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Nonprofiteer
← EAST TENNESSEE CHILDRENS HOSPITAL ASSOCIATION INC

Form 990 for tax year 2022

Filed by EAST TENNESSEE CHILDRENS HOSPITAL ASSOCIATION INC.

Totals

Total revenue
$289,223,404
Total expenses
$278,417,922
Contributions and grants received
$10,615,803
Grants paid
$84,690
Program service revenue
$249,180,373
Investment income
$3,004,614
Other revenue
$26,422,614
Total assets, end of year
$602,174,972
Total liabilities, end of year
$215,580,994
Net assets or fund balances, end of year
$386,593,978
Program services expenses (Part IX)
$214,830,392
Management and general expenses
$61,005,399
Fundraising expenses
$2,582,131
Program service expenses (Part III)
$214,830,392

Program services were 77.2% 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.

  • 1c · Fundraising events

    $1,024,197

  • 1f · All other contributions, gifts and grants

    $9,591,606

  • 2a · Program service revenue: PATIENT CARE REVENUE

    total $247,105,673 · related or exempt $247,076,735 · unrelated business $28,938

  • 2b · Program service revenue: OTHER HEALTHCARE SRVCS

    total $1,160,750 · related or exempt $1,160,750

  • 2c · Program service revenue: PASSTHROUGH REVENUE

    total $840,287 · related or exempt $840,287

  • 2d · Program service revenue: CARES ACT RELIEF FUNDING

    total $73,663 · related or exempt $73,663

  • 3 · Investment income

    total $3,373,694 · excluded $3,373,694

  • 6a · Gross rents

    real property $2,072,159

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $2,072,159

  • 6d · Net rental income or loss

    total $2,072,159 · related or exempt $2,072,159

  • 7a · Gross sales of assets other than inventory

    other assets $441,708

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

    other assets $810,788

  • 7c · Gain or loss

    other assets -$369,080

  • 7d · Net gain or loss

    total -$369,080 · related or exempt -$369,080

  • 8a · Fundraising events: gross income

    $904,863

  • 8a · Fundraising events: contributions included on line 1c

    $1,024,197

  • 8b · Fundraising events: direct expenses

    $807,423

  • 8c · Net income from fundraising events

    total $97,440 · excluded $97,440

  • 9a · Gaming: gross income

    $81,291

  • 9b · Gaming: direct expenses

    $23,337

  • 9c · Net income from gaming

    total $57,954 · excluded $57,954

  • 10a · Gross sales of inventory

    $921,316

  • 10b · Cost of goods sold

    $907,637

  • 10c · Net income from sales of inventory

    total $13,679 · excluded $13,679

  • 11a · Other revenue: MISCELLANEOUS

    total $22,623,048 · related or exempt $22,623,048

  • 11b · Other revenue: CAFETERIA SALES

    total $1,558,334 · excluded $1,558,334

  • 11e · Other revenue, total

    $24,181,382

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $84,690 · program services $84,690

  • 5 · Compensation of officers, directors and key employees

    total $3,659,642 · program services $2,819,469 · management and general $565,174 · fundraising $274,999

  • 7 · Other salaries and wages

    total $114,702,699 · program services $95,353,863 · management and general $18,435,601 · fundraising $913,235

  • 8 · Pension plan contributions

    total $2,655,062 · program services $2,201,673 · management and general $426,735 · fundraising $26,654

  • 9 · Other employee benefits

    total $15,730,929 · program services $13,044,652 · management and general $2,528,355 · fundraising $157,922

  • 10 · Payroll taxes

    total $8,681,644 · program services $7,199,131 · management and general $1,395,358 · fundraising $87,155

  • 11b · Fees: legal

    total $108,107 · program services $108,107

  • 11c · Fees: accounting

    total $173,294 · program services $173,294

  • 11g · Fees: other

    total $29,604,320 · program services $22,444,949 · management and general $6,506,547 · fundraising $652,824

  • 16 · Occupancy

    total $3,629,419 · program services $89,615 · management and general $3,539,804

  • 19 · Conferences, conventions and meetings

    total $663,090 · program services $366,202 · management and general $248,191 · fundraising $48,697

  • 20 · Interest

    total $4,794,312 · management and general $4,794,312

  • 22 · Depreciation, depletion and amortization

    total $14,734,123 · program services $8,177,308 · management and general $6,553,591 · fundraising $3,224

  • 23 · Insurance

    total $1,877,252 · management and general $1,877,252

  • 24a · Other expenses: SUPPLIES

    total $55,789,395 · program services $52,291,170 · management and general $3,300,271 · fundraising $197,954

  • 24b · Other expenses: MAINTENANCE AND RENTAL

    total $14,061,480 · program services $5,229,270 · management and general $8,776,831 · fundraising $55,379

  • 24c · Other expenses: BAD DEBT

    total $4,729,893 · program services $4,729,893

  • 24d · Other expenses: UBI TAXES

    total $5,200 · program services $5,200

  • 24e · All other expenses

    total $2,733,371 · program services $511,906 · management and general $2,057,377 · fundraising $164,088

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $20,321,863 · end of year $21,163,944

  • 3 · Pledges and grants receivable

    beginning of year $3,177,826 · end of year $5,434,671

  • 4 · Accounts receivable

    beginning of year $36,915,552 · end of year $48,046,886

  • 7 · Other notes and loans receivable

    beginning of year $1,045,168 · end of year $1,045,168

  • 8 · Inventories for sale or use

    beginning of year $5,101,428 · end of year $5,425,926

  • 9 · Prepaid expenses and deferred charges

    beginning of year $2,417,832 · end of year $3,383,605

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

    $336,996,758

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

    $153,883,537

  • 10c · Land, buildings and equipment, net

    beginning of year $187,054,968 · end of year $183,113,221

  • 11 · Investments: publicly traded securities

    beginning of year $220,243,230 · end of year $237,415,767

  • 13 · Investments: program-related

    beginning of year $27,058,801 · end of year $25,133,302

  • 14 · Intangible assets

    beginning of year $540,000 · end of year $802,583

  • 15 · Other assets

    beginning of year $74,506,077 · end of year $71,209,899

  • 17 · Accounts payable and accrued expenses

    beginning of year $31,121,383 · end of year $35,955,202

  • 19 · Deferred revenue

    beginning of year $2,386,670 · end of year $1,566,994

  • 20 · Tax-exempt bond liabilities

    beginning of year $122,650,905 · end of year $120,118,824

  • 25 · Other liabilities

    beginning of year $58,438,813 · end of year $57,939,974

  • 27 · Net assets without donor restrictions

    beginning of year $326,412,443 · end of year $347,306,734

  • 28 · Net assets with donor restrictions

    beginning of year $37,372,531 · end of year $39,287,244

Mission and programs · 2022

Mission

AT EAST TENNESSEE CHILDREN'S HOSPITAL ("ETCH"), CHILDREN ARE OUR ONLY CONCERN, AND THAT DRIVES OUR MISSION TO IMPROVE THE HEALTH OF CHILDREN THROUGH EXCEPTIONAL, COMPREHENSIVE FAMILY-CENTERED CARE, WELLNESS AND EDUCATION. IT IS A MISSION THAT CENTERS ON A PROFOUND AND UNCHANGING COMMITMENT TO THE PHYSICAL, EDUCATIONAL AND EMOTIONAL NEEDS OF EACH CHILD.

Activities or mission (Part I)

AT ETCH, CHILDREN ARE OUR ONLY CONCERN, PROVIDING THE BEST HEALTHCARE TO EVERY CHILD SERVED.

  • EAST TENNESSEE CHILDREN'S HOSPITAL ("ETCH") IS THE ONLY COMPREHENSIVE REGIONAL PEDIATRIC CENTER IN EAST TENNESSEE. SINCE 1937, ETCH HAS PROVIDED EXCELLENT PEDIATRIC HEALTH CARE FOR CHILDREN FROM BIRTH TO 21 YEARS OF AGE. ETCH OFFERS MORE PEDIATRIC SUBSPECIALTIES THAN ANY OTHER HOSPITAL IN THE REGION, SERVING CHILDREN FROM EAST TENNESSEE, SOUTHWEST VIRGINIA, SOUTHEAST KENTUCKY AND WESTERN NORTH CAROLINA. THE SUBSPECIALTIES AVAILABLE AT ETCH INCLUDE: ADOLESCENT GYNECOLOGYADOLESCENT MEDICINE(SUBSPECIALTY LIST CONTINUED ON SCHEDULE O)CHILD ABUSE PEDIATRICSDEVELOPMENTAL-BEHAVIORAL PEDIATRICSNEONATOLOGYPEDIATRICS/PRIMARY CAREPEDIATRIC ALLERGY & IMMUNOLOGYPEDIATRIC ANESTHESIOLOGYPEDIATRIC CARDIOLOGY CLINICAL GENETICSPEDIATRIC CRITICAL CAREPEDIATRIC DENTISTRY/PEDODONTICSPEDIATRIC DERMATOLOGYPEDIATRIC EMERGENCY MEDICINEPEDIATRIC ENDOCRINOLOGYPEDIATRIC FORENSIC MEDICINEPEDIATRIC GASTROENTEROLOGYPEDIATRIC AND ADOLESCENT GYNECOLOGYPEDIATRIC HEMATOLOGY/ONCOLOGYPEDIATRIC INFECTIOUS DISEASEPEDIATRIC INPATIENT MEDICINEPEDIATRIC INTENSIVE CAREPEDIATRIC NEPHROLOGYPEDIATRIC NEUROLOGYPEDIATRIC NEUROSURGERYPEDIATRIC OPHTHALMOLOGYPEDIATRIC ORTHOPEDICSPEDIATRIC OTOLARYNGOLOGYPEDIATRIC PHYSIATRYPEDIATRIC PLASTIC/RECONSTRUCTIVE SURGERYPEDIATRIC PULMONOLOGYPEDIATRIC RADIOLOGYPEDIATRIC REHABILITATION SERVICESPEDIATRIC RHEUMATOLOGYPEDIATRIC SLEEP MEDICINEPEDIATRIC SURGERYPEDIATRIC UROLOGYPERINATOLOGYPSYCHOLOGYIN ADDITION, ETCH PROVIDES THE FOLLOWING: MEDICAL/SURGICAL SERVICES:THE EMERGENCY DEPARTMENT IS STAFFED WITH BOARD CERTIFIED PEDIATRIC PHYSICIANS, NURSING STAFF, AND DIAGNOSTIC CAPABILITIES TO PROVIDE TREATMENT FOR ALL TYPES OF EMERGENCIES 24 HOURS A DAY, SEVEN DAYS A WEEK. THE DEPARTMENT PROVIDES EVALUATION AND TREATMENT FOR PATIENTS UP TO 21 YEARS OF AGE WITH VARYING LEVELS OF ILLNESS AND INJURY, FROM MINOR TO LIFE THREATENING. THE HOSPITAL'S PEDIATRIC INTENSIVE CARE UNIT (PICU) PROVIDES COMPREHENSIVE, 24-HOUR-A-DAY TREATMENT FOR CRITICALLY ILL AND INJURED CHILDREN. THE PICU IS STAFFED WITH FELLOWSHIP TRAINED, BOARD CERTIFIED, CRITICAL CARE PHYSICIANS AND NURSES SPECIFICALLY TRAINED AND EXPERIENCED IN THE CARE OF CRITICALLY ILL CHILDREN. PATIENTS IN THE PICU RECEIVE A HIGH LEVEL OF MONITORING AND/OR TREATMENT UNTIL THEY ARE WELL ENOUGH TO BE TRANSFERRED TO A REGULAR PATIENT ROOM OR DISCHARGED HOME.IN THE NEONATAL INTENSIVE CARE UNIT (NICU), TINY AND FRAGILE INFANTS BORN PREMATURELY OR FACING LIFE-THREATENING ILLNESSES RECEIVE TREATMENT FROM A TEAM OF BOARD-CERTIFIED NEONATOLOGISTS, WITH VALUABLE ASSISTANCE FROM SPECIALLY TRAINED NURSES, RESPIRATORY THERAPISTS, LACTATION CONSULTANTS, AND OTHER MEDICAL PROFESSIONALS. THE NICU TREATS MORE THAN 900 NEWBORNS EACH YEAR.AS A REGIONAL REFERRAL CENTER FOR EAST TENNESSEE, ETCH OFFERS NEONATAL AND PEDIATRIC TRANSPORT FROM OUTLYING HOSPITALS IN LIFELINE, A MOBILE INTENSIVE CARE UNIT SPECIALLY DESIGNED TO MAINTAIN THE SAME QUALITY OF CARE DURING TRANSPORT AS PATIENTS RECEIVE IN THE HOSPITAL'S CRITICAL CARE UNITS. LIFELINE CARRIES MORE THAN 1,000 SUPPLIES TO ADMINISTER CARE TO PATIENTS, FROM THE TINIEST PREMATURE INFANT TO AN ADULT-SIZE PEDIATRIC PATIENT, DURING TRANSPORT TO THE HOSPITAL. IN ADDITION TO THE SPECIAL EQUIPMENT, THE LIFELINE MEDICAL TEAM MAY INCLUDE A NEONATOLOGIST, NEONATAL NURSE PRACTITIONER, PEDIATRIC/NEONATAL RN, RESPIRATORY THERAPIST, AN EMT, A-EMT, AND PARAMEDICS, DEPENDING ON THE CONDITION OF THE PATIENT. THE HOSPITAL'S TWO LIFELINE VEHICLES TRAVELED MORE THAN 32,000 MILES IN FY20 TO DOZENS OF DIFFERENT HOSPITALS IN 16 COUNTIES IN TENNESSEE, VIRGINIA, AND KENTUCKY TO TRANSPORT HUNDREDS OF PEDIATRIC PATIENTS TO ETCH.ETCH MEETS A WIDE RANGE OF PEDIATRIC SURGICAL NEEDS, FROM COMMON OUTPATIENT PROCEDURES SUCH AS TONSILLECTOMIES TO MORE COMPLICATED PROCEDURES, SUCH AS RECONSTRUCTIVE SURGERY OR NEUROSURGERY. FIVE DEPARTMENTS COMPRISE ETCH'S SURGICAL SERVICES: OPERATING ROOM, PRE/POST SURGERY (OUTPATIENT SURGERY), INPATIENT SURGERY, ANESTHESIA, AND STERILE PROCESSING. THESE DEPARTMENTS WORK TOGETHER TO MAKE SURE EACH CHILD'S SURGERY AND RECOVERY IS AS QUICK AND PAINLESS AS POSSIBLE. THE DOCTORS, NURSES, ANESTHESIOLOGISTS AND OTHER SURGICAL STAFF ARE TRAINED IN PEDIATRIC MEDICINE. AT ANY GIVEN TIME AND FOR VARIOUS REASONS, A CHILD MAY NEED TO BE ADMITTED TO ETCH AS AN INPATIENT. DOCTORS AND NURSES CONTINUOUSLY MONITOR AND TREAT INPATIENTS ACCORDING TO THEIR INDIVIDUAL NEEDS. ALONG WITH PROVIDING COMPREHENSIVE MEDICAL AND NURSING CARE, ETCH IS DEDICATED TO MAKING A CHILD'S STAY IN THE HOSPITAL AS COMFORTABLE AS POSSIBLE. EACH ROOM HAS A TV WITH ACCESS TO MOVIE CHANNELS, AND PLAY ROOMS ARE LOCATED ON EACH FLOOR. OTHER SERVICES SUCH AS CHILD LIFE, NUTRITION, PASTORAL CARE. REHABILITATION AND SOCIAL WORK PROVIDE FOR THE PHYSICAL AND EMOTIONAL NEEDS OF THE CHILD. THE RESPIRATORY CARE DEPARTMENT AT ETCH IS STAFFED WITH LICENSED AND ACCREDITED RESPIRATORY THERAPISTS WHOSE ROLES INCLUDE TREATING PATIENTS WITH LUNG AND/OR HEART DISEASES SUCH AS ASTHMA, PNEUMONIA, PREMATURE LUNGS AND CYSTIC FIBROSIS. TREATMENTS PROVIDED BY RESPIRATORY THERAPISTS INCLUDE AEROSOL MEDICATIONS, DELIVERY OF OXYGEN AND OTHER MEDICAL GASES, VENTILATOR MANAGEMENT AND MANY OTHER PROCEDURES. RESPIRATORY THERAPISTS HELP PATIENTS THROUGHOUT THE HOSPITAL, FROM THE EMERGENCY DEPARTMENT TO THE NICU. THEY ARE ALSO MEMBERS OF THE PEDIATRIC TRANSPORT TEAM THAT HELPS BRING SICK AND INJURED CHILDREN TO THE HOSPITAL FOR SPECIALIZED CARE. EDUCATION IS ALSO A KEY ROLE OF RESPIRATORY THERAPISTS; THEY TEACH PATIENTS AND THEIR FAMILIES HOW TO CARE FOR CERTAIN CONDITIONS AT HOME. THE PULMONARY FUNCTION LAB, A VITAL PART OF THE RESPIRATORY CARE DEPARTMENT, PERFORMS TESTS TO DIAGNOSE LUNG AND HEART DISEASES. THE DEPARTMENT IS STAFFED BY SPECIALLY TRAINED RESPIRATORY THERAPISTS. SERVICES PROVIDED INCLUDE SPIROMETRY TESTING, METABOLIC STUDIES, CARDIAC STRESS TESTING, LUNG VOLUMES AND THE CYSTIC FIBROSIS CLINIC. ECHOCARDIOGRAMS ARE PERFORMED IN THE ECHO LAB. PATIENTS IN A VARIETY OF HOSPITAL DEPARTMENTS MAY BENEFIT FROM SEDATION DURING SOME PAINFUL TESTS AND PROCEDURES. IN ADDITION, YOUNG CHILDREN MAY NEED SEDATION TO REMAIN STILL DURING LONG TESTS, SUCH AS A MAGNETIC RESONANCE IMAGING (MRI). TO MEET THESE NEEDS, ETCH OFFERS PEDIATRIC ANALGESIA AND SEDATION SPECIALISTS (PASS). WHILE THE HOSPITAL CANNOT ELIMINATE PAIN FOR SOME CHILDREN, IT IS OUR GOAL TO KEEP PAINFUL OR UNCOMFORTABLE SITUATIONS TO A MINIMUM. PASS IS A DEDICATED SERVICE THAT UTILIZES THE MOST CURRENT SEDATION TECHNIQUES TO HELP CHILDREN UNDERGOING LENGTHY OR PAINFUL PROCEDURES AT ETCH. A MULTISPECIALTY TEAM SEES EACH CHILD, INCLUDING A PEDIATRIC SEDATION PHYSICIAN AND PEDIATRIC NURSES WHO ARE SPECIFICALLY PREPARED TO WORK WITH PEDIATRIC SEDATION. DIAGNOSTIC SERVICES:THE CLINICAL LAB IS RESPONSIBLE FOR ALL DIAGNOSTIC TESTING, WHICH INCLUDES THE FOLLOWING AREAS: HEMATOLOGY, CHEMISTRY, MICROBIOLOGY, IMMUNOLOGY, SEROLOGY AND BLOOD BANK.NEUROLOGY LAB - THE NEUROLOGY LAB OFFERS A VARIETY OF DIAGNOSTIC TESTS FOR PATIENTS DEALING WITH SEIZURES, HEARING PROBLEMS, SLEEP DISORDERS AND OTHER CONDITIONS INVOLVING THE BRAIN. THE MOST COMMON TESTS OFFERED IN THE NEUROLOGY LABORATORY ARE THE ELECTROENCEPHALOGRAM (EEG) FOR CHILDREN HAVING SEIZURES AND OTHER NEUROLOGICAL PROBLEMS AND THE BRAINSTEM AUDITORY EVOKED RESPONSE (BAER) HEARING TEST, OFFERED MOST OFTEN TO INFANTS WHO FAIL NEWBORN HEARING SCREENINGS AND TODDLERS WHO ARE SPEECH DELAYED. CHILDREN'S SLEEP MEDICINE CENTER - THE CHILDREN'S SLEEP MEDICINE CENTER OFFERS SLEEP STUDY TESTING FOR CHILDREN WHO ARE HAVING PROBLEMS WITH SLEEP. THE SLEEP STUDIES TAKE PLACE OVERNIGHT, DURING THE CHILD'S REGULAR SLEEP CYCLE, TO FIND THE CAUSE OF PROBLEMS SUCH AS SLEEP DISORDERED BREATHING AND PARASOMNIAS (NIGHT TERRORS, SLEEPWALKING). ETCH IS ACCREDITED BY THE AMERICAN ACADEMY OF SLEEP MEDICINE AS THE ONLY SLEEP MEDICINE CENTER DEDICATED TO PEDIATRICS IN EAST TENNESSEE.THE RADIOLOGY DEPARTMENT SERVES AS AN "IMAGING" CENTER FOR CHILDREN. THESE IMAGES INCLUDE X-RAY, ULTRASOUND, CT SCAN, NUCLEAR MEDICINE, MRI, AND FLUOROSCOPY.

    Expenses $214,830,392 · Grants $84,690 · Revenue $273,477,562

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

Listed in Part VII

  • Alan S Icenhour

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Andrea Anne White

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Barbara Summers MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Bob Baskerville

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Brian T Ferguson

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Bryan Thomas Daniels

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Cameron J Sears MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Cathy Ackermann

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    2

  • Daniel K Carter

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    2

  • David D Stevens

    CHAIRMAN

    Total calculated
    $0
    Hours/week
    2

  • James B Clayton

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Julia G Arana MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Kenneth J Rueter

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Kim Wood

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Lisa Rottmann

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Matt Schaefer

    BOARD MEMBER/PRES & CEO

    Total calculated
    $705,785
    From this org
    $596,451
    From related orgs
    $0
    Other
    $109,334
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $510,706
    Bonus
    $84,905
    Other
    $840
    Deferred
    $86,512
    Nontaxable benefits
    $22,822
    Filer's total
    $705,785

  • Michael R Ragsdale

    BOARD MEMER

    Total calculated
    $0
    Hours/week
    2

  • Scott Daniel

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Scott W Brice MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Victoria Niederhauser

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • William Glaze Vaughan MD

    PEDIATRIC SURGEON

    Total calculated
    $784,948
    From this org
    $748,626
    From related orgs
    $0
    Other
    $36,322
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $632,555
    Bonus
    $111,113
    Other
    $4,958
    Deferred
    $13,500
    Nontaxable benefits
    $22,822
    Filer's total
    $784,948

  • Caryn Hawthorne

    VP/CHIEF FINANCIAL OFFICER

    Total calculated
    $484,261
    From this org
    $420,849
    From related orgs
    $0
    Other
    $63,412
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $351,079
    Bonus
    $59,287
    Other
    $10,483
    Deferred
    $45,710
    Nontaxable benefits
    $17,702
    Filer's total
    $484,261

  • Carlton Long

    VP DEVELOPMENT

    Total calculated
    $394,162
    From this org
    $344,977
    From related orgs
    $0
    Other
    $49,185
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $226,977
    Bonus
    $41,916
    Other
    $76,084
    Deferred
    $31,483
    Nontaxable benefits
    $17,702
    Filer's total
    $394,162

  • Catherine Shuck

    VP OF LEGAL SERVICES

    Total calculated
    $439,832
    From this org
    $408,445
    From related orgs
    $0
    Other
    $31,387
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $364,257
    Bonus
    $41,919
    Other
    $2,269
    Deferred
    $31,387
    Nontaxable benefits
    $0
    Filer's total
    $439,832

  • Joseph Childs

    VP OF MEDICAL SERVICES

    Total calculated
    $539,321
    From this org
    $518,227
    From related orgs
    $0
    Other
    $21,094
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $433,304
    Bonus
    $73,147
    Other
    $11,776
    Deferred
    $3,392
    Nontaxable benefits
    $17,702
    Filer's total
    $539,321

  • Robert Bauer

    VP HUMAN RESOURCES

    Total calculated
    $370,234
    From this org
    $313,023
    From related orgs
    $0
    Other
    $57,211
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $255,292
    Bonus
    $56,420
    Other
    $1,311
    Deferred
    $31,875
    Nontaxable benefits
    $25,336
    Filer's total
    $370,234

  • Ronald J Phillips

    VP OF PATIENT SERVICES/CNO

    Total calculated
    $346,837
    From this org
    $298,495
    From related orgs
    $0
    Other
    $48,342
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $251,299
    Bonus
    $42,586
    Other
    $4,610
    Deferred
    $30,640
    Nontaxable benefits
    $17,702
    Filer's total
    $346,837

  • Steven Godbold

    VP OPERATIONS

    Total calculated
    $454,741
    From this org
    $381,132
    From related orgs
    $0
    Other
    $73,609
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $325,086
    Bonus
    $54,945
    Other
    $1,101
    Deferred
    $48,273
    Nontaxable benefits
    $25,336
    Filer's total
    $454,741

  • Carlos A Angel MD

    PEDIATRIC SURGEON

    Total calculated
    $683,100
    From this org
    $660,963
    From related orgs
    $0
    Other
    $22,137
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $637,151
    Bonus
    $16,954
    Other
    $6,858
    Deferred
    $13,502
    Nontaxable benefits
    $8,635
    Filer's total
    $683,100

  • David M Hurst MD

    PEDIATRIC CARDIOLOGIST

    Total calculated
    $691,684
    From this org
    $658,668
    From related orgs
    $0
    Other
    $33,016
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $343,597
    Bonus
    $314,261
    Other
    $810
    Deferred
    $10,194
    Nontaxable benefits
    $22,822
    Filer's total
    $691,684

  • Eric Jensen MD

    PEDIATRIC SURGEON

    Total calculated
    $670,696
    From this org
    $631,860
    From related orgs
    $0
    Other
    $38,836
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $630,618
    Bonus
    $0
    Other
    $1,242
    Deferred
    $13,500
    Nontaxable benefits
    $25,336
    Filer's total
    $670,696

  • Sumeet Sharma MD

    PEDIATRIC CARDIOLOGIST

    Total calculated
    $1,020,597
    From this org
    $976,985
    From related orgs
    $0
    Other
    $43,612
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $341,733
    Bonus
    $634,442
    Other
    $810
    Deferred
    $20,790
    Nontaxable benefits
    $22,822
    Filer's total
    $1,020,597

  • Kelly Deraney

    VP OF AMBULATORY SERVICES

    Total calculated
    $296,555
    From this org
    $246,383
    From related orgs
    $0
    Other
    $50,172
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $206,750
    Bonus
    $39,274
    Other
    $359
    Deferred
    $24,836
    Nontaxable benefits
    $25,336
    Filer's total
    $296,555

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 · 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
SUPPLEMENTAL NONQUALIFIED EXECUTIVE RETIREMENT PLAN: THE SUPPLEMENTAL EXECUTIVE 457(F) RETIREMENT PLAN IS INTENDED TO SUPPORT RETENTION OF KEY EXECUTIVES AND TO OFFER A COMPETITIVE TOTAL RETIREMENT BENEFIT. THESE BENEFITS ARE PART OF A RETIREMENT PROGRAM THAT PROVIDES RETIREMENT INCOME FOR THE EXECUTIVE'S TOTAL YEARS OF SERVICE WITH THE ORGANIZATION PURSUANT TO A WRITTEN PLAN AGREEMENT AS APPROVED BY INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THESE BENEFITS ARE AT RISK AND WILL NOT BE PAID UNLESS THE EXECUTIVE PROVIDES SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION IN ACCORDANCE WITH A VESTING SCHEDULE. AN ESTIMATE OF THE ANNUAL INCREASE IN ACTUARIAL VALUE IS REPORTED AS DEFERRED COMPENSATION IN PART VII AND IN SCHEDULE J, COLUMN (C) FOR THE APPLICABLE EXECUTIVES. EMPLOYER CONTRIBUTION TO 457(F) EXECUTIVE RETIREMENT BENEFIT PLAN: MATT SCHAEFER $76,262 STEVEN GODBOLD $39,482 CATHERINE SHUCK $25,970 CARYN HAWTHORNE $35,501 RONALD J PHILLIPS $25,501 ROBERT BAUER $25,000 CARLTON LONG $24,500 SUMEET SHARMA $10,540 KELLY DERANEY $20,596

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

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.

  • CAH MANAGEMENT COMPANY LLC

    RELATED · MEDICAL SERVICES · TN · 51% owned · share of income -$630,952 · share of assets $1,295,756

    Directly controlled by ETCH

Related corporations and trusts

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

  • CHILDREN'S PRIMARY CARE CENTER

    C · PEDIATRIC CLINIC HOLDING COMPANY · TN · 100% owned · share of income $24,454,432 · share of assets $9,960,732 · controlled entity

    Directly controlled by EAST TENNESEE CHILDREN'S HOSPITAL ASSOCIATION INC

Provenance

Return type
form_990
Tax year
2022
Filed
15 May 2024
IRS schema version
2022v5.0
Source object
202401369349313270

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