TY 2020 Form 990 Schedule J

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1ROD F HOCHMAN MD FORMER OFFICER - PSJH PRESIDENT/CEO	(i) (ii)	0 ------------- 1,773,896	0 ------------- 6,709,440	0 ------------- 816,258	0 ------------- 782,925	0 ------------- 30,876	0 ------------- 10,113,395	0 ------------- 751,800
2MIKE BUTLER PRESIDENT - THRU 9/20	(i) (ii)	0 ------------- 965,819	0 ------------- 3,330,902	0 ------------- 4,411,516	0 ------------- 34,515	0 ------------- 21,916	0 ------------- 8,764,668	0 ------------- 2,150,861
3DEBRA CANALES FORMER KE - PSJH EVP/CAO	(i) (ii)	0 ------------- 895,727	0 ------------- 575,002	0 ------------- 533,155	0 ------------- 673,455	0 ------------- 17,653	0 ------------- 2,694,992	0 ------------- 487,270
4ERIK WEXLER EVP CHIEF EXECUTIVE PSJH SO CA	(i) (ii)	0 ------------- 964,730	0 ------------- 573,824	0 ------------- 325,727	0 ------------- 425,498	0 ------------- 22,517	0 ------------- 2,312,296	0 ------------- 310,110
5AMY COMPTON-PHILLIPS MD FORMER KE - PSJH EVP/CHF CLIN. OFC.	(i) (ii)	0 ------------- 760,456	0 ------------- 519,149	0 ------------- 429,406	0 ------------- 500,905	0 ------------- 32,184	0 ------------- 2,242,100	0 ------------- 384,671
6RHONDA MEDOWS MD FRMR KE - PSJH PRES. EVP/POP. HEALTH	(i) (ii)	0 ------------- 897,985	0 ------------- 523,880	0 ------------- 392,595	0 ------------- 308,771	0 ------------- 20,090	0 ------------- 2,143,321	0 ------------- 346,425
7VENKAT BHAMIDIPATI EVP/TREASURER - THRU 9/20	(i) (ii)	0 ------------- 713,471	0 ------------- 400,000	0 ------------- 970,660	0 ------------- 4,275	0 ------------- 18,405	0 ------------- 2,106,811	0 ------------- 184,910
8CINDY STRAUSS SECRETARY - THRU 12/20	(i) (ii)	0 ------------- 801,070	0 ------------- 601,420	0 ------------- 343,051	0 ------------- 331,005	0 ------------- 27,088	0 ------------- 2,103,634	0 ------------- 299,545
9VICTOR JORDAN COO SO CA	(i) (ii)	0 ------------- 678,985	0 ------------- 481,726	0 ------------- 555,624	0 ------------- 203,491	0 ------------- 31,382	0 ------------- 1,951,208	0 ------------- 420,036
10LISA VANCE FORMER KE - FPSJH EVP REGIONAL CE OR	(i) (ii)	0 ------------- 771,527	0 ------------- 511,879	0 ------------- 246,300	0 ------------- 384,714	0 ------------- 26,534	0 ------------- 1,940,954	0 ------------- 203,441
11JO ANN ESCASA-HAIGH EVP/TREASURER/CFO	(i) (ii)	0 ------------- 682,465	0 ------------- 370,006	0 ------------- 259,183	0 ------------- 403,809	0 ------------- 31,129	0 ------------- 1,746,592	0 ------------- 218,804
12BERNIE KLEIN MD CHIEF EXEC PROV HOLY CROSS MC	(i) (ii)	0 ------------- 601,104	0 ------------- 227,798	0 ------------- 611,271	0 ------------- 187,633	0 ------------- 28,211	0 ------------- 1,656,017	0 ------------- 584,246
13GREG TILL FORMER CHIEF PEOPLE OFFICER	(i) (ii)	0 ------------- 601,238	0 ------------- 514,002	0 ------------- 189,220	0 ------------- 308,738	0 ------------- 32,912	0 ------------- 1,646,110	0 ------------- 152,175
14AARON MARTIN FRMR KE - PSJH EVP CHF MKT/DIG INN.	(i) (ii)	0 ------------- 644,818	0 ------------- 390,425	0 ------------- 272,510	0 ------------- 266,627	0 ------------- 5,716	0 ------------- 1,580,096	0 ------------- 249,267
15MIKE WATERS FORMER EVP AMBULATORY CARE NETWORK	(i) (ii)	0 ------------- 513,014	0 ------------- 313,206	0 ------------- 294,266	0 ------------- 207,159	0 ------------- 16,048	0 ------------- 1,343,693	0 ------------- 161,221
16JOEL GILBERTSON FORMER EVP COMMUNITY PARTNERSHIPS	(i) (ii)	0 ------------- 578,919	0 ------------- 305,000	0 ------------- 223,675	0 ------------- 195,488	0 ------------- 30,562	0 ------------- 1,333,644	0 ------------- 186,629
17OREST HOLUBEC FORMER SVP CHIEF COMMUNICATION OFCR	(i) (ii)	0 ------------- 472,607	0 ------------- 259,999	0 ------------- 206,774	0 ------------- 173,676	0 ------------- 29,598	0 ------------- 1,142,654	0 ------------- 169,616
18DALE SUROWITZ FORMER KEY EMPLOYEE	(i) (ii)	0 ------------- 401,239	0 ------------- 144,457	0 ------------- 574,338	0 ------------- 6,046	0 ------------- 15,444	0 ------------- 1,141,524	0 ------------- 312,779
19JOHN WHIPPLE SECRETARY	(i) (ii)	0 ------------- 448,628	0 ------------- 316,136	0 ------------- 198,887	0 ------------- 148,450	0 ------------- 27,856	0 ------------- 1,139,957	0 ------------- 169,265
20KELLY LINDEN CHIEF EXEC PROV ST JOSEPH MC	(i) (ii)	0 ------------- 465,848	0 ------------- 157,963	0 ------------- 139,872	0 ------------- 137,692	0 ------------- 30,725	0 ------------- 932,100	0 ------------- 115,470
21GARRY OLNEY CHIEF EXECUTIVE SOUTH BAY	(i) (ii)	0 ------------- 507,190	0 ------------- 190,348	0 ------------- 46,134	0 ------------- 157,459	0 ------------- 13,350	0 ------------- 914,481	0 ------------- 21,732
22DAVID BROWN FORMER SVP CAO AMBULATORY CARE	(i) (ii)	0 ------------- 381,205	0 ------------- 143,506	0 ------------- 183,752	0 ------------- 127,676	0 ------------- 29,222	0 ------------- 865,361	0 ------------- 161,988
23JIM WATSON ESQ ASSISTANT SECRETARY	(i) (ii)	0 ------------- 437,006	0 ------------- 301,877	0 ------------- 5,598	0 ------------- 84,307	0 ------------- 35,749	0 ------------- 864,537	0 ------------- 0
24GREG HOFFMAN PRESIDENT/CEO (PART YEAR)	(i) (ii)	0 ------------- 436,362	0 ------------- 98,549	0 ------------- 141,036	0 ------------- 93,123	0 ------------- 29,372	0 ------------- 798,442	0 ------------- 69,769
25DEBBIE BURTON FORMER SVP CHIEF NURSING OFFICER	(i) (ii)	0 ------------- 377,566	0 ------------- 135,000	0 ------------- 139,297	0 ------------- 8,252	0 ------------- 30,954	0 ------------- 691,069	0 ------------- 107,362
26HOWARD DAVIS CMO TARZANA	(i) (ii)	485,987 ------------- 0	94,274 ------------- 0	75,749 ------------- 0	6,413 ------------- 0	20,246 ------------- 0	682,669 ------------- 0	19,552 ------------- 0
27JIM NOBLE CFO SO CA REGION - THRU 11/20	(i) (ii)	0 ------------- 481,800	0 ------------- 142,499	0 ------------- 4,525	0 ------------- 4,275	0 ------------- 28,319	0 ------------- 661,418	0 ------------- 0
28RICHARD GLIMP CMO TORRANCE	(i) (ii)	494,444 ------------- 0	70,070 ------------- 0	39,813 ------------- 0	5,537 ------------- 0	10,269 ------------- 0	620,133 ------------- 0	25,486 ------------- 0
29DEETTE MONTGOMERY COO-PMI	(i) (ii)	347,465 ------------- 0	186,496 ------------- 0	13,260 ------------- 0	6,413 ------------- 0	14,405 ------------- 0	568,039 ------------- 0	9,847 ------------- 0
30GLEN KOMATSU CMO PTCH	(i) (ii)	414,976 ------------- 0	57,857 ------------- 0	57,240 ------------- 0	8,100 ------------- 0	29,799 ------------- 0	567,972 ------------- 0	24,697 ------------- 0
31REX HOFFMAN CHIEF MEDICAL OFFICER-FAC	(i) (ii)	404,024 ------------- 0	128,402 ------------- 0	2,083 ------------- 0	3,155 ------------- 0	23,153 ------------- 0	560,817 ------------- 0	0 ------------- 0
32TOM MCDONAGH FORMER VP/CHIEF INVESTMENT OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 485,249	0 ------------- 6,415	0 ------------- 24,117	0 ------------- 515,781	0 ------------- 0
33SHARON TONCRAY FORMER SVP/CHIEF LABOR EE COUNSEL	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 361,654	0 ------------- 3,685	0 ------------- 23,776	0 ------------- 389,115	0 ------------- 0
34DONALD ANDERSON JR FORMER ASSISTANT SECRETARY FOR ENROL	(i) (ii)	0 ------------- 204,368	0 ------------- 23,098	0 ------------- 1,007	0 ------------- 11,841	0 ------------- 10,973	0 ------------- 251,287	0 ------------- 0
35TAMMY TEODOSIO FORMER ASSISTANT SECRETARY	(i) (ii)	0 ------------- 95,587	0 ------------- 7,996	0 ------------- 1,522	0 ------------- 4,335	0 ------------- 13,325	0 ------------- 122,765	0 ------------- 0

Schedule J (Form 990) 2020

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
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 OR GROSS-UP PAYMENTS TAX INDEMNIFICATION OR GROSS-UP PAYMENTS - RELOCATION PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO RELOCATION EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THE RELOCATION EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THE RELOCATION BENEFITS, SO THAT A PORTION OF THE REIMBURSEMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - FINANCIAL/RETIREMENT PLANNING PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO FINANCIAL AND RETIREMENT PLANNING EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THESE OTHER EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THIS BENEFIT, SO THAT A PORTION OF THE PAYMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE PROVIDENCE PROVIDES HOUSING ALLOWANCES ONLY FOR PURPOSES OF RELOCATION ASSISTANCE TO A NEWLY HIRED EMPLOYEE. PROVIDENCE MAY PAY TEMPORARY LIVING EXPENSES FOR THE NEWLY HIRED EMPLOYEE UP TO A MAXIMUM OF 90 CALENDAR DAYS. COVERED EXPENSES ARE RENT (EXCLUDING "RENT" WHICH MAY BE PAID IN ORDER TO OCCUPY A NEW PERMANENT RESIDENCE UNTIL THE TITLE CLEARS) AND UTILITIES, INCLUDING HEAT, ELECTRICITY, GAS, WATER, LOCAL INTERNET AND LOCAL TELEPHONE AND GARBAGE SERVICES. THE EXECUTIVE VICE PRESIDENT, CHIEF ADMINISTRATIVE OFFICER OF PROVIDENCE MAY APPROVE TEMPORARY HOUSING ASSISTANCE FOR UP TO SIX MONTHS WHEN FAMILY RELOCATION IS DELAYED TO ACCOMMODATE THE SCHOOL YEAR OR EQUIVALENT CIRCUMSTANCES. ONLY IN EXTENUATING CIRCUMSTANCES IS HOUSING EXTENDED BEYOND THIS SIX-MONTH PERIOD. THE AMOUNTS REPORTED FOR THESE RELOCATION/HOUSING PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE.
PART I, LINE 3	DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY A RELATED TAX EXEMPT ORGANIZATION, PROVIDENCE HEALTH & SERVICES - WASHINGTON, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE.
PART I, LINES 4A-B	THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE YEAR: VENKAT BHAMIDIPATI - $750,000 MIKE BUTLER - $507,235 TOM MCDONAGH - $485,032 SHARON TONCRAY - $367,774 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: ROD F. HOCHMAN, MD - $751,800 MIKE BUTLER - $2,150,861 DEBRA CANALES - $487,270 ERIK WEXLER - $310,110 AMY COMPTON-PHILLIPS, MD - $384,671 RHONDA MEDOWS, MD - $346,425 VENKAT BHAMIDIPATI - $184,910 CINDY STRAUSS - $299,545 VICTOR JORDAN - $420,036 LISA VANCE - $203,441 JO ANN ESCASA-HAIGH - $218,804 BERNIE KLEIN, MD - $584,246 GREG TILL - $152,175 AARON MARTIN - $249,267 MIKE WATERS - $161,221 JOEL GILBERTSON - $186,629 OREST HOLUBEC - $169,616 DALE SUROWITZ - $312,779 JOHN WHIPPLE - $169,265 KELLY LINDEN - $115,470 GARRY OLNEY - $21,732 DAVID BROWN - $161,988 GREG HOFFMAN - $69,769 DEBBIE BURTON - $107,362 HOWARD DAVIS - $19,552 RICHARD GLIMP - $25,486 DEETTE MONTGOMERY - $9,847 GLEN KOMATSU - $24,697
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, WHICH IS A PERFORMANCE-BASED ANNUAL INCENTIVE PLAN THAT AFFORDS 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.

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