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← MONUMENT HEALTH INC

Form 990 for tax year 2022

Filed by MONUMENT HEALTH INC.

Totals

Total revenue
$2,086,512
Total expenses
$2,241,027
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$2,086,512
Investment income
$0
Other revenue
$0
Total assets, end of year
$181
Total liabilities, end of year
$472,519
Net assets or fund balances, end of year
-$472,338
Program services expenses (Part IX)
$2,241,027
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$2,241,027

Program services were 100.0% 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.

  • 2a · Program service revenue: Management Fees

    total $2,086,512 · related or exempt $2,086,512

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $1,829,220 · program services $1,829,220

  • 7 · Other salaries and wages

    total $72,211 · program services $72,211

  • 9 · Other employee benefits

    total $26,612 · program services $26,612

  • 10 · Payroll taxes

    total $41,274 · program services $41,274

  • 11a · Fees: management

    total $90,000 · program services $90,000

  • 11b · Fees: legal

    total $1,066 · program services $1,066

  • 11g · Fees: other

    total $26,235 · program services $26,235

  • 13 · Office expenses

    total $43,859 · program services $43,859

  • 16 · Occupancy

    total $340 · program services $340

  • 17 · Travel

    total $38,802 · program services $38,802

  • 23 · Insurance

    total $3,896 · program services $3,896

  • 24a · Other expenses: Interco. Charges

    total $67,512 · program services $67,512

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year -$1,018

  • 3 · Pledges and grants receivable

    beginning of year -$149 · end of year $181

  • 17 · Accounts payable and accrued expenses

    beginning of year $127,591 · end of year $142,122

  • 25 · Other liabilities

    beginning of year $189,065 · end of year $330,397

  • 27 · Net assets without donor restrictions

    beginning of year -$317,823 · end of year -$472,338

Mission and programs · 2022

Mission

Our vision at Monument Health is to be one team, to listen, to be inclusive, and to show we care. Monument Health is dedicated to improving the health of individuals and our communities.

Activities or mission (Part I)

Monument Health is dedicated to improving the health of individuals and our communities.

  • Monument Health's Board of Directors provides planning and decision making for its supported organizations, Monument Health Rapid City Hospital, Inc., and Monument Health Network, Inc. to best assure services are coordinated among the supported organizations and that all supported organizations are contributing to the achievement of a shared mission. Monument Health's executive administration provides management and other support services to the entire health system.

    Expenses $2,241,027 · Revenue $2,086,512

As filed on the 2022 return.

Listed in Part VII

  • Paulette Davidson

    President and CEO

    Total calculated
    $1,939,705
    From this org
    $1,706,840
    From related orgs
    $0
    Other
    $232,865
    Hours/week
    0.1 + 59.9 related

    Schedule J breakdown matched by us

    Base
    $1,048,570
    Bonus
    $468,970
    Other
    $189,300
    Deferred
    $203,572
    Nontaxable benefits
    $29,293
    Filer's total
    $1,939,705

  • Terry M Graber MD

    Director; Employed Physician

    Total calculated
    $247,096
    From this org
    $0
    From related orgs
    $202,237
    Other
    $44,859
    Hours/week
    0.63 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $195,290 related
    Bonus
    $0 + $6,947 related
    Other
    $0
    Deferred
    $0 + $13,223 related
    Nontaxable benefits
    $0 + $31,636 related
    Filer's total
    $0 + $247,096 related

  • Lewis Trowbridge

    Director

    Total calculated
    $32,500
    From this org
    $0
    From related orgs
    $32,500
    Other
    $0
    Hours/week
    1.37

  • Donald Warne MD

    Director, Independent Contractor

    Total calculated
    $33,000
    From this org
    $0
    From related orgs
    $33,000
    Other
    $0
    Hours/week
    0.38

  • Glenn Fosdick

    Director

    Total calculated
    $15,000
    From this org
    $0
    From related orgs
    $15,000
    Other
    $0
    Hours/week
    0.73

  • Paula Santrach MD

    Director

    Total calculated
    $15,000
    From this org
    $0
    From related orgs
    $15,000
    Other
    $0
    Hours/week
    0.38

  • Richard Tysdal

    Chairman

    Total calculated
    $0
    Hours/week
    1.08

  • Pat Burchill

    Director

    Total calculated
    $0
    Hours/week
    1.54

  • Dusty Pinske

    Director

    Total calculated
    $0
    Hours/week
    0.75 + 1.13 related

  • Dave Emery

    Vice Chair

    Total calculated
    $0
    Hours/week
    0.81

  • Robert Haivala

    Director

    Total calculated
    $0
    Hours/week
    0.54

  • Donald Habbe

    Director

    Total calculated
    $0
    Hours/week
    0.44

  • Mark A Thompson

    CFO/Treasurer

    Total calculated
    $812,360
    From this org
    $0
    From related orgs
    $710,030
    Other
    $102,330
    Hours/week
    0.1 + 54.9 related

    Schedule J breakdown matched by us

    Base
    $0 + $485,887 related
    Bonus
    $0 + $155,035 related
    Other
    $0 + $69,108 related
    Deferred
    $0 + $70,813 related
    Nontaxable benefits
    $0 + $31,517 related
    Filer's total
    $0 + $812,360 related

  • Teresa Burroff

    Gen. Counsel/Secretary Until 11/22

    Total calculated
    $651,745
    From this org
    $0
    From related orgs
    $585,595
    Other
    $66,150
    Hours/week
    0.1 + 54.9 related

    Schedule J breakdown matched by us

    Base
    $0 + $386,929 related
    Bonus
    $0 + $132,493 related
    Other
    $0 + $66,173 related
    Deferred
    $0 + $39,331 related
    Nontaxable benefits
    $0 + $26,819 related
    Filer's total
    $0 + $651,745 related

  • Stephanie Lahr MD

    CIO and CMIO Until 03/23

    Total calculated
    $720,639
    From this org
    $0
    From related orgs
    $658,966
    Other
    $61,673
    Hours/week
    0.1 + 54.9 related

    Schedule J breakdown matched by us

    Base
    $0 + $408,520 related
    Bonus
    $0 + $147,796 related
    Other
    $0 + $102,650 related
    Deferred
    $0 + $44,928 related
    Nontaxable benefits
    $0 + $16,745 related
    Filer's total
    $0 + $720,639 related

  • Brad Archer MD

    Chief Medical Officer

    Total calculated
    $1,004,263
    From this org
    $0
    From related orgs
    $886,440
    Other
    $117,823
    Hours/week
    0.1 + 54.9 related

    Schedule J breakdown matched by us

    Base
    $0 + $613,416 related
    Bonus
    $0 + $196,723 related
    Other
    $0 + $76,301 related
    Deferred
    $0 + $93,920 related
    Nontaxable benefits
    $0 + $23,904 related
    Filer's total
    $0 + $1,004,264 related

  • Nicole Kerkenbush

    CPO Until 06/23

    Total calculated
    $517,705
    From this org
    $0
    From related orgs
    $459,144
    Other
    $58,561
    Hours/week
    0.1 + 54.9 related

    Schedule J breakdown matched by us

    Base
    $0 + $326,336 related
    Bonus
    $0 + $103,759 related
    Other
    $0 + $29,049 related
    Deferred
    $0 + $55,761 related
    Nontaxable benefits
    $0 + $2,800 related
    Filer's total
    $0 + $517,705 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

  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 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)

Part I, Line 1a
Country club dues are paid in the name of the CEO, however the benefit is shared with other executives and is used for business purposes.
Part I, Line 4b
Monument Health provides a supplemental nonqualified retirement plan and a flexible benefit plan that can include deferred compensation for its executives. The following individuals had amounts deferred into the account as reported in column C on Schedule J: Paulette Davidson $190,512 Brad Archer, MD $81,209 Mark Thompson $52,744 Stephanie Lahr, MD $31,868 Teresa Burroff $26,447 Nicole Kerkenbush $42,892 The following individuals had supplemental non-qualified retirement plan amounts included in schedule J, column B(iii) that were previously reported as deferred compensation on Form 990. These amounts are identified in Schedule J, column f. Paulette Davidson $168,800 Brad Archer, MD $64,571 Mark Thompson $48,608 Stephanie Lahr, MD $82,150 Teresa Burroff $45,673 Nicole Kerkenbush $22,921
Part I, Line 7
Executives and other employees of system entities will be eligible to receive annual incentive awards that are competitive with the incentives offered by the organizations in the system's peer group(s) in accordance with the terms of the Monument Health, Inc. annual incentive plan for selected executives and other employees (incentive plan). In accordance with this plan, the board's executive committee reviews and approves all incentive compensation performance measures and all awards, if any. The committee ensures that the total compensation, including incentive awards, is reasonable.

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.

Provenance

Return type
form_990
Tax year
2022
Filed
13 May 2024
IRS schema version
2022v5.0
Source object
202431359349307158

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