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Nonprofiteer
← ST MARYS COMMUNITY HOSPITAL

Form 990 for tax year 2023

Filed by ST MARYS COMMUNITY HOSPITAL.

Totals

Total revenue
$41,717,102
Total expenses
$38,307,042
Contributions and grants received
$752,174
Grants paid
$18,272
Program service revenue
$40,470,201
Investment income
$138,488
Other revenue
$356,239
Total assets, end of year
$67,767,575
Total liabilities, end of year
$5,091,106
Net assets or fund balances, end of year
$62,676,469
Program services expenses (Part IX)
$31,650,996
Management and general expenses
$6,656,046
Fundraising expenses
$0
Program service expenses (Part III)
$31,650,996

Program services were 82.6% 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

    $705,274

  • 1e · Government grants (contributions)

    $46,900

  • 2a · Program service revenue: NET PATIENT SERVICES

    total $39,151,003 · related or exempt $39,151,003 · unrelated business $0 · excluded $0

  • 2b · Program service revenue: PHARMACY SERVICES

    total $1,319,198 · related or exempt $1,319,198 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $46,113 · excluded $46,113

  • 6a · Gross rents

    real property $1,741

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $1,741

  • 6d · Net rental income or loss

    total $1,741 · excluded $1,741

  • 7a · Gross sales of assets other than inventory

    securities $92,375

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

    securities $0

  • 7c · Gain or loss

    securities $92,375

  • 7d · Net gain or loss

    total $92,375 · excluded $92,375

  • 10a · Gross sales of inventory

    $8,063

  • 10b · Cost of goods sold

    $14,071

  • 10c · Net income from sales of inventory

    total -$6,008 · excluded -$6,008

  • 11a · Other revenue: INSURANCE RECOVERIES

    total $165,152 · related or exempt $0 · unrelated business $0 · excluded $165,152

  • 11b · Other revenue: MEDICAL SERVICES

    total $83,127 · related or exempt $0 · unrelated business $0 · excluded $83,127

  • 11c · Other revenue: CAFETERIA

    total $77,035 · related or exempt $0 · unrelated business $0 · excluded $77,035

  • 11d · All other revenue

    total $35,192 · excluded $35,192

  • 11e · Other revenue, total

    $360,506

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $17,122 · program services $17,122

  • 2 · Grants to domestic individuals

    total $1,150 · program services $1,150

  • 5 · Compensation of officers, directors and key employees

    total $481,576 · program services $385,261 · management and general $96,315

  • 7 · Other salaries and wages

    total $15,274,746 · program services $12,219,797 · management and general $3,054,949

  • 8 · Pension plan contributions

    total $770,514 · program services $616,411 · management and general $154,103

  • 9 · Other employee benefits

    total $2,244,297 · program services $1,795,438 · management and general $448,859

  • 10 · Payroll taxes

    total $1,025,250 · program services $820,200 · management and general $205,050

  • 11b · Fees: legal

    total $34,008 · program services $27,206 · management and general $6,802

  • 11d · Fees: lobbying

    total $1,845 · management and general $1,845

  • 11g · Fees: other

    total $7,119,762 · program services $6,762,751 · management and general $357,011

  • 12 · Advertising and promotion

    total $29,561 · program services $23,649 · management and general $5,912

  • 13 · Office expenses

    total $819,241 · program services $666,650 · management and general $152,591

  • 14 · Information technology

    total $655,053 · program services $524,042 · management and general $131,011

  • 16 · Occupancy

    total $526,624 · program services $421,299 · management and general $105,325

  • 17 · Travel

    total $44,278 · program services $35,422 · management and general $8,856

  • 19 · Conferences, conventions and meetings

    total $34,257 · program services $27,406 · management and general $6,851

  • 21 · Payments to affiliates

    total $496,826 · program services $496,826

  • 22 · Depreciation, depletion and amortization

    total $1,916,890 · program services $1,916,890

  • 23 · Insurance

    total $178,806 · management and general $178,806

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $3,980,356 · program services $3,980,356 · management and general $0 · fundraising $0

  • 24b · Other expenses: INRACOMPANY ALLOCATIONS

    total $1,704,244 · program services $0 · management and general $1,704,244 · fundraising $0

  • 24c · Other expenses: REPAIRS AND MAINTENANCE

    total $656,207 · program services $623,397 · management and general $32,810 · fundraising $0

  • 24d · Other expenses: DUES & SUBSCRIPTIONS

    total $37,584 · program services $35,705 · management and general $1,879 · fundraising $0

  • 24e · All other expenses

    total $256,845 · program services $254,018 · management and general $2,827

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $551 · end of year $550

  • 2 · Savings and temporary cash investments

    beginning of year $18,073,811 · end of year $22,147,177

  • 3 · Pledges and grants receivable

    end of year $0

  • 4 · Accounts receivable

    beginning of year $2,535,540 · end of year $2,216,276

  • 5 · Loans and receivables from officers and key people

    end of year $0

  • 6 · Loans and receivables from disqualified persons

    end of year $0

  • 7 · Other notes and loans receivable

    end of year $0

  • 8 · Inventories for sale or use

    beginning of year $563,955 · end of year $562,879

  • 9 · Prepaid expenses and deferred charges

    end of year $0

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

    $56,201,970

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

    $23,440,308

  • 10c · Land, buildings and equipment, net

    beginning of year $33,737,164 · end of year $32,761,662

  • 11 · Investments: publicly traded securities

    end of year $0

  • 12 · Investments: other securities

    beginning of year $3,287,002 · end of year $3,630,424

  • 13 · Investments: program-related

    end of year $0

  • 14 · Intangible assets

    end of year $0

  • 15 · Other assets

    beginning of year $1,668,527 · end of year $6,448,607

  • 17 · Accounts payable and accrued expenses

    beginning of year $706,780 · end of year $4,993,303

  • 18 · Grants payable

    end of year $0

  • 19 · Deferred revenue

    beginning of year $24,152 · end of year $24,152

  • 20 · Tax-exempt bond liabilities

    end of year $0

  • 21 · Escrow or custodial account liability

    end of year $0

  • 22 · Loans and payables to officers and key people

    end of year $0

  • 23 · Secured mortgages and notes payable

    end of year $0

  • 24 · Unsecured notes and loans payable

    end of year $0

  • 25 · Other liabilities

    beginning of year $78,982 · end of year $73,651

  • 27 · Net assets without donor restrictions

    beginning of year $59,053,374 · end of year $62,673,207

  • 28 · Net assets with donor restrictions

    beginning of year $3,262 · end of year $3,262

Mission and programs · 2023

Mission

AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL.

Activities or mission (Part I)

ST. MARY'S IS A NOT FOR PROFIT CRITICAL ACCESS HOSPITAL THAT PROVIDES ACUTE CARE FOR THE BENEFIT OF ALL REGARDLESS OF ABILITY TO PAY AND PROMOTES HEALTH THROUGH COMMUNITY OUTREACH INITIATIVES AND PARTNERSHIPS.

  • ST. MARY'S COMMUNITY HOSPITAL SPECIALIZES IN RURAL MEDICAL CARE FOR YOUR ENTIRE FAMILY, INCLUDING OBSTETRIC, PEDIATRIC AND PREVENTATIVE SERVICES. THE PROVIDERS AND STAFF STRIVE TO PROVIDE THE CARE YOU EXPECT AND DESERVE.

    Expenses $6,137,628 · Grants $1,606 · Revenue $3,556,803

  • ST. MARY'S COMMUNITY HOSPITAL PROVIDES SEVERAL SPECIALTY CLINICS IN THE FOLLOWING AREAS: AUDIOLOGY, EAR, NOSE AND THROAT, CARDIOVASCULAR SERVICES, DERMATOLOGY, GASTROENTEROLOGY, GENERAL SURGERY/WOUND CARE, GYNECOLOGY/OBSTETRICS, ONCOLOGY, OPTHALMOLOGY, ORTHOPEDIC SURGERY, PODIATRY, UROLOGY, SPEECH AND OCCUPATIONAL THERAPY AND PSYCHIATRY.

    Expenses $4,339,401 · Grants $2,253 · Revenue $4,989,960

  • ST. MARY'S COMMUNITY HOSPITAL HAS STRIVED TO IMPROVE THE HEALTH STATUS OF CHILDREN, TEENS, ADULTS, SENIOR CITIZENS, FRIENDS AND NEIGHBORS IN THIS RURAL COMMUNITY. ST. MARY'S COMMUNITY HOSPITAL IS PROUD TO OFFER HEALTHCARE SERVICES CLOSE TO HOME WITHIN THE COMMUNITY. ST. MARY'S COMMUNITY HOSPITAL PROVIDES A VARIETY OF DIAGNOSTIC SERVICES TO THE COMMUNITY, SUCH AS CT SCANS, MRI AND NUCLEAR MEDICINE IN ADDITION TO GENERAL RADIOLOGY, MAMMOGRAPHY, SURGICAL RADIOGRAPHY AND ULTRASOUND.

    Expenses $3,817,336 · Grants $7,345 · Revenue $16,268,530

  • Expenses $17,356,631 · Grants $7,068 · Revenue $15,654,908

As filed on the 2023 return.

Listed in Part VII

  • JOHN PETERSDORF

    BOARD MEMBER

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

    Schedule J breakdown matched by us

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

  • EVERT KUIPER

    FORMER PRESIDENT & CEO CHI HEALTH

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

    Schedule J breakdown matched by us

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

  • TIM BRICKER

    EX-OFFICIO BM/ PRESIDENT & CEO CHI HEALTH

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

    Schedule J breakdown matched by us

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

  • JEANETTE WOJTALEWICZ

    FORMER CFO, CHI HEALTH

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

    Schedule J breakdown matched by us

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

  • JEFFREY STEARNES MD

    FORMER HCE/PHYSICIAN

    Total calculated
    $847,217
    From this org
    $0
    From related orgs
    $786,288
    Other
    $60,929
    Hours/week
    0 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $784,356 related
    Bonus
    $0
    Other
    $0 + $1,932 related
    Deferred
    $0 + $21,584 related
    Nontaxable benefits
    $0 + $39,345 related
    Filer's total
    $0 + $847,217 related

  • STACY BLUM MD

    PHYSICIAN-FAMILY MEDICINE

    Total calculated
    $568,637
    From this org
    $396,948
    From related orgs
    $113,182
    Other
    $58,507
    Hours/week
    40 + 5 related

    Schedule J breakdown matched by us

    Base
    $395,688 + $113,182 related
    Bonus
    $0
    Other
    $1,260
    Deferred
    $19,175
    Nontaxable benefits
    $36,998 + $2,334 related
    Filer's total
    $453,121 + $115,516 related

  • BRETT MEYER MD

    PHYSICIAN-FAMILY MEDICINE

    Total calculated
    $523,494
    From this org
    $387,605
    From related orgs
    $115,157
    Other
    $20,732
    Hours/week
    40 + 5 related

    Schedule J breakdown matched by us

    Base
    $386,590 + $115,157 related
    Bonus
    $0
    Other
    $1,015
    Deferred
    $19,000
    Nontaxable benefits
    $1,732
    Filer's total
    $408,337 + $115,157 related

  • BRADLEY VASA MD

    MEDICAL DIRECTOR

    Total calculated
    $516,583
    From this org
    $458,438
    From related orgs
    $0
    Other
    $58,145
    Hours/week
    45

    Schedule J breakdown matched by us

    Base
    $454,826
    Bonus
    $0
    Other
    $3,612
    Deferred
    $19,350
    Nontaxable benefits
    $38,795
    Filer's total
    $516,583

  • DAVID JONES

    MARKET PRESIDENT, REGIONAL HOSPITALS

    Total calculated
    $514,309
    From this org
    $0
    From related orgs
    $460,692
    Other
    $53,617
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $303,052 related
    Bonus
    $0 + $156,175 related
    Other
    $0 + $1,465 related
    Deferred
    $0 + $19,175 related
    Nontaxable benefits
    $0 + $34,442 related
    Filer's total
    $0 + $514,309 related

  • SAMANTHA BOYER MD

    PHYSICIAN-FAMILY MEDICINE

    Total calculated
    $471,622
    From this org
    $343,205
    From related orgs
    $108,510
    Other
    $19,907
    Hours/week
    35 + 10 related

    Schedule J breakdown matched by us

    Base
    $321,487 + $108,510 related
    Bonus
    $14,818
    Other
    $6,900
    Deferred
    $18,175
    Nontaxable benefits
    $1,732
    Filer's total
    $363,112 + $108,510 related

  • DANIEL DEFREECE MD

    PRESIDENT

    Total calculated
    $469,594
    From this org
    $397,399
    From related orgs
    $0
    Other
    $72,195
    Hours/week
    49 + 1 related

    Schedule J breakdown matched by us

    Base
    $252,743
    Bonus
    $132,482
    Other
    $12,174
    Deferred
    $32,409
    Nontaxable benefits
    $39,786
    Filer's total
    $469,594

  • TIM SCHNACK

    MARKET CFO (BEG 05/24)

    Total calculated
    $417,768
    From this org
    $0
    From related orgs
    $369,715
    Other
    $48,053
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $290,959 related
    Bonus
    $0 + $74,901 related
    Other
    $0 + $3,855 related
    Deferred
    $0 + $19,529 related
    Nontaxable benefits
    $0 + $28,524 related
    Filer's total
    $0 + $417,768 related

  • NICK O'TOOL END 0524

    INTERIM CFO (THRU 05/24)

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

    Schedule J breakdown matched by us

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

  • KIRTIBALA GUPTA MD

    BOARD MEMBER/PHYSICIAN

    Total calculated
    $394,026
    From this org
    $0
    From related orgs
    $346,502
    Other
    $47,524
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

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

  • COLE MAROLF

    PHYSICIAN-FAMILY MEDICINE

    Total calculated
    $372,573
    From this org
    $300,388
    From related orgs
    $27,936
    Other
    $44,249
    Hours/week
    45

    Schedule J breakdown matched by us

    Base
    $299,852 + $27,936 related
    Bonus
    $0
    Other
    $536
    Deferred
    $16,678
    Nontaxable benefits
    $26,776 + $795 related
    Filer's total
    $343,842 + $28,731 related

  • HEATHER MORGAN MD

    BOARD MEMBER/PHYSICIAN

    Total calculated
    $378,802
    From this org
    $0
    From related orgs
    $320,425
    Other
    $58,377
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

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

  • SISTER NADINE HEIMANN OSF

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • SISTER MAURITA SOUKUP

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    1 + 40 related

  • BILL YATES

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • KENT BARNEY

    TREASURER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • MARDELL WILSON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • KELLY BACON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • KEVIN FITZGERALD

    SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • LG SEARCEY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • DAVE TAYLOR

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • CYNTHIA ALLOWAY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • KATE CUTLER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, 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
DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH, USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION.
PART 1, LINE 4A:
CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2023 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): EVERT KUIPER, $2,025,542; JEANETTE WOJTALEWICZ, $1,083,464.
PART 1, LINE 4B:
DURING THE 2023 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2023 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: DANIEL DEFREECE, $9,979. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2023 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH ARE ELIGIBLE TO PARTICIPATE IN NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE. THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENTS FOR ONE BOARD MEMBERS/OFFICER OCCURRED DURING 2023: JOHN PETERSDORF, $713,173. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH PARTICIPATE IN THE DIGNITY HEALTH SUPPLEMENTAL EXECUTIVE RETENTION/RETIREMENT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN WHICH IN 2002 WAS OFFERED TO MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM BY THE DIGNITY HEALTH BOARD OF DIRECTORS AND WOULD BE PAID ONLY IF THE EXECUTIVES STAYED WITH THE ORGANIZATION FOR A SPECIFIED NUMBER OF YEARS AS THE PRIMARY PURPOSE OF THIS PLAN IS TO PROVIDE FOR THE RETENTION AND RETIREMENT OF THE PARTICIPANTS. THE EXECUTIVE MANAGEMENT TEAM IS RECRUITED FROM STABLE CAREERS IN ORGANIZATIONS FROM ACROSS THE COUNTRY AND FROM VARIOUS INDUSTRIES. DUTIES ARE BOTH EXTENSIVE AND COMPLEX AND REQUIRE SUBSTANTIAL AND DIVERSE EXPERIENCE AND SKILL SETS TO EXECUTE THEIR ROLES SUCCESSFULLY. THE CALCULATION FOR THE PAYMENTS TO EACH EXECUTIVE ARE BASED ON THE VALUE OF A FINAL AVERAGE PAY ANNUITY BENEFIT BASED ON RETIREMENT AGE AND SERVICE YEARS TO THE ORGANIZATION. DISTRIBUTION OCCURS EACH JULY 1 IF THE PLAN FORMULA WARRANTS A PAYMENT. NO PAYMENTS PURSUANT TO THE PLAN ARRANGEMENT OCCURRED DURING 2023.
PART II
ST. MARY'S COMMUNITY HOSPITAL FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2023.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

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.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2023
Filed
14 May 2025
IRS schema version
2023v6.0
Source object
202511349349302316

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