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Nonprofiteer
← CAROMONT MEDICAL GROUP INC

Form 990 for tax year 2023

Filed by CAROMONT MEDICAL GROUP INC.

Totals

Total revenue
$165,685,869
Total expenses
$208,769,136
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$161,728,368
Investment income
-$48,187
Other revenue
$4,005,688
Total assets, end of year
$82,782,092
Total liabilities, end of year
$34,390,679
Net assets or fund balances, end of year
$48,391,413
Program services expenses (Part IX)
$198,420,907
Management and general expenses
$10,348,229
Fundraising expenses
$0
Program service expenses (Part III)
$198,420,907

Program services were 95.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • Mr Frank Stewart

    Chair

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Dr Andrew Dyksterhouse

    Director

    Total calculated
    $504,053
    From this org
    $264,395
    From related orgs
    $181,231
    Other
    $58,427
    Hours/week
    20 + 20 related

    Schedule J breakdown matched by us

    Base
    $151,087 + $159,231 related
    Bonus
    $111,985 + $22,000 related
    Other
    $1,323
    Deferred
    $33,821
    Nontaxable benefits
    $24,606
    Filer's total
    $322,822 + $181,231 related

  • Dr Jay Hendler

    Director

    Total calculated
    $558,661
    From this org
    $500,289
    From related orgs
    $0
    Other
    $58,372
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $426,740
    Bonus
    $69,600
    Other
    $3,949
    Deferred
    $43,200
    Nontaxable benefits
    $15,172
    Filer's total
    $558,661

  • Dr Mark Thompson

    Director

    Total calculated
    $870,678
    From this org
    $812,184
    From related orgs
    $0
    Other
    $58,494
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $565,673
    Bonus
    $242,193
    Other
    $4,318
    Deferred
    $43,200
    Nontaxable benefits
    $15,294
    Filer's total
    $870,678

  • Mr Bob Hovis

    Director

    Total calculated
    $32,703
    From this org
    $0
    From related orgs
    $32,703
    Other
    $0
    Hours/week
    1 + 2 related

  • Ms Annette Carter

    Director

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Mr David O'Connor

    EVP/CFO/Asst. Treasurer

    Total calculated
    $1,140,025
    From this org
    $0
    From related orgs
    $956,025
    Other
    $184,000
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $602,432 related
    Bonus
    $0 + $243,238 related
    Other
    $0 + $110,355 related
    Deferred
    $0 + $159,219 related
    Nontaxable benefits
    $0 + $24,781 related
    Filer's total
    $0 + $1,140,025 related

  • Mr K Christopher Peek

    CEO

    Total calculated
    $2,074,421
    From this org
    $0
    From related orgs
    $1,764,966
    Other
    $309,455
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,025,632 related
    Bonus
    $0 + $515,175 related
    Other
    $0 + $224,159 related
    Deferred
    $0 + $284,284 related
    Nontaxable benefits
    $0 + $25,171 related
    Filer's total
    $0 + $2,074,421 related

  • Ms Leigh Hickman

    CLO/Asst. Sec.

    Total calculated
    $675,066
    From this org
    $0
    From related orgs
    $564,906
    Other
    $110,160
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $376,380 related
    Bonus
    $0 + $127,220 related
    Other
    $0 + $61,306 related
    Deferred
    $0 + $93,072 related
    Nontaxable benefits
    $0 + $17,088 related
    Filer's total
    $0 + $675,066 related

  • Dr Dustin Letts

    Physcian

    Total calculated
    $1,094,409
    From this org
    $1,026,424
    From related orgs
    $0
    Other
    $67,985
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $566,563
    Bonus
    $458,412
    Other
    $1,449
    Deferred
    $43,200
    Nontaxable benefits
    $24,785
    Filer's total
    $1,094,409

  • Dr Inderjeet Singh

    Physcian

    Total calculated
    $1,366,814
    From this org
    $1,298,837
    From related orgs
    $0
    Other
    $67,977
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $470,245
    Bonus
    $825,473
    Other
    $3,119
    Deferred
    $43,200
    Nontaxable benefits
    $24,777
    Filer's total
    $1,366,814

  • Dr James Greelish

    Physcian

    Total calculated
    $1,264,123
    From this org
    $1,196,138
    From related orgs
    $0
    Other
    $67,985
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $828,518
    Bonus
    $363,543
    Other
    $4,077
    Deferred
    $43,200
    Nontaxable benefits
    $24,785
    Filer's total
    $1,264,123

  • Dr Oh Chang

    Physcian

    Total calculated
    $1,176,771
    From this org
    $1,108,885
    From related orgs
    $0
    Other
    $67,886
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $731,189
    Bonus
    $374,884
    Other
    $2,812
    Deferred
    $43,200
    Nontaxable benefits
    $24,686
    Filer's total
    $1,176,771

  • Dr Paul Kochupura

    Physcian

    Total calculated
    $1,143,704
    From this org
    $1,119,408
    From related orgs
    $0
    Other
    $24,296
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $571,178
    Bonus
    $547,276
    Other
    $954
    Deferred
    $0
    Nontaxable benefits
    $24,296
    Filer's total
    $1,143,704

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

  • 4b · Supplemental nonqualified retirement plan
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings

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
  • 7 · Other non-fixed payments
  • 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
COMPENSATION PAID TO CEO OF CAROMONT HEALTH, INC. WAS PAID BY GASTON MEMORIAL HOSPITAL, INC D/B/A CAROMONT REGIONAL MEDICAL CENTER, A RELATED ORGANIZATION. CAROMONT REGIONAL MEDICAL CENTER UTILIZED THE FOLLOWING METHODS TO DETERMINE APPROPRIATE COMPENSATION FOR CEO THAT HAD INFLUENCE OVER THE ORGANIZATION'S ACTIVITIES: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACTS - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
THE FOLLOWING INDIVIDUALS RECEIVED DEFERRED COMPENSATION ALLOCATIONS BY RELATED ORGANIZATION CAROMONT REGIONAL MEDICAL CENTER FROM A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP): DAVID O'CONNOR - $ 116,019 K. CHRISTOPHER PEEK - $ 241,084 Leigh Hickman - $ 57,768
Schedule J, Part I, Line 6a Compensation contingent on net earnings of the organization
Certain CaroMont Medical Group Inc. Physician's Compensation packages are based on the individual physician's net results from operations as calculated based soley on his/her net charges less his/her allocable share of clinic overhead costs. Executive Incentive Compensation Plan for all key employees based on the achievement of annual Business Objectives which include a financial goal attributable to operating margin. Manager Incentive Plan based on consolidated corporate and individual performance goals.
Schedule J, Part I, Line 6b Compensation contingent on net earnings of a related organization
Certain CaroMont Medical Group Inc. Physician's Compensation packages are based on the individual physician's net results from operations as calculated based soley on his/her net charges less his/her allocable share of clinic overhead costs. Executive Incentive Compensation Plan for all key employees based on the achievement of annual Business Objectives which include a financial goal attributable to operating margin. Manager Incentive Plan based on consolidated corporate and individual performance goals.

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.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

Provenance

Return type
form_990
Tax year
2023
Filed
25 March 2025
IRS schema version
2023v6.0
Source object
202530849349300833

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