO EXECUTE ON OUR INTEGRATED STRATEGIC AND FINANCIAL PLAN, WHICH CLEARLY EXPRESSES OUR COMMITMENT AND ACCELERATION OF THE IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES AND REDUCE OUR CARBON FOOTPRINT IN THE COMMUNITIES WE SERVE. PROVIDENCE ADVANCES PROGRESS ON OUR CARBON NEGATIVE GOAL AND IN 2023 WE ESTIMATED THAT WE DECREASED EMISSIONS BY OVER 12 PERCENT COMPARED TO OUR 2019 BASELINE. IN ADDITION, OUR EFFORTS LED TO THE INTRODUCTION OF THE GREEN HOSPITALS ACT, LEGISLATION MODELED AFTER PROVIDENCE THAT WOULD PROVIDE CRITICAL FEDERAL FUNDING TO WEATHERIZE AND MODERNIZE HEALTH CARE FACILITIES. PROVIDENCE COMPLETED A COMPREHENSIVE CLIMATE RESILIENCE PLAN IN ALIGNMENT WITH OUR COMMITMENT TO THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES CLIMATE PLEDGE. WE CONTINUE TO REDUCE GREENHOUSE GAS EMISSIONS WITH A FOCUS ON LED LIGHTING UPGRADES, WATER CONSERVATION, MORE EFFICIENT DELIVERY OF NITROUS OXIDE GAS DURING ANESTHESIA, AND ADVANCING OUR WASTE OPTIMIZATION WORK ACROSS ALL HOSPITALS AND CLINICS.PETALUMA VALLEY HOSPITAL ("PVH") AND HEALDSBURG HOSPITAL ("HDH")PVH IS A COMMUNITY HOSPITAL FOUNDED IN 1980 BY THE PETALUMA HEALTHCARE DISTRICT, AND IS LOCATED IN PETALUMA, CA AND HAS 80 LICENSED BEDS AND A CAMPUS THAT IS 14.63 ACRES IN SIZE. PVH HAS A STAFF OF 501 EMPLOYEES AND PROFESSIONAL RELATIONS WITH MORE THAN 260 LOCAL PHYSICIANS. HEALDSBURG HOSPITAL IS A CRITICAL ACCESS HOSPITAL FOUNDED BY DR. J WALTER SEAWELL IN 1905 AND LOCATED IN HEALDSBURG, CALIFORNIA. PROVIDENCE HAS MANAGED OPERATIONS OF THE FACILITY SINCE JANUARY 1, 2021. THE FACILITY HAS 43 LICENSED BEDS, A CAMPUS THAT IS 4 ACRES IN SIZE AND ROUGHLY 300 EMPLOYEES. PETALUMA VALLEY HOSPITAL CAME TOGETHER WITH PROVIDENCE HEALDSBURG TO FORM WESTERN HEALTHCONNECT.2023 PROGRAM SERVICE ACCOMPLISHMENTSPERMANENT SUPPORTIVE HOUSING PROJECTS:SUPPORTING BURBANK HOUSING'S PETALUMA RIVER PLACE IN PETALUMA WILL PRODUCE 50 PERMANENT SUPPORTIVE HOUSING UNITS FOR CHRONICALLY HOMELESS INDIVIDUALS. SUPPORTIVE SERVICES, CASE MANAGEMENT AND ENHANCED SOCIAL OPPORTUNITIES PROVIDED BY COMMITTEE ON THE SHELTERLESS. UNITS INCLUDE FULLY OPERABLE KITCHENS AND SPACE FOR SERVICES AND SOCIALIZATION. $700,000 INVESTMENT.SUPPORTING COMMITTEE ON THE SHELTERLESS' PERMANENT SUPPORTIVE HOUSING PROGRAM, A 13-ROOM. MIC PSH SERVES INDIVIDUALS WITH CHRONIC HEALTH CONDITIONS AND PROVIDES A SAFE PLACE TO LIVE, EFFECTIVE CASE MANAGEMENT, AND ON-SITE SERVICES INCLUDING MENTAL HEALTH SUPPORT. THIS INITIATIVE HELPS INDIVIDUALS LEAD HEALTHIER LIVES AND ACHIEVE HOUSING STABILITY WHILE DECREASING THE NEED FOR COSTLY HOSPITAL STAYS AND MUNICIPAL SERVICES. $102,342 INVESTMENT.ACCESS TO CARE:SUPPORTING HEALTHCARE FOUNDATION SONOMA COUNTY'S TWO-YEAR PARTICIPATORY PLANNING PROCESS COVERING THE INITIAL RESEARCH, VISIONING, AND DEVELOPMENT PHASE FOR CREATING A COMMUNITY WELLNESS CENTER IN HEALDSBURG. THE WELLNESS CENTER CAN ENCOMPASS LINKAGE TO HEALTH-RELATED AND OTHER SERVICES, RECREATIONAL ACTIVITIES, WORKSHOPS AND EDUCATIONAL PROGRAMS, PUBLIC FORUMS, AND PUBLIC EVENT SPACES. THE PROJECT IS GEARED TOWARDS THE SOCIAL, CULTURAL LIFE AND EXPRESSED NEEDS OF HEALDSBURG'S LATINX COMMUNITY. THE WELLNESS CENTER IS AN INVESTMENT IN SOCIAL CAPITAL, SUPPORTING AND EMPOWERING UNDERSERVED NEIGHBORHOODS WHOSE RESIDENTS ARE AMONT THE REGION'S MOST MARGINALIZED AND VULNERABLE. DESIGN INPUT WILL BE COLLECTED FROM COMMUNITY MEMBERS AND STAKEHOLDERS THROUGH A SERIES OF LISTENING SESSIONS. $285,500 INVESTMENT. SUPPORTING THE LAUNCH OF MOBILE VISION SERVICES FOR LOW-INCOME RESIDENTS IN NORTHERN SONOMA COUNTY. THIS IS IN RESPONSE TO A VISION CARE CRISIS FACING OUR LOW-INCOME FAMILIES. THERE ARE CURRENTLY NO OPTOMETRISTS IN THE NORTHERN SONOMA COUNTY WHO CAN SERVE MEDI-CAL ENROLLEES. THE ONE OPTOMETRIST SERVING THE REGION IS BASED UP TO HALF AN HOUR AWAY IN SANTA ROSA. ADDITIONALLY, THIS PROVIDER IS NO LONGER ABLE TO SEE PATIENTS UNDER THE AGE OF 5 YEARS. THIS MEANS THAT UNDERSERVED RESIDENTS MUST WAIT SEVERAL MONTHS TO GET AN APPOINTMENT AND THEN ARRANGE FOR TRANSPORTATION OUT OF TOWN FOR THEIR VISION EXAMS. ALLIANCE PLANS TO LAUNCH A NEW MOBILE VISION SERVICE TO ENSURE THAT ALL RESIDENTS OF OUR SERVICE AREA HAVE EQUITABLE ACCESS TO CARE. THE PROGRAM WILL ALSO ENSURE THAT PATIENTS ARE PROVIDED WITH CULTURALLY AND LINGUISTICALLY SENSITIVE OPTOMETRIC HEALTH CARE. $115,000 INVESTMENT.
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 expenses152,326,213
Form 990 (2023)
Form 990 (2023)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment
List of Attached Documents:
// Content
.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment
List of Attached Documents:
// Content
.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment
List of Attached Documents:
// Content
.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
List of Attached Documents:
// Content
....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment
List of Attached Documents:
// Content
..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment
List of Attached Documents:
// Content
..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment
List of Attached Documents:
// Content
.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment
List of Attached Documents:
// Content
......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2023)
Form 990 (2023)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
List of Attached Documents:
// Content
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
List of Attached Documents:
// Content
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
List of Attached Documents:
// Content
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
63
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2023)
Form 990 (2023)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
841
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, or any disqualified or other person engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2023)
Form 990 (2023)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
11
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
11
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filed
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
JIM MARTIN1801 LIND AVE SW   RENTON,WA98057 (425) 525-3985
Form 990 (2023)
Form 990 (2023)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, box 6 of Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the organization and any related organizations.

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

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

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) ROD F HOCHMAN MD......................................................................
FRMR OFF. - PSJH PRESIDENT & CEO
0.00
.................
65.00
          X 0 13,864,816 935,262
(2) ERIK WEXLER......................................................................
PRESIDENT/CEO
0.50
.................
64.50
    X       0 5,154,374 461,693
(3) GREG HOFFMAN......................................................................
EVP & CFO/TREASURER
0.50
.................
64.50
    X       0 3,204,594 334,955
(4) JO ANN ESCASA-HAIGH......................................................................
FRMR OFFICER
0.00
.................
1.00
          X 0 3,291,797 10,754
(5) ANNA NEWSOM......................................................................
EVP & CHIEF LEGAL OFFICER/SECRETARY
1.00
.................
64.00
    X       0 1,917,204 412,545
(6) JIM WATSON ESQ......................................................................
ASSISTANT SECRETARY
0.50
.................
54.50
    X       0 968,691 146,931
(7) JIM MARTIN......................................................................
ASSISTANT TREASURER (PART YEAR)
1.00
.................
54.00
    X       0 828,928 115,635
(8) MICHAEL BOLLINGER......................................................................
PHYSICIAN
50.00
.................
0.00
        X   651,410 0 64,951
(9) FRANCIS CUTRUZZOLA......................................................................
PHYSICIAN
50.00
.................
0.00
        X   503,367 0 46,094
(10) JOHN WHIPPLE......................................................................
FRMR SECRETARY
0.00
.................
0.00
          X 0 541,701 0
(11) JOSEPH TITO......................................................................
PHYSICIAN
50.00
.................
0.00
        X   430,523 0 18,319
(12) RAJESH RANADIVE......................................................................
CHIEF MEDICAL OFFICER HOSPITAL
50.00
.................
0.00
        X   408,018 0 22,393
(13) DARIAN HARRIS MHA......................................................................
CHIEF EXEC HUMBOLDT - THRU 7/23
27.25
.................
27.75
      X     0 354,702 21,511
(14) BERTA KAEMMERLING......................................................................
DIRECTOR NURSING
50.00
.................
0.00
        X   300,885 0 27,905
(15) DONALD ANDERSON JR......................................................................
ASSISTANT SECRETARY FOR ENROLLMENT
0.50
.................
54.50
    X       0 292,875 30,846
(16) BHARATHA NAOTUNNE......................................................................
CFO PETALUMA & HEALDSBURG
55.00
.................
0.00
      X     0 293,850 15,802
(17) MARY LYONS PHD......................................................................
DIRECTOR
0.50
.................
13.00
X           0 100,085 0
Form 990 (2023)
Form 990 (2023)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) MICHAEL MURPHY........................................................................
BOARD CHAIR
1.00
.......................26.00
X           0 75,066 0
(19) CHARLES SORENSON MD........................................................................
DIRECTOR
0.50
.......................13.00
X           0 50,000 0
(20) ISIAAH CRAWFORD PHD........................................................................
DIRECTOR
0.50
.......................14.50
X           0 50,000 0
(21) RICHARD BLAIR........................................................................
DIRECTOR
0.50
.......................13.00
X           0 50,000 0
(22) ERIC SPRUNK........................................................................
DIRECTOR
0.50
.......................13.50
X           0 40,000 0
(23) MARY BETH KINGSTON........................................................................
DIRECTOR
0.50
.......................13.00
X           0 40,000 0
(24) MARVIN O'QUINN........................................................................
DIRECTOR (PART YEAR)
0.50
.......................12.50
X           0 0 0
(25) SISTER CAROL PACINI LCM........................................................................
DIRECTOR
0.50
.......................13.00
X           0 0 0
(26) SISTER DIANE HEJNA CSJ RN........................................................................
DIRECTOR
0.50
.......................13.00
X           0 0 0
(27) SISTER PHYLLIS HUGHES RSM DRPH........................................................................
DIRECTOR
0.50
.......................13.00
X           0 0 0






1b Sub-Total..............
c Total from continuation sheets to Part VII, Section A..
d Total (add lines 1b and 1c)......... 2,294,203 31,118,683 2,665,596
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization 244
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
AMN LOS ANGELES AMN SHIFTWISE

12400 HIGH BLUFF DR
SAN DIEGO,CA92130
STAFFING SERVICES 2,543,451
AYA HEALTH CARE INC

PO BOX 674907
DALLAS,TX75267
STAFFING SERVICES 2,460,649
CASS INFORMATION SYSTEMS INC

12444 POWERSCOURT DR 550
ST LOUIS,MO63131
PAYMENT SERVICES 1,191,155
ANESTHESIA AND ANAGELSIA

2455 BENNETT VALLEY RD STE C219
SANTA ROSA,CA95404
MEDICAL SERVICES 1,060,952
RADIA INC PS

728 134TH ST SW STE 120
EVERETT,WA98204
MEDICAL SERVICES 885,417
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 39
Form 990 (2023)
Form 990 (2023)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 333,982
f All other contributions, gifts, grants, and similar amounts not included above1f 459,890
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f....... 793,872
 Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 622110 144,777,614 144,777,614    
b MOB RENTAL REVENUE 532000 6,417 6,417    
c OTHER PATIENT SERVICE 900099 1,565 1,565    
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f ..... 144,785,596
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ...... 201,148     201,148
4 Income from investment of tax-exempt bond proceeds        
5 Royalties...........        
(i) Real (ii) Personal
6a Gross rents 6a    
b Less: rental expenses 6b    
c Rental income or (loss) 6c    
d Net rental income or (loss).......        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 7a    
b Less: cost or other basis and sales expenses 7b   21,240
c Gain or (loss) 7c   -21,240
d Net gain or (loss)......... -21,240     -21,240
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..        
 OtherRevenueMiscAmt
Business Code
11a CAFETERIA REVENUE 722514 143,123 143,123    
b INTERAFFILIATE REVENUE 900099 36,635 36,635    
c REBATES & REFUNDS 900099 3,762 3,762    
d All other revenue .... 3,609,986 3,609,986    
e Total. Add lines 11a–11d ...... 3,793,506
12 Total revenue. See instructions..... 149,552,882 148,579,102 0 179,908
Form 990 (2023)
Form 990 (2023)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 1,565,694 1,565,694
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........ 60,997,450 55,613,312 5,384,138  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,263,115 1,151,622 111,493  
9 Other employee benefits ....... 143,321 130,670 12,651  
10 Payroll taxes ........... 4,387,833 4,000,527 387,306  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 432,635 394,447 38,188  
c Accounting ........... 1,751 1,596 155  
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 32,134,080 29,297,661 2,836,419  
12 Advertising and promotion .... 31,851 29,040 2,811  
13 Office expenses ....... 2,583,716 2,355,656 228,060  
14 Information technology ...... 45,505 41,488 4,017  
15 Royalties ..        
16 Occupancy ........... 4,517,503 4,118,751 398,752  
17 Travel ............ 101,183 92,252 8,931  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 25,863 23,580 2,283  
20 Interest ........... 11,234 10,242 992  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 6,007,205 5,476,960 530,245  
23 Insurance ... 165,763 151,131 14,632  
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 SYSTEM COST ALLOCATION 32,791,608 29,897,150 2,894,458  
b MEDICAL SUPPLIES 12,900,260 12,900,260    
c HOSPITAL FEE 4,533,013 4,533,013    
d LICENSES & TAXES 385,318 351,307 34,011  
e All other expenses 208,233 189,854 18,379  
25 Total functional expenses. Add lines 1 through 24e 165,234,134 152,326,213 12,907,921 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).        
Form 990 (2023)
Form 990 (2023)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 22,831,342 1 13,285,710
2 Savings and temporary cash investments ......... 75,472 2 0
3 Pledges and grants receivable, net ...... 30,500 3 51,532
4 Accounts receivable, net ............. 32,477,901 4 40,557,766
5 Loans and other receivables from 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  
8 Inventories for sale or use ............ 2,547,185 8 1,698,956
9 Prepaid expenses and deferred charges ...... 766,005 9 28,510
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 131,658,073
b Less: accumulated depreciation 10b 62,255,901 74,086,307 10c 69,402,172
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 216,131 12 464,788
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 21,192,083 15 24,923,296
16 Total assets. Add lines 1 through 15 (must equal line 33)... 154,222,926 16 150,412,730
Liabilities 17 Accounts payable and accrued expenses ..... 23,778,577 17 11,790,167
18 Grants payable ...   18  
19 Deferred revenue ......... 70,004 19 70,244
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 7,821,285 25 68,267,399
26 Total liabilities. Add lines 17 through 25.. 31,669,866 26 80,127,810
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 121,539,349 27 68,862,942
28 Net assets with donor restrictions ........... 1,013,711 28 1,421,978
Organizations that do not follow FASB ASC 958, check here right arrow 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 ........... 122,553,060 32 70,284,920
33 Total liabilities and net assets/fund balances ........ 154,222,926 33 150,412,730
Form 990 (2023)
Form 990 (2023)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
149,552,882
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
165,234,134
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-15,681,252
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
122,553,060
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-36,586,888
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
70,284,920
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Uniform Guidance, 2 C.F.R. Part 200, Subpart F?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2023)
Form 990 (2023)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public
Inspection
Name of the organization
WESTERN HEALTHCONNECT
 
Employer identification number

45-4171900
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.)
1
A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).
2
A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)
3
A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).
4
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:

5
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.)
6
A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).
7
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.)
8
A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)
9
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:
10
An organization that normally receives: (1) more than 33 1/3% 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 33 1/3% 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.)
11
12
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 on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.
a
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.
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.
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.
d
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.
e
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.
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
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) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (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) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
33 1/3% support test—2023. 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
b
33 1/3% support test—2022. 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—2023. 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
b
10%-facts-and-circumstances test—2022. 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
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
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) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2019 (b) 2020 (c) 2021 (d) 2022 (e) 2023 (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 on line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
First 5 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
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
33 1/3% support tests-2023. 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
b
33 1/3 % support tests—2022. 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
20
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) 2023

Schedule A (Form 990) 2023
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (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 0.015 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 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990) 2023

Schedule A (Form 990) 2023
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2023 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2023
(iii)
Distributable
Amount for 2023
1 Distributable amount for 2023 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2023:
a From 2018.......  
b From 2019.......  
c From 2020.......  
d From 2021.......  
e From 2022.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2023 distributable amount  
i Carryover from 2018 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2023 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2023 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2023, 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 2023. 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 2024. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2019.....  
b Excess from 2020.....  
c Excess from 2021.....  
d Excess from 2022.....  
e Excess from 2023.....  
Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023
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) 2023


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2023
Name of the organization
WESTERN HEALTHCONNECT
 
Employer identification number

45-4171900
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that 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) (2023)
Schedule B (Form 990) (2023) Page 2
Name of organization
WESTERN HEALTHCONNECT
 
Employer identification number
45-4171900
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


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)
Schedule B (Form 990) (2023)
Page 3
Name of organization
WESTERN HEALTHCONNECT
 
Employer identification number

45-4171900
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) (2023)
Schedule B (Form 990) (2023)
Page 4
Name of organization
WESTERN HEALTHCONNECT
 
Employer identification number

45-4171900
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990) (2023)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990)

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

right arrow Complete if the organization is described below. right arrow Attach to Form 990 or Form 990-EZ.
right arrowGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
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
WESTERN HEALTHCONNECT
 
Employer identification number

45-4171900
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................right arrow
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990) 2022

Schedule C (Form 990) 2022
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 right arrowexpenses, and share of excess lobbying expenditures).
B Check right arrow
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2019 (b) 2020 (c) 2021 (d) 2022 (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) 2022


Schedule C (Form 990) 2022
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
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
25,978
j
Total. Add lines 1c through 1i ....................................................................................................
25,978
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1, LOBBYING ACTIVITIES: THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES PAID TO AMERICAN HOSPITAL ASSOCIATION AND CALIFORNIA HOSPITAL ASSOCIATION ALLOCATED TO LOBBYING ACTIVITIES.
Schedule C (Form 990) 2022


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
right arrow 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.
right arrow Attach to Form 990.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
WESTERN HEALTHCONNECT
 
Employer identification number

45-4171900
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow  
4
Number of states where property subject to conservation easement is located right arrow  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under 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.
b
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 .........................right arrow $  
(ii)
Assets included in Form 990, Part X ...............................right arrow $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................right arrow $  
b
Assets included in Form 990, Part X ...............................right arrow $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2022

Schedule D (Form 990) 2022
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment right arrow  
b
Permanent endowment right arrow  
c
Term endowment right arrow  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   3,121,083 3,121,083
b Buildings ....   70,706,355 18,383,135 52,323,220
c Leasehold improvements   11,822,625 9,158,105 2,664,520
d Equipment ....   40,200,557 34,714,661 5,485,896
e Other .....   5,807,453   5,807,453
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..right arrow 69,402,172
Schedule D (Form 990) 2022

Schedule D (Form 990) 2022
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)right arrow  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)right arrow  
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)HOSPITAL FEE/PROVIDER TAX RECEIVABLE 20,042,897
(2)RIGHT OF USE OPERATING LEASES 2,890,107
(3)OTHER ASSETS 1,545,511
(4)DUE FROM THIRD PARTY 444,781
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........right arrow 24,923,296
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
DUE TO AFFILIATES 59,153,446
HOSPITAL FEE/PROVIDER TAX LIABILITY 6,189,251
CAPITAL LEASE OBLIGATIONS 1,455,901
OTHER LIABILITIES 1,004,013
ACCRUED RETIREMENT COMPENSATION 464,788




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)right arrow 68,267,399
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) 2022

Schedule D (Form 990) 2022
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
Schedule D (Form 990) 2022


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow Attach to Form 990.
Medium right arrow Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
WESTERN HEALTHCONNECT
 
Employer identification number

45-4171900
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    1,206,291 0 1,206,291 0.730 %
b Medicaid (from Worksheet 3, column a) . . . . .     48,393,413 26,204,029 22,189,384 13.430 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0    
d Total Financial Assistance and Means-Tested Government Programs . . . . .     49,599,704 26,204,029 23,395,675 14.160 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     513,011 0 513,011 0.310 %
f Health professions education (from Worksheet 5) . . .     0 0    
g Subsidized health services (from Worksheet 6) . . . .     908,493 348,956 559,537 0.340 %
h Research (from Worksheet 7) .     0 0    
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     1,638,763 0 1,638,763 0.990 %
j Total. Other Benefits . .     3,060,267 348,956 2,711,311 1.640 %
k Total. Add lines 7d and 7j .     52,659,971 26,552,985 26,106,986 15.800 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
 
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
56,644,637
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
67,780,887
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-11,136,250
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
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?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 PETALUMA VALLEY HOSPITAL
400 NORTH MCDOWELL BLVD
PETALUMA,CA94954
HTTPS://WWW.PROVIDENCE.ORG/
110000001
X X         X     A
2 HEALDSBURG HOSPITAL
1375 UNIVERSITY AVE
HEALDSBURG,CA95448
WWW.HEALDSBURGDISTRICTHOSPITAL.ORG/
110000019
X X     X   X     A
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
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)
WESTERN HEALTH CONNECT (GROUP A - 1 & 2)
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 No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 23
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 23
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
WESTERN HEALTH CONNECT (GROUP A - 1 & 2)
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, SECTION C
b
SEE PART V, SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 6
Part VFacility Information (continued)

Billing and Collections
WESTERN HEALTH CONNECT (GROUP A - 1 & 2)
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
WESTERN HEALTH CONNECT (GROUP A - 1 & 2)
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
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, LINE 3E WESTERN HEALTHCONNECT (GROUP A - 1 & 2)THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE PRIORITIZED BASED ON THE METHODOLOGY DESCRIBED IN THE MOST RECENT CHNA SECTION ON SIGNIFICANT HEALTH NEEDS.
PART V, SECTION B, LINE 5 DESCRIPTION OF COMMUNITY INPUTWESTERN HEALTHCONNECT (GROUP A - 1 & 2)OVERVIEW OF CHNA PROCESS AND FRAMEWORK:THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS AN IMPORTANT TOOL WE USE TO BETTER UNDERSTAND HEALTH DISPARITIES AND INEQUITIES WITHIN THE COMMUNITIES WE SERVE, AS WELL AS THE COMMUNITY STRENGTHS AND ASSETS. THE EQUITY FRAMEWORK IS FOUNDATIONAL TO OUR OVERALL CHNA FRAMEWORK, A MODIFIED VERSION OF THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) DEVELOPED BY THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS (NACCHO). THE MODIFIED MAPP FRAMEWORK TAKES A MIXED-METHODS APPROACH TO PRIORITIZE HEALTH NEEDS, CONSIDERING POPULATION HEALTH DATA, COMMUNITY INPUT, INTERNAL UTILIZATION DATA, COMMUNITY STRENGTHS AND ASSETS, AND A PRIORITIZATION PROTOCOL.IN GATHERING INFORMATION ON THE COMMUNITIES SERVED BY THE HOSPITAL, WE LOOKED NOT ONLY AT THE HEALTH CONDITIONS OF THE POPULATION, BUT ALSO AT SOCIOECONOMIC FACTORS, THE PHYSICAL ENVIRONMENT, AND HEALTH BEHAVIORS. IN ADDITION, WE RECOGNIZE THAT THERE ARE OFTEN GEOGRAPHIC AREAS WHERE THE CONDITIONS FOR SUPPORTING HEALTH ARE POORER THAN NEARBY AREAS. WHENEVER POSSIBLE AND RELIABLE, DATA ARE REPORTED AT THE CENSUS TRACT LEVEL. THESE SMALLER GEOGRAPHIC AREAS ALLOW US TO BETTER UNDERSTAND THE NEIGHBORHOOD LEVEL NEEDS OF OUR COMMUNITIES AND BETTER ADDRESS INEQUITIES WITHIN AND ACROSS COMMUNITIES.COMMUNITY INPUT:TO BETTER UNDERSTAND THE UNIQUE PERSPECTIVES, OPINIONS, EXPERIENCES, AND KNOWLEDGE OF COMMUNITY MEMBERS, REPRESENTATIVES FROM PETALUMA VALLEY HOSPITAL CONDUCTED 14 KEY INFORMANT INTERVIEWS WITH REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS AND, IN PARTNERSHIP WITH ON THE MARGINS, CONDUCTED 3 LISTENING SESSIONS WITH COMMUNITY MEMBERS. ADDITIONALLY, REPRESENTATIVES FROM COMMUNITY HEALTH INVESTMENT CONDUCTED 1 PROVIDENCE CAREGIVER LISTENING SESSION. DURING THESE INTERVIEWS AND LISTENING SESSIONS, COMMUNITY MEMBERS, NONPROFIT, AND GOVERNMENT KEY INFORMANTS DISCUSSED THE ISSUES AND OPPORTUNITIES OF THE PEOPLE, NEIGHBORHOODS, AND CITIES OF THE SERVICE AREA.NONPROFIT AND GOVERNMENT STAKEHOLDER INTERVIEWS:A TOTAL OF 14 KEY INFORMANT INTERVIEWS WERE COMPLETED BY REPRESENTATIVES FROM SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS. KEY INFORMANTS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND ENGAGEMENT IN WORK THAT DIRECTLY SERVES PEOPLE WHO HAVE LOW INCOMES, HAVE CHRONIC CONDITIONS, AND/OR ARE MEDICALLY UNDERSERVED. SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS AIMED TO ENGAGE STAKEHOLDERS FROM SOCIAL SERVICE AGENCIES, HEALTH CARE, EDUCATION, HOUSING, AND GOVERNMENT, AMONG OTHERS, TO ENSURE A WIDE RANGE OF PERSPECTIVES. INCLUDED IN THE INTERVIEWS WAS A REPRESENTATIVE FROM THE SONOMA COUNTY HUMAN SERVICES DEPARTMENT.KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH:- KT SWAN, PROGRAM DIRECTOR FOR BUCKELEW PROGRAMS (BEHAVIORAL HEALTH)- STEPHANIE MERRIDA-GRANT, ASSISTANT DIRECTOR OF OUTREACH AND ENGAGEMENT FOR CATHOLIC CHARITIES OF SANTA ROSA (SOCIAL SERVICES, HOMELESS SERVICES)- CHRIS CABRAL, CHIEF EXECUTIVE OFFICER FOR COMMITTEE ON THE SHELTERLESS (SOCIAL SERVICES)- KISMET BALDWIN SANTANA MD, INTERIM HEALTH OFFICER FOR COUNTY OF SONOMA PUBLIC HEALTH (PUBLIC HEALTH)- JEN KLOSE, EXECUTIVE DIRECTOR FOR GENERATION HOUSING (AFFORDABLE HOUSING)- KIMBERLY BENDER, EXECUTIVE DIRECTOR FOR HEALTHCARE FOUNDATION OF NORTHERN SONOMA COUNTY (PHILANTHROPY, HEALTHCARE)- STEPHANIE MANIERI, EXECUTIVE DIRECTOR FOR LATINO SERVICE PROVIDERS (SOCIAL SERVICES)- TASHA BOLLINGER, MEDICAL PARTNERSHIP ATTORNEY FOR LEGAL AID OF SONOMA COUNTY (SOCIAL SERVICES)- ESTHER LEMUS, SUPERIVISING ATTORNEY FOR LEGAL AID OF SONOMA COUNTY (SOCIAL SERVICES)- MICHELINE WHITE, EXECUTIVE DIRECTOR FOR MENDONOMA HEALTH ALLIANCE (HEALTHCARE, SOCIAL SERVICES)- ANNIE NICOL, DIRECTOR OF HEALTH SERVICES FOR PETALUMA HEALTH CENTER (HEALTHCARE)- RAMONA FAITH, CHIEF EXECUTIVE OFFICER FOR PETALUMA HEALTHCARE DISTRICT (SOCIAL SERVICES)- ELECE HEMPEL, SECRETARY FOR PETALUMA HEALTHCARE DISTRICT (SOCIAL SERVICES)- TROY GIDEON, CHIEF ADMINISTRATIVE OFFICER FOR PROVIDENCE PETALUMA VALLEY AND HEALDSBURG HOSPITAL- CHUCK KASSIS, CHIEF EXECUTIVE FOR PROVIDENCE SANTA ROSA MEMORIAL HOSPITAL- MARGARET SLUYK, CHIEF EXECUTIVE OFFICER FOR REACH FOR HOME (SOCIAL SERVICES) MEDICALLY UNDERSERVED, LOW-INCOME, OR MINORITY POPULATIONS BEING REPRESENTED BY ORGANIZATIONS OR INDIVIDUALS THAT PROVIDED INPUT:- LATINX- INDIGENOUS/NATIVE AMERICAN- BBIPOC- INDIVIDUALS EXPERIENCING HOMELESSNESS (OR AT-RISK)- INDIVIDUALS EXPERIENCING BEHAVIORAL HEALTH ISSUESOLDER ADULTS DATA LIMITATIONS AND INFORMATION GAPS:WHILE CARE WAS TAKEN TO SELECT AND GATHER DATA THAT WOULD TELL THE STORY OF THE HOSPITAL'S SERVICE AREA, IT IS IMPORTANT TO RECOGNIZE THE LIMITATIONS AND GAPS IN INFORMATION THAT NATURALLY OCCUR, INCLUDING THE FOLLOWING:-NOT ALL DESIRED DATA WERE READILY AVAILABLE, SO SOMETIMES WE HAD TO RELY ON TANGENTIAL OR PROXY MEASURES OR NOT HAVE ANY DATA AT ALL. FOR EXAMPLE, THERE IS LITTLE COMMUNITY-LEVEL DATA ON THE INCIDENCE OF MENTAL HEALTH OR SUBSTANCE USE.-WHILE MOST INDICATORS ARE RELATIVELY CONSISTENT FROM YEAR TO YEAR, OTHER INDICATORS ARE CHANGING QUICKLY (SUCH AS PERCENTAGE OF PEOPLE UNINSURED) AND THE MOST RECENT DATA AVAILABLE ARE NOT A GOOD REFLECTION OF THE CURRENT STATE.-REPORTING DATA AT THE COUNTY LEVEL CAN MASK INEQUITIES WITHIN COMMUNITIES. THIS CAN ALSO BE TRUE WHEN REPORTING DATA BY RACE, WHICH CAN MASK WHAT IS HAPPENING WITHIN RACIAL AND ETHNIC SUBGROUPS. THEREFORE, WHEN APPROPRIATE AND AVAILABLE, WE DISAGGREGATED THE DATA BY GEOGRAPHY AND RACE.-DATA GATHERED THROUGH INTERVIEWS AND SURVEYS MAY BE BIASED DEPENDING ON WHO IS WILLING TO RESPOND TO THE QUESTIONS AND WHETHER THEY ARE REPRESENTATIVE OF THE POPULATION AS A WHOLE.-THE ACCURACY OF DATA GATHERED THROUGH INTERVIEWS AND SURVEYS DEPENDS ON HOW CONSISTENTLY THE QUESTIONS ARE INTERPRETED ACROSS ALL RESPONDENTS AND HOW HONEST PEOPLE ARE IN PROVIDING THEIR ANSWERS.
PART V, SECTION B, LINE 6A WESTERN HEALTHCONNECT (GROUP A - 1 & 2)MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE HOSPITAL FACILITIES:- SUTTER HEALTH- KAISER PERMANENTE- SONOMA WEST MEDICAL CENTER
PART V, SECTION B, LINE 6B WESTERN HEALTHCONNECT (GROUP A - 1 & 2)MANY LOCAL GOVERNMENT AGENCIES AND NOT-FOR-PROFIT ORGANIZATIONS COLLABORATED WITH ST. JOSEPH HEALTH IN THE CHNA PROCESS. AMONG THESE ARE THE FOLLOWING ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES:- SONOMA COUNTY DEPARTMENT OF HEALTH SERVICES- SONOMA COUNTY DEPARTMENT OF PUBLIC HEALTH- BURBANK HOUSING- BUCKELEW PROGRAMS- PETALUMA PEOPLE SERVICES CENTER- WEST COUNTY HEALTH CENTERS- HEALTHY PETALUMA- PETALUMA HEALTH CENTER- ALLIANCE MEDICAL CENTER- LATINO SERVICE PROVIDERS- CATHOLIC CHARITIES OF THE DIOCESE OF SANTA ROSA- COMMITTEE ON THE SHELTERLESS- GENERATION HOUSING- LEGAL AID OF SONOMA COUNTY- MENDONOMA HEALTH ALLIANCE- REACH FOR HOME- ON THE MARGINS- PETALUMA BLACKS FOR COMMUNITY DEVELOPMENT
PART V, SECTION B, LINE 7A: WESTERN HEALTHCONNECT (GROUP A - 1 & 2)CHNA REPORT WEBSITEHTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSUNDER NORTHERN CALIFORNIA
PART V, SECTION B, LINE 9: WESTERN HEALTHCONNECT (GROUP A - 1 & 2)THE HOSPITAL FACILITY ADOPTED ITS IMPLEMENTATION STRATEGY ASSOCIATED WITH THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT ON APRIL 15, 2024, IN ACCORDANCE WITH INTERNAL REVENUE CODE SECTION 1.501(R)-3(A)(1).
PART V, SECTION B, LINE 10A: WESTERN HEALTHCONNECT (GROUP A - 1 & 2)IMPLEMENTATION STRATEGY WEBSITEHTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSUNDER NORTHERN CALIFORNIA
PART V, SECTION B, LINE 11 WESTERN HEALTHCONNECT (GROUP A - 1 & 2)THE 2023 COMMUNITY HEALTH NEEDS PRIORITIZED ARE LISTED BELOW:1) BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER2) ACCESS TO HEALTH CARE AND DENTAL SERVICES3) HOMELESSNESS AND HOUSING INSTABILITY4) AGING ISSUESBEHAVIORAL HEALTH AND SUBSTANCE USE DISORDERPUBLICLY AVAILABLE DATA ALONG WITH PROVIDENCE HOSPITALIZATION DATA SHOW WORSENING TRENDS OF INDIVIDUALS EXPERIENCING A BEHAVIORAL HEALTH CRISIS, MANY OF WHOM ARE UTILIZING EMERGENCY ROOMS FOR CARE. SUBSTANCE USE DISORDER WAS IDENTIFIED AS THE LEADING BEHAVIORAL HEALTH DIAGNOSIS BEING TREATED AT SANTA ROSA MEMORIAL AND PETALUMA VALLEY HOSPITALS. KEY INFORMANTS, COMMUNITY MEMBERS AND CAREGIVERS ALL SHARED THAT LACK OF BEHAVIORAL HEALTH AND SUBSTANCE USE SERVICES WAS A MAJOR BARRIER IN SONOMA COUNTY. LACK OF BILINGUAL/BICULTURAL PROVIDERS AND THE ABSENCE OF MEDICAL DETOX WAS ALSO A COMMONLY VOICED NEED. DATA SHOWED PARTICULAR CONCERN FOR YOUTH.STRATEGIES TO ADDRESS BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER INCLUDE:- LEVERAGE PARTNERSHIPS BETWEEN THE MOBILE HEALTH CLINIC AND BEHAVIORAL HEALTH COMMUNITY-BASED ORGANIZATIONS- CONNECT PATIENTS TO MEDICATION-ASSISTED TREATMENT PROGRAMS THROUGH SUBSTANCE USE NAVIGATION- PROVIDE COMPREHENSIVE CASE MANAGEMENT TO HIGH-RISK AND SEVERE AND PERSISTENT MENTAL ILLNESS POPULATION THROUGH ENHANCED CARE MANAGEMENT (ECM)- ADMINISTER COUNTY-WIDE COMMUNITY GRANTS TO COMMUNITY BASED ORGANIZATIONS ADDRESSING BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDERACCESS TO HEALTH CARE AND DENTAL SERVICESFEWER PEOPLE SAW A PRIMARY CARE DOCTOR OR DENTIST OVER THE PAST YEAR IN 2023. THIS TREND COUPLED WITH QUALITATIVE DATA EXPRESSING LACK OF PRIMARY MEDICAL AND DENTAL PROVIDERS, HIGHLIGHTED LACK OF APPROPRIATE LEVEL OF HEALTH CARE ACCESS IN SONOMA COUNTY. EMERGENCY TRANSPORT TIMES WERE SOME OF THE LONGEST IN THE STATE OF CALIFORNIA IN NORTHERN SONOMA COUNTY. KEY INFORMANTS AND CAREGIVERS EXPRESSED THE NEED FOR EXTENDED HOURS, BILINGUAL/BICULTURAL PROVIDERS AND TRANSPORTATION OPTIONS TO BREAK DOWN ACCESS BARRIERS FOR OLDER ADULTS, PEOPLE EXPERIENCING HOMELESSNESS, AND AGRICULTURAL WORKERS. ACCESS WAS NOTED TO BE HIGHLY LINKED TO ECONOMIC INSECURITY.STRATEGIES TO ADDRESS ACCESS TO CARE INCLUDE:- ENGAGE HIGH-RISK INDIVIDUALS WITH CARE NETWORK'S COMPLEX CARE MANAGEMENT AND ENHANCED CARE MANAGEMENT TEAMS TO INCREASE ACCESS TO HEALTH CARE- PROVIDE COMMUNITY HEALTH WORKER SERVICES INCLUDING SCREENINGS, EDUCATION, NAVIGATION, AND ADVOCACY FOR BBIPOC AND VULNERABLE POPULATIONS- PROVIDE DENTAL CARE TO UN- AND UNDERINSURED PATIENTS THROUGH PROVIDENCE DENTAL CLINIC- PROVIDE PRIMARY CARE AND LINKAGES TO MEDICAL HOMES FOR UN- AND UNDERINSURED PATIENTS THROUGH PROVIDENCE MOBILE HEALTH CLINIC WITH THE GOAL OF REDUCING AVOIDABLE EMERGENCY DEPARTMENT VISITSHOMELESSNESS AND HOUSING INSTABILITY:OVER 25% OF SONOMA COUNTY IS EXPERIENCING SEVERE HOUSE COST BURDEN, SPENDING 50% OR MORE OF THEIR HOUSEHOLD INCOME ON HOUSING. ADDITIONALLY, OVER 2800 INDIVIDUALS WERE FOUND TO BE EXPERIENCING HOMELESSNESS IN 2022. MOST KEY INFORMANTS IDENTIFIED THE NEED FOR ADDITIONAL PERMANENT SUPPORTIVE HOUSING, HOUSING ACCEPTING HOUSING VOUCHERS, AFFORDABLE HOUSING AND SHELTER BEDS. OLDER ADULTS AND BBIPOC POPULATION EXPERIENCE ADDITIONAL BARRIERS TO HOUSING IN SONOMA COUNTY.STRATEGIES TO ADDRESS HOMELESSNESS AND HOUSING INSTABILITY INCLUDE:- INVEST IN THE MAINTENANCE AND EXPANSION OF EXISTING RECUPERATIVE BEDS AND SERVICES- PRIORITIZE FUNDING TOWARDS MAINTAINING OPERATIONAL EXPENSES AT ESTABLISHED PERMANENT SUPPORTIVE HOUSING (PSH) LOCATIONS FOR SUSTAINABILITY OF HOUSING UNITS- PROVIDE COMPREHENSIVE CASE MANAGEMENT TO UNHOUSED POPULATION THROUGH CARE NETWORK'S ENHANCED CARE MANAGEMENT PROGRAM- PROVIDE SUPPORT TO COMMUNITY BASED ORGANIZATIONS FOCUSED ON ADVOCATING FOR HOUSING INITIATIVES WITH THE GOAL OF INCREASING THE SUPPLY AND AFFORDABILITY OF HOMES IN SONOMA COUNTYAGING ISSUES:THERE IS A GROWING POPULATION OF OLDER ADULTS (OVER 60) IN SONOMA COUNTY WITHOUT ADEQUATE RESOURCES TO MEET THEIR NEEDS. OLDER ADULTS EXPERIENCING HOMELESSNESS AND HOUSING INSTABILITY AS WELL AS MENTAL HEALTH ISSUES DUE TO ISOLATION, IS ON THE RISE IN SONOMA COUNTY. A LACK OF PROVIDERS WITH EXPERIENCE SPECIFIC TO GERIATRIC CONDITIONS IS OF CONCERN.STRATEGIES TO ADDRESS AGING ISSUES INCLUDE:- SUPPORT COMMUNITY BASED ORGANIZATIONS THROUGH GRANTS AND PARTNERSHIPS TO INCREASE TRANSPORTATION ACCESS- SERVING SENIORS THROUGH DIRECT SERVICE PROGRAMS- PRIVATE DUTY CAREGIVING- ADMINISTER COMMUNITY GRANTS TO ADDRESS AGING ISSUESFULL DETAIL OF STRATEGIES TO ADDRESS COMMUNITY HEALTH NEEDS CAN FOUND IN THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) HERE: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTSNEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM:NO SINGLE HOSPITAL FACILITY CAN FULLY ADDRESS ALL THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WHILE SANTA ROSA MEMORIAL WILL EMPLOY STRATEGIES TO ADDRESS EACH OF THE FOUR SIGNIFICANT HEALTH NEEDS THAT WERE PRIORITIZED DURING THE CHNA PROCESS, PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS AND GOVERNMENT AGENCIES ARE CRITICAL FOR ACHIEVING THE ESTABLISHED GOALS.PETALUMA VALLEY HOSPITAL WILL COLLABORATE WITH PETALUMA PEOPLE SERVICES CENTER, LA LUZ CENTER, WEST COUNTY COMMUNITY SERVICES, COMMUNITY ACTION PARTNERSHIP OF SONOMA COUNTY, AND A VARIETY OF LOCAL FAMILY RESOURCE CENTERS THAT ADDRESS THE COMMUNITY NEEDS TO COORDINATE CARE AND REFERRALS TO ADDRESS UNMET NEEDS.WITH RESPECT TO SOME OF THE OTHER NEEDS IDENTIFIED IN THE CHNA PROCESS THAT WERE NOT PRIORITIZED FOR ACTION THROUGH THIS PLAN, WE INTEND TO REMAIN ENGAGED IN ADDRESSING: ORAL HEALTH NEEDS THROUGH OUR ONGOING COMMUNITY DENTAL CLINIC AND MOBILE DENTAL CLINIC.FURTHERMORE, WE WILL CONTINUE FUNDING OTHER LOCAL NONPROFIT ORGANIZATIONS THROUGH GRANTS FROM OUR CARE FOR THE POOR PROGRAM MANAGED BY THE SRMH COMMUNITY HEALTH INVESTMENT DEPARTMENT, AND WE WILL ENCOURAGE AND ENDORSE LOCAL NONPROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE PROVIDENCE COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT THE SRMH SERVICE AREAS.
PART V, SECTION B, LINE 13H WESTERN HEALTHCONNECT (GROUP A - 1 & 2)THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTANTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT.
PART V, SECTION B, LINE 16A, FAP WEBSITE: WESTERN HEALTHCONNECT (GROUP A - 1 & 2)HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINE 16B, FAP APPLICATION WEBSITE: WESTERN HEALTHCONNECT (GROUP A - 1 & 2)HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: WESTERN HEALTHCONNECT (GROUP A - 1 & 2)HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE
PART V, SECTION B, LINE 22D: HEALDSBURG HOSPITALCHARGES TO INDIVIDUALS ELIGIBLE FOR ASSISTANCE UNDER THE FAP (FAP-ELIGIBLE INDIVIDUALS) DURING 1/1/2023 - 12/01/2023: HEALDSBURG HOSPITAL USED THE PROSPECTIVE METHOD BASED ON AMOUNTS ALLOWED BY TRADITIONAL MEDICARE FEE-FOR-SERVICE. HEALDSBURG HOSPITAL TRANSITIONED FROM MEDITECH TO EPIC ON 12/02/23 AND MOVED TO THE LOOK-BACK METHOD BASED ON MEDICARE FEE-FOR SERVICE DURING A 12 MONTH PERIOD.
PART V, SECTION B, LINE 24: WESTERN HEALTHCONNECT (GROUP A - 1 & 2)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) 2023
Schedule H (Form 990) 2023
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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2023
Schedule H (Form 990) 2023
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: WESTERN HEALTHCONNECT PREPARES AN ANNUAL REPORT AND IT IS PUBLICLYAVAILABLE AT:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/NORTHERN-CALIFORNIA
PART I, LINE 7: THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING A COST-TO-CHARGE RATIO AND GENERAL LEDGER.
PART I, LINE 7G: NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED.
PART III, LINE 8: THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES ASCOMMUNITY BENEFIT.
PART III, LINE 9B: COLLECTION ACTIVITY:OUR FINANCIAL ASSISTANCE POLICY INCLUDES BILLING AND COLLECTIONS DETAILS. COLLECTION EFFORTS ON UNPAID BALANCES WILL CEASE PENDING FINAL DETERMINATION OF FAP ELIGIBILITY. PROVIDENCE DOES NOT PERFORM, ALLOW, OR ALLOW COLLECTION AGENCIES TO PERFORM ANY EXTRAORDINARY COLLECTION ACTIONS PRIOR TO MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. IT IS STANDARD PRACTICE TO CEASE COLLECTION ACTIVITIES FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2: NEEDS ASSESSMENT:THROUGH A MIXED-METHODS APPROACH USING QUANTITATIVE AND QUALITATIVE DATA, OUR CHNA PROCESS USED SEVERAL SOURCES OF INFORMATION TO IDENTIFY COMMUNITY NEEDS. ACROSS SONOMA COUNTY, INFORMATION COLLECTED INCLUDES PUBLIC HEALTH DATA REGARDING HEALTH BEHAVIORS, MORBIDITY AND MORTALITY, AND HOSPITAL-LEVEL DATA. IN 2019, ST. JOSEPH HEALTH SONOMA PARTNERED WITH SUTTER HEALTH AND KAISER PERMANENTE TO GATHER DATA FROM LISTENING SESSIONS AND INTERVIEWS WITH DIVERSE, LOW-INCOME AND MEDICALLY UNDERSERVED COMMUNITIES IN SONOMA COUNTY. IN 2020, INDIVIDUAL STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH REPRESENTATIVES FROM ORGANIZATIONS THAT SERVE THESE POPULATIONS TO BETTER UNDERSTAND THE IMPACTS OF COVID-19 IN OUR COMMUNITIES. IN ADDITION, STAKEHOLDER PARTICIPATION IN HEALTH ACTION SONOMA COUNTY, A MULTISECTOR COLLABORATIVE, ENSURES ONGOING ASSESSMENT TO ADDRESS SIGNIFICANT NEEDS AS THEY ARISE THROUGHOUT THE YEAR. ADDITIONAL NEEDS CAN BE IDENTIFIED BY COUNTY PUBLIC HEALTH, HHS, AND OTHER NON-PROFIT SERVICE PROVIDERS.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE.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:PETALUMA VALLEY HOSPITAL (PVH), FOUNDED BY THE SISTERS OF ST. JOSEPH OF ORANGE, HAS BEEN SERVING THE HEALTHCARE NEEDS OF FAMILIES IN THE COMMUNITY FOR MORE THAN 60 YEARS. DURING THIS TIME, ITS MISSION HAS REMAINED THE SAME: TO CONTINUALLY IMPROVE THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES SERVED. PART OF A LARGER HEALTHCARE SYSTEM KNOWN AS PROVIDENCE ST. JOSEPH HEALTH (PSJH), PVH AND HEALDSBURG HOSPITAL ARE PART OF A COUNTYWIDE MINISTRY THAT INCLUDES THREE HOSPITALS, URGENT CARE FACILITIES, HOSPICE, HOME HEALTH SERVICES, AND OTHER FACILITIES FOR TREATING THE HEALTHCARE NEEDS OF THE COMMUNITY IN SONOMA COUNTY AND THE REGION. THE MINISTRY'S CORE FACILITIES ARE PETALUMA VALLEY HOSPITAL (PVH), AN 80-BED ACUTE CARE HOSPITAL, SANTA ROSA MEMORIAL HOSPITAL, A FULL SERVICE, STATE OF THE ART 330-BED ACUTE CARE HOSPITAL THAT INCLUDES A LEVEL II TRAUMA CENTER FOR THE COASTAL REGION FROM SAN FRANCISCO TO THE OREGON BORDER, AND HEALDSBURG HOSPITAL, A 43-BED CRITICAL ACCESS HOSPITAL AND CERTIFIED STROKE CENTER. MAJOR PROGRAMS AND SERVICES INCLUDE CRITICAL CARE, CARDIOVASCULAR CARE, STROKE CARE, WOMEN'S AND CHILDREN'S SERVICES, CANCER CARE, AND ORTHOPEDICS. SRMH IS HOME TO THE NORMA & EVERT PERSON HEART & VASCULAR INSTITUTE AND THE UCSF NEONATAL INTENSIVE CARE NURSERY. PVH AND HEALDSBURG HOSPITAL PROVIDE SOUTHERN MENDOCINO, NORTHERN MARIN, AND SONOMA COUNTIES' COMMUNITIES WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. THE HOSPITALS' SERVICE AREA EXTENDS FROM UKIAH. IN THE NORTH, MARSHALL IN THE SOUTH, SONOMA VALLEY IN THE EAST AND BODEGA BAY IN THE WEST. PVH'S AND HEALDSBURG HOSPITAL'S TOTAL SERVICE AREA (TSA) INCLUDES THE CITIES OF SANTA ROSA, PETALUMA, SEBASTOPOL, WINDSOR, HEALDSBURG, ROHNERT PARK, COTATI, SONOMA, CLOVERDALE, UKIAH, AND POINT ARENA.DEFINING THE COMMUNITY:SONOMA COUNTY IS A LARGE, URBAN-RURAL COUNTY ENCOMPASSING 1,575 SQUARE MILES. SONOMA COUNTY RESIDENTS INHABIT NINE CITIES AND A LARGE UNINCORPORATED AREA, INCLUDING MANY GEOGRAPHICALLY ISOLATED COMMUNITIES. THE MAJORITY OF THE COUNTY'S POPULATIO3N RESIDES WITHIN ITS CITIES, THE LARGEST OF WHICH ARE CLUSTERED ALONG THE HIGHWAY 101 CORRIDOR. SANTA ROSA IS THE LARGEST CITY WITH A POPULATION ESTIMATED TO BE NEARLY 171,000 IN 2012 AND IS THE SERVICE HUB FOR THE ENTIRE COUNTY AND THE LOCATION OF THE COUNTY'S THREE MAJOR HOSPITALS. AT LEAST PART OF SONOMA COUNTY, CALIFORNIA, IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA). THE AREA IS 0.8 SQUARE MILES AND IS LOCATED NEAR DOWNTOWN SANTA ROSA. THE CLOVERDALE AREA IN SONOMA COUNTY IS A DESIGNATED PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA (PC-HSPA). PVH'S PRIMARY SERVICE AREA IS LIMITED TO A TIGHT RADIUS, BUT ITS SECONDARY SERVICE AREA COMPRISES THE ENTIRE COUNTY, PLUS NORTHERN MARIN COUNTY AND SOUTHERN MENDOCINO COUNTY. THE CHNA PROCESS AND DATA GATHERING ADDRESSES SONOMA COUNTY. HEALDSBURG HOSPITAL'S PRIMARY SERVICE AREA IS SIMILARLY LIMITED TO A TIGHT RADIUS, BUT ITS SECONDARY SERVICE AREA COMPRISES THE ENTIRE SONOMA COUNTY.
PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:PETALUMA VALLEY HOSPITAL AND HEALDSBURG HOSPITAL PROVIDE VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. PETALUMA VALLEY HOSPITAL AND HEALDSBURG HOSPITAL ARE COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND ISA SUBCOMMITTEE OF THE BOARD OF TRUSTEES2) OPEN MEDICAL STAFF3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.
PART VI, LINE 7, REPORTS FILED WITH STATES CA
PART VI, LINE 6: AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 117,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,000 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WAAS A COMPREHENSIVE HEALTH CARE ORGANIZATION, WE ARE SERVING MORE PEOPLE, ADVANCING BEST PRACTICES AND CONTINUING OUR MORE THAN 100-YEAR TRADITION OF SERVING THE POOR AND VULNERABLE. DELIVERING SERVICES ACROSS SEVEN STATES, PROVIDENCE IS COMMITTED TO TOUCHING MILLIONS OF MORE LIVES AND ENHANCING THE HEALTH OF THE AMERICAN WEST TO TRANSFORM CARE FOR THE NEXT GENERATION AND BEYOND.THROUGH COMMUNITY BENEFIT PROGRAMS AND OTHER HIGH-IMPACT INVESTMENTS, WE WORK TO ENSURE BASIC HEALTH NEEDS ARE MET AND SERVE TO REMOVE BARRIERS TO CARE, BUILD COMMUNITY RESILIENCE AND INNOVATE FOR THE FUTURE. MINISTRIES AND AFFILIATES SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT IMPROVE HEALTH AND WELL-BEING AND INCREASE EQUITABLE ACCESS TO QUALITY CARE AT THE COMMUNITY LEVEL AND AT SCALE ACROSS SEVEN STATES.WE ARE PROUD OF OUR HISTORY AND CONTINUED COMMITMENT TO HELPING BUILD A MORE EQUITABLE, SUSTAINABLE FUTURE. OUR STEADFAST COMMITMENT TO RESPONDING TO COMMUNITY NEED IS ONE OF THE MANY WAYS MINISTRIES, AFFILIATES AND CAREGIVERS LIVE OUT OUR SHARED MISSION AND CONTINUE TO SERVE AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORTENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSPROVIDENCE CONTINUES TO EXECUTE ON OUR INTEGRATED STRATEGIC AND FINANCIAL PLAN, WHICH CLEARLY EXPRESSES OUR COMMITMENT AND ACCELERATION OF THE IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES AND REDUCE OUR CARBON FOOTPRINT IN THE COMMUNITIES WE SERVE. PROVIDENCE ADVANCES PROGRESS ON OUR CARBON NEGATIVE GOAL AND IN 2023 WE ESTIMATED THAT WE DECREASED EMISSIONS BY OVER 12 PERCENT COMPARED TO OUR 2019 BASELINE. IN ADDITION, OUR EFFORTS LED TO THE INTRODUCTION OF THE GREEN HOSPITALS ACT, LEGISLATION MODELED AFTER PROVIDENCE THAT WOULD PROVIDE CRITICAL FEDERAL FUNDING TO WEATHERIZE AND MODERNIZE HEALTH CARE FACILITIES. PROVIDENCE COMPLETED A COMPREHENSIVE CLIMATE RESILIENCE PLAN IN ALIGNMENT WITH OUR COMMITMENT TO THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES CLIMATE PLEDGE. WE CONTINUE TO REDUCE GREENHOUSE GAS EMISSIONS WITH A FOCUS ON LED LIGHTING UPGRADES, WATER CONSERVATION, MORE EFFICIENT DELIVERY OF NITROUS OXIDE GAS DURING ANESTHESIA, AND INVESTING IN OUR COMMUNITIES IS AN ESSENTIAL WAY WE LIVE OUR MISSION FOR GENERATIONS, THE PROVIDENCE FAMILY OF ORGANIZATIONS HAS SERVED AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE. GUIDED BY COMMUNITY HEALTH NEEDS ASSESSMENTS, WE CONTINUE OUR LONGSTANDING COMMITMENT TO THOSE IN NEED THROUGH COMMUNITY BENEFIT AND OTHER HIGH-IMPACT INVESTMENTS.INVESTING IN OUR COMMUNITIES IS AN ESSENTIAL WAY WE LIVE OUR MISSIONFOR GENERATIONS, THE PROVIDENCE FAMILY OF ORGANIZATIONS HAS SERVED AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE. GUIDED BY COMMUNITY HEALTH NEEDS ASSESSMENTS, WE CONTINUE OUR LONGSTANDING COMMITMENT TO THOSE IN NEED THROUGH COMMUNITY BENEFIT AND OTHER HIGH-IMPACT INVESTMENTS.OUR INVESTMENTS GO BEYOND THE WALLS OF OUR HOSPITALS AND CLINICS AND DEEP INTO COMMUNITIES TO SUPPORT ORGANIZATIONS AND CAUSES THAT SERVE THOSE IN NEED; ADDRESS GAPS IN SERVICES AND RESOURCES THAT CONTRIBUTE TO OVERALL HEALTH; AND ENHANCE CARE DELIVERY WITH INNOVATIVE SOLUTIONS TO HEALTH CARE'S BIGGEST CHALLENGES. THIS IS HOW WE INVEST IN HEALTH TODAY TO CREATE A BETTER FUTURE. BELOW WE HIGHLIGHT KEY EXAMPLES.ST. JOSEPH FUND:ST. JOSEPH FUND (SJF) IS PROVIDENCE'S GRANTMAKING FOUNDATION. IT INVESTS IN AND FOSTERS LONG-TERM PARTNERSHIPS, ROOTED IN LOVE, WITH COMMUNITIES TO ENSURE THEY ARE LIVELY, HOPEFUL, HEALTHY, AND JUST. ITS PARTNERSHIPS ARE TAILORED TO PROVIDE EACH GROUP WITH CAPACITY-BUILDING SUPPORT SPECIFIC TO THEIR NEEDS. TOGETHER, THEY BUILD RELATIONSHIPS AND FOSTER ONGOING DIALOGUES BEYOND A GRANT TERM. EACH PARTNERSHIP ENCOURAGES THE ACCESSIBILITY OF STAFF TO GENERATE IDEAS AND INNOVATIONS.SJF INVESTS IN REGIONAL NONPROFITS AND COLLABORATIVES ACROSS ALASKA, CALIFORNIA, MONTANA, OREGON, AND WASHINGTON TO STRENGTHEN AND BUILD THE POWER OF COMMUNITIES, FOCUSING ON BUILDING COMMUNITY IN FOUR KEY AREAS:-DISASTER RESPONSE AND RESILIENCE-LIFELONG EDUCATION THAT OPENS DOORS-POSITIVE CHANGE THROUGH COMMUNITY POWER-COMMUNITY HEALING AND RESILIENCECAPACITY BUILDING IS AT THE CENTER OF SJF'S WORK. BY THAT, IT MEANS INFRASTRUCTURE DEVELOPMENT, INTERNAL ASSESSMENTS, RESEARCH, TRAINING, COHORT LEARNING, EXAMINING POLICIES AND PROCEDURES, AND MORE TO ENCOMPASS THE BUILDING BLOCKS FOR ORGANIZATIONAL POWER TO CARRY FORTH DIRECT COMMUNITY AND SOCIAL IMPACT. IT PARTNERS WITH COMMUNITY MEMBERS TO GO THE DISTANCE WITH THEM TOWARD WHOLENESS. THE SJF DOESN'T JUST FUND INITIATIVES IT REMAINS PARTNERS LONG AFTER THE GRANT FUNDS HAVE BEEN EXPENDED. SJF LEADERS AND THOSE AT THEIR NONPROFIT PARTNERS EACH HAVE LIVED EXPERIENCE AND UNDERSTAND THE NEEDS OF UNDERSERVED COMMUNITIES. THE SJF TEAM IS MOTIVATED BY COMPASSION, KINDNESS, AND THE DESIRE TO BENEFIT OTHERS AND BELIEVES THIS LEADS TO MORE POSITIVE OUTCOMES AND CREATES A SENSE OF FULFILLMENT AND SATISFACTION.ABOVE ALL, SJF BELIEVES IN THE POWER OF THE COMMUNITY.IT CELEBRATES AND CENTERS COMMUNITY EXPERTISE AND EXPERIENCE. IT LISTENS TO THEIR WISDOM. IT UNDERSTANDS THEIR NEEDS. AND IT INVESTS IN THEIR OPPORTUNITIES. SJF ENVISIONS WORKING AND LIVING TOGETHER IN LIVELY, HOPEFUL, HEALTHY, AND JUST COMMUNITIES. THE SJF INVESTS IN LONG-TERM PARTNERSHIPS ROOTED IN LOVE.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/INITIATIVES/ST-JOSEPH-FUNDHEALTH EQUITYCHANGE BEGINS WITH USAT PROVIDENCE, WE RECOGNIZE THAT INEQUITY PERSISTS IN NEARLY EVERY MAJOR FACET OF SOCIETY. THAT INCLUDES IN HEALTH CARE AND THE SOCIAL DETERMINANTS OF HEALTH. AND THE CONSEQUENCES ARE OFTEN DEADLY, LEADING TO HIGHER MORTALITY AND MORBIDITY RATES FOR COMMUNITIES OF COLOR AND MARGINALIZED POPULATIONS. TOWARD THAT END:-WE ARE INVESTING $50 MILLION OVER FIVE YEARS TO IMPROVE HEALTH EQUITY IN OUR COMMUNITIES. OUR HEALTH EQUITY STRATEGIC PLAN AND INTERVENTIONS ARE INFORMED BY ADVANCED DATA ANALYTICS AND THE HEALTH PRIORITIES IDENTIFIED WITH OUR LOCAL COMMUNITY PARTNERS AND CARE TEAMS.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/HEALTH-EQUITYADVOCACY AND SOCIAL RESPONSIBILITYIN PARTNERSHIP WITH COMMUNITIES, THE PROVIDENCE FAMILY OF ORGANIZATIONS ADVOCATES FOR RESPONSIBLE, SUSTAINABLE, AND EQUITABLE POLICIES AND PRACTICES. WE REACH BEYOND THE WALLS OF HOSPITALS AND CARE FACILITIES TO WORK WITH LOCAL, STATE AND NATIONAL PARTNERS TO ADVANCE POLICIES DESIGNED TO BETTER SERVE VULNERABLE POPULATIONS AND PROMOTE JUSTICE IN OUR COMMUNITIES. WE ALSO PARTNER TO PROMOTE PRACTICES AND INFRASTRUCTURE THAT WILL SUSTAIN THE PLANET FOR FUTURE GENERATIONS AND TRANSFORM OUR COMMUNITIES FOR A HEALTHIER, MORE EQUITABLE WORLD.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ADVOCACY-AND-SOCIAL-RESPONSIBILITY
PART VI, LINE 6 (CONTINUED) ENVIRONMENTAL STEWARDSHIPTHE PROVIDENCE FAMILY OF ORGANIZATIONS HAS A VISION OF HEALTH FOR A BETTER WORLD. AS SUCH, WE ARE CALLED TO CARE WISELY FOR OUR COMMUNITIES, RESOURCES, AND EARTH. OUR ORGANIZATIONS STRIVE TO BECOME CARBON NEGATIVE BY 2030. THIS BOLD COMMITMENT GOES BEYOND ADDRESSING CARBON EMISSIONS. THE CLIMATE CRISIS CANNOT BE SOLVED WITHOUT ALSO RESPONDING TO SOCIAL AND RACIAL INEQUITIES. WE ARE COMMITTED TO HEALTH EQUITY, INCLUDING ENVIRONMENTAL EQUITY, AS CLIMATE CHANGE IMPACTS WORSEN, AND DISPARITIES AND INEQUITIES WIDEN DUE TO HISTORICAL AND STRUCTURAL CAUSES OF OPPRESSION. THE CURRENT CRISIS CALLS FOR US TO ACT BOLDLY, WITH COMPASSION. WE ARE DOING SO BY HELPING TO CARE FOR OUR COMMON HOME, ENSURING EQUITY TODAY, AND PASSING A HEALTHY PLANET TO THE GENERATIONS OF TOMORROW.FOR MORE INFORMATION GO TO:HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ADVOCACY-AND-SOCIAL-RESPONSIBILITY/ENVIRONMENTAL-STEWARDSHIPWELL BEING TRUSTPROVIDENCE'S WELL BEING TRUST IS A FOUNDATION DEDICATED TO ADVANCING THE MENTAL, SOCIAL, AND SPIRITUAL HEALTH FOR ALL. WITH A BOLD MISSION, VISION AND OVERARCHING GOAL, WELL BEING TRUST IS INVESTING IN APPROACHES THAT HAVE THE POTENTIAL TO MODEL THE WAY FORWARD AND ADVANCECLINICAL, COMMUNITY AND CULTURAL CHANGETO TRANSFORM THE HEALTH OF THE NATION AND IMPROVE WELL-BEING FOR EVERYONE. FOR MORE INFORMATION GO TO: HTTPS://WELLBEINGTRUST.ORG/ABOUT/
Schedule H (Form 990) 2023
Additional Data


Software ID:  
Software Version:  

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
2023
Open to Public
Inspection
Name of the organization
WESTERN HEALTHCONNECT
 
Employer identification number
45-4171900
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) BURBANK HOUSING
1425 CORPORATE CNTR PKWY
SANTA ROSA,CA95407
95-2627136 501(C)3 700,000 0     COMMUNITY BENEFIT RESTRICTED GRANT
(2) COMMITTEE ON THE SHELTERLESS
PO BOX 2744
PETALUMA,CA94953
68-0176855 501(C)3 289,263 0     COMMUNITY BENEFIT RESTRICTED GRANT
(3) HEALTHCARE FOUNDATION NORTHERN SONOMA CO
111 MONTE VISTA AVE
HEALDSBURG,CA95448
68-0474109 501(C)3 285,000 0     COMMUNITY BENEFIT RESTRICTED GRANT
(4) ALLIANCE MEDICAL CENTER INC
1381 UNIVERSITY ST
HEALDSBURG,CA95448
94-2308748 501(C)3 115,000 0     COMMUNITY BENEFIT RESTRICTED GRANT
(5) CITY OF PETALUMA
PO BOX 61 PETALUMA FIRE PREVENTION
PETALUMA,CA94953
94-6000392 GOV'T 110,000 0     COMMUNITY BENEFIT RESTRICTED GRANT
(6) PETALUMA HEALTHCARE DISTRICT
1425 N MCDOWELL BLVD STE 105
PETALUMA,CA94954
68-0437840 501(C)3 40,000 0     COMMUNITY BENEFIT RESTRICTED GRANT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
6
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2023

Schedule I (Form 990) 2023
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
SCHEDULE I, PART I, LINE 1 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 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) 2023



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic Attach to Form 990.
medium right arrow graphic Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
WESTERN HEALTHCONNECT
 
Employer identification number

45-4171900
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes 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 .....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2023

Schedule J (Form 990) 2023
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, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1ROD F HOCHMAN MD
FRMR OFF. - PSJH PRESIDENT & CEO
(i)

(ii)
0
-------------
2,461,224
0
-------------
10,512,523
0
-------------
891,069
0
-------------
899,903
0
-------------
35,359
0
-------------
14,800,078
0
-------------
823,612
2ERIK WEXLER
PRESIDENT/CEO
(i)

(ii)
0
-------------
1,601,628
0
-------------
2,527,326
0
-------------
1,025,420
0
-------------
426,357
0
-------------
35,336
0
-------------
5,616,067
0
-------------
366,950
3GREG HOFFMAN
EVP & CFO/TREASURER
(i)

(ii)
0
-------------
1,088,176
0
-------------
2,008,809
0
-------------
107,609
0
-------------
297,744
0
-------------
37,211
0
-------------
3,539,549
0
-------------
80,207
4JO ANN ESCASA-HAIGH
FRMR OFFICER
(i)

(ii)
0
-------------
44,915
0
-------------
1,744,873
0
-------------
1,502,009
0
-------------
8,269
0
-------------
2,485
0
-------------
3,302,551
0
-------------
603,250
5ANNA NEWSOM
EVP & CHIEF LEGAL OFFICER/SECRETARY
(i)

(ii)
0
-------------
853,122
0
-------------
1,025,045
0
-------------
39,037
0
-------------
407,728
0
-------------
4,817
0
-------------
2,329,749
0
-------------
36,047
6JIM WATSON ESQ
ASSISTANT SECRETARY
(i)

(ii)
0
-------------
480,026
0
-------------
399,066
0
-------------
89,599
0
-------------
107,204
0
-------------
39,727
0
-------------
1,115,622
0
-------------
64,477
7JIM MARTIN
ASSISTANT TREASURER (PART YEAR)
(i)

(ii)
0
-------------
435,246
0
-------------
339,361
0
-------------
54,321
0
-------------
83,489
0
-------------
32,146
0
-------------
944,563
0
-------------
52,013
8MICHAEL BOLLINGER
PHYSICIAN
(i)

(ii)
438,958
-------------
0
203,798
-------------
0
8,654
-------------
0
24,853
-------------
0
40,098
-------------
0
716,361
-------------
0
0
-------------
0
9FRANCIS CUTRUZZOLA
PHYSICIAN
(i)

(ii)
478,327
-------------
0
25,000
-------------
0
40
-------------
0
20,189
-------------
0
25,905
-------------
0
549,461
-------------
0
0
-------------
0
10JOHN WHIPPLE
FRMR SECRETARY
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
541,701
0
-------------
0
0
-------------
0
0
-------------
541,701
0
-------------
0
11JOSEPH TITO
PHYSICIAN
(i)

(ii)
339,006
-------------
0
61,500
-------------
0
30,017
-------------
0
17,640
-------------
0
679
-------------
0
448,842
-------------
0
7,477
-------------
0
12RAJESH RANADIVE
CHIEF MEDICAL OFFICER HOSPITAL
(i)

(ii)
378,675
-------------
0
25,000
-------------
0
4,343
-------------
0
17,060
-------------
0
5,333
-------------
0
430,411
-------------
0
0
-------------
0
13DARIAN HARRIS MHA
CHIEF EXEC HUMBOLDT - THRU 7/23
(i)

(ii)
0
-------------
203,683
0
-------------
116,801
0
-------------
34,218
0
-------------
4,950
0
-------------
16,561
0
-------------
376,213
0
-------------
0
14BERTA KAEMMERLING
DIRECTOR NURSING
(i)

(ii)
267,325
-------------
0
19,634
-------------
0
13,926
-------------
0
13,028
-------------
0
14,877
-------------
0
328,790
-------------
0
0
-------------
0
15DONALD ANDERSON JR
ASSISTANT SECRETARY FOR ENROLLMENT
(i)

(ii)
0
-------------
266,681
0
-------------
24,827
0
-------------
1,367
0
-------------
15,474
0
-------------
15,372
0
-------------
323,721
0
-------------
0
16BHARATHA NAOTUNNE
CFO PETALUMA & HEALDSBURG
(i)

(ii)
0
-------------
239,826
0
-------------
25,000
0
-------------
29,024
0
-------------
13,111
0
-------------
2,691
0
-------------
309,652
0
-------------
0
Schedule J (Form 990) 2023

Schedule J (Form 990) 2023
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 TAX INDEMNIFICATIONS OR 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 RELATED TO RELOCATION OF NEWLY HIRED EMPLOYEES AND CURRENT EMPLOYEES RELOCATING TO A NEW POSITION. PROVIDENCE MAY PAY TEMPORARY LIVING EXPENSES FOR THE ELIGIBLE EMPLOYEE UP TO A MAXIMUM OF 90 CALENDAR DAYS. COVERED EXPENSES INCLUDE RENT (EXCLUDING AMOUNTS WHICH MAY BE PAID IN ORDER TO OCCUPY A NEW PERMANENT RESIDENCE UNTIL TITLE CLEARS), NON-REFUNDABLE SECURITY DEPOSITS 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 A RELATED TAX-EXEMPT ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, 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 RECIEVED SEVERANCE PAYMENTS DURING 2023: JO ANN ESCASA-HAIGH - $811,814 JOHN WHIPPLE - $539,282 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, M.D. - $823,612 ERIK WEXLER - $366,950 GREG HOFFMAN - $80,207 JO ANN ESCASA-HAIGH - $603,250 JIM WATSON, ESQ - $64,477 JIM MARTIN - $52,013 JOSEPH TITO - $7,477
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 AND LONG-TERM INCENTIVE PLAN, WHICH ARE PERFORMANCE-BASED ANNUAL INCENTIVE PLANS THAT AFFORD 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) 2023

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990)

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2023
Open to Public
Inspection
Name of the organization
WESTERN HEALTHCONNECT
 
Employer identification number

45-4171900
Return Reference Explanation
FORM 990, PART III, LINE 4A, (CONTINUED): MENTAL HEALTH: SUPPORTING THE PETALUMA POLICE DEPARTMENT'S SAFE TEAM TO ADDRESS CRISIS RESPONSE, PREVENTION AND INTERVENTION FOR OUR MOST VULNERABLE COMMUNITY MEMBERS EXPERIENCING CRISES RELATED TO MENTAL HEALTH ISSUES, SUBSTANCE ABUSE ISSUES AND HOMELESSNESS. THE TEAM IS MADE UP OF SPECIALLY TRAINED CIVILIAN FIRST RESPONDERS, WHO RESPOND TO AND PROACTIVELY ADDRESS CALLS FOR SERVICE THAT HAVE TRADITIONALLY BURDENED LAW ENFORCEMENT AND HEALTH CARE PROVIDERS. $110,000 INVESTMENT. SUPPORTING ALEXANDER VALLEY HEALTHCARE'S MENTAL HEALTH AND SUBSTANCE ABUSE SUPPORT PROGRAM. TWO BARRIERS TO ACCESSING MENTAL HEALTH & SUBSTANCE ABUSE SERVICES ARE THE COST OF SERVICE AND THE LACK OF BILINGUAL/BICULTURAL PROVIDERS. PATIENTS WHO QUALIFY FOR MEDI-CAL AND MEDICARE ARE COVERED FOR A VARIETY OF MENTAL HEALTH SERVICES. HOWEVER, FOR PATIENTS WHO DO NOT QUALIFY FOR THESE PUBLIC INSURANCE PROGRAMS AND WHO ARE EITHER UNINSURED, OR UNDER-INSURED, PARTICULARLY THOSE BETWEEN 201%-600% OF THE FEDERAL POVERTY LEVEL, THE COST OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES IS OFTEN PROHIBITIVE AND THEY DO NOT SEEK CARE. FUNDING WILL ENABLE BRIDGING THE GAP FOR MANY OF OUR PATIENTS WHO FALL INTO THIS CATEGORY. $99,500 INVESTMENT. COTS SOCIAL SUPPORTS MANAGER WORKS WITH CLIENTS WHO ARE AT THE INTERSECTION OF HOMELESSNESS AND BEHAVIORAL HEALTH NEEDS. CLIENTS IN THIS PROGRAM RECEIVE BEHAVIORAL HEALTH PROGRAMMING IN GROUP AND ONE-ON-ONE SETTINGS THROUGH ORIGINAL CURRICULUM AT COTS' MARY ISAAK CENTER AND IN COTS' SHARED HOUSING PROGRAMS. OFFERINGS INCLUDE EVIDENCE-BASED PRACTICES SUCH AS SEEKING SAFETY, TRIPLE P, ACES, RECOVERY MODEL, AS WELL AS TOPICS SUCH AS EMOTIONAL REGULATION, HEALTHY COMMUNICATION, AND OVERALL WELLNESS TACTICS. IN ADDITION, THE SOCIAL SUPPORTS MANAGER PROVIDES MONTHLY TRAININGS TO FRONTLINE PROGRAM STAFF ON A VARIETY OF BEHAVIORAL HEALTH TOPICS SUCH AS MOTIVATIONAL INTERVIEWING, TRAUMA INFORMED CARE, HOARDING, AND SELF-CARE TO SUPPORT THEIR WORK WITH CLIENTS. FINALLY, THE MANAGER REPRESENTS COTS IN BEHAVIORAL HEALTH COLLABORATIONS AND SERVES AS A RESOURCE WITHIN SONOMA COUNTY, ATTENDING COMMUNITY MEETINGS AND BEHAVIORAL HEALTH AWARENESS EVENTS, AND ENGAGING WITH COMMUNITY PARTNERS AND BUSINESSES REGARDING BEHAVIORAL HEALTH IN OUR HOMELESS COMMUNITY. $97,386 INVESTMENT. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/NORTHERN-CALIFORN IA
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 ORGANIZATION'S SECTION 4960 TAX ANALYSIS AND REPORTING.
FORM 990, PART VI, SECTION A, LINE 4 WESTERN HEALTHCONNECT AMENDED ITS ARTICLES OF INCORPORATION TO UPDATE THE ARTICLES REGARDING THE DISTRIBUTION OF ASSETS UPON DISSOLUTION.
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, REVISED IN 2023, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY CORE LEADERS 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 RECUSED 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 A 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 PERIODICALLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY.
FORM 990, PART VI, SECTION B, LINE 15B PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY A RELATED TAX-EXEMPT ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, 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 JUNE 2024.
FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS 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 IX, LINE 11G AGENCY & CONTRACT LABOUR: PROGRAM SERVICE EXPENSES 5,841,263. MANAGEMENT AND GENERAL EXPENSES 565,515. TOTAL EXPENSES 6,406,778. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 1,979,784. MANAGEMENT AND GENERAL EXPENSES 191,670. TOTAL EXPENSES 2,171,454. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 1,253,320. MANAGEMENT AND GENERAL EXPENSES 121,339. TOTAL EXPENSES 1,374,659. MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 10,651,729. MANAGEMENT AND GENERAL EXPENSES 1,031,235. TOTAL EXPENSES 11,682,964. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 6,740,337. MANAGEMENT AND GENERAL EXPENSES 652,558. TOTAL EXPENSES 7,392,895. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 2,831,228. MANAGEMENT AND GENERAL EXPENSES 274,102. TOTAL EXPENSES 3,105,330.
FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS -36,586,888.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2023


Additional Data


Software ID:  
Software Version:  
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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2023
Open to Public Inspection
Name of the organization
WESTERN HEALTHCONNECT
 
Employer identification number

45-4171900
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) NORCAL HEALTHCONNECT LLC
1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
85-2390012
HEALTHCARE CA 98,774,844 25,321,600 WHC
 
(2) HEALTH CONNECT PARTNERS LLC
1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
80-0927815
HEALTHCARE WA 0 0 WHC
 








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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)COLLABRIA CARE
414 SOUTH JEFFERSON STREET

NAPA,CA94559
68-0393144
HEALTHCARE CA 501(C)(3) 10 SJHCN
 
Yes
 
(2)COVENANT ACO
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
61-1573313
HEALTHCARE TX 501(C)(3) 12, I CHS
 
Yes
 
(3)COVENANT CHILDREN'S PHYSICIANS GROUP
3615 19TH STREET

LUBBOCK,TX79410
88-1290850
HEALTHCARE TX 501(C)(3) PENDING CHS
 
Yes
 
(4)COVENANT HEALTH NETWORK INC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
46-1259908
HEALTHCARE CA 501(C)(3) 12, III SJHS
 
Yes
 
(5)COVENANT HEALTH PARTNERS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
46-3516417
HEALTHCARE TX 501(C)(3) 12, I CHS
 
Yes
 
(6)COVENANT HEALTH SYSTEM
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2765566
HEALTHCARE TX 501(C)(3) 3 SJHS
 
Yes
 
(7)COVENANT HEALTH SYSTEM FOUNDATION
3623 22ND PLACE

LUBBOCK,TX79410
75-2897026
HEALTHCARE TX 501(C)(3) 7 CHS
 
Yes
 
(8)COVENANT HOME AND COMMUNITY CARE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
92-0275096
HEALTHCARE TX 501(C)(3) 10 CHS
 
Yes
 
(9)COVENANT HOSPITAL HOBBS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
84-4273963
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(10)COVENANT MEDICAL CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
82-2913146
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(11)COVENANT MEDICAL GROUP
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2743883
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(12)EVERETT TRANSITIONAL CARE SERVICES
PO BOX 5128

EVERETT,WA982065128
94-3264605
TRANSITIONAL CARE WA 501(C)(3) 10 N/A
 
No
(13)GAMELIN WASHINGTON ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
20-1910170
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(14)GLOBAL TO LOCAL HEALTH INITIATIVE
2800 SOUTH 192ND ST 104

SEATAC,WA98188
27-3133200
HEALTHCARE WA 501(C)(3) 7 SHS
 
Yes
 
(15)GRACE CLINIC OF LUBBOCK
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
20-3856995
HEALTHCARE TX 501(C)(3) 3 LHH LLC
 
Yes
 
(16)HOSPICE OF LUBBOCK
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2133781
HEALTHCARE TX 501(C)(3) 10 CHS
 
Yes
 
(17)INSTITUTE FOR MENTAL HEALTH & WELLNESS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-4260130
HEALTHCARE WA 501(C)(3) PF PHS SJHS
 
Yes
 
(18)INSTITUTE FOR SYSTEMS BIOLOGY
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-2003593
HEALTHCARE WA 501(C)(3) 7 WHC
 
Yes
 
(19)KADLEC AUXILIARY INC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-6033089
SUPPORT WA 501(C)(3) 12, III KRMC
 
Yes
 
(20)KADLEC FOUNDATION
888 SWIFT BLVD

RICHLAND,WA99352
23-7005501
SUPPORT WA 501(C)(3) 7 KRMC
 
Yes
 
(21)KADLEC REGIONAL MEDICAL CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-0655392
HEALTHCARE WA 501(C)(3) 3 WHC
 
Yes
 
(22)LITTLE COMPANY OF MARY ANCILLARY SERVICES CORPORATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
33-0844408
IMAGING SERVICES CA 501(C)(3) 10 PHS SOCAL
 
Yes
 
(23)LUBBOCK HERITAGE HOSPITAL LLC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
26-4021016
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(24)LUNDBERG ASSOCIATION PROVIDENCE HOUSE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1562797
SUPPORT OR 501(C)(3) 7 PHS OR
 
Yes
 
(25)METHODIST CHILDREN'S HOSPITAL
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2428911
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(26)METHODIST HOSPITAL LEVELLAND
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2246348
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(27)METHODIST HOSPITAL PLAINVIEW
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
75-2426010
HEALTHCARE TX 501(C)(3) 3 CHS
 
Yes
 
(28)MISSION HOSPITAL REGIONAL MEDICAL CTR
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1643360
HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(29)NORTHWEST HOPE & HEALING FOUNDATION
PO BOX 16069

SEATTLE,WA98116
20-0799737
SUPPORT WA 501(C)(3) 12, I SHS
 
Yes
 
(30)OPEN DOOR VENTURES
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1608508
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(31)PACMED CLINICS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
56-2290878
HEALTHCARE WA 501(C)(3) 10 WHC
 
Yes
 
(32)PH&S FOUNDATIONSFVSA & SCVSA
501 SOUTH BUENA VISTA STREET

BURBANK,CA915054809
95-3544877
HEALTHCARE CA 501(C)(3) 7 PHS SOCAL
 
Yes
 
(33)PROVIDENCE ALASKA FOUNDATION
3760 PIPER STREET SUITE 2021

ANCHORAGE,AK99508
92-0093565
HEALTHCARE AK 501(C)(3) 7 PHS WA
 
Yes
 
(34)PROVIDENCE BENEDICTINE NURSING CENTER FOUNDATION
540 SOUTH MAIN ST

MT ANGEL,OR97362
91-1940286
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(35)PROVIDENCE BLANCHET ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1789266
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(36)PROVIDENCE CHILDREN'S HEALTH FOUNDATION
4805 NE GLISAN ST STE 2N35

PORTLAND,OR97213
93-0800140
SUPPORT OR 501(C)(3) 7 PHS OR
 
Yes
 
(37)PROVIDENCE COMMUNITY HEALTH FOUNDATION
940 ROYAL AVE SUITE 410

MEDFORD,OR97504
93-0692907
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(38)PROVIDENCE DETHMAN HOUSE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
47-3385506
SUPPORT WA 501(C)(3) 7 N/A
 
No
(39)PROVIDENCE FACEY MEDICAL FOUNDATION (FKA FACEY MEDICAL FDN)
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-4322584
SUPPORT CA 501(C)(3) 7 PHS SOCAL
 
Yes
 
(40)PROVIDENCE GAMELIN HOUSE ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
31-1744654
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(41)PROVIDENCE HEALTH & SERVICES
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1549796
HEALTHCARE WA 501(C)(3) 12, II PSJH
 
 
No
(42)PROVIDENCE HEALTH & SERVICES - MONTANA
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-0231793
HEALTHCARE MT 501(C)(3) 3 PHS WA
 
Yes
 
(43)PROVIDENCE HEALTH & SERVICES - OREGON
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
51-0216587
HEALTHCARE OR 501(C)(3) 3 PHS
 
Yes
 
(44)PROVIDENCE HEALTH & SERVICES - WASHINGTON
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
51-0216586
HEALTHCARE WA 501(C)(3) 3 PHS
 
Yes
 
(45)PROVIDENCE HEALTH & SERVICES - WESTERN WASHINGTON
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1303277
HEALTHCARE WA 501(C)(3) 3 PMWHC
 
Yes
 
(46)PROVIDENCE HEALTH ASSURANCE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
55-0828701
MEDICAID HEALTHCARE PROVIDER OR 501(C)(4) N/A PHP
 
Yes
 
(47)PROVIDENCE HEALTH PLAN
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
93-0863097
HEALTHCARE OR 501(C)(4) N/A PH GROUP LLC
 
Yes
 
(48)PROVIDENCE HEALTH SYSTEM - SO CALIFORNIA
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
51-0216589
HEALTHCARE CA 501(C)(3) 3 PHS
 
Yes
 
(49)PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL FOUNDATION INC
810 12TH STREET PO BOX 149

HOOD RIVER,OR97031
93-0921990
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(50)PROVIDENCE HOSPICE AND HOME CARE FOUNDATION SNOHOMISH COUNTY
1615 75TH ST SW SUITE 210

EVERETT,WA98203
27-2552749
HEALTHCARE WA 501(C)(3) 7 PHS W WA
 
Yes
 
(51)PROVIDENCE HOSPICE OF SEATTLE FOUNDATION
2811 SOUTH 102ND NO 220

TUKWILA,WA98168
91-2077378
HEALTHCARE WA 501(C)(3) 7 PHS W WA
 
Yes
 
(52)PROVIDENCE INLAND NORTHWEST FOUNDATION (FKA PROV HC FDN - E WA)
101 W 8TH AVE

SPOKANE,WA99204
32-0014330
HEALTHCARE WA 501(C)(3) 7 PHS WA
 
Yes
 
(53)PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION
4101 TORRANCE BLVD

TORRANCE,CA90503
51-0224944
HEALTHCARE CA 501(C)(3) 7 PHS SOCAL
 
Yes
 
(54)PROVIDENCE MARIANWOOD FOUNDATION
3725 PROVIDENCE POINT DRIVE SE

ISSAQUAH,WA980297219
93-1554288
HEALTHCARE WA 501(C)(3) 7 PHS W WA
 
Yes
 
(55)PROVIDENCE MEDICAL FDN (FKA ST JOSEPH HERITAGE HEALTHCARE)
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
33-0185031
HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(56)PROVIDENCE MEDICAL INSTITUTE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
33-0283773
HEALTHCARE CA 501(C)(3) 12, I PHS SOCAL
 
Yes
 
(57)PROVIDENCE MILWAUKIE FOUNDATION
10150 SE 32ND AVE

MILWAUKIE,OR97222
94-3079515
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(58)PROVIDENCE MINISTRIES
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
RELIGIOUS ORG WA 501(C)(3) 1 N/A
 
No
(59)PROVIDENCE MOUNT ST VINCENT FOUNDATION
4831 35TH AVE SW

SEATTLE,WA981262799
91-1188119
HEALTHCARE WA 501(C)(3) 7 PHS WA
 
Yes
 
(60)PROVIDENCE NEWBERG HEALTH FOUNDATION
1001 PROVIDENCE DRIVE

NEWBERG,OR97132
93-0889144
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(61)PROVIDENCE PETER CLAVER ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
31-1629656
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(62)PROVIDENCE PLAN PARTNERS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1861964
HEALTHCARE WA 501(C)(4) N/A PHS OR
 
Yes
 
(63)PROVIDENCE PORTLAND MEDICAL FOUNDATION
4805 NE GLISAN ST

PORTLAND,OR972132967
93-1231494
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(64)PROVIDENCE ROSSI ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
31-1584166
SUPPORT WA 501(C)(3) 10 PHS WA
 
Yes
 
(65)PROVIDENCE SAINT JOHN'S HEALTH CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1684082
HEALTHCARE CA 501(C)(3) 3 PHS SOCAL
 
Yes
 
(66)PROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-4542216
HEALTHCARE CA 501(C)(3) 3 PHS SOCAL
 
Yes
 
(67)PROVIDENCE SEASIDE HOSPITAL FOUNDATION
725 S WAHANNA ROAD

SEASIDE,OR97138
93-0927320
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(68)PROVIDENCE ST ELIZABETH HOUSE ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-2171539
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(69)PROVIDENCE ST FRANCIS ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
94-3244854
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(70)PROVIDENCE ST JOSEPH HEALTH
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-1244422
HEALTHCARE WA 501(C)(3) 12, III N/A
 
No
(71)PROVIDENCE ST JOSEPH HEALTH FOUNDATION
4400 NE HALSEY ST STE 599

PORTLAND,OR97213
94-3078543
HEALTHCARE WA 501(C)(3) 7 PHS WA
 
Yes
 
(72)PROVIDENCE ST JOSEPH MEDICAL CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-0463482
HEALTHCARE MT 501(C)(3) 3 PHS WA
 
Yes
 
(73)PROVIDENCE ST MARY FOUNDATION
401 W POPLAR STREET

WALLA WALLA,WA99362
45-2841492
HEALTHCARE WA 501(C)(3) 7 PHS WA
 
Yes
 
(74)PROVIDENCE ST VINCENT MEDICAL FOUNDATION
9205 SW BARNES ROAD STE MT2111

PORTLAND,OR97225
93-0575982
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(75)PROVIDENCE SW WASHINGTON FOUNDATION (FKA PROV ST PETER FDN)
413 LILLY ROAD NE

OLYMPIA,WA985065166
91-1097056
SUPPORT WA 501(C)(3) 7 PHS W WA
 
Yes
 
(76)PROVIDENCE TRINITYCARE HOSPICE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-3264139
HEALTHCARE CA 501(C)(3) 10 PHS SOCAL
 
Yes
 
(77)PROVIDENCE TRINITYCARE HOSPICE FOUNDATION
5315 TORRANCE BLVD NO B-1

TORRANCE,CA90503
33-0261016
HEALTHCARE CA 501(C)(3) 7 PTCH
 
Yes
 
(78)PROVIDENCE WILLAMETTE FALLS MEDICAL FOUNDATION
1500 DIVISION STREET

OREGON CITY,OR97045
93-1003750
HEALTHCARE OR 501(C)(3) 12, I PHS OR
 
Yes
 
(79)REDWOOD MEMORIAL FOUNDATION
2700 DOBEER STREET

EUREKA,CA95501
94-2779313
HEALTHCARE CA 501(C)(3) 7 SJHNC LLC
 
Yes
 
(80)SAINT JOHN'S CANCER INSTITUTE (FKA JOHN WAYNE CANCER INST)
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-4291515
HEALTHCARE CA 501(C)(3) 4 PSJHC
 
Yes
 
(81)SAINT JOHN'S HOSPITALHEALTH CENTER FOUNDATION
2121 SANTA MONICA BLVD

SANTA MONICA,CA90404
95-6100079
SUPPORT SAINT JOHN HEALTH CENTER & SJCI CA 501(C)(3) 7 PSJHC
 
Yes
 
(82)SEATTLE SCIENCE FOUNDATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
61-1502822
PHYSICIAN COLLABORATION WA 501(C)(3) 7 WHC
 
Yes
 
(83)SISTERS OF PROVIDENCE OF MONTANA CORPORATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
26-2612415
SHELL CORPORATION MT 501(C)(3) 1 PHS WA
 
 
No
(84)SISTERS OF ST JOSEPH OF ORANGE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1643383
RELIGIOUS ORG CA 501(C)(3) 1 N/A
 
No
(85)SRM ALLIANCE HOSPITAL SERVICES (PVH)
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
68-0395200
HEALTHCARE CA 501(C)(3) 3 SJHNC LLC
 
Yes
 
(86)ST JOSEPH HEALTH MINISTRY
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
27-1666576
RELIGIOUS ORG CA 501(C)(3) 1 SSJO
 
 
No
(87)ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-4791043
HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(88)ST JOSEPH HEALTH SYSTEM
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-3589356
HEALTHCARE CA 501(C)(3) 12, I PSJH
 
 
No
(89)ST JOSEPH HEALTH SYSTEM FOUNDATION
3345 MICHELSON DRIVE SUITE 100

IRVINE,CA92612
33-0143024
HEALTHCARE CA 501(C)(3) 10 SJHS
 
Yes
 
(90)ST JOSEPH HOME CARE NETWORK
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
68-0331084
HEALTHCARE CA 501(C)(3) 10 SJHS
 
Yes
 
(91)ST JOSEPH HOSPITAL OF ORANGE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1643359
HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(92)ST JUDE HOSPITAL INC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1643325
HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(93)ST LUKE ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
94-3176618
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(94)ST MARY MEDICAL CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
95-1914489
HEALTHCARE CA 501(C)(3) 3 SJHS
 
Yes
 
(95)ST PATRICK HOSPITAL FOUNDATION
502 W SPRUCE STREET

MISSOULA,MT59802
23-7056976
HEALTHCARE MT 501(C)(3) 7 PHS WA
 
Yes
 
(96)ST THOMAS CHILD AND FAMILY CENTER
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-0233495
EDUCATION MT 501(C)(3) 10 PHS WA
 
Yes
 
(97)SWEDISH EDMONDS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
27-2305304
HEALTHCARE WA 501(C)(3) 3 WHC
 
Yes
 
(98)SWEDISH HEALTH SERVICES
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-0433740
HEALTHCARE WA 501(C)(3) 3 WHC
 
Yes
 
(99)SWEDISH MEDICAL CENTER FOUNDATION
747 BROADWAY

SEATTLE,WA98122
91-0983214
HEALTHCARE WA 501(C)(3) 7 SHS
 
Yes
 
(100)SWEDISH MJM HOLDINGS
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
27-3139262
HOLDING COMPANY WA 501(C)(3) 12, I SHS
 
Yes
 
(101)TARZANA MEDICAL CENTER LLC
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
83-3972614
HEALTHCARE CA 501(C)(3) 3 PHS SOCAL
 
Yes
 
(102)THE GAMELIN ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1180824
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(103)THE GAMELIN OREGON ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
91-1214491
SUPPORT OR 501(C)(3) 10 PHS OR
 
Yes
 
(104)TRI-CITIES CANCER CENTER FOUNDATION
7350 W DESCHUTES AVE BUILDING A

KENNEWICK,WA99336
91-1739024
SUPPORT WA 501(C)(3) 7 KRMC
 
Yes
 
(105)UNIVERSITY OF PROVIDENCE
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
81-0231777
EDUCATION MT 501(C)(3) 2 PHS
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) 20TH STREET SURGERY LLC

1301 20TH STREET STE 140
SANTA MONICA,CA90404
73-1735618
AMBULATORY SURGERY CENTER CA N/A
        No     No  
(2) BRIDGEPORT MEDICAL IMAGING LLC (BMI)

4400 NE HALSEY 495
PORTLAND,OR97213
26-0796953
IMAGING - DIAGNOSTICS OR N/A
        No   Yes    
(3) BROADWAY IMAGING LLC

PO BOX 4587
MISSOULA,MT598064587
52-2405971
MEDICAL IMAGING MT N/A
        No   Yes    
(4) CANBY MEDICAL CENTER I LLC

4800 SW MACADAM AVE STE 120
PORTLAND,OR97239
20-5470937
REAL ESTATE - MOB OR N/A
        No   Yes    
(5) CENTER FOR MEDICAL IMAGING LLC (CMI)

4400 NE HALSEY 495
PORTLAND,OR97213
20-0477972
IMAGING - DIAGNOSTICS OR N/A
        No   Yes    
(6) CLACKAMAS RADIATION ONCOLOGY CENTER LLC

4400 NE HALSEY 495
PORTLAND,OR97213
26-0381897
RADIATION ONCOLOGY OR N/A
        No   Yes    
(7) COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY

1031 W CHAPMAN AVE 101
ORANGE,CA92868
26-4591502
HEALTHCARE CA N/A
        No   Yes    
(8) COVENANT HIGH PLAINS SURGERY CENTER LLC

40 VALLEY STREAM PKWY
MALVERN,PA19355
75-2177401
HEALTHCARE PA N/A
        No   Yes    
(9) COVENANT PARK PHASE I VENTURE LLC

3615 19TH ST
LUBBOCK,TX79410
87-1464045
REAL ESTATE TX N/A
        No     No  
(10) CSS JV LLC

11782 SW BARNES ROAD STE 200 BLDG C
PORTLAND,OR97225
26-3638838
AMBULATORY SURGERY CENTER OR N/A
        No     No  
(11) FIRST HILL SURGERY CENTER LLC

1101 MADISON STREET STE 200
SEATTLE,WA98104
47-2066485
AMBULATORY SURGERY CENTER WA N/A
        No   Yes    
(12) FULLERTON SURGICAL CENTER LP

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
47-0927394
AMBULATORY SURGERY CENTER CA N/A
        No   Yes    
(13) GREATER VALLEY MEDICAL BUILDING LP

501 S BUENA VISTA ST
BURBANK,CA91505
95-4570858
REAL ESTATE - MOB CA N/A
        No   Yes    
(14) HERITAGE INVESTMENT GROUP I LLC

500 S MAIN STREET STE 1000
ORANGE,CA92868
27-1000061
INVESTMENTS CA N/A
        No     No  
(15) IMAGING ASSOCIATES LLC

3650 PIPER STREET STE A
ANCHORAGE,AK99508
20-3906048
MEDICAL IMAGING AK N/A
        No   Yes    
(16) LSC REAL PROPERTY LLC

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
47-4646059
REAL ESTATE TX N/A
        No   Yes    
(17) METHODIST DIAGNOSTIC IMAGING

4005 24TH STREET
LUBBOCK,TX79410
75-2343261
HEALTHCARE TX N/A
        No   Yes    
(18) MISSION VIEJO PARTNERS II LLC

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
82-3943675
REAL ESTATE - MOB CA N/A
        No   Yes    
(19) NORTH OC IMAGING JV HOLDINGS LLC

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
85-2444305
HEALTHCARE CA N/A
        No     No  
(20) OREGON ADVANCED IMAGING LLC

881 OHARE PARKWAY
MEDFORD,OR97504
45-0471748
MEDICAL IMAGING OR N/A
        No   Yes    
(21) PAVILION SURGERY CENTER LLC

1140 WEST LAVETA AVE
ORANGE,CA92868
81-4376492
AMBULATORY SURGERY CENTER CA N/A
        No     No  
(22) PERFORMANCE MEDICAL EQUIPMENT & RESPIRATORY SERVICES LLC

19625 62ND AVENUE SOUTH SUITE 101
KENT,WA98032
45-2901632
MEDICAL EQUIPMENT WA N/A
        No   Yes    
(23) PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC

1221 MADISON STREET
SEATTLE,WA98104
20-3132044
MEDICAL IMAGING WA N/A
        No   Yes    
(24) PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
81-2701056
INVESTMENTS WA N/A
        No     No  
(25) PROVIDENCE & SCA OFF-CAMPUS HOLDINGS LLC

569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM,AL35209
82-3765555
MEDICAL AL N/A
        No     No  
(26) PROVIDENCE & SCA ON-CAMPUS HOLDINGS LLC

569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM,AL35209
82-3270499
MEDICAL AL N/A
        No   Yes    
(27) PROVIDENCE ALASKA HOUSE I OWNER LP

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
88-2819223
SUPPORTIVE HOUSING AK N/A
        No     No  
(28) PROVIDENCE HOUSE OAKLAND LP

540 23RD ST
OAKLAND,CA94612
81-1441264
SUPPORTIVE HOUSING CA N/A
        No   Yes    
(29) PROVIDENCE IMAGING CENTER JOINT VENTURE

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
92-0118807
MEDICAL IMAGING AK N/A
        No     No  
(30) PROVIDENCE ST JOSEPH HEALTH LONG TERM PORTFOLIO

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
82-3190634
INVESTMENTS WA N/A
        No     No  
(31) PROVIDENCE SURGERY CENTER LLC

902 N ORANGE ST
MISSOULA,MT59802
84-1401625
AMBULATORY SURGERY CENTER MT N/A
        No     No  
(32) PROVIDENCEUSP SPOKANE SURGERY CENTERS LLC

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
88-1149413
AMBULATORY SURGERY CENTER WA N/A
        No     No  
(33) PROVIDENCEUSP SURGERY CTRS LLC

11550 INDIAN HILLS ROAD 160
MISSION HILLS,CA91345
20-0684116
AMBULATORY SURGERY CENTER CA N/A
        No     No  
(34) RADIATION THERAPY INNOVATIONS LLC

1221 MADISON ST 1ST FL
SEATTLE,WA98104
30-0553035
HEALTHCARE WA N/A
        No   Yes    
(35) RIVERSIDE HEALTHCARE

1107 HAZELTINE BLVD 200
CHASKA,MN55318
41-1594648
HEALTHCARE MN N/A
        No   Yes    
(36) ST JOSEPH PHYSICIAN VENTURES I LLC

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
45-4521884
REAL ESTATE CA N/A
        No   Yes    
(37) ST JOSEPHSATELLITE DIALYSIS CENTERS LLC

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
81-4657391
HEALTHCARE CA N/A
        No     No  
(38) ST JUDE SURGICAL CENTERS LLC

1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98057
82-3352570
AMBULATORY SURGERY CENTER CA N/A
        No   Yes    
(39) ST PETER-SOUTH SOUND REGIONAL MRI CENTER

3417 ENSIGN RD NE
OLYMPIA,WA98506
91-1455338
MEDICAL IMAGING WA N/A
        No   Yes    
(40) SURGERY CENTER AT TANASBOURNE LLC

11221 ROE AVE STE 300
LEAWOOD,KS66211
20-8187971
AMBULATORY SURGERY CENTER KS N/A
        No   Yes    
(41) THE MADISON SPOKANE INN LLC

15 WEST ROCKWOOD BLVD
SPOKANE,WA99204
84-1606484
HOTEL SERVICES WA N/A
        No   Yes    
(42) WON-ONC LLC

1900 COOKS HILL RD
CENTRALIA,WA98531
26-2181194
REAL ESTATE - MOB WA N/A
        No   Yes    
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) 1221 MADISON STREET OWNERS ASSOC

747 BROADWAY
SEATTLE,WA98122
20-1954319
OWNERS' ASSOCIATION WA N/A
C         No
(2) ADVATA INC (FKA KENSCI INC)

615 2ND AVE 700
SEATTLE,WA98104
47-4048082
HEALTHCARE WA N/A
C         No
(3) AMERICAN UNITY GROUP LTD

90 PITTS BAY ROAD
PEMBROKE   HM08
BD
CAPTIVE INSURANCE BD N/A
C         No
(4) AYIN HEALTH HOLDINGS INC

4400 NE HALSEY ST STE 609 ATTN ACCO
PORTLAND,OR97213
83-3037172
HEALTHCARE DE N/A
C         No
(5) AYIN HEALTH SOLUTIONS INC

4400 NE HALSEY ST STE 609 ATTN ACCO
PORTLAND,OR97213
93-1211733
HEALTHCARE OR N/A
C         No
(6) BOURGET HEALTH SERVICES INC

101 W 8TH AVE TAF C-9
SPOKANE,WA99204
91-1354431
CLINICAL/MEDICAL LAB WA N/A
C         No
(7) CARON CORPORATION

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
81-0486082
MEDICAL PHYSICIAN SERVICE MT N/A
C         No
(8) CLOUD 21 LIMITED

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
HEALTHCARE UK N/A
C         No
(9) ENDOSCOPY CENTER OF SOUTHERN CALIFORNIA

1301 20TH ST STE 280
SANTA MONICA,CA90404
95-2880495
HEALTHCARE CA N/A
S         No
(10) HCSA PROPERTIES LLC

1600 M STREET NW
AUBURN,WA98001
46-0620892
REAL ESTATE RENTAL WA N/A
C         No
(11) KENSCI ASIA PACIFIC PTE LTD

615 2ND AVE 700
SEATTLE,WA98104
HEALTHCARE SN N/A
C         No
(12) KENSCI TECH INDIA PRIVATE LIMITED

615 2ND AVE 700
SEATTLE,WA98104
HEALTHCARE IN N/A
C         No
(13) LUBBOCK METHODIST HOSP PRACTICE MGMT

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
75-2578995
INACTIVE TX N/A
C         No
(14) LUBBOCK METHODIST HOSPITAL SVCS

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
75-2118585
HEALTHCARE TX N/A
C         No
(15) MEDICAL SPECIALTIES MANAGERS INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
33-0406218
HEALTHCARE WA N/A
C         No
(16) MISSION VIEJO MEDICAL VENTURES INC

27800 MEDICAL CENTER RD 354
MISSION VIEJO,CA92691
33-0212905
HEALTHCARE CA N/A
C         No
(17) PHN HOLDINGS

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
46-1814184
STRATEGIC PLANNING SERVICES CA N/A
C         No
(18) PRAIA HEALTH INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
99-0552297
HEALTHCARE DE N/A
C         No
(19) PROVIDENCE GLOBAL CENTER LLP

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
98-1516461
IT SVCS IN N/A
C         No
(20) PROVIDENCE HEALTH CARE VENTURES INC

101 W 8TH AVE TAF C-9
SPOKANE,WA99204
90-0155714
CLINICAL/MEDICAL LAB WA N/A
C         No
(21) PROVIDENCE HEALTH NETWORK

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
80-0886966
PREPAID HEALTHCARE CA N/A
C         No
(22) PROVIDENCE PARTNERS HOLDINGS INC

4400 NE HALSEY ST STE 609 ATTN ACCO
PORTLAND,OR97213
88-2962549
INVESTMENT DE N/A
C         No
(23) PROVIDENCE PHYSICIAN SERVICES CO

101 W 8TH AVE TAF C-9
SPOKANE,WA99204
91-1216033
HEALTHCARE WA N/A
C         No
(24) PROVIDENCE ST JOSEPH HEALTH NETWORK

20555 EARL ST
TORRANCE,CA90503
82-3771547
HEALTHCARE CA N/A
C         No
(25) PROVSOURCE

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
90-2318536
HEALTHCARE DE N/A
C         No
(26) ST JOSEPH HEALTH

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
46-2340232
HOLDING COMPANY CA N/A
C         No
(27) ST JOSEPH HEALTH SOURCE INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
46-1900168
HEALTHCARE CA N/A
C         No
(28) ST JOSEPH MEDICAL PLAZA ASSOCIATION

1140 W LA VETA STE 400
ORANGE,CA92868
33-0621539
CONDO ASSOCIATION CA N/A
C         No
(29) ST JOSEPH PROF SVCS ENTERPRISES INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
33-0155323
HEALTHCARE CA N/A
C         No
(30) TEGRIA HOLDINGS LLC (FKA GRADY BLOCKER LLC)

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
84-2092143
HOLDING COMPANY DE N/A
C         No
(31) TEGRIA INSIGHTS GROUP HOLDINGS INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
86-1400769
HOLDING COMPANY WA N/A
C         No
(32) TEGRIA INSIGHTS GROUP INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
86-1532593
HEALTHCARE WA N/A
C         No
(33) TEGRIA PRODUCTS GROUP INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
87-0995138
HOLDING COMPANY DE N/A
C         No
(34) TEGRIA RCM GROUP US INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
86-3046450
HOLDING COMPANY DE N/A
C         No
(35) TEGRIA RCM GROUP INC (FKA PROV RCM GROUP INC)

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
84-4686520
HOLDING COMPANY DE N/A
C         No
(36) TEGRIA SERVICES GROUP INC (FKA PROVIDENCE SERVICES GROUP)

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
84-4704409
HOLDING COMPANY DE N/A
C         No
(37) TEGRIA SERVICES GROUP-CAN INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
HEALTHCARE CA N/A
C         No
(38) TEGRIA SERVICES GROUP-US INC (FKA BLUETREE NETWORK INC)

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
90-0872936
HEALTHCARE WI N/A
C         No
(39) TRUSANA INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
92-2370159
HEALTHCARE DE N/A
C         No
(40) VINSERRA INC

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
95-3943315
INVESTMENT CA N/A
C         No
(41) WEIGHT LOSS INC (FKA HMR WEIGHT MANAGEMENT SERVICES CORP)

1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
46-3598718
HEALTHCARE WA N/A
C         No
Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) ST JOSEPH HEALTH SYSTEM

P 1,184,689 CASH
(2) PROVIDENCE MEDICAL FOUNDATION

O 12,654,227 CASH
(3) PROVIDENCE HEALTH & SERVICES - WASHINGTON

L 154,435 CASH



Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2023
Schedule R (Form 990) 2023
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) 2023

Additional Data


Software ID:  
Software Version: