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Nonprofiteer
← PROVIDENCE HOSPITAL

Form 990 for tax year 2023

Filed by PROVIDENCE HOSPITAL.

Totals

Total revenue
$60,997,438
Total expenses
$59,543,457
Contributions and grants received
$804,512
Grants paid
$128,807
Program services expenses (Part IX)
$46,806,467
Management and general expenses
$12,736,990
Fundraising expenses
$0
Program service expenses (Part III)
$46,806,467

Program services were 78.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • CHRISTOPHER H BROWN MD

    CHAIR (END 9/2023)

    Total calculated
    $0
    Hours/week
    1

  • COBA SUSAN CORNEJO

    CHIEF OPERATING OFFICER (START 10/2023)

    Total calculated
    $1,276,784
    From this org
    $0
    From related orgs
    $1,214,648
    Other
    $62,136
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $527,390 related
    Bonus
    $0 + $593,993 related
    Other
    $0 + $93,265 related
    Deferred
    $0 + $21,450 related
    Nontaxable benefits
    $0 + $40,686 related
    Filer's total
    $0 + $1,276,784 related

  • RICHARD WILKINS MD

    VICE CHAIR (END 9/2023)

    Total calculated
    $0
    Hours/week
    1

  • TODD STEVEN KENNEDY

    PRESIDENT (END 9/2023)

    Total calculated
    $751,405
    From this org
    $0
    From related orgs
    $705,985
    Other
    $45,420
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $275,521 related
    Bonus
    $0 + $311,099 related
    Other
    $0 + $119,365 related
    Deferred
    $0 + $19,050 related
    Nontaxable benefits
    $0 + $26,370 related
    Filer's total
    $0 + $751,405 related

  • CASEY MELTON

    DIRECTOR (END 9/2023)

    Total calculated
    $0
    Hours/week
    1

  • CHRIS TRACY

    DIRECTOR (END 9/2023)

    Total calculated
    $0
    Hours/week
    1

  • CINDALU ANGELETTE

    DIRECTOR (END 9/2023)

    Total calculated
    $0
    Hours/week
    1

  • DAVID HASSELL MD

    DIRECTOR (END 9/2023)

    Total calculated
    $0
    Hours/week
    1

  • JOSHUA TANNER

    DIRECTOR (END 9/2023)

    Total calculated
    $0
    Hours/week
    1

  • MERRILL THOMAS

    DIRECTOR (END 9/2023)

    Total calculated
    $0
    Hours/week
    1

  • JALIMA TRANK

    CFO, MINISTRY MARKET

    Total calculated
    $617,527
    From this org
    $0
    From related orgs
    $594,044
    Other
    $23,483
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $380,709 related
    Bonus
    $0 + $114,416 related
    Other
    $0 + $98,919 related
    Deferred
    $0 + $15,003 related
    Nontaxable benefits
    $0 + $8,480 related
    Filer's total
    $0 + $617,527 related

  • KATRINA R BROWN RN

    VP, PATIENT CARE

    Total calculated
    $222,938
    From this org
    $191,295
    From related orgs
    $0
    Other
    $31,643
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $142,024
    Bonus
    $39,140
    Other
    $10,131
    Deferred
    $12,329
    Nontaxable benefits
    $19,314
    Filer's total
    $222,938

  • RICHARD A METZGER JR

    VP, OPERATIONS

    Total calculated
    $228,785
    From this org
    $196,133
    From related orgs
    $0
    Other
    $32,652
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $144,513
    Bonus
    $39,140
    Other
    $12,480
    Deferred
    $10,432
    Nontaxable benefits
    $22,220
    Filer's total
    $228,785

  • CHARLES H BOWEN MD

    PHYSICIAN

    Total calculated
    $389,353
    From this org
    $368,894
    From related orgs
    $0
    Other
    $20,459
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $354,323
    Bonus
    $7,200
    Other
    $7,371
    Deferred
    $7,745
    Nontaxable benefits
    $12,714
    Filer's total
    $389,353

  • DAVID CHRISTOPHER BRASWELL MD

    PHYSICIAN

    Total calculated
    $407,765
    From this org
    $374,868
    From related orgs
    $0
    Other
    $32,897
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $356,069
    Bonus
    $11,160
    Other
    $7,639
    Deferred
    $19,510
    Nontaxable benefits
    $13,387
    Filer's total
    $407,765

  • JAMES OREY GALLE MD

    PHYSICIAN (END 9/2023)

    Total calculated
    $637,887
    From this org
    $606,218
    From related orgs
    $0
    Other
    $31,669
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $477,740
    Bonus
    $125,527
    Other
    $2,951
    Deferred
    $8,481
    Nontaxable benefits
    $23,188
    Filer's total
    $637,887

  • JOY STEADMAN MD

    PHYSICIAN

    Total calculated
    $385,569
    From this org
    $365,064
    From related orgs
    $0
    Other
    $20,505
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $357,693
    Bonus
    $0
    Other
    $7,371
    Deferred
    $16,500
    Nontaxable benefits
    $4,005
    Filer's total
    $385,569

  • SHOUKAT ALI BAIG MD

    PHYSICIAN

    Total calculated
    $409,701
    From this org
    $372,259
    From related orgs
    $0
    Other
    $37,442
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $364,663
    Bonus
    $4,798
    Other
    $2,798
    Deferred
    $14,500
    Nontaxable benefits
    $22,942
    Filer's total
    $409,701

  • BRANDON MICHAEL WILLIAMS

    FORMER OFFICER (END 6/2020)

    Total calculated
    $1,001,368
    From this org
    $0
    From related orgs
    $945,329
    Other
    $56,039
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $463,009 related
    Bonus
    $0 + $340,272 related
    Other
    $0 + $142,048 related
    Deferred
    $0 + $18,150 related
    Nontaxable benefits
    $0 + $37,889 related
    Filer's total
    $0 + $1,001,368 related

  • IJAZ IQBAL MD

    FORMER KEY EMPLOYEE (END 12/2019)

    Total calculated
    $418,738
    From this org
    $0
    From related orgs
    $373,750
    Other
    $44,988
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $272,328 related
    Bonus
    $0 + $74,000 related
    Other
    $0 + $27,422 related
    Deferred
    $0 + $18,384 related
    Nontaxable benefits
    $0 + $26,604 related
    Filer's total
    $0 + $418,738 related

  • JASON P ALEXANDER FACHE

    FORMER OFFICER (END 6/2020)

    Total calculated
    $1,683,690
    From this org
    $0
    From related orgs
    $1,625,685
    Other
    $58,005
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $664,093 related
    Bonus
    $0 + $847,839 related
    Other
    $0 + $113,753 related
    Deferred
    $0 + $19,800 related
    Nontaxable benefits
    $0 + $38,205 related
    Filer's total
    $0 + $1,683,690 related

  • STEPHAN F QUIRICONI

    FORMER OFFICER (END 11/2022)

    Total calculated
    $631,265
    From this org
    $0
    From related orgs
    $631,265
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0 + $158,670 related
    Other
    $0 + $472,595 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $631,265 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 — 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

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 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
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
A RELATED ORGANIZATION OF THE FILING ORGANIZATION USES ONE OR MORE OF THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY, AND -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PLEASE REFER TO THE FORM 990, PART VI, LINE 15A DISCLOSURE IN SCHEDULE O FOR ADDITIONAL DETAILS ON HOW COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED.
Schedule J, Part I, Line 4a Severance or change-of-control payment
The following individual(s) received severance payments from the organization or a related organization DURING CALENDAR YEAR 2023: STEPHAN F. QUIRICONI: $450,000
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
ELIGIBLE EXECUTIVES PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO INDIVIDUALS RECEIVED CURRENT YEAR DISTRIBUTIONS.

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

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.

Provenance

Return type
form_990
Tax year
2023
Filed
15 May 2025
IRS schema version
2023v6.0
Source object
202531359349308508

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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