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Nonprofiteer
← ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM

Form 990 for tax year 2022

Filed by ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM.

Totals

Total revenue
$695,333,893
Total expenses
$685,216,987
Contributions and grants received
$9,676,827
Grants paid
$194,690
Program service revenue
$673,322,579
Investment income
$927,707
Other revenue
$11,406,780
Total assets, end of year
$1,102,481,292
Total liabilities, end of year
$138,011,681
Net assets or fund balances, end of year
$964,469,611
Program services expenses (Part IX)
$655,916,922
Management and general expenses
$29,300,065
Fundraising expenses
$0
Program service expenses (Part III)
$655,916,922

Program services were 95.7% 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.

  • 1b · Membership dues

    $120,100

  • 1d · Related organizations

    $861,922

  • 1e · Government grants (contributions)

    $8,694,805

  • 2a · Program service revenue: NET PATIENT SERVICES

    total $660,850,260 · related or exempt $660,850,260 · unrelated business $0 · excluded $0

  • 2b · Program service revenue: LABORATORY SERVICES

    total $7,551,217 · related or exempt $6,989,342 · unrelated business $561,875 · excluded $0

  • 2c · Program service revenue: SERVICES SOLD

    total $3,259,363 · related or exempt $0 · unrelated business $0 · excluded $3,259,363

  • 2d · Program service revenue: MEDICAL SERVICES

    total $991,351 · related or exempt $0 · unrelated business $0 · excluded $991,351

  • 2e · Program service revenue: PHARMACY SERVICES

    total $670,388 · related or exempt $0 · unrelated business $0 · excluded $670,388

  • 3 · Investment income

    total $356,554 · excluded $356,554

  • 6a · Gross rents

    real property $13,737,759

  • 6b · Less rental expenses

    real property $11,205,994

  • 6c · Rental income or loss

    real property $2,531,765

  • 6d · Net rental income or loss

    total $2,531,765 · excluded $2,531,765

  • 7a · Gross sales of assets other than inventory

    securities $267,153 · other assets $304,000

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

    securities $0 · other assets $0

  • 7c · Gain or loss

    securities $267,153 · other assets $304,000

  • 7d · Net gain or loss

    total $571,153 · excluded $571,153

  • 10a · Gross sales of inventory

    $392,025

  • 10b · Cost of goods sold

    $251,528

  • 10c · Net income from sales of inventory

    total $140,497 · excluded $140,497

  • 11a · Other revenue: CAFETERIA

    total $4,499,566 · related or exempt $0 · unrelated business $376,354 · excluded $4,123,212

  • 11b · Other revenue: EMPLOYEE RETENTION CRE

    total $3,453,459 · related or exempt $0 · unrelated business $0 · excluded $3,453,459

  • 11c · Other revenue: BEHAVIORAL HEALTH STAT

    total $618,679 · related or exempt $0 · unrelated business $0 · excluded $618,679

  • 11d · All other revenue

    total $162,814 · excluded $162,814

  • 11e · Other revenue, total

    $8,734,518

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $98,997 · program services $98,997

  • 2 · Grants to domestic individuals

    total $95,693 · program services $95,693

  • 7 · Other salaries and wages

    total $166,561,733 · program services $158,233,646 · management and general $8,328,087

  • 8 · Pension plan contributions

    total $7,853,839 · program services $7,461,147 · management and general $392,692

  • 9 · Other employee benefits

    total $22,550,675 · program services $21,423,141 · management and general $1,127,534

  • 10 · Payroll taxes

    total $12,016,476 · program services $11,415,652 · management and general $600,824

  • 11a · Fees: management

    total $40,707,555 · program services $38,672,177 · management and general $2,035,378

  • 11c · Fees: accounting

    total $42,147 · program services $40,040 · management and general $2,107

  • 11d · Fees: lobbying

    total $26,809 · management and general $26,809

  • 11f · Fees: investment management

    total $38,683 · program services $38,683

  • 11g · Fees: other

    total $180,175,813 · program services $171,372,323 · management and general $8,803,490

  • 12 · Advertising and promotion

    total $245 · program services $245

  • 13 · Office expenses

    total $10,369,196 · program services $9,850,736 · management and general $518,460

  • 14 · Information technology

    total $18,123,113 · program services $17,216,957 · management and general $906,156

  • 16 · Occupancy

    total $6,758,321 · program services $5,860,105 · management and general $898,216

  • 17 · Travel

    total $206,977 · program services $196,628 · management and general $10,349

  • 19 · Conferences, conventions and meetings

    total $30,606 · program services $29,076 · management and general $1,530

  • 20 · Interest

    total $3,857 · program services $3,857

  • 21 · Payments to affiliates

    total $11,618,042 · program services $11,037,140 · management and general $580,902

  • 22 · Depreciation, depletion and amortization

    total $29,275,847 · program services $27,812,055 · management and general $1,463,792

  • 23 · Insurance

    total $2,412,345 · program services $2,291,728 · management and general $120,617

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $112,887,303 · program services $112,887,303 · management and general $0 · fundraising $0

  • 24b · Other expenses: INTERCOMPANY ALLOCATION

    total $56,488,112 · program services $53,663,706 · management and general $2,824,406 · fundraising $0

  • 24c · Other expenses: REPAIRS AND MAINTENANCE

    total $4,801,275 · program services $4,561,211 · management and general $240,064 · fundraising $0

  • 24d · Other expenses: UNRELATED BUSINESS TAXE

    total $161,000 · program services $161,000 · management and general $0 · fundraising $0

  • 24e · All other expenses

    total $1,912,328 · program services $1,493,676 · management and general $418,652

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $2,625 · end of year $2,627

  • 2 · Savings and temporary cash investments

    beginning of year $6,343,677 · end of year $10,755,475

  • 3 · Pledges and grants receivable

    end of year $0

  • 4 · Accounts receivable

    beginning of year $78,696,088 · end of year $101,292,072

  • 5 · Loans and receivables from officers and key people

    end of year $0

  • 6 · Loans and receivables from disqualified persons

    end of year $0

  • 7 · Other notes and loans receivable

    end of year $0

  • 8 · Inventories for sale or use

    beginning of year $16,546,213 · end of year $17,235,827

  • 9 · Prepaid expenses and deferred charges

    beginning of year $749,325 · end of year $757,308

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

    $777,057,606

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

    $485,014,747

  • 10c · Land, buildings and equipment, net

    beginning of year $305,544,785 · end of year $292,042,859

  • 11 · Investments: publicly traded securities

    end of year $0

  • 12 · Investments: other securities

    beginning of year $22,095,083 · end of year $22,891,051

  • 13 · Investments: program-related

    end of year $0

  • 14 · Intangible assets

    end of year $0

  • 15 · Other assets

    beginning of year $689,634,980 · end of year $657,504,073

  • 17 · Accounts payable and accrued expenses

    beginning of year $63,328,771 · end of year $40,604,107

  • 18 · Grants payable

    end of year $0

  • 19 · Deferred revenue

    beginning of year $629,264 · end of year $473,976

  • 20 · Tax-exempt bond liabilities

    end of year $0

  • 21 · Escrow or custodial account liability

    end of year $0

  • 22 · Loans and payables to officers and key people

    end of year $0

  • 23 · Secured mortgages and notes payable

    end of year $0

  • 24 · Unsecured notes and loans payable

    end of year $0

  • 25 · Other liabilities

    beginning of year $101,528,527 · end of year $96,933,598

  • 27 · Net assets without donor restrictions

    beginning of year $954,096,999 · end of year $964,440,396

  • 28 · Net assets with donor restrictions

    beginning of year $29,215 · end of year $29,215

Mission and programs · 2022

Mission

AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL.

Activities or mission (Part I)

THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH.

  • ALEGENT HEALTH-BERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL, COUNCIL BLUFFS OFFER PATIENTS THE MOST COMFORTABLE AND COMPREHENSIVE OPERATING ROOM SERVICES.

    Expenses $113,625,849 · Grants $51,037 · Revenue $175,069,554

  • BERGAN MERCY MEDICAL CENTER IS EQUIPPED WITH THE LATEST TECHNOLOGIES IN THE DIAGNOSTIC CENTER. THE CENTER IS COMPLETELY DIGITAL SO PATIENTS ARE NEVER WAITING ON FILMS. FEMALE PATIENTS CAN COUNT ON EXPERT IMAGING TESTS INCLUDING ULTRASOUND, BONE DENSITY TESTING, STEREOTACTIC BREAST BIOPSY AND DIGITAL MAMMOGRAPHY. THERE ARE A WIDE RANGE OF AVAILABLE TESTS AT THE DIAGNOSTIC CENTER THAT INCLUDE THE FOLLOWING: DIGITAL MAMMOGRAPHY, MRI AND OPEN MRI, CT, PET CT AND CARDIAC CT, 64-SLICE CT, FLUOROSCOPY, PULMONARY FUNCTION TESTING, ULTRASOUND, CARDIOVASCULAR IMAGING, PHLEMBOTOMY, NUCLEAR MEDICINE, DIGITAL IMAGING, EEG, EKG AND EMG, STRESS TESTING AND ARTERIOGRAM.

    Expenses $76,546,853 · Grants $56,374 · Revenue $193,377,847

  • BERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL, COUNCIL BLUFFS OFFER A WIDE RANGE OF CARDIOVASCULAR SERVICES IN THE REGION, USING A TEAM APPROACH TO ADDRESS THE TOTAL NEEDS OF THE CARDIOVASCULAR PATIENT. ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM PROVIDES A COMPREHENSIVE RANGE OF CARDIAC SERVICES, INCLUDING BUT NOT LIMITED TO: VASCULAR AND CARDIAC SURGERY, HEART SCANS AND HEART CHECKS, CARDIAC REHABILITATION, VASCULAR ULTRASOUND, NUCLEAR STRESS TESTS, DUAL SOURCE CT SCANNER AND ANGIOPLASTY. IN 2006, MERCY HOSPITAL OPENED A NEW STATE-OF-THE-ART CARDIAC CATHETERIZATION LAB, ALLOWING PHYSICIANS TO PERFORM PROCEDURES SUCH AS HEART CATHETERIZATIONS, CORONARY INTERVENTIONS INCLUDING BALLOON ANGIOPLASTY AND STENTING, AS WELL AS IMPLANTATION OF PACEMAKERS AND DEFIBRILLATORS.

    Expenses $43,500,049 · Grants $22,480 · Revenue $77,111,075

  • BERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL, COUNCIL BLUFFS PROVIDE A LARGE RANGE OF HOSPITAL SERVICES INCLUDING BUT NOT LIMITED TO: EMERGENCY DEPARTMENT, INPATIENT HOSPITAL FACILITIES, PROCEDURE CENTER, ORTHOPEDIC SERVICES, DIGESTIVE HEALTH CENTER, FAMILY LIFE CENTER, RADIOLOGY, UROLOGY AND PHYSICAL THERAPY. PATIENTS ARE AT THE CENTER OF EVERYTHING DONE AT BERGAN MERCY MEDICAL CENTER AND MERCY HOSPITAL, COUNCIL BLUFFS.

    Expenses $422,244,171 · Grants $64,800 · Revenue $222,281,126

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • John Petersdorf

    BOARD MEMBER

    Total calculated
    $3,026,445
    From this org
    $0
    From related orgs
    $2,349,200
    Other
    $677,245
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $596,879 related
    Bonus
    $0 + $497,099 related
    Other
    $0 + $1,255,222 related
    Deferred
    $0 + $611,834 related
    Nontaxable benefits
    $0 + $65,411 related
    Filer's total
    $0 + $3,026,445 related
  • Evert Kuiper

    EX-OFFICIO BM/ PRESIDENT & CEO CHI HEALTH

    Total calculated
    $1,303,984
    From this org
    $0
    From related orgs
    $1,274,593
    Other
    $29,391
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $891,215 related
    Bonus
    $0 + $275,000 related
    Other
    $0 + $108,378 related
    Deferred
    $0 + $3,276 related
    Nontaxable benefits
    $0 + $26,115 related
    Filer's total
    $0 + $1,303,984 related
  • Jeanette Wojtalewicz

    CFO, CHI HEALTH (TERMED 1/6/23)

    Total calculated
    $1,223,121
    From this org
    $0
    From related orgs
    $1,168,841
    Other
    $54,280
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $649,549 related
    Bonus
    $0 + $463,014 related
    Other
    $0 + $56,278 related
    Deferred
    $0 + $17,750 related
    Nontaxable benefits
    $0 + $36,530 related
    Filer's total
    $0 + $1,223,121 related
  • Jayleen Casano

    PRESIDENT CUMC-BERGAN MERCY (TERMED 3/4/23)

    Total calculated
    $890,021
    From this org
    $0
    From related orgs
    $815,583
    Other
    $74,438
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $463,191 related
    Bonus
    $0 + $312,503 related
    Other
    $0 + $39,889 related
    Deferred
    $0 + $59,775 related
    Nontaxable benefits
    $0 + $14,663 related
    Filer's total
    $0 + $890,021 related
  • Kirtibala Gupta MD

    BOARD MEMBER/PHYSICIAN

    Total calculated
    $440,317
    From this org
    $0
    From related orgs
    $396,003
    Other
    $44,314
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $394,104 related
    Bonus
    $0
    Other
    $0 + $1,899 related
    Deferred
    $0 + $17,575 related
    Nontaxable benefits
    $0 + $26,739 related
    Filer's total
    $0 + $440,317 related
  • Julie Goebel

    INTERIM PRESIDENT CUMC-BERGAN MERCY

    Total calculated
    $386,593
    From this org
    $0
    From related orgs
    $365,482
    Other
    $21,111
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $290,611 related
    Bonus
    $0 + $45,000 related
    Other
    $0 + $29,871 related
    Deferred
    $0 + $810 related
    Nontaxable benefits
    $0 + $20,301 related
    Filer's total
    $0 + $386,593 related
  • Cy Xayarath

    TRAVELER RN

    Total calculated
    $353,146
    From this org
    $191,350
    From related orgs
    $109,535
    Other
    $52,261
    Hours/week
    30 + 20 related

    Schedule J breakdown matched by us

    Base
    $163,525 + $92,153 related
    Bonus
    $0 + $400 related
    Other
    $27,825 + $16,982 related
    Deferred
    $17,788
    Nontaxable benefits
    $29,731 + $4,742 related
    Filer's total
    $238,869 + $114,277 related
  • Marlene Ross

    RN I

    Total calculated
    $339,466
    From this org
    $0
    From related orgs
    $312,763
    Other
    $26,703
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $306,139 related
    Bonus
    $0 + $400 related
    Other
    $0 + $6,224 related
    Deferred
    $0 + $16,676 related
    Nontaxable benefits
    $0 + $10,027 related
    Filer's total
    $0 + $339,466 related
  • Heather Morgan MD

    BOARD MEMBER/PHYSICIAN

    Total calculated
    $329,219
    From this org
    $0
    From related orgs
    $278,612
    Other
    $50,607
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $277,757 related
    Bonus
    $0
    Other
    $0 + $855 related
    Deferred
    $0 + $16,557 related
    Nontaxable benefits
    $0 + $34,050 related
    Filer's total
    $0 + $329,219 related
  • Nick Otool

    INTERIM CFO, CHI HEALTH

    Total calculated
    $304,710
    From this org
    $0
    From related orgs
    $257,678
    Other
    $47,032
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $207,354 related
    Bonus
    $0 + $49,872 related
    Other
    $0 + $452 related
    Deferred
    $0 + $16,380 related
    Nontaxable benefits
    $0 + $30,652 related
    Filer's total
    $0 + $304,710 related
  • Kelli Saucerman-Howard

    VP PATIENT CARE SERVICES

    Total calculated
    $304,401
    From this org
    $260,862
    From related orgs
    $0
    Other
    $43,539
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $230,042
    Bonus
    $28,415
    Other
    $2,405
    Deferred
    $16,173
    Nontaxable benefits
    $27,366
    Filer's total
    $304,401
  • Richard Walden

    TRAVELER RN

    Total calculated
    $284,841
    From this org
    $255,140
    From related orgs
    $9,937
    Other
    $19,764
    Hours/week
    45 + 5 related

    Schedule J breakdown matched by us

    Base
    $242,278 + $7,382 related
    Bonus
    $0 + $2,500 related
    Other
    $12,862 + $55 related
    Deferred
    $9,367
    Nontaxable benefits
    $10,224 + $173 related
    Filer's total
    $274,731 + $10,110 related
  • Makalia Abrahamson

    TRAVELER RN

    Total calculated
    $277,487
    From this org
    $48,721
    From related orgs
    $216,893
    Other
    $11,873
    Hours/week
    10 + 40 related

    Schedule J breakdown matched by us

    Base
    $44,517 + $202,103 related
    Bonus
    $0 + $400 related
    Other
    $4,204 + $14,390 related
    Deferred
    $0 + $11,585 related
    Nontaxable benefits
    $0 + $288 related
    Filer's total
    $48,721 + $228,766 related
  • Matthew Walters

    SENIOR PHYSICIST

    Total calculated
    $269,634
    From this org
    $253,787
    From related orgs
    $485
    Other
    $15,362
    Hours/week
    49 + 1 related

    Schedule J breakdown matched by us

    Base
    $253,020 + $485 related
    Bonus
    $400
    Other
    $367
    Deferred
    $14,740
    Nontaxable benefits
    $622
    Filer's total
    $269,149 + $485 related
  • Marie Knedler

    FORMER PRESIDENT

    Total calculated
    $262,685
    From this org
    $0
    From related orgs
    $249,445
    Other
    $13,240
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $248,945 related
    Bonus
    $0 + $300 related
    Other
    $0 + $200 related
    Deferred
    $0 + $13,240 related
    Nontaxable benefits
    $0
    Filer's total
    $0 + $262,685 related
  • Kelly Bacon

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related
  • Kent Barney

    TREASURER

    Total calculated
    $0
    Hours/week
    1 + 11 related
  • Kevin Fitzgerald PhD

    SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 11 related
  • Sister Nadine Heimann Osf

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 40 related
  • Susanne L Hruza MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related
  • Sister Maurita Soukup

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    1 + 11 related
  • Mardell Wilson EdD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related
  • Bill Yates

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 11 related
  • Lg Searcey

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related
  • Dave Taylor

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 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

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)

PART I, LINE 3
DURING THE CALENDAR YEAR 2022, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART 1, LINE 4A:
CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY.
PART 1, LINE 4B:
DURING THE 2022 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2022 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: JAYLEEN CASANO, $37,957. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2022 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2022, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: JEANETTE WOJTALEWICZ, $50,733. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH ARE ELIGIBLE TO PARTICIPATE IN NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE. THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENTS FOR CERTAIN EMPLOYEES OCCURRED DURING 2022 AND INCLUDE J. PETERSDORF, $1,242,454. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH PARTICIPATE IN THE DIGNITY HEALTH SUPPLEMENTAL EXECUTIVE RETENTION/RETIREMENT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN WHICH IN 2002 WAS OFFERED TO MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM BY THE DIGNITY HEALTH BOARD OF DIRECTORS AND WOULD BE PAID ONLY IF THE EXECUTIVES STAYED WITH THE ORGANIZATION FOR A SPECIFIED NUMBER OF YEARS AS THE PRIMARY PURPOSE OF THIS PLAN IS TO PROVIDE FOR THE RETENTION AND RETIREMENT OF THE PARTICIPANTS. THE EXECUTIVE MANAGEMENT TEAM IS RECRUITED FROM STABLE CAREERS IN ORGANIZATIONS FROM ACROSS THE COUNTRY AND FROM VARIOUS INDUSTRIES. DUTIES ARE BOTH EXTENSIVE AND COMPLEX AND REQUIRE SUBSTANTIAL AND DIVERSE EXPERIENCE AND SKILL SETS TO EXECUTE THEIR ROLES SUCCESSFULLY. THE CALCULATION FOR THE PAYMENTS TO EACH EXECUTIVE ARE BASED ON THE VALUE OF A FINAL AVERAGE PAY ANNUITY BENEFIT BASED ON RETIREMENT AGE AND SERVICE YEARS TO THE ORGANIZATION. DISTRIBUTION OCCURS EACH JULY 1 IF THE PLAN FORMULA WARRANTS A PAYMENT. NO PAYMENTS PURSUANT TO THE PLAN ARRANGEMENT OCCURRED DURING 2022.
PART II:
ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2022.

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.

  • AMERICAN MERCY HOME CARE LLC

    N/A · HOME HEALTH · OH

  • ARIZONA CARE NETWORK - NEXT LLC

    N/A · CARE NETWORK · AZ

  • ARIZONA CARE NETWORK LLC (ACN LLC)

    N/A · CARE NETWORK · AZ

  • ARIZONA DIAGNOSTIC RADIOLOGY GROUP LLC

    N/A · DIAGNOSTIC SERVICES · CA

  • ARIZONA DIAGNOSTIC RADIOLOGY GROUP LLC

    N/A · DIAGNOSTIC SERVICES · CA

  • AUDUBON LAND COMPANY LLC

    N/A · REAL ESTATE · CO

  • BAYLOR CHI ST LUKES HEALTH SERVICES LLC

    N/A · HEALTHCARE SRVC · TX

  • BERGAN MERCY SURGERY CENTER LLC

    N/A · AMBUL SURG CTR · NE

  • BERYWOOD OFFICE PROPERTIES LLC

    N/A · PHYS OFFICE · TN

  • BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD

    N/A · HEALTH SERVICES · CH

  • BLUEGRASS REGIONAL IMAGING CENTER

    N/A · DIAGNOSTIC IMAGING · KY

  • CBCC OUTSMARTING CANCER LLC

    N/A · RADIATION / ONCOLOGY · CA

  • CENTRAL NEBRASKA REHABILITATION SVCS LLC

    N/A · PHYSICAL THERAPY · NE

  • CENTURA SUMMIT ORTHOPEDICS LLC

    N/A · HEALTHCARE SRVC · CO

  • CHICAMSURG SURGERY CENTERS LLC

    N/A · SURGERY CENTER · CO

  • COLORADO SPRINGS CK LEASING LLC

    N/A · REAL ESTATE · CO

  • COMMUNITY MERCY HOME CARE OF SPRINGFLD LLC

    N/A · HOME HEALTH · OH

  • DE JV LLC

    N/A · EMERGENCY CARE · NV

  • DHHP SURGERY CENTERS LLC

    N/A · SURGERY · DE

  • DHRT HOLDINGS LLC

    N/A · HOLDING COMPANY · DE

  • DIGNITY- GOHEALTHURGENT CARE MANAGEMENT LLC

    N/A · MANAGEMENT SERVICES · DE

  • DIGNITY HEALTH AT HOME LLC

    N/A · HEALTHCARE SRVC · DE

  • DIGNITY HEALTH SPECIALTY PHARMACY LLC

    N/A · SPECIALTY PHARMACY SERVICES · DE

  • DIGNITY HOME RECOVERY CARE LLC

    N/A · HOME RECOVERY PROGRAM · DE

  • DIGNITYUSP LAS VEGAS SURGERY CENTERS LLC

    N/A · SURGERY · TX

  • DIGNITYUSP NORCAL SURGERY CENTERS LLC

    N/A · SURGERY · TX

  • DIGNITYUSP PHOENIX SURGERY CENTERS LLC

    N/A · SURGERY · TX

  • DIGNITYUSPJOHN MUIR EAST BAY SURG CTRS LLC

    N/A · SURGERY · TX

  • DIGNITY-ABRAZO HEALTH NETWORK LLC

    N/A · MANAGEMENT SERVICES · AZ

  • DOMINICAN MAGNETIC RESONANCE IMAGING CENTER

    N/A · IMAGING CENTER · CA

  • ECCS ACQUISITION COMPANY LLC

    N/A · AMBUL SURG CTR · CO

  • ENDOSCOPY CENTER OF ARKANSAS

    N/A · DIAGNOSTIC SERVICES · AR

  • FOLSOM SIERRA ENDOSCOPY CENTER LP

    N/A · ENDOSCOPY · CA

  • FRANCISCAN MEDICAL PAVILION BONNEY LAKE LLC

    N/A · REAL ESTATE · WA

  • FRANCISCAN SPECIALTY CARE LLC

    N/A · HEALTHCARE SRVC · WA

  • GOOD SAMARITAN HOME CARE SVCS OF VINCENNE LLC

    N/A · HOME HEALTH · OH

  • HC SL VINTAGE I LLC

    N/A · PROPERTY HOLDING · WI

  • HEALTH AT HOME HOLDCO LLC

    N/A · HOME HEALTH · CO

  • HEALTHCARE SUPPORT SERVICES LLC

    N/A · LAUNDRY · NE

  • HEARTLAND ONCOLOGY LLC

    N/A · ONCOLOGY · KS

  • LAKESIDE AMBULATORY SURGICAL CENTER LLC

    N/A · AMBUL SURG CTR · NE

  • LAKESIDE ENDOSCOPY CENTER LLC

    N/A · ENDOSCOPY SRVC · NE

  • LEXINGTON MBO PARTNERS LTD

    N/A · REAL ESTATE · CO

  • LINCOLN CK LEASING LLC

    N/A · REAL ESTATE · NE

  • MEMORIAL MEDICAL PLAZA

    N/A · REAL ESTATE · CA

  • MERCY DAVIS CANCER CENTER MANAGEMENT CO LLC

    N/A · MANAGEMENT OF CANCER CENTER · CA

  • MERCY REHABILITATION HOSPITAL LLC

    N/A · HEALTHCARE SRVC · TX

  • MILITARY ROAD PROPERTIES LLC

    N/A · REAL ESTATE · WA

  • MOUNTAIN MEDICAL IMAGING LLC

    N/A · MEDICAL IMAGING · TX

  • NEBRASKA SPINE HOSPITAL LLC

    N/A · SPINE HOSPITAL · NE

  • NICU OPERATING CO OF SANTA CRUZ LLC

    N/A · NEONATAL HEALTHCARE · CA

  • NORTH RIVER SURGERY CENTER LLC

    N/A · AMBUL SURG CTR · AR

  • NORTHERN PLAINS LABORATORY LLC

    N/A · DIAGNOSTIC SERVICES · ND

  • NSC CHANNEL ISLANDS LLC

    N/A · AMBULATORY SURGICAL CENTER · CA

  • ORTHOCOLORADO LLC

    N/A · ORTHO HOSPITAL · CO

  • PARK RAPIDS AREA HEALTH CARE

    N/A · HEALTHCARE SRVC · MN

  • PENINSULA RADIATION ONCOLOGY CENTER LLC

    N/A · HEALTHCARE SRVC · WA

  • PENRAD IMAGING LLC

    N/A · MEDICAL IMAGING · CO

  • PERFORMANCE MED EQUIP & RESPIR SVSC LLC

    N/A · HOLDING COMPANY · WA

  • PLAZA SURGERY CENTER LP

    N/A · SURGERY · CA

  • PLAZA SURGERY CENTER LP

    N/A · SURGERY · CA

  • PMC HOSPITAL LLC

    N/A · HOSPITAL · TX

  • PRECISION MEDICINE ALLIANCE LLC

    N/A · DIAGNOSTIC SERVICES · CO

  • RADIATION ONCOLOGY CENTERS OF VENTURA COUNTY

    N/A · IMAGING · CA

  • RBR MANAGEMENT LLC

    N/A · AMBULANCE · NV

  • REID-ANC HOME CARE SERVICES LLC

    N/A · HOME HEALTH · IN

  • SAINT JOSEPH - SCA HOLDINGS LLC

    N/A · INACTIVE · DE

  • SAINT JOSEPH HEALTH ASC LLC

    N/A · SURGERY · KY

  • SAINT JOSEPH-ANC HOME CARE SERVICES

    N/A · HOME HEALTH · KY

  • SANTA CRUZ COMPREHENSIVE IMAGING LLC

    N/A · IMAGING · CA

  • SANTA CRUZ LAND & BUILDING LP

    N/A · REAL ESTATE · CA

  • SANTA CRUZ SURGERY CENTER LLC

    N/A · SURGERY · CA

  • SEVEN OAKS SURGERY CENTER LLC

    N/A · SURGERY · CA

  • SOUTHEASTERN HOME CARE LLC

    N/A · HOME HEALTH · OH

  • ST JOSEPH'S SURGERY CENTER LP

    N/A · SURGERY · TX

  • ST ELIZABETH HOME CARE SERVICES LLC

    N/A · HOME HEALTH · KY

  • ST FRANCIS LAND COMPANY

    N/A · REAL ESTATE · CO

  • ST LUKE'S DIAGNOSTIC CATH LAB LLP

    N/A · DIAGNOSTIC SERVICES · TX

  • ST LUKE'S LAKESIDE HOSPITAL LLC

    N/A · HOSPITAL · TX

  • ST LUKE'S THE WOODLANDS SLEEP CENTER LLC

    N/A · DIAGNOSTIC SERVICES · TX

  • TEMPLETON SURGERY CENTER LLC

    N/A · SURGERY · CA

  • THE MEDICAL PAVILION AT ST JOHN'S

    N/A · REAL ESTATE · CA

  • THE VASCULAR CENTER OF COLORADO LLC

    N/A · MEDICAL SERVCS · CO

  • THREE SPRING IMAGING LLC

    N/A · HEALTHCARE SRVC · CO

  • TIA ARIZONA LLC

    N/A · CLINIC · AZ

  • TOPTOLIFE LLC

    N/A · RETAIL · CO

  • VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC

    N/A · SURGERY · CA

  • WEST LAKES SURGERY CENTER LLC

    N/A · HEALTHCARE SRVC · IA

Related corporations and trusts

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

  • ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SVCS INC

    C · MANAGED CARE · NE

  • ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY INC

    C · HEALTHCARE · TX

  • ALTERNATIVE INSURANCE MANAGEMENT SERVICE INC

    C · MANAGEMENT SERVICES · CO

  • AMERICAN NURSING CARE INC

    C · HOME HEALTH · OH

  • AMERIMED INC

    C · HOME HEALTH · OH

  • BC HOLDING COMPANY INC

    C · INACTIVE · KY

  • BRAZOSPORT HEALTH ALLIANCE

    C · HEALTHCARE · TX

  • CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH

    C · LAB SERVICES · CO

  • CHI ST LUKE'S HEALTH - MEMORIAL CONDOMINIUM ASSOCIATION INC

    C · CONDO ASSOC · TX

  • COASTAL SURGICAL SPECIALISTS INC

    S · AMBULATORY SURGERY CENTER · CA

  • CONSOLIDATED HEALTH SERVICES

    C · HOME HEALTH · OH

  • DES MOINES MEDICAL CENTER INC

    C · REAL ESTATE · IA

  • DIGNITY HEALTH HOLDING CORPORATION

    C · HOLDING CO · NV

  • DIGNITY HEALTH INSURANCE LTD

    C · CAPTIVE INSURANCE · CJ

  • DIGNITY HEALTH PROVIDER RESOURCES INC

    C · HEALTH PLAN · CA

  • DIVERSIFIED HEALTH RESOURCES INC

    C · HEALTHCARE · TX

  • FRANCISCAN SERVICES INC

    C · HOLDING CO · CO

  • GALLERIA PAVILION OWNERS'ASSOCIATION

    C · REAL ESTATE · NV

  • GOOD SAMARITAN OUTREACH SERVICES

    C · MEDICAL CLINIC · NE

  • HARVESTPLAINS HEALTH OF IOWA

    C · INSURANCE · WA

  • HEALTH AT HOME BLOCKER LLC

    C · HOME HEALTH · CO

  • HEALTH SERVICES OF THE PACIFIC CENTRAL COAST INC

    C · HEALTH SERVICES · CA

  • HEALTH SYSTEMS ENTERPRISES INC

    C · MGMT · NE

  • HEALTHCARE MGMT SERVICES ORGANIZATION INC

    C · INACTIVE · WA

  • HEARTLANDPLAINS HEALTH

    C · INSURANCE · NE

  • HIGHLINE MEDICAL GROUP

    C · MEDICAL SERVICES · WA

  • INTEGRATED MEDICAL SERVICES

    C · MULTI-SPECIALTY PHYSICIANS GROUP · AZ

  • MEDICAL OFFICE BUILDING HORIZONTAL PROPERTY REGIME INC

    C · REAL ESTATE · AR

  • MEDQUEST

    C · SALE OF DME · ND

  • MEMORIAL CV SERVICE LINE MANAGEMENT COMPANY LLC

    C · INACTIVE · TX

  • MERCY SERVICES CORP

    C · RETAIL SALES · OR

  • MHI CLINICAL SERVICES

    C · HEALTHCARE · TX

  • MILLENNIUM SURGERY CENTER INC

    S · OUTPATIENT SURGERY SERVICES · CA

  • MOUNTAIN MANAGEMENT SERVICES INC

    C · MGMT SVC ORG · TN

  • NORTH CENTRAL HEALTH CARE ALLIANCE

    C · HEALTHCARE · ND

  • QUALCHOICE HEALTH PLAN SERVICES INC

    C · ADMIN SERVICES · CO

  • QUALCHOICE HEALTH INC

    C · HOLDING CO · CO

  • QUALCHOICE HOLDINGS INC

    C · HOLDING CO · AR

  • RIVERLINK HEALTH

    C · INSURANCE · OH

  • ROSS PARK PHARMACY INC

    C · PHARMACY · OH

  • SAINT CLARE'S PRIMARY CARE INC

    C · INACTIVE · NJ

  • SJH SERVICES CORPORATION

    C · INACTIVE · CO

  • SJL PHYSICIAN MANAGEMENT SERVICES INC

    C · INACTIVE · KY

  • SOUNDPATH HEALTH INC

    C · INSURANCE · WA

  • ST MARY HEALTH VENTURES INC

    C · RETAIL PHARMACY · CA

  • ST ANTHONY DEVELOPMENT COMPANY

    C · ATHLETIC CLUB · OR

  • ST JOSEPH DEVELOPMENT COMPANY INC

    C · RENTAL · WA

  • ST LUKE'S HEALTH SYSTEM HOLDINGS INC

    C · HOLDING CO · TX

  • ST VINCENT COMMUNITY HEALTH SERVICES INC

    C · HEALTHCARE · AR

  • STE HOLDINGS

    C · HOLDING CO · NE

  • TOWSON MANAGEMENT INC

    C · INACTIVE · MD

  • TRINITY MANAGEMENT SERVICES ORGANIZATION

    C · MGMT SERVICES · OH

  • UNITED MEDICAL BUILDING CONDOMINIUM ASSOCIATION

    C · REAL ESTATE · CO

Provenance

Return type
form_990
Tax year
2022
Filed
10 May 2024
IRS schema version
2022v5.0
Source object
202421319349303572

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