Providence Health & Services is a not-for-profit Catholic health care system operating multiple hospitals across 5 states, with headquarters in Renton, Washington. The health system includes 27 hospitals, more than 35 non-acute facilities and numerous other health, supportive housing and educational services in the states of Alaska, Washington, Montana, Oregon and California. Providence Health & Services was started by the Sisters of Providence (Montreal, Quebec) more than 155 years ago. Providence Health System was established by the Sisters of Providence (Montreal, Quebec), a community of Roman Catholic sisters founded in Montreal, Quebec by Mother Émilie Gamelin in 1843. In 1856, Mother Joseph and four sisters came to Vancouver, Washington (then Washington Territory) to serve the native people and settlers. The five pioneer sisters crisscrossed the Northwest and established schools, hospitals, orphanages and other institutions of care. In 1858, they founded St. Joseph Hospital, the Pacific Northwests first permanent hospital (now PeaceHealth Southwest Medical Center). In 1859, the Sisters incorporated their work, creating the network of health care services known as Providence Health & Services. The sisters later established several schools and hospitals in Washington, Montana, Oregon, Alaska, British Columbia, and California. Providence Health System was managed by the Sisters of Providence until 1979, when the first person outside the church was made president of the system because of the declining numbers within the religious community.