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Nonprofiteer
← HEALTHSPAN INTEGRATED CARE

Form 990 for tax year 2022

Filed by HEALTHSPAN INTEGRATED CARE.

Totals

Total revenue
$10,545
Total expenses
$151,676
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$3,224
Investment income
$7,321
Other revenue
$0
Total assets, end of year
$15,448,007
Total liabilities, end of year
$32,340
Net assets or fund balances, end of year
$15,415,667
Program services expenses (Part IX)
$56,374
Management and general expenses
$95,302
Fundraising expenses
$0
Program service expenses (Part III)
$56,374

Program services were 37.2% 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.

  • 2a · Program service revenue: Other Operating Revenue

    total $3,224 · related or exempt $3,224

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $7,321 · excluded $7,321

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 11c · Fees: accounting

    total $55,355 · management and general $55,355

  • 11f · Fees: investment management

    total $30,000 · management and general $30,000

  • 11g · Fees: other

    total $64,631 · program services $54,937 · management and general $9,694 · fundraising $0

  • 24a · Other expenses: Business Licenses and Fees

    total $640 · program services $544 · management and general $96

  • 24b · Other expenses: Other Expenses

    total $1,050 · program services $893 · management and general $157

  • 24e · All other expenses

    total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $15,106,153 · end of year $15,031,690

  • 4 · Accounts receivable

    beginning of year $34,328

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

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

    $0

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

    $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $428,835 · end of year $416,317

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    end of year $32,340

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $0 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $15,569,316 · end of year $15,415,667

Mission and programs · 2022

Mission

To provide high-quality, affordable health care services to improve the health of our members and the communities we serve.

  • During 2016, HealthSpan discontinued its insurance activities. HealthSpan will continue its operations in order to process claims incurred prior to December 31, 2016 and wind down its operations.

    Expenses $56,374 · Revenue $3,224

As filed on the 2022 return.

Listed in Part VII

  • Jeffrey Copeland

    President & CEO, Board Chair

    Total calculated
    $1,212,926
    From this org
    $0
    From related orgs
    $1,180,026
    Other
    $32,900
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $461,002 related
    Bonus
    $0 + $201,544 related
    Other
    $0 + $517,480 related
    Deferred
    $0 + $4,550 related
    Nontaxable benefits
    $0 + $28,350 related
    Filer's total
    $0 + $1,212,926 related

  • Ronald Wehtje

    CFO HealthSpan Partners, Treasurer (End 10/22)

    Total calculated
    $937,872
    From this org
    $0
    From related orgs
    $910,056
    Other
    $27,816
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $446,873 related
    Bonus
    $0 + $195,388 related
    Other
    $0 + $267,795 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $27,816 related
    Filer's total
    $0 + $937,872 related

  • Allan Calonge

    Board Member, BSMH Chief People Officer - Core Operations

    Total calculated
    $669,996
    From this org
    $0
    From related orgs
    $553,790
    Other
    $116,206
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $369,323 related
    Bonus
    $0 + $126,202 related
    Other
    $0 + $58,265 related
    Deferred
    $0 + $87,229 related
    Nontaxable benefits
    $0 + $28,977 related
    Filer's total
    $0 + $669,996 related

  • David Nowiski

    Former CFO HealthSpan Partners, Board Treasurer

    Total calculated
    $290,775
    From this org
    $0
    From related orgs
    $264,638
    Other
    $26,137
    Hours/week
    0 + 10 related

    Schedule J breakdown matched by us

    Base
    $0 + $148,958 related
    Bonus
    $0
    Other
    $0 + $115,680 related
    Deferred
    $0 + $2,638 related
    Nontaxable benefits
    $0 + $23,499 related
    Filer's total
    $0 + $290,775 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
Severance Benefits consisting of continuation of base salary and insurance benefits were provided to listed individuals for specified periods. The listed individuals executed releases and waivers of claims in exchange for the severance benefits. Salary continuation amounts provided during the reporting year to listed individuals were as follows: David Nowiski, $104,020 and Ronald Wehtje, $66,539.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
The Mercy Health SERP plan is a deferred compensation plan which provides supplemental retirement benefits to persons selected by the Board of Trustees or its delegate. It provides annual credits of a specified percentage of compensation and annual interest credits. Participants vest 50%, 75%, and 100% in their accounts after 5, 6, and 7 years of service, respectively. Vesting occurs earlier for death or total disability or reaching age 60 while employed, or involuntary termination of employment within 24 months after a change in control of the organization or due to position elimination. Payments during employment are made for required tax withholding. Payment of the vested account balance in a lump sum occurs after termination of employment. Amounts includable as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Jeffrey Copeland $0.
Schedule J, Part I, Line 4b Terms and conditions of the Bon Secours Mercy Health System SERP
The Bon Secours Mercy Health System SERP is a non-qualified deferred compensation plan which provides supplemental retirement benefits to persons selected by the Board of Trustees or its delegate. The plan provides for annual credits of a specified percentage of an eligible participants base salary paid in a plan year and interest credits. Plan participants vest in plan credits after completing a three year class vesting schedule or earlier for death or total disability or reaching age 60 while employed, or due to involuntary separation of employment other than for cause. Payments during employment are made for required tax withholding and reduce the participants account balance. Distribution of the vested account balance in a lump sum occurs after termination of employment. Amounts includible as taxable compensation for listed individuals due to SERP participation in the reporting year were as follows: Jeffrey Copeland, $103,795; Allan Calonge, $0 and Ronald Wehtje, $55,972.

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.

  • MERCY FRANCISCAN AT WINTON WOODS I LP

    N/A · Rental Real Estate · OH

    Directly controlled by NA

  • Broad64 Imaging LLC

    N/A · Imaging Services · VA

    Directly controlled by NA

  • Memorial Ambulatory Surgery Center LLC

    N/A · Ambulatory Surgery Center · VA

    Directly controlled by NA

  • Richmond Radiation Oncology Center I LLC

    N/A · Radiation Oncology Services · VA

    Directly controlled by NA

  • RI LP

    N/A · Imaging Services · VA

    Directly controlled by NA

  • Chesterfield Community Healthcare MOB I LLC

    N/A · Real Estate · VA

    Directly controlled by NA

  • St Mary's MRI Center LP

    N/A · Imaging Services · VA

    Directly controlled by NA

  • Bon Secours Surgery Center at Harbour View LLC

    N/A · Surgery Center · VA

    Directly controlled by NA

  • Harbour View MOB 2 LLC

    N/A · Real Estate · VA

    Directly controlled by NA

  • Lourdes Ambulatory Surgery Center

    N/A · Surgery Center · KY

    Directly controlled by NA

  • Community Mercy Home Care Services of Springfield LLC

    N/A · Home Care · OH

    Directly controlled by NA

  • NWO Integrated Laboratories Mercy LLC

    N/A · Laboratory services · OH

    Directly controlled by NA

  • Tiffin Ambulatory Surgical Associates

    N/A · Ambulatory Surgery Center · OH

    Directly controlled by NA

  • Urologic Oncology of Mahoning Valley LLC

    N/A · Radiation Therapy · OH

    Directly controlled by NA

  • Mercy Health Rehabilitation Hospital LLC

    N/A · Rehabilitation Services · OH

    Directly controlled by NA

  • New Vision Medical Lab LLC

    N/A · Lab Services · OH

    Directly controlled by NA

  • West Central Ohio Group Ltd

    N/A · Orthopedic Hospital · OH

    Directly controlled by NA

  • Upstate Surgery Center LLC

    N/A · Ambulatory Surgery Center · SC

    Directly controlled by NA

  • Bon Secours Diagnostic Imaging LLC

    N/A · Outpatient Imaging Centers · SC

    Directly controlled by NA

  • Bon Secours Place at St Petersburg LLP

    N/A · Assisted Living/Senior Care · FL

    Directly controlled by NA

  • Bon Secours Apartments Consolidated GP LLC

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Apartments Consolidated LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Apartments II LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Apartments III LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Apartments LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Benet House LLC

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Benet House LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Chesapeake Apartments LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Gibbons Apartments LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours New Shiloh II Limited Partnership

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Shiloh LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Smallwood Summit LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Wayland LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Liberty Senior Housing LP

    N/A · Low Income Housing · MD

    Directly controlled by NA

  • Lowcountry Surgery Center LLC dba Roper St Francis Eye Center

    N/A · Ambulatory Surgery Center · SC

    Directly controlled by NA

  • BON SECOURS MERCY HEALTH INNOVATIONS LLC

    N/A · BUSINESS DEVELOPMENT · OH

    Directly controlled by NA

  • Nordic Holdings LLC

    N/A · Holding company · DE

    Directly controlled by NA

  • BSMH-CSP Surgical Ventures LLC

    N/A · Holding company · SC

    Directly controlled by NA

  • Strive BSMH LLC

    N/A · Holding company · SC

    Directly controlled by NA

  • BSB HealthMOB Limited Partnership No 2

    N/A · Rental Real Estate · DE

    Directly controlled by NA

Related corporations and trusts

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

  • BON SECOURS MERCY HEALTH INSURANCE COMPANY (SPC) LTD

    C Corporation · SELF-INSURANCE · CJ

    Directly controlled by NA

  • Bon Secours - Venice Healthcare Corporation

    C Corporation · Inactive · FL

    Directly controlled by NA

  • MERCY FRANCISCAN AT WINTON WOODS I INC

    C Corporation · LOW-INCOME HOUSING · OH

    Directly controlled by NA

  • MERCY HEALTH VENTURES INC

    C Corporation · DIVERSIFIED ACTIVITIES · OH

    Directly controlled by NA

  • Bon Secours-Virginia Healthsource Inc

    C Corporation · Ambulatory Healthcare Services · VA

    Directly controlled by NA

  • Richmond Radiation Oncology Center Inc

    C Corporation · Ambulatory Healthcare Services · VA

    Directly controlled by NA

  • Ironbridge Assisted Living Retirement Community LC

    C Corporation · Ambulatory Healthcare Services · VA

    Directly controlled by NA

  • Richmond MRI Inc

    C Corporation · Medical Services · VA

    Directly controlled by NA

  • Chesterfield Community Healthcare Center Inc

    C Corporation · Ambulatory Healthcare Services · VA

    Directly controlled by NA

  • RHS Management Corp

    C Corporation · Independent Living Facility · VA

    Directly controlled by NA

  • Professional Health Care Management Services Inc

    C Corporation · Administrative · VA

    Directly controlled by NA

  • Maryview Building Corporation

    C Corporation · Administrative · VA

    Directly controlled by NA

  • Bon Secours - Tidewater Diversified Inc

    C Corporation · Pharmacy · VA

    Directly controlled by NA

  • OSF Inc

    C Corporation · Rental · VA

    Directly controlled by NA

  • Harbour View Station West Mixed-Use Property Owners Association Inc

    C Corporation · REAL PROPERTY MGMNT · VA

    Directly controlled by NA

  • NORTHPARKE MEDICAL COMMONS CONDO ASSN

    C Corporation · REAL PROPERTY MGMNT · OH

    Directly controlled by NA

  • NORTHSIDE CORPORATION

    C Corporation · RESIDENT RENTALS · OH

    Directly controlled by NA

  • RALPH EWE TRUST

    Trust · BENEFICIAL TRUST · NY

    Directly controlled by NA

  • ELIZABETH HINES CATES TRUST

    Trust · BENEFICIAL TRUST · OH

    Directly controlled by NA

  • WILLIS PARK TRUST

    Trust · BENEFICIAL TRUST · OH

    Directly controlled by NA

  • ERMA GIBSON BALDWIN TRUST

    Trust · BENEFICIAL TRUST · OH

    Directly controlled by NA

  • MCAULEY MANAGEMENT SERVICES INC

    C Corporation · PROPERTY RENTAL · OH

    Directly controlled by NA

  • LIMA MEDICAL SUPPLIES INC

    C Corporation · MEDICAL EQUIPMENT · OH

    Directly controlled by NA

  • COMMUNITY HEALTH PARTNERS ENTERPRISES INC

    C Corporation · HOLDING COMPANY · OH

    Directly controlled by NA

  • Optimum Health Network Inc

    C Corporation · Healthcare Services · SC

    Directly controlled by NA

  • Bon Secours-Florida Integrated Services Inc

    C Corporation · Holding Company/Assisted Living · FL

    Directly controlled by NA

  • Unity Housing Inc

    C Corporation · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours Wayland LLC

    C Corporation · Low Income Housing · MD

    Directly controlled by NA

  • Bon Secours New Shiloh II LLC

    C Corporation · Low Income Housing · MD

    Directly controlled by NA

  • HEALTHSPAN INC

    C Corporation · INSURANCE · OH

    Directly controlled by NA

  • HEALTHSPAN SOLUTIONS INC

    C Corporation · CONSULTING · OH

    Directly controlled by NA

  • HEALTHCARE SERVICES AND SUPPORT

    C Corporation · HEALTHCARE SERVICES · OH

    Directly controlled by NA

  • HealthSpan Partners Innovations Inc

    C Corporation · HEALTHCARE SERVICES · OH

    Directly controlled by NA

  • Barringtons Hospital Limited

    C Corporation · Hospital · EI

    Directly controlled by NA

  • Bon Secours Hospital Limerick Dev Co Limited

    C Corporation · REAL PROPERTY MGMNT · EI

    Directly controlled by NA

  • Bon Secours New York Housing Development Fund Corporation

    C Corporation · Low Income Housing · NY

    Directly controlled by NA

  • CareAlliance Medical Services Corporation

    C Corporation · Inactive · SC

    Directly controlled by NA

  • Bon Secours Mercy Health Innovations Inc

    C Corporation · Holding Company · OH

    Directly controlled by NA

  • Nordic Consulting Group Incorporated

    C Corporation · Holding Company · DE

    Directly controlled by NA

  • Nordic Consulting Partners Inc

    C Corporation · Healthcare Consulting · WI

    Directly controlled by NA

  • S & P Consultants Inc

    C Corporation · Healthcare Consulting · MA

    Directly controlled by NA

  • Healthtech Inc

    C Corporation · Healthcare Consulting · CA

    Directly controlled by NA

  • Tasman Global Holdings BV

    C Corporation · Healthcare Consulting · NL

    Directly controlled by NA

  • Tasman Global Healthcare Ireland Limited

    C Corporation · Healthcare Consulting · EI

    Directly controlled by NA

  • Tasman Global Singapore Pte Ltd

    C Corporation · Healthcare Consulting · SN

    Directly controlled by NA

  • Tasman Group Limited

    C Corporation · Healthcare Consulting

    Directly controlled by NA

  • Tasman Global Switzerland GmbH

    C Corporation · Healthcare Consulting · SZ

    Directly controlled by NA

  • Tasman Global Norway AS

    C Corporation · Healthcare Consulting · NO

    Directly controlled by NA

Provenance

Return type
form_990
Tax year
2022
Filed
26 October 2023
IRS schema version
2022v5.0
Source object
202322999349300507

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