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Nonprofiteer
← DEACONESS CLINIC INC

Form 990 for tax year 2022

Filed by DEACONESS CLINIC INC.

Totals

Total revenue
$156,015,406
Total expenses
$228,464,867
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$155,119,860
Investment income
$34,084
Other revenue
$861,462
Total assets, end of year
$91,072,232
Total liabilities, end of year
$90,662,999
Net assets or fund balances, end of year
$409,233
Program services expenses (Part IX)
$202,443,122
Management and general expenses
$26,021,745
Fundraising expenses
$0
Program service expenses (Part III)
$202,443,122

Program services were 88.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • STEPHEN TITZER

    CHAIRMAN

    Total calculated
    $2,400
    From this org
    $2,400
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • MIA HINDI MD

    DIRECTOR & VICE CHAIR

    Total calculated
    $1,248,992
    From this org
    $1,176,195
    From related orgs
    $16,028
    Other
    $56,769
    Hours/week
    50 + 10 related

    Schedule J breakdown matched by us

    Base
    $982,969
    Bonus
    $161,680
    Other
    $31,546 + $16,028 related
    Deferred
    $21,210
    Nontaxable benefits
    $35,559
    Filer's total
    $1,232,964 + $16,028 related

  • CHERYL WATHEN

    SECRETARY/TREASURER

    Total calculated
    $1,021,795
    From this org
    $0
    From related orgs
    $820,174
    Other
    $201,621
    Hours/week
    5 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $577,576 related
    Bonus
    $0 + $134,675 related
    Other
    $0 + $107,923 related
    Deferred
    $0 + $159,494 related
    Nontaxable benefits
    $0 + $42,127 related
    Filer's total
    $0 + $1,021,795 related

  • CHRIS CHACKO MD

    DIRECTOR

    Total calculated
    $352,508
    From this org
    $310,831
    From related orgs
    $0
    Other
    $41,677
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $220,407
    Bonus
    $81,300
    Other
    $9,124
    Deferred
    $21,210
    Nontaxable benefits
    $20,467
    Filer's total
    $352,508

  • GARY KEEPES MD

    DIRECTOR

    Total calculated
    $510,669
    From this org
    $482,582
    From related orgs
    $0
    Other
    $28,087
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $298,110
    Bonus
    $181,672
    Other
    $2,800
    Deferred
    $0
    Nontaxable benefits
    $28,087
    Filer's total
    $510,669

  • GARRETT KOON MD

    DIRECTOR

    Total calculated
    $348,898
    From this org
    $331,619
    From related orgs
    $0
    Other
    $17,279
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $202,282
    Bonus
    $126,996
    Other
    $2,341
    Deferred
    $16,580
    Nontaxable benefits
    $699
    Filer's total
    $348,898

  • BARRY PHILLIPS MD

    DIRECTOR

    Total calculated
    $511,973
    From this org
    $484,027
    From related orgs
    $0
    Other
    $27,946
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $365,509
    Bonus
    $113,810
    Other
    $4,708
    Deferred
    $0
    Nontaxable benefits
    $27,946
    Filer's total
    $511,973

  • JAMES PORTER MD

    DIRECTOR

    Total calculated
    $1,292,570
    From this org
    $0
    From related orgs
    $1,083,242
    Other
    $209,328
    Hours/week
    5 + 63 related

    Schedule J breakdown matched by us

    Base
    $0 + $632,974 related
    Bonus
    $0 + $174,754 related
    Other
    $0 + $275,514 related
    Deferred
    $0 + $172,267 related
    Nontaxable benefits
    $0 + $37,061 related
    Filer's total
    $0 + $1,292,570 related

  • ASHLEY RICHESON MD

    DIRECTOR

    Total calculated
    $288,147
    From this org
    $241,756
    From related orgs
    $0
    Other
    $46,391
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $182,258
    Bonus
    $57,746
    Other
    $1,752
    Deferred
    $13,149
    Nontaxable benefits
    $33,242
    Filer's total
    $288,147

  • WILLIAM SMITH MD

    DIRECTOR

    Total calculated
    $368,494
    From this org
    $336,922
    From related orgs
    $0
    Other
    $31,572
    Hours/week
    50 + 1 related

    Schedule J breakdown matched by us

    Base
    $223,416
    Bonus
    $104,247
    Other
    $9,259
    Deferred
    $21,210
    Nontaxable benefits
    $10,362
    Filer's total
    $368,494

  • JOANN WOOD MD

    DH CMO & VP

    Total calculated
    $701,403
    From this org
    $0
    From related orgs
    $575,994
    Other
    $125,409
    Hours/week
    5 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $462,273 related
    Bonus
    $0 + $106,786 related
    Other
    $0 + $6,935 related
    Deferred
    $0 + $106,362 related
    Nontaxable benefits
    $0 + $19,047 related
    Filer's total
    $0 + $701,403 related

  • JAMIE MULL MD

    DIRECTOR

    Total calculated
    $1,004,009
    From this org
    $970,819
    From related orgs
    $0
    Other
    $33,190
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $788,732
    Bonus
    $169,482
    Other
    $12,605
    Deferred
    $16,580
    Nontaxable benefits
    $16,610
    Filer's total
    $1,004,009

  • DHRUVIN MEHTA MD

    DIRECTOR

    Total calculated
    $460,152
    From this org
    $433,199
    From related orgs
    $0
    Other
    $26,953
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $333,651
    Bonus
    $49,921
    Other
    $49,627
    Deferred
    $16,580
    Nontaxable benefits
    $10,373
    Filer's total
    $460,152

  • JASON WHITE MD

    DIRECTOR

    Total calculated
    $923,229
    From this org
    $871,409
    From related orgs
    $0
    Other
    $51,820
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $795,992
    Bonus
    $65,319
    Other
    $10,098
    Deferred
    $21,210
    Nontaxable benefits
    $30,610
    Filer's total
    $923,229

  • NAROTHAMA R AEDDULA

    DIRECTOR

    Total calculated
    $1,001,089
    From this org
    $970,108
    From related orgs
    $0
    Other
    $30,981
    Hours/week
    50 + 5 related

    Schedule J breakdown matched by us

    Base
    $789,364
    Bonus
    $126,890
    Other
    $53,854
    Deferred
    $0
    Nontaxable benefits
    $30,981
    Filer's total
    $1,001,089

  • BRADLEY SCHEU MD

    SENIOR VICE PRESIDENT

    Total calculated
    $629,682
    From this org
    $500,579
    From related orgs
    $0
    Other
    $129,103
    Hours/week
    50 + 12 related

    Schedule J breakdown matched by us

    Base
    $395,518
    Bonus
    $102,385
    Other
    $2,676
    Deferred
    $92,726
    Nontaxable benefits
    $36,377
    Filer's total
    $629,682

  • SNESHA MODI MD

    DIRECTOR PARTIAL TERM

    Total calculated
    $398,717
    From this org
    $381,795
    From related orgs
    $0
    Other
    $16,922
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $217,981
    Bonus
    $131,459
    Other
    $32,355
    Deferred
    $16,370
    Nontaxable benefits
    $552
    Filer's total
    $398,717

  • JULIE DINGMAN

    OPERATIONS ADMINSTRATOR

    Total calculated
    $288,381
    From this org
    $257,799
    From related orgs
    $0
    Other
    $30,582
    Hours/week
    50 + 2 related

    Schedule J breakdown matched by us

    Base
    $221,219
    Bonus
    $35,200
    Other
    $1,380
    Deferred
    $6,390
    Nontaxable benefits
    $24,192
    Filer's total
    $288,381

  • JON C DAVIS

    PHYSICIAN

    Total calculated
    $3,017,030
    From this org
    $2,965,610
    From related orgs
    $0
    Other
    $51,420
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $2,430,021
    Bonus
    $527,423
    Other
    $8,166
    Deferred
    $21,210
    Nontaxable benefits
    $30,210
    Filer's total
    $3,017,030

  • MANGA D KODALI

    PHYSICIAN

    Total calculated
    $1,579,385
    From this org
    $1,571,204
    From related orgs
    $0
    Other
    $8,181
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $1,510,033
    Bonus
    $52,387
    Other
    $8,784
    Deferred
    $7,320
    Nontaxable benefits
    $861
    Filer's total
    $1,579,385

  • YASODA D DEVABHAKTUNI

    PHYSICIAN

    Total calculated
    $1,562,284
    From this org
    $1,523,208
    From related orgs
    $0
    Other
    $39,076
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $1,453,877
    Bonus
    $48,706
    Other
    $20,625
    Deferred
    $16,580
    Nontaxable benefits
    $22,496
    Filer's total
    $1,562,284

  • MIR FAHAD FAISAL

    PHYSICIAN

    Total calculated
    $1,545,789
    From this org
    $1,489,181
    From related orgs
    $7,500
    Other
    $49,108
    Hours/week
    50 + 1 related

    Schedule J breakdown matched by us

    Base
    $1,301,955
    Bonus
    $178,325
    Other
    $8,901 + $7,500 related
    Deferred
    $16,580
    Nontaxable benefits
    $32,528
    Filer's total
    $1,538,289 + $7,500 related

  • BRUCE W SCHNEIDER

    PHYSICIAN

    Total calculated
    $1,332,957
    From this org
    $1,274,531
    From related orgs
    $0
    Other
    $58,426
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $1,072,025
    Bonus
    $177,528
    Other
    $24,978
    Deferred
    $36,820
    Nontaxable benefits
    $21,606
    Filer's total
    $1,332,957

  • LINDA WHITE

    FORMER DIRECTOR

    Total calculated
    $227,888
    From this org
    $0
    From related orgs
    $212,056
    Other
    $15,832
    Hours/week
    0 + 51 related

    Schedule J breakdown matched by us

    Base
    $0 + $177,170 related
    Bonus
    $0 + $27,529 related
    Other
    $0 + $7,357 related
    Deferred
    $0 + $5,002 related
    Nontaxable benefits
    $0 + $10,830 related
    Filer's total
    $0 + $227,888 related

  • WILLIAM WHITE

    FORMER DIRECTOR

    Total calculated
    $293,240
    From this org
    $0
    From related orgs
    $241,995
    Other
    $51,245
    Hours/week
    0 + 58 related

    Schedule J breakdown matched by us

    Base
    $0 + $151,977 related
    Bonus
    $0 + $44,609 related
    Other
    $0 + $45,409 related
    Deferred
    $0 + $26,812 related
    Nontaxable benefits
    $0 + $24,433 related
    Filer's total
    $0 + $293,240 related

  • MAQBOOL AHMED

    FORMER DIRECTOR

    Total calculated
    $670,305
    From this org
    $500,905
    From related orgs
    $169,400
    Other
    $0
    Hours/week
    50 + 5 related

    Schedule J breakdown matched by us

    Base
    $358,692
    Bonus
    $141,493
    Other
    $720 + $169,400 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $500,905 + $169,400 related

  • RENEE M GALEN

    FORMER DIRECTOR

    Total calculated
    $369,212
    From this org
    $322,111
    From related orgs
    $0
    Other
    $47,101
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $180,194
    Bonus
    $132,625
    Other
    $9,292
    Deferred
    $25,840
    Nontaxable benefits
    $21,261
    Filer's total
    $369,212

  • JOSEPH C KLINK

    FORMER DIRECTOR

    Total calculated
    $1,110,078
    From this org
    $1,070,636
    From related orgs
    $0
    Other
    $39,442
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $899,372
    Bonus
    $163,013
    Other
    $8,251
    Deferred
    $13,890
    Nontaxable benefits
    $25,552
    Filer's total
    $1,110,078

  • MAJED A KOLEILAT

    FORMER DIRECTOR

    Total calculated
    $969,569
    From this org
    $913,730
    From related orgs
    $0
    Other
    $55,839
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $816,725
    Bonus
    $86,907
    Other
    $10,098
    Deferred
    $25,840
    Nontaxable benefits
    $29,999
    Filer's total
    $969,569

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 · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Form 990 of other organizations
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings

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

The filer's explanations (Part III)

PART I, LINE 1A
SOCIAL CLUB DUES ARE PAID FOR LINDA WHITE FOR ORGANIZATION BUSINESS ONLY. ANY PERSONAL USE OF THE CLUB MUST BE PAID BY THE EMPLOYEE.
PART I, LINE 4B
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS: SEVERANCE NONQUALIFIED EQUITY-BASED CHERYL WATHEN $ -0- $ 20,500 $ -0- JAMES PORTER, MD 0 20,500 0 MIA HINDI, MD 0 20,500 0 BRADLEY SCHEU, MD 0 20,500 0 NAROTHAMA AEDDULA 0 20,500 0 GARY KEEPES 0 20,500 0 JAMIE MULL 0 20,500 0 BARRY PHILLIPS 0 20.500 0 JOANN WOOD 0 20,500 0 JON DAVIS 0 20,500 0 MANGA KODALI 0 20,500 0 YASODA DEVABHAKTUNI 0 20,500 0 SEVERANCE NONQUALIFIED EQUITY-BASED BRUCE SCHNIEDER $ -0- $ 20,500 $ -0- LINDA WHITE 0 20,500 0 WILLIAM WHITE 0 15,209 0 MAQBOOL AHMED 0 20,500 0 JOSEPH KLINK, MD 0 20,500 0 PART 1, LINE 4B: CHERYL WATHEN: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $119,207. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $92,511. JAMES PORTER: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $138,747. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $267,465. JOANN WOOD: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $89,782. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $2,691. BRADLEY SCHEU: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $71,516. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $0.00 WILLIAM WHITE: SUPPLEMENTAL ACCUMULATION ACCOUNT CONTRIBUTIONS OF $21,523. SUPPLEMENTAL ACCUMULATION ACCOUNT PAYOUT OF $21,523.
PART I, LINE 6
COMPENSATION CONTINGENT UPON NET EARNINGS: INCENTIVE COMPENSATION PAYMENTS MADE BY THE ORGANZIATION ARE BASED UPON SUCCESSFUL ACHIEVEMENT OF ESTABLISHED INPATIENT SATISFACTION MEASURES, OUTPATIENT SATISFACTION MEASURES, COMPLIANCE WITH PUBLICLY REPORTED QUALITY INDICATORS, OPERATING MARGIN AS WELL AS OTHER TECHNICAL AND PERSONAL FUNCTIONAL GOALS OF BOTH THE ORGANIZATION AND RELATED ORGANIZATIONS. DEACONESS CLINIC'S INCENTIVE COMPENSATION PROGRAMS ARE FORMULATED TO REWARD BEHAVIOR THAT BALANCES PATIENT NEEDS AND EFFICIENT DELIVERY OF PATIENT CARE TO ENSURE THE BEST OUTCOMES ARE ACHIEVED.

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.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2022
Filed
15 August 2024
IRS schema version
2022v5.0
Source object
202442289349302869

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