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Nonprofiteer
← PROVIDENCE HEALTH ASSURANCE

Form 990 for tax year 2022

Filed by PROVIDENCE HEALTH ASSURANCE.

Totals

Total revenue
-$1,390,552
Total expenses
-$114,369
Contributions and grants received
$0
Grants paid
$296,650
Program service revenue
$0
Investment income
-$1,390,552
Other revenue
$0
Total assets, end of year
$369,981,271
Total liabilities, end of year
$308,145,766
Net assets or fund balances, end of year
$61,835,505
Program services expenses (Part IX)
$0
Management and general expenses
-$114,369
Fundraising expenses
$0
Program service expenses (Part III)
not reported

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: MEDICARE REVENUE

    total $786,531,726 · related or exempt $786,531,726

  • 2b · Program service revenue: MEDICAID REVENUE

    total $228,950,995 · related or exempt $228,950,995

  • 2c · Program service revenue: CEDED REINSURANCE

    total -$3,503,374 · related or exempt -$3,503,374

  • 2d · Program service revenue: CEDED REINS TO PHP

    total -$1,011,979,347 · related or exempt -$1,011,979,347

  • 3 · Investment income

    total $1,764,093 · excluded $1,764,093

  • 7a · Gross sales of assets other than inventory

    securities $242,665,091

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

    securities $245,819,736

  • 7c · Gain or loss

    securities -$3,154,645

  • 7d · Net gain or loss

    total -$3,154,645 · excluded -$3,154,645

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $296,650 · program services $296,650

  • 5 · Compensation of officers, directors and key employees

    total $3,496,696 · program services $3,252,304 · management and general $244,392

  • 7 · Other salaries and wages

    total $41,320,029 · program services $38,432,079 · management and general $2,887,950

  • 9 · Other employee benefits

    total $3,125,614 · program services $265,762 · management and general $2,859,852

  • 11b · Fees: legal

    total $128,460 · program services $87,256 · management and general $41,204

  • 11c · Fees: accounting

    total $145,835 · program services $99,058 · management and general $46,777

  • 11f · Fees: investment management

    total -$114,369 · management and general -$114,369

  • 11g · Fees: other

    total $22,417,103 · program services $15,875,246 · management and general $6,541,857

  • 12 · Advertising and promotion

    total $16,516,293 · program services $16,509,977 · management and general $6,316

  • 13 · Office expenses

    total $2,880,155 · program services $2,257,340 · management and general $622,815

  • 14 · Information technology

    total $6,372,512 · program services $4,746,536 · management and general $1,625,976

  • 16 · Occupancy

    total $2,984,415 · program services $1,095,981 · management and general $1,888,434

  • 17 · Travel

    total $135,902 · program services $133,610 · management and general $2,292

  • 19 · Conferences, conventions and meetings

    total $1,030,592 · program services $225,236 · management and general $805,356

  • 21 · Payments to affiliates

    total $1,234,343 · management and general $1,234,343

  • 23 · Insurance

    total $23,308 · management and general $23,308

  • 24a · Other expenses: MEDICAL CLAIMS

    total $895,927,607 · program services $895,927,607

  • 24b · Other expenses: COMMISSIONS AND OTHER

    total $13,943,834 · program services $9,043,853 · management and general $4,899,981

  • 24c · Other expenses: COMMISSIONS CEDED - PHP

    total -$116,051,741 · program services -$92,320,888 · management and general -$23,730,853

  • 24d · Other expenses: MED CLAIMS CEDED TO PHP

    total -$895,927,607 · program services -$895,927,607

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $38,223,207 · end of year $49,179,369

  • 9 · Prepaid expenses and deferred charges

    beginning of year $5,000 · end of year $5,000

  • 11 · Investments: publicly traded securities

    beginning of year $43,745,864 · end of year $41,601,320

  • 15 · Other assets

    beginning of year $242,697,168 · end of year $279,195,582

  • 17 · Accounts payable and accrued expenses

    beginning of year $8,121 · end of year $0

  • 19 · Deferred revenue

    beginning of year $1,104,003 · end of year $980,605

  • 25 · Other liabilities

    beginning of year $258,948,478 · end of year $307,165,161

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $1,670,269 · end of year $2,775,132

  • 31 · Retained earnings, endowment or other funds

    beginning of year $62,940,368 · end of year $59,060,373

Mission and programs · 2022

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 OPROVIDENCEAT 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-REPORT ENVIRONMENTAL, SOCIAL, AND GOVERNANCE STANDARDSPROVIDENCE CONTINUES TO ADVANCE A SOCIAL RESPONSIBILITY FRAMEWORK THAT INCLUDES A STRONGER COMMITMENT TO DIVERSITY, EQUITY, INCLUSION ("DEI"), AND ENVIRONMENTAL STEWARDSHIP. IN 2022, WE ELEVATED THE WORK OF DEI, BY RESTRUCTURING RESOURCES WITH PLANS TO ALIGN AND SCALE DEI STRATEGIES ACROSS THE PROVIDENCE FAMILY OF ORGANIZATIONS. WE CONTINUE TO EXECUTE ON OUR INTEGRATED STRATEGIC & FINANCIAL PLAN WHICH CLEARLY EXPRESSES OUR COMMITMENT AND ACCELERATION OF THIS IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES IN THE COMMUNITIES WE SERVE. PROVIDENCE'S SOCIAL RESPONSIBILITY FRAMEWORK AIMS TO DEPLOY THE ASSETS OF OUR SYSTEM TO SUPPORT COMMUNITY HEALTH IMPROVEMENT, STRENGTHEN LOCAL ECONOMIES AND REDUCE OUR CARBON FOOTPRINT. WE HAVE IMPLEMENTED AN ENVIRONMENTAL STEWARDSHIP SYSTEM STRATEGY THAT ENCOURAGES WASTE REDUCTIONS, EFFICIENT ENERGY AND WATER USAGE, LOCAL AGRICULTURE PARTNERSHIPS, LESS TOXIC AND FEWER CHEMICAL USE, AND A REDUCTION IN CARBON FROM TRAVEL. WE HAVE ALSO HELD ENVIRONMENTAL STEWARDSHIP AS ONE OF THE TOP PRIORITIES FOR OUR LEADERSHIP INCENTIVE PROGRAM TO ENSURE ALIGNMENT AND MOMENTUM CONTINUES. IN APRIL 2022, PROVIDENCE PUBLISHED ITS FIRST ENVIRONMENTAL STEWARDSHIP REPORT, IN WHICH WE REPORTED 12 PERCENT REDUCTION IN CARBON EMISSIONS IN SEVEN KEY CATEGORIES IN OUR ACUTE CARE FACILITIES SINCE OUR 2019 BASELINE. AS OF SEPTEMBER 30, 2022, (THE MOST RECENT DATA AVAILABLE), WE HAVE INCREASED THAT REDUCTION TO 13 PERCENT.

    Grants $296,650

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • DEBRA CANALES

    DIRECTOR

    Total calculated
    $3,808,259
    From this org
    $0
    From related orgs
    $3,335,977
    Other
    $472,282
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,147,661 related
    Bonus
    $0 + $1,738,480 related
    Other
    $0 + $449,836 related
    Deferred
    $0 + $426,885 related
    Nontaxable benefits
    $0 + $45,397 related
    Filer's total
    $0 + $3,808,259 related

  • RHONDA MEDOWS MD

    CHAIR

    Total calculated
    $3,320,750
    From this org
    $0
    From related orgs
    $3,000,545
    Other
    $320,205
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,137,413 related
    Bonus
    $0 + $1,525,631 related
    Other
    $0 + $337,501 related
    Deferred
    $0 + $306,676 related
    Nontaxable benefits
    $0 + $13,529 related
    Filer's total
    $0 + $3,320,750 related

  • DONALD ANTONUCCI

    PRESIDENT/CEO

    Total calculated
    $2,080,373
    From this org
    $0
    From related orgs
    $1,852,789
    Other
    $227,584
    Hours/week
    27 + 28 related

    Schedule J breakdown matched by us

    Base
    $0 + $805,488 related
    Bonus
    $0 + $1,044,679 related
    Other
    $0 + $2,622 related
    Deferred
    $0 + $216,937 related
    Nontaxable benefits
    $0 + $10,647 related
    Filer's total
    $0 + $2,080,373 related

  • ROBERT A GLUCKMAN

    CHIEF MEDICAL OFCR HEALTH PLAN

    Total calculated
    $1,105,301
    From this org
    $0
    From related orgs
    $923,992
    Other
    $181,309
    Hours/week
    18 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $489,418 related
    Bonus
    $0 + $273,012 related
    Other
    $0 + $161,562 related
    Deferred
    $0 + $158,120 related
    Nontaxable benefits
    $0 + $23,189 related
    Filer's total
    $0 + $1,105,301 related

  • MICHAEL G WHITE

    FRMR PRESIDENT/CEO

    Total calculated
    $1,036,155
    From this org
    $0
    From related orgs
    $1,014,618
    Other
    $21,537
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $220,604 related
    Bonus
    $0 + $341,000 related
    Other
    $0 + $453,014 related
    Deferred
    $0 + $16,697 related
    Nontaxable benefits
    $0 + $4,840 related
    Filer's total
    $0 + $1,036,155 related

  • BRADLEY GARRIGUES

    CHIEF SALES-UNDERWRITING OFFCR

    Total calculated
    $706,187
    From this org
    $0
    From related orgs
    $617,363
    Other
    $88,824
    Hours/week
    18 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $281,630 related
    Bonus
    $0 + $291,622 related
    Other
    $0 + $44,111 related
    Deferred
    $0 + $62,460 related
    Nontaxable benefits
    $0 + $26,364 related
    Filer's total
    $0 + $706,187 related

  • NATE PERRIZO

    CHIEF STRA & OPS OFCR PHP - THRU 5/22

    Total calculated
    $664,005
    From this org
    $0
    From related orgs
    $654,189
    Other
    $9,816
    Hours/week
    17 + 33 related

    Schedule J breakdown matched by us

    Base
    $0 + $165,737 related
    Bonus
    $0 + $171,500 related
    Other
    $0 + $316,952 related
    Deferred
    $0 + $1,510 related
    Nontaxable benefits
    $0 + $8,306 related
    Filer's total
    $0 + $664,005 related

  • GREG ZAMUDIO

    SECRETARY

    Total calculated
    $577,519
    From this org
    $0
    From related orgs
    $506,481
    Other
    $71,038
    Hours/week
    17 + 33 related

    Schedule J breakdown matched by us

    Base
    $0 + $303,834 related
    Bonus
    $0 + $141,880 related
    Other
    $0 + $60,767 related
    Deferred
    $0 + $62,724 related
    Nontaxable benefits
    $0 + $8,314 related
    Filer's total
    $0 + $577,519 related

  • PAUL T GIGER

    MED DIRECTOR BEHAVIORAL HEALTH

    Total calculated
    $543,994
    From this org
    $0
    From related orgs
    $471,055
    Other
    $72,939
    Hours/week
    17 + 33 related

    Schedule J breakdown matched by us

    Base
    $0 + $325,846 related
    Bonus
    $0 + $50,250 related
    Other
    $0 + $94,959 related
    Deferred
    $0 + $46,219 related
    Nontaxable benefits
    $0 + $26,720 related
    Filer's total
    $0 + $543,994 related

  • DANIEL W RYAN

    TREASURER/VP

    Total calculated
    $518,218
    From this org
    $0
    From related orgs
    $429,045
    Other
    $89,173
    Hours/week
    17 + 33 related

    Schedule J breakdown matched by us

    Base
    $0 + $269,727 related
    Bonus
    $0 + $136,007 related
    Other
    $0 + $23,311 related
    Deferred
    $0 + $58,855 related
    Nontaxable benefits
    $0 + $30,318 related
    Filer's total
    $0 + $518,218 related

  • LAUREL SOOT

    VP MEDICAL MANAGEMENT PHP

    Total calculated
    $488,781
    From this org
    $0
    From related orgs
    $450,263
    Other
    $38,518
    Hours/week
    17 + 33 related

    Schedule J breakdown matched by us

    Base
    $0 + $336,314 related
    Bonus
    $0 + $100,556 related
    Other
    $0 + $13,393 related
    Deferred
    $0 + $24,084 related
    Nontaxable benefits
    $0 + $14,434 related
    Filer's total
    $0 + $488,781 related

  • STEPHANIE C DREYFUSS

    VP PHP NETWORK DEVELOPMENT

    Total calculated
    $462,132
    From this org
    $0
    From related orgs
    $400,532
    Other
    $61,600
    Hours/week
    17 + 33 related

    Schedule J breakdown matched by us

    Base
    $0 + $291,343 related
    Bonus
    $0 + $83,042 related
    Other
    $0 + $26,147 related
    Deferred
    $0 + $33,040 related
    Nontaxable benefits
    $0 + $28,560 related
    Filer's total
    $0 + $462,132 related

  • CHERYL MORRISON

    COO PHP (PART YEAR)

    Total calculated
    $423,077
    From this org
    $0
    From related orgs
    $300,072
    Other
    $123,005
    Hours/week
    18 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $224,554 related
    Bonus
    $0 + $75,000 related
    Other
    $0 + $518 related
    Deferred
    $0 + $102,717 related
    Nontaxable benefits
    $0 + $20,288 related
    Filer's total
    $0 + $423,077 related

  • THERESA A MUDAY

    MED DIR QUALITY MGMT ADMIN

    Total calculated
    $398,423
    From this org
    $0
    From related orgs
    $359,684
    Other
    $38,739
    Hours/week
    17 + 33 related

    Schedule J breakdown matched by us

    Base
    $0 + $283,419 related
    Bonus
    $0 + $48,404 related
    Other
    $0 + $27,861 related
    Deferred
    $0 + $13,268 related
    Nontaxable benefits
    $0 + $25,471 related
    Filer's total
    $0 + $398,423 related

  • AARON BALS

    CHIEF COMP. /RISK OFC.

    Total calculated
    $379,407
    From this org
    $0
    From related orgs
    $353,853
    Other
    $25,554
    Hours/week
    18 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $278,249 related
    Bonus
    $0 + $74,977 related
    Other
    $0 + $627 related
    Deferred
    $0 + $15,483 related
    Nontaxable benefits
    $0 + $10,071 related
    Filer's total
    $0 + $379,407 related

  • ANDREW TARAB

    VP INFORMATICS PHP

    Total calculated
    $372,765
    From this org
    $0
    From related orgs
    $352,676
    Other
    $20,089
    Hours/week
    17 + 33 related

    Schedule J breakdown matched by us

    Base
    $0 + $260,235 related
    Bonus
    $0 + $73,326 related
    Other
    $0 + $19,115 related
    Deferred
    $0 + $16,130 related
    Nontaxable benefits
    $0 + $3,959 related
    Filer's total
    $0 + $372,765 related

  • MARK JENSEN

    CHIEF SERVICE OPS OFFICER

    Total calculated
    $347,585
    From this org
    $0
    From related orgs
    $301,658
    Other
    $45,927
    Hours/week
    18 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $221,128 related
    Bonus
    $0 + $64,607 related
    Other
    $0 + $15,923 related
    Deferred
    $0 + $30,535 related
    Nontaxable benefits
    $0 + $15,392 related
    Filer's total
    $0 + $347,585 related

  • MICHAEL MATHIAS

    CHIEF INFORMATION OFF. PHP (PT YR)

    Total calculated
    $197,056
    From this org
    $0
    From related orgs
    $152,466
    Other
    $44,590
    Hours/week
    18.5 + 36.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $124,641 related
    Bonus
    $0 + $25,000 related
    Other
    $0 + $2,825 related
    Deferred
    $0 + $34,681 related
    Nontaxable benefits
    $0 + $9,909 related
    Filer's total
    $0 + $197,056 related

  • ISIAAH CRAWFORD PHD

    DIRECTOR

    Total calculated
    $50,000
    From this org
    $0
    From related orgs
    $50,000
    Other
    $0
    Hours/week
    0.5 + 15 related

  • JOSEPH BLANKENSHIP

    DIRECTOR

    Total calculated
    $35,250
    From this org
    $0
    From related orgs
    $35,250
    Other
    $0
    Hours/week
    0.5 + 1 related

  • CECILIA SUN

    DIRECTOR (PART YEAR)

    Total calculated
    $8,750
    From this org
    $0
    From related orgs
    $8,750
    Other
    $0
    Hours/week
    0.5 + 1 related

  • BYRON SCOTT

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1 related

  • HEATH SCHIESSER

    DIRECTOR - THRU 3/22

    Total calculated
    $0
    Hours/week
    0.5 + 1 related

  • KERRY WEEMS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1 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 3
SUPPLEMENTAL COMPENSATION INFORMATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX-EXEMPT PARENT, 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 DURING THE CURRENT YEAR: MICHAEL G. WHITE - $250,546 NATE PERRIZO - $215,518 NONQUALIFIED RETIREMENT PLAN 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: DEBRA CANALES - $396,202 RHONDA MEDOWS, M.D. - $279,201 ROBERT A. GLUCKMAN - $126,584 MICHAEL G. WHITE - $130,372 BRADLEY GARRIGUES - $22,028 NATE PERRIZO - $61,237 GREG ZAMUDIO - $59,185 PAUL T. GIGER - $7,768 LAUREL SOOT - $10,074 STEPHANIE C. DREYFUSS - $5,647
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
2022
Filed
15 November 2023
IRS schema version
2022v5.0
Source object
202303199349311115

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