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Nonprofiteer
← PROVIDENCE ROSSI ASSOCIATION

Form 990 for tax year 2022

Filed by PROVIDENCE ROSSI ASSOCIATION.

Totals

Total revenue
$184,959
Total expenses
$208,772
Contributions and grants received
$126,045
Grants paid
$0
Program service revenue
$51,509
Investment income
$0
Other revenue
$7,405
Total assets, end of year
$499,721
Total liabilities, end of year
$42,402
Net assets or fund balances, end of year
$457,319
Program services expenses (Part IX)
$185,362
Management and general expenses
$23,410
Fundraising expenses
$0
Program service expenses (Part III)
$185,362

Program services were 88.8% 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.

  • 1e · Government grants (contributions)

    $126,045

  • 2a · Program service revenue: TENANT RENTS

    total $51,500 · related or exempt $51,500

  • 2b · Program service revenue: HUD RESERVES INTEREST

    total $9 · related or exempt $9

  • 11a · Other revenue: RESIDENT ACTIVITIES

    total $7,260 · related or exempt $7,260

  • 11b · Other revenue: LAUNDRY & VENDING

    total $145 · related or exempt $145

  • 11e · Other revenue, total

    $7,405

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $40,790 · program services $40,790

  • 9 · Other employee benefits

    total $7,282 · program services $7,282

  • 10 · Payroll taxes

    total $3,036 · program services $3,036

  • 11c · Fees: accounting

    total $11,181 · management and general $11,181

  • 11g · Fees: other

    total $63,435 · program services $63,435

  • 12 · Advertising and promotion

    total $110 · program services $110

  • 13 · Office expenses

    total $4,145 · program services $4,145

  • 16 · Occupancy

    total $23,949 · program services $23,949

  • 19 · Conferences, conventions and meetings

    total $135 · program services $135

  • 21 · Payments to affiliates

    total $12,229 · management and general $12,229

  • 22 · Depreciation, depletion and amortization

    total $36,287 · program services $36,287

  • 23 · Insurance

    total $4,316 · program services $4,316

  • 24a · Other expenses: RESIDENT ACTIVITIES

    total $1,877 · program services $1,877

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $28,176 · end of year $33,638

  • 4 · Accounts receivable

    beginning of year $1,824 · end of year $1,829

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

    $1,297,109

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

    $941,751

  • 10c · Land, buildings and equipment, net

    beginning of year $389,138 · end of year $355,358

  • 15 · Other assets

    beginning of year $98,547 · end of year $108,896

  • 17 · Accounts payable and accrued expenses

    beginning of year $14,287 · end of year $23,566

  • 19 · Deferred revenue

    beginning of year $261 · end of year $249

  • 25 · Other liabilities

    beginning of year $22,004 · end of year $18,587

  • 27 · Net assets without donor restrictions

    beginning of year -$18,200 · end of year -$13,334

  • 28 · Net assets with donor restrictions

    beginning of year $499,333 · end of year $470,653

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 O.PROVIDENCEAT 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.PROGRAM SERVICE ACCOMPLISHMENTSPROVIDE SUBSIDIZED HOUSING WITH APARTMENTS TO LOW INCOME ELDERLY AND PHYSICALLY DISABLED PERSONS.OVERVIEWPROVIDENCE ROSSI HOUSE IS A HIGH-QUALITY, SUPPORTIVE HOUSING PROGRAM SPONSORED, OWNED AND OPERATED BY PROVIDENCE HEALTH & SERVICES. DESIGNED AND BUILT ESPECIALLY FOR LOW-INCOME, AGING SENIORS, PRIVATE APARTMENTS IN TWO ADJACENT BUILDINGS AFFORD ALL THE COMFORTS OF HOME. EACH APARTMENT INCLUDES FULL KITCHEN AMENITIES WITH A DINING AREA, A PRIVATE BATHROOM WITH TUB OR WALK-IN SHOWER, BUILT-IN STORAGE AND AN OPEN FLOOR PLAN. SHARED LAUNDRY FACILITIES AND WELCOMING COMMUNITY SPACES ARE AVAILABLE TO ALL RESIDENTS.LOCATED IN CENTRALIA, WASHINGTON, PROVIDENCE ROSSI HOUSE IS NESTLED AMONG TREES AND METICULOUSLY KEPT GROUNDS NEAR THE CHEHALIS RIVER. PUBLIC TRANSPORTATION PROVIDES EASY ACCESS TO LOCAL DOCTORS' OFFICES, BANKS, GROCERY STORES, CHURCHES AND ENTERTAINMENT. THE COMMUNITY IS A PERFECT CHOICE FOR COMFORTABLE, SECURE AND AFFORDABLE HOUSING FOR SENIORS.PROVIDENCE PLACES A HIGH VALUE IN SUPPORTING INDIVIDUAL RESIDENTS AND CREATING A VIBRANT COMMUNITY BY PROVIDING RAISED GARDEN BEDS, A SHARED COMPUTER STATION WITH INTERNET ACCESS, GATHERING SPACE FOR RESIDENT GROUPS, AND A VARIETY OF SCHEDULED ACTIVITIES INCLUDING EDUCATIONAL AND RECREATIONAL PROGRAMMING. THE SERVICE COORDINATOR HELPS RESIDENTS IDENTIFY AND ACCESS LOCAL RESOURCES AND SERVICES, AND ADVOCATES FOR RESIDENTS WHO NEED ASSISTANCE.PROVIDENCE ROSSI HOUSE RECEIVES AN OPERATING SUBSIDY FROM THE UNITED STATES DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD). HUD REQUIREMENTS STATE THAT APPLICANTS FOR HOUSING AT PROVIDENCE ROSSI HOUSE MUST BE AT LEAST 62 YEARS OF AGE AT THE TIME OF APPLICATION AND THEIR ANNUAL INCOME CANNOT EXCEED 50% OF THE AREA MEDIAN INCOME. RESIDENTS PAY APPROXIMATELY 30% OF THEIR MONTHLY INCOME TOWARD THEIR RENT AND UTILITIES.PROVIDENCE ROSSI HOUSE PROVIDES EQUAL HOUSING OPPORTUNITIES FOR ALL PROSPECTIVE TENANTS REGARDLESS OF RACE, COLOR, NATIONAL ORIGIN, RELIGION, SEX, DISABILITY, PARENTAL/FAMILY STATUS, MARITAL STATUS, AGE, ANCESTRY, SEXUAL ORIENTATION, CREED, POLITICAL IDEOLOGY, GENDER IDENTITY OR MEMBERSHIP IN ANY OTHER CLASS OF PERSONS.

    Expenses $185,362 · Revenue $58,914

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

Listed in Part VII

  • GREG HOFFMAN

    PRESIDENT

    Total calculated
    $2,898,151
    From this org
    $0
    From related orgs
    $2,619,615
    Other
    $278,536
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $919,782 related
    Bonus
    $0 + $1,584,583 related
    Other
    $0 + $115,250 related
    Deferred
    $0 + $253,823 related
    Nontaxable benefits
    $0 + $24,713 related
    Filer's total
    $0 + $2,898,151 related

  • JO ANN ESCASA-HAIGH

    EVP/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

  • MIKE BUTLER

    FRMR PRESIDENT

    Total calculated
    $1,843,534
    From this org
    $0
    From related orgs
    $1,835,706
    Other
    $7,828
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $1,835,706 related
    Deferred
    $0 + $7,828 related
    Nontaxable benefits
    $0
    Filer's total
    $0 + $1,843,534 related

  • ROBERT HELLRIGEL

    EVP CE HOME & COMM CARE - THRU 11/22

    Total calculated
    $1,394,710
    From this org
    $0
    From related orgs
    $1,379,326
    Other
    $15,384
    Hours/week
    4.5 + 50.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $613,354 related
    Bonus
    $0 + $432,607 related
    Other
    $0 + $333,365 related
    Deferred
    $0 + $4,493 related
    Nontaxable benefits
    $0 + $10,891 related
    Filer's total
    $0 + $1,394,710 related

  • JAMIE GOODWIN

    SECRETARY

    Total calculated
    $578,359
    From this org
    $0
    From related orgs
    $508,928
    Other
    $69,431
    Hours/week
    4 + 46 related

    Schedule J breakdown matched by us

    Base
    $0 + $282,542 related
    Bonus
    $0 + $141,967 related
    Other
    $0 + $84,419 related
    Deferred
    $0 + $61,033 related
    Nontaxable benefits
    $0 + $8,398 related
    Filer's total
    $0 + $578,359 related

  • DIANNA REELY

    CHIEF RESIDENTIAL SVCS HCC (PART YR)

    Total calculated
    $383,806
    From this org
    $0
    From related orgs
    $354,554
    Other
    $29,252
    Hours/week
    4.5 + 50.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $276,127 related
    Bonus
    $0 + $71,497 related
    Other
    $0 + $6,930 related
    Deferred
    $0 + $8,221 related
    Nontaxable benefits
    $0 + $21,031 related
    Filer's total
    $0 + $383,806 related

  • CINDY STRAUSS

    FRMR SECRETARY

    Total calculated
    $146,754
    From this org
    $0
    From related orgs
    $146,754
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0 + $146,754 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $146,754 related

  • MARY LYONS PHD

    BOARD CHAIR

    Total calculated
    $75,936
    From this org
    $0
    From related orgs
    $75,936
    Other
    $0
    Hours/week
    1 + 26.5 related

  • RICHARD BLAIR

    DIRECTOR

    Total calculated
    $61,313
    From this org
    $0
    From related orgs
    $61,313
    Other
    $0
    Hours/week
    0.5 + 14.5 related

  • MICHAEL MURPHY

    DIRECTOR

    Total calculated
    $50,668
    From this org
    $0
    From related orgs
    $50,668
    Other
    $0
    Hours/week
    0.5 + 13.5 related

  • CHARLES SORENSON MD

    DIRECTOR

    Total calculated
    $50,000
    From this org
    $0
    From related orgs
    $50,000
    Other
    $0
    Hours/week
    0.5 + 13.5 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

  • CHRISTINA FISHER

    DIRECTOR - THRU 11/22

    Total calculated
    $40,000
    From this org
    $0
    From related orgs
    $40,000
    Other
    $0
    Hours/week
    0.5 + 13.5 related

  • ERIC SPRUNK

    DIRECTOR

    Total calculated
    $40,000
    From this org
    $0
    From related orgs
    $40,000
    Other
    $0
    Hours/week
    0.5 + 13.5 related

  • MARY BETH KINGSTON

    DIRECTOR (PART YEAR)

    Total calculated
    $0
    Hours/week
    0.5 + 12.5 related

  • SISTER CAROL PACINI LCM

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 13.5 related

  • SISTER DIANE HEJNA CSJ RN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 13.5 related

  • SISTER PHYLLIS HUGHES RSM DRPH

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 13.5 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, 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 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 RECEIVED A SEVERANCE PAYMENT DURING THE YEAR: MIKE BUTLER - $1,835,706. ROBERT HELLRIGEL - $95,175. 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: GREG HOFFMAN - $89,848. JO ANN ESCASA-HAIGH - $284,024. ROBERT HELLRIGEL - $165,001. JAMIE GOODWIN - $62,891. DIANNA REELY - $2,874.
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.

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
3 November 2023
IRS schema version
2022v5.0
Source object
202303189349317215

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.