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Nonprofiteer
← LUBBOCK HERITAGE HOSPITAL LLC

Form 990 for tax year 2023

Filed by LUBBOCK HERITAGE HOSPITAL LLC.

Totals

Total revenue
$89,966,836
Total expenses
$102,203,796
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$74,289,553
Management and general expenses
$27,914,243
Fundraising expenses
$0
Program service expenses (Part III)
$74,289,553

Program services were 72.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • AMY THOMPSON MD

    LUBBOCK AREA MARKET/CEO (PART YEAR)

    Total calculated
    $953,499
    From this org
    $0
    From related orgs
    $820,069
    Other
    $133,430
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $422,604 related
    Bonus
    $0 + $338,984 related
    Other
    $0 + $58,481 related
    Deferred
    $0 + $89,571 related
    Nontaxable benefits
    $0 + $43,859 related
    Filer's total
    $0 + $953,499 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

  • SHELLY HOOK MD

    BOARD MEMBER

    Total calculated
    $551,630
    From this org
    $0
    From related orgs
    $512,039
    Other
    $39,591
    Hours/week
    0.5 + 49.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $290,408 related
    Bonus
    $0
    Other
    $0 + $221,631 related
    Deferred
    $0 + $4,950 related
    Nontaxable benefits
    $0 + $34,641 related
    Filer's total
    $0 + $551,630 related

  • CHETLEN CROSSNOE MD

    BOARD MEMBER

    Total calculated
    $454,435
    From this org
    $0
    From related orgs
    $431,678
    Other
    $22,757
    Hours/week
    0.5 + 49.5 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

  • VANESSA BAYOUTH

    CEO GRACE

    Total calculated
    $428,075
    From this org
    $400,911
    From related orgs
    $0
    Other
    $27,164
    Hours/week
    27.5 + 27.5 related

    Schedule J breakdown matched by us

    Base
    $305,524
    Bonus
    $65,363
    Other
    $30,024
    Deferred
    $4,886
    Nontaxable benefits
    $22,278
    Filer's total
    $428,075

  • RANDALL NICHOLS

    EXECUTIVE DIRECTOR OPERATIONS

    Total calculated
    $300,867
    From this org
    $253,567
    From related orgs
    $0
    Other
    $47,300
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $204,722
    Bonus
    $40,107
    Other
    $8,738
    Deferred
    $7,914
    Nontaxable benefits
    $39,386
    Filer's total
    $300,867

  • MELONIE PIPES

    LUBBOCK AREA CFO - THRU 10/23

    Total calculated
    $256,989
    From this org
    $0
    From related orgs
    $224,492
    Other
    $32,497
    Hours/week
    13 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $165,747 related
    Bonus
    $0 + $35,225 related
    Other
    $0 + $23,520 related
    Deferred
    $0 + $4,139 related
    Nontaxable benefits
    $0 + $28,358 related
    Filer's total
    $0 + $256,989 related

  • JENNIFER BRYAN

    LUBBOCK AREA MARKET/CFO (PART YEAR)

    Total calculated
    $235,862
    From this org
    $0
    From related orgs
    $195,795
    Other
    $40,067
    Hours/week
    8 + 47 related

    Schedule J breakdown matched by us

    Base
    $0 + $169,947 related
    Bonus
    $0 + $22,986 related
    Other
    $0 + $2,862 related
    Deferred
    $0 + $14,949 related
    Nontaxable benefits
    $0 + $25,118 related
    Filer's total
    $0 + $235,862 related

  • KATHLEEN BURRELL

    SECR. CHIEF GOVERNANCE OFF. (PT YR)

    Total calculated
    $193,718
    From this org
    $0
    From related orgs
    $162,384
    Other
    $31,334
    Hours/week
    7.5 + 47.5 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

  • MARLA DANIELS

    CHIEF NURSING OFFICER

    Total calculated
    $177,815
    From this org
    $160,895
    From related orgs
    $0
    Other
    $16,920
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $145,918
    Bonus
    $12,979
    Other
    $1,998
    Deferred
    $4,872
    Nontaxable benefits
    $12,048
    Filer's total
    $177,815

  • MARGARITA CASTRO

    ACUTE CARE CHARGE RN

    Total calculated
    $166,474
    From this org
    $145,292
    From related orgs
    $0
    Other
    $21,182
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $145,292
    Bonus
    $0
    Other
    $0
    Deferred
    $4,470
    Nontaxable benefits
    $16,712
    Filer's total
    $166,474

  • JORDAN THOMPSON

    CLINICAL PHARMACIST

    Total calculated
    $146,948
    From this org
    $132,396
    From related orgs
    $0
    Other
    $14,552
    Hours/week
    50

  • DEBORAH GRASS

    ACUTE CARE CHARGE RN

    Total calculated
    $139,621
    From this org
    $132,412
    From related orgs
    $0
    Other
    $7,209
    Hours/week
    50

  • DERICK HAGGARD MD

    BOARD MEMBER

    Total calculated
    $61,050
    From this org
    $0
    From related orgs
    $61,050
    Other
    $0
    Hours/week
    0.5 + 0.5 related

  • CHAD WHEELER

    BOARD MEMBER

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

  • BECKY GARZA

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • DAN BERMAN MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • JESSIE MENDOZA

    BOARD MEMBER/CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • KEINO MCWHINNEY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • MICHELLE MCCORD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • SYDNEY HOPPER

    BOARD MEMBER - THRU 12/31/23

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — 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, LINES 4A-B
THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR: DEBORAH GRASS - $40,976. ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(III) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. THE FOLLOWING INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR: AMY THOMPSON, M.D. - $53,422 JAMES KELLY - $45,298 SHELLY HOOK, M.D. - $8,434 VANESSA BAYOUTH - $2,204
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.

Provenance

Return type
form_990
Tax year
2023
Filed
1 November 2024
IRS schema version
2023v5.1
Source object
202423169349304322

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

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