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Nonprofiteer
← OLMSTED MEDICAL CENTER

Form 990 for tax year 2022

Filed by OLMSTED MEDICAL CENTER.

Totals

Total revenue
$258,723,356
Total expenses
$254,800,158
Contributions and grants received
$79,854
Grants paid
$183,694
Program service revenue
$255,962,007
Investment income
$2,323,986
Other revenue
$357,509
Total assets, end of year
$277,318,598
Total liabilities, end of year
$44,947,503
Net assets or fund balances, end of year
$232,371,095
Program services expenses (Part IX)
$214,111,336
Management and general expenses
$40,032,944
Fundraising expenses
$655,878
Program service expenses (Part III)
$214,111,336

Program services were 84.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • JAMES HOFFMANN MD

    PRESIDENT

    Total calculated
    $631,314
    From this org
    $585,303
    From related orgs
    $0
    Other
    $46,011
    Hours/week
    32 + 1 related

    Schedule J breakdown matched by us

    Base
    $503,580
    Bonus
    $80,723
    Other
    $1,000
    Deferred
    $27,550
    Nontaxable benefits
    $18,461
    Filer's total
    $631,314

  • TAMARA ALEXANDROV MD

    CLINIC TRUSTEE

    Total calculated
    $496,014
    From this org
    $466,060
    From related orgs
    $0
    Other
    $29,954
    Hours/week
    37.2

    Schedule J breakdown matched by us

    Base
    $466,060
    Bonus
    $0
    Other
    $0
    Deferred
    $27,550
    Nontaxable benefits
    $2,404
    Filer's total
    $496,014

  • KEITH KLEIS

    CLINIC TRUSTEE

    Total calculated
    $409,903
    From this org
    $354,654
    From related orgs
    $0
    Other
    $55,249
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $354,654
    Bonus
    $0
    Other
    $0
    Deferred
    $27,550
    Nontaxable benefits
    $27,699
    Filer's total
    $409,903

  • MARAL KENDARIAN

    CLINIC TRUSTEE

    Total calculated
    $389,397
    From this org
    $359,509
    From related orgs
    $0
    Other
    $29,888
    Hours/week
    34

    Schedule J breakdown matched by us

    Base
    $359,509
    Bonus
    $0
    Other
    $0
    Deferred
    $27,550
    Nontaxable benefits
    $2,338
    Filer's total
    $389,397

  • CAROLE NISTLER MD CLINIC

    TRUSTEE THEN PUBLIC TRUSTEE

    Total calculated
    $158,170
    From this org
    $124,534
    From related orgs
    $0
    Other
    $33,636
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $124,534
    Bonus
    $0
    Other
    $0
    Deferred
    $27,550
    Nontaxable benefits
    $6,086
    Filer's total
    $158,170

  • CASSIE HARRINGTON

    PUBLIC TRUSTEE-CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • MIKE MALUGANI

    PUBLIC TRUSTEE-CHAIR ELECT

    Total calculated
    $0
    Hours/week
    1

  • ANDREA CHAPMAN

    PUBLIC TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • JAY HESLEY

    PUBLIC TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • WENDY SHANNON

    PUBLIC TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • DON SUPPALLA

    PUBLIC TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • MICHAEL TUOHY

    PUBLIC TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • TIM WEIR FACHE

    CHIEF EXECUTIVE OFFICER

    Total calculated
    $905,792
    From this org
    $860,633
    From related orgs
    $0
    Other
    $45,159
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $699,187
    Bonus
    $161,446
    Other
    $0
    Deferred
    $27,550
    Nontaxable benefits
    $17,609
    Filer's total
    $905,792

  • KEVIN HIGGINS

    CHIEF FINANCIAL OFFICER

    Total calculated
    $586,508
    From this org
    $525,381
    From related orgs
    $0
    Other
    $61,127
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $428,970
    Bonus
    $79,680
    Other
    $16,731
    Deferred
    $27,550
    Nontaxable benefits
    $33,577
    Filer's total
    $586,508

  • RANDY HEMANN MD

    CHIEF MEDICAL OFFICER

    Total calculated
    $566,843
    From this org
    $520,972
    From related orgs
    $0
    Other
    $45,871
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $449,892
    Bonus
    $70,080
    Other
    $1,000
    Deferred
    $27,550
    Nontaxable benefits
    $18,321
    Filer's total
    $566,843

  • MATTHEW KIRSCH MD

    PHYSICIAN

    Total calculated
    $1,211,974
    From this org
    $1,156,543
    From related orgs
    $0
    Other
    $55,431
    Hours/week
    36

    Schedule J breakdown matched by us

    Base
    $1,156,543
    Bonus
    $0
    Other
    $0
    Deferred
    $27,550
    Nontaxable benefits
    $27,881
    Filer's total
    $1,211,974

  • VIDHAN CHANDRA MD

    PHYSICIAN

    Total calculated
    $1,083,775
    From this org
    $1,053,290
    From related orgs
    $0
    Other
    $30,485
    Hours/week
    36

    Schedule J breakdown matched by us

    Base
    $1,053,290
    Bonus
    $0
    Other
    $0
    Deferred
    $27,550
    Nontaxable benefits
    $2,935
    Filer's total
    $1,083,775

  • SAMER ABDEL-AZIZ MD

    PHYSICIAN

    Total calculated
    $1,073,180
    From this org
    $1,017,576
    From related orgs
    $0
    Other
    $55,604
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $1,017,576
    Bonus
    $0
    Other
    $0
    Deferred
    $27,550
    Nontaxable benefits
    $28,054
    Filer's total
    $1,073,180

  • MARK HERR MD

    PHYSICIAN

    Total calculated
    $1,068,218
    From this org
    $1,037,392
    From related orgs
    $0
    Other
    $30,826
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $1,037,392
    Bonus
    $0
    Other
    $0
    Deferred
    $27,550
    Nontaxable benefits
    $3,276
    Filer's total
    $1,068,218

  • JACOB JUTA MD

    PHYSICIAN

    Total calculated
    $942,018
    From this org
    $886,406
    From related orgs
    $0
    Other
    $55,612
    Hours/week
    36

    Schedule J breakdown matched by us

    Base
    $886,406
    Bonus
    $0
    Other
    $0
    Deferred
    $27,550
    Nontaxable benefits
    $28,062
    Filer's total
    $942,018

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

  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Written employment contract
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 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 4B
THE ORGANIZATION HAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR CERTAIN INDIVIDUALS IN LEADERSHIP POSITIONS. IN 2022 THE FOLLOWING INDIVIDUALS BECAME ELIGIBLE TO BE VESTED IN 2026. THEIR VESTED BALANCES WILL BE TAXABLE IN 2026 WITH THE NET AMOUNT RETURNED TO THEIR 401K ACCOUNTS: TIM WEIR - $88,750 KEVIN HIGGINS - $30,450 RANDY HEMANN - $26,810 JAMES HOFFMANN - $44,375.

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

  • OMC REGIONAL FOUNDATION

    $183,694

    PROVIDE FUNDING TO OMC REGIONAL FOUNDATION FOR HEALTHCARE EDUCATION AND COMMUNITY PURPOSES.

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.

  • OMC REGIONAL FOUNDATION

    501(C)(3) · HEALTHCARE EDUCATION AND COMMUNITY PURPOSES · MN · controlled entity

    Directly controlled by OLMSTED MEDICAL CENTER

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.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

  • OMC RETAIL SERVICES LLC

    PHARMACY · MN · income $8,340,816 · assets $1,149,792

    Directly controlled by OLMSTED MEDICAL CENTER

Provenance

Return type
form_990
Tax year
2022
Filed
18 October 2023
IRS schema version
2022v5.0
Source object
202342929349301529

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