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← PROVIDENCE HEALTH SERVICES INC

Form 990 for tax year 2022

Filed by PROVIDENCE HEALTH SERVICES INC.

Totals

Total revenue
$8,569,347
Total expenses
$15,453,394
Contributions and grants received
$925,970
Grants paid
$0
Program service revenue
$7,617,856
Investment income
$0
Other revenue
$25,521
Total assets, end of year
$1,040,367
Total liabilities, end of year
$3,010,319
Net assets or fund balances, end of year
-$1,969,952
Program services expenses (Part IX)
$13,285,752
Management and general expenses
$2,167,642
Fundraising expenses
$0
Program service expenses (Part III)
$13,285,752

Program services were 86.0% 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.

  • 1a · Federated campaigns

    $0

  • 1b · Membership dues

    $0

  • 1c · Fundraising events

    $0

  • 1d · Related organizations

    $893,434

  • 1e · Government grants (contributions)

    $32,536

  • 1f · All other contributions, gifts and grants

    $0

  • 2a · Program service revenue: Net Patient Service Revenue

    total $7,273,318 · related or exempt $7,273,318

  • 2b · Program service revenue: Value Based Revenue

    total $343,494 · related or exempt $343,494

  • 2c · Program service revenue: Services to Affiliates

    total $909 · related or exempt $909

  • 2d · Program service revenue: Interest Income from Patient Accounts

    total $135 · related or exempt $135

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $0 · excluded $0

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0 · excluded $0

  • 5 · Royalties

    total $0 · excluded $0

  • 6a · Gross rents

    real property $0 · personal property $0

  • 6b · Less rental expenses

    real property $403

  • 6c · Rental income or loss

    real property -$403 · personal property $0

  • 6d · Net rental income or loss

    total -$403 · excluded -$403

  • 7a · Gross sales of assets other than inventory

    securities $0 · other assets $0

  • 7b · Less cost or other basis and sales expenses

    securities $0 · other assets $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 7d · Net gain or loss

    total $0 · excluded $0

  • 8a · Fundraising events: gross income

    $0

  • 8a · Fundraising events: contributions included on line 1c

    $0

  • 8b · Fundraising events: direct expenses

    $0

  • 8c · Net income from fundraising events

    total $0 · excluded $0

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0 · excluded $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $0

  • 10c · Net income from sales of inventory

    total $0 · excluded $0

  • 11a · Other revenue: Medical Records Fees

    total $23,192 · related or exempt $23,192

  • 11b · Other revenue: Escheatment Revenue

    total $1,833 · related or exempt $1,833

  • 11d · All other revenue

    total $899 · related or exempt $899 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $25,924

Functional expenses

Part IX, the statement of functional expenses.

  • 11g · Fees: other

    total $152,136 · program services $143,203 · management and general $8,933 · fundraising $0

  • 12 · Advertising and promotion

    total $9 · program services $9

  • 13 · Office expenses

    total $17,182 · program services $15,437 · management and general $1,745

  • 14 · Information technology

    total $19,570 · program services $9,850 · management and general $9,720

  • 16 · Occupancy

    total $703,412 · program services $637,187 · management and general $66,225

  • 17 · Travel

    total $4,329 · program services $4,329

  • 19 · Conferences, conventions and meetings

    total $15,528 · program services $14,060 · management and general $1,468

  • 22 · Depreciation, depletion and amortization

    total $733,364 · program services $664,319 · management and general $69,045

  • 23 · Insurance

    total $210,325 · management and general $210,325

  • 24a · Other expenses: Wage & Benefit Allocation

    total $9,478,801 · program services $8,586,393 · management and general $892,408

  • 24b · Other expenses: Impairment

    total $3,252,579 · program services $2,946,356 · management and general $306,223

  • 24c · Other expenses: Purchased Services

    total $511,334 · program services $480 · management and general $510,854

  • 24d · Other expenses: Medical Supplies

    total $250,739 · program services $212,996 · management and general $37,743

  • 24e · All other expenses

    total $104,086 · program services $51,133 · management and general $52,953 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $15,239,165 · end of year $41,315

  • 3 · Pledges and grants receivable

    beginning of year $500,000 · end of year $23,445

  • 4 · Accounts receivable

    beginning of year $510,431 · end of year $540,748

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $22,950 · end of year $0

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

    $3,544,976

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

    $3,468,176

  • 10c · Land, buildings and equipment, net

    beginning of year $3,930,120 · end of year $76,800

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 14 · Intangible assets

    beginning of year $49,916 · end of year $0

  • 15 · Other assets

    beginning of year $987,088 · end of year $358,059

  • 17 · Accounts payable and accrued expenses

    beginning of year $790,489 · end of year $446,902

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $1,999,145 · end of year $2,563,417

  • 27 · Net assets without donor restrictions

    beginning of year $18,450,036 · end of year -$1,969,952

  • 28 · Net assets with donor restrictions

    beginning of year $0 · end of year $0

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $0 · end of year $0

  • 31 · Retained earnings, endowment or other funds

    beginning of year $0 · end of year $0

Mission and programs · 2022

Mission

Rooted in the loving ministry of Jesus as healer, we commit ourselves to serving all persons with special attention to those who are poor and vulnerable. Our Catholic health ministry is dedicated to spiritually-centered, holistic care which sustains and improves the health of individuals and communities. We are advocates for a compassionate and just society through our actions and our words.

Activities or mission (Part I)

To improve the health and well-being of all people in the communities we serve.

  • THE FILING ORGANIZATION IS A PART OF THE ASCENSION CATHOLIC HEALTH MINISTRY. ASCENSION IS A FAITH-BASED HEALTHCARE ORGANIZATION THAT DELIVERS PERSONALIZED, COMPASSIONATE CARE TO ALL, ESPECIALLY TO THOSE WHO NEED IT THE MOST. PROVIDENCE HEALTH SERVICES, INC. ASSISTED PHYSICIANS IN ESTABLISHING & MANAGING THEIR PRACTICES AT PROVIDENCE HOSPITAL; THEY ARE EMPLOYED BY THE HOSPITAL, WITH THE COST OF OPERATION TRANSFERRED TO THEIR RESPECTIVE PRACTICES WITHIN PROVIDENCE HEALTH SERVICES, INC. PROVIDENCE HEALTH SERVICES, INC. PROVIDED COMMUNITY CLINICAL CENTERS AS PART OF PROVIDENCE HOSPITAL'S COMMUNITY OUTREACH TO EXTEND PHYSICIAN MEDICAL SERVICES INTO UNDERSERVED AREAS. DURING FISCAL YEAR 2023, PROVIDENCE HEALTH SERVICES, INC. PROVIDED SERVICES FOR 56,719 PHYSICIAN OFFICE VISITS. In northeast Washington, DC, Providence Health Services Internal Medicine provides primary care and specializes in diagnostic medicine. Providence Health Services, Inc. internal medicine care teams deliver primary care for adults of all ages -- close to home. Experienced care teams provide compassionate, personalized care that is right for you. Services provided to help promote, better long-term health, include: Adult (senior) medical care, including high blood pressure and high cholesterol Health prevention and dietary guidance Immunizations Physicals, including DOT/CDL Screening tests Women's health services, including gynecological exams Diagnostic tests, outpatient lab testing and medical imaging. Providence specialty care services Providence Health Services, Inc. focuses on the needs of our community. Our network of family medicine and internal medicine doctors and care teams are committed to providing high-quality care. For chronic health or complex medical conditions, our doctors work closely with the other Providence specialty care doctors and programs: Behavioral and Mental Health Diabetes Education and Nutrition Center Geriatric Medicine Center Wellness Institute As a response to the COVID-19 pandemic Providence Health Service's, Inc.'s medical practices implemented virtual care throughout all its practices. The virtual and telephonic provider visits were for established patients in our Providence physician practices for anyone who needed immediate care. The visits have focused on primary and behavioral health needs, as well as persons covered by Medicaid and have access to the Myhealth GPS program for care coordination. Providence is privileged to continue to serve the Washington DC community and will continue to work to keep our communities healthy.

    Expenses $13,285,752 · Revenue $7,643,780

As filed on the 2022 return.

Listed in Part VII

  • EDWARD R LOVERN

    PRESIDENT (END 5/2023)

    Total calculated
    $825,787
    From this org
    $0
    From related orgs
    $779,035
    Other
    $46,752
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $549,622 related
    Bonus
    $0 + $165,000 related
    Other
    $0 + $64,413 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $28,452 related
    Filer's total
    $0 + $825,787 related

  • MITCHELL G LOMAX

    DIRECTOR/CFO, MINISTRY MARKET

    Total calculated
    $441,354
    From this org
    $0
    From related orgs
    $394,082
    Other
    $47,272
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $300,708 related
    Bonus
    $0 + $91,800 related
    Other
    $0 + $1,574 related
    Deferred
    $0 + $18,725 related
    Nontaxable benefits
    $0 + $28,547 related
    Filer's total
    $0 + $441,354 related

  • WILLIAM B HIGGINBOTHAM

    DIRECTOR/INTERIM PRESIDENT & CEO (START 5/2023)

    Total calculated
    $430,586
    From this org
    $0
    From related orgs
    $385,142
    Other
    $45,444
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $318,477 related
    Bonus
    $0 + $65,000 related
    Other
    $0 + $1,665 related
    Deferred
    $0 + $18,475 related
    Nontaxable benefits
    $0 + $26,969 related
    Filer's total
    $0 + $430,586 related

  • BRIDGETTE INGRID ROBERSON

    DIRECTOR (END 12/2022)

    Total calculated
    $684,687
    From this org
    $0
    From related orgs
    $674,103
    Other
    $10,584
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $323,093 related
    Bonus
    $0 + $225,040 related
    Other
    $0 + $125,970 related
    Deferred
    $0 + $2,693 related
    Nontaxable benefits
    $0 + $7,891 related
    Filer's total
    $0 + $684,687 related

  • CAROL SCHMIDT

    DIRECTOR (END 12/2022)

    Total calculated
    $0
    Hours/week
    1

  • PETER M LEIBOLD

    DIRECTOR

    Total calculated
    $2,038,328
    From this org
    $0
    From related orgs
    $1,987,673
    Other
    $50,655
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $602,973 related
    Bonus
    $0 + $1,224,000 related
    Other
    $0 + $160,700 related
    Deferred
    $0 + $16,775 related
    Nontaxable benefits
    $0 + $33,880 related
    Filer's total
    $0 + $2,038,328 related

  • SHADI SOUFI MD

    DIRECTOR (END 12/2022)

    Total calculated
    $508,772
    From this org
    $0
    From related orgs
    $474,163
    Other
    $34,609
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $432,222 related
    Bonus
    $0 + $40,475 related
    Other
    $0 + $1,466 related
    Deferred
    $0 + $19,825 related
    Nontaxable benefits
    $0 + $14,784 related
    Filer's total
    $0 + $508,772 related

  • SCOTT M FURNISS

    FORMER OFFICER (END 1/2020)

    Total calculated
    $465,588
    From this org
    $0
    From related orgs
    $420,701
    Other
    $44,887
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $317,301 related
    Bonus
    $0 + $97,500 related
    Other
    $0 + $5,900 related
    Deferred
    $0 + $17,747 related
    Nontaxable benefits
    $0 + $27,140 related
    Filer's total
    $0 + $465,588 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

  • 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 THE CALENDAR YEAR 2022: Bridgette I. Roberson - $76,923
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

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.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2022
Filed
14 May 2024
IRS schema version
2022v5.0
Source object
202411359349310176

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