Providence Trinitycare Hospice

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

“The sole Corporate Member has the power to: 1) Fix the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause. 2) Appoint and remove the President/Chief Executive Officer of this Corporation and to remove such President/Chief Executive Officer, with or without cause, after requesting a recommendation from the Board of Directors.”

“The sole Corporate Member has the power to: 1) Adopt or change the mission, philosophy, or values. 2) Amend or repeal the Articles of Incorporation or Bylaws. 3) Approve the acquisition of assets, the incurrence of indebtedness or the lease, sale, transfer, assignment or encumbering of the assets, if the amount involved in any such transaction is in excess of an amount specified from time to time by resolution of the Providence Member and to approve the sale or transfer of other property which may have either historical or religious significance. 4) Approve the dissolution, liquidation, consolidation or merger with another corporation or entity. 5) Approve on a consolidated system-wide basis the annual operating and capital budgets and approval of any deviations from such budget in excess of an amount or percentage specified from time to time by resolution of the Providence Member. 6) Appoint the certified public accountants after receiving the recommendation of the Board of Directors and to receive the annual audit report from such accountants. 7) Approve the initiation or closure of any major work.”

“The Form 990 is prepared by experienced Providence Health & Services staff and reviewed by the internal PH&S 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 reviewed 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. Each year, the Board Chair conducts a formal performance evaluation of the President/CEO that considers input from the other directors and senior leaders reporting to the President. The evaluation is discussed with the Human Resources Committee and then a recommendation is made by the committee to the full Board. The Board Chair and the Chair of the Human Resources Committee also meet with an independent consultant to develop a salary recommendation; which is reviewed and approved first by the committee and then by the Board of Directors. Additionally, 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 Human Resources Committee as a part of the review and approval process. Performance incentives allow executives to earn additional compensation if they achieve specific organizational goals for furthering Providence operating commitments and strategic objectives - advancing the Providence Mission and core values, meeting benchmarks for charity care, achieving quality targets, delivering top-rated patient 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.”

“Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon request. The 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.”

“Michael Holcomb - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Chauncey Boyle, SP - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Marian Schubert, CSJ - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Phyllis Hughes, RSM - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Carolina Reyes, MD - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Michael A. Stein - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Eugene "Al" Parrish - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Bob Wilson - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Sallye Liner - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Isiaah Crawford - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Martha Diaz Aszkenazy - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Kirby McDonald - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Dave Olsen - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Charles (Chuck) Watts - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Rod Hochman, MD - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Todd Hofheins - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Cindy Strauss - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Debra Canales - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Michael Butler - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Janice Newell - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Harvey Smith - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Teresa Spalding - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Debbie Burton - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Aaron Martin - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Rhonda Medows, MD - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Mark Gargett - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Jack Mudd - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Joel Gilbertson - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Sharon Toncray - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Greg Till - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Gary Flaming - 1801 Lind Avenue Avenue SW, Renton, WA 98057. David Brown - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Robert Hellrigel - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Orest Holubec - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Paul Stoddart - 1801 Lind Avenue Avenue SW, Renton, WA 98057. Dave Hunter - 1801 Lind Avenue Avenue SW, Renton, WA 98057.”

“Medical Physician & Director Fees: Program service expenses 792,981. Management and general expenses 0. Fundraising expenses 0. Total expenses 792,981. Agency Labor: Program service expenses 656,404. Management and general expenses 29,076. Fundraising expenses 0. Total expenses 685,480. Purchased Services Room & Board: Program service expenses 1,334,765. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,334,765. Medical/Lab/X-Ray: Program service expenses 27,457. Management and general expenses 0. Fundraising expenses 0. Total expenses 27,457. Patient Transportation: Program service expenses 53,898. Management and general expenses 0. Fundraising expenses 0. Total expenses 53,898. Other Consulting Fees: Program service expenses 41,210. Management and general expenses 11,265. Fundraising expenses 0. Total expenses 52,475.”

“FAS 136 Adjustment UR - Recipient Income on Books 396,654. FAS 136 Adjustment UR - Change in Net Assets on Books 1,525,408. 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.”