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Nonprofiteer
← DOMINICAN SANTA CRUZ HOSPITAL FOUNDATION

Form 990 for tax year 2023

Filed by DOMINICAN SANTA CRUZ HOSPITAL FOUNDATION.

Totals

Total revenue
$4,205,287
Total expenses
$3,254,628
Contributions and grants received
$3,735,263
Grants paid
$2,401,214
Program services expenses (Part IX)
$2,401,214
Management and general expenses
$744,114
Fundraising expenses
$109,300
Program service expenses (Part III)
$2,401,214

Program services were 73.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • NANETTE MICKIEWICZ MD

    BOARD MEMBER

    Total calculated
    $1,021,061
    From this org
    $0
    From related orgs
    $870,368
    Other
    $150,693
    Hours/week
    4 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $456,013 related
    Bonus
    $0 + $396,639 related
    Other
    $0 + $17,716 related
    Deferred
    $0 + $113,802 related
    Nontaxable benefits
    $0 + $36,890 related
    Filer's total
    $0 + $1,021,060 related

  • JEFFREY P DANEFF

    TREASURER/ CFO

    Total calculated
    $452,230
    From this org
    $0
    From related orgs
    $391,571
    Other
    $60,659
    Hours/week
    0.25 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $305,081 related
    Bonus
    $0 + $81,041 related
    Other
    $0 + $5,449 related
    Deferred
    $0 + $23,710 related
    Nontaxable benefits
    $0 + $36,949 related
    Filer's total
    $0 + $452,230 related

  • DREW A GAGNER

    FORMER OFFICER (VP, EXEC DIRECTOR)

    Total calculated
    $422,353
    From this org
    $0
    From related orgs
    $350,401
    Other
    $71,952
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $299,875 related
    Bonus
    $0 + $48,076 related
    Other
    $0 + $2,450 related
    Deferred
    $0 + $42,581 related
    Nontaxable benefits
    $0 + $29,371 related
    Filer's total
    $0 + $422,353 related

  • GERALD JERRY SOUZA

    BOARD MEMBER

    Total calculated
    $309,444
    From this org
    $0
    From related orgs
    $267,564
    Other
    $41,880
    Hours/week
    0.25 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $219,322 related
    Bonus
    $0 + $45,229 related
    Other
    $0 + $3,013 related
    Deferred
    $0 + $27,110 related
    Nontaxable benefits
    $0 + $14,770 related
    Filer's total
    $0 + $309,444 related

  • ANTHONY PAGLIARO

    BOARD MEMBER/VP, EXECUTIVE DIRECTOR

    Total calculated
    $235,084
    From this org
    $0
    From related orgs
    $204,966
    Other
    $30,118
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $178,062 related
    Bonus
    $0 + $25,956 related
    Other
    $0 + $948 related
    Deferred
    $0 + $16,267 related
    Nontaxable benefits
    $0 + $13,851 related
    Filer's total
    $0 + $235,084 related

  • DEAN KASHINO MD

    BOARD MEMBER (THRU 6/30/24)

    Total calculated
    $98,163
    From this org
    $0
    From related orgs
    $98,163
    Other
    $0
    Hours/week
    0.25

  • GARY BENITO

    BOARD MEMBER (THRU 12/11/23)

    Total calculated
    $0
    Hours/week
    0.25

  • TOM BREZSNY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • RITA EILEEN DEAN OP

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • PAUL GODIN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • AHMED HAMDY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • TIFFANY HAMMER

    BOARD MEMBER (THRU 6/30/24)

    Total calculated
    $0
    Hours/week
    0.25

  • MICHAEL HOLLISTER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • MAGDY ISMAIL MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • PATTY KUBO LEZIN MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • SHAWN LIPMAN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • MANUEL MERCADO

    BOARD MEMBER (THRU 6/30/24)

    Total calculated
    $0
    Hours/week
    0.25

  • DARREN POUND

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • PAM SANTACROCE

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.1

  • TRACEA SARALIEV

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • JAMIE SMITH

    BOARD MEMBER (THRU 11/27/23)

    Total calculated
    $0
    Hours/week
    0.25

  • GINNY SOLARI MAZRY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • CHRISTOPHER WESSELMAN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • ALLISON NIDAY

    PAST PRESIDENT

    Total calculated
    $0
    Hours/week
    0.5

  • WILLIAM OW

    SECRETARY

    Total calculated
    $0
    Hours/week
    0.5

  • RODNEY TERRA JR

    BOARD PRESIDENT

    Total calculated
    $0
    Hours/week
    0.5

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 — 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

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
  • 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
THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, COMMONSPIRIT THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE COMMONSPIRIT BOARD OF STEWARDSHIP TRUSTEES ("BOARD"); (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; AND (4) APPROVAL BY THE BOARD OR HUMAN RESOURCES AND COMPENSATION COMMITTEE. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A FOR ADDITIONAL INFORMATION. SCHEDULE J, PART I, LINE 4A CERTAIN LISTED PERSONS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 TO 24 MONTHS 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. NO PAYMENTS PURSUANT TO THE PLAN OCCURRED DURING 2023.
PART I, LINE 4B
CERTAIN OFFICERS 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. NO PAYMENTS PURSUANT TO THE PLAN OCCURRED DURING 2023. COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS OTHER REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)).
SCHEDULE J PART III - SUPPLEMENTAL DISCLOSURES
ALTHOUGH THE ORGANIZATION DOES NOT DIRECTLY EMPLOY ANY PERSONNEL, DIGNITY HEALTH FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE THE SUPPORTED ORGANIZATION 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 IT 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 THE ORGANIZATION'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 2023.

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.

Provenance

Return type
form_990
Tax year
2023
Filed
3 May 2025
IRS schema version
2023v6.0
Source object
202541239349300419

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