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Nonprofiteer
← ASYLUM HILL FAMILY MEDICINE CENTER INC

Form 990 for tax year 2022

Filed by ASYLUM HILL FAMILY MEDICINE CENTER INC.

Totals

Total revenue
$3,937,562
Total expenses
$7,252,856
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$6,812,425
Management and general expenses
$440,431
Fundraising expenses
$0
Program service expenses (Part III)
$6,812,425

Program services were 93.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DEBORAH BITSOLI

    DIRECTOR AND PRESIDENT

    Total calculated
    $839,145
    From this org
    $0
    From related orgs
    $695,941
    Other
    $143,204
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $515,282 related
    Bonus
    $0 + $151,075 related
    Other
    $0 + $29,584 related
    Deferred
    $0 + $99,785 related
    Nontaxable benefits
    $0 + $43,419 related
    Filer's total
    $0 + $839,145 related

  • JENNIFER SCHNEIDER

    DIR; TREASURER; SVP & REG CFO

    Total calculated
    $652,259
    From this org
    $0
    From related orgs
    $525,234
    Other
    $127,025
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $399,132 related
    Bonus
    $0 + $102,000 related
    Other
    $0 + $24,102 related
    Deferred
    $0 + $88,410 related
    Nontaxable benefits
    $0 + $38,615 related
    Filer's total
    $0 + $652,259 related

  • UGO UWAOMA MD

    FORMER OFFICER

    Total calculated
    $644,134
    From this org
    $0
    From related orgs
    $624,968
    Other
    $19,166
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0 + $49,479 related
    Other
    $0 + $575,489 related
    Deferred
    $0 + $742 related
    Nontaxable benefits
    $0 + $18,424 related
    Filer's total
    $0 + $644,134 related

  • MICHAEL GREY MD

    FMR OFFR; TH OF NE PNO CHAIR OF MED

    Total calculated
    $430,010
    From this org
    $0
    From related orgs
    $412,490
    Other
    $17,520
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $376,698 related
    Bonus
    $0 + $30,000 related
    Other
    $0 + $5,792 related
    Deferred
    $0 + $13,725 related
    Nontaxable benefits
    $0 + $3,795 related
    Filer's total
    $0 + $430,010 related

  • ANDREW FELLER MD

    FAMILY MEDICINE PHYSICIAN

    Total calculated
    $370,578
    From this org
    $0
    From related orgs
    $313,123
    Other
    $57,455
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $307,541 related
    Bonus
    $0 + $4,897 related
    Other
    $0 + $685 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $39,155 related
    Filer's total
    $0 + $370,578 related

  • STACY TAYLOR MD

    FAMILY MEDICINE PHYSICIAN

    Total calculated
    $364,769
    From this org
    $0
    From related orgs
    $335,555
    Other
    $29,214
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $306,254 related
    Bonus
    $0 + $25,000 related
    Other
    $0 + $4,301 related
    Deferred
    $0 + $13,725 related
    Nontaxable benefits
    $0 + $15,489 related
    Filer's total
    $0 + $364,769 related

  • KATHERINE TRINGALI MD

    FAMILY MEDICINE PHYSICIAN

    Total calculated
    $311,940
    From this org
    $0
    From related orgs
    $269,328
    Other
    $42,612
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $264,570 related
    Bonus
    $0 + $4,594 related
    Other
    $0 + $164 related
    Deferred
    $0 + $12,494 related
    Nontaxable benefits
    $0 + $30,118 related
    Filer's total
    $0 + $311,940 related

  • JAMES HARRIS

    ASST TREAS; TH OF NE DIR OF REIMB

    Total calculated
    $272,017
    From this org
    $0
    From related orgs
    $226,142
    Other
    $45,875
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $202,556 related
    Bonus
    $0 + $21,108 related
    Other
    $0 + $2,478 related
    Deferred
    $0 + $17,463 related
    Nontaxable benefits
    $0 + $28,412 related
    Filer's total
    $0 + $272,017 related

  • PATRICIA SAMUELS

    NURSE PRACTITIONER

    Total calculated
    $206,651
    From this org
    $0
    From related orgs
    $180,238
    Other
    $26,413
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $179,590 related
    Bonus
    $0
    Other
    $0 + $648 related
    Deferred
    $0 + $13,651 related
    Nontaxable benefits
    $0 + $12,762 related
    Filer's total
    $0 + $206,651 related

  • THOMAS AGRESTA MD

    DIRECTOR, INTERIM CHAIR AS OF 1/23

    Total calculated
    $0
    Hours/week
    1

  • DAVID HENDERSON MD

    DIRECTOR AND CHAIR THROUGH 12/22

    Total calculated
    $0
    Hours/week
    1

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 — 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

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 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
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
ASYLUM HILL FAMILY MEDICINE CENTER IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. ASYLUM HILL FAMILY MEDICINE CENTER'S PRESIDENT IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF ASYLUM HILL FAMILY MEDICINE CENTER'S PRESIDENT: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINES 4A-B
THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2022. THIS AMOUNT IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: UGO UWAOMA - $451,259 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THIS AMOUNT THAT WAS REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. PARTICIPANTS' VESTED BENEFITS WERE PAID OUT IN 2022, AND THEIR NON-VESTED BENEFITS FOR 2022 WERE ACCRUED. THE FOLLOWING PAYOUTS FOR 2022 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: DEBORAH BITSOLI - $13,526 JENNIFER SCHNEIDER - $15,030 UGO UWAOMA - $106,500 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING ACCRUALS FOR 2022 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: DEBORAH BITSOLI - $86,060 JENNIFER SCHNEIDER - $65,535

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.

Provenance

Return type
form_990
Tax year
2022
Filed
5 August 2024
IRS schema version
2022v5.0
Source object
202422189349300312

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