Skip to content
Nonprofiteer
← PROMEDICA GENITO-URINARY SURGEONS LLC

Form 990 for tax year 2022

Filed by PROMEDICA GENITO-URINARY SURGEONS LLC.

Totals

Total revenue
$7,051,723
Total expenses
$10,686,198
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$7,051,723
Investment income
$0
Other revenue
$0
Total assets, end of year
$809,610
Total liabilities, end of year
$1,802,357
Net assets or fund balances, end of year
-$992,747
Program services expenses (Part IX)
$10,686,198
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$10,686,198

Program services were 100.0% 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 SERVICES

    total $7,044,229 · related or exempt $7,044,229

  • 2b · Program service revenue: AUXILIARY DEPARTMENTAL

    total $7,494 · related or exempt $7,494

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $602,363 · program services $602,363

  • 7 · Other salaries and wages

    total $6,705,858 · program services $6,705,858

  • 9 · Other employee benefits

    total $477,028 · program services $477,028

  • 10 · Payroll taxes

    total $313,971 · program services $313,971

  • 11g · Fees: other

    total $619,376 · program services $619,376

  • 13 · Office expenses

    total $25,756 · program services $25,756

  • 14 · Information technology

    total $211 · program services $211

  • 17 · Travel

    total $47,051 · program services $47,051

  • 22 · Depreciation, depletion and amortization

    total $27,405 · program services $27,405

  • 23 · Insurance

    total $133,607 · program services $133,607

  • 24a · Other expenses: INTERCOMPANY SERVICES

    total $825,753 · program services $825,753

  • 24b · Other expenses: DRUGS

    total $589,963 · program services $589,963

  • 24c · Other expenses: BAD DEBT EXPENSE

    total $73,426 · program services $73,426

  • 24d · Other expenses: SUPPLIES

    total $19,903 · program services $19,903

  • 24e · All other expenses

    total $224,527 · program services $224,527

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,387 · end of year $1,387

  • 4 · Accounts receivable

    beginning of year $250,056 · end of year $356,669

  • 9 · Prepaid expenses and deferred charges

    beginning of year $64,565 · end of year $63,176

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

    $2,014,080

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

    $1,879,490

  • 10c · Land, buildings and equipment, net

    beginning of year $161,994 · end of year $134,590

  • 14 · Intangible assets

    beginning of year $266,104 · end of year $253,788

  • 15 · Other assets

    beginning of year $2,103,528 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $859,867 · end of year $1,017,345

  • 25 · Other liabilities

    beginning of year $37,773,400 · end of year $785,012

  • 27 · Net assets without donor restrictions

    beginning of year -$35,785,633 · end of year -$992,747

Mission and programs · 2022

Mission

AS AN INTEGRAL PART OF PROMEDICA HEALTH SYSTEM, INC., WE WILL BE THE PREMIER COMMUNITY-BASED MANAGEMENT SERVICES ORGANIZATION AND PROVIDER OF RELATED HEALTHCARE SERVICES FOR NORTHWEST OHIO/SOURTHEAST MICHIGAN, OFFERING QUALITY, COST-EFFECTIVE, EFFICIENT, AND VALUE-ADDED SERVICES TO ACHIEVE SUPERIOR PATIENT SATISFACTION AND A FINANCIALLY VIABLE NETWORK OF PHYSICIANS SUPPORTING THE MEDICAL NEEDS OF THE COMMUNITY.

Activities or mission (Part I)

PROMEDICA GENITO-URINARY SURGEONS IS PART OF THE PHYSICIAN SERVICES COMPONENT OF PROMEDICA HEALTH SYSTEM, INC.'S INTEGRATED DELIVERY SYSTEM AND PROVIDES SERVICES TO IMPROVE THE HEALTH CARE OF THE COMMUNITY IN AN EFFICIENT AND COST-EFFECTIVE MANNER.

  • PROMEDICA GENITO-URINARY SURGEONS IS A PHYSICIAN SERVICES ORGANIZATION THAT PROVIDES SERVICE-ORIENTED, COST-EFFECTIVE HEALTH CARE SERVICES TO THE GENERAL PUBLIC AT A LOCAL LEVEL BY PEOPLE WHO WORK AND LIVE IN THE COMMUNITY THEY SERVE. - SEE SCHEDULE O.

    Expenses $10,686,198 · Revenue $7,051,723

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • ALEX J GERKEN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • ANGELA M SHEETS

    EX OFFICIO

    Total calculated
    $0
    Hours/week
    1 + 13 related

  • ANN RHEE

    TRUSTEE

    Total calculated
    $787,590
    From this org
    $0
    From related orgs
    $755,303
    Other
    $32,287
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $489,061 related
    Bonus
    $0 + $265,000 related
    Other
    $0 + $1,242 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $32,287 related
    Filer's total
    $0 + $787,590 related

  • BARBARA A PHIBBS RN LAC

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • BARRY F LUSE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 13 related

  • DAVID A SNAVELY

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • DAWN M BUSKEY

    TRUSTEE

    Total calculated
    $761,858
    From this org
    $0
    From related orgs
    $750,062
    Other
    $11,796
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $650,606 related
    Bonus
    $0 + $96,246 related
    Other
    $0 + $3,210 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $11,796 related
    Filer's total
    $0 + $761,858 related

  • DONALD G CRESCENZO MD

    TRUSTEE

    Total calculated
    $924,063
    From this org
    $0
    From related orgs
    $910,472
    Other
    $13,591
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $877,697 related
    Bonus
    $0 + $28,911 related
    Other
    $0 + $3,864 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $13,591 related
    Filer's total
    $0 + $924,063 related

  • EDWARD J BARDI PHD

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • EMMETT T BOYLE JR MD

    TRUSTEE/PHYSICIAN

    Total calculated
    $602,363
    From this org
    $595,480
    From related orgs
    $0
    Other
    $6,883
    Hours/week
    28 + 12 related

    Schedule J breakdown matched by us

    Base
    $563,584
    Bonus
    $27,405
    Other
    $4,491
    Deferred
    $0
    Nontaxable benefits
    $6,883
    Filer's total
    $602,363

  • EVON M EBEID MBA JD

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • IRACEMA AREVALO MD

    TRUSTEE

    Total calculated
    $385,453
    From this org
    $0
    From related orgs
    $353,774
    Other
    $31,679
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $339,583 related
    Bonus
    $0 + $12,649 related
    Other
    $0 + $1,542 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $31,679 related
    Filer's total
    $0 + $385,453 related

  • JAMES H BRENNAN JR

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 14 related

  • KENNETH A MYERS

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 13 related

  • KENT EDWARD BISHOP MD

    TRUSTEE

    Total calculated
    $780,640
    From this org
    $0
    From related orgs
    $768,811
    Other
    $11,829
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $674,591 related
    Bonus
    $0 + $92,255 related
    Other
    $0 + $1,965 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $11,829 related
    Filer's total
    $0 + $780,640 related

  • KEVIN M PIROZEK

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • LAURA W KLINE

    TUSTEE

    Total calculated
    $0
    Hours/week
    1 + 14 related

  • LESLIE A CHAPMAN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 13 related

  • LINDA S THIEL

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 13 related

  • LISA G HAWKER

    CHAIRMAN

    Total calculated
    $40,000
    From this org
    $0
    From related orgs
    $40,000
    Other
    $0
    Hours/week
    1 + 13 related

  • LISA P LOEHR MILLER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 13 related

  • MARCY L BROWN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 14 related

  • MARK S BARNES

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • NANCY P KABAT

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • ROBERT W LACLAIR

    TRUSTEE

    Total calculated
    $50,000
    From this org
    $0
    From related orgs
    $50,000
    Other
    $0
    Hours/week
    1 + 16 related

  • SUSAN P BERNARD

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • TIMOTHY BUBLICK

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1 + 12 related

  • VICTOR J CHERFAN DO

    TRUSTEE

    Total calculated
    $735,749
    From this org
    $0
    From related orgs
    $705,626
    Other
    $30,123
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $374,215 related
    Bonus
    $0 + $330,571 related
    Other
    $0 + $840 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $30,123 related
    Filer's total
    $0 + $735,749 related

  • WILLIAM R MCDONNELL

    CHAIRMAN

    Total calculated
    $0
    Hours/week
    1 + 13 related

  • ARTURO POLIZZI

    PRESIDENT AND CEO

    Total calculated
    $1,618,580
    From this org
    $0
    From related orgs
    $1,605,830
    Other
    $12,750
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,003,178 related
    Bonus
    $0 + $597,348 related
    Other
    $0 + $5,304 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $12,750 related
    Filer's total
    $0 + $1,618,580 related

  • JEFFREY C KUHN

    SECRETARY, CHIEF LEGAL OFFICER - PART YEAR

    Total calculated
    $971,690
    From this org
    $0
    From related orgs
    $927,467
    Other
    $44,223
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $390,988 related
    Bonus
    $0 + $196,494 related
    Other
    $0 + $339,985 related
    Deferred
    $0 + $23,904 related
    Nontaxable benefits
    $0 + $20,319 related
    Filer's total
    $0 + $971,690 related

  • LOUIS ROBICHAUX

    TREASURER

    Total calculated
    $0
    Hours/week
    1 + 55 related

  • RANDALL OOSTRA

    PHS PRES. & CEO - PART YEAR

    Total calculated
    $5,479,619
    From this org
    $0
    From related orgs
    $5,476,040
    Other
    $3,579
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,664,907 related
    Bonus
    $0 + $2,628,840 related
    Other
    $0 + $1,182,293 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $3,579 related
    Filer's total
    $0 + $5,479,619 related

  • STEPHEN M SADOWSKI

    CHIEF LEGAL OFFICER

    Total calculated
    $689,717
    From this org
    $0
    From related orgs
    $683,615
    Other
    $6,102
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $596,289 related
    Bonus
    $0 + $86,275 related
    Other
    $0 + $1,051 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $6,102 related
    Filer's total
    $0 + $689,717 related

  • STEVEN M CAVANAUGH

    TREASURER, CFO - PART YEAR

    Total calculated
    $2,497,252
    From this org
    $0
    From related orgs
    $2,435,815
    Other
    $61,437
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $604,206 related
    Bonus
    $0 + $1,107,251 related
    Other
    $0 + $724,358 related
    Deferred
    $0 + $28,986 related
    Nontaxable benefits
    $0 + $32,451 related
    Filer's total
    $0 + $2,497,252 related

  • CARIN HOPPS

    PHYSICIAN

    Total calculated
    $619,532
    From this org
    $601,690
    From related orgs
    $0
    Other
    $17,842
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $566,981
    Bonus
    $33,167
    Other
    $1,542
    Deferred
    $0
    Nontaxable benefits
    $17,842
    Filer's total
    $619,532

  • ERIC PIZZA

    PHYSICIAN

    Total calculated
    $592,034
    From this org
    $569,762
    From related orgs
    $0
    Other
    $22,272
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $565,271
    Bonus
    $0
    Other
    $4,491
    Deferred
    $0
    Nontaxable benefits
    $22,272
    Filer's total
    $592,034

  • GREGOR EMMERT

    PHYSICIAN

    Total calculated
    $565,222
    From this org
    $558,928
    From related orgs
    $0
    Other
    $6,294
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $521,733
    Bonus
    $37,195
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $6,294
    Filer's total
    $565,222

  • MICHAEL RASHID

    PHYSICIAN

    Total calculated
    $649,852
    From this org
    $613,434
    From related orgs
    $0
    Other
    $36,418
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $559,882
    Bonus
    $52,010
    Other
    $1,542
    Deferred
    $0
    Nontaxable benefits
    $36,418
    Filer's total
    $649,852

  • TIMOTHY SCHUSTER

    PHYSICIAN

    Total calculated
    $650,414
    From this org
    $636,329
    From related orgs
    $0
    Other
    $14,085
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $567,538
    Bonus
    $67,249
    Other
    $1,542
    Deferred
    $0
    Nontaxable benefits
    $14,085
    Filer's total
    $650,414

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
A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, INC., USES AN INDEPENDENT CONSULTANT, COMPENSATION COMMITTEE, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S EXECUTIVES.
PART I, LINES 4A-B
ELIGIBLE EMPLOYEES PARTICIPATE IN VARIOUS NONQUALIFIED DEFERRED COMPENSATION PLANS ORGANIZED UNDER CODE SECTION 457(F). THE EXACT PURPOSE OF EACH PLAN VARIES, BUT THEY INCLUDE: COMPENSATION LIMITATION MAKE-UP PLANS, VOLUNTARY DEFERRAL PLANS, DEFERRAL OF A PORTION OF INCENTIVE BONUS TYPE PLANS, ETC. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EMPLOYEE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO SUPPLEMENTAL NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII. STEVEN CAVANAUGH RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $688,132 DURING 2022. JEFFERY KUHN RECEIVED SEVERANCE PAYMENTS FROM A RELATED ORGANIZATION, PROMEDICA HEALTH SYSTEM, IN THE AMOUNT OF $333,184 DURING 2022.
SCHEDULE J, SUPPLEMENTAL INFORMATION:
IN ADDITION, HCR MANORCARE, INC. A RELATED ORGANIZATION PROVIDES A SPLIT-DOLLAR LIFE INSURANCE PLAN TO ITS CHIEF EXECUTIVE OFFICER FROM WHICH NO CASH PAYMENTS WERE MADE DURING THE YEAR.

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.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2022
Filed
10 November 2023
IRS schema version
2022v5.0
Source object
202323189349311272

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

The source document this was parsed from is served over the API, which is where bulk and document access live.