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Nonprofiteer
← NORTHWEST MEDICAL CENTER ASSOCIATION INC

Form 990 for tax year 2023

Filed by NORTHWEST MEDICAL CENTER ASSOCIATION INC.

Totals

Total revenue
$28,357,942
Total expenses
$25,868,995
Contributions and grants received
$738,322
Grants paid
$5,099
Program service revenue
$27,361,728
Investment income
$79,180
Other revenue
$178,712
Total assets, end of year
$21,267,347
Total liabilities, end of year
$11,179,085
Net assets or fund balances, end of year
$10,088,262
Program services expenses (Part IX)
$21,457,781
Management and general expenses
$4,411,214
Fundraising expenses
$0
Program service expenses (Part III)
$21,457,781

Program services were 82.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • John M Poore

    Director/CEO

    Total calculated
    $1,176,830
    From this org
    $0
    From related orgs
    $1,136,919
    Other
    $39,911
    Hours/week
    1 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $995,932 related
    Bonus
    $0 + $135,653 related
    Other
    $0 + $5,334 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $26,711 related
    Filer's total
    $0 + $1,176,830 related

  • Davin Turner DO

    Director

    Total calculated
    $688,661
    From this org
    $0
    From related orgs
    $645,499
    Other
    $43,162
    Hours/week
    1 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $594,549 related
    Bonus
    $0 + $45,616 related
    Other
    $0 + $5,334 related
    Deferred
    $0 + $12,413 related
    Nontaxable benefits
    $0 + $30,749 related
    Filer's total
    $0 + $688,661 related

  • Gene A Claycomb

    Director

    Total calculated
    $463,405
    From this org
    $0
    From related orgs
    $418,503
    Other
    $44,902
    Hours/week
    1 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $376,783 related
    Bonus
    $0 + $35,458 related
    Other
    $0 + $6,262 related
    Deferred
    $0 + $10,991 related
    Nontaxable benefits
    $0 + $33,911 related
    Filer's total
    $0 + $463,405 related

  • Matt Baker

    Director/Vice Chair

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

  • Serena Naylor

    Director/Chair

    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
    $476,604
    From this org
    $0
    From related orgs
    $459,172
    Other
    $17,432
    Hours/week
    1 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $445,072 related
    Bonus
    $0 + $13,200 related
    Other
    $0 + $900 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $17,432 related
    Filer's total
    $0 + $476,604 related

  • Katie Dias DO

    President - Mosaic Life Care Albany

    Total calculated
    $319,629
    From this org
    $295,975
    From related orgs
    $0
    Other
    $23,654
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $263,107
    Bonus
    $32,136
    Other
    $732
    Deferred
    $4,588
    Nontaxable benefits
    $19,066
    Filer's total
    $319,629

  • Michael R Rinard

    Secretary

    Total calculated
    $326,423
    From this org
    $0
    From related orgs
    $281,508
    Other
    $44,915
    Hours/week
    1 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $255,214 related
    Bonus
    $0 + $24,256 related
    Other
    $0 + $2,038 related
    Deferred
    $0 + $11,666 related
    Nontaxable benefits
    $0 + $33,249 related
    Filer's total
    $0 + $326,423 related

  • Angelia Martin MD

    Staff Physician

    Total calculated
    $313,577
    From this org
    $273,421
    From related orgs
    $2,500
    Other
    $37,656
    Hours/week
    37 + 3 related

    Schedule J breakdown matched by us

    Base
    $268,850 + $2,500 related
    Bonus
    $2,000
    Other
    $2,571
    Deferred
    $5,595
    Nontaxable benefits
    $32,061
    Filer's total
    $311,077 + $2,500 related

  • Callie Hunter

    APRN - Albany

    Total calculated
    $138,738
    From this org
    $116,312
    From related orgs
    $0
    Other
    $22,426
    Hours/week
    40

  • James Bartley DO

    Staff Physician

    Total calculated
    $356,929
    From this org
    $315,154
    From related orgs
    $0
    Other
    $41,775
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $313,246
    Bonus
    $0
    Other
    $1,908
    Deferred
    $9,726
    Nontaxable benefits
    $32,049
    Filer's total
    $356,929

  • Lori L Bishop

    Director - Nursing Services - Albany

    Total calculated
    $143,902
    From this org
    $121,513
    From related orgs
    $0
    Other
    $22,389
    Hours/week
    40

  • Stacey Karns

    Physician Assistant

    Total calculated
    $131,395
    From this org
    $125,941
    From related orgs
    $0
    Other
    $5,454
    Hours/week
    40

  • Mark Laney MD

    Former Director/CEO

    Total calculated
    $1,061,154
    From this org
    $0
    From related orgs
    $1,061,154
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $1,061,154 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $1,061,154 related

  • Michael Pulido

    Former Secretary/Chair

    Total calculated
    $611,076
    From this org
    $0
    From related orgs
    $590,338
    Other
    $20,738
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $590,338 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $20,738 related
    Filer's total
    $0 + $611,076 related

  • Thomas Bieterman

    Former Director/CFO

    Total calculated
    $198,677
    From this org
    $0
    From related orgs
    $185,860
    Other
    $12,817
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $185,573 related
    Bonus
    $0 + $287 related
    Other
    $0
    Deferred
    $0 + $2,890 related
    Nontaxable benefits
    $0 + $9,927 related
    Filer's total
    $0 + $198,677 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 3 Arrangement used to establish the top management official's compensation
COMPENSATION IS ESTABLISHED BY MOSAIC HEALTH SYSTEM, a related tax-exempt organization, USING THE FOLLOWING: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. COMPENSATION SURVEYS OR STUDIES 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
Schedule J, Part I, Line 4a Severance or change-of-control payment
Mosaic Health System, a related tax-exempt organization, paid Samuel Mark Laney, CEO, severance payments during calendar year 2023. This is reported on Form 990, Part VII and Schedule J, Part II as other reportable compensation. Mosaic Health System, a related tax-exempt organization, paid Michael Pulido, COO, severance payments during calendar year 2023. 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
JOHN M POORE - VESTED $0; ACCRUED $200,000 GENE A CLAYCOMB - VESTED $0; ACCRUED $54,431 DAVIN TURNER, DO - VESTED $0; ACCRUED $84,000 MICHAEL R RINARD - VESTED $0; ACCRUED $31,360 DREW KEESBURY - VESTED $0; ACCRUED $53,667 KATIE DIAS, DO - VESTED $0; ACCRUED $20,085 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.

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 corporations and trusts

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

Provenance

Return type
form_990
Tax year
2023
Filed
12 May 2025
IRS schema version
2023v6.0
Source object
202531329349302658

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