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← MISSION HOSPITAL REGIONAL MEDICAL CENTER

Form 990 for tax year 2022

Filed by MISSION HOSPITAL REGIONAL MEDICAL CENTER.

Totals

Total revenue
$774,751,919
Total expenses
$766,688,710
Contributions and grants received
$15,209,962
Grants paid
$1,573,358
Program services expenses (Part IX)
$730,483,299
Management and general expenses
$33,880,267
Fundraising expenses
$2,325,144
Program service expenses (Part III)
$730,483,299

Program services were 95.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • JO ANN ESCASA-HAIGH

    ASSISTANT TREASURER

    Total calculated
    $2,193,229
    From this org
    $0
    From related orgs
    $2,157,414
    Other
    $35,815
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $841,148 related
    Bonus
    $0 + $989,404 related
    Other
    $0 + $326,862 related
    Deferred
    $0 + $27,450 related
    Nontaxable benefits
    $0 + $8,365 related
    Filer's total
    $0 + $2,193,229 related

  • SETH TEIGEN

    CHIEF EXECUTIVE, MHRMC

    Total calculated
    $1,036,617
    From this org
    $0
    From related orgs
    $842,251
    Other
    $194,366
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $533,348 related
    Bonus
    $0 + $225,280 related
    Other
    $0 + $83,623 related
    Deferred
    $0 + $155,103 related
    Nontaxable benefits
    $0 + $39,263 related
    Filer's total
    $0 + $1,036,617 related

  • MICHAEL MARINO DO

    FORMER OFF. - SVP, CHIEF MED INFO

    Total calculated
    $1,023,739
    From this org
    $0
    From related orgs
    $1,013,580
    Other
    $10,159
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $457,840 related
    Bonus
    $0 + $230,830 related
    Other
    $0 + $324,910 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $10,159 related
    Filer's total
    $0 + $1,023,739 related

  • JIM WATSON ESQ

    SECRETARY

    Total calculated
    $961,626
    From this org
    $0
    From related orgs
    $837,237
    Other
    $124,389
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $466,229 related
    Bonus
    $0 + $228,525 related
    Other
    $0 + $142,483 related
    Deferred
    $0 + $98,225 related
    Nontaxable benefits
    $0 + $26,164 related
    Filer's total
    $0 + $961,626 related

  • TERRENCE WOOTEN

    FORMER KE - QVMC CE

    Total calculated
    $778,975
    From this org
    $0
    From related orgs
    $636,393
    Other
    $142,582
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $383,887 related
    Bonus
    $0 + $214,403 related
    Other
    $0 + $38,103 related
    Deferred
    $0 + $124,991 related
    Nontaxable benefits
    $0 + $17,591 related
    Filer's total
    $0 + $778,975 related

  • LINDA SIEGLEN

    CHIEF MEDICAL OFFICER HOSPITAL

    Total calculated
    $620,986
    From this org
    $589,422
    From related orgs
    $0
    Other
    $31,564
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $447,857
    Bonus
    $96,848
    Other
    $44,717
    Deferred
    $14,548
    Nontaxable benefits
    $17,016
    Filer's total
    $620,986

  • EILEEN HAUBL

    SVP & CHIEF FINANCIAL OFFICER

    Total calculated
    $592,010
    From this org
    $0
    From related orgs
    $534,924
    Other
    $57,086
    Hours/week
    27.5 + 27.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $411,026 related
    Bonus
    $0 + $107,000 related
    Other
    $0 + $16,898 related
    Deferred
    $0 + $35,796 related
    Nontaxable benefits
    $0 + $21,290 related
    Filer's total
    $0 + $592,010 related

  • JENNIFER CORD

    CHIEF NURSING OFFICER

    Total calculated
    $464,868
    From this org
    $426,301
    From related orgs
    $0
    Other
    $38,567
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $345,654
    Bonus
    $71,909
    Other
    $8,738
    Deferred
    $17,360
    Nontaxable benefits
    $21,207
    Filer's total
    $464,868

  • JOHN MILLER

    MINISTRY CHIEF, PHILANTHROPY OFF.

    Total calculated
    $447,505
    From this org
    $415,128
    From related orgs
    $0
    Other
    $32,377
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $290,050
    Bonus
    $91,288
    Other
    $33,790
    Deferred
    $4,322
    Nontaxable benefits
    $28,055
    Filer's total
    $447,505

  • EVELYN SCHLOSSER

    EXEC DIR ACUTE CARE OPERATIONS

    Total calculated
    $438,808
    From this org
    $400,235
    From related orgs
    $0
    Other
    $38,573
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $302,689
    Bonus
    $64,158
    Other
    $33,388
    Deferred
    $15,918
    Nontaxable benefits
    $22,655
    Filer's total
    $438,808

  • MARK JABLONSKI

    FORMER OFF. - PSJH CMO

    Total calculated
    $380,123
    From this org
    $0
    From related orgs
    $336,522
    Other
    $43,601
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $299,054 related
    Bonus
    $0 + $5,000 related
    Other
    $0 + $32,468 related
    Deferred
    $0 + $26,998 related
    Nontaxable benefits
    $0 + $16,603 related
    Filer's total
    $0 + $380,123 related

  • MARIA LEXA BATAC

    CLINICAL COORDINATOR

    Total calculated
    $320,115
    From this org
    $300,888
    From related orgs
    $0
    Other
    $19,227
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $297,843
    Bonus
    $0
    Other
    $3,045
    Deferred
    $0
    Nontaxable benefits
    $19,227
    Filer's total
    $320,115

  • DHARM PATEL

    SUPERVISOR CLINICAL LAB - THRU 11/22

    Total calculated
    $308,403
    From this org
    $303,983
    From related orgs
    $0
    Other
    $4,420
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $250,150
    Bonus
    $1,587
    Other
    $52,246
    Deferred
    $0
    Nontaxable benefits
    $4,420
    Filer's total
    $308,403

  • DEANNE NIEDZIELA

    FORMER KE - DIR, NURSING

    Total calculated
    $305,266
    From this org
    $257,296
    From related orgs
    $0
    Other
    $47,970
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $227,051
    Bonus
    $27,593
    Other
    $2,652
    Deferred
    $23,692
    Nontaxable benefits
    $24,278
    Filer's total
    $305,266

  • DONALD ANDERSON JR

    ASSISTANT SECRETARY FOR ENROLLMENT

    Total calculated
    $288,175
    From this org
    $0
    From related orgs
    $256,992
    Other
    $31,183
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $219,186 related
    Bonus
    $0 + $36,718 related
    Other
    $0 + $1,088 related
    Deferred
    $0 + $13,600 related
    Nontaxable benefits
    $0 + $17,583 related
    Filer's total
    $0 + $288,175 related

  • STEPHEN TOCCI MD

    TRUSTEE

    Total calculated
    $25,700
    From this org
    $0
    From related orgs
    $25,700
    Other
    $0
    Hours/week
    0.5

  • GINNY RIPSLINGER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • JAIME MUNOZ

    BOARD VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • JAMES R QUANDT

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • LISA PERRINE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • MARCELO MILLS

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • MARK HEBNER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • MELANIE SPENCER-WOLF

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • PATRICIA WALLACE MD

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • REZA DEHKORDI MD

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • SHANNON DWYER ESQ

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • STEVEN PAL

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    1

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, LINE 3
DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY A RELATED TAX-EXEMPT ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE.
PART I, LINES 4A-B
THE FOLLOWING INDIVIDUALS RECIEVED SEVERANCE PAYMENTS DURING 2022: MICHAEL MARINO, D.O. - $100,876 DHARM PATEL - $27,696 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 OF DURING THE CURRENT YEAR: JO ANN ESCASA-HAIGH - $284,024 SETH TEIGEN - $61,983 MICHAEL MARINO, D.O. - $143,774 JIM WATSON, ESQ - $119,387 LINDA SIEGLEN - $7,397 EILEEN HAUBL - $10,748 JENNIFER CORD - $4,679 JOHN MILLER - $2,164 EVELYN SCHLOSSER - $25,352 MARK JABLONSKI - $2,795
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.

Provenance

Return type
form_990
Tax year
2022
Filed
14 November 2023
IRS schema version
2022v5.0
Source object
202323189349316972

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