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Nonprofiteer
← INDIANA UNIVERSITY HEALTH BLACKFORD HOSPITAL INC

Form 990 for tax year 2022

Filed by INDIANA UNIVERSITY HEALTH BLACKFORD HOSPITAL INC.

Totals

Total revenue
$25,680,950
Total expenses
$28,895,088
Contributions and grants received
$398,802
Grants paid
$16,000
Program services expenses (Part IX)
$27,599,577
Management and general expenses
$1,295,511
Fundraising expenses
$0
Program service expenses (Part III)
$27,599,577

Program services were 95.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DANIEL E BORGENHEIMER

    DIRECTOR/VICE CHAIR (Part Year)

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • DAVID W HYATT

    DIRECTOR / PRESIDENT (PART YEAR)

    Total calculated
    $39,071
    From this org
    $0
    From related orgs
    $29,761
    Other
    $9,310
    Hours/week
    6 + 4 related

  • J STEVEN RHEA

    Director/Secretary/Treasurer

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • JEFFREY C BIRD MD

    DIRECTOR/PRESIDENT (PART-YEAR)/REGIONAL PRESIDENT (ECR)

    Total calculated
    $1,043,278
    From this org
    $0
    From related orgs
    $976,399
    Other
    $66,879
    Hours/week
    10 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $548,667 related
    Bonus
    $0 + $239,923 related
    Other
    $0 + $187,809 related
    Deferred
    $0 + $12,200 related
    Nontaxable benefits
    $0 + $54,679 related
    Filer's total
    $0 + $1,043,278 related

  • JOHN D LITTLER

    DIRECTOR/CHAIR

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • PETER M VOSS MD

    DIRECTOR/VICE CHAIR

    Total calculated
    $518,506
    From this org
    $0
    From related orgs
    $455,476
    Other
    $63,030
    Hours/week
    10 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $390,525 related
    Bonus
    $0 + $40,887 related
    Other
    $0 + $24,064 related
    Deferred
    $0 + $12,200 related
    Nontaxable benefits
    $0 + $50,830 related
    Filer's total
    $0 + $518,506 related

  • WILBUR R DAVIS

    DIRECTOR/VICE CHAIR

    Total calculated
    $4,000
    From this org
    $0
    From related orgs
    $4,000
    Other
    $0
    Hours/week
    2 + 4 related

  • CHANTILLE ALLEN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • CHARLES R ROUTH MD

    DIRECTOR

    Total calculated
    $319,657
    From this org
    $0
    From related orgs
    $253,832
    Other
    $65,825
    Hours/week
    2 + 53 related

    Schedule J breakdown matched by us

    Base
    $0 + $152,342 related
    Bonus
    $0 + $80,990 related
    Other
    $0 + $20,500 related
    Deferred
    $0 + $11,765 related
    Nontaxable benefits
    $0 + $54,060 related
    Filer's total
    $0 + $319,658 related

  • DAVID A LITTLER

    DIRECTOR (PART YEAR)

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • DERRON L BISHOP PHD

    DIRECTOR

    Total calculated
    $7,000
    From this org
    $0
    From related orgs
    $7,000
    Other
    $0
    Hours/week
    2 + 4 related

  • GEOFFREY S MEARNS JD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • JOAN V CASTOR

    DIRECTOR

    Total calculated
    $695,907
    From this org
    $0
    From related orgs
    $557,480
    Other
    $138,427
    Hours/week
    2 + 53 related

    Schedule J breakdown matched by us

    Base
    $0 + $354,591 related
    Bonus
    $0 + $154,908 related
    Other
    $0 + $47,981 related
    Deferred
    $0 + $77,001 related
    Nontaxable benefits
    $0 + $61,426 related
    Filer's total
    $0 + $695,907 related

  • MICHAEL J FISHER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2 + 7 related

  • PATRICK A CLEARY MD

    DIRECTOR

    Total calculated
    $1,000
    From this org
    $0
    From related orgs
    $1,000
    Other
    $0
    Hours/week
    2 + 4 related

  • SAMUEL C KIM MD

    DIRECTOR (PART YEAR)

    Total calculated
    $37,320
    From this org
    $0
    From related orgs
    $37,320
    Other
    $0
    Hours/week
    2 + 4 related

  • TERRY W BAILEY

    DIRECTOR

    Total calculated
    $6,000
    From this org
    $0
    From related orgs
    $6,000
    Other
    $0
    Hours/week
    2 + 4 related

  • WILLIAM W HINKLE

    DIRECTOR

    Total calculated
    $7,000
    From this org
    $0
    From related orgs
    $7,000
    Other
    $0
    Hours/week
    2 + 4 related

  • JONATHAN W VANATOR

    CFO (ECR)

    Total calculated
    $416,822
    From this org
    $0
    From related orgs
    $358,131
    Other
    $58,691
    Hours/week
    10 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $325,908 related
    Bonus
    $0 + $31,413 related
    Other
    $0 + $810 related
    Deferred
    $0 + $12,154 related
    Nontaxable benefits
    $0 + $46,537 related
    Filer's total
    $0 + $416,822 related

  • BRIAN REED

    VP-HUMAN RESOURCES (ECR) (Part Year)

    Total calculated
    $217,487
    From this org
    $0
    From related orgs
    $162,453
    Other
    $55,034
    Hours/week
    10 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $143,813 related
    Bonus
    $0 + $16,788 related
    Other
    $0 + $1,852 related
    Deferred
    $0 + $6,833 related
    Nontaxable benefits
    $0 + $48,200 related
    Filer's total
    $0 + $217,486 related

  • LORI A LUTHER

    COO (ECR)

    Total calculated
    $453,439
    From this org
    $0
    From related orgs
    $386,574
    Other
    $66,865
    Hours/week
    10 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $305,409 related
    Bonus
    $0 + $33,877 related
    Other
    $0 + $47,288 related
    Deferred
    $0 + $11,979 related
    Nontaxable benefits
    $0 + $54,886 related
    Filer's total
    $0 + $453,439 related

  • MEGAN HAYMAKER

    VP-HUMAN RESOURCES (ECR) (Part Year)

    Total calculated
    $184,408
    From this org
    $0
    From related orgs
    $152,393
    Other
    $32,015
    Hours/week
    10 + 35 related

    Schedule J breakdown matched by us

    Base
    $0 + $102,372 related
    Bonus
    $0 + $36,148 related
    Other
    $0 + $13,873 related
    Deferred
    $0 + $10,667 related
    Nontaxable benefits
    $0 + $21,347 related
    Filer's total
    $0 + $184,408 related

  • MELISSA R HICKS

    VP & CNO (ECR) (Part Year)

    Total calculated
    $288,003
    From this org
    $0
    From related orgs
    $258,373
    Other
    $29,630
    Hours/week
    15 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $235,427 related
    Bonus
    $0 + $22,482 related
    Other
    $0 + $464 related
    Deferred
    $0 + $10,484 related
    Nontaxable benefits
    $0 + $19,146 related
    Filer's total
    $0 + $288,003 related

  • RYAN M JOHNSTON MD

    VP & CMO (ECR)

    Total calculated
    $495,681
    From this org
    $0
    From related orgs
    $420,646
    Other
    $75,035
    Hours/week
    10 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $340,681 related
    Bonus
    $0 + $52,579 related
    Other
    $0 + $27,386 related
    Deferred
    $0 + $13,911 related
    Nontaxable benefits
    $0 + $61,124 related
    Filer's total
    $0 + $495,681 related

  • HELEN A BORGENHEIMER MD

    PHYSICIAN

    Total calculated
    $296,039
    From this org
    $231,719
    From related orgs
    $19,200
    Other
    $45,120
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $158,974 + $13,172 related
    Bonus
    $56,940 + $4,718 related
    Other
    $15,805 + $1,310 related
    Deferred
    $9,045 + $749 related
    Nontaxable benefits
    $32,623 + $2,703 related
    Filer's total
    $273,386 + $22,653 related

  • JAN BLAKE MCMILLAN

    VP - CNO - BLACKFORD HOSP

    Total calculated
    $204,662
    From this org
    $158,527
    From related orgs
    $0
    Other
    $46,135
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $144,657
    Bonus
    $12,594
    Other
    $1,275
    Deferred
    $6,565
    Nontaxable benefits
    $39,570
    Filer's total
    $204,662

  • MONICA R GAITHER

    Supervisor-House

    Total calculated
    $250,156
    From this org
    $191,299
    From related orgs
    $20,047
    Other
    $38,810
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $156,401 + $16,388 related
    Bonus
    $34,809 + $3,650 related
    Other
    $88 + $9 related
    Deferred
    $7,779 + $816 related
    Nontaxable benefits
    $27,348 + $2,867 related
    Filer's total
    $226,426 + $23,730 related

  • THOMAS D STEWART MD

    PHYSICIAN

    Total calculated
    $451,933
    From this org
    $401,544
    From related orgs
    $5,400
    Other
    $44,989
    Hours/week
    40 + 10 related

    Schedule J breakdown matched by us

    Base
    $264,766 + $3,620 related
    Bonus
    $133,259 + $1,734 related
    Other
    $3,518 + $46 related
    Deferred
    $9,259 + $120 related
    Nontaxable benefits
    $35,152 + $457 related
    Filer's total
    $445,955 + $5,978 related

  • THOMAS M LEE MD

    PHYSICIAN

    Total calculated
    $443,277
    From this org
    $328,836
    From related orgs
    $73,920
    Other
    $40,521
    Hours/week
    40 + 10 related

    Schedule J breakdown matched by us

    Base
    $152,516 + $35,689 related
    Bonus
    $170,685 + $37,009 related
    Other
    $5,636 + $1,222 related
    Deferred
    $4,002 + $868 related
    Nontaxable benefits
    $29,298 + $6,353 related
    Filer's total
    $362,137 + $81,141 related

  • KEVIN W SCHREIBER MD

    FORMER HIGHEST COMPENSATED EMPLOYEE

    Total calculated
    $456,560
    From this org
    $0
    From related orgs
    $389,885
    Other
    $66,675
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $322,934 related
    Bonus
    $0 + $45,611 related
    Other
    $0 + $21,341 related
    Deferred
    $0 + $12,200 related
    Nontaxable benefits
    $0 + $54,475 related
    Filer's total
    $0 + $456,560 related

  • MICHELLE R ALTOBELLA

    FORMER OFFICER

    Total calculated
    $295,719
    From this org
    $0
    From related orgs
    $253,953
    Other
    $41,766
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $232,959 related
    Bonus
    $0 + $19,817 related
    Other
    $0 + $1,177 related
    Deferred
    $0 + $10,321 related
    Nontaxable benefits
    $0 + $31,445 related
    Filer's total
    $0 + $295,719 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

  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

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
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
IU HEALTH BLACKFORD'S REGIONAL PRESIDENT / PRESIDENT (PART YEAR), JEFFREY C. BIRD, IS EMPLOYED BY IU HEALTH, INC. IU HEALTH BLACKFORD'S PRESIDENT (PART YEAR), DAVID W. HYATT, WAS EMPLOYED BY IU HEALTH BALL MEMORIAL HOSPITAL. IU HEALTH, IU HEALTH BALL AND OTHER RELATED ORGANIZATIONS HAVE A PROCESS IN PLACE FOR DETERMINING THE COMPENSATION FOR THE OFFICERS AND KEY EMPLOYEES. IU HEALTH HUMAN RESOURCES USES MARKET DATA FROM MULTIPLE COMPENSATION EXPERTS/VENDORS WHO UTILIZE A VARIETY OF METHODS AND PROCEDURES TO OBTAIN COMPENSATION RANGES FOR COMPARABLE OFFICERS AND EMPLOYEE POSITONS. THIS MARKET DATA AND MULTIPLE OTHER FACTORS (INCLUDE MARKET PAY BENCHMARKS, INTERNAL EQUITY, CANDIDATE/EMPLOYEE QUALIFICATIONS AND PERFORMANCE, AND OTHER BUSINESS NEEDS) ARE USED TO RECOMMEND COMPENSATION RANGES FOR ITS OFFICERS AND OTHER EMPLOYEES, WHICH ARE THEN USED AS A GUIDE FOR SETTING REASONABLE COMPENSATION BY MANAGEMENT. PLEASE SEE SCHEDULE O FOR ADDITIONAL DETAILS.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
Jeffrey C. Bird, M.D. and Joan V. Castor participate in an IU Health supplemental executive retirement plan. Provisions of which are designed to retain its critical employees. The plan provides for an additional retirement benefit for services through normal retirement or other key dates. If the executive leaves prior to retirement or other key dates, the benefit may be forfeited or reduced. Joan V. Castor has an amount included in column c, deferred compensation, representing the current year unvested contributions made under the supplemental retirement plan. This amount was not paid to this executive during the year. THE FOLLOWING EXECUTIVES HAVE AN AMOUNT INCLUDED IN COLUMN B (III), OTHER REPORTABLE COMPENSATION, REPRESENTING THE CURRENT YEAR VESTED AMOUNTS RECEIVED UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: Joan V. Castor: $44,698 Jeffrey C. Bird: $147,927
Schedule J, Part I, Line 7 Non-fixed payments
AMOUNTS DISCLOSED IN COLUMN B (II) INCLUDE A LONG-TERM AND SHORT-TERM INCENTIVE FOR CERTAIN EXECUTIVES AND SHORT-TERM INCENTIVE FOR OTHER EMPLOYEES ALTHOUGH THESE PLANS ARE BASED ON FIXED FORMULA THAT HAS BEEN APPROVED BY THE BOARD OF DIRECTORS BASED UPON CERTAIN QUALITATIVE AND QUANTITATIVE FACTORS AND GOALS. ALL DISCRETIONARY INCENTIVE PLANS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT.

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
15 November 2023
IRS schema version
2022v5.0
Source object
202333199349303558

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