PROVIDENCE HOSPITAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PROVIDENCE HOSPITAL (EIN 53-0196636)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-09
- IRS object ID
- 201821299349302567
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-09T14:09:13-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 530196636 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Providence Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROV | BusinessNameControlTxt |
| Phone | 3147338000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1150 Varnum Street NE | AddressLine1Txt |
| City | Washington | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20017 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Tonya Mershon | PersonNm |
| Person Title | Tax Officer | PersonTitleTxt |
| Signature | 2017-10-24 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Darcy Burthay | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1150 Varnum Street NE | AddressLine1Txt |
| City | Washington | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20017 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $218,618,182 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.provhosp.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1864 | FormationYr |
| Legal Domicile State | DC | LegalDomicileStateCd |
| Activity Or Mission | To improve the health and well-being of all people in the communities we serve. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 1963 | TotalEmployeeCnt |
| Total Volunteers | 204 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,878,348 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,036,194 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $204,711,422 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $211,749,016 | CYProgramServiceRevenueAmt |
| PY Investment Income | $46,484 | PYInvestmentIncomeAmt |
| CY Investment Income | $119,754 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,983,316 | PYOtherRevenueAmt |
| CY Other Revenue | $4,964,110 | CYOtherRevenueAmt |
| PY Total Revenue | $212,619,570 | PYTotalRevenueAmt |
| CY Total Revenue | $217,869,074 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $92,825,260 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $88,589,120 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $129,498,330 | PYOtherExpensesAmt |
| CY Other Expenses | $158,322,548 | CYOtherExpensesAmt |
| PY Total Expenses | $222,323,590 | PYTotalExpensesAmt |
| CY Total Expenses | $246,911,668 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$9,704,020 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$29,042,594 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $217,711,078 | TotalAssetsBOYAmt |
| Total Assets EOY | $196,822,518 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $166,664,643 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $193,867,141 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $51,046,435 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,955,377 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $225,547,897 | ExpenseAmt |
| Revenue | $212,191,507 | RevenueAmt |
| Desc | PROVIDENCE HOSPITAL IS A 393 LICENSED BED ACUTE CARE HOSPITAL WITH A 252 BED HOSPITAL-BASED SKILLED NURSING HOME. FY2017, THE HOSPITAL HAD 10,153 DISCHARGES, 134,747 PATIENT DAYS, 49,268 EMERGENCY ROOM VISITS, DELIVERED MORE THAN 1,989 NEWBORN INFANTS, AND PERFORMED 4,827 OUTPATIENT SURGICAL CASES AND 1,577 INPATIENT SURGICAL CASES. | Desc |
| Total Program Service Expenses | $225,547,897 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | Yes (true) | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 220 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1963 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | DC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rachel Maloney AVP Finance | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2028547859 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1150 Varnum Street NE | AddressLine1Txt |
| City | Washington | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20017 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| DARCY BURTHAY | ||||||||||
| PRESIDENET & CEO | 20.0 | 21.0 | Yes (X) | Yes (X) | $453,823 | $243,307 | $26,153 | |||
| SISTER TERESA GEORGE | ||||||||||
| TREASURER | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| NALINI N JAIRATH PHD | ||||||||||
| SECRETARY | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| STEVE STRAZZELLA | ||||||||||
| CHAIRMAN | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JUDI TESKE | ||||||||||
| VICE-CHAIRMAN | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| SISTER MARY BADER DC | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| JOEL BOWERS MD | ||||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL FITZGERALD | ||||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| DEREK P LEEBAERT PHD | ||||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN MULLINS CPA | ||||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||||
| SISTER ELYSE STAAB DC | ||||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| VERA VASWANI CHAWLA | ||||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| RODERIC L WOODSON ESQ | ||||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| SCOTT M FURNISS | ||||||||||
| CFO-MINISTRY MKT DC/BALTIMORE | 18.1 | 31.9 | Yes (X) | $0 | $437,628 | $32,131 | ||||
| MARC EDELMAN | ||||||||||
| CHIEF OPERATING OFFICER | 40.0 | 0 | Yes (X) | $265,838 | $0 | $33,052 | ||||
| PATRICIA EVANS MD | ||||||||||
| CHIEF MEDICAL OFFICER | 40.0 | 0 | $304,494 | $0 | $30,466 | Yes (X) | ||||
| MOURINE EVANS | ||||||||||
| CHIEF NURSING OFFICER | 40.0 | 0 | $274,194 | $0 | $17,958 | Yes (X) | ||||
| FRANCISCO F HOYOS | ||||||||||
| CO CHIEF MEDICAL OFFICER | 20.0 | 20.0 | $0 | $521,187 | $39,978 | Yes (X) | ||||
| Olusola Malomo | ||||||||||
| Medical Director | 40.0 | 0 | $267,075 | $0 | $37,907 | Yes (X) | ||||
| Rachel Maloney | ||||||||||
| AVP-Finance-Controller | 40.0 | 0 | $204,103 | $0 | $25,258 | Yes (X) | ||||
| Paul O Oriaifo | ||||||||||
| Medical Director | 40.0 | 0 | $256,958 | $0 | $35,208 | Yes (X) | ||||
| Taisha Williams | ||||||||||
| Associate Medical Director PFC | 40.0 | 0 | $223,346 | $0 | $28,561 | Yes (X) | ||||
| Gregory Ziegler | ||||||||||
| AVP-Finance-Revenue | 40.0 | 0 | $206,864 | $0 | $28,409 | Yes (X) | ||||
| AMY E FREEMAN | ||||||||||
| FORMER OFFICER (END 12/2015) | 0.0 | 50.0 | $0 | $1,096,649 | $25,896 | Yes (X) | ||||
| DAN A MACKSOOD | ||||||||||
| FORMER OFFICER (END 12/2015) | 0.0 | 0.0 | $300,506 | $0 | $476 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,757,201 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,298,771 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $361,453 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 102 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| QUEST DIAGNOSTICS LLC | |||||
| 12436 COLLECTION CENTER DRIVE | CHICAGO | IL | 606930124 | LABORATORY SERVICES | $4,941,462 |
| HARMONY HEALTHCARE LLC | |||||
| 2909 W BAY TO BAY BLVD | TAMPA | FL | 336298178 | HEALTHCARE SERVICES | $2,166,811 |
| PHS TH ANESTHESIA PC | |||||
| PO BOX 638324 | CINCINNATI | OH | 45263 | ANESTHESIOLOGY SERVICES | $2,150,000 |
| UNIVERSAL PROTECTION SERVICE LLC | |||||
| 26375 NETWORK PLACE | CHICAGO | IL | 606731263 | SECURITY SERVICES | $1,623,387 |
| CONTEMPORARY NURSING SOLUTIONS INC | |||||
| 1000 JEFFERSON ST STE 1A | LYNCHBURG | VA | 24504 | NURSING SERVICES | $1,331,973 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 29 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,036,194 | RelatedOrganizationsAmt |
| Total Contributions | $1,036,194 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| HOSPTIAL NET PATIENT REVENUE | 622110 | $180,018,852 | $180,018,852 | |
| NURSING HOME NET PATIENT REVENUE | 623110 | $31,489,980 | $31,489,980 | |
| INCOME FROM JOINT VENTURE | 900099 | $240,184 | $240,184 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $211,749,016 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $119,754 | TotalRevenueColumnAmt |
| Exclusion | $119,754 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,776,342 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,776,342 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,776,342 | TotalRevenueColumnAmt |
| Exclusion | $1,776,342 | ExclusionAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $1,391,215 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $749,108 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $642,107 | TotalRevenueColumnAmt |
| Exclusion | $642,107 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| FEES FROM AFFILIATES | 900099 | $243,232 | $243,232 | |
| CONTRACT INCOME | 900099 | $682,675 | $682,675 | |
| OTHER MISCELLANEOUS REVENUE | 900099 | $1,619,754 | $1,619,754 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,545,661 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $217,869,074 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $212,191,507 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,641,373 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,393,298 | TotalAmt |
| Management And General | $1,393,298 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,995,406 | TotalAmt |
| Program Services | $69,564,381 | ProgramServicesAmt |
| Management And General | $6,431,025 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$2,037,956 | TotalAmt |
| Program Services | -$1,793,457 | ProgramServicesAmt |
| Management And General | -$244,499 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,971,496 | TotalAmt |
| Program Services | $6,319,097 | ProgramServicesAmt |
| Management And General | $652,399 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,266,876 | TotalAmt |
| Program Services | $5,640,188 | ProgramServicesAmt |
| Management And General | $626,688 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,787 | TotalAmt |
| Program Services | $37,608 | ProgramServicesAmt |
| Management And General | $4,179 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,784 | TotalAmt |
| Management And General | $85,784 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,642 | TotalAmt |
| Management And General | $70,642 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,639 | TotalAmt |
| Management And General | $53,639 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,836,794 | TotalAmt |
| Program Services | $6,153,114 | ProgramServicesAmt |
| Management And General | $683,680 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,277 | TotalAmt |
| Program Services | $56,949 | ProgramServicesAmt |
| Management And General | $6,328 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $596,417 | TotalAmt |
| Program Services | $536,775 | ProgramServicesAmt |
| Management And General | $59,642 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,548 | TotalAmt |
| Program Services | $175,993 | ProgramServicesAmt |
| Management And General | $19,555 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,688,660 | TotalAmt |
| Program Services | $4,219,794 | ProgramServicesAmt |
| Management And General | $468,866 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,522 | TotalAmt |
| Program Services | $63,470 | ProgramServicesAmt |
| Management And General | $7,052 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,734 | TotalAmt |
| Program Services | $78,961 | ProgramServicesAmt |
| Management And General | $8,773 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,669,091 | TotalAmt |
| Program Services | $4,202,182 | ProgramServicesAmt |
| Management And General | $466,909 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,805,862 | TotalAmt |
| Program Services | $10,805,862 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,890,280 | TotalAmt |
| Program Services | $5,301,252 | ProgramServicesAmt |
| Management And General | $589,028 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES | $60,310,756 | $54,279,680 | $6,031,076 |
| MEDICAL SUPPLIES | $24,358,680 | $24,358,680 | |
| IMPAIRMENT OF PPE | $17,000,000 | $15,300,000 | $1,700,000 |
| CONTRACT LABOR | $8,802,210 | $7,921,989 | $880,221 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,694,865 | TotalAmt |
| Program Services | $12,325,379 | ProgramServicesAmt |
| Management And General | $1,369,486 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,911,668 | TotalAmt |
| Program Services | $225,547,897 | ProgramServicesAmt |
| Management And General | $21,363,771 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,609 | BOYAmt |
| EOY | $3,609 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,816,682 | BOYAmt |
| EOY | $9,394,224 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,457,485 | BOYAmt |
| EOY | $28,884,781 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,682,360 | BOYAmt |
| EOY | $2,473,914 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,178,423 | BOYAmt |
| EOY | $703,006 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $219,505,975 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $171,461,431 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,653,663 | BOYAmt |
| EOY | $48,044,544 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,826,734 | BOYAmt |
| EOY | $2,281,918 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,427,491 | BOYAmt |
| EOY | $7,835,267 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,664,631 | BOYAmt |
| EOY | $97,201,255 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,711,078 | BOYAmt |
| EOY | $196,822,518 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,416,346 | BOYAmt |
| EOY | $17,593,002 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10 | BOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,248,287 | BOYAmt |
| EOY | $176,274,139 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,664,643 | BOYAmt |
| EOY | $193,867,141 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,046,435 | BOYAmt |
| EOY | $2,955,377 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,046,435 | BOYAmt |
| EOY | $2,955,377 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,711,078 | BOYAmt |
| EOY | $196,822,518 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$29,042,594 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$19,048,464 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $53,639 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $53,639 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | Lobbying expenses represent 1) the portion of dues paid to National and state hospital associations that is specifically allocable to lobbying ($13,139), 2) to Carmen Group for seeking to increase the District of Columbia DSH funding ($40,500). Providence Hospital does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to ) any candidate for public office. |
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | Lobbying expenses represent 1) the portion of dues paid to National and state hospital associations that is specifically allocable to lobbying ($13,139), 2) to Carmen Group for seeking to increase the District of Columbia DSH funding ($40,500). Providence Hospital does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to ) any candidate for public office. |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,585,094 | OtherCostOrOtherBasisAmt |
| Book Value | $2,585,094 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $143,811,039 | OtherCostOrOtherBasisAmt |
| Depreciation | $114,597,249 | DepreciationAmt |
| Book Value | $29,213,790 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $767,621 | OtherCostOrOtherBasisAmt |
| Depreciation | $130,418 | DepreciationAmt |
| Book Value | $637,203 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $60,586,627 | OtherCostOrOtherBasisAmt |
| Depreciation | $54,291,215 | DepreciationAmt |
| Book Value | $6,295,412 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,755,594 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,442,549 | DepreciationAmt |
| Book Value | $9,313,045 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $48,044,544 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (12 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Advances to/from affiliates | |
| Other Current Assets | |
| IC AR/AP netted | |
| Accretive AR | |
| Deferred Comp | |
| Total Deferred Compensation Asset | $4,407,915 |
| Due from Affiliates | $4,629,404 |
| Advances to Affiliates | $84,815,730 |
| Prepaid Pension Assets | $327,958 |
| Estimated Settlements from Third-Party Payor | $1,109,623 |
| Other Miscellaneous Receivables | $1,708,252 |
| Miscellaneous Current Assets | $202,373 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $97,201,255 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (14 entries)
| DescDesc | AmtAmt |
|---|---|
| Self Insurance Liability | |
| Deferred Compensation | $4,407,915 |
| Asset Retirement Obligation | $215,023 |
| Other Misc Current Liabilities | |
| Other Miscellaneous Liabilities | $3,635 |
| Pension Plan Liability | |
| Current Portion of Long-Term Debt | |
| Estimated Settlement to Third-Party Payor | $4,740,935 |
| Net Long-Term Debt | |
| Due to Affiliates | $26,727,049 |
| Debt with Ascension Health Alliance | $137,811,605 |
| Ascension Health Savings Plan Liability | $1,313,012 |
| Recovery Tail Liability | $963,916 |
| Other Taxes Payable | $91,049 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $176,274,139 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2017. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,284,723 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,284,723 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0099 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,140,053 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $102,453,757 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $93,424,776 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $102,453,757 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,284,723 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0099 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,764,114 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,764,114 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0164 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,527,474 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,527,474 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0153 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $7,291,588 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,291,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0317 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $100,716,364 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $102,453,757 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,576,311 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0417 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,817,806 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,145,342 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $54,244,871 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $70,230,833 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$15,985,962 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1150 VARMUM STREET NE | AddressLine1Txt |
| City | Washington | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20017 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | http:/www.provhosp.org | WebsiteAddressTxt |
| State License | HFD01-0212 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.provhosp.org/about-us/community-health-assessment | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.provhosp.org/about-us/community-health-assessment | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.0 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://www.provhosp.org/patients-guests/financial-assistance | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.provhosp.org/patients-guests/financial-assistance | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.provhosp.org/patients-guests/financial-assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 3 Facility , 1 | Facility , 1 - PROVIDENCE HOSPITAL. Providence is committed to conducting a community health needs assessment (CHNA) every three years to understand the health and health care status of DC communities. The assessment guides Providence in targeting its resources to achieve the greatest impact on community health through population health initiatives. |
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - PROVIDENCE HOSPITAL. Building on our last community health needs assessment and the information shared on our DC Health Matters website (www.dchealthmatters.org), the 2015 assessment represents a shift from a focus on individual clinical conditions to larger social determinants of health. In order to achieve this shift in direction, this assessment placed a much larger emphasis on having our community's perspective shape this work. As a result, this report includes community thoughts from the following: 113 online survey respondents, 80 community forum attendees, 60 community-based organizations, 40 focus group participants, 31 key informant interviews, 15 hospitals and community health centers, 11 government agencies, and 8 elected officials, including DC Councilmembers and Advisory Neighborhood Commissioners |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - PROVIDENCE HOSPITAL. Providence Hospital, through its membership in the DC Healthy Communities Collaborative, conducted the CHNA in partnership with three other non-profit hospitals: Howard University Hospital, Children's National Medical Center and Sibley Memorial Hospital; and three community health centers, two of which are Federally qualified health centers, Bread for the City, Community of Hope, and Unity Health Care, Inc. The DC Healthy Communities Collaborative (DCHCC) works to eliminate health disparities and create health equity for all communities in the District of Columbia to realize one healthy Capital city. With the unique perspectives of each hospital and community health center, DCHCC members provided guidance and feedback respective to populations and neighborhoods served. |
| Schedule H, Part V, Section B, Line 7 Facility , 1 | Facility , 1 - PROVIDENCE HOSPITAL. The most recent assessment, released in June 2016 was conducted in partnership with the DC Healthy Communities Collaborative (DCHCC): a consortium of DC hospitals and community health centers who have joined forces to reduce health disparities and increase health equity for the most vulnerable DC populations. Providence is a founding member of the DCHCC. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - Providence Hospital. In the CHNA that was conducted in 2015 the following four (4) needs emerged as the "priority community needs": Mental Health/Behavioral Health, Place-Based Care (Bring Care to the Community), Care Coordination, and Health Literacy. In FY17 Providence Health System is addressing the identified needs Care Coordination and Mental Health via the following strategies: Prioritized Needs Care Coordination - Providence is collaborating with other DCHCC organizations to improve identification of resources by collaborating with community based organizations, government agencies and health care organizations and expanding use of community asset maps. As well as implement a multi-faceted intervention to improve care coordination across systems to ensure that health needs are being met and that the right care is being delivered in the right place, at the right time, by the right person to improve patient care and health outcomes. Mental Health - Providence is co-leading the advocacy for a District-wide capacity assessment and evaluation of mental health services for adults and children; improving care coordination for mental health and substance abuse co-occurring conditions through facilitation of direct hand-offs to the next level of care and tracking of referrals between systems. Providence is also collaborating with other DCHCC organizations to advocate for policy level solutions to improve our ability to provide mental health prevention activities and screenings and for equitable distribution of mental health services in DC. In addition, Providence is collaborating with other DCHCC organizations to develop internal system changes to improve health literacy. Needs that will not be addressed Bringing Care to the Community/Placed-based Care will not be directly addressed by Providence. However, Providence's strategies for Care Coordination and Behavioral Health will have components that align with the definition and need of Place-based Care (via telehealth). |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Carroll Manor Nursing & Rehab Center | ||||
| 1150 Varnum Street NE | Washington | DC | 20017 | Skilled Nursing & Rehabilitation Center |
| Ft Lincoln Family Medicine Center | ||||
| 4151 Bladensburg Road | Colmar Manor | MD | 20722 | Family Medicine Center |
| Perry Family Health Center | ||||
| 128 M Street NW Suite 050 | Washington | DC | 20001 | Perry Family Health Center |
| Model Cities Senior Wellness Center | ||||
| 1901 Evarts Street NE | Washington | DC | 20018 | Senior Connection Program |
| Congress Heights Senior Wellness Ctr | ||||
| 3500 Martin Luther King Jr Ave SE | Washington | DC | 20032 | Senior Connection Program |
| DC Police and Fire Clinic | ||||
| 920 Varnum Street NE | Washington | DC | 20017 | Occupational Health Services |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 6a Community Benefit Report Details | The Providence Hospital Community Benefit Report is prepared by Providence Hospital; the report contains only information related to Providence Hospital. |
| Schedule H, Part V, Section B, Line 17 Billing and Collection Policy | During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization. |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2017 was $3,817,806 at charges. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense is located on page 19. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | The organization has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance certain collection practices do not apply. |
| Schedule H, Part V, Section B, Line 16a FAP website | - PROVIDENCE HOSPITAL: Line 16a URL: http://www.provhosp.org/patients-guests/financial-assistance; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - PROVIDENCE HOSPITAL: Line 16b URL: http://www.provhosp.org/patients-guests/financial-assistance; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - PROVIDENCE HOSPITAL: Line 16c URL: http://www.provhosp.org/patients-guests/financial-assistance; |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DARCY BURTHAY | ||||||||||||||
| PRESIDENET & CEO | $188,555 | $219,139 | $200,982 | $0 | $64,286 | $24,168 | $7,309 | $9,916 | $6,164 | $2,764 | $467,296 | $255,987 | $0 | $0 |
| AMY E FREEMAN | ||||||||||||||
| FORMER OFFICER (END 12/2015) | $0 | $421,670 | $0 | $577,326 | $0 | $97,653 | $0 | $14,575 | $0 | $11,321 | $0 | $1,122,545 | $0 | $0 |
| DAN A MACKSOOD | ||||||||||||||
| FORMER OFFICER (END 12/2015) | $10,385 | $0 | $0 | $0 | $290,121 | $0 | $0 | $0 | $476 | $0 | $300,982 | $0 | $0 | $0 |
| SCOTT M FURNISS | ||||||||||||||
| CFO-MINISTRY MKT DC/BALTIMORE | $0 | $320,367 | $0 | $86,365 | $0 | $30,896 | $0 | $16,347 | $0 | $15,784 | $0 | $469,759 | $0 | $0 |
| MARC EDELMAN | ||||||||||||||
| CHIEF OPERATING OFFICER | $241,576 | $0 | $20,650 | $0 | $3,612 | $0 | $13,250 | $0 | $19,802 | $0 | $298,890 | $0 | $0 | $0 |
| PATRICIA EVANS MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $302,030 | $0 | $0 | $0 | $2,464 | $0 | $12,150 | $0 | $18,316 | $0 | $334,960 | $0 | $0 | $0 |
| MOURINE EVANS | ||||||||||||||
| CHIEF NURSING OFFICER | $248,000 | $0 | $20,650 | $0 | $5,544 | $0 | $12,517 | $0 | $5,441 | $0 | $292,152 | $0 | $0 | $0 |
| FRANCISCO F HOYOS | ||||||||||||||
| CO CHIEF MEDICAL OFFICER | $0 | $462,002 | $0 | $56,089 | $0 | $3,096 | $0 | $17,225 | $0 | $22,753 | $0 | $561,165 | $0 | $0 |
| Olusola Malomo | ||||||||||||||
| Medical Director | $256,489 | $0 | $10,000 | $0 | $586 | $0 | $14,497 | $0 | $23,410 | $0 | $304,982 | $0 | $0 | $0 |
| Rachel Maloney | ||||||||||||||
| AVP-Finance-Controller | $190,462 | $0 | $13,220 | $0 | $421 | $0 | $10,369 | $0 | $14,889 | $0 | $229,361 | $0 | $0 | $0 |
| Paul O Oriaifo | ||||||||||||||
| Medical Director | $249,841 | $0 | $0 | $0 | $7,117 | $0 | $16,784 | $0 | $18,424 | $0 | $292,166 | $0 | $0 | $0 |
| Taisha Williams | ||||||||||||||
| Associate Medical Director PFC | $216,181 | $0 | $7,000 | $0 | $165 | $0 | $10,895 | $0 | $17,666 | $0 | $251,907 | $0 | $0 | $0 |
| Gregory Ziegler | ||||||||||||||
| AVP-Finance-Revenue | $191,039 | $0 | $13,220 | $0 | $2,605 | $0 | $9,111 | $0 | $19,298 | $0 | $235,273 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | Ascension Health, a related organization of Providence Hospital, uses the following to establish the compensation of the organization's President/CEO: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM THE ORGANIZATION OR A RELATED ORGANIZATION: DAN A MACKSOOD - $289,615 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | 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 distributions from the supplemental non-qualified retirement plan were made in the current year. |
Schedule N IRS990ScheduleN
Disposition Of Assets Detail DispositionOfAssetsDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Assets Distri Or Expnss Paid | CASH ACCOUNTS TRANSFERRED TO PARENT'S BALANCE SHEET | AssetsDistriOrExpnssPaidDesc |
| Distribution | 2016-07-01 | DistributionDt |
| Fair Market Value Of Asset | $15,368,984 | FairMarketValueOfAssetAmt |
| Method Of FMV Determination | FMV | MethodOfFMVDeterminationTxt |
| EIN | 453358926 | EIN |
| Person | ASCENSION HEALTH ALLIANCE | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 45998 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63145 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501(C)(3) | IRCSectionTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | false | DirectorOfSuccessor2Ind |
| Employee Of Successor2 | false | EmployeeOfSuccessor2Ind |
| Owner Of Successor2 | false | OwnerOfSuccessor2Ind |
| Receive Compensation2 | false | ReceiveCompensation2Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule N, Part II CASH TRANSFER | FormAndLineReferenceDesc |
| Explanation | PROVIDENCE HOSPITAL TRANSFERRED ITS BEGINNING HSD CASH BALANCES TO ASCENION HEALTH ALLIANCE (45-3358926) AS OF JULY 1, 2016. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL | In determining the compensation of the organization's CEO, the process, performed by Ascension Health, a related organization of Providence Hospital, included a review and approval by independent persons, comparability data and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the committee minutes. The individual was not present when her compensation was decided. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Providence Hospital has a single corporate member, Ascension Health. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Providence Hospital has a single corporate member, Ascension Health, who has the ability to elect members to the governing body of Providence Hospital. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. |
| Form 990, Part VI, Line 12c Conflict of interest policy | The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, THE PROCESS PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF PROVIDENCE HOSPITAL, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE PROVIDENCE HOSPITAL'S EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. |
| Form 990, Part VI, Line 19 Required documents available to the public | The organization will provide any documents open to public inspection upon request. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | FAS 158 Pension - -3679480; Net Asset Transfers to Alpha Fund - -15368984; |
| Form 990, Part XII, Line 2b Audited Financial Statements | The activity of Providence Hospital is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of Providence Hospital is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of Providence Hospital. |
| Form 990, Part XII, Line 2c Audit Committee | Providence Hospital is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH ALLIANCE | ||||||||||
| PO BOX 45998 | ST LOUIS | MO | 631455998 | 453358926 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3) | Type I | NA | false |
| ASCENSION HEALTH | ||||||||||
| PO BOX 45998 | ST LOUIS | MO | 63145 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3) | Type I | ASCENSION HEALTH ALLIANCE | false |
| PROVIDENCE HEALTH SERVICES INC | ||||||||||
| 1150 VARNUM STREET NE | WASHINGTON | DC | 20017 | 521275587 | PHYSICIAN PRACTICES | DC | 501(c)(3) | Type I | PROVIDENCE HOSPITAL | Yes (true) |
| PROVIDENCE HEALTH FOUNDATION INC | ||||||||||
| 1150 VARNUM STREET NE | WASHINGTON | DC | 20017 | 521275583 | FUNDRAISING ORGANIZATION | DC | 501(c)(3) | Type I | PROVIDENCE HOSPITAL | Yes (true) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESOURCE PHARMACIES Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1150 VARNUM STREET NE | AddressLine1Txt |
| City | WASHINGTON | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20017 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 521410076 | EIN |
| Primary Activities | RETAIL PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | DC | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROVIDENCE HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C Corporation | EntityTypeTxt |
| Share Of Total Income | $1,485,458 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $616,810 | ShareOfEOYAssetsAmt |
| Ownership | 1 | OwnershipPct |
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| PROVIDENCE HEALTH FOUNDATION INC | ||
| M | $103,667 | FAIR MARKET VALUE |
| PROVIDENCE HEALTH SERVICES INC | ||
| L | $173,989 | FAIR MARKET VALUE |
| PROVIDENCE HEALTH SERVICES INC | ||
| P | $87,675 | FAIR MARKET VALUE |
| PROVIDENCE HEALTH SERVICES INC | ||
| Q | $69,914,084 | FAIR MARKET VALUE |
| PROVIDENCE HEALTH SERVICES INC | ||
| R | $5,014,719 | FAIR MARKET VALUE |
| PROVIDENCE HEALTH FOUNDATION INC | ||
| C | $1,036,194 | FAIR MARKET VALUE |
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