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Nonprofiteer
← UNIVERSITY COMMUNITY HOSPITAL INC

Form 990 for tax year 2023

Filed by UNIVERSITY COMMUNITY HOSPITAL INC.

Totals

Total revenue
$1,132,158,454
Total expenses
$1,108,019,538
Contributions and grants received
$8,000,287
Grants paid
$135,000
Program service revenue
$1,122,975,381
Investment income
$1,182,786
Other revenue
$0
Total assets, end of year
$1,148,985,422
Total liabilities, end of year
$532,731,942
Net assets or fund balances, end of year
$616,253,480
Program services expenses (Part IX)
$995,997,130
Management and general expenses
$112,022,408
Fundraising expenses
$0
Program service expenses (Part III)
$995,997,130

Program services were 89.9% 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.

  • 1c · Fundraising events

    $0

  • 1d · Related organizations

    $186,520

  • 1f · All other contributions, gifts and grants

    $7,813,767

  • 2a · Program service revenue: Net patient revenue

    total $1,112,382,470 · related or exempt $1,112,382,470

  • 2b · Program service revenue: Medical office building

    total $4,046,407 · related or exempt $4,046,407

  • 2c · Program service revenue: Cafeteria revenue

    total $4,005,517 · related or exempt $4,005,517

  • 2d · Program service revenue: Medical Staff Dues

    total $617,776 · related or exempt $617,776

  • 2e · Program service revenue: Physician Services

    total $427,500 · related or exempt $427,500

  • 2f · All other program service revenue

    total $1,495,711 · related or exempt $1,495,711

  • 3 · Investment income

    total $1,522,120 · excluded $1,522,120

  • 7a · Gross sales of assets other than inventory

    other assets $270,779

  • 7b · Less cost or other basis and sales expenses

    securities $592,948 · other assets $17,165

  • 7c · Gain or loss

    securities -$592,948 · other assets $253,614

  • 7d · Net gain or loss

    total -$339,334 · excluded -$339,334

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $135,000 · program services $135,000

  • 5 · Compensation of officers, directors and key employees

    total $7,220,269 · program services $63,712 · management and general $7,156,557

  • 7 · Other salaries and wages

    total $318,723,218 · program services $306,714,561 · management and general $12,008,657

  • 8 · Pension plan contributions

    total $13,193,003 · program services $12,445,870 · management and general $747,133

  • 9 · Other employee benefits

    total $67,232,221 · program services $61,363,274 · management and general $5,868,947

  • 10 · Payroll taxes

    total $28,411,066 · program services $26,802,119 · management and general $1,608,947

  • 11b · Fees: legal

    total $355,001 · management and general $355,001

  • 11c · Fees: accounting

    total $196,162 · management and general $196,162

  • 11f · Fees: investment management

    total $206,684 · management and general $206,684

  • 11g · Fees: other

    total $210,632,441 · program services $173,400,654 · management and general $37,231,787

  • 12 · Advertising and promotion

    total $29,336,447 · management and general $29,336,447

  • 13 · Office expenses

    total $13,911,360 · program services $8,825,637 · management and general $5,085,723

  • 14 · Information technology

    total $46,736,444 · program services $42,447,710 · management and general $4,288,734

  • 16 · Occupancy

    total $24,575,936 · program services $24,575,936

  • 17 · Travel

    total $1,236,817 · program services $15,217 · management and general $1,221,600

  • 19 · Conferences, conventions and meetings

    total $4,320,184 · management and general $4,320,184

  • 20 · Interest

    total $10,659,540 · program services $10,659,540

  • 22 · Depreciation, depletion and amortization

    total $63,342,183 · program services $63,342,183

  • 23 · Insurance

    total $15,380,645 · program services $14,474,961 · management and general $905,684

  • 24a · Other expenses: Medical Supplies

    total $195,812,001 · program services $195,812,001

  • 24b · Other expenses: State Tax Indigent Asse

    total $34,624,161 · program services $34,624,161

  • 24c · Other expenses: Repairs & maintenance

    total $19,673,974 · program services $19,673,974

  • 24e · All other expenses

    total $2,104,781 · program services $620,620 · management and general $1,484,161

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $10,075 · end of year $9,872

  • 2 · Savings and temporary cash investments

    beginning of year $42,092,422 · end of year $35,370,076

  • 4 · Accounts receivable

    beginning of year $147,389,040 · end of year $165,843,816

  • 8 · Inventories for sale or use

    beginning of year $25,369,132 · end of year $24,761,768

  • 9 · Prepaid expenses and deferred charges

    beginning of year $47,245,601 · end of year $46,026,131

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

    $1,365,842,880

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

    $593,615,540

  • 10c · Land, buildings and equipment, net

    beginning of year $789,618,112 · end of year $772,227,340

  • 14 · Intangible assets

    beginning of year $2,239,998 · end of year $1,399,999

  • 15 · Other assets

    beginning of year $67,639,707 · end of year $103,346,420

  • 17 · Accounts payable and accrued expenses

    beginning of year $56,675,318 · end of year $83,488,277

  • 25 · Other liabilities

    beginning of year $439,759,457 · end of year $449,243,665

  • 27 · Net assets without donor restrictions

    beginning of year $615,893,988 · end of year $605,502,902

  • 28 · Net assets with donor restrictions

    beginning of year $9,275,324 · end of year $10,750,578

Mission and programs · 2023

Mission

Adventist Health System Sunbelt Healthcare Corporation and all its subsidiary organizations were established by the Seventh-Day Adventist Church to bring a ministry of healing and health to the communities served. Our mission is to extend the healing ministry of Christ.The hospital and healthcare system whose parent is Adventist Health System Sunbelt Healthcare Corporation is known as AdventHealth. AdventHealth seeks to be widely respected as a consumer-focused organization that engages individuals in their health by delivering wholistic, best practice care across a connected, comprehensive continuum of services. With Christ as our example, AdventHealth cares for and nurtures people: our employees, our communities, our healthcare professionals, and those who trust us for care and healing.

Activities or mission (Part I)

The provision of medical care to the community through the operation of two hospitals and a long-term acute care facility.

  • Operation of AdventHealth Tampa, a 626-bed general acute care hospital, AdventHealth Carrollwood, a 119-bed general acute care hospital, and AdventHealth Connerton a 77-bed Long-Term Acute Care Hospital. Combined these facilities generated 34,138 patient admissions, 198,402 patient days, and 345,434 outpatient visits during the current tax year.

    Expenses $995,997,130 · Grants $135,000 · Revenue $1,122,975,381

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Bergherm Bruce

    Director/CEO

    Total calculated
    $1,701,501
    From this org
    $0
    From related orgs
    $1,664,566
    Other
    $36,935
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $692,913 related
    Bonus
    $0 + $223,637 related
    Other
    $0 + $748,016 related
    Deferred
    $0 + $17,727 related
    Nontaxable benefits
    $0 + $19,208 related
    Filer's total
    $0 + $1,701,501 related

  • Cannella MD Xavier

    Director

    Total calculated
    $73,418
    From this org
    $43,139
    From related orgs
    $30,279
    Other
    $0
    Hours/week
    5.85

  • Conley MD Amy

    Director

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4

  • Dunkel Jason

    Director (end 4/23)

    Total calculated
    $721,829
    From this org
    $0
    From related orgs
    $630,390
    Other
    $91,439
    Hours/week
    0.4 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $421,104 related
    Bonus
    $0 + $109,446 related
    Other
    $0 + $99,840 related
    Deferred
    $0 + $58,501 related
    Nontaxable benefits
    $0 + $32,938 related
    Filer's total
    $0 + $721,829 related

  • Ennis Jr Henry

    Director (end 6/23)

    Total calculated
    $0
    Hours/week
    0.4

  • Joyner Arthenia

    Director

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4

  • Meyer Fred

    Chairman/Director

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4

  • Muniz Tony

    Director

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4

  • Newman Eric

    Director

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4

  • O'Malley MD Brendan

    Director

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4

  • Ottati David

    Dir/Pres/Vice Chair

    Total calculated
    $2,195,971
    From this org
    $0
    From related orgs
    $1,981,848
    Other
    $214,123
    Hours/week
    18 + 32 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,046,990 related
    Bonus
    $0 + $355,278 related
    Other
    $0 + $579,580 related
    Deferred
    $0 + $173,177 related
    Nontaxable benefits
    $0 + $40,946 related
    Filer's total
    $0 + $2,195,971 related

  • Patel MD Sharad

    Director

    Total calculated
    $19,773
    From this org
    $19,773
    From related orgs
    $0
    Other
    $0
    Hours/week
    2.96

  • Robbins Charlie

    Director

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4

  • Scaglione Basil

    Director (end 12/23)

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4

  • Stonesifer MD Kurt

    Director

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4 + 0.2 related

  • Taneja Supriya

    Director

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4

  • Vivero Jose

    Director

    Total calculated
    $614
    From this org
    $614
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.4

  • Davis Tyson

    CFO-Tampa and Connerton

    Total calculated
    $574,602
    From this org
    $0
    From related orgs
    $491,105
    Other
    $83,497
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $359,271 related
    Bonus
    $0 + $71,933 related
    Other
    $0 + $59,901 related
    Deferred
    $0 + $51,343 related
    Nontaxable benefits
    $0 + $32,154 related
    Filer's total
    $0 + $574,602 related

  • Johnson Joel

    CEO-Carrollwood (beg 5/23)

    Total calculated
    $1,085,530
    From this org
    $0
    From related orgs
    $997,501
    Other
    $88,029
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $484,180 related
    Bonus
    $0 + $135,847 related
    Other
    $0 + $377,474 related
    Deferred
    $0 + $68,780 related
    Nontaxable benefits
    $0 + $19,249 related
    Filer's total
    $0 + $1,085,530 related

  • Skula Erika

    CEO-Carrollwood (end 5/23)

    Total calculated
    $1,005,268
    From this org
    $0
    From related orgs
    $896,623
    Other
    $108,645
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $480,136 related
    Bonus
    $0 + $117,981 related
    Other
    $0 + $298,506 related
    Deferred
    $0 + $90,039 related
    Nontaxable benefits
    $0 + $18,606 related
    Filer's total
    $0 + $1,005,268 related

  • Carlisle Charity

    CNO Carrollwood

    Total calculated
    $322,492
    From this org
    $0
    From related orgs
    $279,852
    Other
    $42,640
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $218,924 related
    Bonus
    $0 + $43,458 related
    Other
    $0 + $17,470 related
    Deferred
    $0 + $14,278 related
    Nontaxable benefits
    $0 + $28,362 related
    Filer's total
    $0 + $322,492 related

  • Colburn Douglas

    COO Tampa

    Total calculated
    $575,414
    From this org
    $0
    From related orgs
    $465,964
    Other
    $109,450
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $372,560 related
    Bonus
    $0 + $71,207 related
    Other
    $0 + $22,197 related
    Deferred
    $0 + $75,699 related
    Nontaxable benefits
    $0 + $33,751 related
    Filer's total
    $0 + $575,414 related

  • Kotak MD Rajesh

    CMO Carrollwood

    Total calculated
    $531,610
    From this org
    $0
    From related orgs
    $433,113
    Other
    $98,497
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $342,286 related
    Bonus
    $0 + $70,522 related
    Other
    $0 + $20,305 related
    Deferred
    $0 + $69,899 related
    Nontaxable benefits
    $0 + $28,598 related
    Filer's total
    $0 + $531,610 related

  • Pittman Michael

    CNO - Tampa (end 12/23)

    Total calculated
    $471,488
    From this org
    $0
    From related orgs
    $392,597
    Other
    $78,891
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $304,041 related
    Bonus
    $0 + $61,177 related
    Other
    $0 + $27,379 related
    Deferred
    $0 + $53,269 related
    Nontaxable benefits
    $0 + $25,622 related
    Filer's total
    $0 + $471,488 related

  • Ross MD Douglas

    CMO-Tampa and Connerton

    Total calculated
    $751,826
    From this org
    $0
    From related orgs
    $665,606
    Other
    $86,220
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $458,459 related
    Bonus
    $0 + $91,994 related
    Other
    $0 + $115,153 related
    Deferred
    $0 + $52,690 related
    Nontaxable benefits
    $0 + $33,530 related
    Filer's total
    $0 + $751,826 related

  • Sauder Christopher

    CFO - Carrollwood

    Total calculated
    $378,683
    From this org
    $0
    From related orgs
    $333,331
    Other
    $45,352
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $262,461 related
    Bonus
    $0 + $52,029 related
    Other
    $0 + $18,841 related
    Deferred
    $0 + $17,427 related
    Nontaxable benefits
    $0 + $27,925 related
    Filer's total
    $0 + $378,683 related

  • Dalsania MD Amar

    Exec Dir/Phys Advisor

    Total calculated
    $568,313
    From this org
    $522,298
    From related orgs
    $0
    Other
    $46,015
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $430,900
    Bonus
    $85,952
    Other
    $5,446
    Deferred
    $17,727
    Nontaxable benefits
    $28,288
    Filer's total
    $568,313

  • Kumar MD Ajoy

    Med Dir / Phys Advisor

    Total calculated
    $434,450
    From this org
    $388,346
    From related orgs
    $0
    Other
    $46,104
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $329,118
    Bonus
    $52,753
    Other
    $6,475
    Deferred
    $17,727
    Nontaxable benefits
    $28,377
    Filer's total
    $434,450

  • Lambert MD Charles

    Physician/Medical Director

    Total calculated
    $471,838
    From this org
    $435,299
    From related orgs
    $0
    Other
    $36,539
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $411,285
    Bonus
    $0
    Other
    $24,014
    Deferred
    $17,727
    Nontaxable benefits
    $18,812
    Filer's total
    $471,838

  • Lorenz MD Miguel

    Med Dir / Phys Advisor

    Total calculated
    $431,528
    From this org
    $381,270
    From related orgs
    $0
    Other
    $50,258
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $325,361
    Bonus
    $52,673
    Other
    $3,236
    Deferred
    $17,727
    Nontaxable benefits
    $32,531
    Filer's total
    $431,528

  • Yarlagadda MD Roopa

    Med Dir / Phys Advisor

    Total calculated
    $388,459
    From this org
    $348,819
    From related orgs
    $0
    Other
    $39,640
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $315,524
    Bonus
    $30,102
    Other
    $3,193
    Deferred
    $11,127
    Nontaxable benefits
    $28,513
    Filer's total
    $388,459

  • Bales-Chubb Denyse

    Former Officer

    Total calculated
    $991,766
    From this org
    $0
    From related orgs
    $847,501
    Other
    $144,265
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $560,485 related
    Bonus
    $0 + $164,124 related
    Other
    $0 + $122,892 related
    Deferred
    $0 + $120,194 related
    Nontaxable benefits
    $0 + $24,071 related
    Filer's total
    $0 + $991,766 related

  • Adams Brian

    Former Officer

    Total calculated
    $1,409,460
    From this org
    $0
    From related orgs
    $1,225,857
    Other
    $183,603
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $848,940 related
    Bonus
    $0 + $253,454 related
    Other
    $0 + $123,463 related
    Deferred
    $0 + $153,128 related
    Nontaxable benefits
    $0 + $30,475 related
    Filer's total
    $0 + $1,409,460 related

  • Didenko Vadym

    Former Officer

    Total calculated
    $1,082,929
    From this org
    $0
    From related orgs
    $930,780
    Other
    $152,149
    Hours/week
    18 + 32 related

    Schedule J breakdown matched by us

    Base
    $0 + $627,726 related
    Bonus
    $0 + $177,428 related
    Other
    $0 + $125,626 related
    Deferred
    $0 + $117,466 related
    Nontaxable benefits
    $0 + $34,683 related
    Filer's total
    $0 + $1,082,929 related

  • Heinrich William

    Former Officer

    Total calculated
    $697,978
    From this org
    $0
    From related orgs
    $603,560
    Other
    $94,418
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $456,376 related
    Bonus
    $0 + $77,380 related
    Other
    $0 + $69,804 related
    Deferred
    $0 + $63,376 related
    Nontaxable benefits
    $0 + $31,042 related
    Filer's total
    $0 + $697,978 related

  • Bjornstad MD Brad

    Former Key Employee

    Total calculated
    $327,239
    From this org
    $0
    From related orgs
    $313,576
    Other
    $13,663
    Hours/week
    18 + 32 related

    Schedule J breakdown matched by us

    Base
    $0 + $198,004 related
    Bonus
    $0 + $82,554 related
    Other
    $0 + $33,018 related
    Deferred
    $0 + $13,663 related
    Nontaxable benefits
    $0
    Filer's total
    $0 + $327,239 related

  • McGuinness Robin

    Former Officer

    Total calculated
    $724,095
    From this org
    $0
    From related orgs
    $651,137
    Other
    $72,958
    Hours/week
    18 + 32 related

    Schedule J breakdown matched by us

    Base
    $0 + $420,334 related
    Bonus
    $0 + $118,892 related
    Other
    $0 + $111,911 related
    Deferred
    $0 + $52,695 related
    Nontaxable benefits
    $0 + $20,263 related
    Filer's total
    $0 + $724,095 related

  • Torres MD Michael

    Former Key Employee

    Total calculated
    $654,212
    From this org
    $0
    From related orgs
    $622,455
    Other
    $31,757
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $281,708 related
    Bonus
    $0 + $84,698 related
    Other
    $0 + $256,049 related
    Deferred
    $0 + $17,727 related
    Nontaxable benefits
    $0 + $14,030 related
    Filer's total
    $0 + $654,212 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

  • 1a · First-class or charter travel
  • 1a · Travel for companions
  • 1a · Tax indemnification and gross-up payments
  • 1a · Discretionary spending account
  • 1a · Housing allowance or residence for personal use
  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 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 1a
The filing organization is a part of the system of healthcare organizations known as AdventHealth. Members of the filing organization's executive management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. AHSSHC is exempt from federal income tax under IRC Section 501(c)(3). The filing organization reimburses AHSSHC for the salary and benefit cost of those executives listed in Part VII that are on the payroll of AHSSHC. At the direction of AHSSHC, and in accordance with the reserved powers in the filing organization's governing documents, the executive team listed on Part VII provides services to the filing organization. First-class or charter travel: Pursuant to the AdventHealth system-wide general policy regarding business travel, no reimbursement will be provided for any additional cost incurred with respect to first-class or charter air travel beyond the cost of a regular coach airfare. As a means of providing additional business travel reimbursement for those members of the AHSSHC senior executive management team that travel frequently on behalf of AdventHealth, a special annual travel allowance is provided for those executives. As AdventHealth operates 50 hospitals in 9 states, the senior leadership of AHSSHC travel extensively and often visit multiple hospital locations in different states as a part of a single business trip. The special travel allowance can provide reimbursements to the executive for such items as the purchase of air travel upgrade coupons, to cover the cost differential between coach and first-class travel, or to cover the cost of a charter flight. The special travel allowance benefit was originally authorized by and codified into a policy by the AHSSHC Board Compensation Committee (the Committee), an independent body of the AHSSHC Board of Directors, who also approves the annual cap on the amount of the allowance. The special travel allowance has an annual cap of $24,000 for members of the Leadership Executive Team (15 AdventHealth Cabinet members and the AdventHealth Multi-State CFO) and $15,000 for AdventHealth Corporate Office Senior Vice Presidents, Regional CEO's, and Division Chief Officers (generally 45 - 55 individual executives). The Divisional CFO, Vadym Didenko, and CNO, Robin Mcguinness, the West Florida Division CEO, David Ottati and Region and Tampa CEO, Bruce Bergherm for AdventHealth are listed on Part VII for the filing organization. All of these positions are considered common law employees of and are on the payroll of AHSSHC. While the special travel allowance benefit is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and either wholly or partially reimbursed by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for first-class or charter travel since it has wholly or partially paid for the cost of providing this benefit. Those executives who receive the special travel allowance are responsible for tracking the expenses reimbursable under the special travel allowance and must submit such expenses on their accountable plan expense report. A report on charter travel is provided to the AHSSHC Board Compensation Committee at each meeting. Any taxable reimbursements made to executives under the special travel allowance arrangement are treated as taxable compensation to the executive. Travel for companions: AHSSHC has a Corporate Executive Policy that provides a benefit to allow for a traveling AHSSHC executive to have his or her spouse accompany the executive on certain business trips each year. Typically, reimbursement is only provided to certain executive leaders and is usually limited to one business trip per year beyond the annual AdventHealth President's Council business meeting and other meetings where the spouse is specifically invited. The AHSSHC Corporate Executive Spousal Travel Policy was originally approved and reviewed by the AHSSHC Board Compensation Committee, an independent body of the AHSSHC Board of Directors. All spousal travel costs reimbursed to the executive are considered taxable compensation to the executive. Tax Indemnification and gross-up payments: AdventHealth has a system-wide policy addressing gross-up payments provided in connection with employer-provided benefits/other taxable items. Under the policy, certain taxable business-related reimbursements (i.e. taxable business-related moving expenses, taxable items provided in connection with employment) provided to any employee may be grossed-up at a 25% rate upon approval by the filing organization's CEO and CFO. Additionally, employees at the Director level and above are eligible for gross-up payments on gifts received for board of director services. Discretionary spending account: Occasional discretionary spending amounts are periodically provided to eligible executives who attend annual business meetings such as the AdventHealth President's Council, CFO Conference or the CMO/CNO business meeting. Payments provided to each executive are considered taxable compensation to the executive. Health or social club dues or initiation fees: AHSSHC has a Corporate Executive Policy that addresses business development expenditures. Under this policy, to encourage executives to establish and cultivate strong working relationships with the medical community and other leaders in the community and industry, certain AdventHealth executives may be reimbursed for member dues and usage charges for a country club or other social club upon authorization. Club memberships must be approved by the AdventHealth President/CEO initially as well as on an annual basis. Each AdventHealth executive who is approved for a club membership must submit an annual report describing how they used the membership to benefit their organization during the preceding year so that the AdventHealth President/CEO can determine if continuance of the club membership furthers the business interests of AdventHealth. In the current year, for this filing organization, two executives listed in Part VII received reimbursement for club fees. While the club dues membership is an AHSSHC compensation policy and practice, the cost of providing this benefit is allocated to and reimbursed in whole or in part by the filing organization. Accordingly, the filing organization has checked the box in Schedule J, Part I, line 1a for health or social club dues since it has wholly or partially paid for the cost of providing this benefit.
Part I, Line 3
The individual who serves as the CEO of the filing organization is appointed and compensated by Adventist Health System Sunbelt Healthcare Corporation (AHSSHC). Compensation and benefits provided to this individual are determined pursuant to policies, procedures, and processes of AHSSHC that are designed to ensure compliance with the intermediate sanctions laws as set forth in IRC Section 4958. AHSSHC has taken steps to ensure that processes are in place to satisfy the rebuttable presumption of reasonableness standard as set forth in Treasury Regulation Section 53.4958-6 with respect to its active executive-level positions. The AHSSHC Board Compensation Committee (the Committee) serves as the governing body for all executive compensation matters. The Committee is composed of certain members of the Board of Directors (the Board) of AHSSHC. Voting members of the Committee include only individuals who serve on the Board as independent representatives, who hold no employment positions with AHSSHC and who do not have relationships with any of the individuals whose compensation is under their review that impacts their best independent judgment as fiduciaries of AHSSHC. The Committee's role is to review and approve all components of the executive compensation plan of AHSSHC. As an independent governing body with respect to executive compensation, it should be noted that the Committee will often confer in executive sessions on matters of compensation policy and policy changes. In such executive sessions, no members of management of AHSSHC are present, other than the Chief People Officer, who remains at the request of the Chairman/committee to provide assistance/information as needed. The Committee is advised by an independent third-party compensation advisor. This advisor prepares all the benchmark studies for the Committee. Compensation levels are benchmarked with a national peer group of other not-for-profit healthcare systems and hospitals of similar size and complexity to AdventHealth and each of its affiliated entities. The following principles guide the establishment of individual executive compensation: - The salary of the President/CEO of AdventHealth will not exceed the 50th percentile of comparable salaries paid by similarly situated organizations; and - Other executive salaries shall be established using market medians. The compensation philosophy, policies, and practices of AHSSHC are consistent with the organization's faith-based mission and conform to applicable laws, regulations, and business practices. As a faith-based organization sponsored by the Seventh-day Adventist Church (the Church), AHSSHC's philosophy and principles with respect to its executive compensation practices reflect the conservative approach of the Church's mission of service and were developed in counsel with the Church's leadership.
Part I, Lines 4a-b
During the year ending December 31, 2023, Michael Torres, MD received severance payments in the amount of $200,914. Pursuant to the AHSSHC Corporate Executive Policy governing executive severance, severance agreements for executives operating at the Vice President level and above are entered into upon eligibility to facilitate the transition to subsequent employment following an involuntary separation from employment with AdventHealth. As discussed in Line 1a above, executives on the filing organization's management team that hold the position of Vice-President or above are compensated by and on the payroll of Adventist Health System Sunbelt Healthcare Corporation (AHSSHC), the parent organization of the healthcare system known as AdventHealth. In recognition of the contribution that each executive makes to the success of AdventHealth, AdventHealth provides supplemental executive retirement benefit plans to eligible executives. As the supplemental executive retirement benefit plans were updated in 2020 and certain individuals still participate as grand-fathered participants in certain plans, the narrative below discusses all plans in which there were any participants in 2023. The SERP III plan effectively replaces the prior SERP II plan, the Executive Flex Benefit Program Plan, and the Senior Executive Death Benefit Plan for qualified executives except for certain grandfathered executive employees. SERP III Plan: The SERP III plan provides eligible executives a percentage of their base pay, which is credited to a deferred compensation account. The plan also provides for compensation deferral and selection of life insurance coverage and long-term care insurance. To be eligible to participate in the SERP III plan, executives must be on the AHSSHC corporate payroll and be either a CEO of an AdventHealth entity, an AHSSHC Vice President (VP) or VP of an AdventHealth entity with a base salary of at least $330,000 in 2023 (adjusted annually by the same percentage as IRC Section 401(a)(17) limit increases), or other leader specifically approved by the AdventHealth President. Eligible executives do not include grandfathered executives, meaning those executives who would satisfy all the eligibility requirements of the SERP II plan prior to Dec 31, 2027, had the plan not been amended and restated as of Jan. 1, 2020. Contribution credits will be established and maintained by class year accounts for each participant using tiered contribution credit percentages of annual base compensation. Contribution credit percentages range between 15% and 19% of base compensation. Contribution credits will be made each quarter in 25% increments with reductions in contributions if the executive is also a grandfathered FLEX participant (see below). SERP III provides for a class year vesting and payment schedule (7 years for each class year) with respect to amounts accumulated in the executive's deferred compensation account. Upon attainment of a normal retirement age (age 62), or upon certain other circumstances as defined in the SERP III plan document, all deferred amounts are paid immediately to the participant. For any executives working beyond the normal retirement age, future employer contributions will be made quarterly from SERP III directly to the participant as a taxable cash bonus. SERP II Plan: The SERP II plan is a defined benefit, non-tax-qualified deferred compensation plan for certain executives who have provided lengthy service to AdventHealth and/or to other Seventh-day Adventist Church hospitals or health care institutions. Under the provisions of the SERP II plan, benefits are provided to qualifying executive participants on a pro-rata schedule beginning with 20 years of service as an employee of AdventHealth and/or another hospital or health care institution controlled by the Seventh-day Adventist Church and who satisfy certain other qualifying criteria. Eligible employees are restricted to those executives who, as of January 1, 2020, satisfied, or if employment continues, will satisfy the eligibility requirements of SERP II prior to December 31, 2027. This supplemental executive retirement plan (SERP II) was designed to provide eligible executives with the economic equivalent of an annual income beginning at normal retirement age equal to 60% of the average of the participant's three, five or seven highest years of base salary from AdventHealth active employment inclusive of income from all other Seventh-day Adventist Church healthcare employer-financed retirement income sources and investment income earned on those contributions through social security normal retirement age as defined in the plan. The number of years included in highest average compensation is determined by the individual's year of entry to SERP II and by the individual's year of entry to the AdventHealth Executive FLEX Benefit Program. FLEX Plan: The Flex Plan was originally designed to provide eligible executives an opportunity to select from among a variety of supplemental benefits, including a split dollar life insurance policy and long-term care insurance, to individually tailor a benefits program appropriate to each executive's needs. In 2020, the Flex Plan was amended to exclude employed executives who are hired or promoted after a certain date from being eligible to participate in the Flex Plan except for certain insurance coverage features of the plan. The Flex Plan provides eligible participants a pre-determined benefits allowance credit that is equal to a percentage of the executive's base pay from which the cost of mandatory and elective employee benefits is deducted. The benefits allowance credit percentage for any plan year shall not be greater than the maximum dollar amount or the percentage of compensation as determined by the AdventHealth Benefits Administration Committee. For grandfathered eligible employees, the annual pre-determined Flex allowance is contributed and any funds that remain after the cost of mandatory and elective benefits are subtracted are, at the employee's option, contributed to either an IRC 457(f) deferred compensation account or to an IRC 457(b) eligible deferred compensation plan. Upon attainment of age 65, all previous 457(f) deferred amounts are paid immediately to the participant and any future employer contributions are made quarterly from the Plan directly to the participant. The Plan provides for a class year vesting schedule (2 years for each class year) with respect to amounts accumulated in the executive's 457(f) deferred compensation account. Distributions could also be made from the executive's 457(f) deferred compensation account upon attainment of age 65 or upon an involuntary separation. The account will be forfeited by the executive upon a voluntary separation. With respect to grandfathered participants, the Flex Plan documents define eligible employees to include the Chief Executive Officers of AdventHealth entities and Vice Presidents of all AdventHealth entities whose base salary was at least equal to the Internal Revenue Code Section 401(a)(17) compensation limit each year. FLEX Plan FLEX Plan SERP II SERP III SERP III Contr. Distr.* Distr. Contr. Distr. Ottati, David $ 155,450 $ 142,998 $ 399,489 $ 0 $ 0 Bergherm, Bruce $ 126,372 $ 103,872 $ 541,847 $ 0 $ 0 Adams, Brian $148,620 $ 62,365 $ 0 $ 9,281 $ 0 Johnson, Joel $ 73,553 $ 63,020 $ 24,264 $ 0 $ 0 Didenko, Vadym $ 99,739 $ 90,599 $ 0 $ 0 $ 0 Skula, Erika $ 72,312 $ 44,712 $ 190,979 $ 0 $ 0 Bales-Chubb, Denyse$ 93,203 $ 78,728 $ 0 $ 9,264 $ 0 Ross, MD, Douglas $ 57,463 $ 41,204 $ 0 $ 13,240 $13,240 McGuinness, Robin $ 57,468 $ 36,267 $ 0 $ 6,645 $ 6,645 Dunkel, Jason $ 44,986 $ 32,825 $ 0 $ 18,288 $ 0 Heinrich, William $ 53,174 $ 21,978 $ 0 $ 14,975 $ 0 Torres, MD, Michael$ 27,644 $ 5,144 $ 0 $ 0 $ 0 Colburn, Douglas $ 0 $ 0 $ 0 $ 57,972 $ 0 Davis, Tyson $ 32,963 $ 13,753 $ 0 $ 23,153 $ 0 Kotak, MD, Rajesh $ 0 $ 0 $ 0 $ 52,172 $ 0 Pittman, Michael $ 0 $ 0 $ 0 $ 46,669 $ 0 Bjornstad, MD, Brad$ 15,829 $ 0 $ 0 $ 2,159 $ 2,159 * Including Investment Earnings

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

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.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2023
Filed
15 October 2024
IRS schema version
2023v5.1
Source object
202423109349302827

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