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Nonprofiteer
← HSHS MEDICAL GROUP INC

Form 990 for tax year 2022

Filed by HSHS MEDICAL GROUP INC.

Totals

Total revenue
$211,724,672
Total expenses
$230,341,325
Contributions and grants received
$0
Grants paid
$75,459
Program service revenue
$211,500,769
Investment income
$223,903
Other revenue
$0
Total assets, end of year
$133,263,176
Total liabilities, end of year
$61,545,114
Net assets or fund balances, end of year
$71,718,062
Program services expenses (Part IX)
$202,870,709
Management and general expenses
$27,470,616
Fundraising expenses
$0
Program service expenses (Part III)
$202,870,709

Program services were 88.1% 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: NET PATIENT SERVICE REVENUE

    total $93,972,462 · related or exempt $93,972,462

  • 2b · Program service revenue: PURCHASED SERVICE REVENUE

    total $96,015,238 · related or exempt $96,015,238

  • 2c · Program service revenue: Hospital Support Services

    total $21,513,069 · related or exempt $21,187,992 · unrelated business $325,077

  • 2f · All other program service revenue

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

  • 3 · Investment income

    total $238,367 · excluded $238,367

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7a · Gross sales of assets other than inventory

    securities $218,407

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

    other assets $232,871

  • 7c · Gain or loss

    securities $218,407 · other assets -$232,871

  • 7d · Net gain or loss

    total -$14,464 · excluded -$14,464

  • 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.

  • 2 · Grants to domestic individuals

    total $75,459 · program services $75,459

  • 5 · Compensation of officers, directors and key employees

    total $1,348,426 · program services $1,281,005 · management and general $67,421

  • 7 · Other salaries and wages

    total $126,268,376 · program services $119,957,670 · management and general $6,310,706

  • 8 · Pension plan contributions

    total $5,830,131 · program services $5,604,672 · management and general $225,459

  • 9 · Other employee benefits

    total $14,690,012 · program services $14,178,096 · management and general $511,916

  • 10 · Payroll taxes

    total $6,779,643 · program services $6,224,370 · management and general $555,273

  • 11b · Fees: legal

    total -$787 · management and general -$787

  • 11g · Fees: other

    total $1,710,926 · program services $1,381,303 · management and general $329,623 · fundraising $0

  • 12 · Advertising and promotion

    total $729,002 · program services $193,605 · management and general $535,397

  • 13 · Office expenses

    total $1,297,127 · program services $833,019 · management and general $464,108

  • 14 · Information technology

    total $4,595,766 · program services $3,781,935 · management and general $813,831

  • 16 · Occupancy

    total $15,438,988 · program services $14,679,284 · management and general $759,704

  • 17 · Travel

    total $412,255 · program services $368,129 · management and general $44,126

  • 19 · Conferences, conventions and meetings

    total $702,630 · program services $640,387 · management and general $62,243

  • 20 · Interest

    total $130 · program services $130

  • 22 · Depreciation, depletion and amortization

    total $5,906,839 · program services $5,763,550 · management and general $143,289

  • 23 · Insurance

    total $6,245,413 · program services $5,964,786 · management and general $280,627

  • 24a · Other expenses: PURCHASED SERVICE

    total $24,408,650 · program services $9,170,956 · management and general $15,237,694

  • 24b · Other expenses: SUPPLIES

    total $10,923,808 · program services $10,862,681 · management and general $61,127

  • 24c · Other expenses: Finance Charges

    total $233,456 · management and general $233,456

  • 24d · Other expenses: Equipment Rental

    total $1,725 · program services $1,725

  • 24e · All other expenses

    total $2,743,350 · program services $1,907,947 · management and general $835,403 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $649,535 · end of year $573,617

  • 2 · Savings and temporary cash investments

    beginning of year $45,381,664 · end of year $67,217,028

  • 4 · Accounts receivable

    beginning of year $10,664,771 · end of year $7,527,798

  • 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

  • 8 · Inventories for sale or use

    beginning of year $780,533 · end of year $369,172

  • 9 · Prepaid expenses and deferred charges

    beginning of year $1,236,094 · end of year $1,177,519

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

    $48,135,653

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

    $29,672,587

  • 10c · Land, buildings and equipment, net

    beginning of year $22,807,650 · end of year $18,463,066

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 14 · Intangible assets

    beginning of year $16,434 · end of year $4,833

  • 15 · Other assets

    beginning of year $41,856,785 · end of year $37,930,143

  • 17 · Accounts payable and accrued expenses

    beginning of year $30,593,967 · end of year $25,016,299

  • 19 · Deferred revenue

    beginning of year $470,158 · end of year $221,502

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $41,378,213 · end of year $36,307,313

  • 27 · Net assets without donor restrictions

    beginning of year $50,951,128 · end of year $71,718,062

Mission and programs · 2022

Mission

TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH A HEALTH CARE MINISTRY BY PROVIDING PRIMARY AND SPECIALTY PHYSICIAN SERVICES TO THE COMMUNITIES HOSPITAL SISTERS HEALTH SYSTEM SERVES.

  • SEE SCHEDULE O

    Expenses $202,870,709 · Grants $75,459 · Revenue $211,175,692

As filed on the 2022 return.

Listed in Part VII

  • Dona McGraw

    2022 SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Marc Shelton MD

    2022 CHAIR (until 4/6/23) - HSHS Senior VP & CCO

    Total calculated
    $1,494,059
    From this org
    $0
    From related orgs
    $1,330,720
    Other
    $163,339
    Hours/week
    2.5 + 57.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $859,848 related
    Bonus
    $0 + $181,018 related
    Other
    $0 + $289,854 related
    Deferred
    $0 + $131,320 related
    Nontaxable benefits
    $0 + $32,019 related
    Filer's total
    $0 + $1,494,059 related

  • Melinda Clark

    CEO MED GROUP (until 8/1/22)

    Total calculated
    $1,348,426
    From this org
    $1,327,375
    From related orgs
    $0
    Other
    $21,051
    Hours/week
    46 + 14 related

    Schedule J breakdown matched by us

    Base
    $386,170
    Bonus
    $180,754
    Other
    $760,451
    Deferred
    $5,318
    Nontaxable benefits
    $15,733
    Filer's total
    $1,348,426

  • Frank L Mikell

    Board Member (until 10/31/22)

    Total calculated
    $0
    Hours/week
    0.3 + 0.3 related

  • Jerry Gaffner

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Kathy Donovan

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Lori Kerans

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Peter Kung

    Board Member

    Total calculated
    $647,403
    From this org
    $0
    From related orgs
    $556,679
    Other
    $90,724
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $419,951 related
    Bonus
    $0 + $88,094 related
    Other
    $0 + $48,634 related
    Deferred
    $0 + $85,494 related
    Nontaxable benefits
    $0 + $5,230 related
    Filer's total
    $0 + $647,403 related

  • Tim Nicoud Jr

    Board Member (until 10/31/22)

    Total calculated
    $0
    Hours/week
    0.3 + 1.3 related

  • Andrew Watson

    CFO (until 1/26/23)

    Total calculated
    $459,641
    From this org
    $0
    From related orgs
    $416,737
    Other
    $42,904
    Hours/week
    36 + 14 related

    Schedule J breakdown matched by us

    Base
    $0 + $302,073 related
    Bonus
    $0 + $43,613 related
    Other
    $0 + $71,051 related
    Deferred
    $0 + $3,504 related
    Nontaxable benefits
    $0 + $39,400 related
    Filer's total
    $0 + $459,641 related

  • Patricia Allen

    CFO - CARE DELIVERY

    Total calculated
    $695,496
    From this org
    $0
    From related orgs
    $541,100
    Other
    $154,396
    Hours/week
    3 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $414,598 related
    Bonus
    $0 + $44,684 related
    Other
    $0 + $81,818 related
    Deferred
    $0 + $126,563 related
    Nontaxable benefits
    $0 + $27,833 related
    Filer's total
    $0 + $695,496 related

  • TODD Smart

    Treasurer

    Total calculated
    $410,831
    From this org
    $0
    From related orgs
    $329,569
    Other
    $81,262
    Hours/week
    0.3 + 59.8 related

    Schedule J breakdown matched by us

    Base
    $0 + $267,686 related
    Bonus
    $0 + $38,335 related
    Other
    $0 + $23,548 related
    Deferred
    $0 + $45,254 related
    Nontaxable benefits
    $0 + $36,008 related
    Filer's total
    $0 + $410,831 related

  • Bassim Assioun MD

    Physician

    Total calculated
    $1,153,458
    From this org
    $1,056,246
    From related orgs
    $0
    Other
    $97,212
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $999,626
    Bonus
    $55,530
    Other
    $1,090
    Deferred
    $76,707
    Nontaxable benefits
    $20,505
    Filer's total
    $1,153,458

  • Danxuan Long MD

    Physician

    Total calculated
    $1,288,671
    From this org
    $1,179,480
    From related orgs
    $0
    Other
    $109,191
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $1,123,360
    Bonus
    $55,520
    Other
    $600
    Deferred
    $86,110
    Nontaxable benefits
    $23,081
    Filer's total
    $1,288,671

  • Leslie Anewenah MD

    Physician

    Total calculated
    $1,717,224
    From this org
    $1,642,704
    From related orgs
    $0
    Other
    $74,520
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $1,603,984
    Bonus
    $33,515
    Other
    $5,205
    Deferred
    $33,282
    Nontaxable benefits
    $41,238
    Filer's total
    $1,717,224

  • Mohammed Rahman MD

    PHYSICIAN

    Total calculated
    $1,480,473
    From this org
    $1,443,076
    From related orgs
    $0
    Other
    $37,397
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $1,424,536
    Bonus
    $17,030
    Other
    $1,510
    Deferred
    $4,222
    Nontaxable benefits
    $33,175
    Filer's total
    $1,480,473

  • Peter Kim MD

    PHYSICIAN

    Total calculated
    $1,169,339
    From this org
    $1,113,166
    From related orgs
    $0
    Other
    $56,173
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $1,092,546
    Bonus
    $20,020
    Other
    $600
    Deferred
    $42,461
    Nontaxable benefits
    $13,712
    Filer's total
    $1,169,339

  • Damond Boatwright

    Former Board Member / HSHS President & CEO

    Total calculated
    $1,964,941
    From this org
    $0
    From related orgs
    $1,693,985
    Other
    $270,956
    Hours/week
    0 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,234,564 related
    Bonus
    $0 + $301,083 related
    Other
    $0 + $158,338 related
    Deferred
    $0 + $255,073 related
    Nontaxable benefits
    $0 + $15,883 related
    Filer's total
    $0 + $1,964,941 related

  • Linda Dace

    FORMER CFO

    Total calculated
    $593,487
    From this org
    $0
    From related orgs
    $492,234
    Other
    $101,253
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $375,753 related
    Bonus
    $0 + $50,393 related
    Other
    $0 + $66,088 related
    Deferred
    $0 + $76,845 related
    Nontaxable benefits
    $0 + $24,408 related
    Filer's total
    $0 + $593,487 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

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Form 990 of other organizations
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 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
PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O.
Schedule J, Part I, Line 4a Severance or change-of-control payment
ORGANIZATION: Hospital sisters Health System EIN: 37-1058692 INTERESTED PERSON: Melinda Clark AMOUNT: $248,500 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF CEO MED GROUP.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS; THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED and TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022; THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Damond Boatwright - $230,862 LINDA DACE - $34,384 Peter Kung - $61,283 MARC SHELTON - $126,002 Todd Smart -- $25,135 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022; THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. MELINDA CLARK -- $349,701 MARC SHELTON - $129,148

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.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

  • KIARA CLINICAL INTEGRATION NETWORK LLC

    HEALTHCARE · IL · income -$105,950 · assets $447,864

    Directly controlled by HSSI

  • PHYSICIAN CLINICAL INTEGRATION NETWORK LLC

    HEALTHCARE · IL · income $554,315 · assets $15,980,466

    Directly controlled by KCIN

  • HSHS ACO LLC

    HEALTHCARE & SOCIAL ASSISTANCE · IL · income $1,805,698 · assets $3,189,003

    Directly controlled by KCIN

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • SPRINGFIELD URGENT CARE REAL ESTATE LLC

    N/A · RENTAL REAL ESTATE · IL · 0% owned

    Directly controlled by LASANTE INC

  • PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC

    Related · MEDICAL · IL · 100% owned · share of income -$7,032 · share of assets $12,572 · general or managing partner

    Directly controlled by HSHS

  • SOUTHWEST ILLINOIS HEALTH SERVICES REAL ESTATE LLP

    Related · REAL ESTATE · IL · 50% owned · share of income -$126,650 · share of assets $1,434,911

    Directly controlled by St John's

  • REHABILITATION HOSPITAL OF WESTERN WISCONSIN LLC

    Related · Medical · DE · 50% owned · share of income -$80,505 · share of assets $4,187,830

    Directly controlled by HSHS

Related corporations and trusts

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

  • KIARA INC

    C Corporation · HEALTHCARE · IL · 100% owned · share of income $601,904 · share of assets $18,670,450 · controlled entity

    Directly controlled by HSHS

  • LASANTE WISCONSIN INC

    C Corporation · HEALTHCARE · IL · controlled entity

    Directly controlled by KIARA INC

  • LASANTE INC

    C Corporation · HEALTHCARE · IL · controlled entity

    Directly controlled by KIARA INC

  • PREVEA HEALTH SERVICES INC

    C Corporation · HEALTHCARE · WI · 50% owned · share of income -$1,641,640 · share of assets $24,425,128 · controlled entity

    Directly controlled by HSSI

  • PREVEA CLINIC INC

    C Corporation · HEALTHCARE · WI · controlled entity

    Directly controlled by PHSI

  • RENAISSANCE QUALITY INSURANCE LTD

    C Corporation · INSURANCE · CJ · 100% owned · share of income $0 · share of assets $156,895,227 · controlled entity

    Directly controlled by HSSI

  • OJV INC

    C Corporation · HEALTHCARE · IL · controlled entity

    Directly controlled by LASANTE INC

Provenance

Return type
form_990
Tax year
2022
Filed
10 May 2024
IRS schema version
2022v5.0
Source object
202421319349305027

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