Form 990 for tax year 2022

Revenue

Part VIII, the statement of revenue.

• 2a · Program service revenue: NET PATIENT SVC REV

  total $3,830,198 · related or exempt $3,830,198

• 6a · Gross rents

  real property $112,975

• 6b · Less rental expenses

  real property $18,000

• 6c · Rental income or loss

  real property $94,975

• 6d · Net rental income or loss

  total $94,975 · excluded $94,975

• 11a · Other revenue: MIH PULMONARY REHAB

  total $9,083 · related or exempt $9,083

• 11b · Other revenue: OTHER INCOME

  total $195 · related or exempt $195

• 11e · Other revenue, total

  $9,278

Functional expenses

Part IX, the statement of functional expenses.

• 7 · Other salaries and wages

  total $2,018,160 · program services $1,662,157 · management and general $356,003

• 8 · Pension plan contributions

  total $52,915 · program services $43,581 · management and general $9,334

• 9 · Other employee benefits

  total $226,393 · program services $186,457 · management and general $39,936

• 10 · Payroll taxes

  total $149,834 · program services $123,403 · management and general $26,431

• 11g · Fees: other

  total $142,932 · program services $117,719 · management and general $25,213

• 13 · Office expenses

  total $199,893 · program services $164,632 · management and general $35,261

• 16 · Occupancy

  total $130,046 · program services $107,106 · management and general $22,940

• 17 · Travel

  total $1,342 · program services $1,105 · management and general $237

• 22 · Depreciation, depletion and amortization

  total $250,504 · program services $206,315 · management and general $44,189

• 23 · Insurance

  total $140,703 · program services $115,883 · management and general $24,820

• 24a · Other expenses: MEDICAL SUPPLIES

  total $185,569 · program services $185,569

• 24b · Other expenses: BAD DEBT EXPENSE

  total $2,463 · program services $2,463

Balance sheet

Part X, book values.

• 1 · Cash, non-interest-bearing

  beginning of year $3,653 · end of year $4,934

• 4 · Accounts receivable

  beginning of year $641,103 · end of year $562,751

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

  $10,773,074

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

  $6,386,792

• 10c · Land, buildings and equipment, net

  beginning of year $4,159,862 · end of year $4,386,282

• 15 · Other assets

  beginning of year $1,215

• 17 · Accounts payable and accrued expenses

  beginning of year $211,518 · end of year $384,321

• 25 · Other liabilities

  beginning of year $43,913 · end of year $82,480

• 27 · Net assets without donor restrictions

  beginning of year $4,550,402 · end of year $4,487,166

The filer's explanations (Part III)

PART I, LINES 4A-B

PART I, LINE 4A: CHIEF OPERATING OFFICER RESIGNED 07/21 AND RECEIVED A SEVERANCE PAYMENT OF $609,999 FOR CALENDAR YEAR 2022. PART I, LINE 4B: THE FOLLOWING EXECUTIVES PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: PAUL HILTZ PRESIDENT AND CEO RICK WYLES CHIEF FINANCIAL OFFICER KRISTIN MASCOTTI, M.D. CHIEF MEDICAL OFFICER JONATHAN KLING CHIEF OPERATING OFFICER JIM MAHON SENIOR VICE PRESIDENT RENEE THIGPEN CHIEF HR OFFICER CARLOS QUINTERO, M.D. CHIEF QUALITY OFFICER MARGARET DIMOND CHIEF ADMINISTRATIVE OFFICER GINA TEEGARDEN, R.N. CHIEF NURSING EXECUTIVE ANDREW COOPER CHIEF INFORMATION OFFICER MATTHEW STACELL CHIEF PERFORMANCE MANAGEMENT OFFICER NOBLE ARRINGTON CHIEF FINANCIAL OFFICER ERIN RANEY CHIEF ADMINISTRATIVE OFFICER THE FOLLOWING EXECUTIVES RECEIVED A DISTRIBUTION FROM THE 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN IN CALENDAR YEAR 2022: PAUL HILTZ PRESIDENT AND CEO $ 151,987 RICK WYLES CHIEF FINANCIAL OFFICER $ 83,104 JIM MAHON SENIOR VICE PRESIDENT $ 58,500 RENEE THIGPEN CHIEF HR OFFICER $ 55,243 MARGARET DIMOND CHIEF ADMINISTRATIVE OFFICER $ 82,652

PART I, LINE 7

PROVISION OF NON-FIXED PAYMENTS THIS ORGANIZATION IS AN AFFILIATE OF NCH HEALTHCARE SYSTEM, INC. ("THE SYSTEM"). THE SYSTEM MAY PROVIDE DISCRETIONARY BONUS AND/OR INCENTIVE COMPENSATION PAYMENTS TO ELIGIBLE EMPLOYEES. COMPENSATION PAYMENTS FOR ALL EMPLOYEES EXCLUDING THE CEO AND SENIOR LEADERSHIP TEAM IS DETERMINED BY THE SYSTEM BOARD OF TRUSTEES HUMAN RESOURCES COMMITTEE AND/OR CEO. COMPENSATION PAYMENTS MADE TO ANY DISQUALIFIED PERSON IS APPROVED BY THE SYSTEM THROUGH THE PROCESS DESCRIBED IN FORM 990, PART VI, SECTION B, LINE 15.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

• PROSCAN NCH IMAGING LLC

  RADIOLOGY SERVICES · DE

• NCH-VH JOINT VENTURE LLC

  SURGICAL SERVICES · KS

Related corporations and trusts

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

• HEALTH RESOURCES CORPORATION

  C · HOLDING COMPANY · FL · controlled entity

  Directly controlled by NCH SYSTEM

• AMBULATORY SURGICAL CARE CENTER INC

  C · OUTPATIENT SURGERY · FL · controlled entity

  Directly controlled by HRC

• COMMUNITY HOME CARE INC

  C · HOME HEALTH · FL · controlled entity

  Directly controlled by HRC

• COMMUNITY IMAGING INC

  C · RADIOLOGY LAB · FL · controlled entity

  Directly controlled by HRC

• GREATER COLLIER INSURANCE LTD

  C · INSURANCE · FL