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Nonprofiteer
← DIGNITY HEALTH MEDICAL FOUNDATION

Form 990 for tax year 2022

Filed by DIGNITY HEALTH MEDICAL FOUNDATION.

Totals

Total revenue
$1,499,323,425
Total expenses
$1,430,783,732
Contributions and grants received
$368,832,174
Grants paid
$11,526
Program service revenue
$1,111,993,180
Investment income
$9,047,722
Other revenue
$9,450,349
Total assets, end of year
$659,338,395
Total liabilities, end of year
$405,519,925
Net assets or fund balances, end of year
$253,818,470
Program services expenses (Part IX)
$1,286,736,966
Management and general expenses
$144,046,766
Fundraising expenses
$0
Program service expenses (Part III)
$1,286,736,966

Program services were 89.9% 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

    $359,734,495

  • 1e · Government grants (contributions)

    $9,097,679

  • 2a · Program service revenue: PATIENT NET OF CHARITY & BAD DEBT

    total $614,324,279 · related or exempt $614,324,279

  • 2b · Program service revenue: MEDICARE / MEDICAID PAYMENTS

    total $390,997,234 · related or exempt $390,997,234

  • 2c · Program service revenue: PHYSICIAN PROFESSIONAL FEES REVEN

    total $93,693,096 · related or exempt $93,693,096

  • 2d · Program service revenue: MANAGEMENT SERVICES

    total $10,915,776 · related or exempt $10,915,776

  • 2e · Program service revenue: MEDICAL OFFICE BUILDING

    total $842,755 · related or exempt $842,755

  • 2f · All other program service revenue

    total $1,220,040 · related or exempt $1,220,040

  • 3 · Investment income

    total $8,954,526 · excluded $8,954,526

  • 7a · Gross sales of assets other than inventory

    other assets $93,196

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

    other assets $0

  • 7c · Gain or loss

    other assets $93,196

  • 7d · Net gain or loss

    total $93,196 · excluded $93,196

  • 11a · Other revenue: EMPLOYEE RETENTION CREDIT

    total $9,168,805 · excluded $9,168,805

  • 11b · Other revenue: A/R FINANCE CHARGES

    total $117,063 · excluded $117,063

  • 11c · Other revenue: MEDICAL RECORDS/ABSTRACT SALE

    total $113,086 · excluded $113,086

  • 11d · All other revenue

    total $51,395 · excluded $51,395

  • 11e · Other revenue, total

    $9,450,349

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $11,526 · program services $11,526

  • 5 · Compensation of officers, directors and key employees

    total $3,240,570 · program services $3,025,678 · management and general $214,892

  • 7 · Other salaries and wages

    total $238,159,571 · program services $227,246,808 · management and general $10,912,763

  • 8 · Pension plan contributions

    total $10,793,760 · program services $10,689,439 · management and general $104,321

  • 9 · Other employee benefits

    total $69,707,253 · program services $63,653,592 · management and general $6,053,661

  • 10 · Payroll taxes

    total $17,884,476 · program services $17,261,721 · management and general $622,755

  • 11b · Fees: legal

    total $2,844,198 · management and general $2,844,198

  • 11d · Fees: lobbying

    total $36,791 · management and general $36,791

  • 11g · Fees: other

    total $647,998,961 · program services $568,346,256 · management and general $79,652,705

  • 12 · Advertising and promotion

    total $3,232,250 · program services $2,935,020 · management and general $297,230

  • 13 · Office expenses

    total $10,818,960 · program services $9,338,978 · management and general $1,479,982

  • 14 · Information technology

    total $38,009,624 · program services $22,601,102 · management and general $15,408,522

  • 16 · Occupancy

    total $38,502,524 · program services $21,532,681 · management and general $16,969,843

  • 17 · Travel

    total $1,174,980 · program services $1,060,310 · management and general $114,670

  • 19 · Conferences, conventions and meetings

    total $207,043 · program services $194,429 · management and general $12,614

  • 20 · Interest

    total $2,626,890 · program services $2,626,890

  • 22 · Depreciation, depletion and amortization

    total $31,333,583 · program services $24,731,346 · management and general $6,602,237

  • 23 · Insurance

    total $3,143,301 · program services $1,249,755 · management and general $1,893,546

  • 24a · Other expenses: MEDICAL PROVIDER/OUT OF

    total $236,597,574 · program services $236,597,574

  • 24b · Other expenses: MEDICAL SUPPLIES

    total $70,308,142 · program services $70,308,142

  • 24c · Other expenses: LICENSES AND TAXES

    total $940,855 · program services $684,524 · management and general $256,331

  • 24d · Other expenses: DUES AND SUBSCRIPTIONS

    total $899,034 · program services $769,638 · management and general $129,396

  • 24e · All other expenses

    total $2,311,866 · program services $1,871,557 · management and general $440,309

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,450 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $58,923,088 · end of year $153,783,913

  • 4 · Accounts receivable

    beginning of year $101,934,901 · end of year $84,541,553

  • 7 · Other notes and loans receivable

    beginning of year $54,147 · end of year $90,000

  • 9 · Prepaid expenses and deferred charges

    beginning of year $16,423,585 · end of year $23,743,650

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

    $294,077,911

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

    $101,306,964

  • 10c · Land, buildings and equipment, net

    beginning of year $199,500,367 · end of year $192,770,947

  • 13 · Investments: program-related

    beginning of year $47,454,001 · end of year $56,364,153

  • 14 · Intangible assets

    beginning of year $13,999,184 · end of year $21,227,218

  • 15 · Other assets

    beginning of year $152,210,683 · end of year $126,816,961

  • 17 · Accounts payable and accrued expenses

    beginning of year $197,382,865 · end of year $185,576,301

  • 19 · Deferred revenue

    beginning of year $1,472,734 · end of year $1,792,322

  • 23 · Secured mortgages and notes payable

    beginning of year $67,006,217 · end of year $75,185,165

  • 25 · Other liabilities

    beginning of year $142,141,146 · end of year $142,966,137

  • 27 · Net assets without donor restrictions

    beginning of year $182,432,513 · end of year $253,742,938

  • 28 · Net assets with donor restrictions

    beginning of year $65,931 · end of year $75,532

Mission and programs · 2022

Mission

SEE SCHEDULE O

Activities or mission (Part I)

TO ESTABLISH, OPERATE, AND MAINTAIN A MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC TO BENEFIT THE COMMUNITIES WE SERVE.

  • DIGNITY HEALTH MEDICAL FOUNDATION OUTPATIENT SERVICES INCLUDE FAMILY, PEDIATRIC, AND GERIATRIC MEDICINE AS WELL AS A VARIETY OF SPECIALTIES. AMONG THE SPECIALTY HEALTHCARE SERVICES WE PROVIDE TO OUR PATIENTS ARE CHARITY CARE, MENTAL HEALTH SERVICES, PAIN MANAGEMENT, REHABILITATION AND OCCUPATIONAL SERVICES, OPHTHALMOLOGY, CARDIOLOGY, DIAGNOSTIC IMAGING, OUTPATIENT SURGERY, NEUROLOGY, ORTHOPEDICS, PODIATRY, RADIATION ONCOLOGY AND INFUSION, AND OBSTETRICS AND GYNECOLOGY.

    Expenses $830,202,690 · Grants $11,526 · Revenue $717,458,000

  • DIGNITY HEALTH MEDICAL FOUNDATION OUTPATIENT SERVICES INCLUDES MEDICAL SERVICES FOR THE COMMUNITY. APPROXIMATELY 35% OF DHMF PATIENT REVENUES AND EXPENSES ARE IN SUPPORT OF MEDI-CAL AND MEDICARE COVERED PATIENTS. OUR CLINICS ARE LOCATED IN THE SACRAMENTO REGION [SACRAMENTO, EL DORADO HILLS, ELK GROVE, FOLSOM, CAMERON PARK, ROSEVILLE, AND ROCKLIN], WOODLAND, SIERRA NEVADA, STOCKTON, SANTA CRUZ, SAN FRANCISCO, NORTHRIDGE, BAKERSFIELD, MERCED, REDDING, VENTURA, INLAND EMPIRE, AND SEQUOIA.

    Expenses $452,416,718 · Revenue $390,976,802

  • OTHER RELATED INCOME - DIGNITY HEALTH MEDICAL FOUNDATION OUTPATIENT SERVICES ALSO INCLUDE SUPPORT FOR OUR COMMUNITIES BY ACTIVELY PARTICIPATING WITH AND/OR IN THE COMMUNITY WITH THE FOLLOWING TYPES OF ACTIVITIES: CLINICAL TRIALS, CARE MANAGEMENT, HOSPITALIST SERVICES AND EMPLOYEE ASSISTANCE PROGRAMS.

    Expenses $4,117,558 · Revenue $3,558,378

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

Listed in Part VII

  • Marvin O'Quinn

    EX-OFFICIO BOARD MEMBER

    Total calculated
    $6,407,226
    From this org
    $0
    From related orgs
    $5,689,780
    Other
    $717,446
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,949,261 related
    Bonus
    $0 + $3,089,471 related
    Other
    $0 + $651,048 related
    Deferred
    $0 + $618,918 related
    Nontaxable benefits
    $0 + $98,528 related
    Filer's total
    $0 + $6,407,226 related

  • Robert Wiebe MD

    BOARD MEMBER

    Total calculated
    $3,606,621
    From this org
    $0
    From related orgs
    $3,174,427
    Other
    $432,194
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,162,841 related
    Bonus
    $0 + $1,651,404 related
    Other
    $0 + $360,182 related
    Deferred
    $0 + $389,791 related
    Nontaxable benefits
    $0 + $42,403 related
    Filer's total
    $0 + $3,606,621 related

  • Thomas McGinn MD MPH

    BOARD MEMBER

    Total calculated
    $2,598,509
    From this org
    $0
    From related orgs
    $2,547,753
    Other
    $50,756
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,045,705 related
    Bonus
    $0 + $1,496,504 related
    Other
    $0 + $5,544 related
    Deferred
    $0 + $17,925 related
    Nontaxable benefits
    $0 + $32,831 related
    Filer's total
    $0 + $2,598,509 related

  • Todd A Strumwasser MD

    BOARD MEMBER (THRU 11/1/22)

    Total calculated
    $1,875,782
    From this org
    $0
    From related orgs
    $1,726,177
    Other
    $149,605
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $781,538 related
    Bonus
    $0 + $900,253 related
    Other
    $0 + $44,386 related
    Deferred
    $0 + $80,929 related
    Nontaxable benefits
    $0 + $68,676 related
    Filer's total
    $0 + $1,875,782 related

  • Gary Greensweig Do

    CHAIR

    Total calculated
    $1,279,985
    From this org
    $0
    From related orgs
    $1,105,530
    Other
    $174,455
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $580,883 related
    Bonus
    $0 + $492,776 related
    Other
    $0 + $31,871 related
    Deferred
    $0 + $83,929 related
    Nontaxable benefits
    $0 + $90,526 related
    Filer's total
    $0 + $1,279,985 related

  • Robert Quinn MD

    VICE-CHAIR, PRESIDENT/CEO

    Total calculated
    $1,112,771
    From this org
    $0
    From related orgs
    $1,011,624
    Other
    $101,147
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $546,030 related
    Bonus
    $0 + $453,873 related
    Other
    $0 + $11,721 related
    Deferred
    $0 + $69,514 related
    Nontaxable benefits
    $0 + $31,633 related
    Filer's total
    $0 + $1,112,771 related

  • Jane A Weldon

    FORMER KEY EMPOYEE (VP OPERATIONS, SO CAL)

    Total calculated
    $823,700
    From this org
    $0
    From related orgs
    $713,733
    Other
    $109,967
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $377,539 related
    Bonus
    $0 + $316,207 related
    Other
    $0 + $19,987 related
    Deferred
    $0 + $69,145 related
    Nontaxable benefits
    $0 + $40,822 related
    Filer's total
    $0 + $823,700 related

  • Nicholas Testa MD

    BOARD MEMBER (STARTED 7/1/22)

    Total calculated
    $797,932
    From this org
    $0
    From related orgs
    $749,076
    Other
    $48,856
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $636,479 related
    Bonus
    $0 + $111,562 related
    Other
    $0 + $1,035 related
    Deferred
    $0 + $27,282 related
    Nontaxable benefits
    $0 + $21,574 related
    Filer's total
    $0 + $797,932 related

  • Lawrence Blumenthal

    BOARD MEMBER (STARTED 7/1/22)

    Total calculated
    $733,702
    From this org
    $0
    From related orgs
    $649,890
    Other
    $83,812
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $520,756 related
    Bonus
    $0 + $125,001 related
    Other
    $0 + $4,133 related
    Deferred
    $0 + $43,539 related
    Nontaxable benefits
    $0 + $40,272 related
    Filer's total
    $0 + $733,701 related

  • Anita Chandrasena MD

    BOARD MEMBER (STARTED 7/1/22)

    Total calculated
    $714,336
    From this org
    $0
    From related orgs
    $682,254
    Other
    $32,082
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $579,552 related
    Bonus
    $0 + $100,168 related
    Other
    $0 + $2,534 related
    Deferred
    $0 + $25,115 related
    Nontaxable benefits
    $0 + $6,967 related
    Filer's total
    $0 + $714,336 related

  • Scott Robertson MD

    SECRETARY

    Total calculated
    $629,950
    From this org
    $0
    From related orgs
    $571,479
    Other
    $58,471
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $486,822 related
    Bonus
    $0 + $81,812 related
    Other
    $0 + $2,845 related
    Deferred
    $0 + $29,648 related
    Nontaxable benefits
    $0 + $28,823 related
    Filer's total
    $0 + $629,950 related

  • Juan P Bravo

    BOARD MEMBER (THRU 5/5/23)

    Total calculated
    $442,909
    From this org
    $0
    From related orgs
    $371,497
    Other
    $71,412
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $292,374 related
    Bonus
    $0 + $68,857 related
    Other
    $0 + $10,266 related
    Deferred
    $0 + $54,626 related
    Nontaxable benefits
    $0 + $16,785 related
    Filer's total
    $0 + $442,908 related

  • Addie Hernandez

    VP POPULATION HEALTH MANAGEMENT (THRU 4/6/23)

    Total calculated
    $440,338
    From this org
    $386,635
    From related orgs
    $0
    Other
    $53,703
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $317,874
    Bonus
    $64,167
    Other
    $4,594
    Deferred
    $33,098
    Nontaxable benefits
    $20,605
    Filer's total
    $440,338

  • Theresa M Hylen

    CFO

    Total calculated
    $398,310
    From this org
    $369,760
    From related orgs
    $0
    Other
    $28,550
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $323,022
    Bonus
    $43,519
    Other
    $3,219
    Deferred
    $25,874
    Nontaxable benefits
    $2,676
    Filer's total
    $398,310

  • Sivasubramanian R Manoharan

    CHIEF RADIATION PHYSICIST

    Total calculated
    $392,096
    From this org
    $327,535
    From related orgs
    $0
    Other
    $64,561
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $303,585
    Bonus
    $9,064
    Other
    $14,886
    Deferred
    $33,045
    Nontaxable benefits
    $31,516
    Filer's total
    $392,096

  • Tristan Kouk

    VP OPERATIONS, BAY AREA

    Total calculated
    $383,306
    From this org
    $321,820
    From related orgs
    $0
    Other
    $61,486
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $287,573
    Bonus
    $33,046
    Other
    $1,201
    Deferred
    $22,503
    Nontaxable benefits
    $38,983
    Filer's total
    $383,306

  • Robert Marchuk

    VP OPERATIONS, GREATER SACRAMENTO

    Total calculated
    $379,631
    From this org
    $323,987
    From related orgs
    $0
    Other
    $55,644
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $288,319
    Bonus
    $32,522
    Other
    $3,146
    Deferred
    $22,400
    Nontaxable benefits
    $33,244
    Filer's total
    $379,631

  • Melanie A Radko

    VP CLINICAL SUPPORT AND PATIENT SAFETY

    Total calculated
    $334,448
    From this org
    $282,123
    From related orgs
    $0
    Other
    $52,325
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $254,381
    Bonus
    $22,105
    Other
    $5,637
    Deferred
    $31,331
    Nontaxable benefits
    $20,994
    Filer's total
    $334,448

  • Edwin Perez

    FIELD SERVICE SPECIALIST III

    Total calculated
    $289,846
    From this org
    $247,487
    From related orgs
    $0
    Other
    $42,359
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $242,727
    Bonus
    $4,047
    Other
    $713
    Deferred
    $23,297
    Nontaxable benefits
    $19,062
    Filer's total
    $289,846

  • Ay Choy Saechao

    VP HUMAN RESOURCES

    Total calculated
    $282,079
    From this org
    $227,464
    From related orgs
    $0
    Other
    $54,615
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $197,487
    Bonus
    $28,666
    Other
    $1,311
    Deferred
    $21,565
    Nontaxable benefits
    $33,050
    Filer's total
    $282,079

  • Cynthia L Garrett

    DIRECTOR AMBULATORY CARE SERVICES

    Total calculated
    $276,247
    From this org
    $228,546
    From related orgs
    $0
    Other
    $47,701
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $206,440
    Bonus
    $17,673
    Other
    $4,433
    Deferred
    $24,135
    Nontaxable benefits
    $23,566
    Filer's total
    $276,247

  • Michael D Crandell

    EXECUTIVE DIRECTOR, CLINIC OPERATIONS (THRU 7/14/2

    Total calculated
    $262,242
    From this org
    $236,077
    From related orgs
    $0
    Other
    $26,165
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $106,503
    Bonus
    $0
    Other
    $129,574
    Deferred
    $22,205
    Nontaxable benefits
    $3,960
    Filer's total
    $262,242

  • Lisa A Perko

    SYS DIRECTOR POP HEALTH MGMT RISK

    Total calculated
    $260,530
    From this org
    $227,589
    From related orgs
    $0
    Other
    $32,941
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $202,222
    Bonus
    $24,109
    Other
    $1,258
    Deferred
    $21,487
    Nontaxable benefits
    $11,454
    Filer's total
    $260,530

  • Deette Montgomery

    COO

    Total calculated
    $216,332
    From this org
    $211,538
    From related orgs
    $0
    Other
    $4,794
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $174,796
    Bonus
    $35,000
    Other
    $1,742
    Deferred
    $0
    Nontaxable benefits
    $4,794
    Filer's total
    $216,332

  • Jaime Mathews

    VP PATIENT ACCESS

    Total calculated
    $216,008
    From this org
    $196,617
    From related orgs
    $0
    Other
    $19,391
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $195,644
    Bonus
    $0
    Other
    $973
    Deferred
    $0
    Nontaxable benefits
    $19,391
    Filer's total
    $216,008

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

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
DIGNITY HEALTH MEDICAL FOUNDATION RELIED ON A RELATED ORGANIZATION, COMMONSPIRIT, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S CEO'S COMPENSATION: (1) HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE COMMONSPIRIT BOARD OF STEWARDSHIP TRUSTEES; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; AND (4) APPROVAL BY THE BOARD OR HUMAN RESOURCES AND COMPENSATION COMMITTEE. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A FOR ADDITIONAL INFORMATION.
PART I, LINES 4A-B
CERTAIN LISTED PERSONS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 TO 24 MONTHS 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 LISTED PERSONS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 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. THE FOLLOWING REPORTABLE INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING THE 2022 CALENDAR YEAR, AND THIS SEVERANCE PAYMENT WAS INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): M. CRANDELL, $81,672. SCHEDULE J, PART I, LINE 4B CERTAIN LISTED PERSONS 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 MADE UNDER THE PLAN DURING 2022 INCLUDE M. O'QUINN, $609,901 AND R. WIEBE, MD, $342,050. COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS OTHER REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)).
SCHEDULE J, PART III SUPPLEMENTAL DISCLOSURES
THE ORGANIZATION FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSPHY IS DESIGNED TO ASSIST THE ORGANIZATION IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE 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 IT 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 THE ORGANIZATION'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 2022.

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.

  • AMERICAN MERCY HOME CARE LLC

    N/A · HOME HEALTH · OH

  • ARIZONA CARE NETWORK - NEXT LLC

    N/A · CARE NETWORK · AZ

  • ARIZONA CARE NETWORK LLC (ACN LLC)

    N/A · CARE NETWORK · AZ

  • ARIZONA DIAGNOSTIC RADIOLOGY GROUP LLC

    N/A · DIAGNOSTIC SERVICES · CA

  • AUDUBON LAND COMPANY LLC

    N/A · REAL ESTATE · CO

  • BAYLOR CHI ST LUKES HEALTH SERVICES LLC

    N/A · HEALTHCARE SRVC · TX

  • BERGAN MERCY SURGERY CENTER LLC

    N/A · AMBUL SURG CTR · NE

  • BERYWOOD OFFICE PROPERTIES LLC

    N/A · PHYS OFFICE · TN

  • BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD

    N/A · HEALTH SERVICES · CH

  • BLUEGRASS REGIONAL IMAGING CENTER

    N/A · DIAGNOSTIC IMAGING · KY

  • CBCC OUTSMARTING CANCER LLC

    N/A · RADIATION / ONCOLOGY · CA

  • CENTRAL NEBRASKA REHABILITATION SVCS LLC

    N/A · PHYSICAL THERAPY · NE

  • CENTURA SUMMIT ORTHOPEDICS LLC

    N/A · HEALTHCARE SRVC · CO

  • CHICAMSURG SURGERY CENTERS LLC

    N/A · SURGERY CENTER · CO

  • COLORADO SPRINGS CK LEASING LLC

    N/A · REAL ESTATE · CO

  • COMMUNITY MERCY HOME CARE OF SPRINGFLD LLC

    N/A · HOME HEALTH · OH

  • DE JV LLC

    N/A · EMERGENCY CARE · NV

  • DHHP SURGERY CENTERS LLC

    N/A · SURGERY · DE

  • DHRT HOLDINGS LLC

    N/A · HOLDING COMPANY · DE

  • DIGNITY-GOHEALTH URGENT CARE MANAGEMENT LLC

    N/A · MANAGEMENT SERVICES · DE

  • DIGNITY HEALTH AT HOME LLC

    N/A · HEALTHCARE SRVC · DE

  • DIGNITY HEALTH SPECIALTY PHARMACY LLC

    N/A · SPECIALTY PHARMACY SERVICES · DE

  • DIGNITY HOME RECOVERY CARE LLC

    N/A · HOME RECOVERY PROGRAM · DE

  • DIGNITYUSP LAS VEGAS SURGERY CENTERS LLC

    N/A · SURGERY · TX

  • DIGNITYUSP NORCAL SURGERY CENTERS LLC

    RELATED · SURGERY · TX · 50.1% owned · share of income $5,526,022 · share of assets $45,011,677

    Directly controlled by DIGNITY HEALTH MEDICAL FOUNDATION

  • DIGNITYUSP PHOENIX SURGERY CENTERS LLC

    N/A · SURGERY · TX

  • DIGNITYUSPJOHN MUIR EAST BAY SURG CTRS LLC

    RELATED · SURGERY · TX · 50.1% owned · share of income $1,417,122 · share of assets $6,559,792

    Directly controlled by DIGNITY HEALTH MEDICAL FOUNDATION

  • DIGNITY-ABRAZO HEALTH NETWORK LLC

    N/A · MANAGEMENT SERVICES · AZ

  • DOMINICAN MAGNETIC RESONANCE IMAGING CENTER

    N/A · IMAGING CENTER · CA

  • ECCS ACQUISITION COMPANY LLC

    N/A · AMBUL SURG CTR · CO

  • ENDOSCOPY CENTER OF ARKANSAS

    N/A · DIAGNOSTIC SERVICES · AR

  • FOLSOM SIERRA ENDOSCOPY CENTER LP

    N/A · ENDOSCOPY · CA

  • FRANCISCAN MEDICAL PAVILION BONNEY LAKE LLC

    N/A · REAL ESTATE · WA

  • FRANCISCAN SPECIALTY CARE LLC

    N/A · HEALTHCARE SRVC · WA

  • GOOD SAMARITAN HOME CARE SVCS OF VINCENNE LLC

    N/A · HOME HEALTH · OH

  • HC SL VINTAGE I LLC

    N/A · PROPERTY HOLDING · WI

  • HEALTH AT HOME HOLDCO LLC

    N/A · HOME HEALTH · CO

  • HEALTHCARE SUPPORT SERVICES LLC

    N/A · LAUNDRY · NE

  • HEARTLAND ONCOLOGY LLC

    N/A · ONCOLOGY · KS

  • LAKESIDE AMBULATORY SURGICAL CENTER LLC

    N/A · AMBUL SURG CTR · NE

  • LAKESIDE ENDOSCOPY CENTER LLC

    N/A · ENDOSCOPY SRVC · NE

  • LEXINGTON MBO PARTNERS LTD

    N/A · REAL ESTATE · CO

  • LINCOLN CK LEASING LLC

    N/A · REAL ESTATE · NE

  • MEMORIAL MEDICAL PLAZA

    N/A · REAL ESTATE · CA

  • MERCY DAVIS CANCER CENTER MANAGEMENT CO LLC

    N/A · MANAGEMENT OF CANCER CENTER · CA

  • MERCY REHABILITATION HOSPITAL LLC

    N/A · HEALTHCARE SRVC · TX

  • MILITARY ROAD PROPERTIES LLC

    N/A · REAL ESTATE · WA

  • MOUNTAIN MEDICAL IMAGING LLC

    N/A · MEDICAL IMAGING · TX

  • NEBRASKA SPINE HOSPITAL LLC

    N/A · SPINE HOSPITAL · NE

  • NICU OPERATING CO OF SANTA CRUZ LLC

    N/A · NEONATAL HEALTHCARE · CA

  • NORTH RIVER SURGERY CENTER LLC

    N/A · AMBUL SURG CTR · AR

  • NORTHERN PLAINS LABORATORY LLC

    N/A · DIAGNOSTIC SERVICES · ND

  • NSC CHANNEL ISLANDS LLC

    N/A · AMBULATORY SURGICAL CENTER · CA

  • ORTHOCOLORADO LLC

    N/A · ORTHO HOSPITAL · CO

  • PARK RAPIDS AREA HEALTH CARE

    N/A · HEALTHCARE SRVC · MN

  • PENINSULA RADIATION ONCOLOGY CENTER LLC

    N/A · HEALTHCARE SRVC · WA

  • PENRAD IMAGING LLC

    N/A · MEDICAL IMAGING · CO

  • PERFORMANCE MED EQUIP & RESPIR SVSC LLC

    N/A · HOLDING COMPANY · WA

  • PLAZA SURGERY CENTER LP

    N/A · SURGERY · CA

  • PMC HOSPITAL LLC

    N/A · HOSPITAL · TX

  • PRECISION MEDICINE ALLIANCE LLC

    N/A · DIAGNOSTIC SERVICES · CO

  • RADIATION ONCOLOGY CENTERS OF VENTURA COUNTY

    N/A · IMAGING · CA

  • RBR MANAGEMENT LLC

    N/A · AMBULANCE · NV

  • REID-ANC HOME CARE SERVICES LLC

    N/A · HOME HEALTH · IN

  • SAINT JOSEPH - SCA HOLDINGS LLC

    N/A · INACTIVE · DE

  • SAINT JOSEPH HEALTH ASC LLC

    N/A · SURGERY · KY

  • SAINT JOSEPH-ANC HOME CARE SERVICES

    N/A · HOME HEALTH · KY

  • SANTA CRUZ COMPREHENSIVE IMAGING LLC

    N/A · IMAGING · CA

  • SANTA CRUZ LAND & BUILDING LP

    N/A · REAL ESTATE · CA

  • SANTA CRUZ SURGERY CENTER LLC

    N/A · SURGERY · CA

  • SEVEN OAKS SURGERY CENTER LLC

    N/A · SURGERY · CA

  • SOUTHEASTERN HOME CARE LLC

    N/A · HOME HEALTH · OH

  • ST JOSEPH'S SURGERY CENTER LP

    N/A · SURGERY · TX

  • ST ELIZABETH HOME CARE SERVICES LLC

    N/A · HOME HEALTH · KY

  • ST FRANCIS LAND COMPANY

    N/A · REAL ESTATE · CO

  • ST LUKE'S DIAGNOSTIC CATH LAB LLP

    N/A · DIAGNOSTIC SERVICES · TX

  • ST LUKE'S LAKESIDE HOSPITAL LLC

    N/A · HOSPITAL · TX

  • ST LUKE'S THE WOODLANDS SLEEP CENTER LLC

    N/A · DIAGNOSTIC SERVICES · TX

  • TEMPLETON SURGERY CENTER LLC

    N/A · SURGERY · CA

  • THE MEDICAL PAVILION AT ST JOHN'S

    N/A · REAL ESTATE · CA

  • THE VASCULAR CENTER OF COLORADO LLC

    N/A · MEDICAL SERVCS · CO

  • THREE SPRING IMAGING LLC

    N/A · HEALTHCARE SRVC · CO

  • TIA ARIZONA LLC

    N/A · CLINIC · AZ

  • TOPTOLIFE LLC

    N/A · RETAIL · CO

  • VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC

    N/A · SURGERY · CA

  • WEST LAKES SURGERY CENTER LLC

    N/A · HEALTHCARE SRVC · IA

Related corporations and trusts

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

  • ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SVCS INC

    C · MANAGED CARE · NE

  • ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY INC

    C · HEALTHCARE · TX

  • ALTERNATIVE INSURANCE MANAGEMENT SERVICE INC

    C · MANAGEMENT SERVICES · CO

  • AMERICAN NURSING CARE INC

    C · HOME HEALTH · OH

  • AMERIMED INC

    C · HOME HEALTH · OH

  • BC HOLDING COMPANY INC

    C · INACTIVE · KY

  • BRAZOSPORT HEALTH ALLIANCE

    C · HEALTHCARE · TX

  • CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH

    C · LAB SERVICES · CO

  • CHI ST LUKE'S HEALTH - MEMORIAL CONDOMINIUM ASSOCIATION INC

    C · CONDO ASSOC · TX

  • COASTAL SURGICAL SPECIALISTS INC

    S · AMBULATORY SURGERY CENTER · CA

  • CONSOLIDATED HEALTH SERVICES

    C · HOME HEALTH · OH

  • DES MOINES MEDICAL CENTER INC

    C · REAL ESTATE · IA

  • DIGNITY HEALTH HOLDING CORPORATION

    C · HOLDING CO · NV

  • DIGNITY HEALTH INSURANCE LTD

    C · CAPTIVE INSURANCE · CJ

  • DIGNITY HEALTH PROVIDER RESOURCES INC

    C · HEALTH PLAN · CA

  • DIVERSIFIED HEALTH RESOURCES INC

    C · HEALTHCARE · TX

  • FRANCISCAN SERVICES INC

    C · HOLDING CO · CO

  • GALLERIA PAVILION OWNERS'ASSOCIATION

    C · REAL ESTATE · NV

  • GOOD SAMARITAN OUTREACH SERVICES

    C · MEDICAL CLINIC · NE

  • HARVESTPLAINS HEALTH OF IOWA

    C · INSURANCE · WA

  • HEALTH AT HOME BLOCKER LLC

    C · HOME HEALTH · CO

  • HEALTH SERVICES OF THE PACIFIC CENTRAL COAST INC

    C · HEALTH SERVICES · CA

  • HEALTH SYSTEMS ENTERPRISES INC

    C · MGMT · NE

  • HEALTHCARE MGMT SERVICES ORGANIZATION INC

    C · INACTIVE · WA

  • HEARTLANDPLAINS HEALTH

    C · INSURANCE · NE

  • HIGHLINE MEDICAL GROUP

    C · MEDICAL SERVICES · WA

  • INTEGRATED MEDICAL SERVICES

    C · MULTI-SPECIALTY PHYSICIANS GROUP · AZ

  • MEDICAL OFFICE BUILDING HORIZONTAL PROPERTY REGIME INC

    C · REAL ESTATE · AR

  • MEDQUEST

    C · SALE OF DME · ND

  • MEMORIAL CV SERVICE LINE MANAGEMENT COMPANY LLC

    C · INACTIVE · TX

  • MERCY SERVICES CORP

    C · RETAIL SALES · OR

  • MHI CLINICAL SERVICES

    C · HEALTHCARE · TX

  • MILLENNIUM SURGERY CENTER INC

    S · OUTPATIENT SURGERY SERVICES · CA

  • MOUNTAIN MANAGEMENT SERVICES INC

    C · MGMT SVC ORG · TN

  • NORTH CENTRAL HEALTH CARE ALLIANCE

    C · HEALTHCARE · ND

  • QUALCHOICE HEALTH PLAN SERVICES INC

    C · ADMIN SERVICES · CO

  • QUALCHOICE HEALTH INC

    C · HOLDING CO · CO

  • QUALCHOICE HOLDINGS INC

    C · HOLDING CO · AR

  • RIVERLINK HEALTH

    C · INSURANCE · OH

  • ROSS PARK PHARMACY INC

    C · PHARMACY · OH

  • SAINT CLARE'S PRIMARY CARE INC

    C · INACTIVE · NJ

  • SJH SERVICES CORPORATION

    C · INACTIVE · CO

  • SJL PHYSICIAN MANAGEMENT SERVICES INC

    C · INACTIVE · KY

  • SOUNDPATH HEALTH INC

    C · INSURANCE · WA

  • ST MARY HEALTH VENTURES INC

    C · RETAIL PHARMACY · CA

  • ST ANTHONY DEVELOPMENT COMPANY

    C · ATHLETIC CLUB · OR

  • ST JOSEPH DEVELOPMENT COMPANY INC

    C · RENTAL · WA

  • ST LUKE'S HEALTH SYSTEM HOLDINGS INC

    C · HOLDING CO · TX

  • ST VINCENT COMMUNITY HEALTH SERVICES INC

    C · HEALTHCARE · AR

  • STE HOLDINGS

    C · HOLDING CO · NE

  • TOWSON MANAGEMENT INC

    C · INACTIVE · MD

  • TRINITY MANAGEMENT SERVICES ORGANIZATION

    C · MGMT SERVICES · OH

  • UNITED MEDICAL BUILDING CONDOMINIUM ASSOCIATION

    C · REAL ESTATE · CO

Provenance

Return type
form_990
Tax year
2022
Filed
2 May 2024
IRS schema version
2022v5.0
Source object
202401239349300400

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