Providence Trinitycare Hospice

“Providence Health System - So. California is the Corporate Member.”

“The Board of Directors for Providence TrinityCare Hospice submits decisions to the Little Company of Mary Community Ministry Board via consent agenda. The Little Company of Mary Community Ministry Board submits decisions to the Providence Health & Services Board of Directors for final approval via consent agenda. The Little Company of Mary Service Area includes the communities served by Providence TrinityCare Hospice.”

“The Form 990 is prepared internally by experienced staff and reviewed by the internal Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS.”

“Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict.”

“It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its employees, including our senior executives. Salaries for senior executives are determined by the Providence Board's Human Resources Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Board retains an independent consultant each year to review salaries of those in the most significant leadership roles in the organization. Part of the consultant's role is to review an extensive array of compensation surveys of large, not-for-profit health care systems in the United States. Providence is one of the larger health systems in the country, and as such, the Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Base salaries for Providence executives are set at the median level of the market, as identified by the independent consultant and reviewed with the Human Resources Committee. Performance incentives allow executives to earn additional compensation if they achieve specific organizational and individual goals for furthering Providence operating principles - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated customer satisfaction, meeting employee satisfaction goals and reaching financial performance objectives. The Board of Directors conducts a thorough process to ensure performance incentives are aligned with appropriate practices for not-for-profit health care systems. The Board's process for executive compensation fully complies with IRS standards and mirrors the best practices recommended in the "Report to Congress and the Nonprofit Sector on Governance, Transparency, and Accountability" submitted to the Senate Finance Committee by the Panel on the Nonprofit Sector. Based upon the above principles, the Executive Director and Chief Medical Officer are reviewed annually by the PHS - So. California HR Department.”

“Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon written request. The Health System consolidated financial statements are available on our public internet site www2.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site.”

“Medical Physician & Director Fees: Program service expenses 758,688. Management and general expenses 0. Fundraising expenses 0. Total expenses 758,688. Agency Labor: Program service expenses 235,129. Management and general expenses 0. Fundraising expenses 0. Total expenses 235,129. Purchased Services Equipment DME: Program service expenses 473,681. Management and general expenses 0. Fundraising expenses 0. Total expenses 473,681. Purchased Services Room & Board: Program service expenses 1,470,155. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,470,155. Medical/Lab/X-Ray: Program service expenses 17,337. Management and general expenses 0. Fundraising expenses 0. Total expenses 17,337. Patient Transportation: Program service expenses 93,940. Management and general expenses 0. Fundraising expenses 0. Total expenses 93,940. Other Consulting Fees: Program service expenses 221,650. Management and general expenses 61,195. Fundraising expenses 0. Total expenses 282,845.”

“FAS 136 396,770. Affiliate Transfer to California Region -27,316. Rounding -1.”

“The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation.”

“The employees working at TrinityCare Hospice are paid by Providence Health System - Southern California EIN# 51-0216589. Therefore, no W-2s are issued by the reporting organization.”

“Our dedicated volunteers provided valuable service to our ministry in Torrance, Van Nuys and Cerritos in addition to supporting the programs of TrinityCare Kids, The Gathering Place and the Bereavement Department. Examples of the services provided include: Patient care, everything from providing companionship to patients, helping them to reach long and short term goals, providing relief care for family members or friends who cared for patients, helping them with siblings or young children of patients, recording family histories as requested, providing support at the time of death, taking patients to medical appointments or just for a ride on a nice day, delivering supplies, walking the family dog, making a light meal, providing supportive phone calls and providing a caring presence for patients who live alone. Administrative support in the office. Helping patients and families create a tangible keepsake, and express themselves through the Legacy Art Program. Making Memory Bears for families after the patient's death. Recognizing the dedication to our country with a visit and a simple gift and poem delivered on Veteran's Day to our patients who served in the Armed forces. Driving TrinityKids Care(TKC) patients to clinic appointments in the TKC van. Knitting blankets, hats and socks to give to patients to keep them cozy. Delivering holiday gifts to our neediest adult and TKC families during the holidays through the Adopt A Family Program.”

“This entity has no fundraising costs since all fundraising is handled through its affiliated Foundation.”