Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Trinity Mother Frances Health System
 
Employer identification number

75-2616975
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.
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
directors, trustees, officers, including 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.
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
Yes
 
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) 2013
Page 2

Schedule J (Form 990) 2013
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
1J LINDSEY BRADLEY JRSYSTEM PRESIDENT/DIRECTOR (i)
(ii)
634,408
240,637
595,420
225,849
0
0
7,858
2,980
10,813
4,101
1,248,499
473,567
0
0
2MARK ANDERSONDIRECTOR (i)
(ii)
0
449,490
0
0
0
5,322
0
8,818
0
21,444
0
485,074
0
0
3STEVEN KEUER MDPRESIDENT/DIRECTOR (i)
(ii)
101,089
101,090
130,000
130,000
216,904
216,903
13,669
13,669
1,250
1,250
462,912
462,912
216,904
216,903
4RAY THOMPSONSYS EXEC VP/SECRETARY/treas (i)
(ii)
295,700
443,550
295,768
443,651
0
0
4,335
6,503
5,966
8,948
601,769
902,652
0
0
5JOYCE HESTERSR. VICE PRESIDENT/CFO (i)
(ii)
80,449
241,347
28,969
86,905
0
0
2,710
8,128
3,104
9,310
115,232
345,690
0
0
6DAVID NORTHCUTTLEGAL COUNSEL (i)
(ii)
175,791
0
500
0
15
0
7,086
0
15,603
0
198,995
0
0
0
7GIFFORD ECKHOUT MDEXEC VICE PRESIDENT/DIRECtor (i)
(ii)
367,502
245,002
80,070
53,380
5,963
3,975
4,838
3,225
1,500
1,000
459,873
306,582
5,963
3,975
8andy navarroVP general counsel (i)
(ii)
146,679
0
0
0
35,948
0
3,789
0
6,932
0
193,348
0
0
0
9JOHN WEBBVP MANAGED CARE/REG SVC (i)
(ii)
185,766
0
16,578
0
10,815
0
7,196
0
19,933
0
240,288
0
0
0
10ELIZABETH PULLIAMVP FINANCE (i)
(ii)
212,564
0
34,208
0
10,965
0
4,604
0
8,302
0
270,643
0
0
0
11JEFFREY PEARSONVP (i)
(ii)
213,223
0
27,716
0
10,890
0
5,871
0
19,146
0
276,846
0
0
0
12DARIN SZILAGYIVP (i)
(ii)
191,265
0
16,698
0
10,815
0
6,278
0
18,521
0
243,577
0
0
0
13THOMAS WILKENSR VP (i)
(ii)
247,599
0
41,651
0
10,875
0
7,697
0
17,905
0
325,727
0
0
0
14ANDREW VON ESCHENBACHvp revenue cycle (i)
(ii)
176,631
0
35,630
0
3,570
0
3,109
0
20,986
0
239,926
0
0
0
15MARY E DODDPROJECT DIRECTOR epic (i)
(ii)
141,998
0
0
0
15
0
6,042
0
13,641
0
161,696
0
0
0
16christina ramseysystem controller (i)
(ii)
126,901
0
0
0
795
0
4,277
0
18,270
0
150,243
0
0
0
17robert jehlingAdministrative Director (i)
(ii)
137,573
0
0
0
10,586
0
1,735
0
18,266
0
168,160
0
0
0
18david teegarden mdsystem president/cmo/director (i)
(ii)
0
97,133
0
0
0
3,673
0
2,250
0
20,266
0
123,322
0
0
19mary jacksonvp (i)
(ii)
194,398
0
30,212
0
13,440
0
7,902
0
7,348
0
253,300
0
0
0
20william bellenfant srsr vp/cfo/director/treasurer (i)
(ii)
0
0
0
0
213,528
0
0
0
0
0
213,528
0
0
0
21lee portwoodvp, operations (i)
(ii)
0
219,945
0
18,913
0
10,800
0
9,341
0
13,307
0
272,306
0
0
Schedule J (Form 990) 2013
Page 3

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
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.
Return Reference Explanation
SCHEDULE J, PART I, LINE 1A TAX INDEMNIFICATION & GROSS UP PAYMENTS: AMOUNTS PAID FOR "GROSSED UP" GIFT CARDS ARE INCLUDED AS TAXABLE COMPENSATION TO THE FOLLOWING INDIVIDUALS: Elizabeth Pulliam, Jeffrey Pearson, Mary Jackson, Andrew Von Eschenbach, John Webb, Darin Szilagyi, Richard Gilbert, Mary Dodd, Christina Ramsey, AND David Northcutt SCHEDULE J, PART I, LINE 4A SEVERANCE & CHANGE OF CONTROL PAYMENTS: ANDY NAVARRO $35,948 william bellenfant sr $213,528
SCHEDULE J, PART I, LINE 4B PARTICIPATION IN OR PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PARTICIPANTS IN SERP REPORTED IN W-2 DEFERRED COMPENSATION -------------------- --------------- --------------------- STEVEN KEUER MD $426,080 NONE PARTICIPANTS IN 457(F) REPORTED IN W-2 ---------------------- ----------------- STEVEN KEUER MD $7,727 GIFFORD ECKHOUT MD $9,938
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version: