Skip to content
Nonprofiteer
← PROVIDENCE TRINITYCARE HOSPICE FOUNDATION

Form 990 for tax year 2024

Filed by PROVIDENCE TRINITYCARE HOSPICE FOUNDATION.

Totals

Total revenue
$6,810,071
Total expenses
$6,095,999
Contributions and grants received
$6,080,272
Grants paid
$4,910,135
Program service revenue
$0
Investment income
$797,868
Other revenue
-$68,069
Total assets, end of year
$17,692,583
Total liabilities, end of year
$30,522
Net assets or fund balances, end of year
$17,662,061
Program services expenses (Part IX)
$4,910,135
Management and general expenses
$324,859
Fundraising expenses
$861,005
Program service expenses (Part III)
$4,910,135

Program services were 80.5% 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

    $438,913

  • 1d · Related organizations

    $1,199,868

  • 1f · All other contributions, gifts and grants

    $4,441,491

  • 1g · Noncash contributions included above

    $15,425

  • 3 · Investment income

    total $626,862 · excluded $626,862

  • 7a · Gross sales of assets other than inventory

    securities $171,006

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

    securities $0

  • 7c · Gain or loss

    securities $171,006

  • 7d · Net gain or loss

    total $171,006 · excluded $171,006

  • 8a · Fundraising events: gross income

    $2,665

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

    $438,913

  • 8b · Fundraising events: direct expenses

    $70,734

  • 8c · Net income from fundraising events

    total -$68,069 · excluded -$68,069

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $4,910,135 · program services $4,910,135

  • 7 · Other salaries and wages

    total $654,042 · management and general $155,962 · fundraising $498,080

  • 8 · Pension plan contributions

    total $38,719 · management and general $9,233 · fundraising $29,486

  • 9 · Other employee benefits

    total $205,038 · management and general $48,893 · fundraising $156,145

  • 10 · Payroll taxes

    total $49,020 · management and general $11,689 · fundraising $37,331

  • 11f · Fees: investment management

    total $55,256 · management and general $55,256

  • 11g · Fees: other

    total $57,146 · management and general $13,627 · fundraising $43,519

  • 12 · Advertising and promotion

    total $11,028 · management and general $2,630 · fundraising $8,398

  • 13 · Office expenses

    total $12,108 · management and general $2,887 · fundraising $9,221

  • 16 · Occupancy

    total $26,231 · management and general $6,255 · fundraising $19,976

  • 17 · Travel

    total $18,129 · management and general $4,323 · fundraising $13,806

  • 24a · Other expenses: SPECIAL EVENTS

    total $20,249 · management and general $4,829 · fundraising $15,420

  • 24b · Other expenses: DUES & SUBSCRIPTIONS

    total $1,032 · management and general $246 · fundraising $786

  • 24c · Other expenses: LICENSES AND TAXES

    total $200 · management and general $48 · fundraising $152

  • 24d · Other expenses: MEDICAL SUPPLIES

    total $65 · management and general $15 · fundraising $50

  • 24e · All other expenses

    total $37,601 · management and general $8,966 · fundraising $28,635

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $496,605 · end of year $1,119,931

  • 3 · Pledges and grants receivable

    beginning of year $450,450 · end of year $1,558,221

  • 4 · Accounts receivable

    end of year $185,981

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

    $10,510

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

    $10,510

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $14,483,261 · end of year $14,828,450

  • 15 · Other assets

    beginning of year $522,421 · end of year $0

  • 17 · Accounts payable and accrued expenses

    end of year $13,325

  • 25 · Other liabilities

    beginning of year $102,660 · end of year $17,197

  • 27 · Net assets without donor restrictions

    beginning of year $4,440,981 · end of year $3,815,674

  • 28 · Net assets with donor restrictions

    beginning of year $11,409,096 · end of year $13,846,387

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 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-REPORT THROUGH 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. REALIZING OUR MISSION - PROVIDENCE HOSPICE, PALLIATIVE CARE, AND KIDS CARE WAS ESTABLISHED IN 1977 AS ONE OF THE FIRST HOSPICE PROGRAMS IN THE NATION. SINCE THAT TIME, WE HAVE PROVIDED THE FULL RANGE OF PALLIATIVE CARE, HOSPICE CARE, AND COMPASSIONATE SUPPORT TO MORE THAN 67,000 PATIENTS AND FAMILIES. IN 2001, WE CREATED KIDS CARE TO HELP CHILDREN WITH LIFE-LIMITING ILLNESSES LIVE AS NORMAL LIVES AS POSSIBLE, FOR AS LONG AS POSSIBLE, IN THEIR OWN HOMES. PROVIDENCE KIDS CARE IS THE ONLY DEDICATED PEDIATRIC HOSPICE AND PALLIATIVE CARE PROVIDER SERVING ALL OF LOS ANGELES AND ORANGE COUNTIES.HOSPICE AND KIDS CARE OFFERS COMFORT AND CARE TO PATIENTS AND THE IMMEDIATE AND EXTENDED FAMILY. OUR TEAMS WORK CLOSELY WITH PATIENTS AND FAMILIES TO CARE FOR ALL PEDIATRIC AND ADULT PATIENTS IN THE FAMILIAR AND COMFORTING SURROUNDINGS OF HOME. AT PROVIDENCE HOSPICE, PALLIATIVE CARE AND KIDS CARE, WE UNDERSTAND THE IMPACT OF A SERIOUSLY ILL CHILD OR ADULT ON THE LIFE OF THE ENTIRE FAMILY.THE PALLIATIVE CARE PROGRAM AND THE OUTPATIENT COMMUNITY (IN-HOME) PALLIATIVE CARE PROGRAM BOTH OFFER CARE FROM AN INTERDISCIPLINARY PALLIATIVE CARE-TRAINED TEAM FROM THE TIME OF DIAGNOSIS TO CURE AND SURVIVORSHIP OR TO HOSPICE AND DEATH. THE TEAM INCLUDES A PHYSICIAN, NURSE PRACTITIONER, RN, SOCIAL WORKER AND CHAPLAIN WORKING IN CLOSE COLLABORATION WITH THE PATIENT'S CURATIVE MEDICAL TEAM (MEDICAL ONCOLOGIST, RADIATION ONCOLOGIST, SURGEON, PRIMARY CARE PHYSICIAN, ETC.). NOT ONLY DOES THE TEAM PROVIDE SERVICES AS DESCRIBED BY ESTABLISHED NATIONAL GUIDELINES AND STANDARDS, BUT THEIR PARADIGM OF CARE IS BROADENED BY EMBRACING A RICHER SCOPE OF CARE KNOWN AS "WHOLE PERSON CARE". THIS PRACTICE ESTABLISHES PATIENTS AND FAMILIES AS COLLABORATIVE PARTNERS IN THEIR CARE EXPERIENCE WITH ALIGNED GOALS, MORE SUPPORT, AND THE HEALTH CARE PROVIDERS EXPERIENCING GREATER JOB SATISFACTION WHILE PROVIDING A HIGHER QUALITY CARE. IN 2017, A NEW COMMUNITY PALLIATIVE CARE PROGRAM WAS STARTED IN PARTNERSHIP WITH THE KEIRO ORGANIZATION TO CREATE A REGIONALLY INTEGRATED, PATIENT-CENTERED, CULTURALLY SENSITIVE CARE SERVICE FOR THE JAPANESE AMERICAN AND JAPANESE-SPEAKING COMMUNITY IN LOS ANGELES. DURING 2022, THE IYASHI CARE PROGRAM PROVIDED CARE TO 530 PATIENTS.BEREAVEMENT SUPPORT, VOLUNTEER SERVICES, AND EDUCATION IS PROVIDED TO FAMILIES FOR 13 MONTHS FOLLOWING THE LOSS OF A LOVED ONE ON HOSPICE. ADDITIONALLY, GRIEF SUPPORT AND EDUCATION IS ALSO AVAILABLE TO ANYONE IN NEED IN THE COMMUNITY WHO HAS SUFFERED THE DEATH OF A LOVED ONE FROM ANY CAUSE. PROGRAMS ARE STAFFED BY LICENSED PROFESSIONALS, GRADUATE-LEVEL MENTAL HEALTH INTERNS AND TRAINED VOLUNTEERS. BEREAVEMENT SERVICES SERVE CHILDREN AGE 5 THROUGH ADULT WHETHER OR NOT THEIR LOVED ONE WAS ON HOSPICE SERVICES WITH TRINITYCARE. IN 2024, THE PROGRAM PROVIDED SERVICES TO MORE THAN 3,400 BEREAVED COMMUNITY MEMBERS, WHO RECEIVED SERVICES THAT INCLUDED ONE-ON-ONE SUPPORTIVE EDUCATION, AND PARTICIPATION IN 15 NINE-WEEK LONG SUPPORT GROUPS TO HELP THESE INDIVIDUALS THROUGH THE GRIEVING PROCESS. OUR VOLUNTEERS OFFER COMFORT AND COMPANIONSHIP TO PATIENTS AND FAMILIES ON OUR HOSPICE SERVICE AND IN BEREAVEMENT. PROGRAM VOLUNTEERS ALSO OFFER COMPANIONSHIP, ART PROGRAMS, PET THERAPY, VIRTUAL REALITY, VETERANS' DAY REMEMBRANCE, AND OTHER SERVICES.CONTINUING EDUCATION IS PROVIDED TO OUR CAREGIVERS THROUGH INCOME FROM THE THOUSAND CRANES ENDOWED CHAIR. THIS ENDOWMENT HAS ALSO BEEN USED FOR TRAININGS BY OUR CHIEF MEDICAL OFFICER FOR THE "SEARCH INSIDE YOURSELF" PROGRAM TO HELP FURTHER DEVELOP RESILIENCY AND PROVIDE TECHNIQUES FOR SELF-CARE FOR OUR CAREGIVERS.TO MEET THE FULL SCOPE AND COMPLEXITY OF THE NEEDS OF OUR PATIENTS AND FAMILIES, OUR INTERDISCIPLINARY TEAMS OF PHYSICIANS, REGISTERED NURSES, SOCIAL WORKERS, HOME HEALTH AIDES, NON-DENOMINATIONAL CHAPLAINS, AND VOLUNTEERS ARE UNIQUELY TRAINED TO CARE FOR CHILDREN AND ADULTS AT THE END OF LIFE AND PROVIDE SUPPORT TO THEIR FAMILIES LOVED ONES. OUR CLINICIANS ARE ON-CALL 24 HOURS-A-DAY, 7 DAYS-A-WEEK TO PROVIDE:- PAIN CONTROL, SYMPTOM MANAGEMENT AND END-OF-LIFE COMFORT CARE- AN ON-CALL NURSE, SOCIAL WORKER AND CHAPLAIN- HOSPICE PHYSICIAN CONSULTATION- FAMILY COUNSELING- EMOTIONAL AND SPIRITUAL SUPPORT- HELP IN OBTAINING MEDICINE, SUPPLIES AND EQUIPMENT FOR PATIENTS- ASSISTANCE WITH THE PRACTICAL NEEDS SUCH AS FEEDING AND BATHING- SUPPORTIVE SERVICES FOR SIBLINGS OF PEDIATRIC PATIENTS- GRIEF AND LOSS SUPPORTNO ONE IS TURNED AWAY FROM TRINITYCARE OR PROVIDENCE KIDS CARE FOR A LACK OF INSURANCE OR INABILITY TO PAY.IN 2024, OVER 8,000 INDIVIDUALS AND THEIR FAMILIES WERE SERVED REGARDLESS OF ABILITY TO PAY, WITH APPROXIMATELY 67% OF PATIENT FAMILIES LIVING BELOW THE FEDERAL POVERTY LINE. TRINITYCARE BECAME JOINT COMMISSION CERTIFIED (JAHC0) IN 2020 AND RECEIVED THE HIGHEST CAREGIVER EXPERIENCE SCORES IN THE PROVIDENCE SYSTEM SINCE 2020. WE WERE ABLE TO REDUCE ACUTE CARE ADMISSIONS BY 63% AND DECREASE TOTAL BED DAYS. IN ADDITION, WE REDUCED TOTAL COST OF CARE, AVOIDABLE SPENDING, AND UTILIZATION IN ALL SETTINGS BY 38%.

    Expenses $4,910,135 · Grants $4,910,135

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

Listed in Part VII

  • TERRI P WARREN

    DIRECTOR

    Total calculated
    $945,043
    From this org
    $0
    From related orgs
    $859,148
    Other
    $85,895
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $431,430 related
    Bonus
    $0 + $358,049 related
    Other
    $0 + $69,669 related
    Deferred
    $0 + $69,323 related
    Nontaxable benefits
    $0 + $16,572 related
    Filer's total
    $0 + $945,043 related

  • BRETT BECK

    FRMR OFF. - EXECUTIVE DIRECTOR

    Total calculated
    $262,594
    From this org
    $0
    From related orgs
    $231,569
    Other
    $31,025
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $210,577 related
    Bonus
    $0 + $11,195 related
    Other
    $0 + $9,797 related
    Deferred
    $0 + $12,732 related
    Nontaxable benefits
    $0 + $18,293 related
    Filer's total
    $0 + $262,594 related

  • MATTHEW SCELZA

    EXECUTIVE DIRECTOR

    Total calculated
    $195,521
    From this org
    $0
    From related orgs
    $179,697
    Other
    $15,824
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $173,594 related
    Bonus
    $0 + $5,250 related
    Other
    $0 + $853 related
    Deferred
    $0 + $8,266 related
    Nontaxable benefits
    $0 + $7,558 related
    Filer's total
    $0 + $195,521 related

  • ANGELA PARK SHELDON

    TREASURER

    Total calculated
    $0
    Hours/week
    1

  • DORA DE LA ROSA

    SECRETARY/VICE-CHAIR

    Total calculated
    $0
    Hours/week
    1

  • SCOTT SHARPE

    CHAIR

    Total calculated
    $0
    Hours/week
    1

  • ALEXIS SCHOMER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • ANN POWELL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • DON SHAW

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • FAISAL AHMED DR

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • GAREE GASPERIAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • JIM SALA

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • LYNN TAYLOR

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • MELISSA ROE

    DIRECTOR (PART YEAR)

    Total calculated
    $0
    Hours/week
    0.5

  • NEIL SIEGEL DR

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • NINA PATEL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • ROBERT MCNERNEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • RYAN MANSOUR

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • SUSAN RULE SANDLER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • TOM SULLIVAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

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 OR 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
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 SYSTEM - SOUTHERN CALIFORNIA, 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
NON-QUALIFIED RETIREMENT PLANS 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: TERRI P. WARREN - $65,337.
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

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
13 October 2025
IRS schema version
2024v5.2
Source object
202513179349311471

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.