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Nonprofiteer
← GAMELIN WASHINGTON ASSOCIATION

Form 990 for tax year 2023

Filed by GAMELIN WASHINGTON ASSOCIATION.

Totals

Total revenue
$706,845
Total expenses
$843,513
Contributions and grants received
$513,907
Grants paid
$0
Program service revenue
$174,326
Investment income
$0
Other revenue
$18,612
Total assets, end of year
$3,814,511
Total liabilities, end of year
$102,608
Net assets or fund balances, end of year
$3,711,903
Program services expenses (Part IX)
$766,996
Management and general expenses
$76,517
Fundraising expenses
$0
Program service expenses (Part III)
$766,996

Program services were 90.9% 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.

  • 1e · Government grants (contributions)

    $513,907

  • 2a · Program service revenue: TENANT RENTS

    total $174,315 · related or exempt $174,315

  • 2b · Program service revenue: HUD RESERVES INTEREST

    total $10 · related or exempt $10

  • 2c · Program service revenue: TENANT DEPOSIT INT.

    total $1 · related or exempt $1

  • 11a · Other revenue: RESIDENT ACTIVITIES

    total $18,204 · related or exempt $18,204

  • 11b · Other revenue: LAUNDRY & VENDING

    total $408 · related or exempt $408

  • 11e · Other revenue, total

    $18,612

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $168,882 · program services $168,882

  • 9 · Other employee benefits

    total $30,944 · program services $30,944

  • 10 · Payroll taxes

    total $12,900 · program services $12,900

  • 11c · Fees: accounting

    total $19,891 · management and general $19,891

  • 11g · Fees: other

    total $117,280 · program services $117,280

  • 13 · Office expenses

    total $18,854 · program services $18,854

  • 16 · Occupancy

    total $233,120 · program services $233,120

  • 19 · Conferences, conventions and meetings

    total -$522 · program services -$522

  • 21 · Payments to affiliates

    total $56,626 · management and general $56,626

  • 22 · Depreciation, depletion and amortization

    total $156,819 · program services $156,819

  • 23 · Insurance

    total $12,951 · program services $12,951

  • 24a · Other expenses: RESIDENT ACTIVITIES

    total $14,958 · program services $14,958

  • 24b · Other expenses: LICENSES AND TAXES

    total $717 · program services $717

  • 24c · Other expenses: BAD DEBTS

    total $93 · program services $93

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $82,229 · end of year $121,347

  • 4 · Accounts receivable

    beginning of year $2,826 · end of year $2,897

  • 9 · Prepaid expenses and deferred charges

    beginning of year $5,389 · end of year $5,980

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

    $6,351,800

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

    $2,868,885

  • 10c · Land, buildings and equipment, net

    beginning of year $3,624,303 · end of year $3,482,915

  • 15 · Other assets

    beginning of year $215,422 · end of year $201,372

  • 17 · Accounts payable and accrued expenses

    beginning of year $30,693 · end of year $32,615

  • 19 · Deferred revenue

    beginning of year $580 · end of year $808

  • 25 · Other liabilities

    beginning of year $50,324 · end of year $69,185

  • 27 · Net assets without donor restrictions

    beginning of year $694,358 · end of year $688,741

  • 28 · Net assets with donor restrictions

    beginning of year $3,154,214 · end of year $3,023,162

Mission and programs · 2023

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.

  • 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 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 117,000 CAREGIVERS (ALL EMPLOYEES) SERVE IN 51 HOSPITALS, 1,000 CLINICS AND A COMPREHENSIVE RANGE OF HEALTH AND SOCIAL SERVICES ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. THE PROVIDENCE FAMILY INCLUDES:-PROVIDENCE ACROSS SEVEN WESTERN STATES-COVENANT HEALTH IN WEST TEXAS-PROVIDENCE FACEY MEDICAL FOUNDATION IN LOS ANGELES, CA-KADLEC IN SOUTHEAST WASHINGTON-PACIFIC MEDICAL CENTERS IN SEATTLE, WA-SWEDISH HEALTH SERVICES IN SEATTLE, WA AS A COMPREHENSIVE HEALTH CARE ORGANIZATION, WE ARE SERVING MORE PEOPLE, ADVANCING BEST PRACTICES AND CONTINUING OUR MORE THAN 100-YEAR TRADITION OF SERVING THE POOR AND VULNERABLE. DELIVERING SERVICES ACROSS SEVEN STATES, PROVIDENCE IS COMMITTED TO TOUCHING MILLIONS OF MORE LIVES AND ENHANCING THE HEALTH OF THE AMERICAN WEST TO TRANSFORM CARE FOR THE NEXT GENERATION AND BEYOND.THROUGH COMMUNITY BENEFIT PROGRAMS AND OTHER HIGH-IMPACT INVESTMENTS, WE WORK TO ENSURE BASIC HEALTH NEEDS ARE MET AND SERVE TO REMOVE BARRIERS TO CARE, BUILD COMMUNITY RESILIENCE AND INNOVATE FOR THE FUTURE. MINISTRIES AND AFFILIATES SUPPORT ORGANIZATIONS, PROGRAMS AND INITIATIVES THAT IMPROVE HEALTH AND WELL-BEING AND INCREASE EQUITABLE ACCESS TO QUALITY CARE AT THE COMMUNITY LEVEL AND AT SCALE ACROSS SEVEN STATES.WE ARE PROUD OF OUR HISTORY AND CONTINUED COMMITMENT TO HELPING BUILD A MORE EQUITABLE, SUSTAINABLE FUTURE. OUR STEADFAST COMMITMENT TO RESPONDING TO COMMUNITY NEED IS ONE OF THE MANY WAYS MINISTRIES, AFFILIATES AND CAREGIVERS LIVE OUT OUR SHARED MISSION AND CONTINUE TO SERVE AS A VITAL SAFETY NET FOR THOSE WHO ARE VULNERABLE.FOR MORE INFORMATION GO TO: HTTPS://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT ENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSPROVIDENCE CONTINUES TO EXECUTE ON OUR INTEGRATED STRATEGIC AND FINANCIAL PLAN, WHICH CLEARLY EXPRESSES OUR COMMITMENT AND ACCELERATION OF THE IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES AND REDUCE OUR CARBON FOOTPRINT IN THE COMMUNITIES WE SERVE. PROVIDENCE ADVANCES PROGRESS ON OUR CARBON NEGATIVE GOAL AND IN 2023 WE ESTIMATED THAT WE DECREASED EMISSIONS BY OVER 12 PERCENT COMPARED TO OUR 2019 BASELINE. IN ADDITION, OUR EFFORTS LED TO THE INTRODUCTION OF THE GREEN HOSPITALS ACT, LEGISLATION MODELED AFTER PROVIDENCE THAT WOULD PROVIDE CRITICAL FEDERAL FUNDING TO WEATHERIZE AND MODERNIZE HEALTH CARE FACILITIES. PROVIDENCE COMPLETED A COMPREHENSIVE CLIMATE RESILIENCE PLAN IN ALIGNMENT WITH OUR COMMITMENT TO THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES CLIMATE PLEDGE. WE CONTINUE TO REDUCE GREENHOUSE GAS EMISSIONS WITH A FOCUS ON LED LIGHTING UPGRADES, WATER CONSERVATION, MORE EFFICIENT DELIVERY OF NITROUS OXIDE GAS DURING ANESTHESIA, AND ADVANCING OUR WASTE OPTIMIZATION WORK ACROSS ALL HOSPITALS AND CLINICS.PROGRAM SERVICE ACCOMPLISHMENTSPROVIDE SUBSIDIZED HOUSING FOR LOW INCOME ELDERLY AGED 62 AND OLDER IN SEATTLE'S PIKE PLACE MARKET.OVERVIEWPROVIDENCE VINCENT HOUSE IS A HIGH-QUALITY, SUPPORTIVE HOUSING PROGRAM FOUNDED BY THE SISTERS OF PROVIDENCE AND NOW SPONSORED, OWNED AND MANAGED BY PROVIDENCE HEALTH & SERVICES. DESIGNED AND BUILT ESPECIALLY FOR SENIORS, THE BUILDING FEATURES PRIVATE STUDIO APARTMENTS WITH ALL THE COMFORTS OF HOME. EACH APARTMENT INCLUDES FULL KITCHEN AMENITIES, A PRIVATE BATHROOM WITH TUB OR WALK-IN SHOWER, BUILT-IN STORAGE AND AN OPEN FLOOR PLAN. SHARED LAUNDRY FACILITIES AND WELCOMING COMMUNITY SPACES, INCLUDING A COURTYARD LUSH WITH GREENERY, ARE AVAILABLE TO ALL RESIDENTS. CONTROLLED BUILDING ACCESS AND EMERGENCY CALL SYSTEMS IN EVERY APARTMENT PROVIDE ADDITIONAL SAFETY AND SECURITY FOR ALL RESIDENTS.LOCATED IN THE HEART OF THE HISTORIC PIKE PLACE MARKET, MANY OF THE APARTMENTS AT PROVIDENCE VINCENT HOUSE OFFER BEAUTIFUL VIEWS OF ELLIOTT BAY AND THE PUGET SOUND. ADDITIONALLY, RESIDENTS ENJOY ALL THE AMENITIES OF THEIR URBAN LOCATION INCLUDING ACCESS TO THE NEARBY MARKET, SHOPPING, DINING AND ENTERTAINMENT. THE SEATTLE ART MUSEUM AND SEATTLE PUBLIC LIBRARY ARE BOTH WITHIN A FEW BLOCKS OF PROVIDENCE VINCENT HOUSE, AND PUBLIC TRANSPORTATION TO OTHER PARTS OF THE CITY IS PLENTIFUL AND FREQUENT.PROVIDENCE PLACES A HIGH VALUE IN SUPPORTING INDIVIDUAL RESIDENTS AND CREATING A VIBRANT COMMUNITY BY PROVIDING RAISED GARDEN BEDS, A SHARED COMPUTER LAB WITH INTERNET ACCESS, GATHERING SPACES FOR RESIDENT GROUPS, AND A WIDE VARIETY OF SCHEDULED ACTIVITIES INCLUDING EDUCATIONAL AND RECREATIONAL PROGRAMMING. THE SERVICE COORDINATOR HELPS RESIDENTS IDENTIFY AND ACCESS LOCAL RESOURCES AND SERVICES AND ADVOCATES FOR RESIDENTS WHO REQUIRE ASSISTANCE.PROVIDENCE VINCENT HOUSE RECEIVES AN OPERATING SUBSIDY FROM THE UNITED STATES DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD). HUD REQUIREMENTS STATE THAT APPLICANTS FOR HOUSING AT PROVIDENCE VINCENT HOUSE MUST BE AT LEAST 62 YEARS OF AGE AT THE TIME OF APPLICATION AND THEIR ANNUAL INCOME CANNOT EXCEED 50% OF THE AREA MEDIAN INCOME. RESIDENTS PAY APPROXIMATELY 30% OF THEIR MONTHLY INCOME TOWARD THEIR RENT AND UTILITIES.PROVIDENCE VINCENT HOUSE PROVIDES EQUAL HOUSING OPPORTUNITIES FOR ALL PROSPECTIVE TENANTS REGARDLESS OF RACE, COLOR, NATIONAL ORIGIN, RELIGION, SEX, DISABILITY, PARENTAL/FAMILY STATUS, MARITAL STATUS, AGE, ANCESTRY, SEXUAL ORIENTATION, CREED, POLITICAL IDEOLOGY, GENDER IDENTITY OR MEMBERSHIP IN ANY OTHER CLASS OF PERSONS.

    Expenses $766,996 · Revenue $192,938

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Erik Wexler

    PRESIDENT

    Total calculated
    $5,616,067
    From this org
    $0
    From related orgs
    $5,154,374
    Other
    $461,693
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,601,628 related
    Bonus
    $0 + $2,527,326 related
    Other
    $0 + $1,025,420 related
    Deferred
    $0 + $426,357 related
    Nontaxable benefits
    $0 + $35,336 related
    Filer's total
    $0 + $5,616,067 related

  • Greg Hoffman

    TREASURER

    Total calculated
    $3,539,549
    From this org
    $0
    From related orgs
    $3,204,594
    Other
    $334,955
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,088,176 related
    Bonus
    $0 + $2,008,809 related
    Other
    $0 + $107,609 related
    Deferred
    $0 + $297,744 related
    Nontaxable benefits
    $0 + $37,211 related
    Filer's total
    $0 + $3,539,549 related

  • Jo Ann Escasa-Haigh

    FRMR EVP/ASSISTANT TREASURER

    Total calculated
    $3,302,551
    From this org
    $0
    From related orgs
    $3,291,797
    Other
    $10,754
    Hours/week
    0 + 1 related

    Schedule J breakdown matched by us

    Base
    $0 + $44,915 related
    Bonus
    $0 + $1,744,873 related
    Other
    $0 + $1,502,009 related
    Deferred
    $0 + $8,269 related
    Nontaxable benefits
    $0 + $2,485 related
    Filer's total
    $0 + $3,302,551 related

  • Robert Hellrigel

    FRMR EVP CE HOME & COMM CARE

    Total calculated
    $1,695,331
    From this org
    $0
    From related orgs
    $1,695,331
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0 + $344,009 related
    Other
    $0 + $1,351,322 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $1,695,331 related

  • Jim Watson Esq

    FRMR OFF - PSJH SEC./ASST. SEC.

    Total calculated
    $1,115,622
    From this org
    $0
    From related orgs
    $968,691
    Other
    $146,931
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $480,026 related
    Bonus
    $0 + $399,066 related
    Other
    $0 + $89,599 related
    Deferred
    $0 + $107,204 related
    Nontaxable benefits
    $0 + $39,727 related
    Filer's total
    $0 + $1,115,622 related

  • Jamie Goodwin

    SECRETARY

    Total calculated
    $710,701
    From this org
    $0
    From related orgs
    $600,401
    Other
    $110,300
    Hours/week
    1 + 10 related

    Schedule J breakdown matched by us

    Base
    $0 + $288,909 related
    Bonus
    $0 + $247,911 related
    Other
    $0 + $63,581 related
    Deferred
    $0 + $74,547 related
    Nontaxable benefits
    $0 + $35,753 related
    Filer's total
    $0 + $710,701 related

  • Dianna Reely

    CHIEF RESIDENTIAL SRVCS - HCC

    Total calculated
    $583,716
    From this org
    $0
    From related orgs
    $415,415
    Other
    $168,301
    Hours/week
    5 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $300,264 related
    Bonus
    $0 + $100,000 related
    Other
    $0 + $15,151 related
    Deferred
    $0 + $144,077 related
    Nontaxable benefits
    $0 + $24,224 related
    Filer's total
    $0 + $583,716 related

  • John Whipple

    FRMR SECRETARY

    Total calculated
    $541,701
    From this org
    $0
    From related orgs
    $541,701
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $541,701 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $541,701 related

  • Donald Anderson Jr

    FRMR OFF - PSJH ASST. SEC. ENROLL.

    Total calculated
    $323,721
    From this org
    $0
    From related orgs
    $292,875
    Other
    $30,846
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $266,681 related
    Bonus
    $0 + $24,827 related
    Other
    $0 + $1,367 related
    Deferred
    $0 + $15,474 related
    Nontaxable benefits
    $0 + $15,372 related
    Filer's total
    $0 + $323,721 related

  • Mary Lyons PhD

    DIRECTOR

    Total calculated
    $100,085
    From this org
    $0
    From related orgs
    $100,085
    Other
    $0
    Hours/week
    0.5 + 13 related

  • Michael Murphy

    BOARD CHAIR

    Total calculated
    $75,066
    From this org
    $0
    From related orgs
    $75,066
    Other
    $0
    Hours/week
    1 + 26 related

  • Charles Sorenson MD

    DIRECTOR

    Total calculated
    $50,000
    From this org
    $0
    From related orgs
    $50,000
    Other
    $0
    Hours/week
    0.5 + 13 related

  • Isiaah Crawford PhD

    DIRECTOR

    Total calculated
    $50,000
    From this org
    $0
    From related orgs
    $50,000
    Other
    $0
    Hours/week
    0.5 + 14.5 related

  • Richard Blair

    DIRECTOR

    Total calculated
    $50,000
    From this org
    $0
    From related orgs
    $50,000
    Other
    $0
    Hours/week
    0.5 + 13 related

  • Eric Sprunk

    DIRECTOR

    Total calculated
    $40,000
    From this org
    $0
    From related orgs
    $40,000
    Other
    $0
    Hours/week
    0.5 + 13.5 related

  • Mary Beth Kingston

    DIRECTOR

    Total calculated
    $40,000
    From this org
    $0
    From related orgs
    $40,000
    Other
    $0
    Hours/week
    0.5 + 13 related

  • Marvin O'Quinn

    DIRECTOR (PART YEAR)

    Total calculated
    $0
    Hours/week
    0.5 + 12.5 related

  • Sister Carol Pacini Lcm

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 13 related

  • Sister Diane Hejna Csj RN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 13 related

  • Sister Phyllis Hughes Rsm Drph

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 13 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
  • 7 · Other non-fixed payments

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
  • 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. 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. 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, PROVIDENCE HEALTH & SERVICES - WASHINGTON, 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, LINES 4A-B
THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING 2023: JO ANN ESCASA-HAIGH - $811,814. ROBERT HELLRIGEL - $749,861. JOHN WHIPPLE - $539,282. 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: ERIC WEXLER - $366,950. GREG HOFFMAN - $80,207. JO ANN ESCASA-HAIGH - $603,250. ROBERT HELLRIGEL - $568,029. JIM WATSON, ESQ - $64,477. JAMIE GOODWIN - $40,012. DIANNA REELY - $10,711.
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 · PA · 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 ALASKA HOUSE I OWNER LP

    SUPPORTIVE HOUSING · AK

  • 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

  • PROVIDENCE SURGERY CENTER LLC

    AMBULATORY SURGERY CENTER · MT

  • 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

  • SURGERY CENTER AT TANASBOURNE LLC

    AMBULATORY SURGERY CENTER · KS · general or managing partner

  • THE MADISON SPOKANE INN LLC

    HOTEL SERVICES · 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

  • AMERICAN UNITY GROUP LTD

    C · CAPTIVE INSURANCE · BD

  • 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

  • HCSA PROPERTIES LLC

    C · REAL ESTATE RENTAL · WA

  • KENSCI ASIA PACIFIC PTE LTD

    C · HEALTHCARE · SN

  • KENSCI TECH INDIA PRIVATE LIMITED

    C · HEALTHCARE · IN

  • 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

  • PRAIA HEALTH INC

    C · HEALTHCARE · DE

  • 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
2023
Filed
21 October 2024
IRS schema version
2023v5.1
Source object
202443169349304274

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