Skip to content
Nonprofiteer
← FLORIDA HOSPITAL MEDICAL GROUP INC

Form 990 for tax year 2022

Filed by FLORIDA HOSPITAL MEDICAL GROUP INC.

Totals

Total revenue
$871,635,550
Total expenses
$864,647,972
Contributions and grants received
$3,178,776
Grants paid
$25,000
Program services expenses (Part IX)
$785,255,104
Management and general expenses
$79,392,868
Fundraising expenses
$0
Program service expenses (Part III)
$785,255,104

Program services were 90.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • PATEL MD VIPUL

    PHYSICIAN

    Total calculated
    $4,980,801
    From this org
    $4,435,690
    From related orgs
    $0
    Other
    $545,111
    Hours/week
    50 + 24 related

    Schedule J breakdown matched by us

    Base
    $2,357,141
    Bonus
    $1,565,081
    Other
    $513,468
    Deferred
    $516,400
    Nontaxable benefits
    $28,711
    Filer's total
    $4,980,801

  • HAFFNER PHD RANDALL

    DIRECTOR/CHAIRMAN

    Total calculated
    $2,610,276
    From this org
    $0
    From related orgs
    $2,420,244
    Other
    $190,032
    Hours/week
    0.5 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,552,405 related
    Bonus
    $0 + $562,179 related
    Other
    $0 + $305,660 related
    Deferred
    $0 + $145,900 related
    Nontaxable benefits
    $0 + $44,132 related
    Filer's total
    $0 + $2,610,276 related

  • BHATHEJA MD ROHIT

    PHYSICIAN

    Total calculated
    $2,377,403
    From this org
    $2,329,843
    From related orgs
    $0
    Other
    $47,560
    Hours/week
    50 + 18 related

    Schedule J breakdown matched by us

    Base
    $1,047,136
    Bonus
    $1,240,290
    Other
    $42,417
    Deferred
    $16,400
    Nontaxable benefits
    $31,160
    Filer's total
    $2,377,403

  • GOODMAN TODD

    DIRECTOR

    Total calculated
    $2,027,198
    From this org
    $0
    From related orgs
    $1,822,857
    Other
    $204,341
    Hours/week
    0.5 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $860,712 related
    Bonus
    $0 + $218,316 related
    Other
    $0 + $743,829 related
    Deferred
    $0 + $145,900 related
    Nontaxable benefits
    $0 + $58,441 related
    Filer's total
    $0 + $2,027,198 related

  • BARSOUM MD BASIEM

    PHYSICIAN

    Total calculated
    $1,924,448
    From this org
    $1,874,772
    From related orgs
    $0
    Other
    $49,676
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $1,141,996
    Bonus
    $723,454
    Other
    $9,322
    Deferred
    $16,400
    Nontaxable benefits
    $33,276
    Filer's total
    $1,924,448

  • KUMAR MD MONIQUE

    PHYSICIAN

    Total calculated
    $1,810,962
    From this org
    $1,761,269
    From related orgs
    $0
    Other
    $49,693
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $485,241
    Bonus
    $1,262,647
    Other
    $13,381
    Deferred
    $16,400
    Nontaxable benefits
    $33,293
    Filer's total
    $1,810,962

  • HOLLOWAY MD ROBERT

    PHYSICIAN

    Total calculated
    $1,796,257
    From this org
    $1,758,408
    From related orgs
    $0
    Other
    $37,849
    Hours/week
    50 + 4 related

    Schedule J breakdown matched by us

    Base
    $1,205,720
    Bonus
    $533,219
    Other
    $19,469
    Deferred
    $16,400
    Nontaxable benefits
    $21,449
    Filer's total
    $1,796,257

  • THOMPSON MICHAEL

    DIRECTOR

    Total calculated
    $1,370,772
    From this org
    $0
    From related orgs
    $1,223,927
    Other
    $146,845
    Hours/week
    16 + 34 related

    Schedule J breakdown matched by us

    Base
    $0 + $638,734 related
    Bonus
    $0 + $197,706 related
    Other
    $0 + $387,487 related
    Deferred
    $0 + $96,504 related
    Nontaxable benefits
    $0 + $50,341 related
    Filer's total
    $0 + $1,370,772 related

  • PATEL MD RAKESH

    FORMER CMSO

    Total calculated
    $1,039,471
    From this org
    $993,648
    From related orgs
    $0
    Other
    $45,823
    Hours/week
    44.2 + 5.8 related

    Schedule J breakdown matched by us

    Base
    $580,706
    Bonus
    $382,366
    Other
    $30,576
    Deferred
    $16,400
    Nontaxable benefits
    $29,423
    Filer's total
    $1,039,471

  • CACCIATORE MD MICHAEL

    CMO (END 08/22)

    Total calculated
    $1,024,104
    From this org
    $0
    From related orgs
    $896,134
    Other
    $127,970
    Hours/week
    31.3 + 18.7 related

    Schedule J breakdown matched by us

    Base
    $0 + $581,889 related
    Bonus
    $0 + $115,928 related
    Other
    $0 + $198,317 related
    Deferred
    $0 + $96,556 related
    Nontaxable benefits
    $0 + $31,414 related
    Filer's total
    $0 + $1,024,104 related

  • MCKINNEY JILLYAN

    CEO

    Total calculated
    $675,177
    From this org
    $0
    From related orgs
    $546,602
    Other
    $128,575
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $506,702 related
    Bonus
    $0 + $26,440 related
    Other
    $0 + $13,460 related
    Deferred
    $0 + $86,050 related
    Nontaxable benefits
    $0 + $42,525 related
    Filer's total
    $0 + $675,177 related

  • WYLIE II WARREN

    COO

    Total calculated
    $574,678
    From this org
    $0
    From related orgs
    $484,223
    Other
    $90,455
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $356,651 related
    Bonus
    $0 + $65,176 related
    Other
    $0 + $62,396 related
    Deferred
    $0 + $50,931 related
    Nontaxable benefits
    $0 + $39,524 related
    Filer's total
    $0 + $574,678 related

  • MAZERES MICHAEL

    FORMER CFO

    Total calculated
    $491,987
    From this org
    $0
    From related orgs
    $417,799
    Other
    $74,188
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $294,134 related
    Bonus
    $0 + $55,502 related
    Other
    $0 + $68,163 related
    Deferred
    $0 + $61,058 related
    Nontaxable benefits
    $0 + $13,130 related
    Filer's total
    $0 + $491,987 related

  • HATCHER NICHOLE

    CFO

    Total calculated
    $410,366
    From this org
    $0
    From related orgs
    $368,255
    Other
    $42,111
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $305,192 related
    Bonus
    $0 + $55,781 related
    Other
    $0 + $7,282 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $25,711 related
    Filer's total
    $0 + $410,366 related

  • DESHAIES MD ERIC

    CHIEF PHYSICIAN EXEC (BEG 08/22)

    Total calculated
    $352,151
    From this org
    $0
    From related orgs
    $306,166
    Other
    $45,985
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $172,808 related
    Bonus
    $0
    Other
    $0 + $133,358 related
    Deferred
    $0 + $27,667 related
    Nontaxable benefits
    $0 + $18,318 related
    Filer's total
    $0 + $352,151 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

  • 1a · Travel for companions
  • 1a · Tax indemnification and gross-up payments
  • 1a · Discretionary spending account
  • 1a · Housing allowance or residence for personal use
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 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 1A
THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FILING ORGANIZATION REIMBURSES AHSSHC FOR THE SALARY AND BENEFIT COST OF THOSE EXECUTIVES LISTED IN PART VII THAT ARE ON THE PAYROLL OF AHSSHC. AT THE DIRECTION OF AHSSHC, AND IN ACCORDANCE WITH THE RESERVED POWERS IN THE FILING ORGANIZATION'S GOVERNING DOCUMENTS, THE EXECUTIVE TEAM LISTED ON PART VII PROVIDES SERVICES TO THE FILING ORGANIZATION. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING AHSSHC EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON CERTAIN BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO CERTAIN EXECUTIVE LEADERS AND IS USUALLY LIMITED TO ONE BUSINESS TRIP PER YEAR BEYOND THE ANNUAL ADVENTHEALTH PRESIDENT'S COUNCIL BUSINESS MEETING AND OTHER MEETINGS WHERE THE SPOUSE IS SPECIFICALLY INVITED. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ADVENTHEALTH HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL BY THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: OCCASIONAL DISCRETIONARY SPENDING AMOUNTS ARE PERIODICALLY PROVIDED TO ELIGIBLE EXECUTIVES WHO ATTEND ANNUAL BUSINESS MEETINGS SUCH AS THE ADVENTHEALTH PRESIDENT'S COUNCIL, CFO CONFERENCE OR THE CMO/CNO BUSINESS MEETING. PAYMENTS PROVIDED TO EACH EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES ASSISTANCE TO EXECUTIVES WHO HAVE BEEN RELOCATED BY THE COMPANY DURING THE YEAR. RELOCATION ASSISTANCE PROVIDED TO EXECUTIVES MAY INCLUDE RELOCATION ALLOWANCES TO ASSIST WITH DUPLICATE HOUSING EXPENSES. RELOCATION ASSISTANCE IS ADMINISTERED PER AHSSHC POLICY BY AN EXTERNAL RELOCATION COMPANY. ALL TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES IN CONNECTION WITH RELOCATION ASSISTANCE ARE TREATED AS WAGES TO THE EXECUTIVE AND ARE SUBJECT TO ALL PAYROLL WITHHOLDING AND REPORTING REQUIREMENTS.
PART I, LINE 3
THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS APPOINTED AND COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC HAS TAKEN STEPS TO ENSURE THAT PROCESSES ARE IN PLACE TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS STANDARD AS SET FORTH IN TREASURY REGULATION SECTION 53.4958-6 WITH RESPECT TO ITS ACTIVE EXECUTIVE-LEVEL POSITIONS. THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE) SERVES AS THE GOVERNING BODY FOR ALL EXECUTIVE COMPENSATION MATTERS. THE COMMITTEE IS COMPOSED OF CERTAIN MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD) OF AHSSHC. VOTING MEMBERS OF THE COMMITTEE INCLUDE ONLY INDIVIDUALS WHO SERVE ON THE BOARD AS INDEPENDENT REPRESENTATIVES, WHO HOLD NO EMPLOYMENT POSITIONS WITH AHSSHC AND WHO DO NOT HAVE RELATIONSHIPS WITH ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS UNDER THEIR REVIEW THAT IMPACTS THEIR BEST INDEPENDENT JUDGMENT AS FIDUCIARIES OF AHSSHC. THE COMMITTEE'S ROLE IS TO REVIEW AND APPROVE ALL COMPONENTS OF THE EXECUTIVE COMPENSATION PLAN OF AHSSHC. AS AN INDEPENDENT GOVERNING BODY WITH RESPECT TO EXECUTIVE COMPENSATION, IT SHOULD BE NOTED THAT THE COMMITTEE WILL OFTEN CONFER IN EXECUTIVE SESSIONS ON MATTERS OF COMPENSATION POLICY AND POLICY CHANGES. IN SUCH EXECUTIVE SESSIONS, NO MEMBERS OF MANAGEMENT OF AHSSHC ARE PRESENT, OTHER THAN THE CHIEF PEOPLE OFFICER, WHO REMAINS AT THE REQUEST OF THE CHAIRMAN/COMMITTEE TO PROVIDE ASSISTANCE/INFORMATION AS NEEDED. THE COMMITTEE IS ADVISED BY AN INDEPENDENT THIRD-PARTY COMPENSATION ADVISOR. THIS ADVISOR PREPARES ALL THE BENCHMARK STUDIES FOR THE COMMITTEE. COMPENSATION LEVELS ARE BENCHMARKED WITH A NATIONAL PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS OF SIMILAR SIZE AND COMPLEXITY TO ADVENTHEALTH AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF ADVENTHEALTH WILL NOT EXCEED THE 50TH PERCENTILE OF COMPARABLE SALARIES PAID BY SIMILARLY SITUATED ORGANIZATIONS; AND - OTHER EXECUTIVE SALARIES SHALL BE ESTABLISHED USING MARKET MEDIANS. THE COMPENSATION PHILOSOPHY, POLICIES, AND PRACTICES OF AHSSHC ARE CONSISTENT WITH THE ORGANIZATION'S FAITH-BASED MISSION AND CONFORM TO APPLICABLE LAWS, REGULATIONS, AND BUSINESS PRACTICES. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP.
PART I, LINE 4B
AS DISCUSSED IN LINE 1A ABOVE, EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT PLANS TO ELIGIBLE EXECUTIVES. AS THE SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT PLANS WERE UPDATED IN 2020 AND CERTAIN INDIVIDUALS STILL PARTICIPATE AS GRAND-FATHERED PARTICIPANTS IN CERTAIN PLANS, THE NARRATIVE BELOW DISCUSSES ALL PLANS IN WHICH THERE WERE ANY PARTICIPANTS IN 2022. THE SERP III PLAN EFFECTIVELY REPLACES THE PRIOR SERP II PLAN, THE EXECUTIVE FLEX BENEFIT PROGRAM PLAN, AND THE SENIOR EXECUTIVE DEATH BENEFIT PLAN FOR QUALIFIED EXECUTIVES EXCEPT FOR CERTAIN GRANDFATHERED EXECUTIVE EMPLOYEES. SERP III PLAN: THE SERP III PLAN PROVIDES ELIGIBLE EXECUTIVES A PERCENTAGE OF THEIR BASE PAY, WHICH IS CREDITED TO A DEFERRED COMPENSATION ACCOUNT. THE PLAN ALSO PROVIDES FOR COMPENSATION DEFERRAL AND SELECTION OF LIFE INSURANCE COVERAGE AND LONG-TERM CARE INSURANCE. TO BE ELIGIBLE TO PARTICIPATE IN THE SERP III PLAN, EXECUTIVES MUST BE ON THE AHSSHC CORPORATE PAYROLL AND BE EITHER A CEO OF AN ADVENTHEALTH ENTITY, AN AHSSHC VICE PRESIDENT (VP) OR VP OF AN ADVENTHEALTH ENTITY WITH A BASE SALARY OF AT LEAST $305,000 IN 2022 (ADJUSTED ANNUALLY BY THE SAME PERCENTAGE AS IRC SECTION 401(A)(17) LIMIT INCREASES), OR OTHER LEADER SPECIFICALLY APPROVED BY THE ADVENTHEALTH PRESIDENT. ELIGIBLE EXECUTIVES DO NOT INCLUDE GRANDFATHERED EXECUTIVES, MEANING THOSE EXECUTIVES WHO WOULD SATISFY ALL THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN PRIOR TO DEC 31, 2027, HAD THE PLAN NOT BEEN AMENDED AND RESTATED AS OF JAN. 1, 2020. CONTRIBUTION CREDITS WILL BE ESTABLISHED AND MAINTAINED BY CLASS YEAR ACCOUNTS FOR EACH PARTICIPANT USING TIERED CONTRIBUTION CREDIT PERCENTAGES OF ANNUAL BASE COMPENSATION. CONTRIBUTION CREDIT PERCENTAGES RANGE BETWEEN 15% AND 19% OF BASE COMPENSATION. CONTRIBUTION CREDITS WILL BE MADE EACH QUARTER IN 25% INCREMENTS WITH REDUCTIONS IN CONTRIBUTIONS IF THE EXECUTIVE IS ALSO A GRANDFATHERED FLEX PARTICIPANT (SEE BELOW). SERP III PROVIDES FOR A CLASS YEAR VESTING AND PAYMENT SCHEDULE (7 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S DEFERRED COMPENSATION ACCOUNT. UPON ATTAINMENT OF A NORMAL RETIREMENT AGE (AGE 62), OR UPON CERTAIN OTHER CIRCUMSTANCES AS DEFINED IN THE SERP III PLAN DOCUMENT, ALL DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT. FOR ANY EXECUTIVES WORKING BEYOND THE NORMAL RETIREMENT AGE, FUTURE EMPLOYER CONTRIBUTIONS WILL BE MADE QUARTERLY FROM SERP III DIRECTLY TO THE PARTICIPANT AS A TAXABLE CASH BONUS. SERP II PLAN: THE SERP II PLAN IS A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO ADVENTHEALTH AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. UNDER THE PROVISIONS OF THE SERP II PLAN, BENEFITS ARE PROVIDED TO QUALIFYING EXECUTIVE PARTICIPANTS ON A PRO-RATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF ADVENTHEALTH AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. ELIGIBLE EMPLOYEES ARE RESTRICTED TO THOSE EXECUTIVES WHO, AS OF JANUARY 1, 2020, SATISFIED, OR IF EMPLOYMENT CONTINUES, WILL SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II PRIOR TO DECEMBER 31, 2027. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP II) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE, FIVE OR SEVEN HIGHEST YEARS OF BASE SALARY FROM ADVENTHEALTH ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. THE NUMBER OF YEARS INCLUDED IN HIGHEST AVERAGE COMPENSATION IS DETERMINED BY THE INDIVIDUAL'S YEAR OF ENTRY TO SERP II AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM. FLEX PLAN: THE FLEX PLAN WAS ORIGINALLY DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES AN OPPORTUNITY TO SELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING A SPLIT DOLLAR LIFE INSURANCE POLICY AND LONG-TERM CARE INSURANCE, TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. IN 2020, THE FLEX PLAN WAS AMENDED TO EXCLUDE EMPLOYED EXECUTIVES WHO ARE HIRED OR PROMOTED AFTER A CERTAIN DATE FROM BEING ELIGIBLE TO PARTICIPATE IN THE FLEX PLAN EXCEPT FOR CERTAIN INSURANCE COVERAGE FEATURES OF THE PLAN. THE FLEX PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS IS DEDUCTED. THE BENEFITS ALLOWANCE CREDIT PERCENTAGE FOR ANY PLAN YEAR SHALL NOT BE GREATER THAN THE MAXIMUM DOLLAR AMOUNT OR THE PERCENTAGE OF COMPENSATION AS DETERMINED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. FOR GRANDFATHERED ELIGIBLE EMPLOYEES, THE ANNUAL PRE-DETERMINED FLEX ALLOWANCE IS CONTRIBUTED AND ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED ARE, AT THE EMPLOYEE'S OPTION, CONTRIBUTED TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT WILL BE FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. WITH RESPECT TO GRANDFATHERED PARTICIPANTS, THE FLEX PLAN DOCUMENTS DEFINE ELIGIBLE EMPLOYEES TO INCLUDE THE CHIEF EXECUTIVE OFFICERS OF ADVENTHEALTH ENTITIES AND VICE PRESIDENTS OF ALL ADVENTHEALTH ENTITIES WHOSE BASE SALARY WAS AT LEAST EQUAL TO THE INTERNAL REVENUE CODE SECTION 401(A)(17) COMPENSATION LIMIT EACH YEAR. FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. HAFFNER, RANDALL $ 150,000 $ 221,968 $ 0 $ 0 GOODMAN, TODD $ 150,000 $ 157,963 $ 532,684 $ 0 THOMPSON, MICHAEL $ 100,604 $ 58,939 $ 278,689 $ 0 FLEX PLAN FLEX PLAN SERP II SERP III CONTR. DISTR.* CONTR./DISTR. CONTR. CACCIATORE, MICHAEL $ 100,656 $ 69,224 $ 0 $ 0 MCKINNEY, JILLYAN $ 0 $ 0 $ 0 $ 75,750 WYLIE, II, WARREN $ 35,637 $ 21,648 $ 0 $ 19,394 MAZERES, MICHAEL $ 38,128 $ 46,873 $ 0 $ 6,530 DESHAIES, ERIC $ 0 $ 0 $ 0 $ 27,667 * INCLUDING INVESTMENT EARNINGS
PART I, LINE 4B (CONTINUED):
PHYSICIAN PLAN IN RECOGNITION OF THE CONTRIBUTION CERTAIN PHYSICIAN EMPLOYEES MAKE TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH HAS PROVIDED AN ADVENTHEALTH PHYSICIAN RETENTION PLAN (THE PHYSICIAN PLAN). THE PLAN WAS ESTABLISHED FOR THE PURPOSES OF PROVIDING DEFERRED BONUSES TO CERTAIN ELIGIBLE PHYSICIANS OF AHSSHC AND ITS AFFILIATES TO AID IN SUCH PHYSICIANS' ATTRACTION AND RETENTION. THIS PHYSICIAN PLAN WAS ADOPTED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (ADVENTHEALTH OR, TOGETHER WITH ANY OTHER PARTICIPATING EMPLOYER, THE "EMPLOYER") FOR CERTAIN PHYSICIAN EMPLOYEES OF THE EMPLOYER. THE PURPOSE OF THE PLAN IS TO OFFER THOSE ELIGIBLE PHYSICIAN EMPLOYEES AN OPPORTUNITY TO RECEIVE DEFERRED BONUS PAYMENT AMOUNTS FROM THE EMPLOYER TAXABLE PURSUANT TO SECTION 457(F) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED (THE "CODE"). THE PLAN IS INTENDED TO BE A "CHURCH PLAN" WITHIN THE MEANING OF SECTION 414(E) OF THE CODE AND SECTION 3(33) OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED, ("ERISA"), AND AS A RESULT, IS EXEMPT FROM ERISA. IT IS INTENDED THAT BENEFITS PAYABLE UNDER THE PLAN SHALL NOT CONSTITUTE DEFERRED COMPENSATION WITHIN THE MEANING OF SECTION 409A OF THE CODE (TOGETHER WITH THE TREASURY REGULATIONS OR ANY OTHER AUTHORITATIVE GUIDANCE ISSUED THEREUNDER, "SECTION 409A") UNDER THE "SHORT-TERM DEFERRAL" EXCEPTION OUTLINED, AS OF THE EFFECTIVE DATE, IN TREASURY REGULATION 1.409A-1(B)(4)-I.E., BECAUSE ALL BENEFIT PAYMENTS UNDER THE PLAN SHALL BE MADE NO LATER THAN TWO AND ONE-HALF (2 1/2) MONTHS FOLLOWING THE LAST DAY OF THE CALENDAR YEAR IN WHICH THE BENEFIT PAYMENTS ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. NOTWITHSTANDING THE PRECEDING, IF AND TO THE EXTENT FUTURE GUIDANCE INDICATES THAT BENEFITS PAYABLE UNDER THE PLAN DO CONSTITUTE DEFERRED COMPENSATION WITHIN THE MEANING OF SECTION 409A, IT IS INTENDED THAT THE PLAN SATISFIES THE REQUIREMENTS OF SECTION 409A. CY EMPLOYER CY CONTRIBUTION DISTRIBUTIONS* VIPUL PATEL, MD $500,000 $500,845 * INCLUDING INVESTMENT EARNINGS

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
22 January 2024
IRS schema version
2022v5.0
Source object
202400309349300120

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.