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Nonprofiteer
← CHI NEBRASKA

Form 990 for tax year 2023

Filed by CHI NEBRASKA.

Totals

Total revenue
$0
Total expenses
$0
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$0
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
not reported

Listed in Part VII

  • JOHN PETERSDORF

    BOARD MEMBER

    Total calculated
    $3,082,567
    From this org
    $0
    From related orgs
    $2,089,747
    Other
    $992,820
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $645,040 related
    Bonus
    $0 + $716,812 related
    Other
    $0 + $727,895 related
    Deferred
    $0 + $923,913 related
    Nontaxable benefits
    $0 + $68,907 related
    Filer's total
    $0 + $3,082,567 related

  • EVERT KUIPER

    FORMER PRESIDENT & CEO CHI HEALTH

    Total calculated
    $2,835,767
    From this org
    $0
    From related orgs
    $2,787,233
    Other
    $48,534
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $749,566 related
    Bonus
    $0
    Other
    $0 + $2,037,667 related
    Deferred
    $0 + $20,045 related
    Nontaxable benefits
    $0 + $28,489 related
    Filer's total
    $0 + $2,835,767 related

  • TIM BRICKER

    EX-OFFICIO BM/REGION PRESIDENT

    Total calculated
    $2,615,718
    From this org
    $0
    From related orgs
    $2,499,192
    Other
    $116,526
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $876,719 related
    Bonus
    $0 + $1,582,430 related
    Other
    $0 + $40,043 related
    Deferred
    $0 + $82,634 related
    Nontaxable benefits
    $0 + $33,892 related
    Filer's total
    $0 + $2,615,718 related

  • JEANETTE WOJTALEWICZ

    FORMER CFO, CHI HEALTH

    Total calculated
    $1,357,202
    From this org
    $0
    From related orgs
    $1,344,835
    Other
    $12,367
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $128,679 related
    Bonus
    $0 + $132,479 related
    Other
    $0 + $1,083,677 related
    Deferred
    $0 + $9,698 related
    Nontaxable benefits
    $0 + $2,669 related
    Filer's total
    $0 + $1,357,202 related

  • NICK O'TOOL

    MARKET CFO

    Total calculated
    $399,969
    From this org
    $0
    From related orgs
    $349,020
    Other
    $50,949
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $252,554 related
    Bonus
    $0 + $96,047 related
    Other
    $0 + $419 related
    Deferred
    $0 + $16,660 related
    Nontaxable benefits
    $0 + $34,289 related
    Filer's total
    $0 + $399,969 related

  • KIRTIBALA GUPTA MD

    BOARD MEMBER/PHYSICIAN

    Total calculated
    $394,026
    From this org
    $0
    From related orgs
    $346,502
    Other
    $47,524
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $342,890 related
    Bonus
    $0
    Other
    $0 + $3,612 related
    Deferred
    $0 + $18,825 related
    Nontaxable benefits
    $0 + $28,699 related
    Filer's total
    $0 + $394,026 related

  • HEATHER MORGAN MD

    BOARD MEMBER/PHYSICIAN

    Total calculated
    $378,802
    From this org
    $0
    From related orgs
    $320,425
    Other
    $58,377
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $319,514 related
    Bonus
    $0
    Other
    $0 + $911 related
    Deferred
    $0 + $18,500 related
    Nontaxable benefits
    $0 + $39,877 related
    Filer's total
    $0 + $378,802 related

  • CYNTHIA ALLOWAY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • KELLY BACON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • KENT BARNEY

    TREASURER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • KATE CUTLER

    BOARD MEMBER

    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

  • LG SEARCEY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • SISTER MAURITA SOUKUP

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • DAVE TAYLOR

    BOARD MEMBER

    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

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

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

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
  • 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 2023, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 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 I, 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. IN ACCORDANCE WITH AN EXECUTIVE SEVERANCE POLICY, DIGNITY HEALTH'S LISTED PERSONS ARE PROVIDED WITH MARKET-STANDARD COMPENSATION RANGING FROM PAYMENTS OF 9-24 MONTHS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2023 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): EVERT KUIPER, $2,025,542; JEANETTE WOJTALEWICZ, $1,083,464.
PART I, LINE 4B:
DURING THE 2023 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. 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 2023 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. 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 2023 AND INCLUDE J. PETERSDORF, $713,173. 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 2023.
PART II:
CHI NEBRASKA 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 2023.

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.

Provenance

Return type
form_990
Tax year
2023
Filed
13 May 2025
IRS schema version
2023v6.0
Source object
202541339349306569

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