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Nonprofiteer
← COMMUNITY HOSPITAL OF BREMEN INC

Form 990 for tax year 2022

Filed by COMMUNITY HOSPITAL OF BREMEN INC.

Totals

Total revenue
$23,900,980
Total expenses
$25,797,807
Contributions and grants received
$557,605
Grants paid
$10,875
Program services expenses (Part IX)
$23,494,401
Management and general expenses
$2,303,406
Fundraising expenses
$0
Program service expenses (Part III)
$23,494,401

Program services were 91.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • Carol Hochstetler

    Chair

    Total calculated
    $150
    From this org
    $150
    From related orgs
    $0
    Other
    $0
    Hours/week
    2

  • Jason Marker MD

    Vice Chair/Chief Med Officer

    Total calculated
    $334,093
    From this org
    $0
    From related orgs
    $299,271
    Other
    $34,822
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $266,611 related
    Bonus
    $0 + $15,952 related
    Other
    $0 + $16,708 related
    Deferred
    $0 + $11,592 related
    Nontaxable benefits
    $0 + $23,230 related
    Filer's total
    $0 + $334,093 related

  • Jeffrey Brinkman

    Secretary/Treasurer

    Total calculated
    $150
    From this org
    $150
    From related orgs
    $0
    Other
    $0
    Hours/week
    2

  • Alfred Alvarado

    Director

    Total calculated
    $150
    From this org
    $150
    From related orgs
    $0
    Other
    $0
    Hours/week
    2

  • Anthony Wagner

    Director (Beg 3/2022)

    Total calculated
    $150
    From this org
    $150
    From related orgs
    $0
    Other
    $0
    Hours/week
    2

  • Bill Davis

    Director

    Total calculated
    $150
    From this org
    $150
    From related orgs
    $0
    Other
    $0
    Hours/week
    2

  • Greg Miller

    Director

    Total calculated
    $150
    From this org
    $150
    From related orgs
    $0
    Other
    $0
    Hours/week
    2

  • Pheanis Wickey

    Director

    Total calculated
    $150
    From this org
    $150
    From related orgs
    $0
    Other
    $0
    Hours/week
    2

  • Trend Weldy

    Director

    Total calculated
    $150
    From this org
    $150
    From related orgs
    $0
    Other
    $0
    Hours/week
    2

  • David H Bailey

    President

    Total calculated
    $497,496
    From this org
    $0
    From related orgs
    $442,401
    Other
    $55,095
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $243,124 related
    Bonus
    $0 + $49,316 related
    Other
    $0 + $149,961 related
    Deferred
    $0 + $53,515 related
    Nontaxable benefits
    $0 + $1,581 related
    Filer's total
    $0 + $497,496 related

  • Jeffrey P Costello

    CFO

    Total calculated
    $1,005,289
    From this org
    $0
    From related orgs
    $878,794
    Other
    $126,495
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $602,522 related
    Bonus
    $0 + $122,536 related
    Other
    $0 + $153,736 related
    Deferred
    $0 + $110,781 related
    Nontaxable benefits
    $0 + $15,714 related
    Filer's total
    $0 + $1,005,289 related

  • Kreg R Gruber

    CEO

    Total calculated
    $1,764,630
    From this org
    $0
    From related orgs
    $1,543,364
    Other
    $221,266
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $994,922 related
    Bonus
    $0 + $261,341 related
    Other
    $0 + $287,101 related
    Deferred
    $0 + $194,557 related
    Nontaxable benefits
    $0 + $26,709 related
    Filer's total
    $0 + $1,764,631 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 — 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

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
COMMUNITY HOSPITAL OF BREMEN, INC. USES A RELATED ORGANIZATION'S (BEACON HEALTH SYSTEM, INC.) COMPENSATION REVIEW PROCESS. THIS REVIEW PROCESS INCLUDES AN EXTENSIVE EXAMINATION USING COMPARABLE MARKET DATA THAT IS THEN REVIEWED BY AN INDEPENDENT CONSULTANT HIRED BY, AND REPORTING TO, THE BOARD OF DIRECTORS. RECOMMENDATIONS ARE PRESENTED TO THE BOARD FOR DELIBERATION AND FINAL DECISION.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
BEACON HEALTH SYSTEM IMPLEMENTED AN EXECUTIVE RETENTION PLAN TO ATTRACT AND RETAIN KEY EMPLOYEES BY PROVIDING ADDITIONAL DEFERRED COMPENSATION. THE CHIEF EXECUTIVE OFFICER WILL PARTICIPATE IN THE PLAN AND WILL SELECT OTHER PARTICIPANTS PURSUANT TO THE GUIDELINES SET BY THE EMPLOYER'S BOARD OF DIRECTORS. THE EMPLOYER MAY MAKE CONTRIBUTIONS UNDER THE PLAN AND HAS SOLE DISCRETION OVER WHETHER TO MAKE A CONTRIBUTION. VESTING OCCURS ON JANUARY 1 OF THE FIFTH YEAR FOR WHICH SUCH CONTRIBUTIONS ARE MADE FOR PARTICIPANTS WHO HAVE BEEN CONTINUOUSLY EMPLOYED. THE PLAN ALSO ALLOWS VESTING TO OCCUR IF THE PARTICIPANT ATTAINS THE AGE OF 62. THE FOLLOWING INDIVIDUALS RECEIVED VESTED PAYMENTS IN 2022, REFLECTED IN COLUMN (B)(III): * KREG GRUBER, $146,136 * JEFFREY COSTELLO, $116,448 * DAVID BAILEY, $122,330 THE FOLLOWING INDIVIDUALS RECEIVED DEFFERED PAYMENTS IN 2022 THAT WILL VEST IN FUTURE YEARS, WHICH ARE REFLECTED IN COLUMN C: * KREG GRUBER, $182,357 * JEFFREY COSTELLO, $98,581 * DAVID BAILEY, $41,315

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
10 November 2023
IRS schema version
2022v5.0
Source object
202343149349304979

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