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← BON SECOURS NEW YORK HEALTH SYSTEM INC

Form 990 for tax year 2022

Filed by BON SECOURS NEW YORK HEALTH SYSTEM INC.

Totals

Total revenue
$0
Total expenses
-$1,843,085
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$0
Management and general expenses
-$1,843,085
Fundraising expenses
$0
Program service expenses (Part III)
$0

Listed in Part VII

  • TRAVIS CRUM

    Chairman (Beg 01/22), BSMH SVP Finance

    Total calculated
    $874,544
    From this org
    $0
    From related orgs
    $748,117
    Other
    $126,427
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $377,713 related
    Bonus
    $0 + $144,614 related
    Other
    $0 + $225,790 related
    Deferred
    $0 + $94,211 related
    Nontaxable benefits
    $0 + $32,216 related
    Filer's total
    $0 + $874,544 related

  • Kristin Upton

    Board Member, BSMH Deputy General Counsel

    Total calculated
    $561,096
    From this org
    $0
    From related orgs
    $515,351
    Other
    $45,745
    Hours/week
    0.5 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $334,105 related
    Bonus
    $0 + $114,913 related
    Other
    $0 + $66,333 related
    Deferred
    $0 + $41,087 related
    Nontaxable benefits
    $0 + $4,658 related
    Filer's total
    $0 + $561,096 related

  • Sr Anne Lutz CBS

    Board Member

    Total calculated
    $0
    Hours/week
    0.5 + 49.5 related

  • Kimberly CARR

    Secretary

    Total calculated
    $101,790
    From this org
    $0
    From related orgs
    $75,770
    Other
    $26,020
    Hours/week
    0.5 + 40 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 — 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

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

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
Bon Secours Mercy Health, Inc., a related organization of the filing organization, uses the following to establish the compensation of the organization's Senior Vice President, Finance: Compensation Committee Independent Compensation Consultant Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
The Bon Secours Mercy Health System SERP is a non-qualified deferred compensation plan which provides supplemental retirement benefits to persons selected by the Board of Trustees or its delegate. The plan provides for annual credits of a specified percentage of an eligible participants base salary paid in a plan year and interest credits. Plan participants vest in plan credits after completing a three year class vesting schedule or earlier for death or total disability or reaching age 60 while employed, or due to involuntary separation of employment other than for cause. Payments during employment are made for required tax withholding and reduce the participants account balance. Distribution of the vested account balance in a lump sum occurs after termination of employment. Amounts includible as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Travis Crum, $105,970; and Kristin Upton, $34,932.

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
9 October 2023
IRS schema version
2022v5.0
Source object
202302829349301110

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