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Nonprofiteer
← ALEGENT HEALTH MERCY HOSPITAL

Form 990 for tax year 2022

Filed by ALEGENT HEALTH MERCY HOSPITAL.

Totals

Total revenue
$21,613,581
Total expenses
$21,659,636
Contributions and grants received
$787,749
Grants paid
$13,000
Program service revenue
$20,427,654
Investment income
$108,480
Other revenue
$289,698
Total assets, end of year
$29,705,594
Total liabilities, end of year
$3,421,674
Net assets or fund balances, end of year
$26,283,920
Program services expenses (Part IX)
$20,680,184
Management and general expenses
$979,452
Fundraising expenses
$0
Program service expenses (Part III)
$20,680,184

Program services were 95.5% 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

    $184,530

  • 1e · Government grants (contributions)

    $600,719

  • 1f · All other contributions, gifts and grants

    $2,500

  • 2a · Program service revenue: NET PATIENT SERVICES

    total $19,319,084 · related or exempt $19,319,084 · unrelated business $0 · excluded $0

  • 2b · Program service revenue: PHARMACY SERVICES

    total $919,656 · related or exempt $919,656 · unrelated business $0 · excluded $0

  • 2c · Program service revenue: PATIENT SERVICES

    total $80,885 · related or exempt $80,885 · unrelated business $0 · excluded $0

  • 2d · Program service revenue: MEDICAL SERVICES

    total $69,131 · related or exempt $69,131 · unrelated business $0 · excluded $0

  • 2e · Program service revenue: EMERGENCY MEDICAL SERV

    total $38,898 · related or exempt $38,898 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $52,575 · excluded $52,575

  • 6a · Gross rents

    real property $2,890

  • 6b · Less rental expenses

    real property $1,240

  • 6c · Rental income or loss

    real property $1,650

  • 6d · Net rental income or loss

    total $1,650 · excluded $1,650

  • 7a · Gross sales of assets other than inventory

    securities $55,905

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

    securities $0

  • 7c · Gain or loss

    securities $55,905

  • 7d · Net gain or loss

    total $55,905 · excluded $55,905

  • 10a · Gross sales of inventory

    $4,105

  • 10b · Cost of goods sold

    $5,863

  • 10c · Net income from sales of inventory

    total -$1,758 · excluded -$1,758

  • 11a · Other revenue: EMPLOYEE RETENTION CRE

    total $123,617 · related or exempt $0 · unrelated business $0 · excluded $123,617

  • 11b · Other revenue: CONTRACT SERVICES REVE

    total $50,000 · related or exempt $0 · unrelated business $0 · excluded $50,000

  • 11c · Other revenue: CAFETERIA

    total $48,024 · related or exempt $0 · unrelated business $0 · excluded $48,024

  • 11d · All other revenue

    total $68,165 · excluded $68,165

  • 11e · Other revenue, total

    $289,806

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $12,000 · program services $12,000

  • 2 · Grants to domestic individuals

    total $1,000 · program services $1,000

  • 5 · Compensation of officers, directors and key employees

    total $160,561 · program services $160,561

  • 7 · Other salaries and wages

    total $8,617,969 · program services $8,180,263 · management and general $437,706

  • 8 · Pension plan contributions

    total $437,734 · program services $415,412 · management and general $22,322

  • 9 · Other employee benefits

    total $1,133,640 · program services $1,076,172 · management and general $57,468

  • 10 · Payroll taxes

    total $554,042 · program services $526,340 · management and general $27,702

  • 11d · Fees: lobbying

    total $2,154 · management and general $2,154

  • 11g · Fees: other

    total $4,027,939 · program services $3,826,171 · management and general $201,768

  • 12 · Advertising and promotion

    total $99,918 · program services $94,922 · management and general $4,996

  • 13 · Office expenses

    total $698,382 · program services $664,641 · management and general $33,741

  • 14 · Information technology

    total $621,197 · program services $590,137 · management and general $31,060

  • 16 · Occupancy

    total $398,862 · program services $378,919 · management and general $19,943

  • 17 · Travel

    total $25,048 · program services $23,796 · management and general $1,252

  • 19 · Conferences, conventions and meetings

    total $379 · program services $379

  • 21 · Payments to affiliates

    total $398,361 · program services $378,443 · management and general $19,918

  • 22 · Depreciation, depletion and amortization

    total $671,605 · program services $638,025 · management and general $33,580

  • 23 · Insurance

    total $143,154 · program services $135,996 · management and general $7,158

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $2,081,987 · program services $2,081,987 · management and general $0 · fundraising $0

  • 24b · Other expenses: INTRACOMPANY ALLOCATION

    total $1,324,091 · program services $1,257,886 · management and general $66,205 · fundraising $0

  • 24c · Other expenses: REPAIRS AND MAINTENANCE

    total $213,735 · program services $203,048 · management and general $10,687 · fundraising $0

  • 24d · Other expenses: DUES & SUBSCRIPTIONS

    total $20,021 · program services $19,020 · management and general $1,001 · fundraising $0

  • 24e · All other expenses

    total $15,857 · program services $15,066 · management and general $791

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $549 · end of year $750

  • 2 · Savings and temporary cash investments

    beginning of year $420,241 · end of year $327,131

  • 3 · Pledges and grants receivable

    end of year $0

  • 4 · Accounts receivable

    beginning of year $1,114,650 · end of year $1,968,377

  • 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 $289,530 · end of year $254,543

  • 9 · Prepaid expenses and deferred charges

    end of year $0

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

    $18,460,320

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

    $13,206,179

  • 10c · Land, buildings and equipment, net

    beginning of year $5,349,879 · end of year $5,254,141

  • 11 · Investments: publicly traded securities

    end of year $0

  • 12 · Investments: other securities

    beginning of year $4,623,625 · end of year $4,790,189

  • 13 · Investments: program-related

    end of year $0

  • 14 · Intangible assets

    end of year $0

  • 15 · Other assets

    beginning of year $19,498,446 · end of year $17,110,463

  • 17 · Accounts payable and accrued expenses

    beginning of year $3,125,722 · end of year $2,586,180

  • 18 · Grants payable

    end of year $0

  • 19 · Deferred revenue

    beginning of year $544,019 · end of year $95,635

  • 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 $1,355,690 · end of year $739,859

  • 27 · Net assets without donor restrictions

    beginning of year $26,271,489 · end of year $26,283,920

  • 28 · Net assets with donor restrictions

    end of year $0

Mission and programs · 2022

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)

THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH.

  • ALEGENT HEALTH MERCY HOSPITAL, CORNING SUPPORTS THE MISSION BY CONTINUALLY MAKING SERVICES MORE CONVENIENT AND ACCESSIBLE WHILE MAINTAINING A LEVEL OF EFFICIENCY. THE HOSPITAL OFFERS THE FOLLOWING SERVICES TO OUR PATIENTS: 24-HOUR EMERGENCY CARE WITH HELIPORT ACCOMMODATIONS, DIAGNOSTIC IMAGING SERVICES, CARDIOVASCULAR SERVICES, CHEMOTHERAPY AND ELECTROENCEPHALOGRAMS (EEGS) PHYSICAL THERAPY.

    Expenses $1,533,256 · Grants $698 · Revenue $1,096,391

  • ALEGENT HEALTH MERCY HOSPITAL, CORNING PROVIDES SEVERAL SPECIALTY CLINICS EACH WEEK THROUGH VISITING SPECIALISTS 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 $1,215,453 · Grants $1,126 · Revenue $1,769,347

  • ALEGENT HEALTH MERCY HOSPITAL, CORNING STRIVES TO IMPROVE THE HEALTH STATUS OF CHILDREN, TEENS, ADULTS, SENIOR CITIZENS, FRIENDS AND NEIGHBORS IN THIS RURAL COMMUNITY. THE HOSPITAL IS PROUD TO OFFER HEALTHCARE SERVICES CLOSE TO HOME WITHIN THE COMMUNITY. ALEGENT HEALTH MERCY HOSPITAL, CORNING 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 $820,465 · Grants $3,214 · Revenue $5,049,989

  • OTHER PROGRAM SERVICES:

    Expenses $17,111,010 · Grants $7,962 · Revenue $12,511,927

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • JOHN PETERSDORF

    EX-OFFICIO BOARD MEMBER

    Total calculated
    $3,026,445
    From this org
    $0
    From related orgs
    $2,349,200
    Other
    $677,245
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $596,879 related
    Bonus
    $0 + $497,099 related
    Other
    $0 + $1,255,222 related
    Deferred
    $0 + $611,834 related
    Nontaxable benefits
    $0 + $65,411 related
    Filer's total
    $0 + $3,026,445 related

  • EVERT KUIPER

    EX-OFFICIO BM/ PRESIDENT & CEO CHI HEALTH

    Total calculated
    $1,303,984
    From this org
    $0
    From related orgs
    $1,274,593
    Other
    $29,391
    Hours/week
    5 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $891,215 related
    Bonus
    $0 + $275,000 related
    Other
    $0 + $108,378 related
    Deferred
    $0 + $3,276 related
    Nontaxable benefits
    $0 + $26,115 related
    Filer's total
    $0 + $1,303,984 related

  • JEANETTE WOJTALEWICZ

    CFO, CHI HEALTH (THRU 1/6/23)

    Total calculated
    $1,223,121
    From this org
    $0
    From related orgs
    $1,168,841
    Other
    $54,280
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $649,549 related
    Bonus
    $0 + $463,014 related
    Other
    $0 + $56,278 related
    Deferred
    $0 + $17,750 related
    Nontaxable benefits
    $0 + $36,530 related
    Filer's total
    $0 + $1,223,121 related

  • CAROLINE AMAO MD

    PHYSICIAN

    Total calculated
    $501,044
    From this org
    $458,958
    From related orgs
    $0
    Other
    $42,086
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $457,146
    Bonus
    $0
    Other
    $1,812
    Deferred
    $17,079
    Nontaxable benefits
    $25,007
    Filer's total
    $501,044

  • KIRTIBALA GUPTA MD

    BOARD MEMBER

    Total calculated
    $440,317
    From this org
    $0
    From related orgs
    $396,003
    Other
    $44,314
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $394,104 related
    Bonus
    $0
    Other
    $0 + $1,899 related
    Deferred
    $0 + $17,575 related
    Nontaxable benefits
    $0 + $26,739 related
    Filer's total
    $0 + $440,317 related

  • JOHN SAFRANEK MD

    PHYSICIAN

    Total calculated
    $385,335
    From this org
    $324,702
    From related orgs
    $8,663
    Other
    $51,970
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $320,615
    Bonus
    $0
    Other
    $4,087 + $8,663 related
    Deferred
    $17,752
    Nontaxable benefits
    $34,218
    Filer's total
    $376,672 + $8,663 related

  • SHERAN FERNANDO MD

    PHYSICIAN

    Total calculated
    $342,628
    From this org
    $315,586
    From related orgs
    $0
    Other
    $27,042
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $281,189
    Bonus
    $25,000
    Other
    $9,397
    Deferred
    $16,055
    Nontaxable benefits
    $10,987
    Filer's total
    $342,628

  • TABITHA WILSON MD

    PEDIATRICIAN GENERAL

    Total calculated
    $346,666
    From this org
    $309,505
    From related orgs
    $0
    Other
    $37,161
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $264,022
    Bonus
    $45,000
    Other
    $483
    Deferred
    $6,366
    Nontaxable benefits
    $30,795
    Filer's total
    $346,666

  • DAVID JONES

    MARKET PRESIDENT, REGIONAL HOSPITALS

    Total calculated
    $338,527
    From this org
    $0
    From related orgs
    $307,588
    Other
    $30,939
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $256,033 related
    Bonus
    $0 + $50,308 related
    Other
    $0 + $1,247 related
    Deferred
    $0 + $11,983 related
    Nontaxable benefits
    $0 + $18,956 related
    Filer's total
    $0 + $338,527 related

  • STEVEN FREEMAN MD

    PHYSICIAN

    Total calculated
    $331,105
    From this org
    $294,444
    From related orgs
    $0
    Other
    $36,661
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $286,230
    Bonus
    $0
    Other
    $8,214
    Deferred
    $15,625
    Nontaxable benefits
    $21,036
    Filer's total
    $331,105

  • HEATHER MORGAN MD

    BOARD MEMBER

    Total calculated
    $329,219
    From this org
    $0
    From related orgs
    $278,612
    Other
    $50,607
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $277,757 related
    Bonus
    $0
    Other
    $0 + $855 related
    Deferred
    $0 + $16,557 related
    Nontaxable benefits
    $0 + $34,050 related
    Filer's total
    $0 + $329,219 related

  • NICK OTOOL

    INTERIM CFO, CHI HEALTH

    Total calculated
    $304,710
    From this org
    $0
    From related orgs
    $257,678
    Other
    $47,032
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $207,354 related
    Bonus
    $0 + $49,872 related
    Other
    $0 + $452 related
    Deferred
    $0 + $16,380 related
    Nontaxable benefits
    $0 + $30,652 related
    Filer's total
    $0 + $304,710 related

  • KURT SARGENT

    FORMER PRESIDENT, MERCY HOSPITAL CORNING

    Total calculated
    $224,577
    From this org
    $215,142
    From related orgs
    $0
    Other
    $9,435
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $49,734
    Bonus
    $0
    Other
    $165,408
    Deferred
    $7,514
    Nontaxable benefits
    $1,921
    Filer's total
    $224,577

  • ALICIA REED

    PRESIDENT, MERCY HOSPITAL CORNING

    Total calculated
    $152,525
    From this org
    $65,359
    From related orgs
    $51,585
    Other
    $35,581
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $64,833 + $42,966 related
    Bonus
    $400
    Other
    $126 + $8,619 related
    Deferred
    $6,026
    Nontaxable benefits
    $25,336 + $4,219 related
    Filer's total
    $96,721 + $55,804 related

  • SUSANNE L HRUZA MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • SISTER MAURITA SOUKUP

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • BILL YATES

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • SISTER NADINE HEIMANN OSF

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • MARDELL WILSON EDD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • KENT BARNEY

    TREASURER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • KELLY BACON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 11 related

  • KEVIN FITZGERALD PHD

    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

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 2022, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH, USED THE FOLLOWING 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.
PART I, LINES 4A-B
SCHEDULE J, PART I, LINE 4A - SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS: 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 2022 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): KURT SARGENT, $165,295. SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: DURING THE 2022 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. 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 2022 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. DURING 2022, THE FOLLOWING PAYMENT WAS MADE PURSUANT TO THE SUPER VESTING RULES: JEANETTE WOJTALEWICZ, $50,733.
SCH J, PART I, LINE 4B, CONTINUED
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 CERTAIN EMPLOYEES OCCURRED DURING 2022: JOHN PETERSDORF, $1,242,454. 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 2022.
SCHEDULE J, PART II
ALEGENT HEALTH-MERCY HOSPITAL, CORNING, IA 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 2022.

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
2022
Filed
10 May 2024
IRS schema version
2022v5.0
Source object
202431319349304583

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