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Nonprofiteer
← ADENA FAYETTE MEDICAL CENTER

Form 990 for tax year 2023

Filed by ADENA FAYETTE MEDICAL CENTER.

Totals

Total revenue
$63,728,712
Total expenses
$57,167,818
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$63,412,759
Investment income
$3,033
Other revenue
$312,920
Total assets, end of year
$26,699,495
Total liabilities, end of year
$6,989,057
Net assets or fund balances, end of year
$19,710,438
Program services expenses (Part IX)
$52,171,885
Management and general expenses
$4,995,933
Fundraising expenses
$0
Program service expenses (Part III)
$52,171,885

Program services were 91.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • JEFF GRAHAM

    AHS PRESIDENT & CEO

    Total calculated
    $1,068,566
    From this org
    $0
    From related orgs
    $1,010,366
    Other
    $58,200
    Hours/week
    1 + 53 related

    Schedule J breakdown matched by us

    Base
    $0 + $956,818 related
    Bonus
    $0 + $39,688 related
    Other
    $0 + $13,860 related
    Deferred
    $0 + $23,080 related
    Nontaxable benefits
    $0 + $35,120 related
    Filer's total
    $0 + $1,068,566 related
  • JENNY BREEDLOVE

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    2
  • BRIAN REAM

    TRUSTEE/CHAIR

    Total calculated
    $0
    Hours/week
    2
  • CHELSIE BAKER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2
  • DOUG BOEDEKER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2
  • JEFF FUNARI

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2
  • ROBYN HADDEN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2
  • MARY E KING

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2
  • CARLA MELVIN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2
  • CHIQUITA NASH

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2
  • KIM PITTSER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2
  • DIANNA WAYNE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2
  • JIM MCMANUS

    AHS CHIEF FINANCIAL OFFICER

    Total calculated
    $747,455
    From this org
    $0
    From related orgs
    $621,511
    Other
    $125,944
    Hours/week
    1 + 53 related

    Schedule J breakdown matched by us

    Base
    $0 + $547,954 related
    Bonus
    $0 + $35,472 related
    Other
    $0 + $38,085 related
    Deferred
    $0 + $74,012 related
    Nontaxable benefits
    $0 + $51,932 related
    Filer's total
    $0 + $747,455 related
  • KATHERINE EDRINGTON

    AHS COO

    Total calculated
    $653,968
    From this org
    $0
    From related orgs
    $621,194
    Other
    $32,774
    Hours/week
    1 + 53 related

    Schedule J breakdown matched by us

    Base
    $0 + $605,161 related
    Bonus
    $0 + $13,933 related
    Other
    $0 + $2,100 related
    Deferred
    $0 + $17,691 related
    Nontaxable benefits
    $0 + $15,083 related
    Filer's total
    $0 + $653,968 related
  • JOSH MCCOY

    SENIOR OPERATIONS EXECTUTIVE DIRECTOR

    Total calculated
    $292,265
    From this org
    $0
    From related orgs
    $252,673
    Other
    $39,592
    Hours/week
    25 + 25 related

    Schedule J breakdown matched by us

    Base
    $0 + $247,938 related
    Bonus
    $0
    Other
    $0 + $4,735 related
    Deferred
    $0 + $11,367 related
    Nontaxable benefits
    $0 + $28,225 related
    Filer's total
    $0 + $292,265 related
  • MELISSA LEMLE

    PHARMACIST

    Total calculated
    $199,411
    From this org
    $161,814
    From related orgs
    $0
    Other
    $37,597
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $148,069
    Bonus
    $333
    Other
    $13,412
    Deferred
    $1,300
    Nontaxable benefits
    $36,297
    Filer's total
    $199,411
  • CAROYLN WALLIN

    DIR OPERATIONS CRITICAL ACCESS

    Total calculated
    $198,237
    From this org
    $154,263
    From related orgs
    $0
    Other
    $43,974
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $152,568
    Bonus
    $1,500
    Other
    $195
    Deferred
    $21,160
    Nontaxable benefits
    $22,814
    Filer's total
    $198,237
  • TAMMIE WILSON

    DIR NURSING

    Total calculated
    $182,287
    From this org
    $152,982
    From related orgs
    $0
    Other
    $29,305
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $151,183
    Bonus
    $1,200
    Other
    $599
    Deferred
    $27,388
    Nontaxable benefits
    $1,917
    Filer's total
    $182,287
  • MATTHEW INSLEY

    TL PHARMACY

    Total calculated
    $182,061
    From this org
    $146,234
    From related orgs
    $0
    Other
    $35,827
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $140,353
    Bonus
    $0
    Other
    $5,881
    Deferred
    $7,627
    Nontaxable benefits
    $28,200
    Filer's total
    $182,061
  • EMILY STEPHENS

    NURSE PRACTITIONER WRVU

    Total calculated
    $151,288
    From this org
    $131,196
    From related orgs
    $0
    Other
    $20,092
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $115,182
    Bonus
    $15,455
    Other
    $559
    Deferred
    $2,470
    Nontaxable benefits
    $17,622
    Filer's total
    $151,288
  • LISA CARLSON

    AHS CFO- FORMER

    Total calculated
    $271,076
    From this org
    $0
    From related orgs
    $270,056
    Other
    $1,020
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $28,082 related
    Bonus
    $0 + $291 related
    Other
    $0 + $241,683 related
    Deferred
    $0 + $931 related
    Nontaxable benefits
    $0 + $89 related
    Filer's total
    $0 + $271,076 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
EXECUTIVE LEADERSHIP AT ADENA FAYETTE MEDICAL CENTER HAS THEIR COMPENSATION REVIEWED EVERY YEAR BY ADENA HEALTH SYSTEM, A RELATED PARTY. THE SYSTEM UTILIZES A SEPARATE COMPENSATION CONSULTING FIRM THAT USES SEVERAL AVAILABLE MARKET STUDIES FOR APPLICABLE POSITIONS IN COMPARABLE MARKETS. OTHER ADENA FAYETTE MEDICAL CENTER MANAGEMENT WAGES ARE REVIEWED INTERNALLY USING MARKET DATA.
PART I, LINE 4B
ADENA HEALTH SYSTEM HAS A 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE FOLLOWING INDIVIDUALS PARTICIPATED IN OR RECEIVED PAYMENT FROM THE SERP IN 2023: LISA CARLSON $241,505 SERP EARNINGS JAMES MCMANUS $29,615 SERP EARNINGS THE SERP ACCRUALS, INCLUDED IN PART II, COLUMN (C), ARE AMOUNTS CREDITED TO THE EXECUTIVE UNDER THE SECTION 457(F) DEFERRED COMPENSATION PLAN. JAMES MCMANUS $60,232 SERP ACCRUAL
PART I, LINE 7
MANAGEMENT OF ADENA HEALTH SYSTEM HAVE A PORTION OF THEIR ANNUAL SALARY AT RISK UNDER A VARIABLE COMPENSATION PLAN. IF THE OPERATING RESULTS OF AHS MEET A MARGIN TARGET IN ANY FISCAL YEAR, ADDITIONAL COMPENSATION IS PAID THAT IS CALCULATED USING THE OPERATING MARGIN ALONG WITH RESULTS IN EMPLOYEE ENGAGEMENT, PATIENT QUALITY, AND SATISFACTION USING A BALANCED SCORECARD FORMULA.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

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

  • ADENA CARE

    C · SEE SCHEDULE R, PART VII · OH · controlled entity

Provenance

Return type
form_990
Tax year
2023
Filed
14 November 2024
IRS schema version
2023v5.1
Source object
202413209349310521

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