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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
OMC REGIONAL FOUNDATION
 
Employer identification number

26-0022777
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 on 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
 
 
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
 
 
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 on 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
 
No
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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on 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 on 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" on 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) 2015
Page 2

Schedule J (Form 990) 2015
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 on 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 in column(B) reported as deferred on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1KATHRYN LOMBARDO MDDIRECTOR/PRESIDENT OF OMC (i)

(ii)
0
-------------
475,803
0
-------------
72,603
0
-------------
10,471
0
-------------
24,700
0
-------------
0
0
-------------
583,577
0
-------------
0
2DAVID LOWE MDDIRECTOR/INTERNAL MED/MED SUBSPECIAL (i)

(ii)
0
-------------
619,247
0
-------------
9,733
0
-------------
9,793
0
-------------
24,700
0
-------------
20,725
0
-------------
684,198
0
-------------
0
3TIM WEIR FACHEDIRECTOR/CEO OF OMC (i)

(ii)
0
-------------
471,873
0
-------------
130,685
0
-------------
5,659
0
-------------
24,700
0
-------------
19,572
0
-------------
652,489
0
-------------
0
4STACEY VANDEN HEUVELVP MARKETING AND PHILANTHROPY (i)

(ii)
0
-------------
140,921
0
-------------
30,736
0
-------------
1,873
0
-------------
15,894
0
-------------
0
0
-------------
189,424
0
-------------
0
5KEVIN HIGGINSCFO OF OMC (i)

(ii)
0
-------------
280,270
0
-------------
63,732
0
-------------
19,845
0
-------------
24,700
0
-------------
20,064
0
-------------
408,611
0
-------------
0
Schedule J (Form 990) 2015
Page 3

Schedule J (Form 990) 2015
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
PART I, LINE 3 THE COMPENSATION FOR THE PRESIDENT AND CEO WAS ESTABLISHED AND PAID BY OLMSTED MEDICAL CENTER, THE SOLE MEMBER OF THE FOUNDATION. THE FOLLOWING METHODS WERE RELIED UPON BY OLMSTED MEDICAL CENTER TO DETERMINE SUCH COMPENSATION: 1. COMPENSATION COMMITTEE, 2. INDEPENDENT COMPENSATION CONSULTANT, 3. COMPENSATION SURVEY OR STUDY, AND 4. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. IN ORDER TO ENSURE THAT ALL OLMSTED MEDICAL CENTER (OMC) EXECUTIVE COMPENSATION DECISIONS ARE COMPETITIVE, EQUITABLE, UNIFORMLY ADMINISTERED, AND CONSISTENT WITH MARKET PRACTICES, OMC FOLLOWS RECOMMENDED BEST PRACTICES. THE GOALS OF EXECUTIVE COMPENSATION ARE TO ATTRACT AND RETAIN HIGHLY QUALIFIED PERSONNEL, TO MAINTAIN COMPENSATION LEVELS COMMENSURATE WITH THE SCOPE OF RESPONSIBILITIES FOR EACH POSITION, AND TO REWARD OUTSTANDING PERFORMANCE. OMC WILL SEEK MANAGEMENT TALENT BY CONDUCTING NATIONAL SEARCHES FOR QUALIFIED APPLICANTS FOR ANY VACANCIES AT THE MEDICAL VICE PRESIDENT HOSPITAL/SURGICAL SERVICES, VICE PRESIDENT MEDICAL SERVICES AND CEO POSITIONS IN ADDITION TO VICE PRESIDENT POSITIONS AS NECESSARY. THE SAME PHILOSOPHY IS APPLICABLE TO THE POSITION OF OMC PRESIDENT. OMC ENGAGES AN EXTERNAL CONSULTANT WHO ANNUALLY COMPILES A PEER GROUP COMPENSATION ANALYSIS AND ON A TWO YEAR BASIS COMPILES A PEER GROUP COMPENSATION AND BENEFITS ANALYSIS. PEER GROUPS FOR EXECUTIVE COMPENSATION, WHICH INCLUDES BASE SALARIES, INCENTIVE AND BENEFITS, WILL BE PROVIDED FOR HEALTH DELIVERY SYSTEMS WITH A MINIMUM OF A HOSPITAL AND AN EMPLOYED PHYSICIAN NETWORK AND NET REVENUES ROUGHLY SIMILAR TO THE REVENUES OF OLMSTED MEDICAL CENTER. MOST RECENTLY A COMPENSATION PEER REVIEW STUDY WAS COMPLETED FOR THE CEO, PRESIDENT, MEDICAL VICE PRESIDENTS, CHIEF MEDICAL INFORMATION OFFICER AND VICE PRESIDENTS AND PRESENTED TO THE BOARD EXECUTIVE COMPENSATION COMMITTEE. THE BOARD OF GOVERNORS RECEIVES AN EXECUTIVE SUMMARY. THE EXECUTIVE COMPENSATION COMMITTEE RECEIVES A SUMMARY OF EVERYONE'S COMPENSATION TO ENSURE IT IS IN ALIGNMENT WITH THE SAME COMPENSATION METHODOLOGY AND AGREED UPON METHODOLOGY OF THE EXECUTIVE COMPENSATION SYSTEM OF OMC. THESE POSITIONS INCLUDE THE MEDICAL VICE PRESIDENTS, CHIEF MEDICAL INFORMATION OFFICER AND VICE PRESIDENTS OF OMC. THE EXECUTIVE COMPENSATION COMMITTEE WILL SET THE COMPENSATION OF THE PRESIDENT, CEO, MEDICAL VICE PRESIDENT HOSPITAL/SURGICAL SERVICES AND VICE PRESIDENT MEDICAL SERVICES AND MINUTES ARE KEPT OF THESE DISCUSSIONS. THE BOARD OF TRUSTEES, ACTING THROUGH THE BOARD OF TRUSTEES COMPENSATION COMMITTEE, MUST APPROVE THE EXECUTIVE COMPENSATION POLICY AND PROCESS OF DETERMINING EXECUTIVE COMPENSATION AND BENEFITS. IN ADDITION, THE PHYSICIAN SALARIES ARE CALCULATED ANNUALLY, USING REGIONAL PHYSICIAN SALARY COMPARISON GUIDES FACTORING IN PRODUCTIVITY AND QUALITY MEASURES, AND REVIEWED ON AN ANNUAL BASIS FOR MARKET REASONABLENESS BY AN INDEPENDANT CONSULTING FIRM. THE PHYSICIANS RECEIVE NO COMPENSATION AS ATTENDING BOARD MEMBERS. THESE DISCUSSIONS ARE NOTED IN THE MINUTES OF THE BOARD OF TRUSTEES COMPENSATION COMMITTEE ANNUAL MEETING. THE BOARD OF TRUSTEES COMPENSATION COMMITTEE REPORTS TO THE FULL BOARD OF TRUSTEES ON AN ANNUAL BASIS THE COMPLETION OF SUCH DUTIES AND ARE ALSO NOTED IN THE MINUTES.
Schedule J (Form 990) 2015
Additional Data


Software ID:  
Software Version: