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Nonprofiteer
← DEKALB MEMORIAL HOSPITAL INC

Form 990 for tax year 2023

Filed by DEKALB MEMORIAL HOSPITAL INC.

Totals

Total revenue
$82,794,771
Total expenses
$79,571,392
Contributions and grants received
$171
Grants paid
$34,684
Program services expenses (Part IX)
$65,090,353
Management and general expenses
$14,481,039
Fundraising expenses
$0
Program service expenses (Part III)
$65,090,353

Program services were 81.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • THOMAS MASON

    DIRECTOR/PH PHYSICIAN

    Total calculated
    $488,987
    From this org
    $9,196
    From related orgs
    $405,873
    Other
    $73,918
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $9,196 + $327,956 related
    Bonus
    $0 + $29,809 related
    Other
    $0 + $48,108 related
    Deferred
    $804 + $35,496 related
    Nontaxable benefits
    $833 + $36,785 related
    Filer's total
    $10,833 + $478,154 related

  • NATASHA EICHER

    DIRECTOR/MARKET PRESIDENT

    Total calculated
    $467,832
    From this org
    $363,341
    From related orgs
    $0
    Other
    $104,491
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $253,450
    Bonus
    $47,021
    Other
    $62,870
    Deferred
    $71,793
    Nontaxable benefits
    $32,698
    Filer's total
    $467,832

  • DOUGLAS MORROW

    DIRECTOR/CHAIR

    Total calculated
    $7,250
    From this org
    $6,000
    From related orgs
    $1,250
    Other
    $0
    Hours/week
    1 + 1 related

  • THOMAS HARTMAN

    DIRECTOR

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

  • MICHAEL TULLIS

    DIRECTOR

    Total calculated
    $4,500
    From this org
    $4,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • BRYAN NUGEN

    DIRECTOR/SECRETARY/TREASURER

    Total calculated
    $4,500
    From this org
    $4,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • TRENTON STUCKEY

    DIRECTOR

    Total calculated
    $3,750
    From this org
    $3,750
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • SCOTT PFLUGHOEFT

    DIRECTOR/VICE CHAIR

    Total calculated
    $4,500
    From this org
    $4,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • CLARAMARY WINEBRENNER

    DIRECTOR

    Total calculated
    $4,250
    From this org
    $4,250
    From related orgs
    $0
    Other
    $0
    Hours/week
    1 + 1 related

  • JEREMY PFISTER

    DIRECTOR

    Total calculated
    $3,000
    From this org
    $3,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • GREG JOHNSON

    DIRECTOR/REGIONAL MARKET PRESIDENT

    Total calculated
    $1,077,497
    From this org
    $0
    From related orgs
    $888,491
    Other
    $189,006
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $681,591 related
    Bonus
    $0 + $112,796 related
    Other
    $0 + $94,104 related
    Deferred
    $0 + $155,300 related
    Nontaxable benefits
    $0 + $33,706 related
    Filer's total
    $0 + $1,077,497 related

  • JEANNE' WICKENS

    PH CHIEF FINANCIAL OFFICER

    Total calculated
    $2,443,396
    From this org
    $0
    From related orgs
    $2,165,508
    Other
    $277,888
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $834,975 related
    Bonus
    $0 + $187,034 related
    Other
    $0 + $1,143,499 related
    Deferred
    $0 + $239,228 related
    Nontaxable benefits
    $0 + $38,660 related
    Filer's total
    $0 + $2,443,396 related

  • KARRA HEGGEN

    DMHOS VP PATIENT CARE SVCS

    Total calculated
    $297,703
    From this org
    $263,484
    From related orgs
    $0
    Other
    $34,219
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $202,846
    Bonus
    $32,782
    Other
    $27,856
    Deferred
    $18,228
    Nontaxable benefits
    $15,991
    Filer's total
    $297,703

  • LON KEYES

    DMHOS PHARMACY MGR

    Total calculated
    $223,447
    From this org
    $195,160
    From related orgs
    $0
    Other
    $28,287
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $179,772
    Bonus
    $13,408
    Other
    $1,980
    Deferred
    $15,568
    Nontaxable benefits
    $12,719
    Filer's total
    $223,447

  • JACOB CLENDENEN

    DMHOS PHARMACIST

    Total calculated
    $202,666
    From this org
    $160,652
    From related orgs
    $147
    Other
    $41,867
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $159,132 + $147 related
    Bonus
    $500
    Other
    $1,020
    Deferred
    $6,792 + $6 related
    Nontaxable benefits
    $35,037 + $32 related
    Filer's total
    $202,481 + $185 related

  • PEGGY ROBERTS

    DMHOS REGISTERED NURSE

    Total calculated
    $160,861
    From this org
    $126,676
    From related orgs
    $20,000
    Other
    $14,185
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $119,101
    Bonus
    $6,350 + $20,000 related
    Other
    $1,225
    Deferred
    $927 + $146 related
    Nontaxable benefits
    $11,324 + $1,788 related
    Filer's total
    $138,927 + $21,934 related

  • BETHANY HEILEMAN

    DMHOS PHARMACIST

    Total calculated
    $193,876
    From this org
    $144,130
    From related orgs
    $1,194
    Other
    $48,552
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $142,700 + $1,194 related
    Bonus
    $500
    Other
    $930
    Deferred
    $16,393 + $136 related
    Nontaxable benefits
    $31,760 + $263 related
    Filer's total
    $192,283 + $1,593 related

  • ANTHONY STUMP

    DMHOS MGR REHAB

    Total calculated
    $187,838
    From this org
    $142,516
    From related orgs
    $0
    Other
    $45,322
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $130,080
    Bonus
    $9,959
    Other
    $2,477
    Deferred
    $13,250
    Nontaxable benefits
    $32,072
    Filer's total
    $187,838

  • MICHAEL PACKNETT

    FORMER OFFICER/RETIRED PH CEO

    Total calculated
    $5,063,462
    From this org
    $0
    From related orgs
    $5,034,209
    Other
    $29,253
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $66,747 related
    Bonus
    $0 + $351,881 related
    Other
    $0 + $4,615,581 related
    Deferred
    $0 + $26,400 related
    Nontaxable benefits
    $0 + $2,853 related
    Filer's total
    $0 + $5,063,462 related

  • BRET CLAGHORN

    FORMER OFFICER/CURRENT PH VP

    Total calculated
    $324,233
    From this org
    $0
    From related orgs
    $261,770
    Other
    $62,463
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $229,678 related
    Bonus
    $0 + $30,283 related
    Other
    $0 + $1,809 related
    Deferred
    $0 + $24,340 related
    Nontaxable benefits
    $0 + $38,123 related
    Filer's total
    $0 + $324,233 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)

PART I, LINE 3
RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF DEKALB MEMORIAL HOSPITAL, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC.
PART I, LINE 4B
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS THE FOLLOWING INDIVIDUALS PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION AND THE AMOUNT OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE FOLLOWING INDIVIDUALS VESTED IN A PORTION OF THEIR DEFERRED COMPENSATION PLANS, WHICH IS TREATED AS TAXABLE INCOME TO THE INDIVIDUALS AT THE TIME OF VESTING. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III): NATASHA EICHER $38,673; GREG JOHNSON $84,817; MICHAEL PACKNETT $4,613,104; JEANNE' WICKENS $1,101,767 AMOUNTS LISTED ABOVE THAT HAVE BEEN REPORTED AS DEFERRED COMPENSATION ON PRIOR FORM 990 WILL ALSO BE REFLECTED IN SCHEDULE J, PART II, COLUMN (F). FOR EXAMPLE, THE AMOUNT OF $4,613,104 REPORTED AS REQUIRED FOR MR. PACKNETT WAS A RESULT OF THE VESTING OF SUCH AMOUNT UNDER THE TERMS OF THE RESPECTIVE PLANS. HOWEVER, THESE AMOUNTS WERE PREVIOUSLY REPORTED IN MR. PACKNETT'S DEFERRED COMPENSATION OVER MORE THAN 10 YEARS AS THE AMOUNTS WERE DEFERRED UNDER THE PLANS. AS SUCH, THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) IS AN INDICATION OF AMOUNTS THAT HAVE BEEN REPORTED TWICE, ONCE AS A DEFERRAL AND ONCE AS VESTED. THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. DEFERRALS REPORTED IN SCHEDULE J, PART II, COLUMN (C) INCLUDE: NATASHA EICHER $48,772; GREG JOHNSON $119,000; JEANNE' WICKENS $216,128
PART I, LINE 7
THE MANAGEMENT INCENTIVE COMPENSATION PLAN (MICP) AND THE PHYSICIAN AND PROVIDER INCENTIVE COMPENSATION PLAN (PICP) ARE ANNUAL INCENTIVE PROGRAMS. THE COMPENSATION COMMITTEE OF RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., REVIEWS AND APPROVES THE PLAN DOCUMENTS FOR MICP AND PICP. AT CONCLUSION OF THE PLAN YEAR, THE PARKVIEW HEALTH SYSTEM, INC. EXECUTIVE COMMITTEE APPROVES FINAL PAYMENT.

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

  • INSPIRATION MINISTRIES INC

    $10,000

    HELP PEOPLE TRANSFORM THEIR LIVES IN TIMES OF TRANSITION

  • GARRETT COMMUNITY CENTER INC

    $6,684

    PROGRAMS TO CELEBRATE AND STRENGTHEN THE VIBRANT COMMUNITY BY CONNECTING PEOPLE AND ORGANIZATIONS THROUGH ACTIVITIES THAT IMPROVE THE QUALITY OF LIFE FOR THE GREATER GARRETT INDIANA AREA.

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
2023
Filed
5 November 2024
IRS schema version
2023v5.1
Source object
202423109349302047

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

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