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Nonprofiteer
← LUBBOCK HERITAGE HOSPITAL LLC

Form 990 for tax year 2024

Filed by LUBBOCK HERITAGE HOSPITAL LLC.

Totals

Total revenue
$71,681,058
Total expenses
$101,497,098
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$70,406,797
Investment income
$1,151,324
Other revenue
$122,937
Total assets, end of year
$251,161,251
Total liabilities, end of year
$172,470,607
Net assets or fund balances, end of year
$78,690,644
Program services expenses (Part IX)
$79,823,157
Management and general expenses
$21,673,941
Fundraising expenses
$0
Program service expenses (Part III)
$79,823,157

Program services were 78.6% 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 $65,886,256 · related or exempt $65,886,256

  • 2b · Program service revenue: MOB RENTAL REVENUE

    total $4,520,541 · excluded $4,520,541

  • 3 · Investment income

    total $1,151,324 · excluded $1,151,324

  • 11a · Other revenue: INTERAFFILIATE REVENUE

    total $34,979 · excluded $34,979

  • 11d · All other revenue

    total $87,958 · excluded $87,958

  • 11e · Other revenue, total

    $122,937

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $402,218 · program services $292,363 · management and general $109,855

  • 7 · Other salaries and wages

    total $11,481,248 · program services $8,345,451 · management and general $3,135,797

  • 8 · Pension plan contributions

    total $725,932 · program services $527,663 · management and general $198,269

  • 9 · Other employee benefits

    total $2,061,577 · program services $1,498,512 · management and general $563,065

  • 10 · Payroll taxes

    total $857,622 · program services $623,385 · management and general $234,237

  • 11c · Fees: accounting

    total $20,175 · program services $14,665 · management and general $5,510

  • 11g · Fees: other

    total $7,191,710 · program services $5,227,486 · management and general $1,964,224

  • 12 · Advertising and promotion

    total $736 · program services $535 · management and general $201

  • 13 · Office expenses

    total $946,199 · program services $687,770 · management and general $258,429

  • 14 · Information technology

    total $728 · program services $529 · management and general $199

  • 16 · Occupancy

    total $3,431,188 · program services $2,494,050 · management and general $937,138

  • 17 · Travel

    total $22,048 · program services $16,026 · management and general $6,022

  • 20 · Interest

    total $6,946,433 · program services $5,049,200 · management and general $1,897,233

  • 22 · Depreciation, depletion and amortization

    total $12,459,366 · program services $9,056,422 · management and general $3,402,944

  • 23 · Insurance

    total $123,531 · program services $89,792 · management and general $33,739

  • 24a · Other expenses: SYSTEM COST ALLOCATION

    total $31,159,368 · program services $22,649,017 · management and general $8,510,351

  • 24b · Other expenses: MEDICAL SUPPLIES

    total $22,007,950 · program services $22,007,950

  • 24c · Other expenses: LICENSES AND TAXES

    total $1,437,673 · program services $1,045,011 · management and general $392,662

  • 24d · Other expenses: HOSPITAL FEE

    total $133,278 · program services $133,278

  • 24e · All other expenses

    total $88,118 · program services $64,052 · management and general $24,066

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $50,846,828 · end of year $80,855,923

  • 4 · Accounts receivable

    beginning of year $17,700,007 · end of year $7,596,274

  • 8 · Inventories for sale or use

    beginning of year $2,342,744 · end of year $1,720,766

  • 9 · Prepaid expenses and deferred charges

    beginning of year $30,875 · end of year $7,989,561

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

    $216,866,884

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

    $63,868,157

  • 10c · Land, buildings and equipment, net

    beginning of year $165,032,933 · end of year $152,998,727

  • 15 · Other assets

    beginning of year $10,403,812 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $991,956 · end of year $3,155,079

  • 19 · Deferred revenue

    beginning of year -$6,274,185 · end of year $119,904

  • 25 · Other liabilities

    beginning of year $174,148,937 · end of year $169,195,624

  • 27 · Net assets without donor restrictions

    beginning of year $77,490,491 · end of year $78,690,644

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 O.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.

  • SEE SCHEDULE OAT 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-REPORTTHROUGH 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.2024 PROGRAM SERVICE ACCOMPLISHMENTSCOVENANT HEALTH LUBBOCK HOSPITALSCOVENANT MEDICAL CENTER, GRACE SURGICAL HOSPITAL, COVENANT CHILDREN'S HOSPITAL AND COVENANT SPECIALTY HOSPITAL WORK COLLABORATIVELY THROUGH A CENTRALIZED/SHARED SERVICE COMMUNITY BENEFIT/COMMUNITY HEALTH INVESTMENT DEPARTMENT TO MEET THE NEEDS IDENTIFIED IN THE CHNA. THE LUBBOCK BASED FACILITIES ARE REFERRED TO COLLECTIVELY AS COVENANT HEALTH LUBBOCK HOSPITALS AND ALL SERVE THE SAME GEOGRAPHIC SERVICE AREA OF WEST TEXAS AND EASTERN NEW MEXICO. ADDITIONALLY, DUE TO OVERLAPPING SERVICE AREAS, CLOSE GEOGRAPHIC PROXIMITY TO ONE ANOTHER, AND SHARED COMMUNITY BENEFIT OUTREACH PROGRAMS, THE COVENANT HEALTH LUBBOCK HOSPITALS WORKED WITH COVENANT HEALTH PLAINVIEW, COVENANT HEALTH LEVELLAND AND COVENANT HOBBS HOSPITAL TO DEVELOP A REGIONAL APPROACH TO MANY OF THEIR CHIP'S. WHILE THERE ARE SOME DIFFERENCES IN SELECT STRATEGIES AND COMMUNITY PARTNERS, COVENANT MEDICAL CENTER, COVENANT CHILDREN'S, GRACE SURGICAL HOSPITAL, COVENANT SPECIALTY HOSPITAL, COVENANT HEALTH PLAINVIEW, COVENANT HOBBS HOSPITAL, AND COVENANT HEALTH LEVELLAND SHARE MANY SIMILAR OUTREACH STRATEGIES, WHICH ALLOWS FOR MORE EFFECTIVELY LEVERAGING INVESTMENTS IN THE REGION TO MEET COMMUNITY NEEDS. COVENANT HEALTH HAS A RICH HISTORY IN THE TEXAS/NEW MEXICO REGION. WHILE HEALTH CARE IN OUR REGION HAS CHANGED OVER THE YEARS, OUR COMMITMENT TO FULFILLING OUR MISSION, VISION, VALUES AND PROMISE HAVE NOT WAIVERED. BELOW WE HIGHLIGHT THREE PRIORITY AREA ACCOMPLISHMENTS ACROSS COVENANT HEALTH LUBBOCK HOSPITALS:MENTAL/RELATIONAL HEALTH AND SUBSTANCE MISUSE:MENTAL, BEHAVIORAL HEALTH TREATMENT, AND SUBSTANCE MISUSE INTERVENTION, AND PREVENTION SERVICES FOR THE COMMUNITY; INCLUDING SOCIAL AND RELATIONAL HEALTH, STIGMA REDUCTION, AND COMMUNITY EDUCATION, COMMUNITY EDUCATION AND AWARENESS THROUGH PARTNERSHIPS WITH NON-PROFITS, LAW ENFORCEMENT, AND SCHOOLS; SUPPORT FOR ACCESSIBILITY AND AVAILABILITY OF ADDICTION TREATMENT OPTIONS1) THE COVENANT COMMUNITY OUTREACH COUNSELING PROGRAM PROVIDES COUNSELING SERVICES TO LOW-INCOME, UNINSURED AND VULNERABLE PERSONS IN OUR COMMUNITIES. IN 2023 AND 2024 SERVICE SITES WERE EXPANDED TO INCLUDE ON-SITE COUNSELING SUPPORT FOR VARIOUS COMMUNITY PARTNERS INCLUDING THE LUBBOCK YWCA AND LUBBOCK CHILDREN'S HEALTH CLINIC. WRAP AROUND COUNSELING SERVICES WERE MADE AVAILABLE TO LUBBOCK ISD STUDENTS ENROLLED IN THE COMMUNITY ADVOCACY PROGRAM. TELE-HEALTH COUNSELING SERVICES WERE CONTINUED TO SUPPORT LEVELLAND, PLAINVIEW AND SURROUNDING COMMUNITIES. A COUNSELING INTERNSHIP PROGRAM WAS EXPANDED THROUGH PARTNERSHIPS WITH AREA UNIVERSITIES CREATING A SIGNIFICANT INCREASE IN SERVICES PROVIDED TO THE COMMUNITY. THE INTERNSHIP PROGRAM HAS GROWN FROM 2 COUNSELOR INTERNS AT THE END OF 2022 TO 6 INTERNS AT THE END OF 2024. IN 2024, THE COVENANT COMMUNITY COUNSELING CENTER COMPLETED 3536 COUNSELING ENCOUNTERS. COVENANT ALSO PARTICIPATED IN A REGIONAL-WIDE MENTAL HEALTH COLLABORATIVE- WEST TEXAS MENTAL HEALTH COLLABORATIVE WHICH PROVIDES SUPPORT TO THE ENTIRE TEXAS SERVICE AREA. THROUGH THIS COLLABORATIVE WE HAVE SUPPORTED THE CREATION OF A NEW DIVERSION CENTER WHICH IS UNDER CONSTRUCTION AND THE COLLABORATIVE HAS ALSO BROUGHT SEVERAL MENTAL HEALTH CONFERENCES TO THE REGION. ADDITIONALLY, COVENANT HEALTH PARTICIPATED IN THE AMERICAN FOUNDATION FOR SUICIDE PREVENTION WEST TEXAS CHAPTER OUT OF THE DARKNESS WALK TO RAISE AWARENESS FOR SUICIDE PREVENT, PARTNERED WITH SEVERAL LOCAL NON-PROFITS ADDRESSING MENTAL HEALTH THROUGH GRANTS, SPONSORSHIPS AND IN-KIND SUPPORT, PARTICIPATED IN COMMUNITY EVENTS TO EDUCATE THE PUBLIC ON MENTAL HEALTH ISSUES, PARTNERED WITH PROVIDENCE WELL-BEING TRUST TO PROVIDE MATCHING MENTAL HEALTH ACCESS EXPANSION GRANTS, AND PROVIDED EDUCATION ON SUBSTANCE MIS-USE AND NALOXONE ADMINISTRATION FOR A LOCAL NON-PROFIT HOUSING/HOMELESSNESS ORGANIZATION. COVENANT HEALTH ALSO CONTINUES TO EXPAND ACCESS TO CHILDREN AND THEIR FAMILIES THROUGH THE RELATIONAL HEALTH UNIT IN OUR COVENANT CHILDREN'S HOSPITAL.ACCESS TO CARE AND HEALTH RESOURCES:ISSUES RELATED TO ACCESSING HEALTH SERVICES AND RESOURCES INCLUDING SOCIAL DETERMINANTS OF HEALTH WITH AN EMPHASIS ON VULNERABLE POPULATIONS:2) THROUGH COVENANT HEATH'S COMMUNITY DENTAL OUTREACH PROGRAM, WE WERE ABLE TO PROVIDE LOW-COST DENTAL SERVICES TO DENTALLY UN-INSURED THROUGH DENTAL OUTREACH CLINICS IN LUBBOCK AND PLAINVIEW, PARTNERING WITH LUBBOCK IMPACT TO HOLD FULL-DAY DENTAL CLINICS, AND PERFORMING DENTAL OUTREACH IN LUBBOCK AND HOCKLEY COUNTIES. IN 2024, THIS PROGRAM TOTALED APPROXIMATELY 1,600 DENTAL ENCOUNTERS PROVIDING ACCESS TO THE FULL ARRAY OF DENTAL SERVICES FROM EXTRACTIONS TO DENTURES TO LOW-INCOME DENTALLY UNINSURED ADULTS IN OUR SERVICE AREA. THIS PROVIDED ACCESS TO DENTAL FOR ADULTS IN OUR SERVICE AREA WHO WOULD OTHERWISE LIKELY BE WITHOUT DENTAL CARE. ADDITIONALLY, WE COMPLETED DENTAL OUTREACH IN LITTLEFIELD AND LEVELLAND SCHOOL DISTRICTS, THE LUBBOCK YWCA AND LUBBOCK IMPACT. THE DENTAL OUTREACH PROGRAM ALSO COMPLETED HYGIENE EDUCATION THROUGH ATTENDING COMMUNITY EVENTS AND PROVIDED HYGIENE ITEMS TO LOW INCOME COMMUNITY MEMBERS IN NEED.3) COVENANT'S COMMUNITY HEALTH EDUCATION PROGRAM PROVIDES FREE HEALTH EDUCATION TO COMMUNITY MEMBERS THROUGH SESSIONS WITH A DIABETIC OUTREACH TEAM, GROUP CLASSES, AND COMMUNITY COOKING CLASSES. IN 2024 WE EXPANDED OUR PROGRAM TO INCLUDE ADDITIONAL STAFF DEDICATED TO HEALTH EDUCATION AND OUTREACH AND A COMMUNITY BASED SOCIAL WORKER TO ASSIST UN-INSURED FAMILIES IN ACCESSING RESOURCES. OUR OUTREACH COUNSELING TEAM ALSO PROVIDED SUPPORT THROUGH CLASSES ON VARIOUS HEALTH TOPICS HELD AT COMMUNITY NON-PROFITS. ADDITIONALLY, WE EXPANDED OUR COMMUNITY HEALTHY COOKING CLASSES THROUGH A COLLABORATION WITH SOUTH PLAINS COLLEGE AND THE LUBBOCK YWCA. COVENANT HOSPITALS ALSO PROVIDED SUPPORT TO EXPAND HEALTH ACCESS TO CARE THROUGH GRANTS, SPONSORSHIPS, AND IN-KIND SUPPORT TO MULTIPLE NON-PROFITS.FOR MORE INFORMATION ON COVENANT HEALTH GO TO: HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/COVENANT-HEALTH/HOME

    Expenses $79,823,157 · Revenue $70,406,797

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

Listed in Part VII

  • AMY THOMPSON MD

    LUBBOCK AREA MARKET/CEO

    Total calculated
    $896,775
    From this org
    $0
    From related orgs
    $784,091
    Other
    $112,684
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $437,621 related
    Bonus
    $0 + $279,325 related
    Other
    $0 + $67,145 related
    Deferred
    $0 + $95,520 related
    Nontaxable benefits
    $0 + $17,164 related
    Filer's total
    $0 + $896,775 related

  • SHELLY HOOK MD

    BOARD MEMBER - THRU 12/31/24

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

    Schedule J breakdown matched by us

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

  • 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

  • VANESSA BAYOUTH

    CEO GRACE

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

    Schedule J breakdown matched by us

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

  • CHETLEN CROSSNOE MD

    BOARD MEMBER

    Total calculated
    $331,286
    From this org
    $0
    From related orgs
    $317,936
    Other
    $13,350
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $260,619 related
    Bonus
    $0 + $22,764 related
    Other
    $0 + $34,553 related
    Deferred
    $0 + $5,175 related
    Nontaxable benefits
    $0 + $8,175 related
    Filer's total
    $0 + $331,286 related

  • JENNIFER BRYAN

    LUBBOCK AREA MARKET/CFO

    Total calculated
    $314,564
    From this org
    $0
    From related orgs
    $285,974
    Other
    $28,590
    Hours/week
    11 + 44 related

    Schedule J breakdown matched by us

    Base
    $0 + $225,686 related
    Bonus
    $0 + $22,499 related
    Other
    $0 + $37,789 related
    Deferred
    $0 + $23,018 related
    Nontaxable benefits
    $0 + $5,572 related
    Filer's total
    $0 + $314,564 related

  • RANDALL NICHOLS

    EXECUTIVE DIRECTOR OPERATIONS

    Total calculated
    $277,920
    From this org
    $238,205
    From related orgs
    $0
    Other
    $39,715
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $206,454
    Bonus
    $24,636
    Other
    $7,115
    Deferred
    $22,616
    Nontaxable benefits
    $17,099
    Filer's total
    $277,920

  • SCOTT BARTLETT

    SUPERVISOR CLINICAL PHARMACY

    Total calculated
    $220,406
    From this org
    $187,673
    From related orgs
    $0
    Other
    $32,733
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $187,353
    Bonus
    $0
    Other
    $320
    Deferred
    $18,036
    Nontaxable benefits
    $14,697
    Filer's total
    $220,406

  • MARLA DANIELS

    CHIEF NURSING OFFICER

    Total calculated
    $188,091
    From this org
    $167,350
    From related orgs
    $0
    Other
    $20,741
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $150,138
    Bonus
    $16,144
    Other
    $1,068
    Deferred
    $15,428
    Nontaxable benefits
    $5,313
    Filer's total
    $188,091

  • KATHLEEN BURRELL

    SECRETARY

    Total calculated
    $180,050
    From this org
    $0
    From related orgs
    $164,613
    Other
    $15,437
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $154,769 related
    Bonus
    $0 + $9,353 related
    Other
    $0 + $491 related
    Deferred
    $0 + $7,665 related
    Nontaxable benefits
    $0 + $7,772 related
    Filer's total
    $0 + $180,050 related

  • KRISTY PEREZ

    SENIOR MANAGER SURGICAL SERVICES

    Total calculated
    $176,532
    From this org
    $157,626
    From related orgs
    $0
    Other
    $18,906
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $138,533
    Bonus
    $18,660
    Other
    $433
    Deferred
    $11,141
    Nontaxable benefits
    $7,765
    Filer's total
    $176,532

  • CANDY LANDBECK

    MANAGER NURSING

    Total calculated
    $154,651
    From this org
    $138,611
    From related orgs
    $0
    Other
    $16,040
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $131,851
    Bonus
    $5,627
    Other
    $1,133
    Deferred
    $12,613
    Nontaxable benefits
    $3,427
    Filer's total
    $154,651

  • DERICK HAGGARD MD

    BOARD MEMBER - THRU 12/31/24

    Total calculated
    $90,700
    From this org
    $0
    From related orgs
    $90,700
    Other
    $0
    Hours/week
    0.5 + 0.5 related

  • CHAD WHEELER

    BOARD MEMBER

    Total calculated
    $7,000
    From this org
    $0
    From related orgs
    $7,000
    Other
    $0
    Hours/week
    0.5 + 0.5 related

  • BECKY GARZA

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • DAN BERMAN MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • JESSIE MENDOZA

    BOARD MEMBER/CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • KEINO MCWHINNEY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • MICHELLE MCCORD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • SHAUN FORGERSON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 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
THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY A RELATED TAX-EXEMPT ORGANIZATION, METHODIST CHILDREN'S HOSPITAL, 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: AMY THOMPSON, M.D. - $64,779 SHELLY HOOK, M.D. - $5,056 JAMES KELLY - $59,375 VANESSA BAYOUTH - $2,446 CHETLEN CROSSNOE, M.D. - $5,945
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.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2024
Filed
3 November 2025
IRS schema version
2024v5.2
Source object
202543119349302154

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