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Nonprofiteer
← FLORIDA HOSPITAL DADE CITY INC

Form 990 for tax year 2022

Filed by FLORIDA HOSPITAL DADE CITY INC.

Totals

Total revenue
$84,523,775
Total expenses
$81,488,133
Contributions and grants received
$13,859
Grants paid
$27,000
Program services expenses (Part IX)
$76,364,368
Management and general expenses
$5,123,765
Fundraising expenses
$0
Program service expenses (Part III)
$76,364,368

Program services were 93.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • Bruce Bergherm

    Dir/Chair/SEO West FL Reg (end 6/22)

    Total calculated
    $1,459,929
    From this org
    $0
    From related orgs
    $1,410,394
    Other
    $49,535
    Hours/week
    0.5 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $673,281 related
    Bonus
    $0 + $174,998 related
    Other
    $0 + $562,115 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $33,135 related
    Filer's total
    $0 + $1,459,929 related

  • Jennifer Wandersleben

    Dir/Chair/CEO Heartland Reg (beg 6/22)

    Total calculated
    $1,119,714
    From this org
    $0
    From related orgs
    $949,270
    Other
    $170,444
    Hours/week
    1.36 + 48.64 related

    Schedule J breakdown matched by us

    Base
    $0 + $649,654 related
    Bonus
    $0 + $180,378 related
    Other
    $0 + $119,238 related
    Deferred
    $0 + $114,611 related
    Nontaxable benefits
    $0 + $55,833 related
    Filer's total
    $0 + $1,119,714 related

  • Denyse Bales-Chubb

    Director (end 7/22)

    Total calculated
    $1,015,812
    From this org
    $0
    From related orgs
    $850,496
    Other
    $165,316
    Hours/week
    0.5 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $582,520 related
    Bonus
    $0 + $114,023 related
    Other
    $0 + $153,953 related
    Deferred
    $0 + $118,558 related
    Nontaxable benefits
    $0 + $46,758 related
    Filer's total
    $0 + $1,015,812 related

  • Amanda Maggard

    Director/Sec/CEO

    Total calculated
    $698,639
    From this org
    $0
    From related orgs
    $571,667
    Other
    $126,972
    Hours/week
    25 + 25 related

    Schedule J breakdown matched by us

    Base
    $0 + $419,708 related
    Bonus
    $0 + $95,122 related
    Other
    $0 + $56,837 related
    Deferred
    $0 + $80,628 related
    Nontaxable benefits
    $0 + $46,344 related
    Filer's total
    $0 + $698,639 related

  • Rainer Chan MD

    Director

    Total calculated
    $559,619
    From this org
    $0
    From related orgs
    $449,774
    Other
    $109,845
    Hours/week
    0.5 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $320,453 related
    Bonus
    $0 + $56,984 related
    Other
    $0 + $72,337 related
    Deferred
    $0 + $64,239 related
    Nontaxable benefits
    $0 + $45,606 related
    Filer's total
    $0 + $559,619 related

  • Rosalie Oliver

    Director

    Total calculated
    $538,009
    From this org
    $0
    From related orgs
    $445,009
    Other
    $93,000
    Hours/week
    2.95 + 47.05 related

    Schedule J breakdown matched by us

    Base
    $0 + $355,552 related
    Bonus
    $0 + $59,207 related
    Other
    $0 + $30,250 related
    Deferred
    $0 + $51,763 related
    Nontaxable benefits
    $0 + $41,237 related
    Filer's total
    $0 + $538,009 related

  • Royce Brown

    Director (beg 10/22)

    Total calculated
    $350,543
    From this org
    $0
    From related orgs
    $262,188
    Other
    $88,355
    Hours/week
    0.5 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $210,760 related
    Bonus
    $0 + $38,601 related
    Other
    $0 + $12,827 related
    Deferred
    $0 + $46,577 related
    Nontaxable benefits
    $0 + $41,778 related
    Filer's total
    $0 + $350,543 related

  • Ken Bradley

    Director

    Total calculated
    $227,815
    From this org
    $0
    From related orgs
    $193,548
    Other
    $34,267
    Hours/week
    0.5 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $158,577 related
    Bonus
    $0 + $21,765 related
    Other
    $0 + $13,206 related
    Deferred
    $0 + $9,165 related
    Nontaxable benefits
    $0 + $25,102 related
    Filer's total
    $0 + $227,815 related

  • Dale Maggard

    Director

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • John Scott

    Director

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Rebecca Gaddis

    Director

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Stephen Herr

    Director

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Scott Cameron

    Director

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Marcus McCants

    Director (end 8/22)

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Elaine Jones

    Director

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Randall Belcher

    Director

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Edwin Aguayo

    Director

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Leroy Hauff

    Director

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Raymond Pichette

    Director

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Melanie Barriffe

    Director (beg 6/22)

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Reggie Roberts

    Director (beg 6/22)

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • Ryan Willis

    CFO & COO (COO end 2/22)

    Total calculated
    $393,146
    From this org
    $0
    From related orgs
    $350,195
    Other
    $42,951
    Hours/week
    25 + 25 related

    Schedule J breakdown matched by us

    Base
    $0 + $290,356 related
    Bonus
    $0 + $51,982 related
    Other
    $0 + $7,857 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $26,551 related
    Filer's total
    $0 + $393,146 related

  • Rodrigo Torres MD

    CMO

    Total calculated
    $540,264
    From this org
    $0
    From related orgs
    $449,353
    Other
    $90,911
    Hours/week
    25 + 25 related

    Schedule J breakdown matched by us

    Base
    $0 + $352,463 related
    Bonus
    $0 + $64,709 related
    Other
    $0 + $32,181 related
    Deferred
    $0 + $48,445 related
    Nontaxable benefits
    $0 + $42,466 related
    Filer's total
    $0 + $540,264 related

  • Gwen Alonso

    CNO

    Total calculated
    $375,354
    From this org
    $0
    From related orgs
    $332,427
    Other
    $42,927
    Hours/week
    25 + 25 related

    Schedule J breakdown matched by us

    Base
    $0 + $270,820 related
    Bonus
    $0 + $50,116 related
    Other
    $0 + $11,491 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $26,527 related
    Filer's total
    $0 + $375,354 related

  • Shane Bedward

    COO (beg 2/22)

    Total calculated
    $300,861
    From this org
    $0
    From related orgs
    $247,575
    Other
    $53,286
    Hours/week
    25 + 25 related

    Schedule J breakdown matched by us

    Base
    $0 + $216,358 related
    Bonus
    $0 + $18,923 related
    Other
    $0 + $12,294 related
    Deferred
    $0 + $11,267 related
    Nontaxable benefits
    $0 + $42,019 related
    Filer's total
    $0 + $300,861 related

  • Michael Schultz

    Former Officer

    Total calculated
    $576,808
    From this org
    $0
    From related orgs
    $566,508
    Other
    $10,300
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $156,759 related
    Bonus
    $0 + $397,536 related
    Other
    $0 + $12,213 related
    Deferred
    $0 + $10,300 related
    Nontaxable benefits
    $0
    Filer's total
    $0 + $576,808 related

  • Jason Newmyer

    Former VP/Admin

    Total calculated
    $392,234
    From this org
    $0
    From related orgs
    $298,304
    Other
    $93,930
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $243,695 related
    Bonus
    $0 + $40,705 related
    Other
    $0 + $13,904 related
    Deferred
    $0 + $52,467 related
    Nontaxable benefits
    $0 + $41,463 related
    Filer's total
    $0 + $392,234 related

  • Robin McGuinness

    Regional CNO - Former Key

    Total calculated
    $723,169
    From this org
    $0
    From related orgs
    $633,401
    Other
    $89,768
    Hours/week
    1.36 + 48.64 related

    Schedule J breakdown matched by us

    Base
    $0 + $406,695 related
    Bonus
    $0 + $94,539 related
    Other
    $0 + $132,167 related
    Deferred
    $0 + $56,683 related
    Nontaxable benefits
    $0 + $33,085 related
    Filer's total
    $0 + $723,169 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 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
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 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 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 49 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 (13 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 50 - 55 individual executives). Two individuals listed in Part VII (J. Wandersleben and R. McGuinness) received the special travel allowance in 2022. These two individuals 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. Housing allowance or residence for personal use: AHSSHC has a Corporate Executive Policy that addresses assistance to executives who have been relocated by the company during the year. Relocation assistance provided to executives may include relocation allowances to assist with duplicate housing expenses. Relocation assistance is administered per AHSSHC policy by an external relocation company. All taxable reimbursements made to executives in connection with relocation assistance are treated as wages to the executive and are subject to all payroll withholding and reporting requirements.
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, Line 4b
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 2022. 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 $305,000 in 2022 (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.* Contr/Distr Contr. Distr.* Bruce Bergherm $103,125 $ 82,625 $ 386,102 $ 0 $ 0 Jennifer Wandersleben $108,827 $60,800 $ 0 $ 9,884 $ 0 Denyse Bales-Chubb $95,900 $ 87,080 $ 0 $ 6,258 $ 0 Robin McGuinness $56,975 $ 57,069 $ 0 $ 4,953 $ 19,805 Amanda Maggard $51,359 $ 36,773 $ 0 $ 12,870 $ 0 Rainer Chan MD $23,919 $ 21,787 $ 0 $ 23,920 $ 0 Rodrigo Torres $31,569 $ 0 $ 0 $ 20,977 $ 0 Rosalie Oliver $35,363 $ 16,239 $ 0 $ 0 $ 0 Jason Newmyer $ 0 $ 0 $ 36,758 $ 0 $ 0 Royce Brown $ 0 $ 0 $ 0 $ 33,005 $ 0 * 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.

Provenance

Return type
form_990
Tax year
2022
Filed
19 October 2023
IRS schema version
2022v5.0
Source object
202343049349301209

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