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Nonprofiteer
← GRACE CLINIC OF LUBBOCK

Form 990 for tax year 2024

Filed by GRACE CLINIC OF LUBBOCK.

Totals

Total revenue
$50,843,887
Total expenses
$50,361,204
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$50,317,543
Investment income
$526,344
Other revenue
$0
Total assets, end of year
$54,649,286
Total liabilities, end of year
$106,814,968
Net assets or fund balances, end of year
-$52,165,682
Program services expenses (Part IX)
$36,502,791
Management and general expenses
$13,858,413
Fundraising expenses
$0
Program service expenses (Part III)
$36,502,791

Program services were 72.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $27,907,149 · related or exempt $27,907,149

  • 2b · Program service revenue: INTER-AFFILIATE REV.

    total $22,410,394 · related or exempt $22,410,394

  • 3 · Investment income

    total $526,344 · excluded $526,344

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $4,427,813 · program services $3,005,350 · management and general $1,422,463

  • 7 · Other salaries and wages

    total $19,496,378 · program services $13,233,041 · management and general $6,263,337

  • 8 · Pension plan contributions

    total $490,866 · program services $333,172 · management and general $157,694

  • 9 · Other employee benefits

    total $4,179,956 · program services $2,837,118 · management and general $1,342,838

  • 10 · Payroll taxes

    total $1,431,489 · program services $971,614 · management and general $459,875

  • 11c · Fees: accounting

    total $20,175 · program services $13,694 · management and general $6,481

  • 11g · Fees: other

    total $7,865,948 · program services $5,338,962 · management and general $2,526,986

  • 12 · Advertising and promotion

    total $44,917 · program services $30,487 · management and general $14,430

  • 13 · Office expenses

    total $430,029 · program services $291,879 · management and general $138,150

  • 14 · Information technology

    total $3,017 · program services $2,048 · management and general $969

  • 16 · Occupancy

    total $3,428,665 · program services $2,327,184 · management and general $1,101,481

  • 17 · Travel

    total $94,336 · program services $64,030 · management and general $30,306

  • 22 · Depreciation, depletion and amortization

    total $15,200 · program services $10,317 · management and general $4,883

  • 23 · Insurance

    total $617,146 · program services $418,884 · management and general $198,262

  • 24a · Other expenses: MEDICAL SUPPLES

    total $7,223,039 · program services $7,223,039

  • 24b · Other expenses: LICENSES & TAXES

    total $290,571 · program services $197,223 · management and general $93,348

  • 24c · Other expenses: DUES & SUBSCRIPTIONS

    total $67,622 · program services $45,898 · management and general $21,724

  • 24d · Other expenses: RECRUITING & RELOCATION

    total $53,153 · program services $36,077 · management and general $17,076

  • 24e · All other expenses

    total $180,884 · program services $122,774 · management and general $58,110

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $27,410,609 · end of year $47,624,487

  • 4 · Accounts receivable

    beginning of year $8,413,643 · end of year $6,683,781

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $40,428

  • 8 · Inventories for sale or use

    beginning of year $300,811 · end of year $222,835

  • 9 · Prepaid expenses and deferred charges

    beginning of year $113,590 · end of year $0

  • 10a · Land, buildings and equipment: cost or other basis

    $154,243

  • 10b · Land, buildings and equipment: accumulated depreciation

    $78,421

  • 10c · Land, buildings and equipment, net

    beginning of year $60,180 · end of year $75,822

  • 15 · Other assets

    beginning of year $13,889 · end of year $1,933

  • 17 · Accounts payable and accrued expenses

    beginning of year $427,561 · end of year $815,691

  • 19 · Deferred revenue

    beginning of year $6,717 · end of year $275,032

  • 25 · Other liabilities

    beginning of year $76,636,349 · end of year $105,724,245

  • 27 · Net assets without donor restrictions

    beginning of year -$40,757,905 · end of year -$52,165,682

Mission and programs · 2024

Mission

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.

Activities or mission (Part I)

SEE SCHEDULE OAS 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.

  • SEE SCHEDULE O.PROVIDENCEAT 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 125,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,014 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE AFFILIATE FAMILY INCLUDES: -PROVIDENCE ACROSS FIVE WESTERN STATES -COVENANT HEALTH IN WEST TEXAS AND NEW MEXICO -FACEY MEDICAL GROUP IN LOS ANGELES, CA -KADLEC IN SOUTHEAST WASHINGTON -PACIFIC MEDICAL CENTERS IN SEATTLE, WA -SWEDISH HEALTH SERVICES IN SEATTLE, WA IN 2024, PROVIDENCE MINISTRIES AND AFFILIATES PROVIDED $1.9 BILLION IN COMMUNITY BENEFIT PROGRAMS. THIS INCLUDES FREE AND DISCOUNTED CARE, UNCOMPENSATED AND SUBSIDIZED CARE, AND OTHER COMMUNITY HEALTH ACTIVITIES. ONE OF THESE VITAL PROGRAMS, MEDICAID, IS A LIFELINE FOR MILLIONS OF INDIVIDUALS, INCLUDING SENIORS, CHILDREN, PREGNANT PATIENTS, THOSE WITH DISABILITIES AND VETERANS. WE ARE GRATEFUL TO EVERYONE IN OUR COMMUNITIES WHO HAS JOINED US IN ADVOCATING FOR CONTINUED FUNDING AND EXPANSION OF THIS PROGRAM. TOGETHER, WE ARE HELPING TO ENSURE MORE PEOPLE HAVE ACCESS TO NEEDED CARE. FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT THROUGH OUR COMMUNITY BENEFIT PROGRAMS, WE FOCUS ON MEETING THE DIVERSE NEEDS OF THE PEOPLE WE SERVE BY WORKING TO ENSURE BASIC HEALTH NEEDS ARE MET, REMOVING BARRIERS TO CARE, BUILDING COMMUNITY RESILIENCE AND INNOVATING FOR THE FUTURE. PROVIDENCE CONTINUES TO WORK TOWARDS CARBON NEGATIVE AND IN 2024 DECREASED EMISSIONS BY 19 PERCENT COMPARED TO OUR 2019 BASELINE. OUR EFFORTS EARNED US A SYSTEM RECORD 55 ENVIRONMENTAL EXCELLENCE AWARDS FROM PRACTICE GREENHEALTH AND MADE US THE FIRST LARGE SYSTEM TO RECEIVE THE JOINT COMMISSION'S SUSTAINABLE HEALTHCARE CERTIFICATION IN 2024 FOR EACH OF OUR HOSPITALS. GRACE CLINIC OF LUBBOCK PROVIDES SERVICES INCLUDING WALK-IN CLINIC, PRIMARY CARE, OBSTETRICS, PAIN MANAGEMENT, PODIATRY AND ORTHOPEDICS, AS WELL AS OUTPATIENT SURGICAL CENTER, PHARMACY, IMAGING AND LABORATORY SERVICES.

    Expenses $36,502,791 · Revenue $50,317,543

As filed on the 2024 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Bhupesh Dihenia MD

    DIRECTOR

    Total calculated
    $870,645
    From this org
    $826,018
    From related orgs
    $0
    Other
    $44,627
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $805,724
    Bonus
    $0
    Other
    $20,294
    Deferred
    $39,493
    Nontaxable benefits
    $5,134
    Filer's total
    $870,645

  • Matthew Soape MD

    DIRECTOR

    Total calculated
    $785,345
    From this org
    $767,776
    From related orgs
    $0
    Other
    $17,569
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $640,587
    Bonus
    $0
    Other
    $127,189
    Deferred
    $4,100
    Nontaxable benefits
    $13,469
    Filer's total
    $785,345

  • Shelly Hook MD

    DIRECTOR

    Total calculated
    $563,295
    From this org
    $542,508
    From related orgs
    $0
    Other
    $20,787
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $293,147
    Bonus
    $0
    Other
    $249,361
    Deferred
    $4,265
    Nontaxable benefits
    $16,522
    Filer's total
    $563,295

  • Duncan Burkholder MD

    DIRECTOR/CHAIR

    Total calculated
    $470,362
    From this org
    $455,771
    From related orgs
    $0
    Other
    $14,591
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $385,788
    Bonus
    $22,931
    Other
    $47,052
    Deferred
    $10,350
    Nontaxable benefits
    $4,241
    Filer's total
    $470,362

  • Rebecca Raedeke MD

    DIRECTOR

    Total calculated
    $427,554
    From this org
    $413,455
    From related orgs
    $0
    Other
    $14,099
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $334,088
    Bonus
    $33,459
    Other
    $45,908
    Deferred
    $4,684
    Nontaxable benefits
    $9,415
    Filer's total
    $427,554

  • Jared Riley

    DIRECTOR (PART YEAR)

    Total calculated
    $348,984
    From this org
    $329,998
    From related orgs
    $0
    Other
    $18,986
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $309,684
    Bonus
    $3,403
    Other
    $16,911
    Deferred
    $14,813
    Nontaxable benefits
    $4,173
    Filer's total
    $348,984

  • Wael Qubti MD

    DIRECTOR

    Total calculated
    $347,566
    From this org
    $326,424
    From related orgs
    $0
    Other
    $21,142
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $275,402
    Bonus
    $18,356
    Other
    $32,666
    Deferred
    $3,943
    Nontaxable benefits
    $17,199
    Filer's total
    $347,566

  • Jared Brinker MD

    DIRECTOR/SECRETARY

    Total calculated
    $322,051
    From this org
    $301,657
    From related orgs
    $0
    Other
    $20,394
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $235,238
    Bonus
    $18,931
    Other
    $47,488
    Deferred
    $4,681
    Nontaxable benefits
    $15,713
    Filer's total
    $322,051

  • Christopher Collins MD

    DIRECTOR

    Total calculated
    $255,475
    From this org
    $245,882
    From related orgs
    $0
    Other
    $9,593
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $232,586
    Bonus
    $8,524
    Other
    $4,772
    Deferred
    $3,073
    Nontaxable benefits
    $6,520
    Filer's total
    $255,475

  • Patti May MD

    DIRECTOR - THRU 1/24

    Total calculated
    $36,535
    From this org
    $33,684
    From related orgs
    $0
    Other
    $2,851
    Hours/week
    0.5

  • Vanessa Bayouth

    CEO GRACE

    Total calculated
    $402,218
    From this org
    $0
    From related orgs
    $369,729
    Other
    $32,489
    Hours/week
    27.5 + 27.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $302,900 related
    Bonus
    $0 + $38,145 related
    Other
    $0 + $28,684 related
    Deferred
    $0 + $19,043 related
    Nontaxable benefits
    $0 + $13,446 related
    Filer's total
    $0 + $402,218 related

  • Sean Hill

    CFO (PART YEAR)

    Total calculated
    $166,022
    From this org
    $0
    From related orgs
    $155,226
    Other
    $10,796
    Hours/week
    54 + 1 related

    Schedule J breakdown matched by us

    Base
    $0 + $141,248 related
    Bonus
    $0 + $12,480 related
    Other
    $0 + $1,498 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $10,796 related
    Filer's total
    $0 + $166,022 related

  • Alejandro Verdugo

    PHYSICIAN

    Total calculated
    $1,191,764
    From this org
    $1,168,806
    From related orgs
    $0
    Other
    $22,958
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $931,235
    Bonus
    $0
    Other
    $237,571
    Deferred
    $5,175
    Nontaxable benefits
    $17,783
    Filer's total
    $1,191,764

  • Stephen Hallier

    PHYSICIAN

    Total calculated
    $816,552
    From this org
    $789,781
    From related orgs
    $0
    Other
    $26,771
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $512,627
    Bonus
    $0
    Other
    $277,154
    Deferred
    $26,542
    Nontaxable benefits
    $229
    Filer's total
    $816,552

  • Mujtaba Mohammed

    PHYSICIAN

    Total calculated
    $793,603
    From this org
    $767,458
    From related orgs
    $0
    Other
    $26,145
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $459,896
    Bonus
    $0
    Other
    $307,562
    Deferred
    $5,175
    Nontaxable benefits
    $20,970
    Filer's total
    $793,603

  • Hemmo Bosscher

    PHYSICIAN

    Total calculated
    $713,354
    From this org
    $702,237
    From related orgs
    $0
    Other
    $11,117
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $651,404
    Bonus
    $0
    Other
    $50,833
    Deferred
    $3,112
    Nontaxable benefits
    $8,005
    Filer's total
    $713,354

  • Elias Ghandour

    PHYSICIAN

    Total calculated
    $691,600
    From this org
    $674,457
    From related orgs
    $0
    Other
    $17,143
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $628,287
    Bonus
    $0
    Other
    $46,170
    Deferred
    $5,175
    Nontaxable benefits
    $11,968
    Filer's total
    $691,600

  • James Kelly

    FRMR OFF. - VP SENIOR CORP COUNSEL

    Total calculated
    $509,442
    From this org
    $0
    From related orgs
    $495,773
    Other
    $13,669
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $165,837 related
    Bonus
    $0 + $269,988 related
    Other
    $0 + $59,948 related
    Deferred
    $0 + $7,763 related
    Nontaxable benefits
    $0 + $5,906 related
    Filer's total
    $0 + $509,442 related

  • Craig Renfroe

    FRMR OFF. - DIRECTOR OF FINANCE

    Total calculated
    $219,394
    From this org
    $0
    From related orgs
    $203,971
    Other
    $15,423
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $188,098 related
    Bonus
    $0 + $14,956 related
    Other
    $0 + $917 related
    Deferred
    $0 + $10,792 related
    Nontaxable benefits
    $0 + $4,631 related
    Filer's total
    $0 + $219,394 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

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. THESE REIMBURSEMENTS ARE NOT REPORTED AS TAXABLE COMPENSATION. 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. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE.THIS BENEFIT IS CONSIDERED A TAXABLE BENEFIT AND IS INCLUDED ON THE EMPLOYEE'S FORM W-2. 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, LUBBOCK HERITAGE HOSPITAL, LLC, 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, LINE 4B
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: ALEJANDRO VERDUGO - $24,840 BHUPESH DIHENIA, M.D. - $12,770 STEPHEN HALLIER - $9,271 MATTHEW SOAPE, M.D. - $12,112 HEMMO BOSSCHER - $13,354 ELIAS GHANDOUR - $31,338 SHELLY HOOK, M.D. - $5,056 JAMES KELLY - $59,375 DUNCAN BURKHOLDER, M.D. - $7,000 REBECCA RAEDEKE, M.D. - $1,226 VANESSA BAYOUTH - $2,446 WAEL QUBTI, M.D. - $291 JARED BRINKER, M.D. - $1,255 CHRISTOPHER COLLINS, M.D. - $2,062 PATTI MAY, M.D. - $288
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.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • 20TH STREET SURGERY LLC

    AMBULATORY SURGERY CENTER · CA

  • BRIDGEPORT MEDICAL IMAGING LLC (BMI)

    IMAGING - DIAGNOSTICS · OR · general or managing partner

  • BROADWAY IMAGING LLC

    MEDICAL IMAGING · MT · general or managing partner

  • CANBY MEDICAL CENTER I LLC

    REAL ESTATE - MOB · OR · general or managing partner

  • CENTER FOR MEDICAL IMAGING LLC (CMI)

    IMAGING - DIAGNOSTICS · OR · general or managing partner

  • CLACKAMAS RADIATION ONCOLOGY CENTER LLC

    RADIATION ONCOLOGY · OR · general or managing partner

  • COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY

    HEALTHCARE · CA · general or managing partner

  • COVENANT HIGH PLAINS SURGERY CENTER LLC

    HEALTHCARE · TX · general or managing partner

  • COVENANT PARK PHASE I VENTURE LLC

    REAL ESTATE · TX

  • CSS JV LLC

    AMBULATORY SURGERY CENTER · OR

  • FIRST HILL SURGERY CENTER LLC

    AMBULATORY SURGERY CENTER · WA · general or managing partner

  • FULLERTON SURGICAL CENTER LP

    AMBULATORY SURGERY CENTER · CA · general or managing partner

  • GREATER VALLEY MEDICAL BUILDING LP

    REAL ESTATE - MOB · CA · general or managing partner

  • HERITAGE INVESTMENT GROUP I LLC

    INVESTMENTS · CA

  • IMAGING ASSOCIATES LLC

    MEDICAL IMAGING · AK · general or managing partner

  • LSC REAL PROPERTY LLC

    REAL ESTATE · TX · general or managing partner

  • METHODIST DIAGNOSTIC IMAGING

    HEALTHCARE · TX · general or managing partner

  • MISSION VIEJO PARTNERS II LLC

    REAL ESTATE - MOB · CA · general or managing partner

  • NORTH OC IMAGING JV HOLDINGS LLC

    HEALTHCARE · CA

  • OREGON ADVANCED IMAGING LLC

    MEDICAL IMAGING · OR · general or managing partner

  • PAVILION SURGERY CENTER LLC

    AMBULATORY SURGERY CENTER · CA

  • PERFORMANCE MEDICAL EQUIPMENT & RESPIRATORY SERVICES LLC

    MEDICAL EQUIPMENT · WA · general or managing partner

  • PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC

    MEDICAL IMAGING · WA · general or managing partner

  • PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO

    INVESTMENTS · WA

  • PROVIDENCE & SCA OFF-CAMPUS HOLDINGS LLC

    MEDICAL · AL

  • PROVIDENCE & SCA ON-CAMPUS HOLDINGS LLC

    MEDICAL · AL · general or managing partner

  • PROVIDENCE HOUSE OAKLAND LP

    SUPPORTIVE HOUSING · CA · general or managing partner

  • PROVIDENCE IMAGING CENTER JOINT VENTURE

    MEDICAL IMAGING · AK

  • PROVIDENCE ST JOSEPH HEALTH LONG TERM PORTFOLIO

    INVESTMENTS · WA

  • PROVIDENCEUSP SPOKANE SURGERY CENTERS LLC

    AMBULATORY SURGERY CENTER · WA

  • PROVIDENCEUSP SURGERY CTRS LLC

    AMBULATORY SURGERY CENTER · CA

  • RADIATION THERAPY INNOVATIONS LLC

    HEALTHCARE · WA · general or managing partner

  • RIVERSIDE HEALTHCARE

    HEALTHCARE · MN · general or managing partner

  • ST JOSEPH PHYSICIAN VENTURES I LLC

    REAL ESTATE · CA · general or managing partner

  • ST JOSEPHSATELLITE DIALYSIS CENTERS LLC

    HEALTHCARE · CA

  • ST JUDE SURGICAL CENTERS LLC

    AMBULATORY SURGERY CENTER · CA · general or managing partner

  • ST PETER-SOUTH SOUND REGIONAL MRI CENTER

    MEDICAL IMAGING · WA · general or managing partner

  • WON-ONC LLC

    REAL ESTATE - MOB · WA · general or managing partner

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • 1221 MADISON STREET OWNERS ASSOC

    C · OWNERS' ASSOCIATION · WA

  • ADVATA INC (FKA KENSCI INC)

    C · HEALTHCARE · WA

  • AYIN HEALTH HOLDINGS INC

    C · HEALTHCARE · DE

  • AYIN HEALTH SOLUTIONS INC

    C · HEALTHCARE · OR

  • BOURGET HEALTH SERVICES INC

    C · CLINICAL/MEDICAL LAB · WA

  • CARON CORPORATION

    C · MEDICAL PHYSICIAN SERVICE · MT

  • CLOUD 21 LIMITED

    C · HEALTHCARE · UK

  • ENDOSCOPY CENTER OF SOUTHERN CALIFORNIA

    S · HEALTHCARE · CA

  • HOSPITAL CENTRAL SERVICES ASSOCIATION

    C · LAUNDRY SERVICES · WA

  • INTEGRIS SOLUTIONS LIMITED

    C · HEALTHCARE · UK

  • KENSCI ASIA PACIFIC PTE LTD

    C · HEALTHCARE · SN

  • KENSCI TECH INDIA PRIVATE LIMITED

    C · HEALTHCARE · IN

  • LINDY TRANSFER HOLDINGS INC

    C · HEALTHCARE · WA

  • LUBBOCK METHODIST HOSP PRACTICE MGMT

    C · INACTIVE · TX

  • LUBBOCK METHODIST HOSPITAL SVCS

    C · HEALTHCARE · TX

  • MEDICAL SPECIALTIES MANAGERS INC

    C · HEALTHCARE · WA

  • MISSION VIEJO MEDICAL VENTURES INC

    C · HEALTHCARE · CA

  • PHN HOLDINGS

    C · STRATEGIC PLANNING SERVICES · CA

  • PROVIDENCE GLOBAL CENTER LLP

    C · IT SVCS · IN

  • PROVIDENCE HEALTH CARE VENTURES INC

    C · CLINICAL/MEDICAL LAB · WA

  • PROVIDENCE HEALTH NETWORK

    C · PREPAID HEALTHCARE · CA

  • PROVIDENCE PARTNERS HOLDINGS INC

    C · INVESTMENT · DE

  • PROVIDENCE PHYSICIAN SERVICES CO

    C · HEALTHCARE · WA

  • PROVIDENCE ST JOSEPH HEALTH NETWORK

    C · HEALTHCARE · CA

  • PROVSOURCE

    C · HEALTHCARE · DE

  • ST JOSEPH HEALTH

    C · HOLDING COMPANY · CA

  • ST JOSEPH HEALTH SOURCE INC

    C · HEALTHCARE · CA

  • ST JOSEPH MEDICAL PLAZA ASSOCIATION

    C · CONDO ASSOCIATION · CA

  • ST JOSEPH PROF SVCS ENTERPRISES INC

    C · HEALTHCARE · CA

  • TEGRIA HOLDINGS LLC (FKA GRADY BLOCKER LLC)

    C · HOLDING COMPANY · DE

  • TEGRIA INSIGHTS GROUP HOLDINGS INC

    C · HOLDING COMPANY · WA

  • TEGRIA INSIGHTS GROUP INC

    C · HEALTHCARE · WA

  • TEGRIA PRODUCTS GROUP INC

    C · HOLDING COMPANY · DE

  • TEGRIA RCM GROUP US INC

    C · HOLDING COMPANY · DE

  • TEGRIA RCM GROUP INC (FKA PROV RCM GROUP INC)

    C · HOLDING COMPANY · DE

  • TEGRIA SERVICES GROUP INC (FKA PROVIDENCE SERVICES GROUP)

    C · HOLDING COMPANY · DE

  • TEGRIA SERVICES GROUP-CAN INC

    C · HEALTHCARE · CA

  • TEGRIA SERVICES GROUP-US INC (FKA BLUETREE NETWORK INC)

    C · HEALTHCARE · WI

  • TRUSANA INC

    C · HEALTHCARE · DE

  • VINSERRA INC

    C · INVESTMENT · CA

  • WEIGHT LOSS INC (FKA HMR WEIGHT MANAGEMENT SERVICES CORP)

    C · HEALTHCARE · WA

Provenance

Return type
form_990
Tax year
2024
Filed
30 October 2025
IRS schema version
2024v5.2
Source object
202503089349303680

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