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Nonprofiteer
← PROVIDENCE MEDICAL FOUNDATION

Form 990 for tax year 2022

Filed by PROVIDENCE MEDICAL FOUNDATION.

Totals

Total revenue
$1,240,305,430
Total expenses
$1,239,857,449
Contributions and grants received
$2,566,191
Grants paid
$38,280
Program service revenue
$1,190,636,296
Investment income
$467,801
Other revenue
$46,635,142
Total assets, end of year
$472,732,137
Total liabilities, end of year
$420,798,711
Net assets or fund balances, end of year
$51,933,426
Program services expenses (Part IX)
$1,072,488,299
Management and general expenses
$167,369,150
Fundraising expenses
$0
Program service expenses (Part III)
$1,072,488,299

Program services were 86.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

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

Revenue

Part VIII, the statement of revenue.

  • 1e · Government grants (contributions)

    $2,304,318

  • 1f · All other contributions, gifts and grants

    $261,873

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $962,266,754 · related or exempt $962,266,754

  • 2b · Program service revenue: INTER-AFFILIATE REV

    total $228,154,016 · related or exempt $228,154,016

  • 2c · Program service revenue: JV INCOME

    total $215,526 · related or exempt $215,526

  • 3 · Investment income

    total $602,865 · excluded $602,865

  • 7a · Gross sales of assets other than inventory

    other assets $19,446

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

    securities $154,510 · other assets $0

  • 7c · Gain or loss

    securities -$154,510 · other assets $19,446

  • 7d · Net gain or loss

    total -$135,064 · excluded -$135,064

  • 11a · Other revenue: PROFESSIONAL SERVICES

    total $36,661,363 · related or exempt $36,661,363

  • 11b · Other revenue: RESEARCH PROJECTS

    total $6,820,693 · related or exempt $6,820,693

  • 11c · Other revenue: COST RECOVERIES

    total $764,358 · related or exempt $764,358

  • 11d · All other revenue

    total $2,388,728 · related or exempt $2,388,728

  • 11e · Other revenue, total

    $46,635,142

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $38,280 · program services $38,280

  • 5 · Compensation of officers, directors and key employees

    total $2,008,811 · program services $1,724,994 · management and general $283,817

  • 7 · Other salaries and wages

    total $257,584,791 · program services $221,191,706 · management and general $36,393,085

  • 8 · Pension plan contributions

    total $3,926,654 · program services $3,371,873 · management and general $554,781

  • 9 · Other employee benefits

    total $2,233,953 · program services $1,918,327 · management and general $315,626

  • 10 · Payroll taxes

    total $17,759,965 · program services $15,250,733 · management and general $2,509,232

  • 11b · Fees: legal

    total $1,123,206 · program services $964,513 · management and general $158,693

  • 11g · Fees: other

    total $804,782,824 · program services $691,078,402 · management and general $113,704,422

  • 12 · Advertising and promotion

    total $895,828 · program services $769,260 · management and general $126,568

  • 13 · Office expenses

    total $6,743,225 · program services $5,790,503 · management and general $952,722

  • 14 · Information technology

    total $1,428,847 · program services $1,226,971 · management and general $201,876

  • 16 · Occupancy

    total $54,705,716 · program services $46,976,573 · management and general $7,729,143

  • 17 · Travel

    total $680,321 · program services $584,201 · management and general $96,120

  • 19 · Conferences, conventions and meetings

    total $157,405 · program services $135,166 · management and general $22,239

  • 20 · Interest

    total $1,602,546 · program services $1,376,129 · management and general $226,417

  • 22 · Depreciation, depletion and amortization

    total $16,556,911 · program services $14,217,654 · management and general $2,339,257

  • 23 · Insurance

    total $7,643,850 · program services $6,563,882 · management and general $1,079,968

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $55,205,466 · program services $55,205,466

  • 24b · Other expenses: RECRUITING & RELOCATION

    total $1,743,258 · program services $1,496,960 · management and general $246,298

  • 24c · Other expenses: LICENSES AND TAXES

    total $1,108,243 · program services $951,664 · management and general $156,579

  • 24d · Other expenses: SPECIAL EVENTS

    total $278,975 · program services $239,560 · management and general $39,415

  • 24e · All other expenses

    total $1,648,374 · program services $1,415,482 · management and general $232,892

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $66,686,503 · end of year $80,111,684

  • 4 · Accounts receivable

    beginning of year $48,469,195 · end of year $46,938,531

  • 8 · Inventories for sale or use

    beginning of year $895,262 · end of year $788,882

  • 9 · Prepaid expenses and deferred charges

    beginning of year $10,336,774 · end of year $8,910,278

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

    $199,908,867

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

    $150,459,986

  • 10c · Land, buildings and equipment, net

    beginning of year $76,744,871 · end of year $49,448,881

  • 11 · Investments: publicly traded securities

    beginning of year $18,747,386 · end of year $18,254,335

  • 14 · Intangible assets

    beginning of year $18,361,737 · end of year $16,479,509

  • 15 · Other assets

    beginning of year $173,025,817 · end of year $251,800,037

  • 17 · Accounts payable and accrued expenses

    beginning of year $131,093,591 · end of year $74,952,278

  • 19 · Deferred revenue

    end of year $9,932,292

  • 25 · Other liabilities

    beginning of year $217,163,953 · end of year $335,914,141

  • 27 · Net assets without donor restrictions

    beginning of year $63,774,474 · end of year $50,792,285

  • 28 · Net assets with donor restrictions

    beginning of year $1,235,527 · end of year $1,141,141

Mission and programs · 2022

Mission

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

  • SEE SCHEDULE 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-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.REALIZING OUR MISSION PROVIDENCE MEDICAL FOUNDATION (FKA ST. JOSEPH HERITAGE HEALTHCARE) HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE LOCAL COMMUNITY FOR OVER 25 YEARS. SERVING THE COMMUNITIES OF ORANGE, LOS ANGELES, SAN BERNADINO, NAPA, SONOMA, HUMBOLDT, LAKE, MARIN AND MENDOCINO COUNTIES, PROVIDENCE MEDICAL FOUNDATION IS A NOT FOR PROFIT MEDICAL PRACTICE FOUNDATION THAT PROVIDES QUALITY CARE IN THE AREAS OF PROFESSIONAL MEDICAL SERVICES AND ADMINISTRATION OF ST. JOSEPH HEALTH FULL RISK PATIENTS WITH OVER 3,400 EMPLOYEES COMMITTED TO REALIZING THE MISSION.AS A MEMBER OF THE PROVIDENCE ST. JOSEPH HEALTH SYSTEM, PROVIDENCE MEDICAL FOUNDATION IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA OVER 100 YEARS AGO.THE SISTERS OF ST. JOSEPH OF ORANGE TRACE THEIR ROOTS BACK TO 17TH CENTURY FRANCE AND THE UNIQUE VISION OF A JESUIT PRIEST NAMED JEAN-PIERRE MEDAILLE. HE SOUGHT TO ORGANIZE AN ORDER OF RELIGIOUS WOMEN WHO, RATHER THAN REMAINING SAFELY CLOISTERED IN A CONVENT, VENTURED OUT INTO THE COMMUNITY TO SEEK OUT "THE DEAR NEIGHBORS AND MINISTER TO THEIR NEEDS. THE CONGREGATION MANAGED TO SURVIVE THE TURBULENCE OF THE FRENCH REVOLUTION AND EVENTUALLY EXPANDED, NOT ONLY THROUGHOUT FRANCE, BUT THROUGHOUT THE WORLD. IN 1912 A SMALL GROUP OF SISTERS OF ST. JOSEPH WENTTO EUREKA, CALIFORNIA AT THE INVITATION OF THE LOCAL BISHOP TO ESTABLISH A SCHOOL. A FEW YEARS LATER, THE GREAT INFLUENZA EPIDEMIC OF 1918 CAUSED THE SISTERS TO TEMPORARILY SET ASIDE THEIR EDUCATION EFFORTS TO CARE FOR THE ILL. THEY REALIZED IMMEDIATELY THAT THE SMALL COMMUNITY DESPERATELY NEEDED A HOSPITAL. THROUGH BOLD FAITH, FORESIGHT, AND FLEXIBLITY IN 1920, THE SISTERS OPENED THE 28-BED ST. JOSEPH HOSPITAL OF EUREKA, THE FIRST ST. JOSEPH HEALTH SYSTEM MINISTRY.THE FOLLOWING DETAILS SOME OF THE OUTREACH WE PROVIDE TO THE COMMUNITIES WE SERVE, BOTH NEAR AND DISTANT.PATIENT FINANCIAL ASSISTANCE PROGRAMPROVIDENCE MEDICAL FOUNDATION BELIEVES THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY PROVIDENCE MEDICAL FOUNDATION HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM (FAP) THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. MEDICAID PROGRAMPROVIDENCE MEDICAL FOUNDATION PROVIDED ACCESS TO UNINSURED AND UNDERINSURED PERSONS BY PARTICIPATING IN THE FEDERAL AND STATE SPONSORED MEDICAID PROGRAM.PROGRAM SERVICE ACCOMPLISHMENTS PROVIDENCE MEDICAL FOUNDATION HAS A LONG-STANDING COMMITMENT TO PARTNERING WITH LIKE-MINDED AGENCIES AND ORGANIZATIONS TO INCREASE OUR OUTREACH AND ADVOCACY ON BEHALF OF UNDER-RESOURCED POPULATIONS AS WE SEEK TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE. THE FOLLOWING LIST REPRESENTS SOME OF OUR KEY COMMUNITY PARTNERS.KEY COMMUNITY PARTNERS: LAURA'S HOUSE, ALZHEIMER'S ORANGE COUNTY, WELLNESS AND PREVENTION CENTER, UNITED WAY, CONCERN AMERICA, TALLER SAN JOSE/HOPE BUILDERS,RADIANT FUTURES, DIOCESE OF ORANGE - CANTLAY CENTER, REDWOOD FOOD BANK, NAPA COUNTY HOMELESS SERVICES, UKIAH FOOD BANK, HUMBOLDT COUNTY SCHOOL DISTRICTS, PACIFIC OUTFITTERS HUMBOLDT COUNTY BEACH CLEAN UP, ALZHEIMER'S ASSOCIATION, AMERICAN FOUNDATION FOR SUICIDE PREVENTION - ORANGE COUNTY.

    Expenses $1,072,488,299 · Grants $38,280 · Revenue $1,237,271,438

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

  • 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
    $1,791,950
    From related orgs
    $0
    Other
    $216,860
    Hours/week
    47 + 3 related

    Schedule J breakdown matched by us

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

  • 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

    CHIEF EXECUTIVE - HERITAGE OC HD

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

    Schedule J breakdown matched by us

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

  • 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 JUST III

    CHIEF EXECUTIVE - N CA MEDICAL GROUP

    Total calculated
    $847,945
    From this org
    $728,901
    From related orgs
    $0
    Other
    $119,044
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $408,808
    Bonus
    $200,408
    Other
    $119,685
    Deferred
    $93,187
    Nontaxable benefits
    $25,857
    Filer's total
    $847,945

  • EUGENE KIM

    CHIEF MEDICAL OFFICER - CALIFORNIA

    Total calculated
    $844,282
    From this org
    $689,852
    From related orgs
    $0
    Other
    $154,430
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $437,058
    Bonus
    $220,624
    Other
    $32,170
    Deferred
    $125,853
    Nontaxable benefits
    $28,577
    Filer's total
    $844,282

  • CHRISTINE MOKROHISKY

    VP POPULATION HLTH MMGT - THRU 10/22

    Total calculated
    $721,049
    From this org
    $690,772
    From related orgs
    $0
    Other
    $30,277
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $251,047
    Bonus
    $107,621
    Other
    $332,104
    Deferred
    $8,122
    Nontaxable benefits
    $22,155
    Filer's total
    $721,049

  • JUDY DANFORTH

    CHIEF PHYSICIAN SVCS - THUR 12/22

    Total calculated
    $584,382
    From this org
    $562,347
    From related orgs
    $0
    Other
    $22,035
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $243,365
    Bonus
    $93,810
    Other
    $225,172
    Deferred
    $9,150
    Nontaxable benefits
    $12,885
    Filer's total
    $584,382

  • 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

  • MARK JABLONSKI

    FRMR KE - PSJH CMO

    Total calculated
    $380,123
    From this org
    $0
    From related orgs
    $336,522
    Other
    $43,601
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $299,054 related
    Bonus
    $0 + $5,000 related
    Other
    $0 + $32,468 related
    Deferred
    $0 + $26,998 related
    Nontaxable benefits
    $0 + $16,603 related
    Filer's total
    $0 + $380,123 related

  • 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

  • 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, LINES 4A-B
THE FOLLOWING INDIVIDUALS RECIEVED SEVERANCE PAYMENTS DURING 2022: AMY COMPTON-PHILLIPS, M.D. - $ 325,280 MIKE WATERS - $ 312,664 JUDY DANFORTH - $ 196,690 CHRISTINE MOKROHISKY - $ 192,756 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: AMY COMPTON-PHILLIPS, M.D. - $ 1,007,563 ERIK WEXLER - $ 884,974 MIKE WATERS - $ 580,363 BJ MOORE - $ 415,491 KEVIN MANEMANN - $ 316,806 DAVID KIM - $ 205,930 JILL DUPLECHAN - $ 186,590 JIM WATSON, ESQ - $ 119,387 CHRISTINE MOKROHISKY - $ 114,556 NATHAN HUSMANN - $ 103,544 ROBERT JUST III - $ 95,426 ALI SANTORE - $ 71,481 EUGENE KIM - $ 28,317 MARK JABLONSKI - $ 2,795 JUDY DANFORTH - $ 1,432
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.

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
202313159349301876

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