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Nonprofiteer
← UPPER VALLEY MEDICAL CENTER

Form 990 for tax year 2022

Filed by UPPER VALLEY MEDICAL CENTER.

Totals

Total revenue
$164,650,246
Total expenses
$136,929,479
Contributions and grants received
$3,420,937
Grants paid
$2,301,916
Program service revenue
$156,626,029
Investment income
$2,286,745
Other revenue
$2,316,535
Total assets, end of year
$183,380,421
Total liabilities, end of year
$111,904,429
Net assets or fund balances, end of year
$71,475,992
Program services expenses (Part IX)
$131,661,885
Management and general expenses
$5,267,594
Fundraising expenses
$0
Program service expenses (Part III)
$131,661,885

Program services were 96.2% 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.

  • 1e · Government grants (contributions)

    $3,250,738

  • 1f · All other contributions, gifts and grants

    $170,199

  • 1g · Noncash contributions included above

    $38,892

  • 2a · Program service revenue: NET PATIENT SERVICE REVENUE

    total $80,483,969 · related or exempt $80,483,969

  • 2b · Program service revenue: MEDICARE / MEDICAID

    total $75,795,583 · related or exempt $75,795,583

  • 2c · Program service revenue: HOSP FRANCHISE TAX RECOVERIES

    total $248,451 · related or exempt $248,451

  • 2d · Program service revenue: ATHLETIC TRAINING

    total $62,741 · related or exempt $62,741

  • 2e · Program service revenue: MEDICAL RECORDS

    total $35,285 · related or exempt $35,285

  • 3 · Investment income

    total $1,028,314 · excluded $1,028,314

  • 6a · Gross rents

    real property $3,757,534

  • 6b · Less rental expenses

    real property $3,028,874

  • 6c · Rental income or loss

    real property $728,660

  • 6d · Net rental income or loss

    total $728,660 · excluded $728,660

  • 7a · Gross sales of assets other than inventory

    securities $208,890,926 · other assets $187,757

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

    securities $207,763,813 · other assets $56,439

  • 7c · Gain or loss

    securities $1,127,113 · other assets $131,318

  • 7d · Net gain or loss

    total $1,258,431 · excluded $1,258,431

  • 10a · Gross sales of inventory

    $198,454

  • 10b · Cost of goods sold

    $198,453

  • 10c · Net income from sales of inventory

    total $1 · excluded $1

  • 11a · Other revenue: PENSION INCOME

    total $786,799 · excluded $786,799

  • 11b · Other revenue: FEMA REVENUE

    total $710,981 · excluded $710,981

  • 11c · Other revenue: EMS EDUCATION

    total $10,151 · excluded $10,151

  • 11d · All other revenue

    total $79,943 · unrelated business $2,416 · excluded $77,527

  • 11e · Other revenue, total

    $1,587,874

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $2,301,916 · program services $2,301,916

  • 5 · Compensation of officers, directors and key employees

    total $1,550,264 · program services $895,504 · management and general $654,760

  • 6 · Compensation of disqualified persons

    total $371,825 · management and general $371,825

  • 7 · Other salaries and wages

    total $46,189,434 · program services $44,208,612 · management and general $1,980,822

  • 8 · Pension plan contributions

    total $2,616,275 · program services $2,452,734 · management and general $163,541

  • 9 · Other employee benefits

    total $3,822,093 · program services $3,583,177 · management and general $238,916

  • 10 · Payroll taxes

    total $3,424,075 · program services $3,210,039 · management and general $214,036

  • 11a · Fees: management

    total $101,367 · program services $101,367

  • 11b · Fees: legal

    total $4,872 · management and general $4,872

  • 11d · Fees: lobbying

    total $4,539 · management and general $4,539

  • 11f · Fees: investment management

    total $166,384 · management and general $166,384

  • 11g · Fees: other

    total $33,742,062 · program services $32,860,523 · management and general $881,539

  • 12 · Advertising and promotion

    total $434,248 · program services $434,248

  • 13 · Office expenses

    total $525,928 · program services $267,945 · management and general $257,983

  • 14 · Information technology

    total $735,825 · program services $622,697 · management and general $113,128

  • 16 · Occupancy

    total $4,794,347 · program services $4,786,702 · management and general $7,645

  • 17 · Travel

    total $27,022 · program services $24,381 · management and general $2,641

  • 20 · Interest

    total $1,633,457 · program services $1,633,457

  • 22 · Depreciation, depletion and amortization

    total $9,007,511 · program services $9,007,511

  • 23 · Insurance

    total $703,293 · program services $680,703 · management and general $22,590

  • 24a · Other expenses: OPERATING SUPPLIES

    total $18,663,535 · program services $18,663,535

  • 24b · Other expenses: HOSPITAL FRANCHISE TAX

    total $4,430,917 · program services $4,430,917

  • 24c · Other expenses: REPAIRS AND MAINTENANCE

    total $1,164,142 · program services $1,164,142

  • 24d · Other expenses: MINOR EQUIPMENT

    total $209,075 · program services $207,317 · management and general $1,758

  • 24e · All other expenses

    total $305,073 · program services $124,458 · management and general $180,615

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $2,510 · end of year $2,560

  • 2 · Savings and temporary cash investments

    beginning of year $5,612,911 · end of year $6,293,431

  • 4 · Accounts receivable

    beginning of year $24,553,932 · end of year $24,709,345

  • 7 · Other notes and loans receivable

    beginning of year $167,837 · end of year $1,153,487

  • 8 · Inventories for sale or use

    beginning of year $1,399,576 · end of year $1,251,423

  • 9 · Prepaid expenses and deferred charges

    beginning of year $1,503,419 · end of year $936,774

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

    $222,758,818

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

    $151,286,042

  • 10c · Land, buildings and equipment, net

    beginning of year $73,096,492 · end of year $71,472,776

  • 11 · Investments: publicly traded securities

    beginning of year $65,997,499 · end of year $50,491,018

  • 12 · Investments: other securities

    beginning of year $25,886,556 · end of year $25,883,359

  • 15 · Other assets

    beginning of year $863,723 · end of year $1,186,248

  • 17 · Accounts payable and accrued expenses

    beginning of year $12,767,656 · end of year $11,496,092

  • 18 · Grants payable

    beginning of year $5,757,841 · end of year $2,851,461

  • 20 · Tax-exempt bond liabilities

    beginning of year $54,156,566 · end of year $53,904,415

  • 23 · Secured mortgages and notes payable

    beginning of year $894,715 · end of year $693,307

  • 25 · Other liabilities

    beginning of year $34,289,475 · end of year $42,959,154

  • 27 · Net assets without donor restrictions

    beginning of year $91,218,202 · end of year $71,475,992

Mission and programs · 2022

Mission

UPPER VALLEY MEDICAL CENTER WILL IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH OTHERS WHO SHARE OUR COMMITMENT TO PROVIDE HIGH-QUALITY, COST-COMPETITIVE HEALTH SERVICES.

Activities or mission (Part I)

SEE PART III, LINE 1

  • THE PRIMARY EXEMPT PURPOSE OF UPPER VALLEY MEDICAL CENTER IS TO PROVIDE COMPREHENSIVE INPATIENT, OUTPATIENT, AND EMERGENCY HEALTH CARE SERVICES TO THE RESIDENTS OF CHAMPAIGN, DARKE, MIAMI, AND SHELBY COUNTIES. THE HOSPITAL FURTHERS ITS TAX-EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY IN MANY WAYS. SEE SCHEDULE H FOR MORE INFORMATION.

    Expenses $131,661,885 · Grants $2,301,916 · Revenue $156,626,029

As filed on the 2022 return.

Listed in Part VII

  • MARY H BOOSALIS

    PREMIER PRES & CEO (TO JAN)

    Total calculated
    $2,291,841
    From this org
    $0
    From related orgs
    $2,267,077
    Other
    $24,764
    Hours/week
    10 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $243,179 related
    Bonus
    $0 + $1,799,215 related
    Other
    $0 + $224,683 related
    Deferred
    $0 + $18,855 related
    Nontaxable benefits
    $0 + $5,909 related
    Filer's total
    $0 + $2,291,841 related

  • MICHAEL C RIORDAN

    PREMIER PRES & CEO (FROM JAN)

    Total calculated
    $1,308,572
    From this org
    $0
    From related orgs
    $1,280,440
    Other
    $28,132
    Hours/week
    10 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,067,901 related
    Bonus
    $0
    Other
    $0 + $212,539 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $28,132 related
    Filer's total
    $0 + $1,308,572 related

  • FAYEZ D ABBOUD MD

    BOARD CHAIR

    Total calculated
    $803,989
    From this org
    $0
    From related orgs
    $767,153
    Other
    $36,836
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $573,568 related
    Bonus
    $0 + $156,559 related
    Other
    $0 + $37,026 related
    Deferred
    $0 + $10,757 related
    Nontaxable benefits
    $0 + $26,079 related
    Filer's total
    $0 + $803,989 related

  • ROBERT M KOHUT MD

    TRUSTEE

    Total calculated
    $740,683
    From this org
    $0
    From related orgs
    $701,281
    Other
    $39,402
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $673,120 related
    Bonus
    $0 + $6,970 related
    Other
    $0 + $21,191 related
    Deferred
    $0 + $9,514 related
    Nontaxable benefits
    $0 + $29,888 related
    Filer's total
    $0 + $740,683 related

  • KEVIN W HARLAN

    PRESIDENT

    Total calculated
    $577,668
    From this org
    $457,330
    From related orgs
    $90,541
    Other
    $29,797
    Hours/week
    37 + 2.5 related

    Schedule J breakdown matched by us

    Base
    $316,920 + $85,638 related
    Bonus
    $126,734
    Other
    $13,676 + $4,903 related
    Deferred
    $15,259 + $3,633 related
    Nontaxable benefits
    $8,808 + $2,097 related
    Filer's total
    $481,397 + $96,271 related

  • DANIEL J ELSHOFF MD

    TRUSTEE

    Total calculated
    $563,127
    From this org
    $0
    From related orgs
    $518,828
    Other
    $44,299
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $316,771 related
    Bonus
    $0 + $179,981 related
    Other
    $0 + $22,076 related
    Deferred
    $0 + $13,135 related
    Nontaxable benefits
    $0 + $31,164 related
    Filer's total
    $0 + $563,127 related

  • SCOTT B KANAGY DO

    TRUSTEE & CMO

    Total calculated
    $513,428
    From this org
    $473,073
    From related orgs
    $0
    Other
    $40,355
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $367,268
    Bonus
    $103,874
    Other
    $1,931
    Deferred
    $12,992
    Nontaxable benefits
    $27,363
    Filer's total
    $513,428

  • TRISHA L WACKLER

    TRUSTEE & COO / CNO

    Total calculated
    $382,076
    From this org
    $355,334
    From related orgs
    $0
    Other
    $26,742
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $264,813
    Bonus
    $71,122
    Other
    $19,399
    Deferred
    $12,555
    Nontaxable benefits
    $14,187
    Filer's total
    $382,076

  • EBBA RAJAB MD

    TRUSTEE

    Total calculated
    $800
    From this org
    $0
    From related orgs
    $800
    Other
    $0
    Hours/week
    0.5

  • DIANNE RUHENKAMP

    BOARD TREASURER

    Total calculated
    $173,363
    From this org
    $144,447
    From related orgs
    $0
    Other
    $28,916
    Hours/week
    38.5 + 1 related

    Schedule J breakdown matched by us

    Base
    $127,842
    Bonus
    $16,000
    Other
    $605
    Deferred
    $8,723
    Nontaxable benefits
    $20,193
    Filer's total
    $173,363

  • ANDREA L FLAUTE

    BOARD SECRETARY

    Total calculated
    $123,107
    From this org
    $0
    From related orgs
    $108,290
    Other
    $14,817
    Hours/week
    0.5 + 39.5 related

  • GEOFFREY P WALKER

    CHIEF LEGAL OFFICER

    Total calculated
    $990,981
    From this org
    $0
    From related orgs
    $942,545
    Other
    $48,436
    Hours/week
    9 + 31 related

    Schedule J breakdown matched by us

    Base
    $0 + $483,803 related
    Bonus
    $0 + $150,928 related
    Other
    $0 + $307,814 related
    Deferred
    $0 + $18,871 related
    Nontaxable benefits
    $0 + $29,565 related
    Filer's total
    $0 + $990,981 related

  • MARC R BELCASTRO DO

    VP MEDICAL AFFAIRS & PREMIER CMO

    Total calculated
    $871,096
    From this org
    $0
    From related orgs
    $834,885
    Other
    $36,211
    Hours/week
    10 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $598,103 related
    Bonus
    $0 + $181,805 related
    Other
    $0 + $54,977 related
    Deferred
    $0 + $10,475 related
    Nontaxable benefits
    $0 + $25,736 related
    Filer's total
    $0 + $871,096 related

  • KEITH D BRICKING MD

    VP & CHIEF CLINICAL OFFICER (FROM OCT)

    Total calculated
    $849,780
    From this org
    $0
    From related orgs
    $782,373
    Other
    $67,407
    Hours/week
    10 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $571,733 related
    Bonus
    $0 + $199,778 related
    Other
    $0 + $10,862 related
    Deferred
    $0 + $34,979 related
    Nontaxable benefits
    $0 + $32,428 related
    Filer's total
    $0 + $849,780 related

  • MARY M CLANCY

    CHIEF DIGITAL OFFICER

    Total calculated
    $756,956
    From this org
    $0
    From related orgs
    $704,534
    Other
    $52,422
    Hours/week
    10 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $470,691 related
    Bonus
    $0 + $150,789 related
    Other
    $0 + $83,054 related
    Deferred
    $0 + $19,693 related
    Nontaxable benefits
    $0 + $32,729 related
    Filer's total
    $0 + $756,956 related

  • J MICHAEL SIMS

    SYS VP & CORPORATE CONTROLLER

    Total calculated
    $727,946
    From this org
    $0
    From related orgs
    $677,602
    Other
    $50,344
    Hours/week
    9 + 31 related

    Schedule J breakdown matched by us

    Base
    $0 + $355,741 related
    Bonus
    $0 + $138,119 related
    Other
    $0 + $183,742 related
    Deferred
    $0 + $19,235 related
    Nontaxable benefits
    $0 + $31,109 related
    Filer's total
    $0 + $727,946 related

  • MARGARET PEGGY W MARK

    VP NURSING/CNO/PATIENT EXP-PH (TO APR)

    Total calculated
    $746,384
    From this org
    $0
    From related orgs
    $566,116
    Other
    $180,268
    Hours/week
    10 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $127,686 related
    Bonus
    $0 + $133,099 related
    Other
    $0 + $305,331 related
    Deferred
    $0 + $154,451 related
    Nontaxable benefits
    $0 + $25,817 related
    Filer's total
    $0 + $746,384 related

  • AMANDA K ADKINS-RICCI

    SYSTEM VP REVENUE CYCLE

    Total calculated
    $310,301
    From this org
    $0
    From related orgs
    $287,332
    Other
    $22,969
    Hours/week
    10 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $241,887 related
    Bonus
    $0 + $44,970 related
    Other
    $0 + $475 related
    Deferred
    $0 + $11,512 related
    Nontaxable benefits
    $0 + $11,457 related
    Filer's total
    $0 + $310,301 related

  • LISA M GOSSETT

    VP NURSING/CNO/PATIENT EXP-PH (FROM JUN)

    Total calculated
    $215,250
    From this org
    $0
    From related orgs
    $202,745
    Other
    $12,505
    Hours/week
    10 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $200,746 related
    Bonus
    $0
    Other
    $0 + $1,999 related
    Deferred
    $0 + $2,855 related
    Nontaxable benefits
    $0 + $9,650 related
    Filer's total
    $0 + $215,250 related

  • RYAN E MCELDOWNEY

    CLINICAL STAFF PHARMACIST I

    Total calculated
    $226,414
    From this org
    $189,605
    From related orgs
    $0
    Other
    $36,809
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $189,485
    Bonus
    $0
    Other
    $120
    Deferred
    $9,893
    Nontaxable benefits
    $26,916
    Filer's total
    $226,414

  • MARSHA S HESS

    CLINICAL STAFF PHARMACIST I

    Total calculated
    $217,963
    From this org
    $187,396
    From related orgs
    $0
    Other
    $30,567
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $187,240
    Bonus
    $0
    Other
    $156
    Deferred
    $5,415
    Nontaxable benefits
    $25,152
    Filer's total
    $217,963

  • TERESA A GULKER

    DIR NRS-WMS SRVC-BEH HLTH

    Total calculated
    $211,413
    From this org
    $188,383
    From related orgs
    $0
    Other
    $23,030
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $149,860
    Bonus
    $37,056
    Other
    $1,467
    Deferred
    $12,495
    Nontaxable benefits
    $10,535
    Filer's total
    $211,413

  • DUANNA R OSTING

    PRES/EXEC DIR-UVMC FOUNDATION

    Total calculated
    $210,442
    From this org
    $182,683
    From related orgs
    $0
    Other
    $27,759
    Hours/week
    10

    Schedule J breakdown matched by us

    Base
    $140,308
    Bonus
    $41,690
    Other
    $685
    Deferred
    $6,056
    Nontaxable benefits
    $21,703
    Filer's total
    $210,442

  • MIKI L GILLESPIE

    RESP THERP II - REG

    Total calculated
    $209,309
    From this org
    $155,625
    From related orgs
    $23,760
    Other
    $29,924
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $145,673 + $19,696 related
    Bonus
    $9,850 + $4,050 related
    Other
    $102 + $14 related
    Deferred
    $3,374 + $440 related
    Nontaxable benefits
    $23,097 + $3,013 related
    Filer's total
    $182,096 + $27,213 related

  • TIMOTHY D SNIDER

    FORMER TRUSTEE & OFFICER

    Total calculated
    $371,825
    From this org
    $328,430
    From related orgs
    $0
    Other
    $43,395
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $70,757
    Other
    $257,673
    Deferred
    $16,007
    Nontaxable benefits
    $27,388
    Filer's total
    $371,825

  • DIANE L PLEIMAN

    FORMER OFFICER

    Total calculated
    $876,949
    From this org
    $0
    From related orgs
    $851,501
    Other
    $25,448
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $436,713 related
    Bonus
    $0 + $225,134 related
    Other
    $0 + $189,654 related
    Deferred
    $0 + $16,571 related
    Nontaxable benefits
    $0 + $8,877 related
    Filer's total
    $0 + $876,949 related

  • BENJAMIN A WATSON ESQ

    FORMER OFFICER

    Total calculated
    $228,296
    From this org
    $0
    From related orgs
    $212,206
    Other
    $16,090
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $175,577 related
    Bonus
    $0 + $36,299 related
    Other
    $0 + $330 related
    Deferred
    $0 + $6,107 related
    Nontaxable benefits
    $0 + $9,983 related
    Filer's total
    $0 + $228,296 related

  • BARBARA A JOHNSON

    FORMER KEY EMPLOYEE

    Total calculated
    $1,191,910
    From this org
    $0
    From related orgs
    $1,165,699
    Other
    $26,211
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $779,540 related
    Bonus
    $0 + $297,335 related
    Other
    $0 + $88,824 related
    Deferred
    $0 + $14,063 related
    Nontaxable benefits
    $0 + $12,148 related
    Filer's total
    $0 + $1,191,910 related

  • GARY G GINTER

    FORMER KEY EMPLOYEE

    Total calculated
    $864,000
    From this org
    $0
    From related orgs
    $814,929
    Other
    $49,071
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $450,593 related
    Bonus
    $0 + $126,517 related
    Other
    $0 + $237,819 related
    Deferred
    $0 + $19,235 related
    Nontaxable benefits
    $0 + $29,836 related
    Filer's total
    $0 + $864,000 related

  • JENNIFER J HAULER DO

    FORMER KEY EMPLOYEE

    Total calculated
    $784,507
    From this org
    $0
    From related orgs
    $765,079
    Other
    $19,428
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $557,482 related
    Bonus
    $0 + $184,044 related
    Other
    $0 + $23,553 related
    Deferred
    $0 + $17,044 related
    Nontaxable benefits
    $0 + $2,384 related
    Filer's total
    $0 + $784,507 related

  • ELAINE LAINIE M DEAN

    FORMER KEY EMPLOYEE

    Total calculated
    $586,099
    From this org
    $0
    From related orgs
    $560,347
    Other
    $25,752
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $407,817 related
    Bonus
    $0 + $129,774 related
    Other
    $0 + $22,756 related
    Deferred
    $0 + $11,065 related
    Nontaxable benefits
    $0 + $14,687 related
    Filer's total
    $0 + $586,099 related

  • BILLIE L LUCENTE-BAKER

    FORMER KEY EMPLOYEE

    Total calculated
    $351,034
    From this org
    $0
    From related orgs
    $319,191
    Other
    $31,843
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $241,999 related
    Bonus
    $0 + $76,411 related
    Other
    $0 + $781 related
    Deferred
    $0 + $16,655 related
    Nontaxable benefits
    $0 + $15,188 related
    Filer's total
    $0 + $351,034 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
COMPENSATION FOR UPPER VALLEY'S CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH UPPER VALLEY IS AN AFFILIATE. SEE EXPLANATION ON SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15.
PART I, LINE 4A:
THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT IN 2022: MARY BOOSALIS $218,596; MARGARET MARK $273,306; TIMOTHY SNIDER $271,152.
PART I, LINE 4B:
DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, CERTAIN PERSONS ARE LIMITED IN THE AMOUNT OF BENEFIT THAT CAN BE EARNED UNDER A QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, UPPER VALLEY AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. UPPER VALLEY SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN AND A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE BENEFITS UNDER THESE SUPPLEMENTAL NONQUALIFIED PLANS ARE SUBJECT TO MULTI-YEAR VESTING AND A PARTICIPANT CAN FORFEIT BENEFITS EARNED IF VESTING REQUIREMENTS ARE NOT SATISFIED. UNDER THE TERMS OF THE SUPPLEMENTAL PLANS, AND BECAUSE OF TAX RULES PERTAINING TO TAXATION OF THE EARNED BENEFITS UPON VESTING, CERTAIN INDIVIDUALS RECEIVED A PAYOUT OF THE CUMULATIVE VESTED BENEFITS UNDER THEIR SUPPLEMENTAL PLAN DURING 2022. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN AND RECEIVED THE ASSOCIATED PAYMENT IN 2022: MARY CLANCY $78,305; DIANE L. PLEIMAN $166,819; J MICHAEL SIMS $156,921; GEOFFREY P. WALKER $300,385. THE INDIVIDUALS LISTED BELOW HAVE MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE SERP AND RECEIVED THE ASSOCIATED PLAN PAYMENT 2022: MARC R. BELCASTRO, D.O. $43,756; GARY GINTER $230,909; BARBARA A. JOHNSON $74,090; MARGARET W. MARK $17,830. IN ADDITION, THE FOLLOWING SERP AMOUNTS WERE DEFERRED ON THE PARTICIPANTS' BEHALF DURING THE YEAR AND WILL BE HELD UNTIL THE INCREMENTAL AMOUNTS ARE VESTED: KEITH BRICKING, M.D. $25,383; KEVIN HARLAN $8,946; JENNIFER J. HAULER, D.O. $7,358; SCOTT B. KANAGY, D.O. $3,285; BILLIE LUCENTE-BAKER $1,828; TRISHA L. WACKLER $227. BASED ON THE GUIDANCE PROVIDED IN THE INSTRUCTIONS TO THE FORM 990, ANY PAYMENTS TO THE PARTICIPANTS RELATED TO THESE PLANS THAT WERE MADE WITHIN 2-1/2 MONTHS AFTER THE END OF THE ORGANIZATION'S TAX YEAR ARE NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES.

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

The 10 largest by cash amount. The API serves every itemized grant.

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
14 November 2023
IRS schema version
2022v5.0
Source object
202313189349314786

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

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