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← PROVIDENCE HOSPITAL

Form 990 for tax year 2023

Filed by PROVIDENCE HOSPITAL.

Totals

Total revenue
$8,019,009
Total expenses
$16,207,595
Contributions and grants received
$77,617
Grants paid
$57,059
Program service revenue
$6,741,748
Investment income
$0
Other revenue
$1,199,644
Total assets, end of year
$6,140,498
Total liabilities, end of year
$13,395,707
Net assets or fund balances, end of year
-$7,255,209
Program services expenses (Part IX)
$10,984,168
Management and general expenses
$5,223,427
Fundraising expenses
$0
Program service expenses (Part III)
$10,984,168

Program services were 67.8% 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.

  • 1a · Federated campaigns

    $0

  • 1b · Membership dues

    $0

  • 1c · Fundraising events

    $0

  • 1d · Related organizations

    $0

  • 1e · Government grants (contributions)

    $77,617

  • 1f · All other contributions, gifts and grants

    $0

  • 2a · Program service revenue: Services to Affiliates

    total $5,620,232 · related or exempt $5,620,232

  • 2b · Program service revenue: Net Patient Service Revenue

    total $680,206 · related or exempt $680,206

  • 2c · Program service revenue: Contracted Services Revenue

    total $587,024 · related or exempt $587,024

  • 2d · Program service revenue: Interest Income from Patient Accounts

    total $286 · related or exempt $286

  • 2e · Program service revenue: Income from Joint Ventures

    total -$146,000 · related or exempt -$146,000

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $0 · excluded $0

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0 · excluded $0

  • 5 · Royalties

    total $0 · excluded $0

  • 6a · Gross rents

    real property $1,112,511 · personal property $0

  • 6b · Less rental expenses

    real property $0 · personal property $0

  • 6c · Rental income or loss

    real property $1,112,511 · personal property $0

  • 6d · Net rental income or loss

    total $1,112,511 · excluded $1,112,511

  • 7a · Gross sales of assets other than inventory

    securities $0 · other assets $0

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

    securities $0 · other assets $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 7d · Net gain or loss

    total $0 · excluded $0

  • 8a · Fundraising events: gross income

    $0

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

    $0

  • 8b · Fundraising events: direct expenses

    $0

  • 8c · Net income from fundraising events

    total $0 · excluded $0

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0 · excluded $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $0

  • 10c · Net income from sales of inventory

    total $0 · excluded $0

  • 11a · Other revenue: Cafeteria/Vending Revenue

    total $86,612 · excluded $86,612

  • 11b · Other revenue: Late Penalty Fees

    total $846 · excluded $846

  • 11c · Other revenue: Medical Records Fees

    total $60 · related or exempt $60

  • 11d · All other revenue

    total -$385 · related or exempt -$880 · unrelated business $0 · excluded $495

  • 11e · Other revenue, total

    $87,133

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $57,059 · program services $57,059

  • 7 · Other salaries and wages

    total $6,514,363 · program services $5,152,137 · management and general $1,362,226

  • 9 · Other employee benefits

    total $581,131 · program services $459,610 · management and general $121,521

  • 10 · Payroll taxes

    total $516,913 · program services $408,821 · management and general $108,092

  • 11b · Fees: legal

    total $321,145 · management and general $321,145

  • 11c · Fees: accounting

    total $5,750 · management and general $5,750

  • 11g · Fees: other

    total $710,262 · program services $909 · management and general $709,353 · fundraising $0

  • 13 · Office expenses

    total $102,409 · program services $2,565 · management and general $99,844

  • 14 · Information technology

    total $35,493 · management and general $35,493

  • 16 · Occupancy

    total $4,339,760 · program services $3,432,268 · management and general $907,492

  • 17 · Travel

    total $528 · management and general $528

  • 19 · Conferences, conventions and meetings

    total $1,349 · program services $1,349

  • 23 · Insurance

    total $1,119,548 · program services $1,007,593 · management and general $111,955

  • 24a · Other expenses: Purchased Services

    total $1,061,225 · program services $440,578 · management and general $620,647

  • 24b · Other expenses: Record Retention Expenses

    total $177,423 · management and general $177,423

  • 24c · Other expenses: Medical Supplies

    total $79,332 · program services $22,209 · management and general $57,123

  • 24d · Other expenses: Minor Equipment

    total $69,420 · program services $67 · management and general $69,353

  • 24e · All other expenses

    total $514,485 · program services -$997 · management and general $515,482 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $202 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $499,294 · end of year $79,631

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $1,073,674 · end of year $925,544

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $89,602 · end of year $54,101

  • 9 · Prepaid expenses and deferred charges

    beginning of year $0 · end of year $0

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

    $150,052,177

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

    $150,021,338

  • 10c · Land, buildings and equipment, net

    beginning of year $75,756 · end of year $30,839

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $3,672,222 · end of year $2,564,534

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $1,014,863 · end of year $2,485,849

  • 17 · Accounts payable and accrued expenses

    beginning of year $10,501,748 · end of year $10,161,335

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $2,617,608 · end of year $3,234,372

  • 27 · Net assets without donor restrictions

    beginning of year -$6,693,743 · end of year -$7,255,209

  • 28 · Net assets with donor restrictions

    beginning of year $0 · end of year $0

Mission and programs · 2023

Mission

ROOTED IN THE LOVING MINISTRY OF JESUS AS HEALER, WE COMMIT OURSELVES TO SERVING ALL PERSONS WITH SPECIAL ATTENTION TO THOSE WHO ARE POOR AND VULNERABLE. OUR CATHOLIC HEALTH MINISTRY IS DEDICATED TO SPIRITUALLY-CENTERED, HOLISTIC CARE WHICH SUSTAINS AND IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES. WE ARE ADVOCATES FOR A COMPASSIONATE AND JUST SOCIETY THROUGH OUR ACTIONS AND OUR WORDS.

Activities or mission (Part I)

To improve the health and well-being of all people in the communities we serve.

  • THE FILING ORGANIZATION IS A PART OF THE ASCENSION CATHOLIC HEALTH MINISTRY. ASCENSION IS A FAITH-BASED HEALTHCARE ORGANIZATION THAT DELIVERS PERSONALIZED, COMPASSIONATE CARE TO ALL, ESPECIALLY TO THOSE WHO NEED IT THE MOST. AS A MEMBER OF ASCENSION HEALTH, THE NATION'S LARGEST CATHOLIC HEALTHCARE SYSTEM, PROVIDENCE HOSPITAL CONTINUES TO BUILD AND STRENGTHEN SUSTAINABLE COLLABORATIVE EFFORTS THAT BENEFIT THE HEALTH OF INDIVIDUALS, FAMILIES AND SOCIETY AS A WHOLE. THE GOAL OF PROVIDENCE HOSPITAL IS TO PERPETUATE THE HEALING MISSION OF THE CHURCH.

    Expenses $10,984,168 · Grants $57,059 · Revenue $6,740,928

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

Listed in Part VII

  • MITCHELL G LOMAX

    DIRECTOR/CFO, MINISTRY MARKET

    Total calculated
    $453,541
    From this org
    $0
    From related orgs
    $402,645
    Other
    $50,896
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $304,685 related
    Bonus
    $0 + $94,554 related
    Other
    $0 + $3,406 related
    Deferred
    $0 + $20,036 related
    Nontaxable benefits
    $0 + $30,860 related
    Filer's total
    $0 + $453,541 related

  • WILLIAM B HIGGINBOTHAM

    DIRECTOR/INTERIM PRES & CEO (END 9/2023)/PRES & CEO (START 9/2023)

    Total calculated
    $503,708
    From this org
    $0
    From related orgs
    $452,658
    Other
    $51,050
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $383,633 related
    Bonus
    $0 + $65,000 related
    Other
    $0 + $4,025 related
    Deferred
    $0 + $20,888 related
    Nontaxable benefits
    $0 + $30,162 related
    Filer's total
    $0 + $503,708 related

  • PETER M LEIBOLD

    DIRECTOR

    Total calculated
    $2,349,185
    From this org
    $0
    From related orgs
    $2,301,991
    Other
    $47,194
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $602,487 related
    Bonus
    $0 + $1,530,612 related
    Other
    $0 + $168,892 related
    Deferred
    $0 + $18,150 related
    Nontaxable benefits
    $0 + $29,044 related
    Filer's total
    $0 + $2,349,185 related

  • ASIM HARACIC MD

    PHYSICIAN

    Total calculated
    $430,432
    From this org
    $390,021
    From related orgs
    $0
    Other
    $40,411
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $385,140
    Bonus
    $0
    Other
    $4,881
    Deferred
    $11,550
    Nontaxable benefits
    $28,861
    Filer's total
    $430,432

  • BINDU C JOSEPH MD

    PHYSICIAN

    Total calculated
    $462,572
    From this org
    $436,149
    From related orgs
    $0
    Other
    $26,423
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $431,871
    Bonus
    $0
    Other
    $4,278
    Deferred
    $21,450
    Nontaxable benefits
    $4,973
    Filer's total
    $462,572

  • MELISSA T FAGONDE MD

    PHYSICIAN

    Total calculated
    $330,960
    From this org
    $294,230
    From related orgs
    $0
    Other
    $36,730
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $267,252
    Bonus
    $24,088
    Other
    $2,890
    Deferred
    $17,355
    Nontaxable benefits
    $19,375
    Filer's total
    $330,960

  • OLUSOLA MALOMO MD

    MEDICAL DIRECTOR

    Total calculated
    $388,792
    From this org
    $335,242
    From related orgs
    $0
    Other
    $53,550
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $316,751
    Bonus
    $15,000
    Other
    $3,491
    Deferred
    $21,450
    Nontaxable benefits
    $32,100
    Filer's total
    $388,792

  • SHADI SOUFI MD

    PHYSICIAN

    Total calculated
    $508,458
    From this org
    $470,578
    From related orgs
    $0
    Other
    $37,880
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $435,382
    Bonus
    $30,800
    Other
    $4,396
    Deferred
    $21,450
    Nontaxable benefits
    $16,430
    Filer's total
    $508,458

  • EDWARD R LOVERN

    FORMER OFFICER (END 5/2023)

    Total calculated
    $284,555
    From this org
    $0
    From related orgs
    $260,441
    Other
    $24,114
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $227,833 related
    Bonus
    $0
    Other
    $0 + $32,608 related
    Deferred
    $0 + $12,416 related
    Nontaxable benefits
    $0 + $11,698 related
    Filer's total
    $0 + $284,555 related

  • SCOTT M FURNISS

    FORMER OFFICER (END 1/2020)

    Total calculated
    $478,895
    From this org
    $0
    From related orgs
    $428,233
    Other
    $50,662
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $321,012 related
    Bonus
    $0 + $100,425 related
    Other
    $0 + $6,796 related
    Deferred
    $0 + $18,622 related
    Nontaxable benefits
    $0 + $32,040 related
    Filer's total
    $0 + $478,895 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

  • 4b · Supplemental nonqualified retirement plan

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
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
A RELATED ORGANIZATION OF THE FILING ORGANIZATION USES ONE OR MORE OF THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PLEASE REFER TO THE FORM 990, PART VI, LINE 15A DISCLOSURE IN SCHEDULE O FOR ADDITIONAL DETAILS ON HOW COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
ELIGIBLE EXECUTIVES PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO INDIVIDUALS RECEIVED CURRENT YEAR DISTRIBUTIONS.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2023
Filed
15 May 2025
IRS schema version
2023v6.0
Source object
202521359349310162

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