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Nonprofiteer
← ST JOSEPH HOME CARE NETWORK

Form 990 for tax year 2023

Filed by ST JOSEPH HOME CARE NETWORK.

Totals

Total revenue
$42,761,229
Total expenses
$45,837,069
Contributions and grants received
$1,723,979
Grants paid
$509
Program service revenue
$41,067,206
Investment income
$10,153
Other revenue
-$40,109
Total assets, end of year
$17,531,793
Total liabilities, end of year
$51,554,479
Net assets or fund balances, end of year
-$34,022,686
Program services expenses (Part IX)
$39,302,955
Management and general expenses
$6,348,298
Fundraising expenses
$185,816
Program service expenses (Part III)
$39,302,955

Program services were 85.7% 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.

  • 1c · Fundraising events

    $105,850

  • 1e · Government grants (contributions)

    $66,234

  • 1f · All other contributions, gifts and grants

    $1,551,895

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $41,067,206 · related or exempt $41,067,206

  • 3 · Investment income

    total $11,709 · excluded $11,709

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

    securities $1,556

  • 7c · Gain or loss

    securities -$1,556

  • 7d · Net gain or loss

    total -$1,556 · excluded -$1,556

  • 8a · Fundraising events: gross income

    $0

  • 8a · Fundraising events: contributions included on line 1c

    $105,850

  • 8b · Fundraising events: direct expenses

    $40,109

  • 8c · Net income from fundraising events

    total -$40,109 · excluded -$40,109

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $509 · program services $509

  • 7 · Other salaries and wages

    total $24,303,030 · program services $20,518,758 · management and general $3,661,291 · fundraising $122,981

  • 8 · Pension plan contributions

    total $557,529 · program services $470,715 · management and general $83,993 · fundraising $2,821

  • 9 · Other employee benefits

    total $160,242 · program services $135,290 · management and general $24,141 · fundraising $811

  • 10 · Payroll taxes

    total $1,846,435 · program services $1,558,923 · management and general $278,168 · fundraising $9,344

  • 11b · Fees: legal

    total $176,286 · program services $176,286

  • 11f · Fees: investment management

    total $2,332 · management and general $2,332

  • 11g · Fees: other

    total $4,378,644 · program services $3,756,344 · management and general $622,013 · fundraising $287

  • 12 · Advertising and promotion

    total $129,615 · program services $111,234 · management and general $18,381

  • 13 · Office expenses

    total $512,766 · program services $440,050 · management and general $72,716

  • 16 · Occupancy

    total $1,209,074 · program services $1,209,074

  • 17 · Travel

    total $644,968 · program services $553,505 · management and general $91,463

  • 19 · Conferences, conventions and meetings

    total $12,510 · program services $10,736 · management and general $1,774

  • 22 · Depreciation, depletion and amortization

    total $23,604 · program services $23,604

  • 23 · Insurance

    total $6,877 · program services $5,902 · management and general $975

  • 24a · Other expenses: SYSTEM COST ALLOCATION

    total $9,796,144 · program services $8,270,767 · management and general $1,475,805 · fundraising $49,572

  • 24b · Other expenses: MEDICAL SUPPLIES

    total $1,968,996 · program services $1,968,996

  • 24c · Other expenses: RECRUITING & RELOCATION

    total $41,780 · program services $35,855 · management and general $5,925

  • 24d · Other expenses: LICENSES AND TAXES

    total $15,192 · program services $13,038 · management and general $2,154

  • 24e · All other expenses

    total $50,536 · program services $43,369 · management and general $7,167

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    end of year $3,551,377

  • 2 · Savings and temporary cash investments

    beginning of year -$24,296,056

  • 4 · Accounts receivable

    beginning of year $24,573,998 · end of year $11,514,450

  • 9 · Prepaid expenses and deferred charges

    beginning of year $17,703 · end of year $17,703

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

    $2,452,700

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

    $1,834,619

  • 10c · Land, buildings and equipment, net

    beginning of year $1,882,766 · end of year $618,081

  • 11 · Investments: publicly traded securities

    end of year $845,770

  • 15 · Other assets

    beginning of year $129,551 · end of year $984,412

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,976,522 · end of year $1,516,671

  • 19 · Deferred revenue

    beginning of year $578,575 · end of year $186,174

  • 25 · Other liabilities

    beginning of year $24,597,375 · end of year $49,851,634

  • 27 · Net assets without donor restrictions

    beginning of year -$26,535,571 · end of year -$36,112,855

  • 28 · Net assets with donor restrictions

    beginning of year $1,691,061 · end of year $2,090,169

Mission and programs · 2023

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 OAT 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 EXECUTE ON OUR INTEGRATED STRATEGIC AND FINANCIAL PLAN, WHICH CLEARLY EXPRESSES OUR COMMITMENT AND ACCELERATION OF THE IMPORTANT WORK TO ADDRESS SOCIAL, RACIAL, AND ECONOMIC DISPARITIES AND REDUCE OUR CARBON FOOTPRINT IN THE COMMUNITIES WE SERVE. PROVIDENCE ADVANCES PROGRESS ON OUR CARBON NEGATIVE GOAL AND IN 2023 WE ESTIMATED THAT WE DECREASED EMISSIONS BY OVER 12 PERCENT COMPARED TO OUR 2019 BASELINE. IN ADDITION, OUR EFFORTS LED TO THE INTRODUCTION OF THE GREEN HOSPITALS ACT, LEGISLATION MODELED AFTER PROVIDENCE THAT WOULD PROVIDE CRITICAL FEDERAL FUNDING TO WEATHERIZE AND MODERNIZE HEALTH CARE FACILITIES. PROVIDENCE COMPLETED A COMPREHENSIVE CLIMATE RESILIENCE PLAN IN ALIGNMENT WITH OUR COMMITMENT TO THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES CLIMATE PLEDGE. WE CONTINUE TO REDUCE GREENHOUSE GAS EMISSIONS WITH A FOCUS ON LED LIGHTING UPGRADES, WATER CONSERVATION, MORE EFFICIENT DELIVERY OF NITROUS OXIDE GAS DURING ANESTHESIA, AND ADVANCING OUR WASTE OPTIMIZATION WORK ACROSS ALL HOSPITALS AND CLINICS.PROGRAM SERVICE ACCOMPLISHMENTSTHE PRIMARY SERVICE PROVIDED BY THE AGENCY IS HOME CARE SERVICES IN THEFORM OF NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, SOCIAL WORK, AID SERVICES, AND HOSPICE SERVICES.FOR MORE INFORMATION ABOUT ST. JOSEPH HOME CARE NETWORK, PLEASE VISIT HTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/NORCAL/ST-JOSEPH-HOME-HEALTH-SONOMA-COUNTY

    Expenses $39,302,955 · Grants $509 · Revenue $41,067,206

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Terrence Wooten

    TRUSTEE - THRU 10/23

    Total calculated
    $947,009
    From this org
    $0
    From related orgs
    $912,433
    Other
    $34,576
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $359,303 related
    Bonus
    $0 + $424,891 related
    Other
    $0 + $128,239 related
    Deferred
    $0 + $9,900 related
    Nontaxable benefits
    $0 + $24,676 related
    Filer's total
    $0 + $947,009 related

  • Terri Warren

    TRUSTEE/PRESIDENT

    Total calculated
    $943,695
    From this org
    $0
    From related orgs
    $705,158
    Other
    $238,537
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $414,738 related
    Bonus
    $0 + $275,000 related
    Other
    $0 + $15,420 related
    Deferred
    $0 + $200,540 related
    Nontaxable benefits
    $0 + $37,997 related
    Filer's total
    $0 + $943,695 related

  • Dianna Reely

    TRUSTEE

    Total calculated
    $583,716
    From this org
    $0
    From related orgs
    $415,415
    Other
    $168,301
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $300,264 related
    Bonus
    $0 + $100,000 related
    Other
    $0 + $15,151 related
    Deferred
    $0 + $144,077 related
    Nontaxable benefits
    $0 + $24,224 related
    Filer's total
    $0 + $583,716 related

  • Mike Clark

    TRUSTEE

    Total calculated
    $46,954
    From this org
    $0
    From related orgs
    $35,668
    Other
    $11,286
    Hours/week
    0.5

  • Janice Burger

    TRUSTEE

    Total calculated
    $21,291
    From this org
    $0
    From related orgs
    $19,454
    Other
    $1,837
    Hours/week
    0.5 + 49.5 related

  • Eddie Swafford

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Jim Zapp

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5 + 1 related

  • Joanne Roberts

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Jody Albright

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Larry Schecter

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Pete Fullerton

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Robert McCann

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Terry Rogers

    CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Tulasi Siddhartha

    TRUSTEE - THRU 5/23

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Oluyemi Adeyanju Esq

    SECRETARY - THRU 4/23

    Total calculated
    $829,721
    From this org
    $0
    From related orgs
    $739,595
    Other
    $90,126
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $388,930 related
    Bonus
    $0 + $301,838 related
    Other
    $0 + $48,827 related
    Deferred
    $0 + $76,133 related
    Nontaxable benefits
    $0 + $13,993 related
    Filer's total
    $0 + $829,721 related

  • Mark Provan

    PRESIDENT - THRU 4/23

    Total calculated
    $608,352
    From this org
    $0
    From related orgs
    $602,960
    Other
    $5,392
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $282,663 related
    Bonus
    $0 + $245,555 related
    Other
    $0 + $74,742 related
    Deferred
    $0 + $1,846 related
    Nontaxable benefits
    $0 + $3,546 related
    Filer's total
    $0 + $608,352 related

  • Malisa Westlund

    TREASURER

    Total calculated
    $506,564
    From this org
    $0
    From related orgs
    $370,244
    Other
    $136,320
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $269,988 related
    Bonus
    $0 + $76,000 related
    Other
    $0 + $24,256 related
    Deferred
    $0 + $115,502 related
    Nontaxable benefits
    $0 + $20,818 related
    Filer's total
    $0 + $506,564 related

  • Donald Anderson Jr

    ASSISTANT SECRETARY FOR ENROLLMENT

    Total calculated
    $323,721
    From this org
    $0
    From related orgs
    $292,875
    Other
    $30,846
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $266,681 related
    Bonus
    $0 + $24,827 related
    Other
    $0 + $1,367 related
    Deferred
    $0 + $15,474 related
    Nontaxable benefits
    $0 + $15,372 related
    Filer's total
    $0 + $323,721 related

  • Celine Regalia

    PRESIDENT - THRU 4/23

    Total calculated
    $257,995
    From this org
    $0
    From related orgs
    $226,240
    Other
    $31,755
    Hours/week
    25 + 25 related

    Schedule J breakdown matched by us

    Base
    $0 + $202,937 related
    Bonus
    $0 + $20,114 related
    Other
    $0 + $3,189 related
    Deferred
    $0 + $10,194 related
    Nontaxable benefits
    $0 + $21,561 related
    Filer's total
    $0 + $257,995 related

  • Rachel Arrington

    SECRETARY (PART YEAR)

    Total calculated
    $103,142
    From this org
    $0
    From related orgs
    $95,446
    Other
    $7,696
    Hours/week
    1 + 49 related

  • Jill Souza

    DIRECTOR PALLIATIVE CARE

    Total calculated
    $281,627
    From this org
    $228,313
    From related orgs
    $0
    Other
    $53,314
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $207,029
    Bonus
    $18,887
    Other
    $2,397
    Deferred
    $20,957
    Nontaxable benefits
    $32,357
    Filer's total
    $281,627

  • Heather Johnson

    MANAGER HOSPICE RN

    Total calculated
    $223,875
    From this org
    $181,911
    From related orgs
    $0
    Other
    $41,964
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $166,534
    Bonus
    $0
    Other
    $15,377
    Deferred
    $15,612
    Nontaxable benefits
    $26,352
    Filer's total
    $223,875

  • Maureen Maloney

    MANAGER HOME HEALTH RN

    Total calculated
    $216,738
    From this org
    $187,411
    From related orgs
    $0
    Other
    $29,327
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $165,734
    Bonus
    $5,568
    Other
    $16,109
    Deferred
    $14,451
    Nontaxable benefits
    $14,876
    Filer's total
    $216,738

  • Kaye Tudorache

    DIRECTOR HOME HEALTH

    Total calculated
    $216,612
    From this org
    $182,245
    From related orgs
    $0
    Other
    $34,367
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $166,343
    Bonus
    $13,312
    Other
    $2,590
    Deferred
    $8,234
    Nontaxable benefits
    $26,133
    Filer's total
    $216,612

  • Erika Keaton

    HOSPICE RN

    Total calculated
    $215,947
    From this org
    $179,670
    From related orgs
    $0
    Other
    $36,277
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $179,548
    Bonus
    $0
    Other
    $122
    Deferred
    $16,120
    Nontaxable benefits
    $20,157
    Filer's total
    $215,947

  • Patti Pilgrim

    FRMR OFF. - CFO/TREASURER

    Total calculated
    $482,134
    From this org
    $0
    From related orgs
    $453,848
    Other
    $28,286
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $138,985 related
    Bonus
    $0 + $277,043 related
    Other
    $0 + $37,820 related
    Deferred
    $0 + $14,850 related
    Nontaxable benefits
    $0 + $13,436 related
    Filer's total
    $0 + $482,134 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 THE YEAR: TERRENCE WOOTEN - $32,558 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 INDIVIDUAL RECEIVED A PAYOUT DURING THE CURRENT YEAR: TERRENCE WOOTEN - $4,006 TERRI WARREN - $11,263 OLUYEMI ADEYANJU, ESQ. - $47,943 MARK PROVAN - $49,324 DIANNA REELY - $10,711 MALISA WESTLUND - $230 PATTI PILGRIM - $13,469
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

  • 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

  • HERITAGE INVESTMENT GROUP I 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

  • 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

  • PERFORMANCE MEDICAL EQUIPMENT & RESPIRATORY SERVICES LLC

    MEDICAL EQUIPMENT · WA · general or managing partner

  • PETCT IMAGING AT SWEDISH CANCER INSTITUTE LLC

    MEDICAL IMAGING · WA · general or managing partner

  • PHS INVESTMENT TRUST SHORT TERM INVESTMENT PORTFOLIO

    INVESTMENTS · WA

  • PROVIDENCE & SCA OFF-CAMPUS HOLDINGS LLC

    MEDICAL · AL

  • PROVIDENCE & SCA ON-CAMPUS HOLDINGS LLC

    MEDICAL · AL · general or managing partner

  • PROVIDENCE ALASKA HOUSE I OWNER LP

    SUPPORTIVE HOUSING · AK

  • 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

  • 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 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

  • ADVATA INC (FKA KENSCI INC)

    C · HEALTHCARE · WA

  • AMERICAN UNITY GROUP LTD

    C · CAPTIVE INSURANCE · BD

  • AYIN HEALTH HOLDINGS INC

    C · HEALTHCARE · DE

  • AYIN HEALTH SOLUTIONS INC

    C · HEALTHCARE · OR

  • BOURGET HEALTH SERVICES INC

    C · CLINICAL/MEDICAL LAB · WA

  • CARON CORPORATION

    C · MEDICAL PHYSICIAN SERVICE · MT

  • CLOUD 21 LIMITED

    C · HEALTHCARE · UK

  • ENDOSCOPY CENTER OF SOUTHERN CALIFORNIA

    S · HEALTHCARE · CA

  • HCSA PROPERTIES LLC

    C · REAL ESTATE RENTAL · WA

  • KENSCI ASIA PACIFIC PTE LTD

    C · HEALTHCARE · SN

  • KENSCI TECH INDIA PRIVATE LIMITED

    C · HEALTHCARE · IN

  • LUBBOCK METHODIST HOSP PRACTICE MGMT

    C · INACTIVE · TX

  • LUBBOCK METHODIST HOSPITAL SVCS

    C · HEALTHCARE · TX

  • MEDICAL SPECIALTIES MANAGERS INC

    C · HEALTHCARE · WA

  • MISSION VIEJO MEDICAL VENTURES INC

    C · HEALTHCARE · CA

  • PHN HOLDINGS

    C · STRATEGIC PLANNING SERVICES · CA

  • PRAIA HEALTH INC

    C · HEALTHCARE · DE

  • 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 ST JOSEPH HEALTH NETWORK

    C · HEALTHCARE · CA

  • PROVSOURCE

    C · HEALTHCARE · DE

  • 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 ENTERPRISES 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 US INC

    C · HOLDING COMPANY · DE

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

    C · HOLDING COMPANY · DE

  • TEGRIA SERVICES GROUP INC (FKA PROVIDENCE SERVICES GROUP)

    C · HOLDING COMPANY · DE

  • TEGRIA SERVICES GROUP-CAN INC

    C · HEALTHCARE · CA

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

    C · HEALTHCARE · WI

  • TRUSANA INC

    C · HEALTHCARE · DE

  • VINSERRA INC

    C · INVESTMENT · CA

  • WEIGHT LOSS INC (FKA HMR WEIGHT MANAGEMENT SERVICES CORP)

    C · HEALTHCARE · WA

Provenance

Return type
form_990
Tax year
2023
Filed
5 November 2024
IRS schema version
2023v5.1
Source object
202443189349306704

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