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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
 
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

51-0216589
E Telephone number

G Gross receipts $ 2,190,739,358
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:
HTTP://CALIFORNIA.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 0928
K Form of organization:  
L Year of formation: 1903
M State of legal domicile: CA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE OAS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.
2 Check this box
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 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 13,194
6 Total number of volunteers (estimate if necessary) ............. 6 3,560
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a -8,549,392
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 351,188
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 39,080,962 66,971,656
9 Program service revenue (Part VIII, line 2g) ......... 1,695,202,975 1,890,412,941
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 4,833,233 4,626,255
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 236,171,077 207,762,503
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,975,288,247 2,169,773,355
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 7,561,224 1,996,606
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) 736,067,366 801,674,661
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) 3,071,873    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 1,374,013,293 1,493,108,154
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 2,117,641,883 2,296,779,421
19 Revenue less expenses. Subtract line 18 from line 12....... -142,353,636 -127,006,066
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,734,938,016 2,506,012,773
21 Total liabilities (Part X, line 26)............. 4,094,208,599 3,835,592,397
22 Net assets or fund balances. Subtract line 21 from line 20..... -2,359,270,583 -1,329,579,624
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: AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 2,058,542,683 including grants of $ 1,996,606 ) (Revenue $ 2,095,436,275 )
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-REPORT ENVIRONMENTAL , 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.2023 PROGRAM SERVICE ACCOMPLISHMENTSPROVIDENCE CONTINUES ITS MISSION OF SERVICE IN THE SOUTH BAY SERVICE AREA OF LOS ANGELES COUNTY THROUGH TWO MINISTRIES: PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO AND PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE. PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE IS LOCATED AT 4101 TORRANCE BOULEVARD, TORRANCE, CA, 90503. IT IS AN ACUTE CARE HOSPITAL WITH 327 LICENSED BEDS FOUNDED IN 1960. PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO IS LOCATED AT 1300 WEST SEVENTH STREET, SAN PEDRO, CA, 90732. IT IS AN ACUTE CARE HOSPITAL WITH 231 LICENSED BEDS FOUNDED IN 1925. THESE TWO PROVIDENCE MEDICAL CENTERS SHARE THE SOUTH BAY AS A COMMON SERVICE AREA BECAUSE OF THEIR GEOGRAPHIC PROXIMITY TO EACH OTHER, WHICH IS MADE UP OF A POPULATION OF 884,116 PEOPLE.THE PROVIDENCE LOS ANGELES SERVICE AREA - VALLEY SERVICE AREA IS COMPRISED OF THE GEOGRAPHICALLY CONTIGUOUS SERVICE AREAS OF THE THREE PROVIDENCE MEDICAL CENTERS: NAMELY, PROVIDENCE HOLY CROSS MEDICAL CENTER (PHCMC; MISSION HILLS); PROVIDENCE ST. JOSEPH MEDICAL CENTER (PSJMC; BURBANK); AND PROVIDENCE CEDARS-SINAI TARZANA MEDICAL CENTER (PCSTMC; TARZANA). PROVIDENCE CEDAR-SINAI TARZANA INFORMATION IS REFLECTED IN A SEPARATE 990 SCHEDULE H AND PROGRAM ACCOMPLISHMENTS NARRATIVE.DURING CALENDAR YEAR 2023, THE COMBINED ECONOMIC VALUE OF COMMUNITY BENEFIT PROVIDED BY LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE, PROVIDENCE HOLY CROSS AND PROVIDENCE ST. JOSEPH MEDICAL CENTER BURBANK, THE SOUTHERN CALIFORNIA REGIONAL OFFICE AND HOME HEALTH AGENCIES WAS $198M (INCLUDES CHARITY CARE, MEDI-CAL SHORTFALL AND COMMUNITY BENEFIT SERVICES), EXCLUDING COMMUNITY BUILDING.SOUTH BAY:IN RESPONSE TO COMMUNITY, THE SOUTH BAY HOSPITALS ADDRESSED THE FOLLOWING NEEDS WITHIN OUR COMMUNITIES:1. ACCESS TO HEALTH CARE AND PREVENTATIVE CARE2. HOMELESSNESS AND HOUSING INSTABILITY3. BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE/MISUSE)THESE THREE PRIORITIZED HEALTH NEEDS ARE BEING ADDRESSED WITHIN OUR COMMUNITY-BASED PROGRAMS THAT PROVIDE INFORMATION, RESOURCES, AND ASSISTANCE TO THE UNDERSERVED COMMUNITIES WITHIN OUR SOUTH BAY (SB) SERVICE AREA AS PART OF A THREE-YEAR IMPLEMENTATION STRATEGY. BELOW ARE THE 2023 ACCOMPLISHMENTS.1. ACCESS TO HEALTH CARE AND PREVENTATIVE CARE- ASSISTED WITH OVER 2,800 INSURANCE APPLICATIONS THROUGH OUR COMMUNITY HEALTH INSURANCE PROGRAM, WITH 94% OF THEM CONFIRMED ENROLLED.- CONDUCTED 1,217 HOME VISITATIONS TO PREGNANT AND/OR NEW PARENTS, PROVIDING THEM INFORMATION AND SUPPORTING THEM THROUGH THEIR JOURNEY OF PREGNANCY AND EARLY PARENTHOOD.- ADMINISTERED 3,490 CHILDHOOD VACCINES AND 267 INFLUENZA VACCINES.- 34,275 OUTREACH CONTACTS MADE TO DELIVER GRASSROOTS OUTREACH THAT PROMOTES INFORMATION ON COVID-19 PREVENTION, LOCAL TESTING, AND VACCINATIONS TO COMMUNITY RESIDENTS THROUGH OUR COMMUNITY PUBLIC HEALTH TEAM.- PROVIDED 1,140 FOLLOW-UP PRIMARY CARE REFERRALS AND APPOINTMENTS MADE THROUGH OUR ED COMMUNITY HEALTH WORKER PROGRAM.2. HOMELESSNESS AND HOUSING INSTABILITY- COMPLETED DISCHARGE PAPERWORK FOR 416 HOMLESS PATIENTS AND CONNECTED 155 OF THEM TO SHELTER/HOUSING THROUGH OUR HOMELESS NAVIGATORS PROGRAM.- PROVIDED FINANCIAL SUPPORT TO LOCAL PARTNERS, AWARDING $1,705,000 TO SIX GRANTEES TO PROVIDE HOMELESSNESS AND HOUSING SUPPORT THROUGH RECUPERATIVE CARE, STREET MEDICINE, AND INTERIM HOUSING.3. BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE/MISUSE)- HAD 370 PARTICIPANTS TRAINED IN MENTAL HEALTH FIRST AID- COMPLETED 848 MENTAL HEALTH SCREENINGS BY OUR STAFF AT THE VASEK POLAK HEALTH CLINIC, REFERRING 177 FOR THERAPY SERVICES.- AWARDED $2,141,176 TO SEVEN LOCAL PARTNERS SUPPORTING ACCESS TO MENTAL HEALTH SERVICES.SAN FERNANDO VALLEY:THESE THREE PRIORITIZED HEALTH NEEDS ARE BEING ADDRESSED WITHIN OUR COMMUNITY-BASED PROGRAMS THAT PROVIDE INFORMATION, RESOURCES, AND ASSISTANCE TO THE UNDERSERVED COMMUNITIES WITHIN OUR SAN FERNANDO VALLEY (SFV) SERVICE AREA AS PART OF A THREE-YEAR IMPLEMENTATION STRATEGY.1. ACCESS TO HEALTH CARE AND PREVENTIVE CARE:- ASSISTED WITH OVER 1,092 INSURANCE APPLICATIONS IN 2023 THROUGH OUR SFV COMMUNITY HEALTH INSURANCE PROGRAM, CONFIRMING ENROLLMENT FOR 94% OF THEM.- PROVIDED 528 FLU VACCINATIONS AND 129 COVID-19 VACCINES TO COMMUNITY MEMBERS AT LOCAL SCHOOL SITES IN THE SFV.- MADE PRIMARY CARE REFERRALS FOR 377 EMERGENCY DEPARTMENT PATIENTS, AS WELL AS 300 MEDI-CAL APPOINTMENTS, LINKING PATIENTS TO FINANCIAL COUNSELORS.- AWARDED $4,225,188 TO LOCAL ORGANIZATIONS WORKING TO INCREASE ACCESS TO CARE FOR LOW-INCOME AND VULNERABLE COMMUNITY MEMBERS.2. HOUSING AND HOMELESSNESS- COMPLETED DISCHARGE PAPERWORK FOR 648 HOMELESS PATIENTS VISITING OUR SFV EMERGENCY DEPARTMENTS, SUCCESSFULLY CONNECTING 190 OF THEM IN A FORM OF HOUSING.- AWARDED $2,421,000 TO LOCAL ORGANIZATIONS SUPPORTING HOMELESSNESS AND HOUSING INSTABILITY WITHIN THE SFV.3. MENTAL HEALTH INCLUDING SUBSTANCE USE/MISUSE- PROVIDED 32 MENTAL HEALTH FIRST AID TRAINING SESSIONS AT COMMUNITY LOCATIONS IN THE SFV, WITH 451 PARTICIPANTS COMPLETING THEM.- CONTACTED 343 PATIENTS IN OUR SFV EMERGENCY DEPARTMENTS, SCREENING THEM FOR MENTAL HEALTH, BEHAVIORAL HEALTH, OR SUBSTANCE USE/MISUSE ISSUES. 115 OF THEM WERE SUCCESSFULLY REFERRED TO ADDITIONAL SERVICES.- AWARDED $1,917,878 TO ORGANIZATIONS WITHIN THE SFV PROVIDING MENTAL HEALTH SUPPORT TO UNDERSERVED POPULATIONS.
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 expenses2,058,542,683
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
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment
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
Yes
 
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
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
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
565
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
13,194
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
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
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
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe 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
 
No
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
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filed
CA
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) ERIK WEXLER......................................................................
PRESIDENT/CEO
0.50
.................
64.50
    X       0 5,154,374 461,693
(2) GREG HOFFMAN......................................................................
EVP & CFO/TREASURER
0.50
.................
64.50
    X       0 3,204,594 334,955
(3) JO ANN ESCASA-HAIGH......................................................................
FRMR EVP/TREASURER/CFO
0.00
.................
1.00
          X 0 3,291,797 10,754
(4) ANNA NEWSOM......................................................................
EVP & CHIEF LEGAL OFFICER/SECRETARY
1.00
.................
64.00
    X       0 1,917,204 412,545
(5) KEVIN MANEMANN......................................................................
DIV CHF EXEC SOUTH - THRU 2/23
0.50
.................
54.50
      X     0 2,026,390 13,287
(6) LAUREEN DRISCOLL RN......................................................................
DIV CHF EXEC SOUTH (PART YEAR)
62.50
.................
2.50
      X     0 1,726,763 275,234
(7) JEREMY ZOCH......................................................................
CHIEF EXECUTIVE SJO - THRU 9/23
18.00
.................
37.00
      X     0 1,873,290 36,993
(8) BRIAN LEE HELLELAND......................................................................
DIVISION COO - SOUTH
54.00
.................
1.00
      X     0 1,636,484 245,496
(9) BERNIE KLEIN MD......................................................................
CHIEF EXEC PROV HOLY CROSS MC
54.50
.................
0.50
      X     0 1,535,785 258,015
(10) GARRY OLNEY......................................................................
CHIEF EXECUTIVE LCM MC
55.00
.................
0.00
      X     0 1,324,604 206,887
(11) NATHAN HUSMANN......................................................................
DIVISION CFO - SOUTH
28.00
.................
27.00
      X     0 1,095,778 198,695
(12) JIM WATSON ESQ......................................................................
ASSISTANT SECRETARY
0.50
.................
54.50
    X       0 968,691 146,931
(13) JIM MARTIN......................................................................
ASSISTANT TREASURER (PART YEAR)
1.00
.................
54.00
    X       0 828,928 115,635
(14) KARL KEELER......................................................................
CHIEF EXEC PROV ST JOSEPH MC
54.50
.................
0.50
      X     0 705,497 228,964
(15) REX HOFFMAN......................................................................
CHIEF MEDICAL OFFICER HOSPITAL
50.00
.................
0.00
        X   611,821 0 55,483
(16) GLEN KOMATSU......................................................................
CHIEF MEDICAL OFFICER HOSPITAL
50.00
.................
0.00
        X   563,396 0 79,655
(17) LISA LAURENT......................................................................
CHIEF MEDICAL OFFICER HOSPITAL
50.00
.................
0.00
        X   564,426 0 47,528
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) AMY HEROLD........................................................................
CHIEF MEDICAL OFFICER HOSPITAL
50.00
.......................0.00
        X   537,530 0 62,975
(19) JOHN WHIPPLE........................................................................
FRMR SECRETARY
0.00
.......................0.00
          X 0 541,701 0
(20) GREGORY GISSENDANNER........................................................................
ED ASSOCIATE CHIEF PHILANTHROPY OFFICER
50.00
.......................0.00
        X   468,007 0 22,945
(21) DONALD ANDERSON JR........................................................................
ASSISTANT SECRETARY FOR ENROLLMENT
0.50
.......................54.50
    X       0 292,875 30,846
(22) MARY LYONS PHD........................................................................
DIRECTOR
0.50
.......................13.00
X           0 100,085 0
(23) MICHAEL MURPHY........................................................................
BOARD CHAIR
1.00
.......................26.00
X           0 75,066 0
(24) CHARLES SORENSON MD........................................................................
DIRECTOR
0.50
.......................13.00
X           0 50,000 0
(25) ISIAAH CRAWFORD PHD........................................................................
DIRECTOR
0.50
.......................14.50
X           0 50,000 0
(26) RICHARD BLAIR........................................................................
DIRECTOR
0.50
.......................13.00
X           0 50,000 0
(27) ERIC SPRUNK........................................................................
DIRECTOR
0.50
.......................13.50
X           0 40,000 0
(28) MARY BETH KINGSTON........................................................................
DIRECTOR
0.50
.......................13.00
X           0 40,000 0
(29) MARVIN O'QUINN........................................................................
DIRECTOR (PART YEAR)
0.50
.......................12.50
X           0 0 0
(30) SISTER CAROL PACINI LCM........................................................................
DIRECTOR
0.50
.......................13.00
X           0 0 0
(31) SISTER DIANE HEJNA CSJ RN........................................................................
DIRECTOR
0.50
.......................13.00
X           0 0 0
(32) 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)......... 2,745,180 28,529,906 3,245,516
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 3,087
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 CORP HQ
SAN DIEGO,CA92130
STAFFING SERVICES 67,228,851
MCCARTHY BUILDING COMPANIES

3117 S BIG BEND BLVD
SAINT LOUIS,MO63143
CONSTRUCTION SERVICES 59,152,009
CASS INFORMATION SYSTEMS INC

12444 POWERSCOURT DR 550
ST LOUIS,MO63131
PAYMENT SERVICES 26,166,176
AYA HEALTHCARE

PO BOX 674907
DALLAS,TX75267
STAFFING SERVICES 22,075,400
AV CONSTRUCTION

18444 WARD ST
FOUNTAIN VALLEY,CA92708
CONSTRUCTION SERVICES 16,682,359
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 348
Form 990 (2023)
Form 990 (2023)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 25,919,228
e Government grants (contributions)1e 29,629,367
f All other contributions, gifts, grants, and similar amounts not included above1f 11,423,061
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f....... 66,971,656
 Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 622110 1,889,333,499 1,889,333,499    
b OTHER PATIENT SERVICE 622110 1,662,672 1,662,672    
c JV INCOME 900099 -583,230 -583,230    
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f ..... 1,890,412,941
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ...... 4,227,679   -8,733,015 12,960,694
4 Income from investment of tax-exempt bond proceeds        
5 Royalties...........        
(i) Real (ii) Personal
6a Gross rents 6a 23,243,456  
b Less: rental expenses 6b 20,687,910  
c Rental income or (loss) 6c 2,555,546  
d Net rental income or (loss)....... 2,555,546     2,555,546
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 7a 301,394 375,275
b Less: cost or other basis and sales expenses 7b 278,093 0
c Gain or (loss) 7c 23,301 375,275
d Net gain or (loss)......... 398,576     398,576
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 INTERAFFILIATE REVENUE 900099 175,336,695 175,336,695    
b MISC REVENUE 900099 11,234,594 11,050,971 183,623  
c COST RECOVERIES 900099 7,522,890 7,522,890    
d All other revenue .... 11,112,778 11,112,778    
e Total. Add lines 11a–11d ...... 205,206,957
12 Total revenue. See instructions..... 2,169,773,355 2,095,436,275 -8,549,392 15,914,816
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 .... 1,996,606 1,996,606
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........ 725,859,921 635,966,692 88,733,967 1,159,262
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 17,352,173 15,203,214 2,121,246 27,713
9 Other employee benefits ....... 4,714,885 4,130,976 576,379 7,530
10 Payroll taxes ........... 53,747,682 47,091,366 6,570,476 85,840
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 4,163,043 3,647,476 508,918 6,649
c Accounting ...........        
d Lobbying ...........        
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 27,294   27,294  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 260,078,917 227,869,764 31,793,784 415,369
12 Advertising and promotion .... 1,458,766 1,278,107 178,329 2,330
13 Office expenses ....... 25,632,917 22,458,440 3,133,539 40,938
14 Information technology ...... 110,823 97,098 13,548 177
15 Royalties ..        
16 Occupancy ........... 32,192,316 28,205,498 3,935,404 51,414
17 Travel ............ 4,378,729 3,836,451 535,285 6,993
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 19,242,502 16,859,438 2,352,332 30,732
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 64,570,832 56,574,137 7,893,570 103,125
23 Insurance ... 19,356 16,959 2,366 31
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 702,940,758 615,885,924 85,932,176 1,122,658
b MEDICAL FEES 253,787,905 253,787,905    
c HOSPITAL FEES 117,500,300 117,500,300    
d UBI TAXES PAID 45,000 39,427 5,573  
e All other expenses 6,958,696 6,096,905 850,679 11,112
25 Total functional expenses. Add lines 1 through 24e 2,296,779,421 2,058,542,683 235,164,865 3,071,873
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 ........ 126,913,750 1 248,797,681
2 Savings and temporary cash investments ......... 68,062,444 2 137,148
3 Pledges and grants receivable, net ...... 6,110,810 3 9,983,288
4 Accounts receivable, net ............. 240,345,451 4 168,532,667
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 ........... 8,591,057 7 7,257,418
8 Inventories for sale or use ............ 16,694,971 8 17,439,771
9 Prepaid expenses and deferred charges ...... 2,201,365 9 3,518,898
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 2,243,758,191
b Less: accumulated depreciation 10b 1,496,511,692 756,969,282 10c 747,246,499
11 Investments—publicly traded securities . 7,804,836 11 7,694,650
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 .. 206,613,639 13 755,039,598
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 294,630,411 15 540,365,155
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,734,938,016 16 2,506,012,773
Liabilities 17 Accounts payable and accrued expenses ..... 1,030,493,371 17 166,862,883
18 Grants payable ...   18  
19 Deferred revenue ......... 880,318 19 2,447,084
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 3,062,834,910 25 3,666,282,430
26 Total liabilities. Add lines 17 through 25.. 4,094,208,599 26 3,835,592,397
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 .......... -2,463,048,228 27 -1,458,599,421
28 Net assets with donor restrictions ........... 103,777,645 28 129,019,797
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 ........... -2,359,270,583 32 -1,329,579,624
33 Total liabilities and net assets/fund balances ........ 1,734,938,016 33 2,506,012,773
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
2,169,773,355
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
2,296,779,421
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-127,006,066
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
-2,359,270,583
5
Net unrealized gains (losses) on investments ...............
5
-159,194
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
1,156,856,219
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
-1,329,579,624
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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number

51-0216589
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number

51-0216589
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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number
51-0216589
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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number

51-0216589
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990) (2023)
Schedule B (Form 990) (2023)
Page 4
Name of organization
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number

51-0216589
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number

51-0216589
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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
 
304,468
j
Total. Add lines 1c through 1i ....................................................................................................
304,468
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 1I, LOBBYING ACTIVITIES THE LOBBYING EXPENDITURES REPORTED REPRESENT THE PORTION OF DUES PAID TO ALLIANCE OF CATHOLIC HEALTH CARE, AMERICAN HOSPITAL ASSOCIATION AND CALIFORNIA HOSPITAL ASSOCIATION FOR LOBBYING SERVICES.
Schedule C (Form 990) 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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number

51-0216589
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
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 .... 689,162 661,628 552,550 552,550 511,439
b Contributions ...   39,754 60,991   35,929
c Net investment earnings, gains, and losses 37,817 -12,220 48,087   5,182
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses .... 3,579        
g End of year balance ...... 723,400 689,162 661,628 552,550 552,550
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment right arrow0 %
b
Permanent endowment right arrow100.000 %
c
Term endowment right arrow0 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
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 .....   37,922,161 37,922,161
b Buildings ....   1,145,308,708 651,925,016 493,383,692
c Leasehold improvements   63,305,186 25,331,833 37,973,353
d Equipment ....   915,912,806 819,254,843 96,657,963
e Other .....   81,309,330   81,309,330
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..right arrow 747,246,499
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)HEALTHCARE JOINT VENTURES 542,085,316 F
(2)BENEFICIAL INTEREST IN FOUNDATION 212,954,282 F
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)right arrow 755,039,598
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 303,432,244
(2)RIGHT OF USE OPERATING LEASES 112,931,453
(3)DUE FROM AFFILIATES 20,506,617
(4)DUE FROM THIRD PARTY 20,108,603
(5)OTHER ASSETS 1,647,540
(6)INVESTMENT IN CORP SUBSIDIARIES 81,738,698
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........right arrow 540,365,155
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 2,910,649,327
I/C - TAX-EXEMPT BOND LIABILITIES 263,820,000
OTHER LIABILITIES 188,269,508
HOSPITAL FEE/PROVIDER TAX LIABILITY 178,853,751
CAPITAL LEASE OBLIGATIONS 67,407,182
DUE TO THIRD PARTY 57,282,662



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)right arrow 3,666,282,430
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 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
PART V, LINE 4: THE HIGH SCHOOL HAS TWO ENDOWMENT FUNDS ESTABLISHED FOR SCHOLARSHIP PURPOSES AND IS DONOR-RESTRICTED.
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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number

51-0216589
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) . . .
    12,717,333 0 12,717,333 0.550 %
b Medicaid (from Worksheet 3, column a) . . . . .     633,956,594 484,730,014 149,226,580 6.500 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     646,673,927 484,730,014 161,943,913 7.050 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     20,354,942 6,638,775 13,716,167 0.600 %
f Health professions education (from Worksheet 5) . . .     6,801,296 50,051 6,751,245 0.290 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     15,886,707 0 15,886,707 0.690 %
j Total. Other Benefits . .     43,042,945 6,688,826 36,354,119 1.580 %
k Total. Add lines 7d and 7j .     689,716,872 491,418,840 198,298,032 8.630 %
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
715,815,850
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
897,732,234
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-181,916,384
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

 

No
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?4Name, 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 PROVIDENCE ST JOSEPH MEDICAL CENTER
501 S BUENA VISTA ST
BURBANK,CA91505
HTTPS://WWW.PROVIDENCE.ORG/OBP
930000159
X X         X     A
2 PROVIDENCE LCM MED CTR - TORRANCE
4101 TORRANCE BOULEVARD
TORRANCE,CA90505
HTTPS://WWW.PROVIDENCE.ORG/OBP
930000089
X X         X     B
3 PROVIDENCE HOLY CROSS MEDICAL CENTER
15031 RINALDI ST
MISSION HILLS,CA91345
HTTPS://WWW.PROVIDENCE.ORG/OBP
930000404
X X     X   X     A
4 PROVIDENCE LCM MED CTR - SAN PEDRO
1300 WEST SEVENTH STREET
SAN PEDRO,CA90732
HTTPS://WWW.PROVIDENCE.ORG/OBP
930000142
X X         X     B
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)
PHS - SOUTHERN CALIFORNIA ( GROUP A)
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 22
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)
PHS - SOUTHERN CALIFORNIA ( GROUP A)
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
PHS - SOUTHERN CALIFORNIA ( GROUP A)
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)
PHS - SOUTHERN CALIFORNIA ( GROUP A)
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 Yes  
If "Yes," explain in Section C.
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)
PHS - SOUTHERN CALIFORNIA ( GROUP B)
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 22
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)
PHS - SOUTHERN CALIFORNIA ( GROUP B)
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
PHS - SOUTHERN CALIFORNIA ( GROUP B)
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)
PHS - SOUTHERN CALIFORNIA ( GROUP B)
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 Yes  
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 FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: PROVIDENCE ST. JOSEPH MEDICAL CENTER, - FACILITY 3: PROVIDENCE HOLY CROSS MEDICAL CENTER
PART V, SECTION B FACILITY REPORTING GROUP B
FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 2: PROVIDENCE LCM MED. CTR. - TORRANCE, - FACILITY 4: PROVIDENCE LCM MED. CTR. - SAN PEDRO
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE PRIORITIZED BASED ON THE METHODOLOGY DESCRIBED IN THE MOST RECENT CHNA SECTION ON SIGNIFICANT HEALTH NEEDS.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 5: PROVIDENCE ST. JOSEPH AND PROVIDENCE HOLY CROSS (PROVIDENCE VSA) CONDUCTED KEY INFORMANT INTERVIEWS AND LISTENING SESSIONS WITH INDIVIDUALS WHO REPRESENT A VARIETY OF LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS THROUGHOUT THE HOSPITALS' SERVICE AREA. BOTH MEDICAL CENTERS ARE GOVERNED BY THE VALLEY SERVICE AREA COMMUNITY MINISTRY BOARD.PROVIDENCE VSA RECOGNIZES THE VALUE OF INPUT FROM COMMUNITY MEMBERS AND LOCAL STAKEHOLDERS DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. AS THE PEOPLE WHO LIVE AND WORK IN THE SAN FERNANDO VALLEY, THEY HAVE FIRST-HAND KNOWLEDGE OF THE NEEDS AND STRENGTHS OF THEIR COMMUNITY AND THEIR OPINIONS HELP TO SHAPE OUR FUTURE DIRECTION. TO BETTER UNDERSTAND THEIR UNIQUE PERSPECTIVES, OPINIONS, EXPERIENCES, AND KNOWLEDGE, PROVIDENCE VSA CONDUCTED STAKEHOLDER INTERVIEWS WITH REPRESENTATIVES OF COMMUNITY-BASED ALONG WITH LISTENING SESSIONS WITH COMMUNITY MEMBERS. DURING THESE INTERVIEWS AND LISTENING SESSIONS, COMMUNITY MEMBERS AND NONPROFIT AND GOVERNMENT STAKEHOLDERS DISCUSSED THE ISSUES AND OPPORTUNITIES OF THE PEOPLE, NEIGHBORHOODS, AND CITIES OF THE SERVICE AREA. KEY TAKEAWAYS GATHERED THROUGH ORGANIZATIONAL LEADER INTERVIEWS AND COMMUNITY RESIDENT LISTENING SESSIONS ARE INCLUDED IN THIS REPORT, ORGANIZED BY RELEVANT HEALTH NEED.2022 CHNA KEY INFORMANTS: - ALL-INCLUSIVE COMMUNITY HEALTH CENTER (COMMUNITY BASED ORGANIZATION, HEALTH CARE) - ASCENCIA (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS) - BCR, A PLACE TO GROW (COMMUNITY BASED ORGANIZATION, MENTAL HEALTH) - BURBANK COMMUNITY YMCA (NATIONAL ORGANIZATION, HEALTHY LIVING AND YOUTH DEVELOPMENT) - CITY OF BURBANK (GOVERNMENT) - CITY OF SAN FERNANDO (GOVERNMENT) - COMPREHENSIVE COMMUNITY HEALTH CENTER (COMMUNITY BASED ORGANIZATION, HEALTH CARE) - EL PROYECTO DEL BARRIO (COMMUNITY BASED ORGANIZATION, HEALTH CARE) - HELPING HANDS SENIOR FOUNDATION (COMMUNITY BASED ORGANIZATION, AGING SERVICES) - HOME AGAIN LA (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS) - HOPE OF THE VALLEY RESCUE MISSION (HOUSING/HOMELESSNESS) - KIDS' COMMUNITY DENTAL CLINIC (COMMUNITY BASED ORGANIZATION, DENTAL CARE) - LA FAMILY HOUSING (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS) - LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH (GOVERNMENT, PUBLIC HEALTH) - MEND (COMMUNITY BASED ORGANIZATION, FOOD INSECURITY) - NORTH VALLEY CARING SERVICES (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS) - NORTHEAST VALLEY HEALTH CORPORATION (COMMUNITY BASED ORGANIZATION, HEALTH CARE) - ONEGENERATION (COMMUNITY BASED ORGANIZATION, AGING SERVICES) - SAN FERNANDO COMMUNITY HEALTH CENTER (COMMUNITY BASED ORGANIZATION, HEALTH CARE) - SHERMAN OAKS ADULT CENTER & BERNARDI SENIOR CENTER (COMMUNITY BASED ORGANIZATION, AGING SERVICES) - TARZANA TREATMENT CENTERS (COMMUNITY BASED ORGANIZATION, HEALTH CARE) - THE OFFICE OF LAUSD SCHOOL BOARD MEMBER (GOVERNMENT, EDUCATION) - THE VILLAGE FAMILY SERVICES (COMMUNITY BASED ORGANIZATION, ACCESS TO CARE) - YMCA OF METROPOLITAN LOS ANGELES (NATIONAL ORGANIZATION, HEALTHY LIVING AND YOUTH DEVELOPMENT)THE 2022 CHNA WAS APPROVED BY THE VALLEY SERVICE AREA BOARD OF DIRECTORS ON OCTOBER 20, 2022, AND WAS MADE PUBLICLY AVAILABLE ON DECEMBER 28, 2022.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 6A: PROVIDENCE ST. JOSEPH MEDICAL CENTER AND PROVIDENCE HOLY CROSS MEDICAL CENTER COLLABORATED WITH PROVIDENCE CEDAR SINAI TARZANA MEDICAL CENTER TO COMPLETE THEIR JOINT COMMUNITY HEALTH NEEDS ASSESSMENT. THE THREE MEDICAL CENTERS AGREED UPON A COMMON DEFINITION OF COMMUNITY (SERVICE PLANNING AREA 2-SAN FERNANDO VALLEY) AND THE PRIMARY AND SECONDARY DATA WAS COLLECTED ACROSS THE SAN FERNANDO VALLEY.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN PARTNERSHIP WITH BIEL CONSULTING, INC, WHO TOOK PART IN STAKEHOLDER INTERVIEWS AND REVIEWED LISTENING SESSION SUMMARIES AND SECONDARY DATA, CONSOLIDATING THE INFORMATION AND HELPING WRITE OUR REPORT.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, LINE 7B, CHNA REPORT WEBSITE: HTTPS://PROVIDENCE.ORG/-/MEDIA/PROJECT/PSJH/PROVIDENCE/SOCAL/FILES/ABOUT/COMMUNITY-BENEFIT/PDFS/2022/2022-CHNA-PROVIDENCESAINTJOSEPHMEDICALCENTER.PDFHTTPS://PROVIDENCE.ORG/-/MEDIA/PROJECT/PSJH/PROVIDENCE/SOCAL/FILES/ABOUT/COMMUNITY-BENEFIT/PDFS/2022/2022-CHNA-PROVIDENCEHOLYCROSSMEDICALCENTER.PDF
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 10A: HTTPS://PROVIDENCE.ORG/-/MEDIA/PROJECT/PSJH/PROVIDENCE/SOCAL/FILES/ABOUT/COMMUNITY-BENEFIT/REPORTS/2023-2025_CHIP_SAINTJOSEPHMEDICALCENTER.PDFHTTPS://PROVIDENCE.ORG/-/MEDIA/PROJECT/PSJH/PROVIDENCE/SOCAL/FILES/ABOUT/COMMUNITY-BENEFIT/REPORTS/2023-2025_CHIP_HOLYCROSSMEDICALCENTER.PDFOUR THREE-YEAR IMPLEMENTATION PLAN WAS ADOPTED IN RESPONSE TO THE IDENTIFIED HEALTH NEEDS FROM OUR MOST RECENT CHNA AND SERVES AS THE IMPLEMENTATION STRATEGY FOR OUR HOSPITAL TO ADDRESS THESE NEEDS.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 11: IN DEVELOPING THE LIST OF PRIORITY NEEDS, PROVIDENCE LOOKED AT BRINGING ITS EXPERTISE AND RESOURCES TO THOSE ISSUES WHERE IT CAN MAKE POSITIVE CHANGE. IN OUR 2022 CHNA, THE MISSION COMMUNITY HEALTH COMMITTEE ADOPTED THE FOLLOWING AS THE HIGHEST PRIORITY NEEDS WITHIN OUR COMMUNITIES:1) ACCESS TO HEALTH CARE AND PREVENTIVE CARE2) HOUSING AND HOMELESSNESS3) BEHAVIORAL HEALTH (MENTAL HEALTH INCLUDING SUBSTANCE USE/MISUSE)THESE THREE PRIORITIZED HEALTH NEEDS ARE BEING ADDRESSED WITHIN OUR COMMUNITY-BASED PROGRAMS THAT PROVIDE INFORMATION, RESOURCES, AND ASSISTANCE TO THE UNDERSERVED COMMUNITIES WITHIN OUR SAN FERNANDO VALLEY (SFV) SERVICE AREA AS PART OF A THREE-YEAR IMPLEMENTATION STRATEGY.1. ACCESS TO HEALTH CARE AND PREVENTIVE CARE:- ASSISTED WITH OVER 1,092 INSURANCE APPLICATIONS IN 2023 THROUGH OUR SFV COMMUNITY HEALTH INSURANCE PROGRAM, CONFIRMING ENROLLMENT FOR 94% OF THEM.- PROVIDED 528 FLU VACCINATIONS AND 129 COVID-19 VACCINES TO COMMUNITY MEMBERS AT LOCAL SCHOOL SITES IN THE SFV.- MADE PRIMARY CARE REFERRALS FOR 377 EMERGENCY DEPARTMENT PATIENTS, AS WELL AS 300 MEDI-CAL APPOINTMENTS, LINKING PATIENTS TO FINANCIAL COUNSELORS.- AWARDED $4,225,188 TO LOCAL ORGANIZATIONS WORKING TO INCREASE ACCESS TO CARE FOR LOW-INCOME AND VULNERABLE COMMUNITY MEMBERS.2. HOUSING AND HOMELESSNESS- COMPLETED DISCHARGE PAPERWORK FOR 648 HOMELESS PATIENTS VISITING OUR SFV EMERGENCY DEPARTMENTS, SUCCESSFULLY CONNECTING 190 OF THEM IN A FORM OF HOUSING.- AWARDED $2,421,000 TO LOCAL ORGANIZATIONS SUPPORTING HOMELESSNESS AND HOUSING INSTABILITY WITHIN THE SFV.3. MENTAL HEALTH INCLUDING SUBSTANCE USE/MISUSE- PROVIDED 32 MENTAL HEALTH FIRST AID TRAINING SESSIONS AT COMMUNITY LOCATIONS IN THE SFV, WITH 451 PARTICIPANTS COMPLETING THEM.- CONTACTED 343 PATIENTS IN OUR SFV EMERGENCY DEPARTMENTS, SCREENING THEM FOR MENTAL HEALTH, BEHAVIORAL HEALTH, OR SUBSTANCE USE/MISUSE ISSUES. 115 OF THEM WERE SUCCESSFULLY REFERRED TO ADDITIONAL SERVICES.- AWARDED $1,917,878 TO ORGANIZATIONS WITHIN THE SFV PROVIDING MENTAL HEALTH SUPPORT TO UNDERSERVED POPULATIONS.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. OUR ABILITY TO ADDRESS ALL OF THE IDENTIFIED HEALTH NEEDS IS LINKED TO OUR MISSION TO PAY SPECIAL ATTENTION TO THE POOR AND VULNERABLE AND BY THE STRENGTH OF OUR PARTNERSHIPS WITH OTHER ORGANIZATIONS WHO CAN SUPPLEMENT OR COMPLEMENT OUR ANNUALLY BUDGETED RESOURCES. ONE HEALTH NEED THAT WAS IDENTIFIED IN OUR CHNA WAS DENTAL CARE, AND WHILE PROVIDENCE VSA DEEPLY UNDERSTANDS THE IMPORTANT ROLE IT PLAYS IN THE OVERALL HEALTH OF OUR COMMUNITY MEMBERS, WE BELIEVE THERE ARE ORGANIZATIONS THAT ARE BETTER SITUATED AND RESOURCED TO ADDRESS THIS PARTICULAR NEED. AND WHILE WE CANNOT DIRECTLY TACKLE IT OURSELVES, WE WILL CONTINUE TO PARTNER WITH THESE COMMUNITY ORGANIZATIONS TO SUPPORT AND ASSIST THEM IN WHATEVER WAYS WE CAN, LIKE GRANT FUNDING, WHICH WAS PROVIDED IN 2023.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 16A: FAP WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 16B: FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 16C: FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 24: IF THE SERVICES WERE NOT MEDICALLY NECESSARY OR WERE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY, THEY WERE BILLED AT THE GROSS CHARGE.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE PRIORITIZED BASED ON THE METHODOLOGY DESCRIBED IN THE MOST RECENT CHNA SECTION ON SIGNIFICANT HEALTH NEEDS.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 5: PROVIDENCE SOUTH BAY RECOGNIZES THE VALUE OF INPUT FROM COMMUNITY MEMBERS AND LOCAL STAKEHOLDERS DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. AS THE PEOPLE WHO LIVE AND WORK IN THE SOUTH BAY, THEY HAVE FIRST-HAND KNOWLEDGE OF THE NEEDS AND STRENGTHS OF THEIR COMMUNITY AND THEIR OPINIONS HELP TO SHAPE OUR FUTURE DIRECTION. TO BETTER UNDERSTAND THEIR UNIQUE PERSPECTIVES, OPINIONS, EXPERIENCES, AND KNOWLEDGE, PROVIDENCE SOUTH BAY CONDUCTED STAKEHOLDER INTERVIEWS WITH REPRESENTATIVES OF COMMUNITY-BASED ALONG WITH LISTENING SESSIONS WITH COMMUNITY MEMBERS. DURING THESE INTERVIEWS AND LISTENING SESSIONS, COMMUNITY MEMBERS AND NONPROFIT AND GOVERNMENT STAKEHOLDERS DISCUSSED THE ISSUES AND OPPORTUNITIES OF THE PEOPLE, NEIGHBORHOODS, AND CITIES OF THE SERVICE AREA. KEY TAKEAWAYS GATHERED THROUGH ORGANIZATIONAL LEADER INTERVIEWS AND COMMUNITY RESIDENT LISTENING SESSIONS ARE INCLUDED IN THIS REPORT, ORGANIZED BY RELEVANT HEALTH NEED.2022 CHNA KEY INFORMANTS:- BEACH CITIES HEALTH DISTRICT (COMMUNITY BASED ORGANIZATION, HEALTH ACCESS AND EDUCATION)- BEHAVIORAL HEALTH SERVICES, INC. (COMMUNITY BASED ORGANIZATION, BEHAVIORAL HEALTH)- BLUE SHIELD PROMISE/LA CARE HEALTH PLAN (COMMUNITY BASED ORGANIZATION, ACCESS)- BOYS & GIRLS CLUBS OF THE LOS ANGELES HARBOR (NATIONAL ORGANIZATION, YOUTH DEVELOPMENT)- CALIFORNIA COMMUNITY FOUNDATION (COMMUNITY BASED ORGANIZATION, ACCESS)- CARING HOUSE (COMMUNITY BASED ORGANIZATION, HOSPICE CARE)- CHILD LANE (COMMUNITY BASED ORGANIZATION, EARLY EDUCATION)- CITY OF CARSON (GOVERNMENT)- CITY OF LAWNDALE (GOVERNMENT)- CITY OF TORRANCE (GOVERNMENT)- COMMUNITY'S CHILD (COMMUNITY BASED ORGANIZATION, HOUSING/ HOMELESSNESS)- EXP THE OPPORTUNITY ENGINE (YOUTH EMPLOYMENT SERVICES)- GOODWILL INDUSTRIES (COMMUNITY BASED ORGANIZATION, EMPLOYMENT SERVICES)- HARBOR INTERFAITH SERVICES (HOUSING/HOMELESSNESS)- LAWNDALE ELEMENTARY SCHOOL DISTRICT (SCHOOL DISTRICT, EDUCATION)- LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH (GOVERNMENT)- LOS ANGELES HARBOR COLLEGE (SCHOOL, EDUCATION)- LOS ANGELES HOMELESS SERVICES AGENCY (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS)- LOS ANGELES POLICE DEPARTMENT (GOVERNMENT)- LOS ANGELES UNIFIED SCHOOL DISTRICT (SCHOOL DISTRICT, EDUCATION)- MYCHAL'S LEARNING PLACE (COMMUNITY BASED ORGANIZATION, EMPLOYMENT SERVICES)- NATIONAL HEALTH FOUNDATION (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS)- OFFICE OF SAMOAN AFFAIRS (COMMUNITY BASED ORGANIZATION, ACCESS)- RICHSTONE FAMILY CENTER (COMMUNITY BASED ORGANIZATION, CHILD ABUSE TREATMENT AND PREVENTION)- SAN PEDRO UNITED METHODIST CHURCH (RELIGIOUS ORGANIZATION)- SOUTH BAY CHILDREN'S HEALTH CENTER (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- SOUTH BAY FAMILY HEALTH CARE (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- SOUTH BAY VILLAGE (COMMUNITY BASED ORGANIZATION, AGING SERVICES)- THE VOLUNTEER CENTER SOUTH BAY, HARBOR, LONG BEACH (COMMUNITY BASED ORGANIZATION, MENTAL HEALTH, FOOD INSECURITY, COMMUNITY WELLBEING)- UNIHEALTH FOUNDATION (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS)- VOLUNTEER CENTER SOUTH BAY-HARBOR-LONG BEACH (COMMUNITY BASED ORGANIZATION, VOLUNTEER SERVICES)- WILMINGTON COMMUNITY CLINIC (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- WILMINGTON YMCA (NATIONAL ORGANIZATION, HEALTHY LIVING AND YOUTH DEVELOPMENT)- YMCA OF METROPOLITAN LOS ANGELES (NATIONAL ORGANIZATION, HEALTHY LIVING AND YOUTH DEVELOPMENT)IN ADDITION TO CONDUCTING KEY INFORMANT INTERVIEWS AS PART OF ITS PRIMARY DATA COLLECTION, PROVIDENCE ALSO CONDUCTED LISTENING SESSIONS WITH PEOPLE WHO HAVE CHRONIC CONDITIONS, ARE FROM DIVERSE COMMUNITIES, HAVE LOW-INCOMES, AND/OR ARE MEDICALLY UNDERSERVED.THE 2022 CHNA WAS APPROVED BY THE MISSION COMMUNITY HEALTH COMMITTEE ON BEHALF OF THE PROVIDENCE LITTLE COMPANY OF MARY COMMUNITY MINISTRY BOARD ON SEPTEMBER 13, 2022, AND WAS MADE PUBLICLY AVAILABLE BY DECEMBER 28, 2022.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 6A: PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO AND PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE COLLABORATED TOGETHER TO COMPLETE THEIR JOINT COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITALS AGREED UPON A COMMON DEFINITION OF COMMUNITY (SERVICE PLANNING AREA 8 - SOUTH BAY, EXCLUDING LONG BEACH) AND THE PRIMARY AND SECONDARY DATA WAS COLLECTED ACROSS THE SOUTH BAY.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN PARTNERSHIP WITH BIEL CONSULTING, INC, WHO TOOK PART IN STAKEHOLDER INTERVIEWS AND REVIEWED LISTENING SESSION SUMMARIES AND SECONDARY DATA, CONSOLIDATING THE INFORMATION AND HELPING WRITE OUR REPORT.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, LINE 7B, CHNA REPORT WEBSITE: HTTPS://PROVIDENCE.ORG/-/MEDIA/PROJECT/PSJH/PROVIDENCE/SOCAL/FILES/ABOUT/COMMUNITY-BENEFIT/PDFS/2022/2022-CHNA-PROVIDENCELITTLECOMPANYOFMARYTORRANCE.PDFHTTPS://PROVIDENCE.ORG/-/MEDIA/PROJECT/PSJH/PROVIDENCE/SOCAL/FILES/ABOUT/COMMUNITY-BENEFIT/PDFS/2022/2022-CHNA-PROVIDENCELITTLECOMPANYOFMARYSANPEDRO.PDF
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 10A: HTTPS://PROVIDENCE.ORG/-/MEDIA/PROJECT/PSJH/PROVIDENCE/SOCAL/FILES/ABOUT/COMMUNITY-BENEFIT/REPORTS/2023-2025_CHIP_LITTLECOMPANYOFMARYTORRANCE.PDFHTTPS://PROVIDENCE.ORG/-/MEDIA/PROJECT/PSJH/PROVIDENCE/SOCAL/FILES/ABOUT/COMMUNITY-BENEFIT/REPORTS/2023-2025_CHIP_LITTLECOMPANYOFMARYSANPEDRO.PDFOUR THREE-YEAR IMPLEMENTATION PLAN WAS ADOPTED IN RESPONSE TO THE IDENTIFIED HEALTH NEEDS FROM OUR MOST RECENT CHNA AND SERVES AS THE IMPLEMENTATION STRATEGY FOR OUR HOSPITAL TO ADDRESS THESE NEEDS.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 11: IN DEVELOPING THE LIST OF PRIORITY NEEDS, PROVIDENCE LOOKED AT BRINGING ITS EXPERTISE AND RESOURCES TO THOSE ISSUES WHERE IT CAN MAKE POSITIVE CHANGE. IN OUR LATEST CHNA, THE MISSION COMMUNITY HEALTH COMMITTEE ADOPTED THE FOLLOWING AS THE HIGHEST PRIORITY NEEDS WITHIN OUR COMMUNITIES:1. ACCESS TO HEALTH CARE AND PREVENTATIVE CARE2. HOMELESSNESS AND HOUSING INSTABILITY3. BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE/MISUSE)THESE THREE PRIORITIZED HEALTH NEEDS ARE BEING ADDRESSED WITHIN OUR COMMUNITY-BASED PROGRAMS THAT PROVIDE INFORMATION, RESOURCES, AND ASSISTANCE TO THE UNDERSERVED COMMUNITIES WITHIN OUR SOUTH BAY (SB) SERVICE AREA AS PART OF A THREE-YEAR IMPLEMENTATION STRATEGY.1. ACCESS TO HEALTH CARE AND PREVENTATIVE CARE- ASSISTED WITH OVER 2,863 INSURANCE APPLICATIONS THROUGH OUR COMMUNITY HEALTH INSURANCE PROGRAM, WITH 94% OF THEM CONFIRMED ENROLLED.- CONDUCTED 1,217 HOME VISITATIONS TO PREGNANT AND/OR NEW PARENTS, PROVIDING THEM INFORMATION AND SUPPORTING THEM THROUGH THEIR JOURNEY OF PREGNANCY AND EARLY PARENTHOOD.- ADMINISTERED 3,490 CHILDHOOD VACCINES AND 267 INFLUENZA VACCINES.- 34,275 OUTREACH CONTACTS MADE TO DELIVER GRASSROOTS OUTREACH THAT PROMOTES INFORMATION ON COVID-19 PREVENTION, LOCAL TESTING, AND VACCINATIONS TO COMMUNITY RESIDENTS THROUGH OUR COMMUNITY PUBLIC HEALTH TEAM.- PROVIDED 1,140 FOLLOW-UP PRIMARY CARE REFERRALS AND APPOINTMENTS MADE THROUGH OUR ED COMMUNITY HEALTH WORKER PROGRAM.2. HOMELESSNESS AND HOUSING INSTABILITY- COMPLETED DISCHARGE PAPERWORK FOR 416 HOMLESS PATIENTS AND CONNECTED 155 OF THEM TO SHELTER/HOUSING THROUGH OUR HOMELESS NAVIGATORS PROGRAM.- PROVIDED FINANCIAL SUPPORT TO LOCAL PARTNERS, AWARDING $1,705,000 TO SIX GRANTEES TO PROVIDE HOMELESSNESS AND HOUSING SUPPORT THROUGH RECUPERATIVE CARE, STREET MEDICINE, AND INTERIM HOUSING.3. BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE USE/MISUSE)- HAD 370 PARTICIPANTS TRAINED IN MENTAL HEALTH FIRST AID- COMPLETED 848 MENTAL HEALTH SCREENINGS BY OUR STAFF AT THE VASEK POLAK HEALTH CLINIC, REFERRING 177 FOR THERAPY SERVICES.- AWARDED $2,141,176 TO SEVEN LOCAL PARTNERS SUPPORTING ACCESS TO MENTAL HEALTH SERVICES.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW:- ORAL HEALTH: OUR HEALTH FACILITIES DO NOT PROVIDE ORAL HEALTH CARE, AND IT IS NOT OUR AREA OF EXPERTISE WITHIN THE PROVIDENCE HEALTH SYSTEM IN THE LOS ANGELES REGION. HOWEVER, THERE ARE A NUMBER OF COMMUNITY PARTNERS INCLUDING LOCAL FEDERALLY QUALIFIED HEALTH CLINICS WHO ARE FOCUSING ON INCREASING ACCESS TO ORAL HEALTH CARE, ESPECIALLY FOR THE MEDI-CAL POPULATION. FOR COMMUNITY MEMBERS IN NEED OF THESE SERVICES, WE REFER THEM TO THESE PROVIDERS OF LOW-COST DENTAL CARE.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 16A: FAP WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 16B: FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 16C: FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 24: IF THE SERVICES WERE NOT MEDICALLY NECESSARY OR WERE NOT COVERED UNDER THE FINANCIAL ASSISTANCE POLICY, THEY WERE BILLED AT THE GROSS CHARGE.
   
Schedule H (Form 990) 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?8
Name and address Type of Facility (describe)
1 1 - PROVIDENCE LCMMC TORRANCE PHARMACY
4101 TORRANCE BLVD
TORRANCE,CA905034607
PHARMACY
2 2 - PROVIDENCE ST ELIZABETH CARE CENTER
10425 MAGNOLIA BLVD
NORTH HOLLYWOOD,CA91601
SKILLED NURSING FACILITY
3 3 - PROVIDENCE HCMC - TRAUMA CENTER
15031 RINALDI ST
MISSION HILLS,CA913451207
CLINIC/GROUP PRACTICE
4 4 - PROVIDENCE HOME HEALTH
LA COUNTY NORTH C
BURBANK,CA915021211
HOME HEALTH
5 5 - PROVIDENCEUCLAUSP SURGERY CENTERS
14201 DALLAS PARKWAY
DALLAS,TX75254
AMBULATORY SURGERY CENTER
6 6 - PROVIDENCEUSP SOUTH BAY SURGERY CNTR
14201 DALLAS PARKWAY
DALLAS,TX75254
AMBULATORY SURGERY CENTER
7 7 - PROVIDENCEUSP SURGERY CENTERS LLC
14201 DALLAS PARKWAY
DALLAS,TX75254
AMBULATORY SURGERY CENTER
8 8 - COAST SURGERY CENTER LP
14201 DALLAS PARKWAY
DALLAS,TX75254
AMBULATORY SURGERY CENTER
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: PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/SOUTHERN-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: THERE WERE NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS.
PART III, LINE 4: AS A RESULT OF ADOPTING ASU 2014-09, THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0 AS OF DECEMBER 31, 2019.
PART III, LINE 8: THE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT.
PART III, LINE 9B: 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.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 2: NEEDS ASSESSMENT:REPORTING GROUP AEVERY THREE YEARS, PROVIDENCE HOLY CROSS AND PROVIDENCE SAINT JOSEPH MEDICAL CENTERS CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE COMMUNITIES IN THE SAN FERNANDO VALLEY. THESE TWO MEDICAL CENTERS SHARE A COMMON GOVERNING BOARD KNOWN AS THE VALLEY SERVICE AREA COMMUNITY MINISTRY BOARD (VSA CMB). THE VSA CMB HAS DELEGATED APPROVAL OF THE CHNA TO THE MISSION COMMUNITY HEALTH COMMITTEE, WHICH IS CHAIRED BY A MEMBER OF THE VSA CMB. THIS ONGOING OVERSIGHT ENSURES CONTINUING ENGAGEMENT BY THE VSA CMB AS THEY RECEIVE REPORTS FROM THE COMMITTEE CHAIR AT EVERY MEETING. THE PRIORITIZED NEEDS IDENTIFIED IN THE 2022 CHNA ARE LISTED ABOVE IN PART V, SECTION B, AND THEY BECOME THE BASIS OF THE COMMUNITY HEALTH IMPROVEMENT PLAN/IMPLEMENTATION STRATEGY THAT SETS FORTH OBJECTIVES TO BE ACCOMPLISHED OVER THREE YEARS, UNTIL THE NEXT CHNA IS CONDUCTED.THE 2022 CHNA WAS APPROVED BY THE MISSION COMMUNITY HEALTH COMMITTEE OF THE VSA SERVICE AREA CMB ON OCTOBER 20, 2022. THE CHNA REPORT WAS MADE PUBLICLY AVAILABLE ON DECEMBER 28, 2022.REPORTING GROUP BEVERY THREE YEARS, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTERS, SAN PEDRO AND TORRANCE CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE COMMUNITIES IN THE SOUTH BAY. THESE TWO MEDICAL CENTERS SHARE A COMMON GOVERNING BOARD KNOWN AS THE PROVIDENCE LITTLE COMPANY OF MARY COMMUNITY MINISTRY BOARD. THIS BOARD HAS DELEGATED APPROVAL OF THE CHNA TO THE MISSION COMMUNITY HEALTH COMMITTEE, WHICH IS CHAIRED BY A MEMBER OF THE COMMUNITY MINISTRY BOARD. THIS ONGOING OVERSIGHT ENSURES CONTINUING ENGAGEMENT BY THE BOARD AS THEY RECEIVE REPORTS FROM THE COMMITTEE CHAIR AT EVERY MEETING. THE PRIORITIZED NEEDS IDENTIFIED IN THE 2022 CHNA ARE LISTED ABOVE IN PART V, SECTION B, AND THEY BECOME THE BASIS OF THE COMMUNITY HEALTH IMPROVEMENT PLAN/IMPLEMENTATION STRATEGY THAT SETS FORTH OBJECTIVES TO BE ACCOMPLISHED OVER THREE YEARS, UNTIL THE NEXT CHNA IS CONDUCTED.THE 2022 CHNA WAS APPROVED BY THE MISSION COMMUNITY HEALTH COMMITTEE OF THE PROVIDENCE LITTLE COMPANY OF MARY COMMUNITY BOARD ON SEPTEMBER 13, 2022, AND MADE PUBLICLY AVAILABLE BY DECEMBER 28, 2022.
PART VI, LINE 3: COMMUNICATION TO THE PUBLIC:REPORTING GROUPS A & BTHE 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 WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS 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:REPORTING GROUP ATHE PROVIDENCE SAN FERNANDO VALLEY SERVICE AREA (VSA) IS COMPRISED OF THE SERVICE AREAS OF TWO PROVIDENCE MEDICAL CENTERS: PROVIDENCE HOLY CROSS MEDICAL CENTER (PHCMC; MISSION HILLS) AND PROVIDENCE ST. JOSEPH MEDICAL CENTER (PSJMC; BURBANK). THE PROVIDENCE SAN FERNANDO VALLEY COMMUNITY BENEFIT SERVICE AREA CONSISTS OF HIGH NEED COMMUNITIES WITHIN EACH OF THE THREE MEDICAL CENTERS SERVICE AREAS. SIMILARLY, THE PROVIDENCE SAN FERNANDO VALLEY BROADER SERVICE AREA CONSISTS OF ZIP CODES WITHIN THE SFV SERVICE AREA, BUT OUTSIDE OF THE COMMUNITY BENEFIT SERVICE AREA. COMMUNITIES IN THE BROADER SERVICE AREA ARE MORE RESOURCE-RICH WITH A POPULATION ON THE HIGHER END OF THE SOCIOECONOMIC SPECTRUM. THIS ENTIRE SERVICE AREA ROUGHLY ALIGNS WITH LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH'S SERVICE PLANNING AREA (SPA) 2.POPULATION AND AGE DEMOGRAPHICSTHE TOTAL POPULATION OF THE PROVIDENCE SAN FERNANDO VALLEY (SFV) SERVICE AREA IN 2022 IS 2,230,501 PEOPLE, WHICH REPRESENTS A 0.2% INCREASE COMPARED TO THE 2022 POPULATION, OR APPROXIMATELY 5,000 ADDITIONAL RESIDENTS LIVING IN THE AREA. THE TOTAL POPULATION OF THE SFV COMMUNITY BENEFIT SERVICE AREA IS JUST OVER 52% OF THE TOTAL SERVICE AREA POPULATION, WITH NEARLY 1.2 MILLION PEOPLE. THE MAJORITY OF RESIDENTS IN THE SFV SERVICE AREA ARE BETWEEN 10 AND 39 YEARS OLD.ADULTS 60 YEARS OF AGE AND OLDER MAKE UP 19.7% OF THE TOTAL SERVICE AREA POPULATION, COMPARED TO THE STATE OF CALIFORNIA, ADULTS 65 AND OLDER MAKE UP 15.2% OF THE POPULATION.POPULATION BY RACE AND ETHNICITYAMONG SFV COMMUNITY BENEFIT SERVICE AREA RESIDENTS, IN 2022, 57.9% WERE WHITE, 8.9% WERE ASIAN/PACIFIC ISLANDER/HAWAIIAN, 0.6% WERE ALASKA NATIVE OR AMERICAN INDIAN, 3.8% WERE AFRICAN AMERICAN OR BLACK, AND 3.1% WERE OF TWO OR MORE RACES. APPROXIMATELY 57.9% OF THE RESIDENTS IDENTIFY AS LATINO.INCOME LEVELSIN 2022, THE MEDIAN HOUSEHOLD INCOME OF THE SFV SERVICE AREA VARIED SIGNIFICANTLY FROM A LOW OF $48,888 FOR THE COMMUNITY OF GLENDALE, TO $187,297 FOR THE COMMUNITY OF LA CANADA FLINTRIDGE. THE MEDIAN HOUSEHOLD INCOME IN THE SFV HIGH NEED SERVICE AREA IS JUST $55,396, COMPARED TO LOS ANGELES COUNTY'S $65,817. THE HIGH NEED SERVICE AREA IS ALSO HOME TO A HIGHER CONCENTRATION OF LOW-INCOME RESIDENTS; APPROXIMATELY 45% OF FAMILIES HAVE ANNUAL INCOMES BELOW 200% OF THE FEDERAL POVERTY LEVEL (FPL; $51,500 FOR A FAMILY OF 4) COMPARED TO 34.9% IN LOS ANGELES COUNTY AS A WHOLE.EDUCATION LEVELWHILE MANY OF THE ADULTS LIVING IN THE SFV COMMUNITY BENEFIT SERVICE AREA HAVE AT LEAST A HIGH SCHOOL DIPLOMA (71.6%), THERE WERE SEVERAL ZIP CODES WITH A HIGH CONCENTRATION OF ADULTS WHO HAD NOT COMPLETED HIGH SCHOOL. THESE ZIP CODES INCLUDED PACOIMA (91331; 44.8%), SAN FERNANDO (91340; 39.3%), PANORAMA CITY (91402; 36.4%) AND SUN VALLEY (91352; 34.1%).ECONOMIC INDICATORSTHE PERCENT UNEMPLOYED IN THE HIGH NEED SFV COMMUNITY BENEFIT SERVICE AREA AVERAGES 6.5%. IN THE BROADER SERVICE AREA, IT IS ONLY 5.3%. 12.9% OF HOUSEHOLDS RECEIVE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) BENEFITS, COMPARED TO JUST 3.3% IN THE BROADER SERVICE AREA AND 8.7% FOR LA COUNTY.LANGUAGE PROFICIENCYWHILE 9.4% OF SAN FERNANDO VALLEY RESIDENTS EXPERIENCE DIFFICULTIES WITH LIMITED ENGLISH PROFICIENCY, IN THE HIGH NEED SFV COMMUNITY BENEFIT SERVICE AREA, 16% OF RESIDENTS HAVE THIS STRUGGLE. IN LA COUNTY, THAT NUMBER IS 10.8%, STILL LOWER THAN THE HIGH NEED SFV COMMUNITY BENEFIT SERVICE AREA.HEALTH PROFESSION SHORTAGE AREATHE HEALTH RESOURCES & SERVICES ADMINISTRATION (HRSA) DEFINES A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) AS SHORTAGES OF PRIMARY CARE, DENTAL CARE OR MENTAL HEALTH PROVIDERS BY GEOGRAPHIES OR POPULATIONS. THERE ARE PRIMARY CARE SHORTAGE AREAS IN THE SAN FERNANDO VALLEY WITH THE BOUNDARY OF THE HIGH NEED COMMUNITY AS DEFINED BY THE COMMUNITY NEEDS INDEX.OTHER HOSPITALS IN SERVICE AREATHE HOSPITALS IN THE SERVICE AREA INCLUDE: PROVIDENCE HOLY CROSS MEDICAL CENTER, PROVIDENCE ST. JOSEPH MEDICAL CENTER, PROVIDENCE CEDAR SINAI (TARZANA), KAISER FOUNDATION HOSPITAL PANORAMA CITY, MISSION COMMUNITY HOSPITAL, DIGNITY MEDICAL CENTER, NORTHRIDGE, AND VALLEY PRESBYTERIAN HOSPITAL.REPORTING GROUP BTHE TWO PROVIDENCE SOUTH BAY COMMUNITY MEDICAL CENTERS, PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER SAN PEDRO AND PROVIDENCE LITTLE COMPANY OF MARY MEDICAL CENTER TORRANCE (HEREAFTER SOUTH BAY COMMUNITY), SHARE A COMMON GEOGRAPHY BECAUSE OF THEIR CLOSE PROXIMITY TO EACH OTHER. THE SOUTH BAY COMMUNITY SERVICE AREA IS COMPOSED OF 16 DISTINCT MUNICIPALITIES AND IS A DEMOGRAPHICALLY AND GEOGRAPHICALLY DIVERSE REGION STRETCHING FROM EL SEGUNDO (NORTH), TO CARSON (EAST), TO THE PORT OF LOS ANGELES (SOUTH), TO THE PACIFIC OCEAN (WEST).POPULATION AND AGE DEMOGRAPHICSTHE SOUTH BAY SERVICE AREA IS SLIGHTLY YOUNGER, ON AVERAGE, THAN THE TOTAL POPULATION OF THE STATE OF CALIFORNIA. PEOPLE UNDER THE AGE OF 40 ARE DISPROPORTIONATELY REPRESENTED IN THE HIGH NEED SERVICE AREA, WHILE PEOPLE AGED 40 AND OLDER ARE MORE LIKELY TO LIVE IN THE BROADER SERVICE AREA. ADULTS AGED 60 YEARS AND OLDER MAKE UP 21.3% OF THE TOTAL SERVICE AREA POPULATION, WHICH IS GREATER THAN THE STATE POPULATION AGED 65 AND OVER.POPULATION BY RACE/ETHNICITYAPPROXIMATELY 47.9% OF SOUTH BAY RESIDENTS IDENTIFY AS WHITE, WHILE 35.7% IDENTIFY AS ASIAN/PACIFIC ISLANDER, AMERICAN INDIAN/ALASKAN NATIVE, OR ANOTHER RACE. 10% IDENTIFY AS BLACK. WHILE 36.8% OF RESIDENTS IN THE GENERAL COMMUNITY IDENTIFY AS HISPANIC, IN OUR HIGH NEED SERVICE AREA, 60% DO SO.INCOME LEVELSIN 2022, 25.9% OF SOUTH BAY RESIDENTS FELL BELOW 200% OF THE FEDERAL POVERTY LEVEL. HOWEVER, IN THE PROVIDENCE SOUTH BAY HIGH NEED SERVICE AREAS, THAT NUMBER IS 41.7%, WHICH IS HIGHER THAN THE PERCENTAGE OF LOS ANGELES COUNTY (34.9%).EDUCATION LEVELWHILE MANY OF THE ADULTS AGE 25+ LIVING IN HOUSEHOLDS IN THE SOUTH BAY HAVE AT LEAST GRADUATED FROM HIGH SCHOOL, THE 72.1% WITH A HIGH SCHOOL DIPLOMA IN PROVIDENCE SOUTH BAY HIGH NEED SERVICE AREAS IS LESS THAN LOS ANGELES COUNTY, WHICH IS 79.1%.ECONOMIC INDICATORSTHE SOUTH BAY SERVICE AREA HAS SOME NOTABLE ECONOMIC INDICATORS. THE PERCENT UNEMPLOYED IN THE AREA AVERAGES 5.1%, WHILE IN THE HIGH NEED SERVICE AREAS, IT CLIMBS TO 6.1%.LANGUAGE PROFICIENCYWITHIN LOS ANGELES COUNTY, 10.8% OF RESIDENTS HAVE LIMITED ENGLISH PROFICIENCY. IN THE PROVIDENCE SOUTH BAY HIGH NEED SERVICE AREAS, HOWEVER, IT IS 12.7%, MORE THAN DOUBLE THAT OF THE BROADER SERVICE AREA (5.3%).OTHER HOSPITALS IN SERVICE AREAIN ADDITION TO PROVIDENCE LITTLE COMPANY OF MARY SAN PEDRO AND PROVIDENCE LITTLE COMPANY OF MANY IN TORRANCE, THE OTHER HOSPITALS IN THE SERVICE AREA INCLUDE KAISER PERMANENTE HARBOR CITY, TORRANCE MEMORIAL, AND HARBOR UCLA.
PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:REPORTING GROUPS A & BACROSS SOUTHERN CALIFORNIA, PROVIDENCE IS BRINGING TO LIFE OUR VISION OF HEALTH FOR A BETTER WORLD. BY TAPPING THE EXPERTISE OF COMMUNITY PARTNERS, WE FOCUS ON REDUCING HEALTH DISPARITIES AS WE ADDRESS OUR NEIGHBORS' CHALLENGES. TOGETHER WE SEEK INNOVATIVE AND COMPASSIONATE WAYS TO MEET A RANGE OF NEEDS.IN 2023, PROVIDENCE INVESTED $198 MILLION IN COMMUNITY BENEFIT ACROSS PROVIDENCE SOUTHERN CALIFORNIA HOSPITALS IN LOS ANGELES- SOUTH BAY AND SAN FERNANDO VALLEY, HOME HEALTH AND REGIONAL OFFICE. TARGETED INVESTMENTS SUPPORTED THESE AND MANY OTHER PROGRAMS:- $149 MILLION TO COVER THE UNPAID COSTS OF MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT// PROGRAMS.- $13 MILLION IN FREE AND DISCOUNTED CARE FOR THE UNINSURED AND UNDERINSURED.- OFFERING FREE VACCINATIONS FOR SCHOOL CHILDREN IN UNDERSERVED SOUTH BAY COMMUNITIES.PROVIDENCE SOUTHERN CALIFORNIA PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. PROVIDENCE IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) THE MISSION COMMUNITY HEALTH COMMITTEE (MCHC) OF THE SOUTH BAY AND SAN FERNANDO VALLEY HOSPITAL COMMUNITY MINISTRY BOARDS ARE RESPONSIBLE FOR THE OVERSIGHT OF THE MINISTRY'S COMMUNITY HEALTH NEEDS ASSESSMENT AND THE PRIORITIZATION OF THE IDENTIFIED SIGNIFICANT COMMUNITY NEEDS,2) WE HAVE AN OPEN MEDICAL STAFF, 3) SURPLUS FUNDS ARE USED TO ADVANCE PATIENT CARE AND FUND A ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.FURTHERMORE, SURPLUS FUNDS ARE USED TO MAKE IMPROVEMENTS IN OUR HOSPITALS, AND TO ADVANCE HEALTH PROFESSIONS EDUCATION AND MEDICAL RESEARCH.AS A NOT-FOR-PROFIT CATHOLIC HEALTH CARE MINISTRY, PROVIDENCE HEALTH & SERVICES EMBRACES ITS RESPONSIBILITY TO PROVIDE FOR THE NEEDS OF THE COMMUNITIES IT SERVES - ESPECIALLY THE POOR AND VULNERABLE. PROVIDENCE'S NOT-FOR-PROFIT, TAX-EXEMPT STATUS ENABLES PROVIDENCE TO SERVE ITS COMMUNITIES, TO SOLICIT DONATIONS THROUGH ITS FOUNDATIONS AND TO RESPOND TO COMMUNITY NEEDS THAT OTHERWISE WOULD GO UNMET.HEALTH CARE IS FUNDAMENTALLY DIFFERENT FROM MOST OTHER GOODS AND SERVICES. IT IS ABOUT THE MOST HUMAN AND INTIMATE NEED OF PEOPLE, THEIR FAMILIES AND COMMUNITIES. PROVIDENCE EXECUTIVES ARE ENGAGED ON MANY LOCAL AREA BOARDS AND SOCIAL SERVICE ORGANIZATIONS.
PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:REPORTING GROUPS A & B:PROVIDENCE'S MORE THAN 165-YEAR LEGACY OF INVESTING IN ITS COMMUNITIES IS ROOTED IN A TRADITION OF CARING FOR THOSE IN NEED, WITH COMPASSION AND IN PARTNERSHIP WITH THE PEOPLE WE SERVE.TO ACHIEVE OUR VISION OF HEALTH FOR A BETTER WORLD, THE PROVIDENCE FAMILY OF ORGANIZATIONS COMBINES A LONG-STANDING COMMITMENT TO IMPROVING COMMUNITY HEALTH WITH HIGH-QUALITY CARE TO CREATE HEALTHY COMMUNITIES AND PROMOTE HEALTH EQUITY.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.PROVIDENCE ACROSS FIVE WESTERN STATES:- ALASKA- MONTANA- OREGON- NORTHERN CALIFORNIA- SOUTHERN CALIFORNIA- WASHINGTONTHE PROVIDENCE AFFILIATE FAMILY INCLUDES:- COVENANT HEALTH IN WEST TEXAS AND NEW MEXICO- FACEY MEDICAL GROUP IN LOS ANGELES, CA.- KADLEC IN SOUTHEAST WASHINGTON- PACIFIC MEDICAL CENTERS IN SEATTLE, WA.- SWEDISH HEALTH SERVICES IN SEATTLE, WA.2023 HIGHLIGHTS AND KEY INSTITUTES:INVESTING IN THE COMMUNITIES WE SERVE IS AN ESSENTIAL WAY THE PROVIDENCE FAMILY OF ORGANIZATIONS LIVES ITS MISSION AND WORKS TOWARD OUR VISION OF HEALTH FOR A BETTER WORLD. FOR GENERATIONS, PROVIDENCE MINISTRIES AND AFFILIATES HAVE SERVED AS A VITAL SAFETY NET. GUIDED BY COMMUNITY HEALTH NEEDS ASSESSMENTS, WE CONTINUE OUR LONGSTANDING COMMITMENT TO THOSE WHO ARE VULNERABLE THROUGH COMMUNITY BENEFIT AND OTHER HIGH-IMPACT INVESTMENTS. IN 2023, PROVIDENCE MINISTRIES AND AFFILIATES INVESTED NEARLY $2.1 BILLION IN COMMUNITY BENEFIT PROGRAMS, INCLUDING PROACTIVE COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND FREE, DISCOUNTED AND UNCOMPENSATED CARE. THIS SIGNIFICANT INVESTMENT IN COMMUNITY BENEFIT PROGRAMS REPRESENTS AN INCREASED FOCUS ON ADDRESSING ROOT CAUSES OF COMMUNITY HEALTH ISSUES AND PROGRAMS THAT INCREASE EQUITABLE ACCESS TO QUALITY CARE AT THE COMMUNITY LEVEL AND AT SCALE ACROSS SEVEN STATES. INVESTMENTS WENT 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. AN EXAMPLE OF THIS IMPORTANT WORK CAN BE FOUND IN THE LAUNCH OF THE PROVIDENCE HEALTH EQUITY FELLOWSHIP, WHICH WAS CREATED TO BUILD CAREGIVERS' CAPACITY AND EXPERTISE THROUGH CLASSROOM LEARNING AND THE REAL-TIME APPLICATION OF HEALTH EQUITY PRINCIPLES. FELLOWS MOOJAN REZVAN AND SHELLEY SCHOEPFLIN SANDERS, M.D., HAVE DEDICATED THEIR PROJECTS TO IMPROVING THE HEALTH OUTCOMES OF SEPSIS PATIENTS. INITIAL OUTCOMES FROM BOTH PROGRAMS ARE PROMISING, WITH AVERAGE LENGTHS OF STAY AND READMISSION RATES IMPROVING. TOGETHER, CAREGIVERS AND COMMUNITY LEADERS AND ORGANIZATIONS TOUCHED THE LIVES OF THOUSANDS OF PEOPLE AND PATIENTS THROUGH THESE INVESTMENTS IN 2023. THEY ALSO HELPED TO BUILD AND STRENGTHEN COMMUNITY RESILIENCE AND THE HUMAN CONNECTION, ESPECIALLY IN TIMES OF NEED. OUR COMMITMENT TO MEETING THE DIVERSE NEEDS OF THE COMMUNITIES WE SERVE DOMESTICALLY AND ABROAD HAS NEVER BEEN STRONGER. FOR THE PAST SEVEN YEARS, PROVIDENCE HAS FUNDED HEALTH PARTNERS IN MANGOCHI DISTRICT, MALAWI TO BUILD CRITICAL HEALTH SYSTEM INFRASTRUCTURE FOR 1.5 MILLION PEOPLE. IN 2023, INVESTMENTS EXPANDED HEALTH CARE TRAINING AND WATER, SANITATION AND HYGIENE IMPROVEMENTS, INCLUDING A RELIABLE WATER SOURCE, ACCESSIBLE TOILETS AND SAFE MEDICAL WASTE DISPOSAL AT TWO CLINICS. MORE EXAMPLES OF THIS IMPORTANT WORK ARE CAPTURED THROUGHOUT PROVIDENCE'S 2023 ANNUAL REPORT TO OUR COMMUNITIES, WHICH WE INVITE CAREGIVERS, COMMUNITY PARTNERS AND OTHER STAKEHOLDERS TO READ. WE COULDN'T BE PROUDER OF THIS WORK, THESE PROGRAMS AND THEIR IMPACT.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORTTHE FOLLOWING ARE KEY EXAMPLES OF HOW WE ARE INVESTING IN ADVANCING THE HEALTH OF OUR COMMUNITIES: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-FUNDINVESTING 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.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.HEALTH EQUITY:CHANGE BEGINS WITH US:AT 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 RESPONSIBILITY:IN 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 THAT SERVE VULNERABLE POPULATIONS AND PROMOTE JUSTICE. 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 (CONTINUATION): ENVIRONMENTAL STEWARDSHIP:THE 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 ADVANCE CLINICAL, 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/INSTITUTE FOR SYSTEMS BIOLOGY: ON OUR JOURNEY TO CREATE HEALTHIER COMMUNITIES, WE ARE TURNING TO THE SCIENCE OF GENOMICS TO HELP INDIVIDUALS MAP A PERSONAL PATH TO WELLNESS. IT'S A UNIQUE APPROACH TO PERSONALIZED MEDICINE THAT WE CALL SCIENTIFIC WELLNESS.THE INSTITUTE FOR SYSTEMS BIOLOGY IS A NOT-FOR-PROFIT BIOMEDICAL RESEARCH ORGANIZATION THAT IS PART OF THE PROVIDENCE FAMILY. THE SCIENTISTS AND ENGINEERS AT ISB ARE WORKING TO UNLOCK THE MYSTERY OF THE GENOME TO LEARN HOW WE CAN KEEP PEOPLE HEALTHY WELL INTO THEIR 90S.THIS IS A PROACTIVE APPROACH TO MEDICINE THAT WILL HELP US SHIFT FROM A DISEASE FOCUS TO A WELLNESS FOCUS. WITH ISB, WE ARE PURSUING RESEARCH IN THE AREAS OF BREAST CANCER SURVIVORSHIP, ALZHEIMER'S, GLIOBLASTOMA AND MARKERS TO HELP US IDENTIFY AND REVERSE DISEASE AT THE EARLIEST POSSIBLE STAGES. OUR PARTNERSHIP GIVES US THE OPPORTUNITY TO BRING THESE ADVANCES TO PEOPLE IN THE COMMUNITIES WE SERVE.FOR MORE INFORMATION GO TO: HTTPS://ISBSCIENCE.ORG/
PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: CA
Schedule H (Form 990) 2023
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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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number
51-0216589
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) PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION
4101 TORRANCE BLVD
TORRANCE,CA90503
51-0224944 501 (C) (3) 1,425,891 0     SPONSORSHIP
(2) PROVIDENCE HEALTH & SERVICES FOUNDATION - VSA
501 SOUTH BUENA VISTA ST
BURBANK,CA915054809
95-3544877 501 (C) (3) 268,022 0     SPONSORSHIP
(3) CSUDH FOUNDATION
100 E VICTORIA ST CLINICAL SCIENCES
PROGRAM
CARSON,CA97047
95-2543028 501 (C) (3) 28,800 0     SPONSORSHIP
(4) BURBANK CHAMBER OF COMMERCE
200 W MAGNOLIA BLVD
BURBANK,CA91502
95-0583680 501 (C) (6) 10,000 0     SPONSORSHIP
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
3
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
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
PART I, LINE 2: DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT 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



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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number

51-0216589
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
1ERIK 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
2GREG 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
3JO ANN ESCASA-HAIGH
FRMR EVP/TREASURER/CFO
(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
4ANNA 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
5KEVIN MANEMANN
DIV CHF EXEC SOUTH - THRU 2/23
(i)

(ii)
0
-------------
115,132
0
-------------
1,717,844
0
-------------
193,414
0
-------------
9,900
0
-------------
3,387
0
-------------
2,039,677
0
-------------
170,754
6LAUREEN DRISCOLL RN
DIV CHF EXEC SOUTH (PART YEAR)
(i)

(ii)
0
-------------
865,621
0
-------------
500,000
0
-------------
361,142
0
-------------
240,719
0
-------------
34,515
0
-------------
2,001,997
0
-------------
0
7JEREMY ZOCH
CHIEF EXECUTIVE SJO - THRU 9/23
(i)

(ii)
0
-------------
403,819
0
-------------
713,904
0
-------------
755,567
0
-------------
9,900
0
-------------
27,093
0
-------------
1,910,283
0
-------------
505,924
8BRIAN LEE HELLELAND
DIVISION COO - SOUTH
(i)

(ii)
0
-------------
682,875
0
-------------
701,652
0
-------------
251,957
0
-------------
208,217
0
-------------
37,279
0
-------------
1,881,980
0
-------------
133,676
9BERNIE KLEIN MD
CHIEF EXEC PROV HOLY CROSS MC
(i)

(ii)
0
-------------
684,163
0
-------------
648,033
0
-------------
203,589
0
-------------
212,935
0
-------------
45,080
0
-------------
1,793,800
0
-------------
173,566
10GARRY OLNEY
CHIEF EXECUTIVE LCM MC
(i)

(ii)
0
-------------
584,639
0
-------------
547,093
0
-------------
192,872
0
-------------
170,571
0
-------------
36,316
0
-------------
1,531,491
0
-------------
147,007
11NATHAN HUSMANN
DIVISION CFO - SOUTH
(i)

(ii)
0
-------------
525,717
0
-------------
488,588
0
-------------
81,473
0
-------------
165,017
0
-------------
33,678
0
-------------
1,294,473
0
-------------
57,263
12JIM 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
13JIM 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
14KARL KEELER
CHIEF EXEC PROV ST JOSEPH MC
(i)

(ii)
0
-------------
560,463
0
-------------
117,439
0
-------------
27,595
0
-------------
192,904
0
-------------
36,060
0
-------------
934,461
0
-------------
0
15REX HOFFMAN
CHIEF MEDICAL OFFICER HOSPITAL
(i)

(ii)
524,397
-------------
0
78,006
-------------
0
9,418
-------------
0
23,506
-------------
0
31,977
-------------
0
667,304
-------------
0
6,796
-------------
0
16GLEN KOMATSU
CHIEF MEDICAL OFFICER HOSPITAL
(i)

(ii)
460,902
-------------
0
38,573
-------------
0
63,921
-------------
0
51,564
-------------
0
28,091
-------------
0
643,051
-------------
0
26,935
-------------
0
17LISA LAURENT
CHIEF MEDICAL OFFICER HOSPITAL
(i)

(ii)
448,590
-------------
0
50,000
-------------
0
65,836
-------------
0
21,486
-------------
0
26,042
-------------
0
611,954
-------------
0
0
-------------
0
18AMY HEROLD
CHIEF MEDICAL OFFICER HOSPITAL
(i)

(ii)
460,516
-------------
0
40,973
-------------
0
36,041
-------------
0
22,536
-------------
0
40,439
-------------
0
600,505
-------------
0
33,960
-------------
0
19JOHN WHIPPLE
FRMR SECRETARY
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
541,701
0
-------------
0
0
-------------
0
0
-------------
541,701
0
-------------
0
20GREGORY GISSENDANNER
ED ASSOCIATE CHIEF PHILANTHROPY OFFI
(i)

(ii)
367,277
-------------
0
76,914
-------------
0
23,816
-------------
0
18,951
-------------
0
3,994
-------------
0
490,952
-------------
0
0
-------------
0
21DONALD 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
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 OR GROSS-UP PAYMENTS TAX INDEMNIFICATION 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 RECEIVED SEVERANCE PAYMENTS DURING THE YEAR: JO ANN ESCASA-HAIGH - $811,414 JEREMY ZOCH - $158,766 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: ERIK WEXLER - $366,950 GREG HOFFMAN - $80,207 KEVIN MANEMANN - $170,754 JO ANN ESCASA-HAIGH - $603,250 JEREMY ZOCH - $505,924 BRIAN LEE HELLELAND - $133,676 BERNIE KLEIN, M.D. - $173,566 GARRY OLNEY - $147,007 NATHAN HUSMANN - $57,263 JIM WATSON, ESQ - $64,477 JIM MARTIN - $52,013 REX HOFFMAN - $6,796 GLEN KOMATSU - $26,935 AMY HEROLD - $33,960
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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number

51-0216589
Return Reference Explanation
FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUATION) IN ADDITION, IN FY23 THE FOLLOWING HEALTH EQUITY EFFORTS INCLUDED GRANT MAKING TO THE FOLLOWING NON-PROFITS: IDREAM FOR RACIAL EQUALITY, THE LGBTQ+ CENTER OF LONG BEACH AND THE TIGER WOOD FOUNDATION, TOTALING $1.2M. IDREAM FOR RACIAL HEALTH EQUALITY WAS FUNDED $295,343 TO IMPLEMENT ITS BLACK MAMAS GLOWING PROGRAM FOCUSED ON ADDRESSING BLACK MATERIAL MORTALITYAND LOW BIRTH WEIGHT THROUGH SUPPORT GROUP FOR EXPECTANT MOTHERS THAT IS CULTURALLY APPROPRIATE AND RESPONSIVE. THIS PEER SUPPORT GROUP IS INTENDED TO REDUCE ISOLATION AND BUILD COMMUNITY FOR BLACK BIRTHING FAMILES AND THE EXPANDED BLACK PRENATAL WORKFORCE INCLUDING BIRTH WORKERS. INCREASING ACCESS TO CARE FOR THE LGBTQ+ COMMUNITY: IN FY23, PROVIDENCE GRANTED $106,765 TO THE LGBTQ+ CENTER IN LONG BEACH TO HELP ADDRESS ACCESS BARRIERS TO BASIC HEALTH CARE EXPERIENCED BY THE OLDER ADULT LGBTQ+ COMMUNITY. THROUGH THIS FINANCIAL SUPPORT A LINGUISTICALLY AND CULTURALLY RESPONSIVE PATIENT NAVIGATOR WAS HIRED TO SUPPORT ACCESS TO CARE AND HEALTH CARE COVERAGE. PARTNERSHIP WITH THE TIGER WOODS FOUNDATION/YOUTH CAREER MENTORSHIP: IN FY2023, PROVIDENCE FUNDED $800,000 TO PROVIDE CAREER PATH MENTORSHIP PROGRAMMING. EMPOWERED HEALTH BY PROVIDENCE AND TGR FOUNDATION WAS CREATED TO INVEST IN YOUTH BY PROVIDING MEANINGFUL CAREER PATHS GUIDED BY MENTORS TO ENSURE THEY HAVE THE ABILITY TO REACH THEIR FULL POTENTIAL. YOUTH AND THEIR FAMILIES ALSO WILL HAVE EASY ACCESS TO HEALTH PROGRAMS THAT PROVIDE MULTI-GENERATIONAL CARE IN A TRUSTED, CULTURALLY SENSITIVE ENVIRONMENT. FOR MORE INFORMATION GO TO: HTTPS://PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/SOUTHERN-CALIFORNIA
FORM 990, PART V, LINE 15 INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF THE RELATED ORGANIZATION. IT IS THE INTENTION OF PROVIDENCE AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE EMPLOYEES OF A RELATED ORGANIZATION WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. THE RELATED ORGANIZATION COMMON LAW EMPLOYEES ARE INCLUDED IN THE RELATED ORGANIZATIONS SECTION 4960 TAX ANALYSIS AND REPORTING.
FORM 990, PART VI, SECTION A, LINE 6 DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS PROVIDENCE HEALTH & SERVICES IS THE SOLE CORPORATE MEMBER OF PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA.
FORM 990, PART VI, SECTION A, LINE 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT THE PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA'S GOVERNING BOARD. ALL NOMINATIONS THAT COME FROM THE PROVIDENCE HEALTH SYSTEM - SOUTHERN CALIFORNIA BOARD AS NOMINATIONS MUST BE APPROVED BY PROVIDENCE HEALTH & SERVICES, AS THE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE FOLLOWING POWERS RESIDE WITH THE CORPORATE MEMBER: 1) TO ADOPT OR CHANGE THE MISSION, PHILOSOPHY, AND VALUES, INCLUDING THE STRATEGIC PLAN AND MISSION STATEMENT. 2) TO AMEND OR REPEAL THE ARTICLES OF INCORPORATION OR BYLAWS. 3) TO APPROVE THE ACQUISITION OF ASSETS, THE INCURRENCE OF INDEBTEDNESS OR THE LEASE, SALE TRANSFER, ASSIGNMENT OR ENCUMBERING OF ASSETS EXCEEDING A SPECIFIED THRESHOLD, OR THE SALE OR TRANSFER OF ANY PROPERTY WHICH MAY HAVE HISTORICAL OR RELIGIOUS SIGNIFICANCE. 4) TO APPROVE THE DISSOLUTION OR LIQUIDATION. 5) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS. 6) TO APPOINT THE CERTIFIED PUBLIC ACCOUNTANTS. 7) TO APPROVE THE CLOSURE OF ANY INSTITUTION OR MAJOR ENTITY OR WORK OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE DEPARTMENT OF LEGAL AFFAIRS. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. MANAGEMENT PRESENTED THE RETURNS TO THE AUDIT AND COMPLIANCE COMMITTEE, AND DISCUSSED KEY DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. IN ADDITION, A COPY OF THE FORM 990 WAS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING.
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 15 PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/PRESIDENT/EXECUTIVE DIRECTOR IS PAID BY A 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 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 LABOR: PROGRAM SERVICE EXPENSES 70,907,377. MANAGEMENT AND GENERAL EXPENSES 9,893,431. FUNDRAISING EXPENSES 129,252. TOTAL EXPENSES 80,930,060. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 36,313,784. MANAGEMENT AND GENERAL EXPENSES 5,066,721. FUNDRAISING EXPENSES 66,194. TOTAL EXPENSES 41,446,699. MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 56,460,862. MANAGEMENT AND GENERAL EXPENSES 7,877,765. FUNDRAISING EXPENSES 102,919. TOTAL EXPENSES 64,441,546. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 29,833,539. MANAGEMENT AND GENERAL EXPENSES 4,162,558. FUNDRAISING EXPENSES 54,382. TOTAL EXPENSES 34,050,479. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 169,338. MANAGEMENT AND GENERAL EXPENSES 23,627. FUNDRAISING EXPENSES 309. TOTAL EXPENSES 193,274. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 34,184,864. MANAGEMENT AND GENERAL EXPENSES 4,769,682. FUNDRAISING EXPENSES 62,313. TOTAL EXPENSES 39,016,859.
FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS -141,856,653. FAS 136 - RECIPIENT ORGANIZATION ADJUSTMENT 3,023,638. OTHER CHANGES IN NET ASSETS 1,298,930,106. CHANGE IN INVESTMENT IN JOINT VENTURES -3,591,942. INVESTMENT IN CORPORATE SUBSIDIARIES 351,070.
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
PROVIDENCE HEALTH SYSTEM - SO
CALIFORNIA
Employer identification number

51-0216589
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) BELL RIVER LLC
1801 LIND AVENUE SW ATTN TAX DEPT
RENTON,WA98058
51-0216589
RENTAL CA 195,000 0 PHS - SO CALIFORNIA
 
(2) PROVIDENCE PARTNERS FOR HEALTH LLC
20555 EARL ST
TERRANCE,CA90503
45-4041798
CLIN QUALITY/INT CA 0 0 PHS - SO CALIFORNIA
 
(3) PROVINITY HEALTH ALLIANCE LLC
3345 MICHELSON DR
IRVINE,CA92612
88-2646023
HEALTHCARE CA 0 0 PHS - SO CALIFORNIA
 
(4) TARZANA PEDIATRIC VENTURES LLC
18321 CLARK ST
TARZANA,CA91356
82-1308306
HEALTHCARE CA 0 0 PHS - SO CALIFORNIA
 




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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
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 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
 
(49)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
 
(50)PROVIDENCE HOSPICE OF SEATTLE FOUNDATION
2811 SOUTH 102ND NO 220

TUKWILA,WA98168
91-2077378
HEALTHCARE WA 501(C)(3) 7 PHS W WA
 
Yes
 
(51)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
 
(52)PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION
4101 TORRANCE BLVD

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

ISSAQUAH,WA980297219
93-1554288
HEALTHCARE WA 501(C)(3) 7 PHS W WA
 
Yes
 
(54)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
 
(55)PROVIDENCE MEDICAL INSTITUTE
1801 LIND AVENUE SW ATTN TAX DEPT

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

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

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

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

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

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

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

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

RENTON,WA98057
31-1584166
SUPPORT WA 501(C)(3) 10 PHS WA
 
Yes
 
(64)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
 
(65)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
 
(66)PROVIDENCE SEASIDE HOSPITAL FOUNDATION
725 S WAHANNA ROAD

SEASIDE,OR97138
93-0927320
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(67)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
 
(68)PROVIDENCE ST FRANCIS ASSOCIATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
94-3244854
SUPPORT WA 501(C)(3) 7 PHS WA
 
Yes
 
(69)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
(70)PROVIDENCE ST JOSEPH HEALTH FOUNDATION
4400 NE HALSEY ST STE 599

PORTLAND,OR97213
94-3078543
HEALTHCARE WA 501(C)(3) 7 PHS WA
 
Yes
 
(71)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
 
(72)PROVIDENCE ST MARY FOUNDATION
401 W POPLAR STREET

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

PORTLAND,OR97225
93-0575982
HEALTHCARE OR 501(C)(3) 7 PHS OR
 
Yes
 
(74)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
 
(75)PROVIDENCE TRINITYCARE HOSPICE
1801 LIND AVENUE SW ATTN TAX DEPT

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

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

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

EUREKA,CA95501
94-2779313
HEALTHCARE CA 501(C)(3) 7 SJHNC LLC
 
Yes
 
(79)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
 
(80)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
 
(81)SEATTLE SCIENCE FOUNDATION
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
61-1502822
PHYSICIAN COLLABORATION WA 501(C)(3) 7 WHC
 
Yes
 
(82)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
(83)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
(84)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
 
(85)ST JOSEPH HEALTH MINISTRY
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
27-1666576
RELIGIOUS ORG CA 501(C)(3) 1 SSJO
 
 
No
(86)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
 
(87)ST JOSEPH HEALTH SYSTEM
1801 LIND AVENUE SW ATTN TAX DEPT

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

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

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

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

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

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

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

MISSOULA,MT59802
23-7056976
HEALTHCARE MT 501(C)(3) 7 PHS WA
 
Yes
 
(95)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
 
(96)SWEDISH EDMONDS
1801 LIND AVENUE SW ATTN TAX DEPT

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

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

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

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

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

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

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

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

RENTON,WA98057
81-0231777
EDUCATION MT 501(C)(3) 2 PHS
 
Yes
 
(105)WESTERN HEALTHCONNECT
1801 LIND AVENUE SW ATTN TAX DEPT

RENTON,WA98057
45-4171900
HEALTHCARE WA 501(C)(3) 3 PHS W WA
 
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 PHS SOCAL
 
N/A 478,455 7,146,038   No   Yes   50.000 %
(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 PHS WA
 
EXCLUDED 412,695 8,013,900   No -1,257   No 0.190 %
(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 PHS SOCAL
 
RELATED 2,275,032 9,927,847   No     No 49.950 %
(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 PHS SOCAL
 
C 343,422,617 81,738,698 100.000 %   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 PHS SOCAL
 
C 342,748,212 81,070,225 100.000 %   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 PHS SOCAL
 
C 674,405 658,473 100.000 %   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 ENTERPRSES 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
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
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
Yes
 
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
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
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 79,573,457 COST
(2) ST JOSEPH HEALTH SYSTEM

P 241,744 COST
(3) ST JOSEPH HEALTH SYSTEM

R 853,074 COST
(4) LCM ANCILLARY SERVICES CORPORATION

J 812,498 COST
(5) PROVIDENCE FACEY MEDICAL FOUNDATION

J 102,081 COST
(6) PROVIDENCE HEALTH & SERVICES - OREGON

L 123,483 COST
(7) PROVIDENCE HEALTH & SERVICES - WASHINGTON

A 651,293 COST
(8) PROVIDENCE HEALTH & SERVICES - WASHINGTON

J 1,738,650 COST
(9) PROVIDENCE HEALTH & SERVICES - WASHINGTON

L 969,870 COST
(10) PROVIDENCE MEDICAL INSTITUTE

J 9,011,157 COST
(11) PROVIDENCE MEDICAL INSTITUTE

L 136,800 COST
(12) PROVIDENCE MEDICAL INSTITUTE

O 8,532,663 COST
(13) PROVIDENCE SAINT JOHNS HEALTH CENTER

J 1,585,857 COST
(14) PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION

J 10,583,747 COST
(15) PROVIDENCE TRINITYCARE HOSPICE

J 274,392 COST
(16) PROVIDENCE TRINITYCARE HOSPICE

O 94,301 COST
(17) ST JOSEPH HEALTH SYSTEM

J 238,241 COST
(18) PROVIDENCE MEDICAL FDN (FKA ST JOSEPH HERITAGE HEALTHCARE)

L 165,292 COST
(19) PROVIDENCE HEALTH & SERVICES - OREGON

M 278,779 COST
(20) PROVIDENCE MEDICAL FDN (FKA ST JOSEPH HERITAGE HEALTHCARE)

M 165,292 COST
(21) PROVIDENCE FACEY MEDICAL FOUNDATION

K 329,420 COST
(22) PROVIDENCE MEDICAL INSTITUTE

O 8,344,140 COST
(23) PROVIDENCE TRINITYCARE HOSPICE

O 1,390,867 COST
(24) PROVIDENCE SAINT JOHN'S HEALTH CENTER

K 500,608 COST
(25) PROVIDENCE HEALTH & SERVICES FOUNDATION - VSA

C 12,878,700 COST
(26) PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION

C 12,710,528 COST
(27) PROVIDENCE ST JOSEPH HEALTH FOUNDATION

C 330,000 COST
(28) PROVIDENCE LITTLE COMPANY OF MARY FOUNDATION

B 1,425,891 COST
(29) PROVIDENCE HEALTH & SERVICES FOUNDATION - VSA

B 268,022 COST
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


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