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Nonprofiteer
← COVENANT ACO INC

Form 990 for tax year 2023

Filed by COVENANT ACO INC.

Totals

Total revenue
$486,519
Total expenses
$486,519
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$486,519
Investment income
$0
Other revenue
$0
Total assets, end of year
$5,890,648
Total liabilities, end of year
$6,734,127
Net assets or fund balances, end of year
-$843,479
Program services expenses (Part IX)
$330,720
Management and general expenses
$155,799
Fundraising expenses
$0
Program service expenses (Part III)
$330,720

Program services were 68.0% 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.

  • 2a · Program service revenue: INTERAFFILIATE REVENUE

    total $486,519 · related or exempt $486,519

Functional expenses

Part IX, the statement of functional expenses.

  • 11g · Fees: other

    total $486,519 · program services $330,720 · management and general $155,799

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $2,490,523 · end of year $5,533,936

  • 15 · Other assets

    beginning of year $356,712 · end of year $356,712

  • 17 · Accounts payable and accrued expenses

    beginning of year $608 · end of year $999

  • 19 · Deferred revenue

    beginning of year $3,203,587 · end of year $6,733,128

  • 27 · Net assets without donor restrictions

    beginning of year -$356,960 · end of year -$843,479

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-REPORTENVIRONMENTAL, 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 ACCOMPLISHMENTSCOVENANT ACO, INC., A TEXAS NONPROFIT CORPORATION ("COVENANT ACO"), IS A PHYSICIAN-GOVERNED ENTITY ORGANIZED TO PARTICIPATE AS AN ACCOUNTABLE CARE ORGANIZATION ("ACO") IN THE MEDICARE SHARED SAVINGS PROGRAM ("MSSP"), WHERE GROUPS OF DOCTORS AND OTHER HEALTH CARE PROVIDERS VOLUNTARILY WORK TOGETHER WITH MEDICARE TO GIVE HIGH QUALITY SERVICE TO MEDICARE FEE-FOR-SERVICE BENEFICIARIES. COVENANT ACO AIMS TO IMPROVE PATIENT OUTCOMES AND ENRICH THE HEALTHCARE EXPERIENCE BY PROVIDING BETTER CARE FOR INDIVIDUALS AND LOWERING HEALTHCARE EXPENSES.FOR MORE INFORMATION ABOUT COVENANT ACO, INC., PLEASE VISIT WWW.COVENANTHEALTHPARTNERS.ORGFOR MORE INFORMATION ABOUT PROVIDENCE ST. JOSEPH HEALTH, PLEASE VISIT WWW.PROVIDENCE.OR

    Expenses $330,720 · Revenue $486,519

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

Listed in Part VII

  • Nilesh Patel MD

    BOARD MEMBER

    Total calculated
    $1,056,348
    From this org
    $0
    From related orgs
    $954,028
    Other
    $102,320
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $872,777 related
    Bonus
    $0 + $16,200 related
    Other
    $0 + $65,051 related
    Deferred
    $0 + $65,913 related
    Nontaxable benefits
    $0 + $36,407 related
    Filer's total
    $0 + $1,056,348 related

  • Jason Strefling MD

    BOARD MEMBER

    Total calculated
    $953,345
    From this org
    $0
    From related orgs
    $886,608
    Other
    $66,737
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $856,611 related
    Bonus
    $0 + $5,856 related
    Other
    $0 + $24,141 related
    Deferred
    $0 + $26,330 related
    Nontaxable benefits
    $0 + $40,407 related
    Filer's total
    $0 + $953,345 related

  • Ryan Owen MD

    BOARD MEMBER

    Total calculated
    $815,456
    From this org
    $0
    From related orgs
    $750,749
    Other
    $64,707
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $704,790 related
    Bonus
    $0 + $4,770 related
    Other
    $0 + $41,189 related
    Deferred
    $0 + $29,850 related
    Nontaxable benefits
    $0 + $34,857 related
    Filer's total
    $0 + $815,456 related

  • Richard Henderson MD

    BOARD MEMBER

    Total calculated
    $770,536
    From this org
    $0
    From related orgs
    $683,460
    Other
    $87,076
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $608,700 related
    Bonus
    $0 + $5,500 related
    Other
    $0 + $69,260 related
    Deferred
    $0 + $50,742 related
    Nontaxable benefits
    $0 + $36,334 related
    Filer's total
    $0 + $770,536 related

  • Jeremy Dalton MD

    BOARD MEMBER (PART YEAR)

    Total calculated
    $655,838
    From this org
    $0
    From related orgs
    $606,212
    Other
    $49,626
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $550,298 related
    Bonus
    $0 + $6,000 related
    Other
    $0 + $49,914 related
    Deferred
    $0 + $45,842 related
    Nontaxable benefits
    $0 + $3,784 related
    Filer's total
    $0 + $655,838 related

  • Chetlen Crossnoe MD

    BOARD MEMBER/VICE CHAIR

    Total calculated
    $454,435
    From this org
    $0
    From related orgs
    $431,678
    Other
    $22,757
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $397,415 related
    Bonus
    $0 + $25,587 related
    Other
    $0 + $8,676 related
    Deferred
    $0 + $4,950 related
    Nontaxable benefits
    $0 + $17,807 related
    Filer's total
    $0 + $454,435 related

  • Jeffrey Hannel MD

    BOARD MEMBER

    Total calculated
    $448,615
    From this org
    $0
    From related orgs
    $400,757
    Other
    $47,858
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $249,395 related
    Bonus
    $0 + $34,377 related
    Other
    $0 + $116,985 related
    Deferred
    $0 + $9,900 related
    Nontaxable benefits
    $0 + $37,958 related
    Filer's total
    $0 + $448,615 related

  • Jeremy L Brown MD

    BOARD MEMBER

    Total calculated
    $447,504
    From this org
    $0
    From related orgs
    $375,452
    Other
    $72,052
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $333,850 related
    Bonus
    $0 + $16,801 related
    Other
    $0 + $24,801 related
    Deferred
    $0 + $29,054 related
    Nontaxable benefits
    $0 + $42,998 related
    Filer's total
    $0 + $447,504 related

  • William B Snodgrass MD

    BOARD MEMBER/CHAIR

    Total calculated
    $425,613
    From this org
    $0
    From related orgs
    $383,904
    Other
    $41,709
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $370,434 related
    Bonus
    $0 + $1,800 related
    Other
    $0 + $11,670 related
    Deferred
    $0 + $19,021 related
    Nontaxable benefits
    $0 + $22,688 related
    Filer's total
    $0 + $425,613 related

  • Christopher Collins MD

    BOARD MEMBER

    Total calculated
    $388,859
    From this org
    $0
    From related orgs
    $370,047
    Other
    $18,812
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $307,965 related
    Bonus
    $0 + $3,404 related
    Other
    $0 + $58,678 related
    Deferred
    $0 + $4,950 related
    Nontaxable benefits
    $0 + $13,862 related
    Filer's total
    $0 + $388,859 related

  • Karen Talusan-Soriano MD

    BOARD MEMBER

    Total calculated
    $370,247
    From this org
    $0
    From related orgs
    $306,694
    Other
    $63,553
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $287,830 related
    Bonus
    $0 + $4,100 related
    Other
    $0 + $14,764 related
    Deferred
    $0 + $28,428 related
    Nontaxable benefits
    $0 + $35,125 related
    Filer's total
    $0 + $370,247 related

  • Brent Nall MD

    BOARD MEMBER

    Total calculated
    $366,840
    From this org
    $0
    From related orgs
    $331,682
    Other
    $35,158
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $322,484 related
    Bonus
    $0
    Other
    $0 + $9,198 related
    Deferred
    $0 + $9,900 related
    Nontaxable benefits
    $0 + $25,258 related
    Filer's total
    $0 + $366,840 related

  • Joel Landry

    BOARD MEMBER

    Total calculated
    $314,151
    From this org
    $0
    From related orgs
    $276,429
    Other
    $37,722
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $249,865 related
    Bonus
    $0 + $1,950 related
    Other
    $0 + $24,614 related
    Deferred
    $0 + $24,561 related
    Nontaxable benefits
    $0 + $13,161 related
    Filer's total
    $0 + $314,151 related

  • Marissa Yates MD

    BOARD MEMBER

    Total calculated
    $297,553
    From this org
    $0
    From related orgs
    $259,056
    Other
    $38,497
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $253,476 related
    Bonus
    $0
    Other
    $0 + $5,580 related
    Deferred
    $0 + $8,055 related
    Nontaxable benefits
    $0 + $30,442 related
    Filer's total
    $0 + $297,553 related

  • Angela Ferguson MD

    BOARD MEMBER

    Total calculated
    $251,872
    From this org
    $0
    From related orgs
    $211,917
    Other
    $39,955
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $201,402 related
    Bonus
    $0 + $3,600 related
    Other
    $0 + $6,915 related
    Deferred
    $0 + $16,133 related
    Nontaxable benefits
    $0 + $23,822 related
    Filer's total
    $0 + $251,872 related

  • Joshua Hill MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 1 related

  • Randy Rozean MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Swetha Gadwala MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 1 related

  • Walter Cathey

    CEO (PART YEAR)

    Total calculated
    $1,645,841
    From this org
    $0
    From related orgs
    $1,442,423
    Other
    $203,418
    Hours/week
    18 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $605,945 related
    Bonus
    $0 + $770,228 related
    Other
    $0 + $66,250 related
    Deferred
    $0 + $164,039 related
    Nontaxable benefits
    $0 + $39,379 related
    Filer's total
    $0 + $1,645,841 related

  • John Grigson

    REGIONAL CFO - THRU 3/23

    Total calculated
    $1,057,577
    From this org
    $0
    From related orgs
    $1,026,044
    Other
    $31,533
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $144,524 related
    Bonus
    $0 + $386,296 related
    Other
    $0 + $495,224 related
    Deferred
    $0 + $23,281 related
    Nontaxable benefits
    $0 + $8,252 related
    Filer's total
    $0 + $1,057,577 related

  • Michael Robertson MD

    CEO - THRU 11/23

    Total calculated
    $525,865
    From this org
    $0
    From related orgs
    $486,174
    Other
    $39,691
    Hours/week
    27.5 + 27.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $404,435 related
    Bonus
    $0 + $60,766 related
    Other
    $0 + $20,973 related
    Deferred
    $0 + $7,425 related
    Nontaxable benefits
    $0 + $32,266 related
    Filer's total
    $0 + $525,865 related

  • Adam Spivey

    CFO - THRU 11/23

    Total calculated
    $260,906
    From this org
    $0
    From related orgs
    $229,966
    Other
    $30,940
    Hours/week
    14 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $172,623 related
    Bonus
    $0 + $34,407 related
    Other
    $0 + $22,936 related
    Deferred
    $0 + $3,518 related
    Nontaxable benefits
    $0 + $27,422 related
    Filer's total
    $0 + $260,906 related

  • Kathleen Burrell

    SECR./ASSOCIATE COUNSEL (PART YEAR)

    Total calculated
    $193,718
    From this org
    $0
    From related orgs
    $162,384
    Other
    $31,334
    Hours/week
    7 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $148,491 related
    Bonus
    $0 + $13,427 related
    Other
    $0 + $466 related
    Deferred
    $0 + $7,527 related
    Nontaxable benefits
    $0 + $23,807 related
    Filer's total
    $0 + $193,718 related

  • James Kelly

    FRMR OFF. - VP SENIOR CORP COUNSEL

    Total calculated
    $808,682
    From this org
    $0
    From related orgs
    $704,260
    Other
    $104,422
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $354,037 related
    Bonus
    $0 + $304,115 related
    Other
    $0 + $46,108 related
    Deferred
    $0 + $71,532 related
    Nontaxable benefits
    $0 + $32,890 related
    Filer's total
    $0 + $808,682 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 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 TAX-EXEMPT RELATED 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 INDIVIDUAL RECEIVED SEVERANCE PAYMENTS DURING THE YEAR: JOHN GRIGSON - $388,278 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: WALTER CATHEY - $64,541 JOHN GRIGSON - $56,385 NILESH PATEL, M.D. - $27,632 JASON STREFLING, M.D. - $11,127 RYAN OWEN, M.D. - $9,649 JAMES KELLY - $45,298 RICHARD HENDERSON, M.D. - $14,644 JEREMY DALTON, M.D. - $5,312 MICHAEL ROBERTSON, M.D. - $6,295 JEFFREY HANNEL, M.D. - $929 JEREMY L. BROWN, M.D. - $4,501 WILLIAM B. SNODGRASS, M.D. - $81 BRENT NALL, M.D. - $3,270
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 ENTERPRSES 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
25 October 2024
IRS schema version
2023v5.1
Source object
202443169349303774

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