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Nonprofiteer
← HEALTHEAST WOODWINDS HOSPITAL

Form 990 for tax year 2023

Filed by HEALTHEAST WOODWINDS HOSPITAL.

Totals

Total revenue
$241,875,110
Total expenses
$242,144,639
Contributions and grants received
$63,900
Grants paid
$0
Program service revenue
$241,739,087
Investment income
$6,000
Other revenue
$66,123
Total assets, end of year
$116,139,236
Total liabilities, end of year
$11,288,648
Net assets or fund balances, end of year
$104,850,588
Program services expenses (Part IX)
$199,962,373
Management and general expenses
$42,182,266
Fundraising expenses
$0
Program service expenses (Part III)
$199,962,373

Program services were 82.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $27,619

  • 1f · All other contributions, gifts and grants

    $36,281

  • 2a · Program service revenue: Patient Revenue

    total $241,009,531 · related or exempt $241,009,531

  • 2b · Program service revenue: Cafeteria

    total $675,103 · related or exempt $675,103

  • 2c · Program service revenue: Lab Services Revenue

    total $54,453 · unrelated business $54,453

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 6a · Gross rents

    real property $66,123

  • 6c · Rental income or loss

    real property $66,123 · personal property $0

  • 6d · Net rental income or loss

    total $66,123 · excluded $66,123

  • 7a · Gross sales of assets other than inventory

    other assets $6,000

  • 7c · Gain or loss

    securities $0 · other assets $6,000

  • 7d · Net gain or loss

    total $6,000 · excluded $6,000

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $93,129,770 · program services $88,362,225 · management and general $4,767,545

  • 8 · Pension plan contributions

    total $2,763,341 · program services $2,624,416 · management and general $138,925

  • 9 · Other employee benefits

    total $11,450,874 · program services $11,181,676 · management and general $269,198

  • 10 · Payroll taxes

    total $6,114,544 · program services $5,767,323 · management and general $347,221

  • 11a · Fees: management

    total $34,030,487 · program services $539,805 · management and general $33,490,682

  • 11b · Fees: legal

    total $2,494 · program services $2,494

  • 11d · Fees: lobbying

    total $11,609 · management and general $11,609

  • 11g · Fees: other

    total $12,204,527 · program services $10,657,476 · management and general $1,547,051 · fundraising $0

  • 13 · Office expenses

    total $4,300,602 · program services $3,665,561 · management and general $635,041

  • 16 · Occupancy

    total $3,485,459 · program services $3,137,231 · management and general $348,228

  • 17 · Travel

    total $51,107 · program services $37,567 · management and general $13,540

  • 19 · Conferences, conventions and meetings

    total $121,704 · program services $104,408 · management and general $17,296

  • 20 · Interest

    total $3,214,892 · program services $3,214,892

  • 22 · Depreciation, depletion and amortization

    total $4,121,898 · program services $3,849,002 · management and general $272,896

  • 23 · Insurance

    total $491,280 · program services $491,280

  • 24a · Other expenses: Medical Supplies

    total $55,982,217 · program services $55,871,944 · management and general $110,273

  • 24b · Other expenses: Management Fee - D&T

    total $4,272,635 · program services $4,272,635

  • 24c · Other expenses: Taxes - Medical

    total $3,847,987 · program services $3,847,987

  • 24d · Other expenses: Utilities Repair & Maintenance

    total $1,225,237 · program services $1,189,821 · management and general $35,416

  • 24e · All other expenses

    total $1,321,975 · program services $1,144,630 · management and general $177,345 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,531 · end of year $0

  • 4 · Accounts receivable

    beginning of year $36,970,181 · end of year $42,830,519

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $4,015,476 · end of year $2,986,549

  • 9 · Prepaid expenses and deferred charges

    beginning of year $121,548 · end of year $0

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

    $90,552,687

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

    $20,230,519

  • 10c · Land, buildings and equipment, net

    beginning of year $70,463,911 · end of year $70,322,168

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $10,783,760 · end of year $11,288,648

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $0 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $100,788,887 · end of year $104,850,588

Mission and programs · 2023

Mission

Fairview is driven to heal, discover, and educate for longer, healthier lives.

Activities or mission (Part I)

HealthEast Woodwinds Hospital is an acute care hospital.

  • Woodwinds Health Campus opened its 86-bed hospital in August of 2000 and is located on 30 acres of pristine wetlands in Woodbury, MN. It's the only hospital in the southeast metro area. Woodwinds provides convenient and quality health care for the community. The campus includes a full-service hospital and emergency care department, doctors' offices, outpatient services, and auditorium. All the services you need in one convenient location, known for attention to detail - and attention to patients. The calming ambiance is enhanced by the surrounding woods and wetlands. At Woodwinds, patients find traditional medicine and state-of-the-art technology working in partnership with natural approaches to wellness and health. Hospital revenue includes payment from the Medicare and Medicaid programs. The medical services relate directly to the exempt purpose of caring for sick, infirm, aged and injured persons regardless of their race, color, creed, religion, national origin, sex, marital status, status with regard to public assistance, membership or activity in a local commission, disability, sexual orientation, gender identity or expression, age or genetic information. This organization provides emergency and medically necessary non-emergency services regardless of ability to pay. Additionally, this organization offers financial aid for eligible services in the form of free or discounted care to those low income, underinsured or uninsured individuals who meet qualification criteria. Woodwinds Hospital is part of Fairview Health Services. Fairview Health Services is an integrated academic health system located in Minneapolis, Minnesota, and, along with its affiliates and subsidiaries, is one of the leading health care providers in Minnesota with $7.3 billion in operating revenue for 2023. Fairview offers a broad continuum of health care services through its hospitals, clinics, and other health care related operations and is a Minnesota nonprofit corporation that is exempt from federal income taxation under Section 501(c)(3) of the Internal Revenue Code. The most recent community health needs assessment (CHNA) identified 3 key areas as the greatest needs in our community - navigating and accessing care and resources; healing, connectedness, and mental health; structural racism and barriers to equity. Fairview Health Services is meeting the needs of the community by focusing on racial and ethnic populations experiencing health disparities and people experiencing poverty through partnering with the community to build solutions, removing barriers to create and expand relevant programs and focused services. Please see Schedule H for a description of additional services, community benefit activities, and the full spectrum of charity care that Fairview Health Services provides to the community. Fairview serves the entire twelve-county Minneapolis/St. Paul Metro Area, as well as communities throughout greater Minnesota and portions of Northern Iowa and Western Wisconsin and is one of the most comprehensive and geographically accessible systems in Minnesota. The Fairview System consists of ten hospitals, including M Health Fairview University of Minnesota Medical Center and M Health Fairview Masonic Children's Hospital (collectively, "UMMC"), which is the adult and pediatric teaching hospital of the University of Minnesota. UMMC and seven of Fairview's other hospitals are in the Metro Area. Fairview's other two hospitals are located in northern Minnesota. Fairview operates over 80 primary and specialty care clinics, seven ambulatory care centers, 37 retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, physician network, senior care housing and long- term care facilities and medical transportation. Fairview, through its integrated care model, aims to deliver the benefits of academic medicine to more patients and families by expanding care, research, and education by offering access to a greater pool of physicians and patients, while seeking to reduce the total cost of care for patients. Fairview, the University of Minnesota and the University of Minnesota Physicians approved an agreement which became effective in late 2018 (the "M Health Fairview Agreement"). While the parties maintain their separate governance, the M Health Fairview Agreement further integrated operations across the clinical delivery system and enhances research and education by creating a joint clinical enterprise among the parties. The M Health Fairview Agreement brings together UMMC and its related service lines, Fairview's community hospitals and primary care clinics, and other services. All are part of a shared care delivery system that is led by a single structure that includes academic physician leadership. The goal of the joint clinical enterprise is to create a nationally-renowned academic health system. This care system was united in 2020 under a single brand, M Health Fairview, which is inclusive of Fairview's ten hospitals and its clinics. Fairview owns and operates the following hospitals: UMMC, M Health Fairview Southdale Hospital, M Health Fairview Ridges Hospital, M Health Fairview Lakes Medical Center, M Health Fairview Northland Medical Center, Fairview University Medical Center - Mesabi ("Range"), Grand Itasca Clinic and Hospital, M Health Fairview St. John's Hospital, M Health Fairview Woodwinds Hospital and M Health Fairview Bethesda Long Term Acute Hospital. As of December 31, 2023, the Fairview System Hospitals had a total of 3,529 licensed beds and 1,824 staffed beds. Fairview operates their more than 80 primary and specialty care clinics throughout the Metro Area, greater Minnesota and western Wisconsin. These clinics offer services in over 70 medical specialties, including family medicine, pediatrics, obstetrics, gynecology, heart care, cancer care, otolaryngology, transplant care, and orthopedics. As of December 31, 2023, Fairview owned all or a portion of six ambulatory surgery centers located in the Metro Area. Fairview and Fairview Pharmacy Services own and operate pharmacies at 37 locations, including a network of retail pharmacies, oncology pharmacies, two home infusion pharmacies (Minneapolis and Duluth, Minnesota), and a specialty pharmacy. M Health Fairview Rehabilitation Services ("MHFRS") provides a full continuum of inpatient and outpatient rehabilitation services for pediatric and adult patients as well as an inpatient rehabilitation facility, a hospital based skilled nursing facility and an adult day program. In addition to providing inpatient services in nine hospitals, MHFRS has 58 outpatient hospital based and free-standing clinics that serve pediatric and adult patients. Specialty services include rehabilitation in the following areas: Cardiac and Pulmonary rehabilitation, Audiology, Orthopedic, Sports related injuries, Neurological, Vestibular, and Cancer Rehab. Hand therapy services are also provided in seven locations. MHFRS serves about 750,000 patient visits/year. M Health Fairview Emergency Medical Services offers emergency medical services and scheduled transportation across the Metro Area and supports the community by responding to more than 60,000 calls annually. Ebenezer, a non-profit subsidiary of Fairview, provides long-term senior care facilities, senior housing, adult care services. Ebenezer's goal is to provide a supportive environment where older adults can pursue longer, healthier, and more meaningful lives. Fairview, an anchor institution rooted in our communities, continues to invest heavily in the health and wellness of its communities in which it operates. This commitment includes education, training, community programs and research, as well as significant investments in care delivery. The COVID pandemic exposed persistent health inequities for communities of color and has exacerbated racial disparities. Communities of color experienced statistically higher rates of COVID, including higher rates of hospitalization and death. To reduce the impact on Black, Indigenous, or people of color ("BIPOC"), vaccinations must be accessible, free and provided within a trusted space with appropriate language and cultural considerations. Fairview has led a multi-cultural mobile vaccination program for the past 17 years, which excels at reaching BIPOC communities facing barriers to immunization.

    Expenses $199,962,373 · Revenue $241,739,087

As filed on the 2023 return.

Listed in Part VII

  • Jakub Tolar MD

    Vice Chair

    Total calculated
    $0
    Hours/week
    0 + 2 related

  • James Hereford

    President & CEO

    Total calculated
    $5,246,751
    From this org
    $0
    From related orgs
    $5,208,444
    Other
    $38,307
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,888,932 related
    Bonus
    $0 + $1,260,653 related
    Other
    $0 + $2,058,859 related
    Deferred
    $0 + $21,097 related
    Nontaxable benefits
    $0 + $17,210 related
    Filer's total
    $0 + $5,246,751 related

  • Karen Grabow

    Vice Chair

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 2 related

  • RIch Ostlund

    Chair

    Total calculated
    $35,000
    From this org
    $0
    From related orgs
    $35,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Timothy Marx

    Secretary

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Ann Lowry MD

    Director

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Ann Williamson

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Barclay Berdan

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 4 related

  • Brad Wallin

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 4 related

  • David Levy

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Jodi RIchard

    Director

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 4 related

  • John Heinmiller

    Director

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Julie Causey

    Director

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 4 related

  • Kenneth Roering

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Melissa Geller MD

    Director

    Total calculated
    $0
    Hours/week
    0 + 2 related

  • Michael Connly

    Director

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 4 related

  • Myron Frans

    Director

    Total calculated
    $0
    Hours/week
    0 + 4 related

  • PJ Hill

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Shawntera Hardy

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Stephen Swensen MD

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Andrea Mokros

    Chf Public Affairs Officer

    Total calculated
    $847,342
    From this org
    $0
    From related orgs
    $749,408
    Other
    $97,934
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $506,680 related
    Bonus
    $0 + $241,891 related
    Other
    $0 + $837 related
    Deferred
    $0 + $88,477 related
    Nontaxable benefits
    $0 + $9,457 related
    Filer's total
    $0 + $847,342 related

  • Euthemy Lebrew

    EVP & Chf Transformation Officer

    Total calculated
    $929,487
    From this org
    $0
    From related orgs
    $813,268
    Other
    $116,219
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $543,788 related
    Bonus
    $0 + $265,338 related
    Other
    $0 + $4,142 related
    Deferred
    $0 + $94,841 related
    Nontaxable benefits
    $0 + $21,378 related
    Filer's total
    $0 + $929,487 related

  • Jeoff Will

    EVP, COO

    Total calculated
    $1,253,184
    From this org
    $0
    From related orgs
    $1,082,554
    Other
    $170,630
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $709,455 related
    Bonus
    $0 + $322,267 related
    Other
    $0 + $50,832 related
    Deferred
    $0 + $148,183 related
    Nontaxable benefits
    $0 + $22,447 related
    Filer's total
    $0 + $1,253,184 related

  • Joseph Gaylord

    CFO

    Total calculated
    $1,843,940
    From this org
    $0
    From related orgs
    $1,643,003
    Other
    $200,937
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $997,400 related
    Bonus
    $0 + $640,623 related
    Other
    $0 + $4,980 related
    Deferred
    $0 + $178,444 related
    Nontaxable benefits
    $0 + $22,493 related
    Filer's total
    $0 + $1,843,940 related

  • Laura Reed

    COO

    Total calculated
    $2,033,363
    From this org
    $0
    From related orgs
    $1,929,528
    Other
    $103,835
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,136,201 related
    Bonus
    $0 + $658,230 related
    Other
    $0 + $135,097 related
    Deferred
    $0 + $86,725 related
    Nontaxable benefits
    $0 + $17,110 related
    Filer's total
    $0 + $2,033,363 related

  • Mark Welton

    CMO

    Total calculated
    $1,681,615
    From this org
    $0
    From related orgs
    $1,577,623
    Other
    $103,992
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $777,411 related
    Bonus
    $0 + $499,863 related
    Other
    $0 + $300,349 related
    Deferred
    $0 + $86,958 related
    Nontaxable benefits
    $0 + $17,034 related
    Filer's total
    $0 + $1,681,615 related

  • Mary Nease

    Chf People Officer

    Total calculated
    $1,035,357
    From this org
    $0
    From related orgs
    $969,761
    Other
    $65,596
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $617,160 related
    Bonus
    $0 + $349,603 related
    Other
    $0 + $2,998 related
    Deferred
    $0 + $43,474 related
    Nontaxable benefits
    $0 + $22,122 related
    Filer's total
    $0 + $1,035,357 related

  • Robert Beacher

    EVP & Chf Shared Clinical Svcs

    Total calculated
    $1,510,285
    From this org
    $0
    From related orgs
    $1,304,189
    Other
    $206,096
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $784,252 related
    Bonus
    $0 + $411,436 related
    Other
    $0 + $108,501 related
    Deferred
    $0 + $183,623 related
    Nontaxable benefits
    $0 + $22,473 related
    Filer's total
    $0 + $1,510,285 related

  • Sameer Badlani

    Chf Digital Officer2

    Total calculated
    $1,371,769
    From this org
    $0
    From related orgs
    $1,183,898
    Other
    $187,871
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $724,541 related
    Bonus
    $0 + $407,178 related
    Other
    $0 + $52,179 related
    Deferred
    $0 + $165,645 related
    Nontaxable benefits
    $0 + $22,226 related
    Filer's total
    $0 + $1,371,769 related

  • Trudi Trysla

    Chf Legal Counsel

    Total calculated
    $1,409,522
    From this org
    $0
    From related orgs
    $1,133,415
    Other
    $276,107
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $684,965 related
    Bonus
    $0 + $351,134 related
    Other
    $0 + $97,316 related
    Deferred
    $0 + $260,378 related
    Nontaxable benefits
    $0 + $15,729 related
    Filer's total
    $0 + $1,409,522 related

  • Aziza Shireen MD

    Physician

    Total calculated
    $478,360
    From this org
    $0
    From related orgs
    $440,775
    Other
    $37,585
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $335,077 related
    Bonus
    $0 + $24,688 related
    Other
    $0 + $81,010 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $24,385 related
    Filer's total
    $0 + $478,360 related

  • Erica Kuhlman MD

    Physician

    Total calculated
    $501,228
    From this org
    $0
    From related orgs
    $468,603
    Other
    $32,625
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $460,451 related
    Bonus
    $0 + $7,725 related
    Other
    $0 + $427 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $19,425 related
    Filer's total
    $0 + $501,228 related

  • James Olson MD

    Physician

    Total calculated
    $445,264
    From this org
    $0
    From related orgs
    $414,136
    Other
    $31,128
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $391,091 related
    Bonus
    $0 + $6,863 related
    Other
    $0 + $16,182 related
    Deferred
    $0 + $6,737 related
    Nontaxable benefits
    $0 + $24,391 related
    Filer's total
    $0 + $445,264 related

  • Jawali Jaranilla MD

    Physician

    Total calculated
    $611,528
    From this org
    $0
    From related orgs
    $585,966
    Other
    $25,562
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $394,006 related
    Bonus
    $0 + $38,013 related
    Other
    $0 + $153,947 related
    Deferred
    $0 + $12,137 related
    Nontaxable benefits
    $0 + $13,425 related
    Filer's total
    $0 + $611,528 related

  • Juan Zeballos Chavez MD

    Physician

    Total calculated
    $509,334
    From this org
    $0
    From related orgs
    $478,639
    Other
    $30,695
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $462,935 related
    Bonus
    $0 + $14,063 related
    Other
    $0 + $1,641 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $17,495 related
    Filer's total
    $0 + $509,334 related

  • Elizabeth Cameron MD

    Former Physician

    Total calculated
    $445,885
    From this org
    $0
    From related orgs
    $425,430
    Other
    $20,455
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $369,497 related
    Bonus
    $0 + $53,173 related
    Other
    $0 + $2,760 related
    Deferred
    $0 + $8,436 related
    Nontaxable benefits
    $0 + $12,019 related
    Filer's total
    $0 + $445,885 related

  • Sunn Sunn Thaw MD

    Former Physician

    Total calculated
    $870,234
    From this org
    $0
    From related orgs
    $832,036
    Other
    $38,198
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $399,036 related
    Bonus
    $0 + $431,878 related
    Other
    $0 + $1,122 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $24,998 related
    Filer's total
    $0 + $870,234 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)

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD, SAMEER BADLANI, LAURA REED, MARK WELTON, ROBERT BEACHER, TRUDI TRYSLA, MARY NEASE, ANDREA MOKROS, Joseph Gaylord, Jeoff WIll, Eithemy Lebrew DUE TO A VESTING EVENT, THE FOLLOWING INDIVIDUALS HAD INCOME IN PART VII AND SCHEDULE J RELATED TO A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD $2,049,355 LAURA REED $126,353 MARK WELTON $286,840 ROBERT BEACHER $97,040 TRUDI TRYSLA $93,957 Sameer Badlani $50,935 Jeoff WIll $49,594
Schedule J, Part I, Line 7 Non-fixed payments
Fairview Health Services provides lump sum financial awards based on system-wide, business unit and/or departments financial and quality measures. Annual goals, specifically tied to productivity and quality indicators, are set for the year and an incentive paid out annually if key goals and measures are achieved.
Schedule J, Part I, Line 3 Related Org to establish compensation
THE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS.
Schedule J, Part I, Line 4a
Severance benefit payments will commence on the first regularly scheduled pay date that occurs at least five (5) days after the expiration of the rescission period. Payment of severance benefits is contingent upon (i) my having first signed and not rescinded my Service Agreement and Release Agreement and (ii) the return of Fairview's property.
Schedule J, Part I, Line 4b
The nonqualified plan (the Plan) is only open to a select group of highly compensated employees. The plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualified retirement plans. Participants may not elect to defer compensation. Contributions will be made in the form of a credit to the participant's account. Within 60 days after a participant becomes vested in a contribution, the Plan shall pay to the participant an amount equal to the amount the Participant is required to pay Federal, state, local, and foreign income taxes and employment taxes due to the vesting. The remaining amount in the participant's account shall not be paid until the separation from service payment date. A participant's account shall be distributed in cash. The plan complies with section 457(f) of the Code.

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 partnerships

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

  • Ridges Surgery Center LLC

    N/A · Surgery Center · MN

    Directly controlled by Fairview Health Services

  • SouthHealth ASC LLC

    N/A · Surgery Center · MN

    Directly controlled by Fairview Health Services

Related corporations and trusts

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

  • Fairview Clinics

    C Corporation · Physician · MN

    Directly controlled by Fairview Health Services

  • Fairview Physician and Clinic Services

    C Corporation · Physician · MN

    Directly controlled by Fairview Health Services

  • Fairview Development Company

    C Corporation · Leasehold · MN

    Directly controlled by Fairview Health Services

  • Fairview Express Care

    C Corporation · Physician · MN

    Directly controlled by Fairview Health Services

  • FHS Assurance Limited

    C Corporation · Self insur · MN

    Directly controlled by Fairview Health Services

  • HealthEast Diversified Services Inc

    C Corporation · Lab & Real · MN

    Directly controlled by Fairview Bethesda Hospital

Provenance

Return type
form_990
Tax year
2023
Filed
11 November 2024
IRS schema version
2023v5.1
Source object
202403169349304710

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