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Nonprofiteer
← GAMELIN WASHINGTON ASSOCIATION

Form 990 for tax year 2022

Filed by GAMELIN WASHINGTON ASSOCIATION.

Totals

Total revenue
$671,595
Total expenses
$789,022
Contributions and grants received
$502,777
Grants paid
$0
Program service revenue
$154,608
Investment income
$0
Other revenue
$14,210
Total assets, end of year
$3,930,169
Total liabilities, end of year
$81,597
Net assets or fund balances, end of year
$3,848,572
Program services expenses (Part IX)
$713,808
Management and general expenses
$75,214
Fundraising expenses
$0
Program service expenses (Part III)
$713,808

Program services were 90.5% 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.

  • 1e · Government grants (contributions)

    $502,777

  • 2a · Program service revenue: TENANT RENTS

    total $154,597 · related or exempt $154,597

  • 2b · Program service revenue: HUD RESERVES INTEREST

    total $10 · related or exempt $10

  • 2c · Program service revenue: TENANT DEPOSIT INT.

    total $1 · related or exempt $1

  • 11a · Other revenue: RESIDENT ACTIVITIES

    total $13,683 · related or exempt $13,683

  • 11b · Other revenue: LAUNDRY & VENDING

    total $527 · related or exempt $527

  • 11e · Other revenue, total

    $14,210

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $141,734 · program services $141,734

  • 10 · Payroll taxes

    total $20,886 · program services $20,886

  • 11a · Fees: management

    total $11,387 · program services $11,387

  • 11c · Fees: accounting

    total $21,691 · management and general $21,691

  • 11g · Fees: other

    total $120,387 · program services $120,387

  • 12 · Advertising and promotion

    total $160 · program services $160

  • 13 · Office expenses

    total $16,810 · program services $16,810

  • 16 · Occupancy

    total $222,867 · program services $222,867

  • 19 · Conferences, conventions and meetings

    total $348 · program services $348

  • 21 · Payments to affiliates

    total $53,523 · management and general $53,523

  • 22 · Depreciation, depletion and amortization

    total $155,354 · program services $155,354

  • 23 · Insurance

    total $7,044 · program services $7,044

  • 24a · Other expenses: RESIDENT ACTIVITIES

    total $12,416 · program services $12,416

  • 24b · Other expenses: BAD DEBTS

    total $2,220 · program services $2,220

  • 24c · Other expenses: LICENSES AND TAXES

    total $2,195 · program services $2,195

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $87,524 · end of year $82,229

  • 4 · Accounts receivable

    beginning of year $2,306 · end of year $2,826

  • 9 · Prepaid expenses and deferred charges

    end of year $5,389

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

    $6,336,369

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

    $2,712,066

  • 10c · Land, buildings and equipment, net

    beginning of year $3,760,893 · end of year $3,624,303

  • 15 · Other assets

    beginning of year $214,993 · end of year $215,422

  • 17 · Accounts payable and accrued expenses

    beginning of year $23,775 · end of year $30,693

  • 19 · Deferred revenue

    beginning of year $589 · end of year $580

  • 25 · Other liabilities

    beginning of year $75,354 · end of year $50,324

  • 27 · Net assets without donor restrictions

    beginning of year $680,732 · end of year $694,358

  • 28 · Net assets with donor restrictions

    beginning of year $3,285,266 · end of year $3,154,214

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-REPORTENVIRONMENTAL, 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 FOR LOW INCOME ELDERLY AGED 62 AND OLDER IN SEATTLE'S PIKE PLACE MARKET.OVERVIEWPROVIDENCE VINCENT HOUSE IS A HIGH-QUALITY, SUPPORTIVE HOUSING PROGRAM FOUNDED BY THE SISTERS OF PROVIDENCE AND NOW SPONSORED, OWNED AND MANAGED BY PROVIDENCE HEALTH & SERVICES. DESIGNED AND BUILT ESPECIALLY FOR SENIORS, THE BUILDING FEATURES PRIVATE STUDIO APARTMENTS WITH ALL THE COMFORTS OF HOME. EACH APARTMENT INCLUDES FULL KITCHEN AMENITIES, A PRIVATE BATHROOM WITH TUB OR WALK-IN SHOWER, BUILT-IN STORAGE AND AN OPEN FLOOR PLAN. SHARED LAUNDRY FACILITIES AND WELCOMING COMMUNITY SPACES, INCLUDING A COURTYARD LUSH WITH GREENERY, ARE AVAILABLE TO ALL RESIDENTS. CONTROLLED BUILDING ACCESS AND EMERGENCY CALL SYSTEMS IN EVERY APARTMENT PROVIDE ADDITIONAL SAFETY AND SECURITY FOR ALL RESIDENTS.LOCATED IN THE HEART OF THE HISTORIC PIKE PLACE MARKET, MANY OF THE APARTMENTS AT PROVIDENCE VINCENT HOUSE OFFER BEAUTIFUL VIEWS OF ELLIOTT BAY AND THE PUGET SOUND. ADDITIONALLY, RESIDENTS ENJOY ALL THE AMENITIES OF THEIR URBAN LOCATION INCLUDING ACCESS TO THE NEARBY MARKET, SHOPPING, DINING AND ENTERTAINMENT. THE SEATTLE ART MUSEUM AND SEATTLE PUBLIC LIBRARY ARE BOTH WITHIN A FEW BLOCKS OF PROVIDENCE VINCENT HOUSE, AND PUBLIC TRANSPORTATION TO OTHER PARTS OF THE CITY IS PLENTIFUL AND FREQUENT.PROVIDENCE PLACES A HIGH VALUE IN SUPPORTING INDIVIDUAL RESIDENTS AND CREATING A VIBRANT COMMUNITY BY PROVIDING RAISED GARDEN BEDS, A SHARED COMPUTER LAB WITH INTERNET ACCESS, GATHERING SPACES FOR RESIDENT GROUPS, AND A WIDE 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 REQUIRE ASSISTANCE.PROVIDENCE VINCENT 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 VINCENT 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 VINCENT 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 $713,808 · Revenue $168,818

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 & TREASURER

    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/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

  • 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

  • John Whipple

    FRMR OFFICER - PSJH SECRETARY

    Total calculated
    $1,754,801
    From this org
    $0
    From related orgs
    $1,743,754
    Other
    $11,047
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $319,672 related
    Bonus
    $0 + $277,940 related
    Other
    $0 + $1,146,142 related
    Deferred
    $0 + $5,571 related
    Nontaxable benefits
    $0 + $5,476 related
    Filer's total
    $0 + $1,754,801 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

  • Jim Watson Esq

    FRMR OFF - PSJH SEC./ASST. SEC.

    Total calculated
    $961,626
    From this org
    $0
    From related orgs
    $837,237
    Other
    $124,389
    Hours/week
    0 + 55 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

  • 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

  • Donald Anderson Jr

    FRMR OFF - PSJH ASST. SEC. ENROLL.

    Total calculated
    $288,175
    From this org
    $0
    From related orgs
    $256,992
    Other
    $31,183
    Hours/week
    0 + 55 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

  • 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 SEVERANCE PAYMENTS DURING 2022: MIKE BUTLER - $1,835,706. JOHN WHIPPLE - $186,674. 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. JOHN WHIPPLE - $855,652. ROBERT HELLRIGEL - $165,001. JIM WATSON, ESQ - $119,387. 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.

  • 20TH STREET SURGERY LLC

    AMBULATORY SURGERY CENTER · CA

  • BRIDGEPORT MEDICAL IMAGING LLC (BMI)

    IMAGING - DIAGNOSTICS · OR · general or managing partner

  • BROADWAY IMAGING LLC

    MEDICAL IMAGING · MT · general or managing partner

  • CANBY MEDICAL CENTER I LLC

    REAL ESTATE - MOB · OR · general or managing partner

  • CENTER FOR MEDICAL IMAGING LLC (CMI)

    IMAGING - DIAGNOSTICS · OR · general or managing partner

  • CLACKAMAS RADIATION ONCOLOGY CENTER LLC

    RADIATION ONCOLOGY · OR · general or managing partner

  • COASTAL ASC HOLDINGS LLC

    HEALTHCARE · CA · general or managing partner

  • COMPREHENSIVE IMAGING PARTNERS OF ORANGE COUNTY

    HEALTHCARE · CA · general or managing partner

  • COVENANT HIGH PLAINS SURGERY CENTER LLC

    HEALTHCARE · PA · general or managing partner

  • COVENANT PARK PHASE I VENTURE LLC

    REAL ESTATE · TX

  • CSS JV LLC

    AMBULATORY SURGERY CENTER · OR

  • FIRST HILL SURGERY CENTER LLC

    AMBULATORY SURGERY CENTER · WA · general or managing partner

  • FULLERTON SURGICAL CENTER LP

    AMBULATORY SURGERY CENTER · CA · general or managing partner

  • GREATER VALLEY MEDICAL BUILDING LP

    REAL ESTATE - MOB · CA · general or managing partner

  • HCSA PROPERTIES LLC

    REAL ESTATE RENTAL · WA

  • HERITAGE INVESTMENT GROUP I LLC

    INVESTMENTS · CA

  • HOAG ORTHOPEDIC INSTITUTE

    HEALTHCARE · CA

  • HOI ASC HOLDINGS LLC

    INVESTMENTS · CA

  • IMAGING ASSOCIATES LLC

    MEDICAL IMAGING · AK · general or managing partner

  • LSC REAL PROPERTY LLC

    REAL ESTATE · TX · general or managing partner

  • METHODIST DIAGNOSTIC IMAGING

    HEALTHCARE · TX · general or managing partner

  • MISSION VIEJO PARTNERS II LLC

    REAL ESTATE - MOB · CA · general or managing partner

  • NEWPORT IMAGING CENTER

    HEALTHCARE · CA · general or managing partner

  • NORTH OC IMAGING JV HOLDINGS LLC

    HEALTHCARE · CA

  • OREGON ADVANCED IMAGING LLC

    MEDICAL IMAGING · OR · general or managing partner

  • PAVILION SURGERY CENTER LLC

    AMBULATORY SURGERY CENTER · CA

  • PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC

    MEDICAL IMAGING · WA · general or managing partner

  • PERFORMANCE MEDICAL EQUIPMENT & RESPIRATORY SERVICES LLC

    MEDICAL EQUIPMENT · WA · general or managing partner

  • PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO

    INVESTMENTS · WA

  • PROVIDENCE ALASKA HOUSE I OWNER LP

    SUPPORTIVE HOUSING · AK

  • PROVIDENCE & SCA OFF-CAMPUS HOLDINGS LLC

    MEDICAL · AL

  • PROVIDENCE & SCA ON-CAMPUS HOLDINGS LLC

    MEDICAL · AL · general or managing partner

  • PROVIDENCE HOUSE OAKLAND LP

    SUPPORTIVE HOUSING · CA · general or managing partner

  • PROVIDENCE IMAGING CENTER JOINT VENTURE

    MEDICAL IMAGING · AK

  • PROVIDENCE ST JOSEPH HEALTH LONG TERM PORTFOLIO

    INVESTMENTS · WA

  • PROVIDENCE SURGERY CENTER LLC

    AMBULATORY SURGERY CENTER · MT

  • PROVIDENCEUSP SPOKANE SURGERY CENTERS LLC

    AMBULATORY SURGERY CENTER · WA

  • PROVIDENCEUSP SURGERY CTRS LLC

    AMBULATORY SURGERY CENTER · CA

  • RADIATION THERAPY INNOVATIONS LLC

    HEALTHCARE · WA · general or managing partner

  • RIVERSIDE HEALTHCARE

    HEALTHCARE · MN · general or managing partner

  • SJO ASC HOLDINGS LLC

    HEALTHCARE · CA

  • ST JOSEPH PHYSICIAN VENTURES I LLC

    REAL ESTATE · CA · general or managing partner

  • ST JOSEPHSATELLITE DIALYSIS CENTERS LLC

    HEALTHCARE · CA

  • ST JUDE SURGICAL CENTERS LLC

    AMBULATORY SURGERY CENTER · CA · general or managing partner

  • ST MARY MEDICAL CENTER LLC

    HEALTHCARE · CA

  • ST PETER-SOUTH SOUND REGIONAL MRI CENTER

    MEDICAL IMAGING · WA · general or managing partner

  • SURGERY CENTER AT TANASBOURNE LLC

    AMBULATORY SURGERY CENTER · KS · general or managing partner

  • THE MADISON SPOKANE INN LLC

    HOTEL SERVICES · WA · general or managing partner

  • WON-ONC LLC

    REAL ESTATE - MOB · WA · general or managing partner

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • 1221 MADISON STREET OWNERS ASSOC

    C · OWNERS' ASSOCIATION · WA

  • ACCLARA SOLUTIONS GROUP LLC

    C · HOLDING COMPANY · TX

  • ACCLARA SOLUTIONS INTERMEDIATE LLC

    C · HEALTHCARE FINANCIAL SERVICES · TX

  • ADVATA INC (FKA KENSCI INC)

    C · HEALTHCARE · WA

  • AMERICAN UNITY GROUP LTD

    C · CAPTIVE INSURANCE · BD

  • AYIN HEALTH SOLUTIONS INC

    C · HEALTHCARE · DE

  • BOURGET HEALTH SERVICES INC

    C · CLINICAL/MEDICAL LAB · WA

  • CARON CORPORATION

    C · MEDICAL PHYSICIAN SERVICE · MT

  • CLOUD 21 LIMITED

    C · HEALTHCARE · UK

  • COLBURN HILL GROUP INC

    C · HEALTHCARE · DE

  • ENDOSCOPY CENTER OF SOUTHERN CALIFORNIA

    S · HEALTHCARE · CA

  • HMR WEIGHT MANAGEMENT SERVICES CORP

    C · HEALTHCARE · WA

  • HOAG MANAGEMENT SERVICES INC

    C · HEALTHCARE · CA

  • HOAG PHYSICIAN PARTNERS

    C · HEALTHCARE · CA

  • KENSCI TECH INDIA PRIVATE LIMITED

    C · HEALTHCARE · IN

  • KENSCI ASIA PACIFIC PTE LTD

    C · HEALTHCARE · SN

  • LUBBOCK METHODIST HOSP PRACTICE MGMT

    C · INACTIVE · TX

  • LUBBOCK METHODIST HOSPITAL SVCS

    C · HEALTHCARE · TX

  • LUMEDIC INC (FKA LUMEDIC ACQ CO INC)

    C · HEALTHCARE · WA

  • MEDICAL SPECIALTIES MANAGERS INC

    C · HEALTHCARE · WA

  • MISSION VIEJO MEDICAL VENTURES INC

    C · HEALTHCARE · CA

  • PERFORMANCE HEALTH TECHNOLOGY LTD

    C · HEALTHCARE · OR

  • PHN HOLDINGS

    C · STRATEGIC PLANNING SERVICES · CA

  • PROVIDENCE ASSURANCE INC

    C · CAPTIVE INSURANCE · AZ

  • PROVIDENCE GLOBAL CENTER LLP

    C · IT SVCS · IN

  • PROVIDENCE HEALTH CARE VENTURES INC

    C · CLINICAL/MEDICAL LAB · WA

  • PROVIDENCE HEALTH NETWORK

    C · PREPAID HEALTHCARE · CA

  • PROVIDENCE PARTNERS HOLDINGS INC

    C · INVESTMENT · DE

  • PROVIDENCE PHYSICIAN SERVICES CO

    C · HEALTHCARE · WA

  • PROVIDENCE RE

    C · INVESTMENT · CJ

  • PROVIDENCE ST JOSEPH HEALTH NETWORK

    C · HEALTHCARE · CA

  • QUIVIQ INC

    C · HEALTHCARE ANALYTICS · WA

  • ST JOSEPH HEALTH

    C · HOLDING COMPANY · CA

  • ST JOSEPH HEALTH SOURCE INC

    C · HEALTHCARE · CA

  • ST JOSEPH MEDICAL PLAZA ASSOCIATION

    C · CONDO ASSOCIATION · CA

  • ST JOSEPH PROF SVCS ENTERPRSES INC

    C · HEALTHCARE · CA

  • TEGRIA HOLDINGS LLC (FKA GRADY BLOCKER LLC)

    C · HOLDING COMPANY · DE

  • TEGRIA INSIGHTS GROUP HOLDINGS INC

    C · HOLDING COMPANY · WA

  • TEGRIA INSIGHTS GROUP INC

    C · HEALTHCARE · WA

  • TEGRIA PRODUCTS GROUP INC

    C · HOLDING COMPANY · DE

  • TEGRIA RCM GROUP INC (FKA PROV RCM GROUP INC)

    C · HOLDING COMPANY · DE

  • TEGRIA RCM GROUP US INC

    C · HOLDING COMPANY · DE

  • TEGRIA SERVICES GROUP-CAN INC

    C · HEALTHCARE · CA

  • TEGRIA SERVICES GROUP INC (FKA PROVIDENCE SERVICES GROUP)

    C · HOLDING COMPANY · DE

  • TEGRIA SERVICES GROUP-US INC (FKA BLUETREE NETWORK INC)

    C · HEALTHCARE · WI

  • TRUSANA INC

    C · HEALTHCARE · DE

  • VINSERRA INC

    C · INVESTMENT · CA

Provenance

Return type
form_990
Tax year
2022
Filed
3 November 2023
IRS schema version
2022v5.0
Source object
202323189349317407

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