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← PROVIDENCE GENERAL FOUNDATION

Form 990 for tax year 2022

Filed by PROVIDENCE GENERAL FOUNDATION.

Totals

Total revenue
$4,679,043
Total expenses
$6,306,805
Contributions and grants received
$4,236,908
Grants paid
$4,536,021
Program services expenses (Part IX)
$4,536,021
Management and general expenses
$633,960
Fundraising expenses
$1,136,824
Program service expenses (Part III)
$4,536,021

Program services were 71.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DARREN REDICK

    DIRECTOR - THRU 8/22

    Total calculated
    $0
    Hours/week
    0.5

  • KRISTY CARRINGTON

    DIRECTOR (PART YEAR)

    Total calculated
    $0
    Hours/week
    0.5

  • TARVINDER SINGH MD

    DIRECTOR (PART YEAR)

    Total calculated
    $0
    Hours/week
    0.5

  • TINA GILSON

    CHIEF PHILANTHROPY OFFICER

    Total calculated
    $296,926
    From this org
    $271,999
    From related orgs
    $0
    Other
    $24,927
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $215,512
    Bonus
    $56,285
    Other
    $202
    Deferred
    $24,927
    Nontaxable benefits
    $0
    Filer's total
    $296,926

  • ANDY HALL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • BOB LEACH

    DIRECTOR - THRU 1/22

    Total calculated
    $0
    Hours/week
    0.5

  • CAROL KLEIN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • CHRISTIE TIPTON

    DIRECTOR - THRU 5/22

    Total calculated
    $0
    Hours/week
    0.5

  • DAN GAFFNEY

    BOARD TREASURER

    Total calculated
    $0
    Hours/week
    1

  • DAN HARKINS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • DONNA BJORG

    BOARD SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • DOUG BELL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • GARRY CLARK

    DIRECTOR (PART YEAR)

    Total calculated
    $0
    Hours/week
    0.5

  • JAN GAFFNEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • JEAN MESSNER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • JEFF MITCHELL

    DIRECTOR - THRU 1/22

    Total calculated
    $0
    Hours/week
    0.5

  • LARRY JUBIE

    DIRECTOR - THRU 1/22

    Total calculated
    $0
    Hours/week
    0.5

  • LYNNE HALL

    FIRST VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • MARGARET BAVASI

    SECOND VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • MARK DUFFY

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    1

  • MEL SHELDON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • MICHAEL HOLCOMB

    DIRECTOR (PART YEAR)

    Total calculated
    $0
    Hours/week
    0.5

  • PAUL PITRE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • RAY STEPHANSON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • ROCHELLE LUBBERS

    DIRECTOR - THRU 10/22

    Total calculated
    $0
    Hours/week
    0.5

  • RON BROWN MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • SCOTT MURPHY

    DIRECTOR (PART YEAR)

    Total calculated
    $0
    Hours/week
    0.5

  • SHANNON O'KELLEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • SHIRLEY AYERS

    DIRECTOR - THRU 1/22

    Total calculated
    $0
    Hours/week
    0.5

  • STEVE KLEIN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • SUSIE BLACK

    DIRECTOR (PART YEAR)

    Total calculated
    $0
    Hours/week
    0.5

  • TODD KARR

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

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

  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 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 PROVIDENCE HEALTH & SERVICES - WASHINGTON. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE.
PART I, LINE 4B
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. NO INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR.
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.
SCHEDULE J, PART II
ALL INDIVIDUALS REPORTED ON SCHEDULE J, PART II ARE PAID ENTIRELY BY AN UNRELATED ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON. THE COMPENSATION IS PAID TO INDIVIDUALS FOR THEIR SERVICES PERFORMED FOR THE PROVIDENCE ST. JOSEPH HEALTH SYSTEM, EXCEPT FOR THE CHIEF PHILANTHROPY OFFICER WHOSE COMPENSATION IS FOR THEIR SERVICES TO PROVIDENCE GENERAL FOUNDATION.

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

Provenance

Return type
form_990
Tax year
2022
Filed
25 October 2023
IRS schema version
2022v5.0
Source object
202303169349300105

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