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Nonprofiteer
← MOSAIC MEDICAL CENTER - MARYVILLE

Form 990 for tax year 2022

Filed by MOSAIC MEDICAL CENTER - MARYVILLE.

Totals

Total revenue
$91,746,203
Total expenses
$91,433,911
Contributions and grants received
$10,288,013
Grants paid
$41,105
Program service revenue
$79,942,543
Investment income
-$22,110
Other revenue
$1,537,757
Total assets, end of year
$51,033,011
Total liabilities, end of year
$25,238,028
Net assets or fund balances, end of year
$25,794,983
Program services expenses (Part IX)
$76,408,314
Management and general expenses
$15,025,597
Fundraising expenses
$0
Program service expenses (Part III)
$76,408,314

Program services were 83.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • John M Poore

    Director/Chair

    Total calculated
    $661,497
    From this org
    $0
    From related orgs
    $646,385
    Other
    $15,112
    Hours/week
    1 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $630,107 related
    Bonus
    $0 + $13,827 related
    Other
    $0 + $2,451 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $15,112 related
    Filer's total
    $0 + $661,497 related

  • Thomas Bieterman

    Former CFO/Treasurer

    Total calculated
    $169,989
    From this org
    $0
    From related orgs
    $167,017
    Other
    $2,972
    Hours/week
    1 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $166,756 related
    Bonus
    $0 + $261 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $2,972 related
    Filer's total
    $0 + $169,989 related

  • Davin Turner DO

    Director/Vice Chair

    Total calculated
    $414,592
    From this org
    $0
    From related orgs
    $393,638
    Other
    $20,954
    Hours/week
    1 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $354,867 related
    Bonus
    $0 + $35,973 related
    Other
    $0 + $2,798 related
    Deferred
    $0 + $8,299 related
    Nontaxable benefits
    $0 + $12,655 related
    Filer's total
    $0 + $414,592 related

  • Gene A Claycomb

    Director/Vice Chair

    Total calculated
    $489,917
    From this org
    $0
    From related orgs
    $443,355
    Other
    $46,562
    Hours/week
    1 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $344,147 related
    Bonus
    $0 + $94,682 related
    Other
    $0 + $4,526 related
    Deferred
    $0 + $10,588 related
    Nontaxable benefits
    $0 + $35,974 related
    Filer's total
    $0 + $489,917 related

  • Matt Baker

    Director

    Total calculated
    $2,500
    From this org
    $0
    From related orgs
    $2,500
    Other
    $0
    Hours/week
    1 + 3 related

  • Serena Naylor

    Director

    Total calculated
    $2,500
    From this org
    $0
    From related orgs
    $2,500
    Other
    $0
    Hours/week
    1 + 4 related

  • Drew Keesbury

    CFO/Treasurer

    Total calculated
    $0
    Hours/week
    1 + 36 related

  • Michael R Rinard

    Secretary

    Total calculated
    $315,515
    From this org
    $0
    From related orgs
    $273,849
    Other
    $41,666
    Hours/week
    1 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $213,676 related
    Bonus
    $0 + $58,812 related
    Other
    $0 + $1,361 related
    Deferred
    $0 + $9,254 related
    Nontaxable benefits
    $0 + $32,412 related
    Filer's total
    $0 + $315,515 related

  • Nathan Blackford

    President

    Total calculated
    $387,019
    From this org
    $346,157
    From related orgs
    $0
    Other
    $40,862
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $271,302
    Bonus
    $73,973
    Other
    $882
    Deferred
    $10,250
    Nontaxable benefits
    $30,612
    Filer's total
    $387,019

  • Benjamin Kinderknecht DO

    Staff Physician

    Total calculated
    $544,149
    From this org
    $502,475
    From related orgs
    $0
    Other
    $41,674
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $501,017
    Bonus
    $0
    Other
    $1,458
    Deferred
    $10,250
    Nontaxable benefits
    $31,424
    Filer's total
    $544,149

  • John Terry T Symonds DO

    Staff Physician

    Total calculated
    $615,620
    From this org
    $573,196
    From related orgs
    $0
    Other
    $42,424
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $400,629
    Bonus
    $152,361
    Other
    $20,206
    Deferred
    $12,200
    Nontaxable benefits
    $30,224
    Filer's total
    $615,620

  • Lorraine Dodson MD

    Staff Physician

    Total calculated
    $585,629
    From this org
    $565,190
    From related orgs
    $0
    Other
    $20,439
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $447,075
    Bonus
    $100,315
    Other
    $17,800
    Deferred
    $10,878
    Nontaxable benefits
    $9,561
    Filer's total
    $585,629

  • Timothy J Monahan MD

    Staff Physician

    Total calculated
    $754,202
    From this org
    $714,061
    From related orgs
    $0
    Other
    $40,141
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $713,467
    Bonus
    $0
    Other
    $594
    Deferred
    $7,167
    Nontaxable benefits
    $32,974
    Filer's total
    $754,202

  • William J Kinderknecht DO

    Staff Physician

    Total calculated
    $562,272
    From this org
    $521,798
    From related orgs
    $0
    Other
    $40,474
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $418,161
    Bonus
    $90,473
    Other
    $13,164
    Deferred
    $10,250
    Nontaxable benefits
    $30,224
    Filer's total
    $562,272

  • Dwain Stilson

    Former CFO/Treasurer

    Total calculated
    $163,042
    From this org
    $0
    From related orgs
    $157,969
    Other
    $5,073
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $157,169 related
    Bonus
    $0 + $550 related
    Other
    $0 + $250 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $5,073 related
    Filer's total
    $0 + $163,042 related

  • Karen S Miller

    Former CFO/Treasurer

    Total calculated
    $191,840
    From this org
    $0
    From related orgs
    $179,091
    Other
    $12,749
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $178,284 related
    Bonus
    $0
    Other
    $0 + $807 related
    Deferred
    $0 + $7,236 related
    Nontaxable benefits
    $0 + $5,513 related
    Filer's total
    $0 + $191,840 related

  • Mark Laney MD

    Former Director/CEO

    Total calculated
    $3,059,649
    From this org
    $0
    From related orgs
    $3,032,113
    Other
    $27,536
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $3,027,894 related
    Bonus
    $0 + $228 related
    Other
    $0 + $3,991 related
    Deferred
    $0 + $8,220 related
    Nontaxable benefits
    $0 + $19,316 related
    Filer's total
    $0 + $3,059,649 related

  • Michael Pulido

    Former Secretary/Director/Chair

    Total calculated
    $1,292,933
    From this org
    $0
    From related orgs
    $1,258,302
    Other
    $34,631
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $1,255,487 related
    Bonus
    $0
    Other
    $0 + $2,815 related
    Deferred
    $0 + $8,102 related
    Nontaxable benefits
    $0 + $26,529 related
    Filer's total
    $0 + $1,292,933 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)

Schedule J, Part I, Line 4a Severance or change-of-control payment
Mosaic Health System, a related organization, paid Samuel Mark Laney, CEO, severance payments during calendar year 2022. This is reported on Form 990, Part VII and Schedule J, Part II as other reportable compensation. Mosaic Health System, a related organization, paid Michael Pulido, COO, severance payments during calendar year 2022. This is reported on Form 990, Part VII and Schedule J, Part II as other reportable compensation.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
NATHAN BLACKFORD - VESTED $0; ACCRUED $28,000 GENE A CLAYCOMB - VESTED $0; ACCRUED $50,400 DAVIN TURNER - VESTED $0; ACCRUED $21,000 MICHAEL R RINARD - VESTED $0; ACCRUED $31,360 JOHN M POORE - VESTED $0; ACCRUED $116,667 THOSE LISTED ABOVE HAVE SIGNED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WHICH RECOGNIZES THE VALUE OF THE INDIVIDUAL AND THE MUTUAL BENEFIT OF CONTINUED EMPLOYMENT FOR AN EXTENDED PERIOD OF TIME BY ESTABLISHING A 457F PLAN. THE FOLLOWING ARE THE GENERAL STIPULATIONS OF THE AGREEMENT: 1. THE PLAN IS FUNDED YEARLY AS THE RESULT OF A CALCULATION DESCRIBED IN THE AGREEMENT, WHICH WILL REWARD THE INDIVIDUAL WITH 100% VESTING BASED ON A 5-YEAR CLIFF VESTING SCHEDULE. 2. FOR SERP PARTICIPANTS PRIOR TO 2019, DISTRIBUTION WILL OCCUR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE. THEN A LUMP SUM PAYMENT WILL BE DISBURSED WITHIN 90 DAYS OF EACH SITUATION TAKING INTO CONSIDERATION A NON-COMPETE COVENANT. 3. FOR SERP PARTICIPANTES AFTER 2019, DISTRIBUTION WILL OCCUR UPON DEATH OR UPON SEPARATION FROM SERVICE DUE TO DISABILITY OR UPON INVOLUNTARY SEPARATION FROM SERVICE WITHOUT CAUSE. THEN A LUMP SUM PAYMENT DISTRIBUTES WITHIN 60 DAYS AND DOESN'T TAKE INTO ACCOUNT NON-COMPETE COVENANT. 4. SEPARATION WITH CAUSE MAKES THE SUPPLEMENTAL EXECUTIVE RETIREMENT AGREEMENT NULL AND VOID.
Schedule J, Part I, Line 3 Compensation Plan
COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, A RELATED ENTITY, USING THE FOLLOWING: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEYS OR STUDIES 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

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.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2022
Filed
8 May 2024
IRS schema version
2022v5.0
Source object
202431299349303773

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

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