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Nonprofiteer
← ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC

Form 990 for tax year 2024

Filed by ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC.

Totals

Total revenue
$1,461,929,147
Total expenses
$1,587,238,005
Contributions and grants received
$7,810,920
Grants paid
$8,966,476
Program service revenue
$1,398,071,739
Investment income
$39,652,143
Other revenue
$16,394,345
Total assets, end of year
$1,201,322,405
Total liabilities, end of year
$549,388,008
Net assets or fund balances, end of year
$651,934,397
Program services expenses (Part IX)
$1,527,229,684
Management and general expenses
$57,015,623
Fundraising expenses
$2,992,698
Program service expenses (Part III)
$1,527,229,684

Program services were 96.2% 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.

  • 1c · Fundraising events

    $214,580

  • 1d · Related organizations

    $477,307

  • 1e · Government grants (contributions)

    $760,793

  • 1f · All other contributions, gifts and grants

    $6,358,240

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $1,393,297,123 · related or exempt $1,393,297,123

  • 2b · Program service revenue: MOB RENTAL REVENUE

    total $4,240,745 · excluded $4,240,745

  • 2c · Program service revenue: PATHOLOGY & LABORATORY

    total $475,846 · unrelated business $475,846

  • 2d · Program service revenue: OTHER PATIENT REVENUE

    total $58,025 · related or exempt $58,025

  • 3 · Investment income

    total $4,908,433 · unrelated business $26,732 · excluded $4,881,701

  • 7a · Gross sales of assets other than inventory

    securities $10,963,901 · other assets $24,869,350

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

    securities $1,089,541 · other assets $0

  • 7c · Gain or loss

    securities $9,874,360 · other assets $24,869,350

  • 7d · Net gain or loss

    total $34,743,710 · excluded $34,743,710

  • 8a · Fundraising events: gross income

    $132,161

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

    $214,580

  • 8b · Fundraising events: direct expenses

    $238,132

  • 8c · Net income from fundraising events

    total -$105,971 · excluded -$105,971

  • 11a · Other revenue: PHARMACY REVENUE

    total $3,004,196 · related or exempt $3,004,196

  • 11b · Other revenue: CAFETERIA REVENUE

    total $2,132,675 · related or exempt $2,132,675

  • 11c · Other revenue: INTERAFFILIATE REVENUE

    total $1,866,162 · related or exempt $1,866,162

  • 11d · All other revenue

    total $9,497,283 · related or exempt $9,497,283

  • 11e · Other revenue, total

    $16,500,316

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $8,966,476 · program services $8,966,476

  • 7 · Other salaries and wages

    total $518,321,125 · program services $494,529,240 · management and general $22,592,711 · fundraising $1,199,174

  • 8 · Pension plan contributions

    total $30,506,993 · program services $29,106,667 · management and general $1,329,746 · fundraising $70,580

  • 9 · Other employee benefits

    total $67,177,219 · program services $64,093,663 · management and general $2,928,137 · fundraising $155,419

  • 10 · Payroll taxes

    total $37,039,492 · program services $35,339,311 · management and general $1,614,487 · fundraising $85,694

  • 11b · Fees: legal

    total $2,241,562 · program services $2,138,670 · management and general $97,706 · fundraising $5,186

  • 11c · Fees: accounting

    total $1,642 · program services $1,566 · management and general $72 · fundraising $4

  • 11f · Fees: investment management

    total $632,485 · management and general $632,485

  • 11g · Fees: other

    total $238,317,784 · program services $227,378,563 · management and general $10,387,855 · fundraising $551,366

  • 12 · Advertising and promotion

    total $270,268 · program services $257,862 · management and general $11,781 · fundraising $625

  • 13 · Office expenses

    total $15,587,138 · program services $14,871,660 · management and general $679,416 · fundraising $36,062

  • 14 · Information technology

    total $692,732 · program services $660,934 · management and general $30,195 · fundraising $1,603

  • 16 · Occupancy

    total $27,670,068 · program services $26,399,961 · management and general $1,206,090 · fundraising $64,017

  • 17 · Travel

    total $1,200,120 · program services $1,145,032 · management and general $52,311 · fundraising $2,777

  • 19 · Conferences, conventions and meetings

    total $477,376 · program services $455,464 · management and general $20,808 · fundraising $1,104

  • 20 · Interest

    total $14,213,040 · program services $13,560,635 · management and general $619,522 · fundraising $32,883

  • 22 · Depreciation, depletion and amortization

    total $35,442,465 · program services $33,815,591 · management and general $1,544,875 · fundraising $81,999

  • 23 · Insurance

    total $7,210 · program services $6,879 · management and general $314 · fundraising $17

  • 24a · Other expenses: SYSTEM COST ALLOCATION

    total $281,625,195 · program services $268,698,085 · management and general $12,275,550 · fundraising $651,560

  • 24b · Other expenses: MEDICAL SUPPLIES

    total $218,889,920 · program services $218,889,920

  • 24c · Other expenses: HOSPITAL FEE

    total $65,209,303 · program services $65,209,303

  • 24d · Other expenses: UBI TAXES PAID

    total $1,499 · program services $1,431 · management and general $65 · fundraising $3

  • 24e · All other expenses

    total $22,746,893 · program services $21,702,771 · management and general $991,497 · fundraising $52,625

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $16,191,294 · end of year $10,061,346

  • 3 · Pledges and grants receivable

    beginning of year $4,041,055 · end of year $1,965,505

  • 4 · Accounts receivable

    beginning of year $229,906,135 · end of year $197,573,076

  • 7 · Other notes and loans receivable

    beginning of year $634,074 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $21,443,846 · end of year $21,312,098

  • 9 · Prepaid expenses and deferred charges

    beginning of year $2,506,344 · end of year $2,213,874

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

    $1,551,993,332

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

    $962,914,415

  • 10c · Land, buildings and equipment, net

    beginning of year $609,950,841 · end of year $589,078,917

  • 11 · Investments: publicly traded securities

    beginning of year $226,288,583 · end of year $111,837,595

  • 13 · Investments: program-related

    beginning of year $48,728,356 · end of year $46,475,721

  • 15 · Other assets

    beginning of year $233,543,785 · end of year $220,804,273

  • 17 · Accounts payable and accrued expenses

    beginning of year $90,975,920 · end of year $76,143,152

  • 19 · Deferred revenue

    beginning of year $1,481,739 · end of year $249,556

  • 23 · Secured mortgages and notes payable

    beginning of year $2,050,000 · end of year $36,458

  • 25 · Other liabilities

    beginning of year $570,707,305 · end of year $472,958,842

  • 27 · Net assets without donor restrictions

    beginning of year $640,637,480 · end of year $572,638,918

  • 28 · Net assets with donor restrictions

    beginning of year $87,381,869 · end of year $79,295,479

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

  • SEE SCHEDULE O

    Expenses $1,527,229,684 · Grants $8,966,476 · Revenue $1,414,572,055

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

Listed in Part VII

  • LAUREEN DRISCOLL RN

    PRESIDENT

    Total calculated
    $2,396,240
    From this org
    $0
    From related orgs
    $2,086,520
    Other
    $309,720
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,069,196 related
    Bonus
    $0 + $973,551 related
    Other
    $0 + $43,773 related
    Deferred
    $0 + $300,285 related
    Nontaxable benefits
    $0 + $9,435 related
    Filer's total
    $0 + $2,396,240 related

  • MICHAEL KELEMAN

    BOARD MEMBER (PART-YEAR)/RMH CEO

    Total calculated
    $646,232
    From this org
    $0
    From related orgs
    $583,200
    Other
    $63,032
    Hours/week
    54.5 + 0.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $364,512 related
    Bonus
    $0 + $35,000 related
    Other
    $0 + $183,688 related
    Deferred
    $0 + $45,533 related
    Nontaxable benefits
    $0 + $17,499 related
    Filer's total
    $0 + $646,232 related

  • KEITH FLAMER

    BOARD MEMBER

    Total calculated
    $874
    From this org
    $0
    From related orgs
    $874
    Other
    $0
    Hours/week
    0.5

  • ALEX DE MORAES

    BOARD MEMBER - THRU 8/24

    Total calculated
    $0
    Hours/week
    0.5

  • CON HEWITT

    BOARD MEMBER - THRU 12/31/24

    Total calculated
    $0
    Hours/week
    0.5

  • JAMES DEVORE MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5

  • JED WEISSBERG MD

    BOARD MEMBER - THRU 12/31/24

    Total calculated
    $0
    Hours/week
    0.5

  • JENNIELYNN HOLMES

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5

  • JOHN ARYANPUR MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • JUDY COFFEY

    CHAIR

    Total calculated
    $0
    Hours/week
    1

  • PAM KINDIG

    BOARD MEMBER - THRU 12/31/24

    Total calculated
    $0
    Hours/week
    0.5

  • SISTER MARY BERNADETTE MCNULTY

    BOARD MEMBER - THRU 12/31/24

    Total calculated
    $0
    Hours/week
    0.5

  • NATHAN HUSMANN

    CFO/TREASURER - THRU 5/24

    Total calculated
    $1,329,179
    From this org
    $0
    From related orgs
    $1,136,956
    Other
    $192,223
    Hours/week
    27.5 + 27.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $568,543 related
    Bonus
    $0 + $424,809 related
    Other
    $0 + $143,604 related
    Deferred
    $0 + $178,479 related
    Nontaxable benefits
    $0 + $13,744 related
    Filer's total
    $0 + $1,329,179 related

  • OLUYEMI ADEYANJU ESQ

    SECRETARY - THRU 12/24

    Total calculated
    $713,414
    From this org
    $0
    From related orgs
    $701,123
    Other
    $12,291
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $392,524 related
    Bonus
    $0 + $249,513 related
    Other
    $0 + $59,086 related
    Deferred
    $0 + $7,763 related
    Nontaxable benefits
    $0 + $4,528 related
    Filer's total
    $0 + $713,414 related

  • SHELBY ARVESON

    CFO/TREASURER (PART YEAR)

    Total calculated
    $642,555
    From this org
    $0
    From related orgs
    $511,276
    Other
    $131,279
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $396,249 related
    Bonus
    $0 + $30,254 related
    Other
    $0 + $84,773 related
    Deferred
    $0 + $127,421 related
    Nontaxable benefits
    $0 + $3,858 related
    Filer's total
    $0 + $642,555 related

  • DONALD ANDERSON JR

    ASSISTANT SECRETARY FOR ENROLLMENT

    Total calculated
    $335,486
    From this org
    $0
    From related orgs
    $316,554
    Other
    $18,932
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $287,131 related
    Bonus
    $0 + $28,005 related
    Other
    $0 + $1,418 related
    Deferred
    $0 + $14,332 related
    Nontaxable benefits
    $0 + $4,600 related
    Filer's total
    $0 + $335,486 related

  • GARRY OLNEY

    CHIEF EXECUTIVE NOR CA

    Total calculated
    $1,891,041
    From this org
    $0
    From related orgs
    $1,680,593
    Other
    $210,448
    Hours/week
    27.5 + 27.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $648,004 related
    Bonus
    $0 + $475,203 related
    Other
    $0 + $557,386 related
    Deferred
    $0 + $195,060 related
    Nontaxable benefits
    $0 + $15,388 related
    Filer's total
    $0 + $1,891,041 related

  • SCOTT CIESIELSKI

    CHIEF ADMINISTRATIVE OFFICER

    Total calculated
    $695,806
    From this org
    $549,383
    From related orgs
    $119,286
    Other
    $27,137
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $313,669 + $82,367 related
    Bonus
    $62,613
    Other
    $173,101 + $36,919 related
    Deferred
    $12,422 + $2,697 related
    Nontaxable benefits
    $9,874 + $2,144 related
    Filer's total
    $571,679 + $124,127 related

  • AMY HEROLD

    CHIEF MEDICAL OFFICER HOSPITAL

    Total calculated
    $600,447
    From this org
    $419,038
    From related orgs
    $164,908
    Other
    $16,501
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $354,463 + $89,403 related
    Bonus
    $56,733
    Other
    $7,842 + $75,505 related
    Deferred
    $7,947 + $3,187 related
    Nontaxable benefits
    $3,387 + $1,980 related
    Filer's total
    $430,372 + $170,075 related

  • ERIC HODES

    CHIEF MEDICAL OFFICER HOSPITAL

    Total calculated
    $600,221
    From this org
    $563,972
    From related orgs
    $0
    Other
    $36,249
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $479,753
    Bonus
    $76,904
    Other
    $7,315
    Deferred
    $22,127
    Nontaxable benefits
    $14,122
    Filer's total
    $600,221

  • REBECCA ALTHOFF

    ACUTE CARE RN

    Total calculated
    $488,064
    From this org
    $447,834
    From related orgs
    $0
    Other
    $40,230
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $428,658
    Bonus
    $0
    Other
    $19,176
    Deferred
    $37,090
    Nontaxable benefits
    $3,140
    Filer's total
    $488,064

  • DONOVAN TAYLOR

    CHIEF ADMINISTRATIVE OFFICER

    Total calculated
    $416,190
    From this org
    $409,614
    From related orgs
    $0
    Other
    $6,576
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $235,184
    Bonus
    $34,500
    Other
    $139,930
    Deferred
    $4,022
    Nontaxable benefits
    $2,554
    Filer's total
    $416,190

  • TERRENCE WOOTEN

    FORMER CE QVMC

    Total calculated
    $694,493
    From this org
    $0
    From related orgs
    $694,493
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $694,493 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $694,493 related

  • CHARLES KASSIS

    FORMER CE - SONOMA

    Total calculated
    $583,471
    From this org
    $0
    From related orgs
    $583,471
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $583,471 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $583,471 related

  • ROBERTA LUSKIN-HAWK MD

    FRMR CHIEF EXEC EUREKA

    Total calculated
    $221,347
    From this org
    $0
    From related orgs
    $221,347
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $221,347 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $221,347 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. 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. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE PROVIDENCE PROVIDES HOUSING ALLOWANCES RELATED TO RELOCATION OF NEWLY HIRED EMPLOYEES AND CURRENT EMPLOYEES RELOCATING TO A NEW POSITION. PROVIDENCE MAY PAY TEMPORARY LIVING EXPENSES FOR THE ELIGIBLE EMPLOYEE UP TO A MAXIMUM OF 90 CALENDAR DAYS. COVERED EXPENSES INCLUDE RENT (EXCLUDING AMOUNTS WHICH MAY BE PAID IN ORDER TO OCCUPY A NEW PERMANENT RESIDENCE UNTIL TITLE CLEARS), NON-REFUNDABLE SECURITY DEPOSITS AND UTILITIES, INCLUDING HEAT, ELECTRICITY, GAS, WATER, LOCAL INTERNET AND LOCAL TELEPHONE AND GARBAGE SERVICES. THE EXECUTIVE VICE PRESIDENT, CHIEF ADMINISTRATIVE OFFICER OF PROVIDENCE MAY APPROVE TEMPORARY HOUSING ASSISTANCE FOR UP TO SIX MONTHS WHEN FAMILY RELOCATION IS DELAYED TO ACCOMMODATE THE SCHOOL YEAR OR EQUIVALENT CIRCUMSTANCES. ONLY IN EXTENUATING CIRCUMSTANCES IS HOUSING EXTENDED BEYOND THIS SIX-MONTH PERIOD. THE AMOUNTS REPORTED FOR THESE RELOCATION/HOUSING 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
DESCRIPTION OF PROCESS TO REVIEW COMOPENSATION 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 A SEVERANCE PAYMENT IN 2024: TERRENCE WOOTEN - $423,259 CHARLES KASSIS - $451,507 DONOVAN TAYLOR - $138,464 ROBERTA LUSKIN-HAWK, M.D. - $221,347 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: GARRY OLNEY - $153,246 NATHAN HUSMANN - $116,109 OLUYEMI ADEYANJU, ESQ. - $57,718 SCOTT CIESIELSKI - $5,490 TERRENCE WOOTEN - $262,982 AMY HEROLD - $6,200 CHARLES KASSIS - $131,964 REBECCA ALTHOFF - $4,328
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

The 10 largest by cash amount. The API serves every itemized grant.

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
11 November 2025
IRS schema version
2024v5.2
Source object
202523179349305107

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