2018-05-15T14:02:37-05:00 2017-06-30 990 2016-07-01 462847744 Alabama Providence Healthcare Services ALAB 3147338000 6801 Airport Boulevard Mobile AL 36608 Tonya Mershon Tax Officer 2018-05-15 2016 2022-09-23 18:48:47Z C SUSAN CORNEJO 6801 Airport Boulevard Mobile AL 36608 47805720 false X WWW.PROVIDENCEHOSPITAL.ORG X 2013 AL TO SERVE ALL PERSONS, WITH SPECIAL ATTENTION TO THOSE THAT ARE POOR AND VULNERABLE. 5 0 347 0 0 0 0 0 28023089 46050461 118 20329 2912921 1722469 30936128 47793259 8500 0 0 20627288 40414334 0 0 0 16946118 19953436 37581906 60367770 -6645778 -12574511 12099703 8096297 28337836 11103838 -16238133 -3007541 OUR MISSION IS TO COMMIT OURSELVES TO SERVICING ALL PERSONS, WITH SPECIAL ATTENTION TO THOSE WHO ARE POOR AND VULNERABLE. WE ARE DEDICATED TO SPIRITUALLY CENTERED, HOLISTIC CARE THAT SUSTAINS AND IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES. WE ARE ADVOCATES FOR A COMPASSIONATE AND JUST SOCIETY THROUGH OUR ACTIONS AND OUR WORDS. false false 60367770 47772190 TO EMPLOY PHYSICIANS AND MANAGE THEIR PRACTICES IN A MANNER WHICH SUPPORTS THE OPERATION AND MISSION OF PROVIDENCE HOSPITAL. THERE WERE 155,415 PHYSICIAN VISITS DURING THE FISCAL YEAR. 60367770 true false false false false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true 33 0 true 347 true false false false false false false false false false false X 5 0 false false false false true true true true true false false false true true true true true false false false X C SUSAN CORNEJO 2516331660 6801 AIRPORT BLVD MOBILE AL 36608 ALLISON B DOUGLAS MD VICE CHAIR (end 10/2016) 40.0 0 X X 143648 0 28916 ELIZABETH B DUDLEY SECRETARY/TREASURER (start 10/2016) 20.0 20.0 X X 0 196122 23716 TODD S KENNEDY BOARD MEMBER & HOSPITAL PRESIDENT 1.0 43.0 X X 0 617042 36866 CHARLES A PINKERT BOARD PRESIDENT AND COO-VP 20.0 20.0 X X 0 201176 26554 JAMES L WALKER MD CHAIR 39.0 1.0 X X 531308 0 21911 BOB MURPHY BOARD MEMBER (start 10/2016) 1.0 41.0 X 0 161732 10537 SUSAN L DAVIS RN SVP - GULF COAST MINISTRY MKT EXEC (end 10/2016) 1.0 44.0 X 0 2410776 37018 ROBERT W ISRAEL MD Physician 40.0 1.0 X 486941 0 42317 MICHELLE S JACKSON Physician 40.0 0 X 443041 0 33254 ERIC C JOHNSON Physician 40.0 0 X 490016 0 43376 DAVID M PHILLIPS Physician 40.0 0 X 457584 0 39428 JAMES K SIMPSON Physician 40.0 0 X 742763 0 44729 CLARK P CHRISTIANSON FORMER OFFICER (END 9/2015) 0.0 0.0 X 0 432100 12560 3295301 4018948 401182 49 true true false MCKESSON SPECIALTY CARE DISTRIBUTION JV 15212 COLLECTION CENTER DRIVE CHICAGO IL 606930152 HEALTHCARE SERVICES 2899370 LABORATORY CORPORATION OF AMERICA HOLDINGS P O BOX 8006 BURLINGTON NC 27216 LABORATORY TESTS AND SERVICES 419495 BENNETT CONSULTING LLC 999 FORT PICKENS ROAD SUITE 309 PENSACOLA BEACH FL 32561 CONSULTING SERVICES 128808 ORION VENTURES LLC 9985 AIRPORT BLVD MOBILE AL 366089525 INFORMATION TECHNOLOGY CONSULTING SVCS 121715 4 0 NET PATIENT REVENUE 621110 39627130 39627130 i/c management fees 541610 6423331 6423331 0 0 0 0 46050461 5472 5472 0 0 27318 12461 0 14857 14857 14857 OTHER REVENUE 900099 1717681 1717681 BILLING ARRANGEMENT 900099 4048 4048 CAFETERIA/vending rEVENUE 722514 740 740 0 0 0 0 1722469 47793259 47772190 0 21069 725783 725783 35319897 35319897 815602 815602 1648419 1648419 1904633 1904633 2000 2000 2709056 2709056 0 0 2345 2345 398927 398927 73734 73734 1930751 1930751 136174 136174 125906 125906 89 89 514616 514616 577451 577451 MEDICAL SUPPLIES 7432069 7432069 PURCHASED SERVICES 6060421 6060421 equipment rent 772167 772167 minor equipment 172770 172770 -955040 -955040 0 0 60367770 60367770 0 0 0 400 1609022 3448419 0 0 0 297990 0 335510 86435 8518 45025 5301398 4635330 432113 666068 0 45000 45000 0 242267 9371550 3562683 12099703 8096297 2251452 2790622 0 26086384 8313216 28337836 11103838 X -16238133 -3007541 -16238133 -3007541 12099703 8096297 X -12574511 25805103 X false true X true false X 0 12891952 26453486 28023089 46050461 113418988 0 0 0 0 12891952 26453486 28023089 46050461 113418988 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113418988 614 118 5472 6204 0 0 0 614 118 5472 6204 0 0 0 2523565 2912921 1722469 7158955 0 12891952 28977665 30936128 47778402 120584147 X Schedule A, Part III, Line 12 Other Income DESCRIPTION - EQUIPMENT RENTAL, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 19613.0, COLUMN D - 9969.0, COLUMN E - 0.0, COLUMN F - 29582.0; DESCRIPTION - MISC. REVENUE, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 2503952.0, COLUMN D - 2799356.0, COLUMN E - 1717681.0, COLUMN F - 7020989.0; DESCRIPTION - MANAGEMENT FEES, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 103596.0, COLUMN E - 0.0, COLUMN F - 103596.0; DESCRIPTION - BILLING ARRANGEMENT, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 4048.0, COLUMN F - 4048.0; DESCRIPTION - CAFETERIA/VENDING, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 0.0, COLUMN E - 740.0, COLUMN F - 740.0; 365209 297876 67333 131895 131895 0 4803038 4204303 598735 1256 1256 0 666068 DUE FROM AFFILIATES 3094007 NR Physicians 36800 Other Receivables 431876 3562683 DUE TO AFFILIATE 4054280 SELF INSURANCE LIABILITY AH SAVINGS PLAN Pension and Other Post retirement Liability 3909623 other liabilities 349313 8313216 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote 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. true true false false false false false false false ALLISON B DOUGLAS MD VICE CHAIR (end 10/2016) 94130 0 49049 0 469 0 9691 0 19225 0 172564 0 0 0 ELIZABETH B DUDLEY SECRETARY/TREASURER (start 10/2016) 0 149178 0 36929 0 10015 0 12000 0 11716 0 219838 0 0 TODD S KENNEDY BOARD MEMBER & HOSPITAL PRESIDENT 0 329760 0 227843 0 59439 0 15900 0 20966 0 653908 0 0 CHARLES A PINKERT BOARD PRESIDENT AND COO-VP 0 149122 0 40428 0 11626 0 11984 0 14570 0 227730 0 0 JAMES L WALKER MD CHAIR 417980 0 54741 0 58587 0 17225 0 4686 0 553219 0 0 0 BOB MURPHY BOARD MEMBER (start 10/2016) 0 114891 0 44543 0 2298 0 2954 0 7583 0 172269 0 0 CLARK P CHRISTIANSON FORMER OFFICER (END 9/2015) 0 0 0 0 0 432100 0 0 0 12560 0 444660 0 0 SUSAN L DAVIS RN SVP - GULF COAST MINISTRY MKT EXEC (end 10/2016) 0 799161 0 1277731 0 333884 0 15900 0 21118 0 2447794 0 0 ROBERT W ISRAEL MD Physician 277290 0 203260 0 6391 0 17225 0 25092 0 529258 0 0 0 MICHELLE S JACKSON Physician 220292 0 220959 0 1790 0 15900 0 17354 0 476295 0 0 0 ERIC C JOHNSON Physician 221942 0 264351 0 3723 0 17225 0 26151 0 533392 0 0 0 DAVID M PHILLIPS Physician 189062 0 259370 0 9152 0 16727 0 22701 0 497012 0 0 0 JAMES K SIMPSON Physician 476173 0 69786 0 196804 0 17225 0 27504 0 787492 0 182326 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation ASCENSION HEALTH, A RELATED ORGANIZATION OF ALABAMA PROVIDENCE HEALTHCARE SERVICES, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT AND CEO: - COMPENSATION COMMITTEE, - INDEPENDENT COMPENSATION CONSULTANT, - COMPENSATION SURVEY OR STUDY, AND - 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: Clark P. Christianson - $402,699 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals received payment from the supplemental nonqualified retirement plan in the amount as noted: James K. Simpson, MD - $182,326 Form 990, Part III, Line 4a COMMUNITY BENEFIT REPORT JUNE 30 2017 ALABAMA PROVIDENCE HEALTHCARE SERVICES IS ONE OF THE REGION'S LARGEST NONPROFIT PHYSICIAN PRACTICE ORGANIZATIONS. WE ARE AFFILIATED WITH GULF COAST HEALTH SYSTEM, INC., WHICH IS ONE OF THE OLDEST HEALTHCARE PROVIDERS IN MOBILE ALABAMA, HAVING SERVED ITS CITIZENS SINCE 1854. ON A NATIONAL LEVEL, PROVIDENCE IS A MEMBER OF ASCENSION HEALTH, THE NATION'S LARGEST NONPROFIT CATHOLIC HEALTHCARE SYSTEM. ASCENSION IS DIRECTED BY THE CATHOLIC CHURCH TO CARE FOR THOSE MOST IN NEED. OUR CATHOLIC PHILOSOPHY PERMEATES OUR PROMISE TO PROVIDE HEALTHCARE THAT WORKS, HEALTHCARE THAT IS SAFE, AND HEALTHCARE THAT LEAVES NO ONE BEHIND. - HEALTHCARE THAT WORKS CALLS US TO MEET THE PROMISE OF A CONSISTENT, EXCEPTIONAL ASCENSION HEALTH EXPERIENCE IN EVERY ENCOUNTER WITH THOSE WE SERVE. - HEALTHCARE THAT IS SAFE IS A FOCUS ON PERSON-CENTERED CARE, WHICH HAS INSPIRED AND CONTINUES TO SPARK UNPRECEDENTED IMPROVEMENTS IN HEALTHCARE QUALITY AND SAFETY. - HEALTHCARE THAT LEAVES NO ONE BEHIND REPRESENTS ASCENSION HEALTH'S COMMITMENT TO 100 PERCENT ACCESS AND COVERAGE FOR ALL AMERICANS. MISSION OUR MISSION IS TO COMMIT OURSELVES TO SERVICING ALL PERSONS, WITH SPECIAL ATTENTION TO THOSE WHO ARE POOR AND VULNERABLE. WE ARE DEDICATED TO SPIRITUALLY CENTERED, HOLISTIC CARE THAT SUSTAINS AND, IMPROVES THE HEALTH OF INDIVIDUALS AND COMMUNITIES. WE ARE ADVOCATES FOR A COMPASSIONATE AND JUST SOCIETY THROUGH OUR ACTIONS AND OUR WORDS. VISION OUR VISION IS A STRONG, VIBRANT CATHOLIC HEALTH MINISTRY IN THE UNITED STATES WHICH WILL LEAD TO THE TRANSFORMATION OF HEALTHCARE. WE WILL ENSURE SERVICE THAT IS COMMITTED TO HEALTH AND WELL-BEING OF OUR COMMUNITIES AND THAT RESPONDS TO THE NEEDS OF INDIVIDUALS THROUGHOUT THE LIFE CYCLE. WE WILL EXPAND THE ROLE OF THE LAITY, IN BOTH LEADERSHIP AND SPONSORSHIP, TO ENSURE A CATHOLIC HEALTH MINISTRY OF THE FUTURE. VALUES WE SHARE A COMMON VISION AND ARE CALLED TO ACT UPON THE FOLLOWING IDEAS AND BELIEFS: SERVICE OF THE POOR - GENEROSITY OF SPIRIT, ESPECIALLY FOR PERSONS MOST IN NEED. REVERENCE - RESPECT AND COMPASSION FOR THE DIGNITY AND DIVERSITY OF LIFE. INTEGRITY - INSPIRING TRUST THROUGH PERSONAL LEADERSHIP. WISDOM - INTEGRATING EXCELLENCE AND STEWARDSHIP. CREATIVITY - COURAGEOUS INNOVATION. DEDICATION - AFFIRMING THE HOPE AND JOY OF OUR MINISTRY. SERVICES ALABAMA PROVIDENCE HEALTHCARE SERVICES PROVIDES THE FOLLOWING INPATIENT AND OUTPATIENT MEDICAL SERVICES TO THE COMMUNITY: ENDOCRINOLOGY, ENT, NEUROLOGY, PEDIATRICS, FAMILY PRACTICE, GASTROENTEROLOGY, INTERNAL MEDICINE. CHARITY CARE ALABAMA PROVIDENCE HEALTHCARE SERVICES IS DEDICATED TO SERVING THOSE WHO ARE POOR AND VULNERABLE. SERVICES TO CARE FOR THIS POPULATION HAVE BEEN PROVIDED THROUGH OUR NETWORK LOCATIONS. PFP - AIRPORT: $1,695 PFP - SARALAND: $269 PFP - SEMMES: $1,010 PFP - TILLMAN'S CORNER: $1,186 PFP - CITRONELLE: $678 PMG - COTTAGE HILL: $2,184 PFP - CITRONELLE: $441 DAWES: $808 PFP -MOBILE DIAGNOSTIC CENTER: $17,271 PALLATIVE CARE: $4,785 WEST MOBILE MEDIAL GROUP: $12,270 MDC ANCILLARY SERVICES $67,082. HEALTHCARE SERVICES SEEKS TO IMPROVE THE PHYSICAL, MENTAL SOCIAL AND SPIRITUAL HEALTH STATUS OF ITS SURROUNDING COMMUNITY. SERVICES ARE PROVIDED IN THE CLINIC SETTING, AT THE HOSPITAL, AND IN A MOBILE MEDICAL SETTING WITH TWO MOBILE MEDICAL VANS. OUR PHYSICIANS HAVE CONTRIBUTED THEIR SKILLS AND TIME TOWARD CAMP RAP-A HOPE. THE CAMP PROVIDES A WEEK-LONG SUMMER CAMP AND IS OPEN TO CHILDREN BETWEEN THE AGES OF 7 AND 17 WHO HAVE OR HAVE EVER HAD CANCER. THE CAMP IS OFFERED FOR FREE TO THE CAMPERS. Our physicians also sponsored and participated in the inaugural One Fit Mobile Event at Cottage Hill Park, which raised money for the community's effort to promote a healthier lifestyle for its citizens. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL In determining the compensation of the Organization's Top Management Official, the process performed by Ascension Health, a related organization of Alabama Providence Healthcare Services, 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 Top Management Official 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 his compensation was decided. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS, THE PROCESS PERFORMED BY GULF COAST HEALTH SYSTEM, INC., A RELATED ORGANIZATION OF ALABAMA PROVIDENCE HEALTHCARE SERVICES, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE GULF COAST HEALTH SYSTEM, INC. 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 6 Classes of members or stockholders ALABAMA PROVIDENCE HEALTHCARE SERVICES HAS A SINGLE CORPORATE MEMBER, GULF COAST HEALTH SYSTEM, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ALABAMA PROVIDENCE HEALTHCARE SERVICES HAS A SINGLE CORPORATE MEMBER, GULF COAST HEALTH SYSTEM, INC., WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ALABAMA PROVIDENCE HEALTHCARE SERVICES. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Alabama Providence Healthcare Services' financial information or corporation as a whole are subject to approval by its sole corporate member, Gulf Coast Health System, Inc. 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 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 - -676185; transfer from alpha - 26481288; Form 990, Part XII, Line 2b audit of financial statements The activity of Alabama Providence Healthcare Services is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of Alabama Providence Healthcare Services is completed. Therefore, the audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of Alabama Providence Healthcare Services. Form 990, Part XII, Line 2c oversight of audit or selection of independent accountant Alabama Providence Healthcare Services 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. 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