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ObjectId: 201411359349307781 - Submission: 2014-05-15
TIN: 95-1644600
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
Attach to Form 990.
See separate instructions.
OMB No. 1545-0047
20
12
Open to Public Inspection
Name of the organization
CEDARS-SINAI MEDICAL CENTER
Employer identification number
95-1644600
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
First-class or charter travel
Housing allowance or residence for personal use
Travel for companions
Payments for business use of personal residence
Tax idemnification and gross-up payments
Health or social club dues or initiation fees
Discretionary spending account
Personal services (e.g., maid, chauffeur, chef)
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain
....
1b
Yes
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a?
.......
2
Yes
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
Compensation committee
Written employment contract
Independent compensation consultant
Compensation survey or study
Form 990 of other organizations
Approval by the board or compensation committee
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment?
................
4a
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan?
.........
4b
Yes
c
Participate in, or receive payment from, an equity-based compensation arrangement?
.........
4c
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization?
...........................
5a
No
b
Any related organization?
.........................
5b
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
...........................
6a
No
b
Any related organization?
.........................
6b
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III
............
7
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III
.............................
8
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)?
.........................
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012
Page 2
Schedule J (Form 990) 2012
Page
2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees.
Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note.
The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A)
Name and Title
(B)
Breakdown of W-2 and/or 1099-MISC compensation
(C)
Retirement and other deferred compensation
(D)
Nontaxable
benefits
(E)
Total of columns
(B)(i)-(D)
(F)
Compensation
reported as deferred
in prior Form 990
(i)
Base compensation
(ii)
Bonus & incentive compensation
(iii)
Other reportable compensation
(1)
THOMAS M PRISELAC
PRESIDENT/CEO
(i)
(ii)
1,165,490
0
801,113
0
903,677
0
655,598
0
28,362
0
3,554,240
0
444,631
0
(2)
ILANA CASS MD
BOARD MEMBER/STAFF PHYS.
(i)
(ii)
345,698
0
33,094
0
57,310
0
26,355
0
39,426
0
501,883
0
0
0
(3)
BETH KARLAN MD
BOARD MEMBER/STAFF PHYS.
(i)
(ii)
387,629
0
39,755
0
97,689
0
47,428
0
2,227
0
574,728
0
0
0
(4)
SCOTT KARLAN MD
BOARD MEMBER/CHIEF OF STAF
(i)
(ii)
340,221
0
32,897
0
39,580
0
28,524
0
27,883
0
469,105
0
0
0
(5)
ANDREW KLEIN MD
BOARD MEMBER/STAFF PHYS.
(i)
(ii)
799,741
0
162,970
0
137,794
0
35,919
0
42,628
0
1,179,052
0
0
0
(6)
ZAB MOSENIFAR MD
BOARD MEMBER/STAFF PHYS.
(i)
(ii)
544,346
0
108,478
0
325,437
0
184,031
0
28,963
0
1,191,255
0
0
0
(7)
PAUL SILKA MD
BOARD MEMBER/CHIEF MEDICAL
(i)
(ii)
403,087
0
74,062
0
68,525
0
26,191
0
41,762
0
613,627
0
0
0
(8)
EDWARD PRUNCHUNAS
CHIEF FINANCIAL OFFICER
(i)
(ii)
638,179
0
248,132
0
927,223
0
83,825
0
30,319
0
1,927,678
0
298,488
0
(9)
MARK GAVENS
CHIEF OPERATING OFFICER
(i)
(ii)
718,653
0
302,882
0
241,948
0
21,935
0
40,020
0
1,325,438
0
0
0
(10)
SHLOMO MELMED MD
CHIEF ACADEMIC OFFICER
(i)
(ii)
830,864
0
314,455
0
216,332
0
442,703
0
27,393
0
1,831,747
0
0
0
(11)
KEITH BLACK MD
CHAIRMAN-NEUROSURGERY
(i)
(ii)
1,760,278
0
318,875
0
876,783
0
13,750
0
49,900
0
3,019,586
0
0
0
(12)
BRUCE GEWERTZ MD
CHAIRMAN-DEPT OF SURGERY
(i)
(ii)
1,203,882
0
221,292
0
402,148
0
49,954
0
27,940
0
1,905,216
0
0
0
(13)
EDUARDO MARBAN MD
DIRECTOR - HEART INSTITUTE
(i)
(ii)
1,219,053
0
728,927
0
416,015
0
179,624
0
38,462
0
2,582,081
0
0
0
(14)
ALFREDO TRENTO MD
DIRECTOR-CARDIOTHORACIC SU
(i)
(ii)
1,045,496
0
471,252
0
543,052
0
49,989
0
27,011
0
2,136,800
0
119,240
0
(15)
RAJENDRA MAKKAR MD
DIRECTOR - INTERVENTIONAL CARDIOLOGY
(i)
(ii)
1,070,038
0
901,233
0
205,779
0
21,593
0
42,102
0
2,240,745
0
0
0
Schedule J (Form 990) 2012
Page 3
Schedule J (Form 990) 2012
Page
3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier
Return Reference
Explanation
PART I, LINE 1A
THE ORGANIZATION'S TRAVEL POLICY CONTAINS A PROVISION THAT ALLOWS FLYING FIRST CLASS FOR ANY ONE-WAY FLIGHT THAT IS LONGER THAN EIGHT HOURS. EXCEPTIONS REQUIRE SENIOR EXECUTIVE APPROVAL. THE OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHEST-COMPENSATED EMPLOYEES HAVE, FROM TIME TO TIME, FLOWN FIRST CLASS AS ALLOWED BY THE TRAVEL POLICY.
PART I, LINE 4B
THERE ARE TWO NONQUALIFIED DEFERRED COMPENSATION PLANS IN WHICH ONE OR MORE OF THE LISTED PERSONS PARTICIPATE. THE FIRST PLAN IS A DEFERRED COMPENSATION PLAN. THIS IS A "GRANDFATHERED" TRADITIONAL DEFINED BENEFIT PLAN (NO NEW PARTICIPANTS HAVE BEEN ADDED SINCE 1986). THE BENEFIT FORMULA IS A PERCENTAGE OF THE HIGHEST FIVE YEARS AVERAGE ANNUAL SALARY TIMES THE NUMBER OF YEARS OF ELIGIBLE SERVICE, WITH A MAXIMUM CREDITED SERVICE OF 30 YEARS. THE SECOND PLAN IS A SUPPLEMENTAL RETIREMENT ALLOWANCE THAT IS PAYABLE DIRECTLY TO THE PARTICIPANTS EACH QUARTER. THE BENEFIT FORMULA FOR THIS PLAN HAS ANNUAL CONTRIBUTIONS THAT ARE EITHER A PERCENTAGE OF SALARY, OR ARE DESIGNED TO FUND A PERCENTAGE OF THE ESTIMATED FINAL 5-YEAR AVERAGE SALARY. CERTAIN INDIVIDUALS ALSO RECEIVED PAYOUTS FROM AMOUNTS ACCRUED IN PRIOR YEARS. IN ADDITION, ONE INDIVIDUAL HAS A RETENTION INCENTIVE WHICH HAD A CLIFF VESTING DATE IN 2012. THE FOLLOWING OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHEST-COMPENSATED EMPLOYEES RECEIVED PAYMENTS DURING THE YEAR ENDED DECEMBER 31, 2012 RELATED TO THE PLANS REFERENCED ABOVE. THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II AND ARE NOT INCREMENTAL PAYMENTS. KEITH BLACK, MD 737,125 ILANA CASS, MD 42,350 MARK GAVENS 192,216 BRUCE GEWERTZ, MD 323,079 BETH KARLAN, MD 72,358 SCOTT KARLAN, MD 38,802 ANDREW KLEIN, MD 106,776 RAJENDRA MAKKAR, MD 205,547 EDUARDO MARBAN, MD 329,985 SHLOMO MELMED, MD 163,336 ZAB MOSENIFAR, MD 280,276 THOMAS M. PRISELAC 832,527 EDWARD PRUNCHUNAS 867,658 PAUL SILKA, MD 46,965 ALFREDO TRENTO, MD 492,200
Schedule J (Form 990) 2012
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