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Nonprofiteer
← MEMORIAL HOSPITAL-WEST VOLUSIA INC

Form 990 for tax year 2022

Filed by MEMORIAL HOSPITAL-WEST VOLUSIA INC.

Totals

Total revenue
$200,841,270
Total expenses
$192,030,772
Contributions and grants received
$505,237
Grants paid
$316,055
Program services expenses (Part IX)
$179,763,978
Management and general expenses
$12,266,794
Fundraising expenses
$0
Program service expenses (Part III)
$179,763,978

Program services were 93.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • OTTATI DAVID

    FORMER DIR/CHAIR/AH CFN REG

    Total calculated
    $3,906,271
    From this org
    $0
    From related orgs
    $3,686,151
    Other
    $220,120
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $990,100 related
    Bonus
    $0 + $268,500 related
    Other
    $0 + $2,427,551 related
    Deferred
    $0 + $166,400 related
    Nontaxable benefits
    $0 + $53,720 related
    Filer's total
    $0 + $3,906,271 related

  • GOODMAN TODD

    DIRECTOR

    Total calculated
    $2,027,198
    From this org
    $0
    From related orgs
    $1,822,857
    Other
    $204,341
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $860,712 related
    Bonus
    $0 + $218,316 related
    Other
    $0 + $743,829 related
    Deferred
    $0 + $145,900 related
    Nontaxable benefits
    $0 + $58,441 related
    Filer's total
    $0 + $2,027,198 related

  • CELANO PATRICIA

    FORMER KEY EMPLOYEE/REGIONAL CCO

    Total calculated
    $1,870,874
    From this org
    $0
    From related orgs
    $1,713,469
    Other
    $157,405
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $586,288 related
    Bonus
    $0 + $120,334 related
    Other
    $0 + $1,006,847 related
    Deferred
    $0 + $109,292 related
    Nontaxable benefits
    $0 + $48,113 related
    Filer's total
    $0 + $1,870,874 related

  • GREGORY PHD AUDREY

    DIR/CHAIR/CEO CFN REG

    Total calculated
    $1,567,088
    From this org
    $0
    From related orgs
    $1,335,554
    Other
    $231,534
    Hours/week
    6 + 44 related

    Schedule J breakdown matched by us

    Base
    $0 + $890,725 related
    Bonus
    $0
    Other
    $0 + $444,829 related
    Deferred
    $0 + $187,400 related
    Nontaxable benefits
    $0 + $44,134 related
    Filer's total
    $0 + $1,567,088 related

  • THOMAS DEBORA

    DIRECTOR (END 01/22)

    Total calculated
    $918,454
    From this org
    $0
    From related orgs
    $817,018
    Other
    $101,436
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $478,627 related
    Bonus
    $0 + $140,091 related
    Other
    $0 + $198,300 related
    Deferred
    $0 + $70,810 related
    Nontaxable benefits
    $0 + $30,626 related
    Filer's total
    $0 + $918,454 related

  • PRADO MD MARTIN

    DIRECTOR

    Total calculated
    $780,864
    From this org
    $0
    From related orgs
    $738,931
    Other
    $41,933
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $412,729 related
    Bonus
    $0 + $319,224 related
    Other
    $0 + $6,978 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $25,533 related
    Filer's total
    $0 + $780,864 related

  • GHOSN C JOSEF

    DIRECTOR

    Total calculated
    $754,242
    From this org
    $0
    From related orgs
    $676,425
    Other
    $77,817
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $380,607 related
    Bonus
    $0 + $90,809 related
    Other
    $0 + $205,009 related
    Deferred
    $0 + $44,246 related
    Nontaxable benefits
    $0 + $33,571 related
    Filer's total
    $0 + $754,242 related

  • DAVIS BRENT

    DIRECTOR/CFO - CFN REG

    Total calculated
    $741,504
    From this org
    $0
    From related orgs
    $603,791
    Other
    $137,713
    Hours/week
    6 + 44 related

    Schedule J breakdown matched by us

    Base
    $0 + $478,024 related
    Bonus
    $0 + $110,337 related
    Other
    $0 + $15,430 related
    Deferred
    $0 + $90,095 related
    Nontaxable benefits
    $0 + $47,618 related
    Filer's total
    $0 + $741,504 related

  • BROWN LORENZO

    CEO - W.VOLUSIA MKT

    Total calculated
    $687,604
    From this org
    $0
    From related orgs
    $562,472
    Other
    $125,132
    Hours/week
    10 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $417,649 related
    Bonus
    $0 + $99,712 related
    Other
    $0 + $45,111 related
    Deferred
    $0 + $67,245 related
    Nontaxable benefits
    $0 + $57,887 related
    Filer's total
    $0 + $687,604 related

  • WEIS DAVID

    CEO - HOSPITAL FACILITY (END 08/22)

    Total calculated
    $640,189
    From this org
    $0
    From related orgs
    $523,042
    Other
    $117,147
    Hours/week
    37.5 + 12.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $406,063 related
    Bonus
    $0 + $87,239 related
    Other
    $0 + $29,740 related
    Deferred
    $0 + $71,453 related
    Nontaxable benefits
    $0 + $45,694 related
    Filer's total
    $0 + $640,189 related

  • HINDS NIGEL

    FORMER CFO

    Total calculated
    $621,988
    From this org
    $0
    From related orgs
    $549,070
    Other
    $72,918
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $335,995 related
    Bonus
    $0 + $97,179 related
    Other
    $0 + $115,896 related
    Deferred
    $0 + $23,503 related
    Nontaxable benefits
    $0 + $49,415 related
    Filer's total
    $0 + $621,988 related

  • SMITH MD CHRISTOPHER

    FORMER CMO

    Total calculated
    $552,955
    From this org
    $0
    From related orgs
    $470,281
    Other
    $82,674
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $369,406 related
    Bonus
    $0 + $72,800 related
    Other
    $0 + $28,075 related
    Deferred
    $0 + $52,218 related
    Nontaxable benefits
    $0 + $30,456 related
    Filer's total
    $0 + $552,955 related

  • SCOGGINS MD THOMAS

    CMO - HOSPITAL FACILITY

    Total calculated
    $539,629
    From this org
    $0
    From related orgs
    $429,014
    Other
    $110,615
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $319,694 related
    Bonus
    $0
    Other
    $0 + $109,320 related
    Deferred
    $0 + $66,322 related
    Nontaxable benefits
    $0 + $44,293 related
    Filer's total
    $0 + $539,629 related

  • LUNDE ERIC

    DIR/CEO HOSP. FACILITY (BEG 09/22)

    Total calculated
    $480,613
    From this org
    $0
    From related orgs
    $370,922
    Other
    $109,691
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $324,955 related
    Bonus
    $0 + $32,230 related
    Other
    $0 + $13,737 related
    Deferred
    $0 + $66,535 related
    Nontaxable benefits
    $0 + $43,156 related
    Filer's total
    $0 + $480,613 related

  • GRIFFITH SUE ELLEN

    DIRECTOR (BEG 03/22)

    Total calculated
    $449,846
    From this org
    $0
    From related orgs
    $424,415
    Other
    $25,431
    Hours/week
    0.2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $246,472 related
    Bonus
    $0 + $147,898 related
    Other
    $0 + $30,045 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $9,031 related
    Filer's total
    $0 + $449,846 related

  • GLASS KYLE

    CFO - HOSPITAL FACILITY (END 08/22)

    Total calculated
    $417,502
    From this org
    $0
    From related orgs
    $356,649
    Other
    $60,853
    Hours/week
    15 + 35 related

    Schedule J breakdown matched by us

    Base
    $0 + $288,224 related
    Bonus
    $0 + $57,115 related
    Other
    $0 + $11,310 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $44,453 related
    Filer's total
    $0 + $417,502 related

  • LINDSEY CRAIG

    FORMER CNO

    Total calculated
    $397,680
    From this org
    $0
    From related orgs
    $350,710
    Other
    $46,970
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $284,542 related
    Bonus
    $0 + $54,446 related
    Other
    $0 + $11,722 related
    Deferred
    $0 + $16,400 related
    Nontaxable benefits
    $0 + $30,570 related
    Filer's total
    $0 + $397,680 related

  • AGUERO SAMUEL

    FORMER COO

    Total calculated
    $342,779
    From this org
    $0
    From related orgs
    $288,878
    Other
    $53,901
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $236,314 related
    Bonus
    $0 + $42,586 related
    Other
    $0 + $9,978 related
    Deferred
    $0 + $14,522 related
    Nontaxable benefits
    $0 + $39,379 related
    Filer's total
    $0 + $342,779 related

  • LEBRON MICHELE

    CNO - HOSPITAL FACILITY

    Total calculated
    $296,144
    From this org
    $0
    From related orgs
    $243,878
    Other
    $52,266
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $196,540 related
    Bonus
    $0 + $35,308 related
    Other
    $0 + $12,030 related
    Deferred
    $0 + $7,681 related
    Nontaxable benefits
    $0 + $44,585 related
    Filer's total
    $0 + $296,144 related

  • BEJARANO NICHOLAS

    COO - HOSPITAL FACILITY (BEG 01/22)

    Total calculated
    $272,325
    From this org
    $0
    From related orgs
    $221,364
    Other
    $50,961
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $195,224 related
    Bonus
    $0 + $14,429 related
    Other
    $0 + $11,711 related
    Deferred
    $0 + $9,934 related
    Nontaxable benefits
    $0 + $41,027 related
    Filer's total
    $0 + $272,325 related

  • STEPHAN KELLY

    AH DEL ADMIN SUPERVISOR

    Total calculated
    $256,175
    From this org
    $233,838
    From related orgs
    $0
    Other
    $22,337
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $204,633
    Bonus
    $21,095
    Other
    $8,110
    Deferred
    $11,867
    Nontaxable benefits
    $10,470
    Filer's total
    $256,175

  • SANCHEZ ANGEL

    AH DEL ADMIN SUPERVISOR

    Total calculated
    $240,921
    From this org
    $211,767
    From related orgs
    $0
    Other
    $29,154
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $174,602
    Bonus
    $21,886
    Other
    $15,279
    Deferred
    $10,688
    Nontaxable benefits
    $18,466
    Filer's total
    $240,921

  • HAGGERTY MARIA

    AH DEL ADMIN SUPERVISOR PRN

    Total calculated
    $217,181
    From this org
    $198,726
    From related orgs
    $0
    Other
    $18,455
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $165,918
    Bonus
    $20,617
    Other
    $12,191
    Deferred
    $9,668
    Nontaxable benefits
    $8,787
    Filer's total
    $217,181

  • WELLS JEFFREY

    AH ASSISTANT NURSE MANAGER

    Total calculated
    $209,140
    From this org
    $191,265
    From related orgs
    $0
    Other
    $17,875
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $153,787
    Bonus
    $11,626
    Other
    $25,852
    Deferred
    $9,241
    Nontaxable benefits
    $8,634
    Filer's total
    $209,140

  • WESTERBERG SAMANTHA

    AH DEL RN

    Total calculated
    $205,296
    From this org
    $205,296
    From related orgs
    $0
    Other
    $0
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $197,851
    Bonus
    $2,109
    Other
    $5,336
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $205,296

  • POTTER ARIEANNA

    CFO - HOSPITAL FACILITY (BEG 08/22)

    Total calculated
    $197,202
    From this org
    $91,151
    From related orgs
    $61,448
    Other
    $44,603
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $71,080 + $59,506 related
    Bonus
    $10,996
    Other
    $9,075 + $1,942 related
    Deferred
    $4,510 + $2,898 related
    Nontaxable benefits
    $26,610 + $10,585 related
    Filer's total
    $122,271 + $74,931 related

  • REINER RICHARD

    DIRECTOR

    Total calculated
    $55,914
    From this org
    $0
    From related orgs
    $55,914
    Other
    $0
    Hours/week
    0.2

  • BOUIE AL

    DIRECTOR

    Total calculated
    $253
    From this org
    $253
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.2

  • COURTHEYN DOREEN

    DIRECTOR

    Total calculated
    $253
    From this org
    $253
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.2

  • DIBELLO MD CHRISTOPHER

    DIRECTOR/CHIEF OF STAFF

    Total calculated
    $253
    From this org
    $253
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.2

  • FLOWERS W BEN

    DIRECTOR

    Total calculated
    $253
    From this org
    $253
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.2

  • HAGSTROM LORNA JEAN

    DIRECTOR

    Total calculated
    $253
    From this org
    $253
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.2

  • WEINER DO TRACY

    DIRECTOR

    Total calculated
    $253
    From this org
    $253
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.2

  • WOODS MICHAEL

    DIRECTOR

    Total calculated
    $253
    From this org
    $253
    From related orgs
    $0
    Other
    $0
    Hours/week
    0.2

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

  • 1a · First-class or charter travel
  • 1a · Travel for companions
  • 1a · Tax indemnification and gross-up payments
  • 1a · Discretionary spending account
  • 1a · Housing allowance or residence for personal use
  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 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 1A
THE FILING ORGANIZATION IS A PART OF THE SYSTEM OF HEALTHCARE ORGANIZATIONS KNOWN AS ADVENTHEALTH. MEMBERS OF THE FILING ORGANIZATION'S EXECUTIVE MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. AHSSHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE FILING ORGANIZATION REIMBURSES AHSSHC FOR THE SALARY AND BENEFIT COST OF THOSE EXECUTIVES LISTED IN PART VII THAT ARE ON THE PAYROLL OF AHSSHC. AT THE DIRECTION OF AHSSHC, AND IN ACCORDANCE WITH THE RESERVED POWERS IN THE FILING ORGANIZATION'S GOVERNING DOCUMENTS, THE EXECUTIVE TEAM LISTED ON PART VII PROVIDES SERVICES TO THE FILING ORGANIZATION. FIRST-CLASS OR CHARTER TRAVEL: PURSUANT TO THE ADVENTHEALTH SYSTEM-WIDE GENERAL POLICY REGARDING BUSINESS TRAVEL, NO REIMBURSEMENT WILL BE PROVIDED FOR ANY ADDITIONAL COST INCURRED WITH RESPECT TO FIRST-CLASS OR CHARTER AIR TRAVEL BEYOND THE COST OF A REGULAR COACH AIRFARE. AS A MEANS OF PROVIDING ADDITIONAL BUSINESS TRAVEL REIMBURSEMENT FOR THOSE MEMBERS OF THE AHSSHC SENIOR EXECUTIVE MANAGEMENT TEAM THAT TRAVEL FREQUENTLY ON BEHALF OF ADVENTHEALTH, A SPECIAL ANNUAL TRAVEL ALLOWANCE IS PROVIDED FOR THOSE EXECUTIVES. AS ADVENTHEALTH OPERATES 49 HOSPITALS IN 9 STATES, THE SENIOR LEADERSHIP OF AHSSHC TRAVEL EXTENSIVELY AND OFTEN VISIT MULTIPLE HOSPITAL LOCATIONS IN DIFFERENT STATES AS A PART OF A SINGLE BUSINESS TRIP. THE SPECIAL TRAVEL ALLOWANCE CAN PROVIDE REIMBURSEMENTS TO THE EXECUTIVE FOR SUCH ITEMS AS THE PURCHASE OF AIR TRAVEL UPGRADE COUPONS, TO COVER THE COST DIFFERENTIAL BETWEEN COACH AND FIRST-CLASS TRAVEL, OR TO COVER THE COST OF A CHARTER FLIGHT. THE SPECIAL TRAVEL ALLOWANCE BENEFIT WAS ORIGINALLY AUTHORIZED BY AND CODIFIED INTO A POLICY BY THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE), AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS, WHO ALSO APPROVES THE ANNUAL CAP ON THE AMOUNT OF THE ALLOWANCE. THE SPECIAL TRAVEL ALLOWANCE HAS AN ANNUAL CAP OF $24,000 FOR MEMBERS OF THE LEADERSHIP EXECUTIVE TEAM (13 ADVENTHEALTH CABINET MEMBERS AND THE ADVENTHEALTH MULTI-STATE CFO) AND $15,000 FOR ADVENTHEALTH CORPORATE OFFICE SENIOR VICE PRESIDENTS, REGIONAL CEO'S, AND DIVISION CHIEF OFFICERS (GENERALLY 50 - 55 INDIVIDUAL EXECUTIVES). A REGIONAL CEO FOR ADVENTHEALTH IS A MEMBER OF THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION. THE REGIONAL CEO IS CONSIDERED A COMMON LAW EMPLOYEE OF AND IS ON THE PAYROLL OF AHSSHC. WHILE THE SPECIAL TRAVEL ALLOWANCE BENEFIT IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS ALLOCATED TO AND EITHER WHOLLY OR PARTIALLY REIMBURSED BY THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION HAS CHECKED THE BOX IN SCHEDULE J, PART I, LINE 1A FOR FIRST-CLASS OR CHARTER TRAVEL SINCE IT HAS WHOLLY OR PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT. THOSE EXECUTIVES WHO RECEIVE THE SPECIAL TRAVEL ALLOWANCE ARE RESPONSIBLE FOR TRACKING THE EXPENSES REIMBURSABLE UNDER THE SPECIAL TRAVEL ALLOWANCE AND MUST SUBMIT SUCH EXPENSES ON THEIR ACCOUNTABLE PLAN EXPENSE REPORT. A REPORT ON CHARTER TRAVEL IS PROVIDED TO THE AHSSHC BOARD COMPENSATION COMMITTEE AT EACH MEETING. ANY TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES UNDER THE SPECIAL TRAVEL ALLOWANCE ARRANGEMENT ARE TREATED AS TAXABLE COMPENSATION TO THE EXECUTIVE. TRAVEL FOR COMPANIONS: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT PROVIDES A BENEFIT TO ALLOW FOR A TRAVELING AHSSHC EXECUTIVE TO HAVE HIS OR HER SPOUSE ACCOMPANY THE EXECUTIVE ON CERTAIN BUSINESS TRIPS EACH YEAR. TYPICALLY, REIMBURSEMENT IS ONLY PROVIDED TO CERTAIN EXECUTIVE LEADERS AND IS USUALLY LIMITED TO ONE BUSINESS TRIP PER YEAR BEYOND THE ANNUAL ADVENTHEALTH PRESIDENT'S COUNCIL BUSINESS MEETING AND OTHER MEETINGS WHERE THE SPOUSE IS SPECIFICALLY INVITED. THE AHSSHC CORPORATE EXECUTIVE SPOUSAL TRAVEL POLICY WAS ORIGINALLY APPROVED AND REVIEWED BY THE AHSSHC BOARD COMPENSATION COMMITTEE, AN INDEPENDENT BODY OF THE AHSSHC BOARD OF DIRECTORS. ALL SPOUSAL TRAVEL COSTS REIMBURSED TO THE EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: ADVENTHEALTH HAS A SYSTEM-WIDE POLICY ADDRESSING GROSS-UP PAYMENTS PROVIDED IN CONNECTION WITH EMPLOYER-PROVIDED BENEFITS/OTHER TAXABLE ITEMS. UNDER THE POLICY, CERTAIN TAXABLE BUSINESS-RELATED REIMBURSEMENTS (I.E. TAXABLE BUSINESS-RELATED MOVING EXPENSES, TAXABLE ITEMS PROVIDED IN CONNECTION WITH EMPLOYMENT) PROVIDED TO ANY EMPLOYEE MAY BE GROSSED-UP AT A 25% RATE UPON APPROVAL BY THE FILING ORGANIZATION'S CEO AND CFO. ADDITIONALLY, EMPLOYEES AT THE DIRECTOR LEVEL AND ABOVE ARE ELIGIBLE FOR GROSS-UP PAYMENTS ON GIFTS RECEIVED FOR BOARD OF DIRECTOR SERVICES. DISCRETIONARY SPENDING ACCOUNT: OCCASIONAL DISCRETIONARY SPENDING AMOUNTS ARE PERIODICALLY PROVIDED TO ELIGIBLE EXECUTIVES WHO ATTEND ANNUAL BUSINESS MEETINGS SUCH AS THE ADVENTHEALTH PRESIDENT'S COUNCIL, CFO CONFERENCE OR THE CMO/CNO BUSINESS MEETING. PAYMENTS PROVIDED TO EACH EXECUTIVE ARE CONSIDERED TAXABLE COMPENSATION TO THE EXECUTIVE. HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES ASSISTANCE TO EXECUTIVES WHO HAVE BEEN RELOCATED BY THE COMPANY DURING THE YEAR. RELOCATION ASSISTANCE PROVIDED TO EXECUTIVES MAY INCLUDE RELOCATION ALLOWANCES TO ASSIST WITH DUPLICATE HOUSING EXPENSES. RELOCATION ASSISTANCE IS ADMINISTERED PER AHSSHC POLICY BY AN EXTERNAL RELOCATION COMPANY. ALL TAXABLE REIMBURSEMENTS MADE TO EXECUTIVES IN CONNECTION WITH RELOCATION ASSISTANCE ARE TREATED AS WAGES TO THE EXECUTIVE AND ARE SUBJECT TO ALL PAYROLL WITHHOLDING AND REPORTING REQUIREMENTS. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: AHSSHC HAS A CORPORATE EXECUTIVE POLICY THAT ADDRESSES BUSINESS DEVELOPMENT EXPENDITURES. UNDER THIS POLICY, TO ENCOURAGE EXECUTIVES TO ESTABLISH AND CULTIVATE STRONG WORKING RELATIONSHIPS WITH THE MEDICAL COMMUNITY AND OTHER LEADERS IN THE COMMUNITY AND INDUSTRY, CERTAIN ADVENTHEALTH EXECUTIVES MAY BE REIMBURSED FOR MEMBER DUES AND USAGE CHARGES FOR A COUNTRY CLUB OR OTHER SOCIAL CLUB UPON AUTHORIZATION. CLUB MEMBERSHIPS MUST BE APPROVED BY THE ADVENTHEALTH PRESIDENT/CEO INITIALLY AS WELL AS ON AN ANNUAL BASIS. EACH ADVENTHEALTH EXECUTIVE WHO IS APPROVED FOR A CLUB MEMBERSHIP MUST SUBMIT AN ANNUAL REPORT DESCRIBING HOW THEY USED THE MEMBERSHIP TO BENEFIT THEIR ORGANIZATION DURING THE PRECEDING YEAR SO THAT THE ADVENTHEALTH PRESIDENT/CEO CAN DETERMINE IF CONTINUANCE OF THE CLUB MEMBERSHIP FURTHERS THE BUSINESS INTERESTS OF ADVENTHEALTH. IN THE CURRENT YEAR, FOR THIS FILING ORGANIZATION, THE CEO OF THE WEST VOLUSIA MARKET LISTED IN PART VII RECEIVED REIMBURSEMENT FOR CLUB FEES. WHILE THE CLUB DUES MEMBERSHIP IS AN AHSSHC COMPENSATION POLICY AND PRACTICE, THE COST OF PROVIDING THIS BENEFIT IS ALLOCATED TO AND REIMBURSED IN WHOLE OR IN PART BY THE FILING ORGANIZATION. ACCORDINGLY, THE FILING ORGANIZATION HAS CHECKED THE BOX IN SCHEDULE J, PART I, LINE 1A FOR HEALTH OR SOCIAL CLUB DUES SINCE IT HAS WHOLLY OR PARTIALLY PAID FOR THE COST OF PROVIDING THIS BENEFIT.
PART I, LINE 3
THE INDIVIDUAL WHO SERVES AS THE CEO OF THE FILING ORGANIZATION IS APPOINTED AND COMPENSATED BY ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC). COMPENSATION AND BENEFITS PROVIDED TO THIS INDIVIDUAL ARE DETERMINED PURSUANT TO POLICIES, PROCEDURES, AND PROCESSES OF AHSSHC THAT ARE DESIGNED TO ENSURE COMPLIANCE WITH THE INTERMEDIATE SANCTIONS LAWS AS SET FORTH IN IRC SECTION 4958. AHSSHC HAS TAKEN STEPS TO ENSURE THAT PROCESSES ARE IN PLACE TO SATISFY THE REBUTTABLE PRESUMPTION OF REASONABLENESS STANDARD AS SET FORTH IN TREASURY REGULATION SECTION 53.4958-6 WITH RESPECT TO ITS ACTIVE EXECUTIVE-LEVEL POSITIONS. THE AHSSHC BOARD COMPENSATION COMMITTEE (THE COMMITTEE) SERVES AS THE GOVERNING BODY FOR ALL EXECUTIVE COMPENSATION MATTERS. THE COMMITTEE IS COMPOSED OF CERTAIN MEMBERS OF THE BOARD OF DIRECTORS (THE BOARD) OF AHSSHC. VOTING MEMBERS OF THE COMMITTEE INCLUDE ONLY INDIVIDUALS WHO SERVE ON THE BOARD AS INDEPENDENT REPRESENTATIVES, WHO HOLD NO EMPLOYMENT POSITIONS WITH AHSSHC AND WHO DO NOT HAVE RELATIONSHIPS WITH ANY OF THE INDIVIDUALS WHOSE COMPENSATION IS UNDER THEIR REVIEW THAT IMPACTS THEIR BEST INDEPENDENT JUDGMENT AS FIDUCIARIES OF AHSSHC. THE COMMITTEE'S ROLE IS TO REVIEW AND APPROVE ALL COMPONENTS OF THE EXECUTIVE COMPENSATION PLAN OF AHSSHC. AS AN INDEPENDENT GOVERNING BODY WITH RESPECT TO EXECUTIVE COMPENSATION, IT SHOULD BE NOTED THAT THE COMMITTEE WILL OFTEN CONFER IN EXECUTIVE SESSIONS ON MATTERS OF COMPENSATION POLICY AND POLICY CHANGES. IN SUCH EXECUTIVE SESSIONS, NO MEMBERS OF MANAGEMENT OF AHSSHC ARE PRESENT, OTHER THAN THE CHIEF PEOPLE OFFICER, WHO REMAINS AT THE REQUEST OF THE CHAIRMAN/COMMITTEE TO PROVIDE ASSISTANCE/INFORMATION AS NEEDED. THE COMMITTEE IS ADVISED BY AN INDEPENDENT THIRD-PARTY COMPENSATION ADVISOR. THIS ADVISOR PREPARES ALL THE BENCHMARK STUDIES FOR THE COMMITTEE. COMPENSATION LEVELS ARE BENCHMARKED WITH A NATIONAL PEER GROUP OF OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS AND HOSPITALS OF SIMILAR SIZE AND COMPLEXITY TO ADVENTHEALTH AND EACH OF ITS AFFILIATED ENTITIES. THE FOLLOWING PRINCIPLES GUIDE THE ESTABLISHMENT OF INDIVIDUAL EXECUTIVE COMPENSATION: - THE SALARY OF THE PRESIDENT/CEO OF ADVENTHEALTH WILL NOT EXCEED THE 50TH PERCENTILE OF COMPARABLE SALARIES PAID BY SIMILARLY SITUATED ORGANIZATIONS; AND - OTHER EXECUTIVE SALARIES SHALL BE ESTABLISHED USING MARKET MEDIANS. THE COMPENSATION PHILOSOPHY, POLICIES, AND PRACTICES OF AHSSHC ARE CONSISTENT WITH THE ORGANIZATION'S FAITH-BASED MISSION AND CONFORM TO APPLICABLE LAWS, REGULATIONS, AND BUSINESS PRACTICES. AS A FAITH-BASED ORGANIZATION SPONSORED BY THE SEVENTH-DAY ADVENTIST CHURCH (THE CHURCH), AHSSHC'S PHILOSOPHY AND PRINCIPLES WITH RESPECT TO ITS EXECUTIVE COMPENSATION PRACTICES REFLECT THE CONSERVATIVE APPROACH OF THE CHURCH'S MISSION OF SERVICE AND WERE DEVELOPED IN COUNSEL WITH THE CHURCH'S LEADERSHIP.
PART I, LINE 4B
AS DISCUSSED IN LINE 1A ABOVE, EXECUTIVES ON THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE-PRESIDENT OR ABOVE ARE COMPENSATED BY AND ON THE PAYROLL OF ADVENTIST HEALTH SYSTEM SUNBELT HEALTHCARE CORPORATION (AHSSHC), THE PARENT ORGANIZATION OF THE HEALTHCARE SYSTEM KNOWN AS ADVENTHEALTH. IN RECOGNITION OF THE CONTRIBUTION THAT EACH EXECUTIVE MAKES TO THE SUCCESS OF ADVENTHEALTH, ADVENTHEALTH PROVIDES SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT PLANS TO ELIGIBLE EXECUTIVES. AS THE SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT PLANS WERE UPDATED IN 2020 AND CERTAIN INDIVIDUALS STILL PARTICIPATE AS GRAND-FATHERED PARTICIPANTS IN CERTAIN PLANS, THE NARRATIVE BELOW DISCUSSES ALL PLANS IN WHICH THERE WERE ANY PARTICIPANTS IN 2022. THE SERP III PLAN EFFECTIVELY REPLACES THE PRIOR SERP II PLAN, THE EXECUTIVE FLEX BENEFIT PROGRAM PLAN, AND THE SENIOR EXECUTIVE DEATH BENEFIT PLAN FOR QUALIFIED EXECUTIVES EXCEPT FOR CERTAIN GRANDFATHERED EXECUTIVE EMPLOYEES. SERP III PLAN: THE SERP III PLAN PROVIDES ELIGIBLE EXECUTIVES A PERCENTAGE OF THEIR BASE PAY, WHICH IS CREDITED TO A DEFERRED COMPENSATION ACCOUNT. THE PLAN ALSO PROVIDES FOR COMPENSATION DEFERRAL AND SELECTION OF LIFE INSURANCE COVERAGE AND LONG-TERM CARE INSURANCE. TO BE ELIGIBLE TO PARTICIPATE IN THE SERP III PLAN, EXECUTIVES MUST BE ON THE AHSSHC CORPORATE PAYROLL AND BE EITHER A CEO OF AN ADVENTHEALTH ENTITY, AN AHSSHC VICE PRESIDENT (VP) OR VP OF AN ADVENTHEALTH ENTITY WITH A BASE SALARY OF AT LEAST $305,000 IN 2022 (ADJUSTED ANNUALLY BY THE SAME PERCENTAGE AS IRC SECTION 401(A)(17) LIMIT INCREASES), OR OTHER LEADER SPECIFICALLY APPROVED BY THE ADVENTHEALTH PRESIDENT. ELIGIBLE EXECUTIVES DO NOT INCLUDE GRANDFATHERED EXECUTIVES, MEANING THOSE EXECUTIVES WHO WOULD SATISFY ALL THE ELIGIBILITY REQUIREMENTS OF THE SERP II PLAN PRIOR TO DEC 31, 2027, HAD THE PLAN NOT BEEN AMENDED AND RESTATED AS OF JAN. 1, 2020. CONTRIBUTION CREDITS WILL BE ESTABLISHED AND MAINTAINED BY CLASS YEAR ACCOUNTS FOR EACH PARTICIPANT USING TIERED CONTRIBUTION CREDIT PERCENTAGES OF ANNUAL BASE COMPENSATION. CONTRIBUTION CREDIT PERCENTAGES RANGE BETWEEN 15% AND 19% OF BASE COMPENSATION. CONTRIBUTION CREDITS WILL BE MADE EACH QUARTER IN 25% INCREMENTS WITH REDUCTIONS IN CONTRIBUTIONS IF THE EXECUTIVE IS ALSO A GRANDFATHERED FLEX PARTICIPANT (SEE BELOW). SERP III PROVIDES FOR A CLASS YEAR VESTING AND PAYMENT SCHEDULE (7 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S DEFERRED COMPENSATION ACCOUNT. UPON ATTAINMENT OF A NORMAL RETIREMENT AGE (AGE 62), OR UPON CERTAIN OTHER CIRCUMSTANCES AS DEFINED IN THE SERP III PLAN DOCUMENT, ALL DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT. FOR ANY EXECUTIVES WORKING BEYOND THE NORMAL RETIREMENT AGE, FUTURE EMPLOYER CONTRIBUTIONS WILL BE MADE QUARTERLY FROM SERP III DIRECTLY TO THE PARTICIPANT AS A TAXABLE CASH BONUS. SERP II PLAN: THE SERP II PLAN IS A DEFINED BENEFIT, NON-TAX-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES WHO HAVE PROVIDED LENGTHY SERVICE TO ADVENTHEALTH AND/OR TO OTHER SEVENTH-DAY ADVENTIST CHURCH HOSPITALS OR HEALTH CARE INSTITUTIONS. UNDER THE PROVISIONS OF THE SERP II PLAN, BENEFITS ARE PROVIDED TO QUALIFYING EXECUTIVE PARTICIPANTS ON A PRO-RATA SCHEDULE BEGINNING WITH 20 YEARS OF SERVICE AS AN EMPLOYEE OF ADVENTHEALTH AND/OR ANOTHER HOSPITAL OR HEALTH CARE INSTITUTION CONTROLLED BY THE SEVENTH-DAY ADVENTIST CHURCH AND WHO SATISFY CERTAIN OTHER QUALIFYING CRITERIA. ELIGIBLE EMPLOYEES ARE RESTRICTED TO THOSE EXECUTIVES WHO, AS OF JANUARY 1, 2020, SATISFIED, OR IF EMPLOYMENT CONTINUES, WILL SATISFY THE ELIGIBILITY REQUIREMENTS OF SERP II PRIOR TO DECEMBER 31, 2027. THIS SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP II) WAS DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES WITH THE ECONOMIC EQUIVALENT OF AN ANNUAL INCOME BEGINNING AT NORMAL RETIREMENT AGE EQUAL TO 60% OF THE AVERAGE OF THE PARTICIPANT'S THREE, FIVE OR SEVEN HIGHEST YEARS OF BASE SALARY FROM ADVENTHEALTH ACTIVE EMPLOYMENT INCLUSIVE OF INCOME FROM ALL OTHER SEVENTH-DAY ADVENTIST CHURCH HEALTHCARE EMPLOYER-FINANCED RETIREMENT INCOME SOURCES AND INVESTMENT INCOME EARNED ON THOSE CONTRIBUTIONS THROUGH SOCIAL SECURITY NORMAL RETIREMENT AGE AS DEFINED IN THE PLAN. THE NUMBER OF YEARS INCLUDED IN HIGHEST AVERAGE COMPENSATION IS DETERMINED BY THE INDIVIDUAL'S YEAR OF ENTRY TO SERP II AND BY THE INDIVIDUAL'S YEAR OF ENTRY TO THE ADVENTHEALTH EXECUTIVE FLEX BENEFIT PROGRAM. FLEX PLAN: THE FLEX PLAN WAS ORIGINALLY DESIGNED TO PROVIDE ELIGIBLE EXECUTIVES AN OPPORTUNITY TO SELECT FROM AMONG A VARIETY OF SUPPLEMENTAL BENEFITS, INCLUDING A SPLIT DOLLAR LIFE INSURANCE POLICY AND LONG-TERM CARE INSURANCE, TO INDIVIDUALLY TAILOR A BENEFITS PROGRAM APPROPRIATE TO EACH EXECUTIVE'S NEEDS. IN 2020, THE FLEX PLAN WAS AMENDED TO EXCLUDE EMPLOYED EXECUTIVES WHO ARE HIRED OR PROMOTED AFTER A CERTAIN DATE FROM BEING ELIGIBLE TO PARTICIPATE IN THE FLEX PLAN EXCEPT FOR CERTAIN INSURANCE COVERAGE FEATURES OF THE PLAN. THE FLEX PLAN PROVIDES ELIGIBLE PARTICIPANTS A PRE-DETERMINED BENEFITS ALLOWANCE CREDIT THAT IS EQUAL TO A PERCENTAGE OF THE EXECUTIVE'S BASE PAY FROM WHICH THE COST OF MANDATORY AND ELECTIVE EMPLOYEE BENEFITS IS DEDUCTED. THE BENEFITS ALLOWANCE CREDIT PERCENTAGE FOR ANY PLAN YEAR SHALL NOT BE GREATER THAN THE MAXIMUM DOLLAR AMOUNT OR THE PERCENTAGE OF COMPENSATION AS DETERMINED BY THE ADVENTHEALTH BENEFITS ADMINISTRATION COMMITTEE. FOR GRANDFATHERED ELIGIBLE EMPLOYEES, THE ANNUAL PRE-DETERMINED FLEX ALLOWANCE IS CONTRIBUTED AND ANY FUNDS THAT REMAIN AFTER THE COST OF MANDATORY AND ELECTIVE BENEFITS ARE SUBTRACTED ARE, AT THE EMPLOYEE'S OPTION, CONTRIBUTED TO EITHER AN IRC 457(F) DEFERRED COMPENSATION ACCOUNT OR TO AN IRC 457(B) ELIGIBLE DEFERRED COMPENSATION PLAN. UPON ATTAINMENT OF AGE 65, ALL PREVIOUS 457(F) DEFERRED AMOUNTS ARE PAID IMMEDIATELY TO THE PARTICIPANT AND ANY FUTURE EMPLOYER CONTRIBUTIONS ARE MADE QUARTERLY FROM THE PLAN DIRECTLY TO THE PARTICIPANT. THE PLAN PROVIDES FOR A CLASS YEAR VESTING SCHEDULE (2 YEARS FOR EACH CLASS YEAR) WITH RESPECT TO AMOUNTS ACCUMULATED IN THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT. DISTRIBUTIONS COULD ALSO BE MADE FROM THE EXECUTIVE'S 457(F) DEFERRED COMPENSATION ACCOUNT UPON ATTAINMENT OF AGE 65 OR UPON AN INVOLUNTARY SEPARATION. THE ACCOUNT WILL BE FORFEITED BY THE EXECUTIVE UPON A VOLUNTARY SEPARATION. WITH RESPECT TO GRANDFATHERED PARTICIPANTS, THE FLEX PLAN DOCUMENTS DEFINE ELIGIBLE EMPLOYEES TO INCLUDE THE CHIEF EXECUTIVE OFFICERS OF ADVENTHEALTH ENTITIES AND VICE PRESIDENTS OF ALL ADVENTHEALTH ENTITIES WHOSE BASE SALARY WAS AT LEAST EQUAL TO THE INTERNAL REVENUE CODE SECTION 401(A)(17) COMPENSATION LIMIT EACH YEAR. FLEX PLAN FLEX PLAN SERP II SERP III AHS457B CONTR. DISTR.* CONTR./DISTR. CONTR. DISTR.* OTTATI,DAVID $ 150,000 $ 140,915 $ 2,256,444 $ 0 $ 0 GOODMAN,TODD $ 150,000 $ 157,963 $ 532,684 $ 0 $ 0 CELANO,PATRICIA $ 92,892 $ 60,594 $ 913,228 $ 0 $ 0 GREGORY,AUDREY $ 0 $ 0 $ 0 $ 171,000 $ 0 THOMAS,DEBORA $ 74,910 $ 48,092 $ 102,171 $ 0 $ 0 GHOSN,C. JOSEF $ 48,346 $ 21,774 $ 136,059 $ 0 $ 0 DAVIS,BRENT $ 0 $ 0 $ 0 $ 73,695 $ 0 BROWN,LORENZO $ 50,845 $ 28,338 $ 0 $ 0 $ 0 WEIS,DAVID $ 45,712 $ 13,071 $ 0 $ 15,441 $ 0 HINDS,NIGEL $ 27,603 $ 22,482 $ 53,748 $ 0 $ 0 SMITH,CHRISTOPHER $ 47,330 $ 0 $ 0 $ 8,988 $ 0 SCOGGINS,THOMAS $ 0 $ 0 $ 0 $ 49,922 $ 0 LUNDE,ERIC $ 0 $ 0 $ 0 $ 50,135 $ 0 REINER,RICHARD $ 0 $ 0 $ 0 $ 0 $ 55,914 * INCLUDING INVESTMENT EARNINGS

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
2022
Filed
22 January 2024
IRS schema version
2022v5.0
Source object
202430239349301323

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