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← PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION

Form 990 for tax year 2022

Filed by PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION.

Totals

Total revenue
$244,994,906
Total expenses
$244,994,906
Contributions and grants received
$1,704,473
Grants paid
$3,000
Program service revenue
$233,252,979
Investment income
$0
Other revenue
$10,037,454
Total assets, end of year
$83,182,646
Total liabilities, end of year
$105,717,191
Net assets or fund balances, end of year
-$22,534,545
Program services expenses (Part IX)
$234,825,790
Management and general expenses
$10,169,116
Fundraising expenses
$0
Program service expenses (Part III)
$234,825,790

Program services were 95.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $1,594,766

  • 1f · All other contributions, gifts and grants

    $109,707

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $149,697,070 · related or exempt $149,697,070

  • 2b · Program service revenue: INTERAFFILIATE REVENUE

    total $82,920,805 · related or exempt $82,920,805

  • 2c · Program service revenue: HEALTHCARE JV

    total $635,104 · related or exempt $39,352 · unrelated business $595,752

  • 6a · Gross rents

    real property $284,811

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $284,811

  • 6d · Net rental income or loss

    total $284,811 · excluded $284,811

  • 11a · Other revenue: MEDICAL SERVICES

    total $8,081,188 · related or exempt $8,081,188

  • 11b · Other revenue: CARE MANAGEMENT

    total $1,352,041 · related or exempt $1,352,041

  • 11c · Other revenue: MISCELLANEOUS REVENUE

    total $317,554 · related or exempt $317,554

  • 11d · All other revenue

    total $1,860 · related or exempt $1,860

  • 11e · Other revenue, total

    $9,752,643

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $3,000 · program services $3,000

  • 7 · Other salaries and wages

    total $30,689,894 · program services $29,137,697 · management and general $1,552,197

  • 8 · Pension plan contributions

    total $236,846 · program services $224,867 · management and general $11,979

  • 9 · Other employee benefits

    total $390,012 · program services $370,286 · management and general $19,726

  • 10 · Payroll taxes

    total $2,600,264 · program services $2,468,751 · management and general $131,513

  • 11b · Fees: legal

    total $379,420 · program services $360,230 · management and general $19,190

  • 11g · Fees: other

    total $155,963,173 · program services $148,075,056 · management and general $7,888,117

  • 12 · Advertising and promotion

    total $1,826,804 · program services $1,734,410 · management and general $92,394

  • 13 · Office expenses

    total $1,357,879 · program services $1,289,202 · management and general $68,677

  • 14 · Information technology

    total $50,701 · program services $48,137 · management and general $2,564

  • 16 · Occupancy

    total $17,303,385 · program services $17,303,385

  • 17 · Travel

    total $52,114 · program services $49,478 · management and general $2,636

  • 19 · Conferences, conventions and meetings

    total $418,231 · program services $397,078 · management and general $21,153

  • 22 · Depreciation, depletion and amortization

    total $2,251,188 · program services $2,137,330 · management and general $113,858

  • 23 · Insurance

    total $2,596,374 · program services $2,465,058 · management and general $131,316

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $26,625,665 · program services $26,625,665

  • 24b · Other expenses: LICENSES AND TAXES

    total $907,014 · program services $861,140 · management and general $45,874

  • 24c · Other expenses: DUES & SUSCRIPTIONS

    total $495,424 · program services $470,367 · management and general $25,057

  • 24d · Other expenses: UBI TAXES PAID

    total $291,583 · program services $276,836 · management and general $14,747

  • 24e · All other expenses

    total $555,935 · program services $527,817 · management and general $28,118

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $3,585,944 · end of year $3,572,089

  • 4 · Accounts receivable

    beginning of year $36,291,156 · end of year $21,511,339

  • 8 · Inventories for sale or use

    beginning of year $288,394 · end of year $288,394

  • 9 · Prepaid expenses and deferred charges

    beginning of year $189,258 · end of year $4,326,774

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

    $21,319,527

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

    $11,668,241

  • 10c · Land, buildings and equipment, net

    beginning of year $7,797,647 · end of year $9,651,286

  • 13 · Investments: program-related

    beginning of year $4,114,181 · end of year $4,022,785

  • 14 · Intangible assets

    beginning of year $4,376,172 · end of year $3,868,896

  • 15 · Other assets

    beginning of year $4,232,467 · end of year $35,941,083

  • 17 · Accounts payable and accrued expenses

    beginning of year $28,275,819 · end of year $32,426,075

  • 19 · Deferred revenue

    beginning of year $131,969 · end of year $723,234

  • 25 · Other liabilities

    beginning of year $9,367,287 · end of year $72,567,882

  • 27 · Net assets without donor restrictions

    beginning of year $23,100,144 · end of year -$22,534,545

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.

Activities or mission (Part I)

SEE SCHEDULE O.AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE.

  • SEE SCHEDULE O.AT 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 ACCOMPLISHMENTSPROVIDENCE SAINT JOHN'S MEDICAL FOUNDATION D.B.A. SAINT JOHN'S PHYSICIAN PARTNERS (SJPP) HAS BEEN SERVING THE SANTA MONICA AND WESTSIDE LOS ANGELES COUNTY COMMUNITIES SINCE 2018, AND HAS QUICKLY ESTABLISHED A REPUTATION FOR PERSONALIZED, HIGH-QUALITY, COORDINATED CARE.TODAY, SJPP IS A 1206(L) MEDICAL FOUNDATION WITH 195 HIGHLY ENGAGED AND SATISFIED PROVIDERS INCLUDING 151 PHYSICIANS, 21 NURSE PRACTITIONERS, AND 15 PHYSICIAN ASSISTANTS. APPROXIMATELY 250 CAREGIVERS (EMPLOYEES), DELIVERY ACCESSIBLE, COST-EFFECTIVE CARE IN 43 LOCATIONS THROUGHOUT LOS ANGELES COUNTY, WITH THE MAJORITY OF OUR SITES BEING BETWEEN PACIFIC PALISADES TO THE NORTH, BEVERLY HILLS TO THE EAST, AND TORRANCE TO THE SOUTH. SAINT JOHN'S PHYSICIAN PROVIDERS PROVIDES THE LATEST IN PRIMARY CARE ACCESS AND HIGH-QUALITY SPECIALTY CARE WITH A STRONG COMMITMENT TO ITS CORE SERVICE LINES: PRIMARY CARE (INTERNAL MEDICINE, FAMILY PRACTICE, PEDIATRICS, OB/GYN) CARDIOVASCULAR SERVICES, ONCOLOGY, ORTHOPEDICS, AND NEUROSCIENCES. SAINT JOHN'S PHYSICIAN PARTNERS IS HOME TO THE WORLD-RENOWNED JOHN WAYNE CANCER INSTITUTE PROVIDERS, DEDICATED TO CLINICAL RESEARCH AND MEDICAL ADVANCEMENTS IN CANCER CARE. SJPP IS ALSO THE PROUD HOME OF THE PACIFIC HEART INSTITUTE, PACIFIC NEUROSCIENCE INSTITUTE, AND CENTER FOR HIP AND KNEE REPLACEMENT.PROVIDENCE SAINT JOHN'S REPUTATION FOR ACADEMICALLY-BASED CARE GUIDED BY RESEARCH AND EVIDENCE-BASED MEDICINE IS DUE TO THE COMMITMENT TO EXCELLENCE BY OUR PHYSICIANS, NURSES AND CAREGIVERS. OUR CANCER SURGEONS CARE FOR PATIENTS IN THE CANCER CENTER AND HOLD FACULTY POSITIONS AT THE JOHN WAYNE CANCER INSTITUTE AND OTHER TEACHING INSTITUTIONS IN THE COMMUNITY. NEARLY EVERY CORE SERVICE LINE AT PROVIDENCE SAINT JOHN'S PHYSICIAN PARTNERS PARTICIPATES IN RESEARCH OR CLINICAL TRIALS.SJPP WAS BORN FROM THE PHYSICIANS ON STAFF AT PROVIDENCE SAINT JOHN'S HEALTH CENTER. FOUNDED BY THE SISTERS OF CHARITY OF LEAVENWORTH, WHO IN 2014 PASSED ITS SPONSORSHIP TO PROVIDENCE HEALTH & SERVICES, PROVIDENCE SAINT JOHN'S IS ROOTED IN THE CATHOLIC HEALTH CARE TRADITION, WHICH IS DEVOTED TO PROVIDING LEADING-EDGE MEDICINE WITH UNWAVERING COMPASSION AND PERSONALIZED CARE. IN LINE WITH BOTH ITS CATHOLIC MISSION AND ITS RESPONSIBILITIES AS A NON-PROFIT HEALTH CARE PROVIDER, PROVIDENCE SAINT JOHN'S SEEKS TO CREATE HEALTHIER COMMUNITIES BY INVESTING IN COMMUNITY BENEFIT PROGRAMS, WITH AN EMPHASIS ON THE POOR AND VULNERABLE.PROVIDENCE SAINT JOHN'S PHYSICIAN PARTNERS ACHIEVED TOP RATINGS AND FOR PROVIDER ENGAGEMENT AND SATISFACTION, AND PATIENT SATISFACTION SCORING IN THE TOP PERCENTILE FOR ALL GROUPS IN THE COUNTRY. WITHIN THE PAST DECADE, PROVIDENCE SAINT JOHN'S HEALTH CENTER HAS RECEIVED MULTIPLE ACCLAMATIONS BY THESE ORGANIZATIONS FOR A VARIETY OF SERVICES INCLUDING CARDIAC CARE, CORONARY INTERVENTION, AND ORTHOPEDICS, JOINT REPLACEMENT, NEUROSURGERY, AND WOMEN'S HEALTH. THE PROVIDERS RESPONSIBLE FOR THESE ACHIEVEMENTS NOW MAKE UP THE SJPP MEDICAL FOUNDATION.THROUGH THE DEDICATION AND COLLABORATIVE EFFORTS OF THE COMMUNITY, FRIENDS, PATRONS, PHYSICIANS, NURSES, STAFF AND VOLUNTEERS, PROVIDENCE SAINT JOHN'S ALONG WITH SJPP CONTINUES ITS WORLD-CLASS TRADITION ESTABLISHED MORE THAN 70 YEARS AGO BY PROVIDING BREAKTHROUGH MEDICINE IN AN ENVIRONMENT OF INSPIRED HEALING.YEAR AFTER YEAR, PROVIDENCE SAINT JOHN'S HEALTH CENTER ALONG WITH ITS STAFF, PHYSICIANS AND NURSES ARE RECOGNIZED BY THE NATION'S LEADING HEALTHCARE RATING ORGANIZATIONS, THE MEDICAL COMMUNITY AND THE MEDIA FOR CLINICAL EXCELLENCE AND EXCEPTIONAL PATIENT CARE. THIS COMES NATURALLY, GIVEN PROVIDENCE SAINT JOHN'S MISSION TOWARDS PROVIDING CUTTING-EDGE MEDICINE WITH UNWAVERING COMPASSION AND PERSONALIZED CARE.

    Expenses $234,825,790 · Grants $3,000 · Revenue $243,005,622

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

Listed in Part VII

  • ERIK WEXLER

    DIRECTOR

    Total calculated
    $5,101,912
    From this org
    $0
    From related orgs
    $4,701,760
    Other
    $400,152
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,437,860 related
    Bonus
    $0 + $2,266,630 related
    Other
    $0 + $997,270 related
    Deferred
    $0 + $382,614 related
    Nontaxable benefits
    $0 + $17,538 related
    Filer's total
    $0 + $5,101,912 related

  • AMY COMPTON-PHILLIPS MD

    DIRECTOR - THRU 9/22

    Total calculated
    $3,811,361
    From this org
    $0
    From related orgs
    $3,802,673
    Other
    $8,688
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $706,291 related
    Bonus
    $0 + $1,616,800 related
    Other
    $0 + $1,479,582 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $8,688 related
    Filer's total
    $0 + $3,811,361 related

  • BJ MOORE

    DIRECTOR

    Total calculated
    $3,768,235
    From this org
    $0
    From related orgs
    $3,485,676
    Other
    $282,559
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,008,868 related
    Bonus
    $0 + $2,055,960 related
    Other
    $0 + $420,848 related
    Deferred
    $0 + $267,185 related
    Nontaxable benefits
    $0 + $15,374 related
    Filer's total
    $0 + $3,768,235 related

  • KEVIN MANEMANN

    DIRECTOR

    Total calculated
    $2,795,917
    From this org
    $0
    From related orgs
    $2,756,394
    Other
    $39,523
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $991,006 related
    Bonus
    $0 + $1,426,372 related
    Other
    $0 + $339,016 related
    Deferred
    $0 + $4,575 related
    Nontaxable benefits
    $0 + $34,948 related
    Filer's total
    $0 + $2,795,917 related

  • JO ANN ESCASA-HAIGH

    FRMR OFF - PSJH EVP/ASST. TREAS.

    Total calculated
    $2,193,229
    From this org
    $0
    From related orgs
    $2,157,414
    Other
    $35,815
    Hours/week
    0 + 65 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 WATERS

    DIRECTOR - THRU 7/22

    Total calculated
    $2,092,159
    From this org
    $0
    From related orgs
    $2,090,589
    Other
    $1,570
    Hours/week
    0.5 + 54.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $396,838 related
    Bonus
    $0 + $730,722 related
    Other
    $0 + $963,029 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $1,570 related
    Filer's total
    $0 + $2,092,159 related

  • DAVID KIM

    PRESIDENT

    Total calculated
    $2,008,810
    From this org
    $0
    From related orgs
    $1,791,950
    Other
    $216,860
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $704,196 related
    Bonus
    $0 + $856,375 related
    Other
    $0 + $231,379 related
    Deferred
    $0 + $197,812 related
    Nontaxable benefits
    $0 + $19,048 related
    Filer's total
    $0 + $2,008,810 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

  • ALI SANTORE

    DIRECTOR

    Total calculated
    $1,292,824
    From this org
    $0
    From related orgs
    $1,135,327
    Other
    $157,497
    Hours/week
    0.5 + 64.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $521,009 related
    Bonus
    $0 + $541,697 related
    Other
    $0 + $72,621 related
    Deferred
    $0 + $152,019 related
    Nontaxable benefits
    $0 + $5,478 related
    Filer's total
    $0 + $1,292,824 related

  • JILL DUPLECHAN

    FRMR OFF. - HERITAGE OC HD CE

    Total calculated
    $1,071,303
    From this org
    $0
    From related orgs
    $921,359
    Other
    $149,944
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $473,400 related
    Bonus
    $0 + $251,103 related
    Other
    $0 + $196,856 related
    Deferred
    $0 + $136,065 related
    Nontaxable benefits
    $0 + $13,879 related
    Filer's total
    $0 + $1,071,303 related

  • NATHAN HUSMANN

    FRMR OFF. DIV CFO SOUTH

    Total calculated
    $1,058,165
    From this org
    $0
    From related orgs
    $886,113
    Other
    $172,052
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $497,929 related
    Bonus
    $0 + $263,000 related
    Other
    $0 + $125,184 related
    Deferred
    $0 + $137,653 related
    Nontaxable benefits
    $0 + $34,399 related
    Filer's total
    $0 + $1,058,165 related

  • JIM WATSON ESQ

    SECRETARY

    Total calculated
    $961,626
    From this org
    $0
    From related orgs
    $837,237
    Other
    $124,389
    Hours/week
    0.5 + 54.5 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

  • ROBERT KLEIN

    PRESIDENT/CEO FOUNDATION

    Total calculated
    $813,776
    From this org
    $0
    From related orgs
    $717,866
    Other
    $95,910
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $468,046 related
    Bonus
    $0 + $167,943 related
    Other
    $0 + $81,877 related
    Deferred
    $0 + $60,943 related
    Nontaxable benefits
    $0 + $34,967 related
    Filer's total
    $0 + $813,776 related

  • MELAYNE YOCUM

    CFO

    Total calculated
    $538,476
    From this org
    $0
    From related orgs
    $507,005
    Other
    $31,471
    Hours/week
    14 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $376,882 related
    Bonus
    $0 + $119,326 related
    Other
    $0 + $10,797 related
    Deferred
    $0 + $19,537 related
    Nontaxable benefits
    $0 + $11,934 related
    Filer's total
    $0 + $538,476 related

  • STELLA NICHOLS

    CFO COO SJHC FOUNDATION

    Total calculated
    $515,095
    From this org
    $0
    From related orgs
    $455,370
    Other
    $59,725
    Hours/week
    54.5 + 0.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $337,543 related
    Bonus
    $0 + $98,186 related
    Other
    $0 + $19,641 related
    Deferred
    $0 + $39,799 related
    Nontaxable benefits
    $0 + $19,926 related
    Filer's total
    $0 + $515,095 related

  • TONYA ALLEN

    DIR OPS INFASTR

    Total calculated
    $312,016
    From this org
    $289,930
    From related orgs
    $0
    Other
    $22,086
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $201,507
    Bonus
    $82,282
    Other
    $6,141
    Deferred
    $11,595
    Nontaxable benefits
    $10,491
    Filer's total
    $312,016

  • DONALD ANDERSON JR

    ASSISTANT SECRETARY FOR ENROLLMENT

    Total calculated
    $288,175
    From this org
    $0
    From related orgs
    $256,992
    Other
    $31,183
    Hours/week
    0.5 + 54.5 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

  • KATHERINE KERR

    DIRECTOR PRACTICE MANAGEMENT

    Total calculated
    $250,125
    From this org
    $237,746
    From related orgs
    $0
    Other
    $12,379
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $150,206
    Bonus
    $65,605
    Other
    $21,935
    Deferred
    $0
    Nontaxable benefits
    $12,379
    Filer's total
    $250,125

  • PANTHEA SHAFIPOUR

    DIR FINANCE OPS PSJH

    Total calculated
    $236,675
    From this org
    $220,820
    From related orgs
    $0
    Other
    $15,855
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $189,911
    Bonus
    $30,302
    Other
    $607
    Deferred
    $11,743
    Nontaxable benefits
    $4,112
    Filer's total
    $236,675

  • BECKY NATALI

    MANAGER PHARMACY

    Total calculated
    $225,289
    From this org
    $201,091
    From related orgs
    $0
    Other
    $24,198
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $173,144
    Bonus
    $7,034
    Other
    $20,913
    Deferred
    $6,551
    Nontaxable benefits
    $17,647
    Filer's total
    $225,289

  • TIFFANY SAN JUAN

    DIRECTOR CLINICAL OPERATIONS

    Total calculated
    $196,068
    From this org
    $188,345
    From related orgs
    $0
    Other
    $7,723
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $157,353
    Bonus
    $30,737
    Other
    $255
    Deferred
    $6,601
    Nontaxable benefits
    $1,122
    Filer's total
    $196,068

  • 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

  • ABHIJIT ADHYE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • ANNE FORD MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • CONNIE BARTLETT DO

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • ELIZABETH SANDER MD

    DIRECTOR/CHAIR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • JEANNETTE CURRIE MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • KEITH MARTON MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • MARK NEEDHAM MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • MICHAEL SUGARMAN MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • RAUL RUDY MARQUEZ MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • ROBERT DEL JUNCO MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • ROBERT ROSENBERG MD

    DIRECTOR - THRU 12/22

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • ROSCOE MARTER MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 related

  • WILLIAM BARCELONA

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5 + 1.5 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. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE PROVIDENCE PROVIDES HOUSING ALLOWANCES ONLY FOR PURPOSES OF RELOCATION ASSISTANCE TO A NEWLY HIRED EMPLOYEE. PROVIDENCE MAY PAY TEMPORARY LIVING EXPENSES FOR THE NEWLY HIRED EMPLOYEE UP TO A MAXIMUM OF 90 CALENDAR DAYS. COVERED EXPENSES ARE RENT (EXCLUDING "RENT" WHICH MAY BE PAID IN ORDER TO OCCUPY A NEW PERMANENT RESIDENCE UNTIL THE TITLE CLEARS) AND UTILITIES, INCLUDING HEAT, ELECTRICITY, GAS, WATER, LOCAL INTERNET AND LOCAL TELEPHONE AND GARBAGE SERVICES. THE EXECUTIVE VICE PRESIDENT, CHIEF ADMINISTRATIVE OFFICER OF PROVIDENCE MAY APPROVE TEMPORARY HOUSING ASSISTANCE FOR UP TO SIX MONTHS WHEN FAMILY RELOCATION IS DELAYED TO ACCOMMODATE THE SCHOOL YEAR OR EQUIVALENT CIRCUMSTANCES. ONLY IN EXTENUATING CIRCUMSTANCES IS HOUSING EXTENDED BEYOND THIS SIX-MONTH PERIOD. THE AMOUNTS REPORTED FOR THESE RELOCATION/HOUSING 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 MEDICAL FOUNDATION, 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 RECIEVED SEVERANCE PAYMENTS DURING 2022: AMY COMPTON-PHILLIPS, M.D. - $325,280 MIKE WATERS - $312,664 JOHN WHIPPLE - $186,674 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: ERIK WEXLER - $884,974 AMY COMPTON - $ 1,007,563 BJ MOORE - $415,491 KEVIN MANEMANN - $316,806 JO ANN ESCASA - $284,024 MIKE WATERS - $580,363 DAVID KIM - $205,930 JOHN WHIPPLE - $855,652 ALI SANTORE - $71,481 JILL DUPLECHAN - $186,590 NATHAN HUSMANN - $103,544 JIM WATSON - $119,387 ROBERT KLEIN - $46,792 STELLA NICHOLS - $14,715
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.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

Related partnerships

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

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2022
Filed
9 November 2023
IRS schema version
2022v5.0
Source object
202313159349301871

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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