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Nonprofiteer
← HEALTHEAST WOODWINDS HOSPITAL

Form 990 for tax year 2022

Filed by HEALTHEAST WOODWINDS HOSPITAL.

Totals

Total revenue
$211,387,346
Total expenses
$229,918,297
Contributions and grants received
$51,385
Grants paid
$0
Program service revenue
$211,281,475
Investment income
-$11,655
Other revenue
$66,141
Total assets, end of year
$111,572,647
Total liabilities, end of year
$10,783,760
Net assets or fund balances, end of year
$100,788,887
Program services expenses (Part IX)
$184,599,537
Management and general expenses
$45,318,760
Fundraising expenses
$0
Program service expenses (Part III)
$184,599,537

Program services were 80.3% 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.

  • 1d · Related organizations

    $13,222

  • 1f · All other contributions, gifts and grants

    $38,163

  • 2a · Program service revenue: Patient Revenue

    total $210,674,755 · related or exempt $210,674,755

  • 2b · Program service revenue: Cafeteria

    total $526,852 · related or exempt $526,852

  • 2c · Program service revenue: Lab Services Revenue

    total $79,868 · unrelated business $79,868

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 6a · Gross rents

    real property $66,141

  • 6c · Rental income or loss

    real property $66,141 · personal property $0

  • 6d · Net rental income or loss

    total $66,141 · excluded $66,141

  • 7a · Gross sales of assets other than inventory

    other assets $17,642

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

    other assets $29,297

  • 7c · Gain or loss

    securities $0 · other assets -$11,655

  • 7d · Net gain or loss

    total -$11,655 · excluded -$11,655

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $87,720,651 · program services $83,378,180 · management and general $4,342,471

  • 8 · Pension plan contributions

    total $3,581,040 · program services $3,365,829 · management and general $215,211

  • 9 · Other employee benefits

    total $9,770,434 · program services $9,255,261 · management and general $515,173

  • 10 · Payroll taxes

    total $5,556,784 · program services $5,266,967 · management and general $289,817

  • 11a · Fees: management

    total $34,754,363 · program services $308,902 · management and general $34,445,461

  • 11b · Fees: legal

    total $95 · program services $95

  • 11d · Fees: lobbying

    total $10,272 · management and general $10,272

  • 11g · Fees: other

    total $12,803,372 · program services $8,883,121 · management and general $3,920,251 · fundraising $0

  • 13 · Office expenses

    total $3,595,090 · program services $3,074,013 · management and general $521,077

  • 16 · Occupancy

    total $4,377,743 · program services $4,069,726 · management and general $308,017

  • 17 · Travel

    total $24 · program services $9 · management and general $15

  • 19 · Conferences, conventions and meetings

    total $112,190 · program services $87,277 · management and general $24,913

  • 20 · Interest

    total $2,808,251 · program services $2,808,251

  • 22 · Depreciation, depletion and amortization

    total $3,544,988 · program services $3,242,481 · management and general $302,507

  • 23 · Insurance

    total $258,142 · program services $258,142

  • 24a · Other expenses: Medical Supplies

    total $47,263,888 · program services $47,108,693 · management and general $155,195

  • 24b · Other expenses: Management Fee - D&T

    total $8,000,000 · program services $8,000,000

  • 24c · Other expenses: Taxes - Medical

    total $3,434,769 · program services $3,434,769

  • 24d · Other expenses: Utilities Repair & Maintenance

    total $1,238,380 · program services $1,140,170 · management and general $98,210

  • 24e · All other expenses

    total $1,087,821 · program services $917,651 · management and general $170,170 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,531 · end of year $1,531

  • 4 · Accounts receivable

    beginning of year $51,140,039 · end of year $36,970,181

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $3,240,242 · end of year $4,015,476

  • 9 · Prepaid expenses and deferred charges

    beginning of year $45,369 · end of year $121,548

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

    $86,607,848

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

    $16,143,937

  • 10c · Land, buildings and equipment, net

    beginning of year $65,152,402 · end of year $70,463,911

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $8,259,745 · end of year $10,783,760

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $0 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $111,319,838 · end of year $100,788,887

Mission and programs · 2022

Mission

Fairview is driven to heal, discover, and educate for longer, healthier lives.

Activities or mission (Part I)

HealthEast Woodwinds Hospital is an acute care hospital.

  • Woodwinds Health Campus opened its 86-bed hospital in August of 2000 and is located on 30 acres of pristine wetlands in Woodbury, MN. It's the only hospital in the southeast metro area. Woodwinds provides convenient and quality health care for the community. The campus includes a full-service hospital and emergency care department, doctors' offices, outpatient services, and auditorium. All the services you need in one convenient location, known for attention to detail - and attention to patients. The calming ambiance is enhanced by the surrounding woods and wetlands. At Woodwinds, patients find traditional medicine and state-of-the-art technology working in partnership with natural approaches to wellness and health. Hospital revenue includes payment from the Medicare and Medicaid programs. The medical services relate directly to the exempt purpose of caring for sick, infirm, aged and injured persons regardless of their race, color, creed, religion, national origin, sex, marital status, status with regard to public assistance, membership or activity in a local commission, disability, sexual orientation, gender identity or expression, age or genetic information. This organization provides emergency and medically necessary non-emergency services regardless of ability to pay. Additionally, this organization offers financial aid for eligible services in the form of free or discounted care to those low income, underinsured or uninsured individuals who meet qualification criteria. Woodwinds Hospital is part of Fairview Health Services. Fairview Health Services is an industry-leading, award-winning, nonprofit, integrated health system providing exceptional health care across the full spectrum of health care services. Founded in 1906, Fairview serves the twelve-county Minneapolis/St. Paul Metro Area, as well as communities throughout greater Minnesota and portions of Northern Iowa and Western Wisconsin and is one of the most comprehensive and geographically accessible systems in Minnesota. Fairview, the University of Minnesota and the University of Minnesota Physicians approved an agreement which became effective in late 2018 (the "M Health Fairview Agreement"). While the parties maintain their separate governance, the M Health Fairview Agreement further integrated operations across the clinical delivery system and enhances research and education by creating a joint clinical enterprise among the parties. The M Health Fairview Agreement brings together not only UMMC and its related service lines, but also Fairview's other hospitals, primary care clinics, and other services. All are part of a shared care delivery system that is led by a single structure that includes academic physician leadership. The goal of the joint clinical enterprise is to create a nationally-renowned academic health system. This care system was united under a single brand, M Health Fairview, which is inclusive of the Fairview Hospitals and Clinics Fairview owns and operates the following hospitals: UMMC, M Health Fairview Southdale Hospital,M Health Fairview Ridges Hospital, M Health Fairview Lakes Medical Center, M Health FairviewNorthland Medical Center, Fairview University Medical Center - Mesabi ("Range"), Grand Itasca Clinic and Hospital, M Health Fairview St. John's Hospital, M Health Fairview Woodwinds Hospital and M Health Fairview Bethesda Hospital. As of December 31, 2022, the Fairview System Hospitals had a total of 3,529licensed beds and 1,824 staffed beds. Fairview operates their more than 80 primary and specialty care clinics throughout the Metro Area, greater Minnesota and western Wisconsin. These clinics offer services in over 70 medical specialties, including family medicine, pediatrics, obstetrics, gynecology, heart care, cancer care, otolaryngology, transplant care, and orthopedics. As of December 30, 2022, Fairview owned all or a portion of seven ambulatory surgery centers located in the Metro Area. Through its mission and its role as an anchor institution, Fairview is in a unique position to be a catalyst for progress and change. Fairview continues to invest heavily in the health and wellness of its communities in which it operates. This commitment includes education, training, community programs and research, as well as significant investments in care delivery. The COVID-19 pandemic exposed persistent health inequities for communities of color and has exacerbated racial disparities. Communities of color experienced statistically higher rates of COVID-19, including higher rates of hospitalization and death. To reduce the impact on Black, Indigenous, or people of color ("BIPOC"), vaccinations must be accessible, free and provided within a trusted space with appropriate language and cultural considerations. Fairview has led a multi-cultural mobile vaccination program for the past 15 years, which excels at reaching BIPOC communities facing barriers to immunization. Based on this established and successful model, Fairview was able to quickly adapt and partner with public health agencies for its COVID-19 response, including testing and vaccination clinics. Further, Fairview's longstanding relationship with local public health agencies and community partners has allowed Fairview to provide staffing, coordination, and outreach for a remarkable program called the Minnesota Immunization Network Initiative (MINI). MINI is a collaboration led by Fairview and supported by over 150 community partners, works to reduce barriers to vaccinations for communities experiencing health disparities. MINI provides flu, COVID, Mpox and other immunizations free of charge to community members age six months and older. More than 110,000 influenza and almost 60,000 COVID vaccines have been administered. The MINI clinics are hosted in community-based locations such as local churches, mosques, temples, schools, community centers, public high rises, libraries, food pantries, and homeless shelters. The clinics are hosted by the local partner who provides the space, promotion, and serves as a trusted messenger for community members. Fairview provides the vaccine and clinical team - including interpreters and support staff - and information about other local community resources. Vaccinations are provided at no charge to participants, ages six months and older. The past several years, MINI clinics have expanded their reach to include other services such as blood pressure screening and cardiovascular health education, free dental varnish treatments, oral health education and opioid overdose prevention education. Services are often provided in conjunction with MINI vaccination clinics or on their own. During the COVID-19 pandemic, the MINI program leveraged over 15 years of experience providing mobile clinical services in diverse settings to respond to the urgent public health crisis. MINI launched a large scale, low barrier testing initiative in partnership with Saint Paul Ramsey County Public Health and the Minnesota Department of Health. This collaboration enabled thousands of community members to receive a free COVID-19 test in convenient, trusted community spaces. In total, MINI supported 47 testing events and administered almost 20,000 tests. Once the COVID-19 vaccine became available, MINI immediately pivoted to providing COVID-19 vaccinations. To date, MINI has provided 1,250 community based COVID vaccination clinics and given over 59,000 vaccinations. MINI is also supporting Mpox outreach response efforts and launched a Mpox vaccination effort in October of 2022.

    Expenses $184,599,537 · Revenue $211,281,475

As filed on the 2022 return.

Listed in Part VII

  • Ann Lowry MD

    Vice Chair

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Jakub Tolar MD

    Vice Chair

    Total calculated
    $0
    Hours/week
    0 + 2 related

  • James Hereford

    President & CEO

    Total calculated
    $3,487,618
    From this org
    $0
    From related orgs
    $3,370,758
    Other
    $116,860
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,753,793 related
    Bonus
    $0 + $1,399,311 related
    Other
    $0 + $217,654 related
    Deferred
    $0 + $100,535 related
    Nontaxable benefits
    $0 + $16,325 related
    Filer's total
    $0 + $3,487,618 related

  • Karen Grabow

    Secretary

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 2 related

  • RIch Ostlund

    Chair

    Total calculated
    $35,000
    From this org
    $0
    From related orgs
    $35,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Ann Williamson

    Director

    Total calculated
    $0
    Hours/week
    0 + 2 related

  • Barclay Berdan

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 4 related

  • Brad Wallin

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 4 related

  • David Levy

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Jodi RIchard

    Director

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 4 related

  • John Heinmiller

    Director

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Julie Causey

    Director

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 4 related

  • Kenneth Roering

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Melissa Geller MD

    Director

    Total calculated
    $0
    Hours/week
    0 + 2 related

  • Michael Connly

    Director

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 4 related

  • Myron Frans

    Director

    Total calculated
    $0
    Hours/week
    0 + 4 related

  • PJ Hill

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Shawntera Hardy

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Stephen Swensen MD

    Director

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Timothy Marx

    Director

    Total calculated
    $25,000
    From this org
    $0
    From related orgs
    $25,000
    Other
    $0
    Hours/week
    0 + 2 related

  • Andrea Mokros

    Chf Public Affairs Officer

    Total calculated
    $647,023
    From this org
    $0
    From related orgs
    $561,164
    Other
    $85,859
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $414,176 related
    Bonus
    $0 + $146,324 related
    Other
    $0 + $664 related
    Deferred
    $0 + $74,789 related
    Nontaxable benefits
    $0 + $11,070 related
    Filer's total
    $0 + $647,023 related

  • John Batson Term 8312022

    CFO

    Total calculated
    $1,087,917
    From this org
    $0
    From related orgs
    $1,077,616
    Other
    $10,301
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $646,045 related
    Bonus
    $0 + $431,486 related
    Other
    $0 + $85 related
    Deferred
    $0 + $9,150 related
    Nontaxable benefits
    $0 + $1,151 related
    Filer's total
    $0 + $1,087,917 related

  • Joseph Gaylord

    CFO

    Total calculated
    $753,916
    From this org
    $0
    From related orgs
    $714,491
    Other
    $39,425
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $587,842 related
    Bonus
    $0 + $124,500 related
    Other
    $0 + $2,149 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $21,125 related
    Filer's total
    $0 + $753,916 related

  • Laura Reed

    COO

    Total calculated
    $1,736,000
    From this org
    $0
    From related orgs
    $1,544,185
    Other
    $191,815
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $989,718 related
    Bonus
    $0 + $469,914 related
    Other
    $0 + $84,553 related
    Deferred
    $0 + $175,641 related
    Nontaxable benefits
    $0 + $16,174 related
    Filer's total
    $0 + $1,736,000 related

  • Mark Welton

    CMO

    Total calculated
    $1,360,981
    From this org
    $0
    From related orgs
    $1,326,543
    Other
    $34,438
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $748,058 related
    Bonus
    $0 + $370,594 related
    Other
    $0 + $207,891 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $16,138 related
    Filer's total
    $0 + $1,360,981 related

  • Mary Nease

    Chf People Officer

    Total calculated
    $958,739
    From this org
    $0
    From related orgs
    $835,496
    Other
    $123,243
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $599,106 related
    Bonus
    $0 + $233,484 related
    Other
    $0 + $2,906 related
    Deferred
    $0 + $102,355 related
    Nontaxable benefits
    $0 + $20,888 related
    Filer's total
    $0 + $958,739 related

  • Robert Beacher

    EVP & Chf Shared Clinical Svcs

    Total calculated
    $1,083,973
    From this org
    $0
    From related orgs
    $1,044,422
    Other
    $39,551
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $699,780 related
    Bonus
    $0 + $257,612 related
    Other
    $0 + $87,030 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $21,251 related
    Filer's total
    $0 + $1,083,973 related

  • Sameer Badlani

    Chf Digital Officer2

    Total calculated
    $1,193,331
    From this org
    $0
    From related orgs
    $1,043,054
    Other
    $150,277
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $695,927 related
    Bonus
    $0 + $267,164 related
    Other
    $0 + $79,963 related
    Deferred
    $0 + $129,294 related
    Nontaxable benefits
    $0 + $20,983 related
    Filer's total
    $0 + $1,193,331 related

  • Scott Weber Term 132022

    Chf Marketing Officer

    Total calculated
    $718,923
    From this org
    $0
    From related orgs
    $715,234
    Other
    $3,689
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $8,462 related
    Bonus
    $0 + $183,210 related
    Other
    $0 + $523,562 related
    Deferred
    $0 + $3,689 related
    Nontaxable benefits
    $0
    Filer's total
    $0 + $718,923 related

  • Trudi Trysla

    Chf Legal Counsel

    Total calculated
    $1,048,997
    From this org
    $0
    From related orgs
    $931,521
    Other
    $117,476
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $598,239 related
    Bonus
    $0 + $233,318 related
    Other
    $0 + $99,964 related
    Deferred
    $0 + $102,593 related
    Nontaxable benefits
    $0 + $14,883 related
    Filer's total
    $0 + $1,048,997 related

  • Aziza Shireen MD

    Physician

    Total calculated
    $464,829
    From this org
    $0
    From related orgs
    $424,369
    Other
    $40,460
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $340,995 related
    Bonus
    $0 + $25,966 related
    Other
    $0 + $57,408 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $22,160 related
    Filer's total
    $0 + $464,829 related

  • Erica Kuhlman MD

    Physician

    Total calculated
    $530,326
    From this org
    $0
    From related orgs
    $496,013
    Other
    $34,313
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $478,555 related
    Bonus
    $0 + $7,500 related
    Other
    $0 + $9,958 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $16,013 related
    Filer's total
    $0 + $530,326 related

  • Jawali Jaranilla MD

    Physician

    Total calculated
    $584,256
    From this org
    $0
    From related orgs
    $554,096
    Other
    $30,160
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $393,350 related
    Bonus
    $0 + $12,549 related
    Other
    $0 + $148,197 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $11,860 related
    Filer's total
    $0 + $584,256 related

  • John Scanlon

    Physician

    Total calculated
    $566,233
    From this org
    $0
    From related orgs
    $533,945
    Other
    $32,288
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $423,111 related
    Bonus
    $0 + $51,579 related
    Other
    $0 + $59,255 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $13,988 related
    Filer's total
    $0 + $566,233 related

  • Juan Zeballos Chavez MD

    Physician

    Total calculated
    $521,341
    From this org
    $0
    From related orgs
    $486,766
    Other
    $34,575
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $470,537 related
    Bonus
    $0 + $11,250 related
    Other
    $0 + $4,979 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $16,275 related
    Filer's total
    $0 + $521,341 related

  • Elizabeth Cameron MD

    Physician

    Total calculated
    $541,296
    From this org
    $0
    From related orgs
    $509,693
    Other
    $31,603
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $409,309 related
    Bonus
    $0 + $97,405 related
    Other
    $0 + $2,979 related
    Deferred
    $0 + $14,153 related
    Nontaxable benefits
    $0 + $17,450 related
    Filer's total
    $0 + $541,296 related

  • Srijoy Mahapatra

    Former Chf Strategy Officer

    Total calculated
    $113,742
    From this org
    $0
    From related orgs
    $113,742
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $113,742 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $113,742 related

  • Sunn Sunn Thaw MD

    Physician

    Total calculated
    $738,128
    From this org
    $0
    From related orgs
    $696,370
    Other
    $41,758
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $364,212 related
    Bonus
    $0 + $328,382 related
    Other
    $0 + $3,776 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $23,458 related
    Filer's total
    $0 + $738,128 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

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

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
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 4a Severance or change-of-control payment
SEVERANCE PAYMENTS MADE TO INDIVIDUALS: SRIJOY MAHAPATRA $102,141 SCOTT WEBER $376,946
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD, SAMEER BADLANI, LAURA REED, MARK WELTON, ROBERT BEACHER, TRUDI TRYSLA, MARY NEASE, ANDREA MOKROS, SCOTT WEBER DUE TO A VESTING EVENT, THE FOLLOWING INDIVIDUALS HAD INCOME IN PART VII AND SCHEDULE J RELATED TO A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD $208,150 SCOTT WEBER $146,616 LAURA REED $76,998 MARK WELTON $194,062 ROBERT BEACHER $76,880 TRUDI TRYSLA $97,069 SRIJOY MAHAPATRA $11,441
Schedule J, Part I, Line 7 Non-fixed payments
Fairview Health Services provides lump sum financial awards based on system-wide, business unit and/or departments financial and quality measures. Annual goals, specifically tied to productivity and quality indicators, are set for the year and an incentive paid out annually if key goals and measures are achieved.
Schedule J, Part I, Line 3 Related Org to establish compensation
THE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS.
Schedule J, Part I, Line 4a
Severance benefit payments will commence on the first regularly scheduled pay date that occurs at least five (5) days after the expiration of the rescission period. Payment of severance benefits is contingent upon (i) my having first signed and not rescinded my Service Agreement and Release Agreement and (ii) the return of Fairview's property.
Schedule J, Part I, Line 4b
The nonqualified plan (the Plan) is only open to a select group of highly compensated employees. The plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualified retirement plans. Participants may not elect to defer compensation. Contributions will be made in the form of a credit to the participant's account. Within 60 days after a participant becomes vested in a contribution, the Plan shall pay to the participant an amount equal to the amount the Participant is required to pay Federal, state, local, and foreign income taxes and employment taxes due to the vesting. The remaining amount in the participant's account shall not be paid until the separation from service payment date. A participant's account shall be distributed in cash. The plan complies with section 457(f) of the Code.

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
7 November 2023
IRS schema version
2022v5.0
Source object
202323119349303617

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