2025-03-11T12:31:41-05:00 2022-12-31 346565596 ERNST & YOUNG US LLP 560 MISSION STREET SUITE 1600 SAN FRANCISCO CA 94105 990 2022-01-01 810231793 PROVIDENCE HEALTH & SERVICES - MONTANA PROV 4255253985 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 GREG HOFFMAN CHIEF ACCOUNTING OFFICER 4255253985 2025-03-11 1 0 EVA NITTA P01286320 4158948000 2025-03-04 2022 2025-03-06 01:10:19Z X PROVIDENCE ST PATRICK HOSPITAL GREG HOFFMAN 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 482046238 0 0928 X HTTP://MONTANA.PROVIDENCE.ORG X 1991 MT 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. 10 4 2849 210 429880 210477 23179890 1443260 441354572 450832373 4345007 2375993 17311108 25665830 486190577 480317456 120367 196722 0 0 170959194 183958579 0 0 0 274422626 296959277 445502187 481114578 40688390 -797122 247287860 259167225 110750317 78944700 136537543 180222525 X 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. 0 0 445703161 196722 473035441 SEE SCHEDULE O.AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 117,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,000 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, 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 ADVANCE A SOCIAL RESPONSIBILITY FRAMEWORK THAT INCLUDES A STRONGER COMMITMENT TO DIVERSITY, EQUITY, INCLUSION ("DEI"), AND ENVIRONMENTAL STEWARDSHIP. IN 2022, WE ELEVATED THE WORK OF DEI, BY RESTRUCTURING RESOURCES WITH PLANS TO ALIGN AND SCALE DEI STRATEGIES ACROSS THE PROVIDENCE FAMILY OF ORGANIZATIONS. WE CONTINUE TO EXECUTE ON OUR INTEGRATED STRATEGIC & FINANCIAL PLAN WHICH CLEARLY EXPRESSES OUR COMMITMENT AND ACCELERATION OF THIS IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES IN THE COMMUNITIES WE SERVE. PROVIDENCE'S SOCIAL RESPONSIBILITY FRAMEWORK AIMS TO DEPLOY THE ASSETS OF OUR SYSTEM TO SUPPORT COMMUNITY HEALTH IMPROVEMENT, STRENGTHEN LOCAL ECONOMIES AND REDUCE OUR CARBON FOOTPRINT. WE HAVE IMPLEMENTED AN ENVIRONMENTAL STEWARDSHIP SYSTEM STRATEGY THAT ENCOURAGES WASTE REDUCTIONS, EFFICIENT ENERGY AND WATER USAGE, LOCAL AGRICULTURE PARTNERSHIPS, LESS TOXIC AND FEWER CHEMICAL USE, AND A REDUCTION IN CARBON FROM TRAVEL. WE HAVE ALSO HELD ENVIRONMENTAL STEWARDSHIP AS ONE OF THE TOP PRIORITIES FOR OUR LEADERSHIP INCENTIVE PROGRAM TO ENSURE ALIGNMENT AND MOMENTUM CONTINUES. IN APRIL 2022, PROVIDENCE PUBLISHED ITS FIRST ENVIRONMENTAL STEWARDSHIP REPORT, IN WHICH WE REPORTED 12 PERCENT REDUCTION IN CARBON EMISSIONS IN SEVEN KEY CATEGORIES IN OUR ACUTE CARE FACILITIES SINCE OUR 2019 BASELINE. AS OF SEPTEMBER 30, 2022, (THE MOST RECENT DATA AVAILABLE), WE HAVE INCREASED THAT REDUCTION TO 13 PERCENT.2022 PROGRAM SERVICE ACCOMPLISHMENTSIN 2022, PROVIDENCE MONTANA CONTINUED ITS TRADITION OF COMPASSION AND DEDICATION TO OUR COMMUNITIES BY INVESTING TO ADDRESS COMMUNITY NEED. IN 2022, PROVIDENCE ST. PATRICK HOSPITAL FOCUSED ON IDENTIFIED PRIORITY NEEDS OF ACCESS TO MENTAL HEALTH SERVICES, SAFE AND AFFORDABLE HOUSING, ACCESS TO SUBSTANCE USE DISORDER TREATMENT, AND ADDRESSING HOMELESSNESS.CARING FOR MONTANA DURING THE COVID PANDEMICIN 2022 PROVIDENCE MONTANA CONTINUED TO CARE FOR OUR COMMUNITIES AS THE COVID-19 PANDEMIC LESSENED IN INTENSITY. DESPITE COVID-19 INFECTIONS DECREASING OVERALL, MANY COMMUNITY HEALTH NEEDS BECAME MORE APPARENT, INCLUDING MENTAL HEALTH AND SUBSTANCE USE TREATMENT ACCESS AND MORE PEOPLE BECOMING HOUSING INSECURE.ACCESS TO MENTAL HEALTH SERVICESPROVIDENCE MEDICAL GROUP ADDED BEHAVIORAL HEALTH CARE MANAGERS TO NINE PRIMARY CARE CLINICS WITH FUNDING FROM MONTANA HEALTHCARE FOUNDATION IN 2020. IN 2022, OVER 8,000 BEHAVIORAL HEALTH TELEHEALTH SESSIONS WERE COMPLETED IN FOR PATIENTS OF PROVIDENCE MONTANA (INCLUDES PROVIDENCE ST. PATRICK HOSPITAL AND PROVIDENCE MEDICAL GROUP).PROVIDENCE ST. PATRICK HOSPITAL SUPPORTED THE CONTINUATION OF THE CITY'S MOBILE SUPPORT TEAM FOLLOWING THE CONCLUSION OF A SUCCESS PILOT PERIOD, WHICH SERVES PEOPLE IN CRISIS IN CONJUNCTION WITH EMERGENCY RESPONSE.SAFE AND AFFORDABLE HOUSINGIN 2022, PROVIDENCE MONTANA STAFF REFERRED 41 PATIENTS FOR LEGAL HELP WITH HOUSING/UTILITY ASSISTANCE THROUGH OUR MEDICAL-LEGAL PARTNERSHIP WITH MONTANA LEGAL SERVICES ASSOCIATION. SINCE THE PROGRAM LAUNCHED IN 2020, ONE OUT OF THREE REFERRALS TO THE MEDICAL-LEGAL PARTNERSHIP ARE RELATED TO HOUSING CONCERNS. THIS PARTNERSHIP ALSO PROVIDED RAPID ACCESS TO MONTANA EMERGENCY RENTAL ASSISTANCE (MERA) PROGRAM VIA MONTANA LEGAL SERVICES ASSOCIATION TO SUPPORT PEOPLE TO MAINTAINING THEIR HOUSING.ACCESS TO SUBSTANCE USE DISORDER TREATMENTPROVIDENCE ST. PATRICK HOSPITAL EMERGENCY DEPARTMENT CONTINUED PILOT OF MOUD (MEDICATION FOR OPIOID USE) IN ED SETTING WITH REFERRAL TO COMMUNITY-BASED SERVICES FOR ONGOING CARE.ADDRESSING HOMELESSNESSPROVIDENCE ST. PATRICK HOSPITAL STAFF PARTICIPATE IN WEEKLY COMMUNITY MEETINGS TO ADDRESS THE NEEDS OF PEOPLE IN THE COMMUNITY WHO ARE UNSHELTERED AND AT THE HIGHEST RISK DUE TO MENTAL HEALTH, SUBSTANCE ABUSE, AND CHRONIC ILLNESS. WITH SUPPORT FROM PROVIDENCE, COMMUNITY SOLUTIONS BEGAN WORK WITH THE CITY OF MISSOULA TO IMPLEMENT THE COMMUNITY INTERVENTION BUILT FOR ZERO, THE GOAL OF WHICH IS FOR MISSOULA TO REACH "FUNCTIONAL ZERO" IN THE LOCAL RATE OF HOMELESSNESS. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/MONTANA 445703161 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 77 0 1 2849 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 1 1 MT X JIM MARTIN 4255253985 1801 LIND AVE SW RENTON WA 98057 GREG HOFFMAN PRESIDENT/CEO & TREASURER 0.50 64.50 X 0 2619615 278536 JOEL GILBERTSON DIVISION CHIEF EXEC - CENTRAL 13.50 41.50 X 0 2134351 264363 JO ANN ESCASA-HAIGH EVP/ASSISTANT TREASURER 0.50 64.50 X 0 2157414 35815 JOSEPH SCHMOKER PHYSICIAN 50.00 0.00 X 1904525 0 33560 MIKE BUTLER FRMR PRESIDENT 0.00 0.00 X 0 1835706 7828 JOHN WHIPPLE SECRETARY - THRU 5/22 0.50 54.50 X 0 1743754 11047 CARTER BECK MD PHYSICIAN 50.00 0.00 X 1497042 0 95652 SCOTT O'BRIEN DIVISION COO - CENTRAL 14.00 41.00 X 0 1320902 182976 ROBERT HELLRIGEL FRMR EVP CE HOME & COMM CARE 0.00 55.00 X 0 1379326 15384 SIMONE MUSCO MD PHYSICIAN 50.00 0.00 X 1069551 0 123138 JAMES MADDUX PHYSICIAN 50.00 0.00 X 1028002 0 109110 DANIEL SPOON PHYSICIAN 50.00 0.00 X 1036561 0 76475 ANNA NEWSOM SECRETARY (PART YEAR) 0.50 54.50 X 0 801000 225085 JOYCE DOMBROUSKI CHIEF EXEC WESTERN MT SVC AREA 27.00 28.00 X 0 826371 167806 JIM WATSON ESQ ASSISTANT SECRETARY 0.50 54.50 X 0 837237 124389 HELEN ANDRUS REGIONAL CFO WA AND MT 27.50 27.50 X 0 750190 105778 MELISSA DAMM DIVISION CFO - CENTRAL 14.00 41.00 X 0 634079 85380 KIRK BODLOVIC FRMR KE - PSJH REG. COO 0.00 55.00 X 0 369722 46661 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 0.50 54.50 X 0 256992 31183 CINDY STRAUSS FRMR SECRETARY 0.00 0.00 X 0 146754 0 MARY LYONS PHD BOARD CHAIR 1.00 26.50 X 0 75936 0 RICHARD BLAIR DIRECTOR 0.50 14.50 X 0 61313 0 MICHAEL MURPHY DIRECTOR 0.50 13.50 X 0 50668 0 CHARLES SORENSON MD DIRECTOR 0.50 13.50 X 0 50000 0 ISIAAH CRAWFORD PHD DIRECTOR 0.50 15.00 X 0 50000 0 CHRISTINA FISHER DIRECTOR - THRU 11/22 0.50 13.50 X 0 40000 0 ERIC SPRUNK DIRECTOR 0.50 13.50 X 0 40000 0 MARY BETH KINGSTON DIRECTOR (PART YEAR) 0.50 12.50 X 0 0 0 SISTER CAROL PACINI LCM DIRECTOR 0.50 13.50 X 0 0 0 SISTER DIANE HEJNA CSJ RN DIRECTOR 0.50 13.50 X 0 0 0 SISTER PHYLLIS HUGHES RSM DRPH DIRECTOR 0.50 13.50 X 0 0 0 6535681 18181330 2020166 333 1 1 0 WESTERN MT EMERGENCY PHYS PO BOX 4506 MISSOULA MT 59806 MEDICAL SERVICES 3800172 MT CANCER SPECIALISTS PO BOX 7609 MISSOULA MT 59807 MEDICAL SERVICES 1921262 UNIVERSITY OF MONTANA MSU 1205 E BROADWAY ST MISSOULA MT 59802 MEDICAL SERVICES 1476169 HIREUP LEADERSHIP PO BOX 404678 ATLANTA GA 30384 STAFFING SERVICES 1446865 BUREAU OF BUSINESS & ECONOMIC RESEARCH 32 CAMPUS DR MISSOULA MT 59812 RESEARCH SERVICES 953782 18 947599 495661 1443260 NET PATIENT SERVICE 621110 444082529 444082529 JV INCOME 900099 6749844 6749844 450832373 1186573 288 1186285 4522159 1580017 2942142 2942142 2942142 1338185 148765 1189420 1189420 1189420 91028 0 91028 91028 PROFESSIONAL SERVICES 900099 8620720 8191128 429592 INTERAFFILIATE REVENUE 900099 7648549 7648549 COST RECOVERIES 900099 4080077 4080077 2283314 2283314 22632660 480317456 473035441 429880 5408875 X 196722 196722 168663546 153163366 15500180 2903995 2637118 266877 1493956 1356661 137295 10897082 9895640 1001442 286960 260588 26372 1750 1589 161 297374 297374 71999567 65382807 6616760 747941 679205 68736 2894003 2628044 265959 37120 33709 3411 6836217 6207969 628248 863548 784188 79360 476867 433043 43824 7945521 7215328 730193 2159 1961 198 SYSTEM COST ALLOCATION 103696125 94166451 9529674 MEDICAL SUPPLIES 91122452 91122452 HOSPITAL FEE 7408333 7408333 LICENSES AND TAXES 749318 680456 68862 1594022 1447531 146491 481114578 445703161 35411417 0 4874 4877 1166710 44379080 228272 43160828 33307718 7100628 6617274 6191088 6167461 596621 958669 285428707 213245865 75373287 72182842 55784015 47239797 32519704 23252312 25390105 24828923 247287860 259167225 35572376 36915846 224937 74953004 42028854 110750317 78944700 X 124298684 167991888 12238859 12230637 136537543 180222525 247287860 259167225 X -797122 -10451569 54933673 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 20318 0 1 6202 26520 0 PART II-B, LINE 1: THE PORTION OF MONTHLY DUES PAID TO THE MONTANA HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION DESIGNATED FOR LOBBYING. INITIATIVE SUPPORT: COSTS ASSOCIATED WITH THE DIRECT CONTACT WITH LEGISLATORS. 8321841 8321841 132481677 90008024 42473653 663793 597507 66286 134891131 122640334 12250797 9070265 9070265 72182842 BENEFICIAL INTEREST IN FOUNDATION 15625548 C HEALTHCARE JOINT VENTURES 7626764 C 23252312 HOSPITAL FEE 13800000 RIGHT OF USE OPERATING LEASES 8761691 OTHER ASSETS 2060865 DUE FROM THIRD-PARTY 206367 24828923 DUE TO THIRD-PARTY 27892780 CAPITAL LEASE OBLIGATIONS 6788699 OTHER LIABILITIES 3729375 HOSPITAL FEES/PROVIDER TAX LIABILITY 3618000 42028854 1 1 X 1 X 300.000000000000 1 X 1 1 1 0 1 1 4145211 4145211 0.00860 59635639 66780812 0 0.00000 9724 5760 3964 0.00000 63790574 66786572 4149175 0.00860 446716 0 446716 0.00090 7149862 1206788 5943074 0.01240 37706656 27213409 10493247 0.02180 0 0 120027 0 120027 0.00020 45423261 28420197 17003064 0.03530 109213835 95206769 21152239 0.04390 500 500 0.00000 52145 52145 0.00010 1750 1750 0.00000 54395 54395 0.00010 0 190130922 207880491 -17749569 X 1 0 1 PROVIDENCE SURGERY CENTER SAME DAY SURGERY, NON-EMERGENT CARE 0.51000 0.00000 0.39000 1 1 PROVIDENCE ST PATRICK HOSPITAL 500 WEST BROADWAY MISSOULA MT 59802 HTTPS://WWW.PROVIDENCE.ORG 13200 X X X X REHAB AND PSYCH PROVIDENCE ST PATRICK HOSPITAL 1 0 0 1 X X X X X X X X X 20 1 0 1 1 X SEE PART V, SECTION C X 1 21 1 SEE PART V, SECTION C 0 1 X 300.000000000000 400.000000000000 X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X X 1 X 0 1 PROVIDENCE ST. PATRICK HOSPITAL - PART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. PROVIDENCE ST. PATRICK HOSPITAL - PART V, SECTION B, LINE 5: A TOTAL OF 10 STAKEHOLDER INTERVIEWS WITH 12 PARTICIPANTS WERE COMPLETED BY REPRESENTATIVES FROM PROVIDENCE ST. PATRICK HOSPITAL-MISSOULA. STAKEHOLDERS WERE SELECTED BASED ON THEIR KNOWLEDGE OF THE COMMUNITY AND ENGAGEMENT IN WORK THAT DIRECTLY SERVES PEOPLE WHO HAVE LOW INCOMES, HAVE CHRONIC CONDITIONS, AND/OR ARE MEDICALLY UNDERSERVED. PROVIDENCE ST. PATRICK HOSPITAL-MISSOULA AIMED TO ENGAGE STAKEHOLDERS FROM SOCIAL SERVICE AGENCIES, HEALTH CARE, EDUCATION, HOUSING, AND GOVERNMENT, AMONG OTHERS, TO ENSURE A WIDE RANGE OF PERSPECTIVES. INCLUDED IN THE INTERVIEWS WAS A REPRESENTATIVE FROM THE MISSOULA CITY-COUNTY HEALTH DEPARTMENT.-ALL NATIONS HEALTH CENTER - D'SHANE BARNETT, EXECUTIVE DIRECTOR, MENTAL HEALTH, ACCESS TO CARE-CITY OF MISSOULA, HOUSING AND COMMUNITY DEVELOPMENT - THERESA WILLIAMS, REACHING HOME PROGRAM MANAGER, HOMELESSNESS-HUMAN RESOURCE COUNCIL - KATE YBARRA, EXECUTIVE DIRECTOR, COMMUNITY RESOURCES, AGING AND VULNERABLE POPULATIONS-MISSOULA AGING SERVICES - SHELLI FORTUNE, IN-HOME SERVICES DIRECTOR AGING SERVICES AND GABRIEL GOERES, CARE MANAGEMENT SUPERVISOR, AGING AND VULNERABLE POPULATIONS-MISSOULA CITY-COUNTY HEALTH DEPARTMENT - NANCY HOBBINS, SUICIDE PREVENTION COORDINATOR, MENTAL HEALTH-MISSOULA FOOD BANK - AARON BROCK, EXECUTIVE DIRECTOR, FOOD INSECURITY, AGING AND VULNERABLE POPULATIONS-MONTANA FOOD BANK NETWORK - GAYLE CARLSON, CHIEF EXECUTIVE OFFICER, FOOD INSECURITY, AGING AND VULNERABLE POPULATIONS-OPEN AID ALLIANCE - CHRISTA WEATHERS, EXECUTIVE DIRECTOR, HOMELESSNESS, SUBSTANCE ABUSE-PARTNERSHIP HEALTH CENTER - REBECCA GOE, DIRECTOR OF INNOVATION, MENTAL HEALTH, ACCESS TO CARE-PROJECT TOMORROW MONTANA - ROSIE AYERS, SUICIDE PREVENTION COORDINATOR, MENTAL HEALTH-UNIVERSITY OF MONTANA, COLLEGE OF HEALTH PROFESSIONS AND BIOMEDICAL SCIENCES-MISSOULA COUNTY PUBLIC SCHOOLS - WILENA OLD PERSON, PROGRAM COORDINATOR, HEALTH CAREERS OPPORTUNITY PROGRAM, BOARD OF TRUSTEES MEMBER EDUCATION PROVIDENCE ST. PATRICK HOSPITAL - PART V, SECTION B, LINE 6B: -MISSOULA CITY-COUNTY HEALTH DEPARTMENT-GRANT CREEK FAMILY MEDICINE-MISSOULA AGING SERVICES-MISSOULA FORUM FOR CHILDREN & YOUTH-MISSOULA INDIAN CENTER-PARTNERSHIP HEALTH CENTER-UNITED WAY OF MISSOULA COUNTY PROVIDENCE ST. PATRICK HOSPITAL - PART V, SECTION B, LINE 7A: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTSPLEASE CLICK ON "MONTANA" TAB PROVIDENCE ST. PATRICK HOSPITAL - PART V, SECTION B, LINE 10A: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTSPLEASE CLICK ON "MONTANA" TAB PROVIDENCE ST. PATRICK HOSPITAL - PART V, SECTION B, LINE 11: BEYOND PROVIDING COMPASSIONATE CLINICAL CARE TO OUR COMMUNITIES DURING THE COVID-19 PANDEMIC, PROVIDENCE MONTANA MADE SIGNIFICANT FINANCIAL CONTRIBUTIONS TO PARTNER ORGANIZATIONS IN SUPPORT OF HOUSING AND FOOD SECURITY, INCLUDING THE MISSOULA FOOD BANK AND COMMUNITY CENTER, AND UNITED WAY OF MISSOULA COUNTY. MEDICAL-LEGAL PARTNERSHIP:PROVIDENCE ST. PATRICK HOSPITAL AND MONTANA LEGAL SERVICES ASSOCIATION (MLSA) CONTINUED PARTNERSHIP IN THE FIRST ACUTE-HOSPITAL BASED MEDICAL-LEGAL PARTNERSHIP IN MONTANA. THIS PROGRAM ALLOWS HOSPITAL STAFF TO REFER PATIENTS WHO ARE EXPERIENCING HEALTH-HARMING CIVIL-LEGAL NEEDS TO (MLSA) DIRECTLY TO THE MLP ATTORNEY. OUR PRIORITY POPULATIONS ARE PATIENTS WHO ARE HOMELESS OR HOUSING INSECURE, PEOPLE WITH MENTAL ILLNESS, AND THOSE WHO ARE OTHERWISE SOCIALLY VULNERABLE. THIS PROGRAM WAS LAUNCHED IN 2020 WITH PARTIAL SUPPORT FROM THE MONTANA HEALTHCARE FOUNDATION. FOOD SECURITY AND OBESITY PREVENTION THROUGH PRESCRIPTION PRODUCE:IN 2022, PROVIDENCE ST. PATRICK CONTINUED SUPPORT OF THE PRESCRIPTION PRODUCE PROGRAM IN PARTNERSHIP WITH THE LOCAL MISSOULA FARMER'S MARKET TO EXPAND ACCESS TO OUR PRESCRIPTION PRODUCE PROGRAM. PROVIDENCE ST. PATRICK HOSPITAL SUPPORTED FOOD SECURITY IN THE MISSOULA COMMUNITY THROUGH CASH CONTRIBUTIONS TO COMMUNITY ORGANIZATIONS, INCLUDING THE MISSOULA FOOD BANK & COMMUNITY CENTER, THE MONTANA FOOD BANK NETWORK, NORTH MISSOULA COMMUNITY DEVELOPMENT CORPORATION, AND UNITED WAY OF MISSOULA COUNTY. HOMELESSNESS AND HOUSING:PROVIDENCE ST. PATRICK HOSPITAL PARTICIPATES IN SEVERAL COMMUNITY COLLABORATIVES FOCUSED ON SERVING PEOPLE WHO ARE WITHOUT HOUSING. AN SPH REPRESENTATIVE PARTICIPATES IN WEEKLY COORDINATED ENTRY SYSTEM (PART OF THE STATE'S CONTINUUM OF CARE) CASE CONFERENCING, AS WELL AS WEEKLY MEETINGS TO COORDINATE CARE AND HOUSING GOALS FOR PEOPLE IN THE COMMUNITY WHO HAVE THE MOST CONTACT WITH EMERGENCY HEALTH SERVICES, LAW ENFORCEMENT, AND JAIL. PROVIDENCE ST. PATRICK HOSPITAL SUPPORTED THE WINTER WARMING SHELTER, A CRUCIAL COMMUNITY EFFORT TO PREVENT DEATHS OF MISSOULIANS DURING THE LONG WINTER SEASON. PROVIDENCE ST. PATRICK HOSPITAL MADE FINANCIAL AND IN-KIND CONTRIBUTIONS TO PARTNER ORGANIZATIONS THAT SERVE PEOPLE EXPERIENCING HOMELESSNESS, INCLUDING TO THE HOUSING SOLUTIONS FUND THROUGH UNITED WAY OF MISSOULA COUNTY, THE POVERELLO CENTER EMERGENCY SHELTER AND MEDICAL RESPITE PROGRAM. PROVIDENCE ST. PATRICK HOSPITAL ALSO PROVIDED FUNDING TO SUPPORT BRINGING COMMUNITY SOLUTIONS' BUILT FOR ZERO INTERVENTION TO THE COMMUNITY IN SUPPORT OF ENDING HOMELESSNESS.CHILDHOOD OBESITY:CATCH (COORDINATED APPROACH TO CHILD HEALTH) UNITES MULTIPLE ORGANIZATIONS IN A CHILD'S LIFE TO CREATE A COMMUNITY OF HEALTH. PROVIDENCE ST. PATRICK HOSPITAL HAS SUPPORTED MISSOULA'S CATCH PROGRAM FOR OVER A DECADE. CATCH'S EVIDENCE-BASED PROGRAM PREVENTS AND DECREASES THE RATES OF CHILDHOOD OBESITY. THE PROGRAM FOCUSES ON THE MESSAGING A CHILD RECEIVES IN PHYSICAL EDUCATION, THE LUNCHROOM, THE CLASSROOM, AND AT HOME, TO INFLUENCE A CHILD'S CHOICES NOT ONLY IN SCHOOL, BUT LIFELONG. NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAM NO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. WE ARE COMMITTED TO COLLABORATING WITH PARTNER ORGANIZATIONS IN THE COMMUNITY TO ADDRESS THE NEEDS IDENTIFIED IN OUR CHNA, WITH FULL ACKNOWLEDGMENT THAT THESE NEEDS ARE AMONG THE MOST CHALLENGING TO ADDRESS IN ANY COMMUNITY, AND REQUIRE LONG-TERM FOCUS AND INVESTMENT FROM ALL LEVELS OF COMMUNITY STAKEHOLDERS. SCHEDULE H, PART V, SECTION B, LINE 13A: DURING 1/1/2022 - 06/30/2022 PROVIDENCE ST. PATRICK HOSPITAL 100% DISCOUNT WAS UP TO 300% FPL AND 75% DISCOUNT BETWEEN 301% TO 350% FPL. EFFECTIVE 7/01/22 THROUGH 12/31/2022, PROVIDENCE ST. PATRICK HOSPITAL 100% DISCOUNT WAS UP TO 300% FPL AND 75% DISCOUNT BETWEEN 301% TO 400% FPL. THE FPL THRESHOLD PERCENTAGE WAS RAISED DURING THE YEAR TO COMPLY WITH NEW STATE LAW. PROVIDENCE ST. PATRICK HOSPITAL - PART V, SECTION B, LINE 16A: FAP WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/MT/FINANCIAL-ASSISTANCE-APPLICATIONPROVIDENCE ST. PATRICK HOSPITAL - PART V, SECTION B, LINE 16B:FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/MT/FINANCIAL-ASSISTANCE-APPLICATION PROVIDENCE ST. PATRICK HOSPITAL - PART V, SECTION B, LINE 16C: FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/MT/FINANCIAL-ASSISTANCE-APPLICATION PROVIDENCE ST. PATRICK HOSPITAL - PART V, SECTION B, LINE 20E: FINANCIAL ASSISTANCE INFORMATION ALONG WITH PAYMENT OPTIONS ARE GIVEN ON EACH BILLING STATEMENT TO THE PATIENT. PROVIDENCE ST. PATRICK HOSPITAL - 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. 87 1 - PROVIDENCE HEALTH AND SERVICES MT 310 MAIN STREET DEER LODGE MT 597221000 SPECIALTY CLINIC 2 - PROVIDENCE MEDICAL GROUP MONTANA 2829 GREAT NORTHERN LOOP STE 300 MISSOULA MT 598081752 SPECIALTY CLINIC 3 - PROVIDENCE MEDICAL GROUP MONTANA 500 W BROADWAY ST MISSOULA MT 598024008 SPECIALTY CLINIC 4 - PROVIDENCE MEDICAL GROUP MONTANA 500 W BROADWAY ST STE 320 MISSOULA MT 598024031 SPECIALTY CLINIC 5 - PROVIDENCE MEDICAL GROUP MONTANA 601 W SPRUCE ST STE D MISSOULA MT 598024047 SPECIALTY CLINIC 6 - PROVIDENCE MEDICAL GROUP MONTANA 77 DEER CREEK RD SOMERS MT 599328000 SPECIALTY CLINIC 7 - PROVIDENCE MEDICAL GROUP MONTANA 805 MAIN ST SALMON ID 83467 SPECIALTY CLINIC 8 - PMG - MT - BARIATRIC SURGERY 500 W BROADWAY ST FLR 5 MISSOULA MT 598024096 SPECIALTY CLINIC 9 - PMG - MT - BROADWAY INT MED 500 W BROADWAY ST FLR 4 MISSOULA MT 598024096 PRIMARY CARE 10 - PMG - MT - CANCER CENTER 500 W BROADWAY ST MISSOULA MT 598024008 SPECIALTY CLINIC 11 - PMG - MT - COMM HOSP OF ANACONDA 401 W PENNSYLVANIA ST ANACONDA MT 59711 SPECIALTY CLINIC 12 - PMG - MT - COMMUNITY MEDICAL CENTER 2827 FORT MISSOULA RD MISSOULA MT 598047408 SPECIALTY CLINIC 13 - PMG - MT - DIABETES PREVENTION PROGRAM 500 W BROADWAY ST MISSOULA MT 598024014 SPECIALTY CLINIC 14 - PMG - MT - DISCOVERY CARE CENTER 601 N 10TH ST HAMILTON MT 598402060 SPECIALTY CLINIC 15 - PMG - MT - EDGEWOOD VISTA KALISPELL 141 INTERSTATE LN KALISPELL MT 59901 SPECIALTY CLINIC 16 - PMG - MT - EDGEWOOD VISTA MISSOULA 2815 PALMER ST MISSOULA MT 59808 SPECIALTY CLINIC 17 - PMG-MT - ENDOCRINOLOGY DIABETES & NUTRI 900 N ORANGE ST STE 304 MISSOULA MT 598022951 SPECIALTY CLINIC 18 - PMG - MT - EVERGREEN ASSISTED LIVING 3018 RATTLESNAKE DR MISSOULA MT 598026101 SPECIALTY CLINIC 19 - PMG - MT - EVERGREEN HEALTH CARE 3018 RATTLESNAKE DR MISSOULA MT 598026101 SPECIALTY CLINIC 20 - PMG - MT - FLORENCE FAMILY MEDICINE 5549 OLD US HWY 93 FLORENCE MT 59833 SPECIALTY CLINIC 21 - PMG - MT - GRANT CREEK LAB 3075 N RESERVE ST STE Q MISSOULA MT 598081390 PRIMARY CARE 22 - PMG - MT - GRANT CREEK PRIMARY CARE 3075 N RESERVE ST STE Q MISSOULA MT 598081390 PRIMARY CARE 23 - PMG - MT - HILLSIDE HEALTH CARE 4720 23RD AVE MISSOULA MT 59803 SPECIALTY CLINIC 24 - PMG - MT - HOME HEALTH OF MONTANA 1903 S RUSSELL ST STE 1 MISSOULA MT 598016624 SPECIALTY CLINIC 25 - PMG - MT - IHI CPAM ST PATRICK HOSP AND HE 601 W SPRUCE ST STE A MISSOULA MT 598024030 SPECIALTY CLINIC 26 - PMG - MT - IHI HAMILTON MARCUS DALY MEMORI 1200 WESTWOOD DR HAMILTON MT 598402345 SPECIALTY CLINIC 27 - PMG - MT - IHI LINCOLN PARKER MED CTR 2363 W HWY 200 LINCOLN MT 59639 SPECIALTY CLINIC 28 - PMG - MT - IHI MONTANA CARDIOLOGY 203 S DAISY ST SALMON ID 834674709 SPECIALTY CLINIC 29 - PMG - MT - IHI MT POLSON 6 13TH AVE E STE 1 POLSON MT 59860 SPECIALTY CLINIC 30 - PMG - MT - IHI PLAINS FAMILY MEDICINE 10 KRUGER RD PLAINS MT 59859 PRIMARY CARE 31 - PMG - MT - IHI ST JAMES HEALTHCARE 400 S CLARK ST BUTTE MT 597012328 SPECIALTY CLINIC 32 - PMG - MT - IHI SURGERY 500 W BROADWAY ST MISSOULA MT 598024096 SPECIALTY CLINIC 33 - PMG - MT - INFECTION DISEASE 902 N ORANGE ST MISSOULA MT 598022928 SPECIALTY CLINIC 34 - PMG - MT - INT HEART INST OF MT 500 W BROADWAY ST STE 320 MISSOULA MT 598024031 SPECIALTY CLINIC 35 - PMG - MT - INT HEART INST OF MT BUTTE 435 S CRYSTAL ST STE 240 BUTTE MT 89701 SPECIALTY CLINIC 36 - PMG - MT - LIFESPAN FAM MED 715 MAIN ST STEVENSVILLE MT 59870 PRIMARY CARE 37 - PMG - MT - LONGTERM MOBILITY CARE 500 W BROADWAY ST MISSOULA MT 598024008 SPECIALTY CLINIC 38 - PMG - MT - METABOLIC CTR OF ENDO DIAB AND 902 N ORANGE ST STE 304 MISSOULA MT 598022951 SPECIALTY CLINIC 39 - PMG - MT - MISSOULA FAMILY MEDICAL 601 W SPRUCE ST STE A MISSOULA MT 598024047 PRIMARY CARE 40 - PMG - MT - MONTANA GENERAL SURGERY 500 W BROADWAY ST MISSOULA MISSOULA MT 598024096 SPECIALTY CLINIC 41 - PMG - MT - MONTANA NEUROLOGY SPECIALISTS 902 N ORANGE ST STE 303 MISSOULA MT 598022951 SPECIALTY CLINIC 42 - PMG - MT - MT NEUROSURGICAL SPECIALIS 500 W BROADWAY ST STE 310 MISSOULA MT 598024012 SPECIALTY CLINIC 43 - PMG - MT - MT SPINE & PAIN POLSON 6 13TH AVE EAST POLSON MT 598605315 SPECIALTY CLINIC 44 - PMG - MT - MT SPINE AND PAIN CENTER 500 W BROADWAY ST FLR 3 MISSOULA MT 598024096 SPECIALTY CLINIC 45 - PMG - MT - NEPHROLOGY 500 W BROADWAY ST FLR 4 MISSOULA MT 598024096 PRIMARY CARE 46 - PMG - MT - OCCUPATIONAL HEALTH SERVICES 2875 TINA AVE STE 104 MISSOULA MT 598081582 SPECIALTY CLINIC 47 - PMG - MT - PEDIATRIC HOSPITALIST 500 W BROADWAY ST MISSOULA MT 598024096 SPECIALTY CLINIC 48 - PMG - MT - PEDIATRICS 900 N ORANGE ST STE 303 MISSOULA MT 598022956 SPECIALTY CLINIC 49 - PMG - MT - PMG MT PULMONOLOGY & SLEEP MED 900 N ORANGE ST STE 106 MISSOULA MT 598022951 SPECIALTY CLINIC 50 - PMG - MT - POWELL COUNTY MEDICAL CLINIC 1101 TEXAS AVE DEER LODGE MT 59722 SPECIALTY CLINIC 51 - PMG - MT - PSYCHIATRY 900 N ORANGE ST STE 202 MISSOULA MT 598022951 SPECIALTY CLINIC 52 - PMG - MT - RADIATION ONCOLOGY 500 W BROADWAY ST MISSOULA MT 598024008 SPECIALTY CLINIC 53 - PROVIDENCE MEDICAL GROUP MONTANA - REHAB 902 N ORANGE ST FLR 4 MISSOULA MT 598022998 REHAB & PHYSICAL THERAPY 54 - PMG - MT - RIVERSIDE HEALTH CARE 1301 E BROADWAY ST MISSOULA MT 598024905 SPECIALTY CLINIC 55 - PMG - MT - ROCKY MOUNTAIN HEART LUNG 350 HERITAGE WAY STE 2100 KALISPELL MT 599013167 SPECIALTY CLINIC 56 - PMG - MT - SPH ANTICOAGULATION CLINIC 500 W BROADWAY ST MISSOULA MT 598024096 SPECIALTY CLINIC 57 - PMG - MT - SPH FIRST STEP 900 N ORANGE ST STE 103 MISSOULA MT 598022951 SPECIALTY CLINIC 58 - PMG - MT - SPH INPATIENT HOSP 500 W BROADWAY ST MISSOULA MT 598024096 SPECIALTY CLINIC 59 - PMG - MT - SPH INPATIENT PHY SERVICES 500 W BROADWAY ST MISSOULA MT 598024096 SPECIALTY CLINIC 60 - PMG - MT - SPH ST PATRICKS ER PHYS 500 W BROADWAY ST MISSOULA MT 598024008 SPECIALTY CLINIC 61 - PMG - MT - ST LUKE COMMUNITY HEALTHCARE 107 RIDGEWATER DR POLSON MT 59860 SPECIALTY CLINIC 62 - PMG - MT - ST PATRICK HOSP CORP BUTTE 400 S CLARK ST BUTTE MT 597012328 SPECIALTY CLINIC 63 - PMG - MT - SURGERY CENTER 902 N ORANGE STE 100 MISSOULA MT 598022928 SPECIALTY CLINIC 64 - PMG - MT - TRAUMA SERVICES 500 W BROADWAY ST FLR 5 MISSOULA MT 598024096 SPECIALTY CLINIC 65 - PMG - MT - TRIBAL HLTH & HUMAN SERVICES 308 MISSION DR ST IGNATIUS MT 59865 SPECIALTY CLINIC 66 - PMG - MT - URGENT MENTAL HEALTH CLINIC 900 N ORANGE ST STE 202 MISSOULA MT 598022951 SPECIALTY CLINIC 67 - PMG - MT - VALLEY VIEW ESTATES HEALTHCARE 225 N 8TH ST HAMILTON MT 59840 SPECIALTY CLINIC 68 - PMG - MT - VILLIAGE HEALTH CARE 2651 SOUTH AVE W MISSOULA MT 598046405 SPECIALTY CLINIC 69 - PMG - MT - WOMEN'S CARE CTR & FAMILY WELLN 1211 S RESERVE ST STE 101 MISSOULA MT 59801 PRIMARY CARE 70 - PMG - MT - WOUND CARE 902 N ORANGE ST MISSOULA MT 598022928 SPECIALTY CLINIC 71 - PMG - MT AT AUTUMN HOUSE 1185 EASTSIDE HWY CORVALLIS MT 59828 SPECIALTY CLINIC 72 - PMG - MT AT BEEHIVE HOMES 2406 RIVER RD MISSOULA MT 59804 SPECIALTY CLINIC 73 - PMG - MT AT MARCUS DALY HOSPICE & PALLITIV 1200 WESTWOOD DR HAMILTON MT 598402345 SPECIALTY CLINIC 74 - PMG - MT AT MARCUS DALY MEMORIAL HOSPITAL 1200 WESTWOOD DR HAMILTON MT 598402345 SPECIALTY CLINIC 75 - PMG - MT AT MARCUS DALY MEMORIAL HOSPITAL 1200 WESTWOOD DR HAMILTON MT 598402345 SPECIALTY CLINIC 76 - PMG - MT AT ST PATRICK HOSP & HLTH SCI CTR 500 W BROADWAY ST MISSOULA MT 598024008 SPECIALTY CLINIC 77 - PMG - MT INT HEART INSTITUTE 1102 E COMMERCIAL AVE ANACONDA MT 59711 SPECIALTY CLINIC 78 - PMG - MT LAKESIDE CLINIC 2181 HWY 2 E STE 7 KALISPELL MT 59901 SPECIALTY CLINIC 79 - PMG - MT MISSOULA FAMILY MEDICAL 621 W ALDER MISSOULA MT 598024014 SPECIALTY CLINIC 80 - PMG - MT OCCUPATIONAL HLTH SERVICES 601 W SPRUCE ST STE C MISSOULA MT 598024057 SPECIALTY CLINIC 81 - PMG - MT PALLIATIVE CARE 601 W SPRUCE ST STE K MISSOULA MT 59802 SPECIALTY CLINIC 82 - PMG - MT PLASTIC SURGERY 900 N ORAGE ST STE 205 MISSOULA MT 59802 SPECIALTY CLINIC 83 - PMG - MT - PMG MT ACUTE SURGERY AND TRAUMA 500 W BROADWAY MISSOULA MT 59802 SPECIALTY CLINIC 84 - PMG - MT PROVIDENCE OCCUPATIONAL HEALTH 3055 N RESERVE ST STE D MISSOULA MT 598081395 SPECIALTY CLINIC 85 - PMG - MT -PULMONARY AND SLEEP MEDICINE 601 W SPRUCE ST STE J MISSOULA MT 598024047 SPECIALTY CLINIC 86 - ST PATRICK PATHOLOGISTS 500 W BROADWAY ST MISSOULA MT 59802 SPECIALTY CLINIC 87 - PROVIDENCE SURGERY CENTER LLC 902 N ORANGE ST MISSOULA MT 59802 AMBULATORY SURGERY CENTER 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 & SERVICES - MONTANA PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE AT HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/MONTANA PART I, LINE 7: THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS. PART I, LINE 7G: PROVIDENCE PHYSICIANS MONTANA REPORTED $3,214,590 COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES. PART II, COMMUNITY BUILDING ACTIVITIES: IN 2022, PROVIDENCE ST. PATRICK HOSPITAL CONTINUED OUR AWARD-WINNING WORK TO REDUCE ENVIRONMENTAL IMPACTS FROM HOSPITAL OPERATIONS. THIS EFFORT, CALLED GREEN 4 GOOD, IS LED BY A DEDICATED STAFF PERSON (.5 FTE) IN THE MONTANA SERVICE AREA. IN 2022, PROVIDENCE ST. PATRICK HOSPITAL EARNED PRACTICE GREENHEALTH AWARDS, INCLUDING TOP 25, CIRCLE OF EXCELLENCE FOR WASTE, LEADERSHIP, & CLIMATE, AND GREENING THE OR. 2022 GREEN 4 GOOD ACCOMPLISHMENTS INCLUDE TRIPLING SUSTAINABLE FOOD PURCHASES COMPARED TO 2021 (7% UP TO 21%) AND REDUCING GREENHOUSE GAS (GHG) EMISSIONS BY 10.2% SINCE BASELINE YEAR OF 2019. ENVIRONMENTAL JUSTICE EDUCATION WAS PROVIDED BY UNIVERSITY OF MONTANA PROFESSOR (DR. ROBIN SAHA), WITH A GOAL OF ALIGNING HOSPITAL ENVIRONMENTAL STEWARDSHIP WORK WITH ENVIRONMENTAL JUSTICE.PROVIDENCE ST. PATRICK HOSPITAL SUPPORTED COMMUNITY EQUITY AND ANTI-RACISM WORK. IN 2022, THE COMMUNITY COMMEMORATED THE RECONSTRUCTION OF A HISTORICALLY-SIGNFICANT BRIDGE FOR THE CONFEDERATED SALISH AND KOOTENAI TRIBES WITH A RENAMING CEREMONY FOR THE NEWLY-RENAMED BEARTRACKS BRIDGE. THE NAME HONORS THE ORIGINAL INHABITANTS OF THE MISSOULA VALLEY AND REMEMBERS THE U.S. GOVERNMENT'S FORCIBLE REMOVAL OF INDIGENOUS PEOPLE IN 1891.PROVIDENCE ST. PATRICK HOSPITAL CONTRIBUTED TO COMMUNITY ORGANIZATIONS ENGAGED WITH ANTI-RACISM WORK IN THE COMMUNITY IN HONOR OF MARTIN LUTHER KING, JR DAY. 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: COLLECTION ACTIVITYOUR FINANCIAL ASSISTANCE POLICY INCLUDES BILLING AND COLLECTIONS DETAILS. COLLECTION EFFORTS ON UNPAID BALANCES WILL CEASE PENDING FINAL DETERMINATION OF FAP ELIGIBILITY. PROVIDENCE DOES NOT PERFORM, ALLOW, OR ALLOW COLLECTION AGENCIES TO PERFORM ANY EXTRAORDINARY COLLECTION ACTIONS PRIOR TO MAKING A REASONABLE EFFORT TO DETERMINE IF THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. IT IS STANDARD PRACTICE TO CEASE COLLECTION ACTIVITIES FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. PART VI, LINE 2: NEEDS ASSESSMENTWE RECOGNIZE THAT CARING FOR THE POOR AND VULNERABLE IS NOT A TASK WE CAN DO ON OUR OWN. ON A ROUTINE BASIS WE CONDUCT A FORMAL COMMUNITY ASSESSMENT TO DETERMINE WHO IN OUR COMMUNITIES IS EXPERIENCING THE GREATEST NEED. THIS OUTREACH CONNECTS US TO MANY NOT-FOR-PROFIT ORGANIZATIONS AND SOCIAL SERVICE AGENCIES AS WELL AS CARE PROVIDERS AND THEIR CLIENTS IN THE COMMUNITIES. TO ENSURE THAT WE CONDUCT A COMPREHENSIVE ASSESSMENT, OUR PROCESS INCLUDES RESEARCH, MEETINGS, INTERVIEWS, FOCUS GROUPS AND SURVEYS. A REPRESENTATIVE FROM PROVIDENCE ST. PATRICK HOSPITAL PARTICIPATES IN MISSOULA COUNTY HEALTH DEPARTMENT'S COMMUNITY NEEDS ASSESSMENT PROCESS; THIS MOST RECENT ASSESSMENT WAS COMPLETED IN 2021: HTTPS://WWW.MISSOULACOUNTY.US/GOVERNMENT/COMMUNITY-DEVELOPMENT/COMMUNITY-PLANNING-SERVICES/GRANTS-COMMUNITY-PROGRAMS/PROJECTS-AND-PROGRAMS/COMMUNITY-NEEDS-ASSESSMENTADDITIONALLY, PROVIDENCE MINISTRIES HAVE COMMUNITY AND FOUNDATION BOARDS. THE CIVIC LEADERS THAT SERVE ON PROVIDENCE BOARDS CONNECT OUR MISSION WITH A LOCAL PERSPECTIVE ON COMMUNITY NEEDS. OUR ASSESSMENT FINDINGS ARE ASSEMBLED TO MAKE CERTAIN WE UNDERSTAND AND RESPOND TO LOCAL AND REGIONAL NEEDS, WHICH OFTEN VARY FROM ONE CITY OR COUNTY TO ANOTHER. IDENTIFIED AREAS OF NEED NOT ONLY GUIDE OUR COMMUNITY BENEFIT GIVING, BUT ALSO GUIDE OUR STRATEGIC PLANNING. WE BELIEVE MEANINGFUL COMMUNITY NEEDS ASSESSMENT PROVIDES INSIGHT INTO THE COMPLETE COMMUNITY BENEFIT THAT IS REQUIRED, BEYOND JUST FREE AND DISCOUNTED CARE. PART VI, LINE 3: COMMUNICATION TO THE PUBLICTHE 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 INFORMATIONPROVIDENCE ST. PATRICK HOSPITAL PROVIDES COMMUNITIES IN WESTERN MONTANA WITH ACCESS TO ADVANCED CARE AND ADVANCED CARING. DUE TO THE LEVEL OF CARE PROVIDED AT THIS HOSPITAL, PROVIDENCE ST. PATRICK HOSPITAL SEES PATIENTS FROM SURROUNDING COUNTIES, ALTHOUGH FOR THE PURPOSES OF THE CHNA, THE TOTAL SERVICE AREA IS MISSOULA COUNTY. THOSE SURROUNDING AREAS EXTEND FROM LAKE AND SANDERS COUNTIES IN THE NORTH, RAVALLI, GRANITE, DEER LODGE AND SILVER BOW COUNTIES IN THE SOUTH, POWELL AND LEWIS AND CLARK COUNTIES IN THE EAST AND MINERAL COUNTY IN THE WEST. THE TOTAL SERVICE AREA, MISSOULA COUNTY, INCLUDES A POPULATION OF APPROXIMATELY 122,000 PEOPLE. MISSOULA COUNTY COVERS AN AREA OF ROUGHLY 2,600 SQUARE MILES IN WESTERN MONTANA. THE COUNTY IS MOUNTAINOUS, WITH MORE THAN 1,975 MILES OF RIVERS AND STREAMS AND FIVE VALLEYS THAT SIT ABOUT 3,200 FEET ABOVE SEA LEVEL. THE AREA IS HOME TO ABUNDANT WILDLIFE. THE FIRST INHABITANTS OF THE MISSOULA AREA WERE AMERICAN INDIANS FROM THE SALISH TRIBE. THE FIRST WHITE SETTLEMENT WAS ESTABLISHED IN 1860.THE POPULATION OF MISSOULA COUNTY IS ESTIMATED AT 122,000. THE AMERICAN COMMUNITY SURVEY FIVE-YEAR ESTIMATES OF THE POPULATION REFLECTS: 23.77% PERCENT YOUTH (0-17 YEARS) 29.79% PERCENT YOUNG ADULTS (18-34 YEARS) 35.99% PERCENT OLDER ADULTS (35-64 YEARS) 15.75% PERCENT SENIORS (65 YEARS AND OLDER) AMONG MISSOULA RESIDENTS IN THE ACS FIVE-YEAR ESTIMATES, 91.12% ARE WHITE, 1.72% ASIAN, 2.6% WERE ALASKA NATIVE OR AMERICAN INDIAN, .51% WERE AFRICAN AMERICAN OR BLACK, .08% WERE NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER, .59% WERE OTHER AND 3.38% WERE OF TWO OR MORE RACES. 3.38% OF THE POPULATION IDENTIFIES AS HISPANIC OR LATINO. INCOME LEVELS AND HOUSING IN THE 2019 AMERICAN COMMUNITY SURVEY, THE MEDIAN HOUSEHOLD INCOME FOR MISSOULA COUNTY WAS $53,890. THE MEDIAN INCOME OF MISSOULA COUNTY'S HIGH NEED SERVICE AREA IS $41,081, OR 76% OF THE BROADER SERVICE AREA MEDIAN INCOME. ON AVERAGE, APPROXIMATELY 27% OF HOUSEHOLDS IN MISSOULA COUNTY ARE SEVERELY HOUSING COST BURDENED. THIS IS SLIGHTLY LOWER THAN THE HIGH NEED AREAS IN WHICH NEARLY 30% OF RENTER HOUSEHOLDS ARE SEVERELY HOUSING COST BURDENED.THE ORGANIZED HEALTH CARE DELIVERY SYSTEMS INCLUDE THE MISSOULA CITY-COUNTY HEALTH DEPARTMENT, COMMUNITY MEDICAL CENTER, AS WELL AS FEDERALLY-QUALIFIED HEALTH CENTERS. IN ADDITION, THERE ARE NUMEROUS SOCIAL SERVICE NON-PROFIT AGENCIES, FAITH-BASED ORGANIZATIONS, AND PRIVATE AND PUBLIC-SCHOOL SYSTEMS THAT CONTRIBUTE RESOURCES TO ADDRESS THESE IDENTIFIED NEEDS: 2 HOSPITALS, INCLUDING ONE WITH PSYCHIATRIC INPATIENT UNIT AND AMBULATORY OUTPATIENT CLINICS. ONE FEDERALLY-QUALIFIED HEALTH CENTER, INCLUDING SATELLITE CLINICS 60+ DENTAL PROVIDERS MENTAL HEALTH PROVIDERS: 1 CRISIS STABILIZATION HOME, 2 OUTPATIENT MENTAL HEALTH TREATMENT CENTERS SERVING BOTH ADULTS AND CHILDREN ADDICTION TREATMENT: 1 INPATIENT CENTER AND 2 OUTPATIENT CENTERS TO SERVE BOTH ADULT AND CHILDREN. PART VI, LINE 5: COMMUNITY HEALTH PROMOTIONPROVIDENCE HEALTH & SERVICES - MONTANA PROVIDES VITAL COMMUNITY HEALTHSERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSUREDTHROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTEDCARE. PROVIDENCE HEALTH & SERVICES - MONTANA IS COMMITTED TO PROMOTINGTHE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS ISDEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) OPEN MEDICAL STAFF2) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:AT PROVIDENCE, WE USE OUR VOICE TO ADVOCATE FOR VULNERABLE POPULATIONS AND NEEDED REFORMS IN HEALTH CARE. WE ARE ALSO PURSUING INNOVATIVE WAYS TO TRANSFORM HEALTH CARE BY KEEPING PEOPLE HEALTHY, AND MAKING OUR SERVICES MORE CONVENIENT, ACCESSIBLE AND AFFORDABLE FOR ALL. IN AN INCREASINGLY UNCERTAIN WORLD, WE ARE COMMITTED TO HIGH-QUALITY, COMPASSIONATE CARE FOR EVERYONE - REGARDLESS OF COVERAGE OR ABILITY TO PAY. WE HELP PEOPLE AND COMMUNITIES BENEFIT FROM THE BEST HEALTH CARE MODEL FOR THE FUTURE - TODAY.TOGETHER, OUR 117,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,000 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, 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 PART VI, LINE 7, REPORTS FILED WITH STATES MT 1 MISSOULA ECONOMIC PARTNERSHIP PO BOX 7457 MISSOULA MT 59802 273994460 501(C)(6) 50000 0 SPONSORSHIP ST PATRICK HOSPITAL FOUNDATION 502 W SPRAUCE ST MISSOULA MT 59808 237056976 501(C)(3) 44694 0 SPONSORSHIP CATHOLIC SOCIAL SERVICES INC PO BOX 907 FOR MONTANA HELENA MT 59624 240818341 501(C)(3) 35000 0 SPONSORSHIP YMCA MISSOULA FAMILY 3000 S RUSSEL ST MISSOULA MT 59801 810300829 501(C)(3) 25000 0 OPERATIONAL SUPPORT UNITED WAY OF MISSOULA COUNTY 412 W ALDER ST MISSOULA MT 59802 810287854 501(C)(3) 10000 0 OPERATIONAL SUPPORT 4 1 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. 1 1 0 0 0 0 0 1 0 GREG HOFFMAN PRESIDENT/CEO & TREASURER 0 919782 0 1584583 0 115250 0 253823 0 24713 0 2898151 0 89848 JOEL GILBERTSON DIVISION CHIEF EXEC - CENTRAL 0 858041 0 1026760 0 249550 0 248529 0 15834 0 2398714 0 210446 JO ANN ESCASA-HAIGH EVP/ASSISTANT TREASURER 0 841148 0 989404 0 326862 0 27450 0 8365 0 2193229 0 284024 JOSEPH SCHMOKER PHYSICIAN 1432494 0 314506 0 157525 0 0 0 33560 0 1938085 0 104436 0 MIKE BUTLER FRMR PRESIDENT 0 0 0 0 0 1835706 0 7828 0 0 0 1843534 0 0 JOHN WHIPPLE SECRETARY - THRU 5/22 0 319672 0 277940 0 1146142 0 5571 0 5476 0 1754801 0 855652 CARTER BECK MD PHYSICIAN 847457 0 508016 0 141569 0 91286 0 4366 0 1592694 0 116076 0 SCOTT O'BRIEN DIVISION COO - CENTRAL 0 605546 0 510039 0 205317 0 180710 0 2266 0 1503878 0 183677 ROBERT HELLRIGEL FRMR EVP CE HOME & COMM CARE 0 613354 0 432607 0 333365 0 4493 0 10891 0 1394710 0 165001 SIMONE MUSCO MD PHYSICIAN 749865 0 115950 0 203736 0 86866 0 36272 0 1192689 0 105548 0 JAMES MADDUX PHYSICIAN 790806 0 112500 0 124696 0 88346 0 20764 0 1137112 0 101509 0 DANIEL SPOON PHYSICIAN 790806 0 112500 0 133255 0 62599 0 13876 0 1113036 0 75550 0 ANNA NEWSOM SECRETARY (PART YEAR) 0 535718 0 50000 0 215282 0 202914 0 22171 0 1026085 0 0 JOYCE DOMBROUSKI CHIEF EXEC WESTERN MT SVC AREA 0 439109 0 245954 0 141308 0 145731 0 22075 0 994177 0 113749 JIM WATSON ESQ ASSISTANT SECRETARY 0 466229 0 228525 0 142483 0 98225 0 26164 0 961626 0 119387 HELEN ANDRUS REGIONAL CFO WA AND MT 0 425620 0 235000 0 89570 0 89229 0 16549 0 855968 0 62305 MELISSA DAMM DIVISION CFO - CENTRAL 0 379873 0 170000 0 84206 0 83219 0 2161 0 719459 0 62794 KIRK BODLOVIC FRMR KE - PSJH REG. COO 0 275969 0 80000 0 13753 0 35438 0 11223 0 416383 0 6310 DONALD ANDERSON JR ASSISTANT SECRETARY FOR ENROLLMENT 0 219186 0 36718 0 1088 0 13600 0 17583 0 288175 0 0 CINDY STRAUSS FRMR SECRETARY 0 0 0 146754 0 0 0 0 0 0 0 146754 0 0 PART I, LINE 1A PROVIDENCE EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: FIRST CLASS TRAVEL OR CHARTER TRAVEL AIR TRAVEL IS GENERALLY REIMBURSABLE AT THE LEAST EXPENSIVE AIRFARE WHICH PERMITS DEPARTURES AND ARRIVALS AT REASONABLE TIMES AND REASONABLE DISTANCE TRAVELED. EMPLOYEES ARE ENCOURAGED TO PLAN IN ADVANCE TO GET AVAILABLE DISCOUNTS. AIRLINE FREQUENT FLYER UPGRADES WILL NEVER BE REIMBURSED. IN LIMITED SITUATIONS, FIRST CLASS TICKETS AND CHARTER MAY BE REIMBURSED WHEN APPROVED BY A SENIOR LEVEL SUPERVISOR. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - RELOCATION PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO RELOCATION EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD-PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THE RELOCATION EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THE RELOCATION BENEFITS, SO THAT A PORTION OF THE REIMBURSEMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - FINANCIAL/RETIREMENT PLANNING PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO FINANCIAL AND RETIREMENT PLANNING EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THESE OTHER EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THIS BENEFIT, SO THAT A PORTION OF THE PAYMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE PROVIDENCE PROVIDES HOUSING ALLOWANCES ONLY FOR PURPOSES OF RELOCATION ASSISTANCE TO A NEWLY HIRED EMPLOYEE. PROVIDENCE MAY PAY TEMPORARY LIVING EXPENSES FOR THE NEWLY HIRED EMPLOYEE UP TO A MAXIMUM OF 90 CALENDAR DAYS. COVERED EXPENSES ARE RENT (EXCLUDING "RENT" WHICH MAY BE PAID IN ORDER TO OCCUPY A NEW PERMANENT RESIDENCE UNTIL THE TITLE CLEARS) AND UTILITIES, INCLUDING HEAT, ELECTRICITY, GAS, WATER, LOCAL INTERNET AND LOCAL TELEPHONE AND GARBAGE SERVICES. THE EXECUTIVE VICE PRESIDENT, CHIEF ADMINISTRATIVE OFFICER OF PROVIDENCE MAY APPROVE TEMPORARY HOUSING ASSISTANCE FOR UP TO SIX MONTHS WHEN FAMILY RELOCATION IS DELAYED TO ACCOMMODATE THE SCHOOL YEAR OR EQUIVALENT CIRCUMSTANCES. ONLY IN EXTENUATING CIRCUMSTANCES IS HOUSING EXTENDED BEYOND THIS SIX-MONTH PERIOD. THE AMOUNTS REPORTED FOR THESE RELOCATION/HOUSING PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE. PART I, LINE 3 DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY 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 THIS YEAR: MIKE BUTLER - $1,835,706 JOHN WHIPPLE - $186,674 ROBERT HELLRIGEL - $95,175 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: GREG HOFFMAN - $89,848 JOEL GILBERTSON - $210,446 JO ANN ESCASA-HAIGH - $284,024 JOSEPH SCHMOKER - $104,436 JOHN WHIPPLE - $855,652 CARTER BECK MD - $116,076 SCOTT O'BRIEN - $183,677 ROBERT HELLRIGEL - $165,001 SIMONE MUSCO M.D. - $105,548 JAMES MADDUX - $101,509 DANIEL SPOON - $75,550 JOYCE DOMBROUSKI - $113,749 JIM WATSON, ESQ - $119,387 HELEN ANDRUS - $62,305 MELISSA DAMM - $62,794 KIRK BODLOVIC - $6,310 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. FORM 990, ITEM B, AMENDED RETURN FORM 990 IS BEING AMENDED TO REMOVE UNRELATED BUSINESS INCOME, REPORTED ON PART VIII, LINE 2B, JV INCOME AND REPORT IT AS PROGRAM SERVICE REVENUE. UPON FURTHER REVIEW OF PROVIDENCE SURGERY CENTER, LLC'S AMENDED OPERATING AGREEMENT DATED DECEMBER 14, 2020 IT WAS DETERMINED THAT PROVIDENCE HEALTH & SERVICES - MONTANA HAD THE REQUIRED ELEMENTS OF CONTROL AND PROVIDENCE SURGERY CENTER, LLC'S PURPOSE IS TO FURTHER THE 501(C)(3) TAX-EXEMPT PURPOSE OF PROVIDENCE HEALTH & SERVICES - MONTANA. PLEASE SEE BELOW FOR THE SECTION OF FORM 990 THAT WERE UPDATED: - FORM 990, PART VIII, LINE 2B - FORM 990, SCHEDULE R, PART III, COLUMN (I) - PROVIDENCE SURGERY CENTER FORM 990, PART V, LINE 15 INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF THE RELATED ORGANIZATION. IT IS THE INTENTION OF PROVIDENCE AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE EMPLOYEES OF A RELATED ORGANIZATION WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. THE RELATED ORGANIZATION COMMON LAW EMPLOYEES ARE INCLUDED IN THE RELATED ORGANIZATION'S SECTION 4960 TAX ANALYSIS AND REPORTING. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS PROVIDENCE HEALTH & SERVICES IS THE SOLE CORPORATE MEMBER OF PROVIDENCE HEALTH & SERVICES - MONTANA. FORM 990, PART VI, SECTION A, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS PROVIDENCE HEALTH & SERVICES - MONTANA HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT THE PROVIDENCE HEALTH & SERVICES - MONTANA'S GOVERNING BOARD. ALL NOMINATIONS THAT COME FROM THE PROVIDENCE HEALTH & SERVICES - MONTANA 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 GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, REVISED IN 2023, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY CORE LEADERS ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS RECUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE A PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE PERIODICALLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION 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 2023. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE PROVIDENCE COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, CONSOLIDATED AUDITED FINANCIAL STATEMENTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PROVIDENCE INTERNET SITE. FORM 990, PART IX, LINE 11G MEDICAL DIRECTOR & MED. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 21,015,646. MANAGEMENT AND GENERAL EXPENSES 2,126,790. TOTAL EXPENSES 23,142,436. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 5,576,866. MANAGEMENT AND GENERAL EXPENSES 564,381. TOTAL EXPENSES 6,141,247. OTHER PATIENT SERVICES FEES: PROGRAM SERVICE EXPENSES 28,327,061. MANAGEMENT AND GENERAL EXPENSES 2,866,707. TOTAL EXPENSES 31,193,768. AGENCY & CONTRACT LABOR FEES: PROGRAM SERVICE EXPENSES 6,329,734. MANAGEMENT AND GENERAL EXPENSES 640,571. TOTAL EXPENSES 6,970,305. REPAIRS & MAINTENANCE FEES: PROGRAM SERVICE EXPENSES 4,133,386. MANAGEMENT AND GENERAL EXPENSES 418,300. TOTAL EXPENSES 4,551,686. BILLING & COLLECTIONS FEES: PROGRAM SERVICE EXPENSES 114. MANAGEMENT AND GENERAL EXPENSES 11. TOTAL EXPENSES 125. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS 59,888,057. FAS 136 - RECIPIENT ORGANIZATION ADJUSTMENT -1,639,285. OTHER ADJUSTMENTS -3,315,099. COLLABRIA CARE 414 SOUTH JEFFERSON STREET NAPA CA 94559 680393144 HEALTHCARE CA 501(C)(3) 10 SJHCN 1 COVENANT ACO 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 611573313 HEALTHCARE TX 501(C)(3) 12, I CHS 1 COVENANT CHILDREN'S PHYSICIANS GROUP 3615 19TH STREET LUBBOCK TX 79410 881290850 HEALTHCARE TX 501(C)(3) PENDING CHS 1 COVENANT HEALTH NETWORK INC 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 461259908 HEALTHCARE CA 501(C)(3) 12, III SJHS 1 COVENANT HEALTH PARTNERS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 463516417 HEALTHCARE TX 501(C)(3) 12, I CHS 1 COVENANT HEALTH SYSTEM 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS 1 COVENANT HEALTH SYSTEM FOUNDATION 3623 22ND PLACE LUBBOCK TX 79410 752897026 HEALTHCARE TX 501(C)(3) 7 CHS 1 COVENANT HOME AND COMMUNITY CARE 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 920275096 HEALTHCARE TX 501(C)(3) 10 CHS 1 COVENANT HOSPITAL HOBBS 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 844273963 HEALTHCARE TX 501(C)(3) 3 CHS 1 COVENANT MEDICAL CENTER 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 822913146 HEALTHCARE TX 501(C)(3) 3 CHS 1 COVENANT MEDICAL GROUP 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 752743883 HEALTHCARE TX 501(C)(3) 3 CHS 1 EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT WA 982065128 943264605 TRANSITIONAL CARE WA 501(C)(3) 10 N/A 0 GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 201910170 SUPPORT WA 501(C)(3) 7 PHS WA 1 GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC WA 98188 273133200 HEALTHCARE WA 501(C)(3) 7 SHS 1 GRACE CLINIC OF LUBBOCK 1801 LIND AVENUE SW ATTN TAX DEPT RENTON WA 98057 203856995 HEALTHCARE TX 501(C)(3) 3 CHS 1 HMTS INC 1 HOAG DRIVE NEWPORT BEACH CA 92658 453583707 HEALTHCARE CA 501(C)(3) 12, I HMHP 1 HOAG CHARITY SPORTS 2081 BUSINESS CENTER DR STE 195 NEWPORT BEACH CA 92663 452982422 SUPPORT CA 501(C)(3) 7 HHF 1 HOAG CLINIC 1 HOAG DRIVE NEWPORT BEACH CA 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