SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2021
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) . . . 		    19,496,798   19,496,798 0.980 %
b Medicaid (from Worksheet 3, column a) . . . . .     363,560,064 240,632,655 122,927,409 6.210 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     383,056,862 240,632,655 142,424,207 7.190 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     22,897,230 5,174,896 17,722,334 0.900 %
f Health professions education (from Worksheet 5) . . .     8,210,946   8,210,946 0.410 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     11,693,322   11,693,322 0.590 %
j Total. Other Benefits . .     42,801,498 5,174,896 37,626,602 1.900 %
k Total. Add lines 7d and 7j .     425,858,360 245,807,551 180,050,809 9.090 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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
601,170,000
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
713,096,939
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-111,926,939
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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 19
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 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS
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) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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 19
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 20
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS
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) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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 CONDUCTED KEY INFORMANT INTERVIEWS WITH INDIVIDUALS WHO REPRESENT A VARIETY OF LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS THROUGHOUT THE HOSPITALS' SERVICE AREA.2019 CHNA KEY INFORMANTS: - 3WINS FITNESS (PROGRAM, PHYSICAL ACTIVITY) - CAL STATE UNIVERSITY, NORTHRIDGE (UNIVERSITY, PHYSICAL ACTIVITY) - ALLIANCE FOR COMMUNITY EMPOWERMENT (COMMUNITY BASED ORGANIZATION, COMMUNITY PROGRAMMING AND EMPOWERMENT) - ALL- INCLUSIVE COMMUNITY HEALTH CENTER (COMMUNITY BASED ORGANIZATION, HEALTH CARE) - BURBANK HOUSING CORPORATION (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS) - CITY OF BURBANK (GOVERNMENT) - EL CENTRO DE AMISTAD (COMMUNITY BASED ORGANIZATION, BEHAVIORAL HEALTH) - EL PROYECTO DEL BARRIO (COMMUNITY BASED ORGANIZATION, HEALTH CARE) - LA FAMILY HOUSING (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS) - LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH (GOVERNMENT, PUBLIC HEALTH) - NORTH VALLEY CARING SERVICES (COMMUNITY BASED ORGANIZATION, HOUSING/HOMELESSNESS) - NORTHEAST VALLEY HEALTH CORPORATION (COMMUNITY BASED ORGANIZATION, HEALTH CARE) - SAN FERNANDO AND SANTA CLARITA VALLEY HOMELESS COALITION (COALITION, 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) - THE OFFICE OF LAUSD SCHOOL BOARD MEMBER (GOVERNMENT, EDUCATION) - VALLEY CROSSROADS SEVENTH-DAY ADVENTIST CHURCH (FAITH BASED ORGANIZATION) - WEST VALLEY YMCA (NATIONAL ORGANIZATION, HEALTHY LIVING AND YOUTH DEVELOPMENT)IN ADDITION TO CONDUCTING KEY INFORMANT INTERVIEWS AS PART OF ITS PRIMARY DATA COLLECTION, PROVIDENCE ALSO INCLUDED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY WHO PARTICIPATED AS PART OF THE BOARD COMMITTEE ON COMMUNITY BENEFIT AUTHORIZED BY THE GOVERNING BOARD IN MARCH 2019.THE CHNA OVERSIGHT COMMITTEE MET TWICE IN THE FALL OF 2019 TO PRIORITIZE AND RECOMMEND THE TOP IDENTIFIED HEALTH NEEDS TO BE ADDRESSED OVER THE NEXT THREE YEARS. THE EXTERNAL REPRESENTATIVES INCLUDED THE PERSPECTIVE OF A PEDIATRICIAN, AN FQHC, MENTAL HEALTH SERVICES PROVIDER, AN AFFORDABLE HOUSING ORGANIZATION, SENIOR SERVICES PROVIDER AND THE AREA HEALTH OFFICER FOR THE SAN FERNANDO VALLEY FROM THE DEPARTMENT OF PUBLIC HEALTH. THE GROUP PARTICIPATED IN TWO MEETINGS TO REVIEW THE ASSEMBLED PRIMARY AND SECONDARY DATA FOR EACH IDENTIFIED HEALTH NEED. THE FIRST MEETING INCLUDED DISCUSSIONS ON HOW EACH ISSUE AFFECTED THE COMMUNITIES IN THE REGION, USING THE IDENTIFIED NEED OF HOMELESSNESS AND HOUSING INSTABILITY TO FAMILIARIZE AND PREPARE THE PARTICIPANTS FOR CRITERIA THAT WOULD BE APPLIED DURING THE PRIORITIZATION MEETING. IN THE SECOND MEETING COMMITTEE PARTICIPANTS RECEIVED A QUESTIONNAIRE AT THE START OF THE MEETING AND ASKED TO RATE THE SEVERITY OF EACH IDENTIFIED HEALTH NEED USING THREE CRITERIA: (1) THE CHANGE OVER TIME, (2) THE AVAILABILITY OF COMMUNITY RESOURCES/ASSETS TO ADDRESS THE HEALTH NEED, AND (3) THE COMMUNITY READINESS TO IMPLEMENT/SUPPORT PROGRAMS TO ADDRESS THE HEALTH NEED. OVERSIGHT COMMITTEE MEMBERS WERE THEN ASKED TO CONSIDER THE THREE QUESTIONS BELOW AND GIVEN THREE DOTS, OR "VOTES", TO ASSIGN TO THE IDENTIFIED HEALTH NEEDS, RESULTING IN A LIST OF PRIORITIZED NEEDS.- HOW DOES THIS NEED IMPACT THE WORK OF YOUR ORGANIZATION AND THE CLIENTS YOU SERVE?- WHAT OTHER SERVICE GAPS CURRENTLY EXIST?- WHAT ROLE CAN PROVIDENCE PLAY IN ADDRESSING THIS NEED?
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 HOSPITALS 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 THE CENTER FOR NONPROFIT MANAGEMENT (CNM), LOS ANGELES, CA.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, LINE 7B, CHNA REPORT WEBSITE: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTSCLICK ON "SOUTHERN CALIFORNIA" TAB
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 LATEST CHNA, THE BOARD COMMITTEE ON COMMUNITY BENEFITS IDENTIFIED THE FOLLOWING AS THE HIGHEST PRIORITY NEEDS WITHIN OUR COMMUNITIES:1) HOMELESSNESS2) BEHAVIORAL HEALTH, INCLUDING MENTAL HEALTH AND SUBSTANCE USE3) FOOD INSECURITY4) PREVENTION AND MANAGEMENT OF CHRONIC DISEASES5) ACCESS TO HEALTH CARE AND RESOURCESTHE FIVE PRIORITIZED HEALTH NEEDS ARE BEING ADDRESSED WITHIN THE CONTEXT OF FOUR INITIATIVES THAT MAKE UP THREE-YEAR IMPLEMENTATION STRATEGY:INITIATIVE #1: STRENGTHEN INFRASTRUCTURE OF CONTINUUM OF CARE FOR PATIENTS EXPERIENCING HOMELESSNESS- ASSISTED PATIENTS EXPERIENCING HOMELESSNESS THROUGH OUR CHW HOMELESS NAVIGATORS PROGRAM WITH DISCHARGE TO SHELTER OR HOMELESS SERVICE PROVIDERS. WORKED WITH OVER 890 HOMELESS PATIENTS IN 2021- ASCENCIA AND NATIONAL HEALTH FOUNDATION WERE IDENTIFIED AS STRATEGIC PARTNERS TO ADDRESS RECUPERATIVE CARE/INTERIM SHELTER FOR PATIENTS EXPERIENCING HOMELESSNESSINITIATIVE #2: INCREASE REACH AND UTILIZATION OF COMMUNITY BASED WELLNESS AND ACTIVITY CENTERS- INCREASED THE NUMBER OF SENIOR PARTICIPANTS ACTIVE IN INDIVIDUAL SHORT-TERM COUNSELING AND GROUP COUNSELING THROUGH OUR VAN NUYS WELLNESS CENTER.- 42 HEALTH EDUCATION CLASSES HELD ON ZOOM THROUGH OUR PACOIMA WELLNESS CENTERINITIATIVE #3: IMPROVE ACCESS TO HEALTHCARE SERVICES AND PREVENTIVE RESOURCES- ASSISTED COMMUNITY MEMBERS WITH 192 APPLICATIONS FOR HEALTH INSURANCE ENROLLMENT- ENROLLED 48 CLIENTS IN CALFRESH- RAN OUR FIRST FEAST PROGRAM WITH 14 PARTICIPANTS TO PROVIDE NUTRITION EDUCATION FOR COMMUNITY MEMBERS- BEGAN OUR MENTAL HEALTH FIRST AID PROGRAM, TRAINING 120 COMMUNITY MEMBERSINITIATIVE #4: SUPPORT COLLABORATIVE PARTNERSHIPS FOR BETTER HEALTH- PROVIDED OVER 9,500 COVID VACCINATIONS AND BOOSTERS WITHIN THE SFV SERVICE AREANEEDS 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. FOR EXAMPLE, PROVIDENCE HAS PROVIDED A TATTOO REMOVAL PROGRAM FOR MANY YEARS FOR EX-GANG MEMBERS AND OFFENDERS WHO HAVE COMMITTED TO TURNING THEIR LIFE AROUND. YET, WE HAVE LEARNED THAT REMOVING THE TATTOO IS JUST PART OF THE SOLUTION TO SUPPORTING THE INDIVIDUAL WHO FACES MANY BARRIERS AND STRESSORS. SO, WE ARE COMMITTED TO PARTNERING WITH ORGANIZATIONS THAT CAN PROVIDE THE WRAP AROUND MENTAL HEALTH, JOB TRAINING AND OTHER SERVICES THAT IMPROVE THE CHANCES OF A SUCCESSFUL RE-ENTRY BACK INTO THE COMMUNITY. THE COMMUNITY HEALTH IMPROVEMENT PLAN BELOW PRESUMES THAT ADDITIONAL ORGANIZATIONAL PARTNER RELATIONSHIPS WILL ALLOW US TO ADDRESS ALL EIGHT IDENTIFIED HEALTH NEEDS. THESE ORGANIZATIONS ARE PUBLIC AND PRIVATE COMMUNITY PARTNERS THAT HAVE EXPERTISE IN ADDRESSING THE IDENTIFIED COMMUNITY HEALTH NEEDS AT THE LOCAL LEVEL.
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 16A: FAP WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 16B: FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/FINANCIAL-ASSISTANCE-APPLICATION
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 16C: FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP A) - PART V, SECTION B, LINE 24: FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES.
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 CONDUCTED KEY INFORMANT INTERVIEWS WITH INDIVIDUALS WHO REPRESENT A VARIETY OF LOW-INCOME, MEDICALLY UNDERSERVED, AND MINORITY POPULATIONS THROUGHOUT THE HOSPITALS' SERVICE AREA.2019 CHNA KEY INFORMANTS:- BEHAVIORAL HEALTH SERVICES, INC. (COMMUNITY BASED ORGANIZATION, BEHAVIORAL HEALTH)- ST. JOSEPH CHURCH HAWTHORNE (RELIGIOUS ORGANIZATION)- LAWNDALE ELEMENTARY SCHOOL DISTRICT (SCHOOL DISTRICT, EDUCATION)- HARBOR COMMUNITY CLINIC (COMMUNITY BASED ORGANIZATION, HEALTH CARE)- BOYS & GIRLS CLUBS OF THE LOS ANGELES HARBOR (NATIONAL ORGANIZATION, YOUTH DEVELOPMENT)- THE VOLUNTEER CENTER SOUTH BAY, HARBOR, LONG BEACH (COMMUNITY BASED ORGANIZATION, MENTAL HEALTH, FOOD INSECURITY, COMMUNITY WELLBEING)- CALIFORNIA ASSOCIATION OF FOOD BANKS (STATE ORGANIZATION, FOOD INSECURITY)- FLYAWAYHOMES (COMMUNITY BASED ORGANIZATION, HOMELESSNESS)- RICHSTONE FAMILY CENTER (COMMUNITY BASED ORGANIZATION, CHILD ABUSE TREATMENT AND PREVENTION)- SOUTH BAY COALITION TO END HOMELESSNESS (COALITION, HOMELESSNESS)IN ADDITION TO CONDUCTING KEY INFORMANT INTERVIEWS AS PART OF ITS PRIMARY DATA COLLECTION, PROVIDENCE ALSO INCLUDED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY AS PART OF ITS CHNA OVERSIGHT COMMITTEE.THE CHNA OVERSIGHT COMMITTEE, AUTHORIZED BY THE GOVERNING BOARD, MET TWICE IN THE FALL OF 2019 TO PRIORITIZE AND RECOMMEND THE TOP IDENTIFIED HEALTH NEEDS TO BE ADDRESSED OVER THE NEXT THREE YEARS. THE EXTERNAL REPRESENTATIVES INCLUDED THE PERSPECTIVE OF A FQHC, NONPROFIT SOCIAL SERVICES AGENCY, PUBLIC SCHOOLS AND THE DIRECTOR OF NUTRITION AND PHYSICAL ACTIVITY PROGRAM FROM THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH. THE GROUP PARTICIPATED IN TWO MEETINGS TO REVIEW THE ASSEMBLED PRIMARY AND SECONDARY DATA FOR EACH IDENTIFIED HEALTH NEED. THE FIRST MEETING INCLUDED DISCUSSIONS ON HOW EACH ISSUE AFFECTED THE COMMUNITIES IN THE REGION, USING THE IDENTIFIED NEEDS OF FOOD INSECURITY AND BEHAVIORAL HEALTH TO FAMILIARIZE AND PREPARE THE PARTICIPANTS FOR CRITERIA THAT WOULD BE APPLIED DURING THE PRIORITIZATION MEETING. IN THE SECOND MEETING COMMITTEE PARTICIPANTS RECEIVED A QUESTIONNAIRE AT THE START OF THE MEETING AND ASKED TO RATE THE SEVERITY OF EACH IDENTIFIED HEALTH NEED USING THREE CRITERIA: (1) THE CHANGE OVER TIME, (2) THE AVAILABILITY OF COMMUNITY RESOURCES/ASSETS TO ADDRESS THE HEALTH NEED, AND (3) THE COMMUNITY READINESS TO IMPLEMENT/SUPPORT PROGRAMS TO ADDRESS THE HEALTH NEED. OVERSIGHT COMMITTEE MEMBERS WERE THEN ASKED TO CONSIDER THE THREE QUESTIONS BELOW AND GIVEN THREE DOTS, OR "VOTES," TO ASSIGN TO THE IDENTIFIED HEALTH NEEDS, RESULTING IN A LIST OF PRIORITIZED NEEDS.- HOW DOES THIS NEED IMPACT THE WORK OF YOUR ORGANIZATION AND THE CLIENTS YOU SERVE?- WHAT OTHER SERVICE GAPS CURRENTLY EXIST?- WHAT ROLE CAN PROVIDENCE PLAY IN ADDRESSING THIS NEED?
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 SAN FERNANDO VALLEY.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN PARTNERSHIP WITH THE CENTER FOR NONPROFIT MANAGEMENT (CNM), LOS ANGELES, CA.
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, LINE 7B, CHNA REPORT WEBSITE: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/REPORTS/CHNA-AND-CHIP-REPORTS
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 BOARD COMMITTEE ON COMMUNITY BENEFITS IDENTIFIED THE FOLLOWING AS THE HIGHEST PRIORITY NEEDS WITHIN OUR COMMUNITIES:1. HOMELESSNESS AND HOUSING INSTABILITY2. ACCESS TO HEALTH CARE3. BEHAVIORAL HEALTH4. ECONOMIC INSECURITY AND WORKFORCE DEVELOPMENTTHE FOUR PRIORITIZED HEALTH NEEDS ARE BEING ADDRESSED WITHIN THE CONTEXT OF FOUR INITIATIVES THAT MAKE UP THE THREE-YEAR IMPLEMENTATION STRATEGY:INITIATIVE #1: STRENGTHEN INFRASTRUCTURE OF CONTINUUM OF CARE FOR PATIENTS EXPERIENCING HOMELESSNESS - ASSISTED PATIENTS EXPERIENCING HOMELESSNESS THROUGH OUR CHW HOMELESS NAVIGATORS PROGRAM WITH DISCHARGE TO SHELTER OR HOMELESS SERVICE PROVIDERS. WORKED WITH OVER 640 HOMELESS PATIENTS IN 2021. - THROUGH OUR COORDINATED ENTRY SYSTEM HOSPITAL LIAISON COLLABORATIVE WORKGROUP OF PRIVATE NON-PROFIT HOSPITALS IN THE SOUTH BAY TO HAVE A DIRECT, SINGLE POINT OF CONTACT WITH THE LOCAL LEAD HOMELESS SERVICE AGENCY TO COORDINATE REFERRALS AND EDUCATE HOSPITAL STAFF ON CHANGING RESOURCES, WE LINKED OVER 280 HOMELESS PATIENTS TO SOME FORM OF SHELTER IN 2021.INITIATIVE #2: IMPROVE ACCESS TO HEALTH CARE SERVICES - INCREASED THE NUMBER OF MEDICAL VISITS TO OUR VASEK POLAK HEALTH CLINIC. - ENROLLED 200 PATIENTS INTO MENTAL HEALTH THERAPY PROGRAMS. - PROVIDED OVER 8,800 COVID VACCINATIONS IN 2021.INITIATIVE #3: INVEST IN EXPANSION OF COMMUNITY-BASED WELLNESS AND ACTIVITY CENTERS - CONTINUED OUR WEEKLY FARMER'S MARKET AND MARKET MATCH PROGRAM TO PROVIDE ACCESS TO HEALTHY FOOD IN OUR WILMINGTON COMMUNITY. - SELECTED A DESIGN PROFESSIONAL AND BEGAN INITIAL DESIGN PLANNING FOR OUR LAWNDALE WELLNESS AND ACTIVITY CENTER. - PROVIDED OVER 7,200 COVID TESTS AT OUR WILMINGTON WELLNESS AND ACTIVITY CENTER.INITIATIVE #4: TRAIN AND DEPLOY A WORKFORCE OF COMMUNITY HEALTH WORKERS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH IN UNDERSERVED POPULATIONS - RAN OUR FIRST FULL YEAR OF OUR CHW ACADEMY IN COLLABORATION WITH CHARLES DREW UNIVERSITY TO TRAIN COMMUNITY MEMBERS TO BECOME COMMUNITY HEALTH WORKERS, WITH OVER 10 GRADUATING. - CONTINUED OFFERING MENTAL HEALTH FIRST AID TO COMMUNITY MEMBERS, HAVING OVER 260 COMPLETING THE COURSE. - PROVIDED SEVERAL COHORTS OF MENTAL HEALTH SUPPORT GROUPS AND CHRONIC DISEASE SELF-MANAGEMENT CLASSES TO COMMUNITY MEMBERS BOTH IN PERSON AND VIRTUALLY.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 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/CA-LA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 16B: FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/FINANCIAL-ASSISTANCE-APPLICATION
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 16C: FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/CA-LA/FINANCIAL-ASSISTANCE
PHS - SOUTHERN CALIFORNIA (GROUP B) - PART V, SECTION B, LINE 24: FOR NON-MEDICALLY NECESSARY SERVICES A PATIENT MAY BE CHARGED FULL BILLED CHARGES.
   
   
   
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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?5
Name and address Type of Facility (describe)
1 1 - PROVIDENCE LCMMC SAN PEDRO PHARMACY
1300 W 7TH ST
SAN PEDRO,CA907323505 		PHARMACY
2 2 - PROVIDENCE LCMMC TORRANCE PHARMACY
4101 TORRANCE BLVD
TORRANCE,CA905034607 		PHARMACY
3 3 - PROVIDENCE ST ELIZABETH CARE CENTER
10425 MAGNOLIA BLVD
NORTH HOLLYWOOD,CA91601 		SKILLED NURSING FACILITY
4 4 - PROVIDENCE SJMC BURBANK - PROV HOME CARE
3413 W PACIFIC AVE
BURBANK,CA91505 		HOME HEALTH
5 5 - PROVIDENCE HCMC - TRAUMA CENTER
15031 RINALDI ST
MISSION HILLS,CA913451207 		CLINIC/GROUP PRACTICE
6
7
8
9
10
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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. THIS INFORMATION IS INCLUDED IN OUR CHARITY POLICY HOWEVER THIS DETAIL IS NOT ADDRESSED IN OUR COLLECTION POLICY.
PART VI, LINE 2: NEEDS ASSESSMENT:REPORTING GROUP AEVERY THREE YEARS, PROVIDENCE HOLY CROSS AND PROVIDENCE SAINT JOSEPH CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR THE COMMUNITIES IN THE SAN FERNANDO VALLEY. PRIOR TO BEGINNING THE PROCESS, THE COMMUNITY HEALTH DEPARTMENT STAFF MAKES A PRESENTATION TO THE SAN FERNANDO VALLEY COMMUNITY MINISTRY BOARD OUTLINING THE FRAMEWORK OF THE CHNA PROCESS AND REQUESTS AUTHORITY FROM THE GOVERNING BOARD TO FORM A BOARD COMMITTEE ON COMMUNITY BENEFIT TO OVERSEE THE CHNA PROCESS. THE COMMITTEE IS COMPOSED OF NINE INTERNAL PROVIDENCE STAFF, AND NINE COMMUNITY STAKEHOLDERS (I.E. PUBLIC SCHOOLS, PUBLIC HEALTH, FEDERALLY QUALIFIED HEALTH CENTERS (FQHC'S), AND COMMUNITY-BASED ORGANIZATIONS), AND THE COMMITTEE WAS CHAIRED BY THE REGIONAL CHIEF MISSION INTEGRATION OFFICER. THIS GROUP IS CHARGED WITH REVIEWING THE FINDINGS FROM THE PRIMARY AND SECONDARY DATA COLLECTED AND PRIORITIZING THE IDENTIFIED COMMUNITY NEEDS. THE PRIORITIZED NEEDS IDENTIFIED IN THE 2019 CHNA ARE LISTED ABOVE IN PART V, SECTION B. THESE PRIORITIZED NEEDS 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 COMMITTEE MET TWICE IN THE FALL OF 2019 TO PRIORITIZE AND RECOMMEND THE TOP IDENTIFIED HEALTH NEEDS TO BE ADDRESSED OVER THE NEXT THREE YEARS. FINAL APPROVAL OF THE CHNA BY THE BOARD OF DIRECTORS TOOK PLACE AT THEIR DECEMBER 19, 2019 MEETING.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. PRIOR TO BEGINNING THE PROCESS, THE COMMUNITY HEALTH DEPARTMENT STAFF MAKES A PRESENTATION TO THE SOUTH BAY COMMUNITY MINISTRY BOARD OUTLINING THE FRAMEWORK OF THE CHNA PROCESS AND REQUESTS AUTHORITY FROM THE GOVERNING BOARD TO FORM A BOARD COMMITTEE ON COMMUNITY BENEFIT TO OVERSEE THE CHNA PROCESS. THE COMMITTEE IS COMPOSED OF FOUR INTERNAL PROVIDENCE STAFF, AND FOUR COMMUNITY STAKEHOLDERS (I.E. PUBLIC SCHOOLS, PUBLIC HEALTH, FEDERALLY QUALIFIED HEALTH CENTERS (FQHC'S), AND COMMUNITY-BASED ORGANIZATIONS) AND CHAIRED BY A MEMBER OF THE GOVERNING BOARD. THIS GROUP IS CHARGED WITH REVIEWING THE FINDINGS FROM THE PRIMARY AND SECONDARY DATA COLLECTED AND PRIORITIZING THE IDENTIFIED COMMUNITY NEEDS. THE PRIORITIZED NEEDS IDENTIFIED IN THE 2019 CHNA ARE LISTED ABOVE IN PART V, SECTION B. THESE PRIORITIZED NEEDS BECOME THE BASIS OF THE COMMUNITY HEALTH IMPROVEMENT PLAN/IMPLEMENTATION STRATEGY THAT SETS FORTH OBJECTIVE TO BE ACCOMPLISHED OVER THREE YEARS, UNTIL THE NEXT CHNA IS CONDUCTED.THE COMMITTEE MET TWICE IN THE FALL OF 2019 TO PRIORITIZE AND RECOMMEND THE TOP IDENTIFIED HEALTH NEEDS TO BE ADDRESSED OVER THE NEXT THREE YEARS. FINAL APPROVAL OF THE CHNA BY THE BOARD OF DIRECTORS TOOK PLACE AT THEIR DECEMBER 3, 2019 MEETING.
PART VI, LINE 3: COMMUNICATION TO THE PUBLIC:REPORTING GROUPS A & BPROVIDENCE HOLY CROSS AND PROVIDENCE SAINT JOSEPH AS WELL AS PROVIDENCE LITTLE COMPANY OF MARY, SAN PEDRO AND PROVIDENCE LITTLE COMPANY OF MARY, TORRANCE POST NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO LOW-INCOME UNINSURED PATIENTS. THESE NOTICES ARE POSTED IN VISIBLE LOCATIONS THROUGHOUT THE HOSPITAL SUCH AS ADMITTING/REGISTRATION, BILLING OFFICE, EMERGENCY DEPARTMENT AND OTHER OUTPATIENT SETTINGS.EVERY POSTED NOTICE REGARDING FINANCIAL ASSISTANCE POLICIES CONTAINS BRIEF INSTRUCTIONS ON HOW TO APPLY FOR FINANCIAL ASSISTANCE OR A DISCOUNTED PAYMENT. THE NOTICES ALSO INCLUDE A CONTACT TELEPHONE NUMBER THAT A PATIENT OR FAMILY MEMBER CAN CALL TO OBTAIN MORE INFORMATION.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 (SFV SERVICE AREA) IS COMPRISED OF THE SERVICE AREAS OF THREE PROVIDENCE MEDICAL CENTERS INCLUDING PROVIDENCE HOLY CROSS MEDICAL CENTER (PHCMC; MISSION HILLS); PROVIDENCE ST. JOSEPH MEDICAL CENTER (PSJMC; BURBANK); AND PROVIDENCE CEDARS-SINAI TARZANA MEDICAL CENTER (PCSTMC; TARZANA). 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 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 2019 IS 2,225,425 PEOPLE, WHICH REPRESENTS A 0.2% INCREASE COMPARED TO THE 2016 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. CHILDREN UNDER THE AGE OF 19 MAKE UP 28.2% OF THE POPULATION. THIS IS NOTABLE AND INDICATES A GREATER PROPORTION OF YOUTH THAN ELSEWHERE IN THE STATE, WHERE CHILDREN UNDER THE AGE OF 18 MAKE UP 22.7% OF THE POPULATION.ADULTS 60 YEARS OF AGE AND OLDER MAKE UP 13.9% OF THE TOTAL SERVICE AREA POPULATION, COMPARED TO THE STATE OF CALIFORNIA, ADULTS 65 AND OLDER MAKE UP 14.3% OF THE POPULATION. THE SFV SERVICE AREA, THEREFORE, IS NOTABLY YOUNGER, ON AVERAGE, THAN THE TOTAL POPULATION OF THE STATE OF CALIFORNIA.POPULATION BY RACE AND ETHNICITYAMONG SFV COMMUNITY BENEFIT SERVICE AREA RESIDENTS, IN 2019, 52.3% WERE WHITE, 11.1% WERE ASIAN/PACIFIC ISLANDER/HAWAIIAN, 0.7% WERE ALASKA NATIVE OR AMERICAN INDIAN, 3.6% WERE AFRICAN AMERICAN OR BLACK, AND 5.0% WERE OF TWO OR MORE RACES. APPROXIMATELY 59.0% OF THE RESIDENTS IDENTIFY AS LATINO.INCOME LEVELSIN 2019, THE MEDIAN HOUSEHOLD INCOME OF THE SFV SERVICE AREA VARIED SIGNIFICANTLY FROM A LOW OF $41,053 FOR THE COMMUNITY OF GLENDALE, TO $166,406 FOR THE COMMUNITY OF LA CANADA FLINTRIDGE. THE SFV COMMUNITY BENEFIT SERVICE AREA, COMPARED TO LOS ANGELES COUNTY, IS HOME TO A HIGHER CONCENTRATION OF LOW-INCOME RESIDENTS; APPROXIMATELY 45.4% OF FAMILIES HAVE ANNUAL INCOMES BELOW 200% OF THE FEDERAL POVERTY LEVEL (FPL; $51,500 FOR A FAMILY OF 4) COMPARED TO 39.6% 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 (73.2%), 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 SFV AVERAGES 4.9%. NONETHELESS, 35.1% OF THE POPULATION IS EXPERIENCING SEVERE HOUSING COST BURDEN, AND 11.3% OF THE POPULATION IS ENROLLED IN SNAP, OR FOOD ASSISTANCE PROGRAMS.LANGUAGE PROFICIENCYWITHIN LOS ANGELES COUNTY, 56.6% OF RESIDENTS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. FAR FEWER HOUSEHOLDS (AN AVERAGE OF 30.1%) IN THE SFV SERVICE AREA SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME, AND INDIVIDUALS SPEAKING LANGUAGES OTHER THAN ENGLISH AT HOME ARE CONCENTRATED IN PANORAMA CITY, PACOIMA, GLENDALE, AND SAN FERNANDO.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.
PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:REPORTING GROUPS A & BPROVIDENCE 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) OPEN MEDICAL STAFF2) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS.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'S EXECUTIVES ARE ENGAGED ON MANY LOCAL AREA BOARDS, INCLUDING CCO LEADERSHIP, AND SOCIAL SERVICE ORGANIZATIONS.
PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:REPORTING GROUP A & B: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 HEALTH 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 120,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 52 HOSPITALS, 1,085 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- FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA.- KADLEC IN SOUTHEAST WASHINGTON- PACIFIC MEDICAL CENTERS IN SEATTLE, WA.- SWEDISH HEALTH SERVICES IN SEATTLE, WA.
PART VI, LINE 7, REPORTS FILED WITH STATES CA
Schedule H (Form 990) 2021
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