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ObjectId: 201743199349306769 - Submission: 2017-11-15
TIN: 86-0181654
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" on Form 990, Part IV, line 23.
Attach to Form 990.
Information about Schedule J (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
16
Open to Public Inspection
Name of the organization
SCOTTSDALE HEALTHCARE HOSPITALS
Employer identification number
86-0181654
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.
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
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.
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 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
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), 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 nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III
............
7
Yes
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) 2016
Page 2
Schedule J (Form 990) 2016
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
1
THOMAS Sadvary
DIRECTOR/CEO, HONORHEALTH
(i)
(ii)
1,082,635
-------------
0
362,952
-------------
0
143,019
-------------
0
10,600
-------------
0
15,823
-------------
0
1,615,029
-------------
0
0
-------------
0
2
Rhonda Forsyth
DIRECTOR/PRES, HONORHEALTH
(i)
(ii)
860,654
-------------
0
637,288
-------------
0
482,096
-------------
0
10,600
-------------
0
23,099
-------------
0
2,013,737
-------------
0
271,015
-------------
0
3
Alan Kelly thru 32016
SVP/General Counsel
(i)
(ii)
136,411
-------------
0
94,520
-------------
0
358,585
-------------
0
10,600
-------------
0
3,229
-------------
0
603,345
-------------
0
0
-------------
0
4
Todd LaPorte
EVP/CHIEF ADMIN OFFICER
(i)
(ii)
647,768
-------------
0
170,955
-------------
0
12,882
-------------
0
147,040
-------------
0
24,970
-------------
0
1,003,615
-------------
0
0
-------------
0
5
Nathan Anspach
SVP/ceo Physician Network
(i)
(ii)
449,909
-------------
0
104,402
-------------
0
236,005
-------------
0
10,600
-------------
0
17,725
-------------
0
818,641
-------------
0
124,603
-------------
0
6
Wendy Crawford
SVP/Chief HR Officer
(i)
(ii)
347,268
-------------
0
0
-------------
0
39,578
-------------
0
10,600
-------------
0
15,445
-------------
0
412,891
-------------
0
0
-------------
0
7
David Damore
SVP/Chief Legal Officer
(i)
(ii)
269,268
-------------
0
0
-------------
0
4,821
-------------
0
27,616
-------------
0
8,544
-------------
0
310,249
-------------
0
0
-------------
0
8
Stephanie Jackson MD
VP Quality/Cmo
(i)
(ii)
381,768
-------------
0
52,104
-------------
0
13,501
-------------
0
69,927
-------------
0
14,700
-------------
0
532,000
-------------
0
0
-------------
0
9
David Lamparter
INTEGRATION OFFICER
(i)
(ii)
442,689
-------------
0
103,012
-------------
0
69,361
-------------
0
10,600
-------------
0
15,823
-------------
0
641,485
-------------
0
0
-------------
0
10
Bruce Pearson
SVP/COO
(i)
(ii)
556,798
-------------
0
146,641
-------------
0
49,915
-------------
0
125,636
-------------
0
24,402
-------------
0
903,392
-------------
0
38,417
-------------
0
11
Alice Pope
SVP/CFO
(i)
(ii)
372,117
-------------
0
100,000
-------------
0
32,936
-------------
0
48,294
-------------
0
9,641
-------------
0
562,988
-------------
0
0
-------------
0
12
Kimberly Post
SVP/CCO
(i)
(ii)
436,064
-------------
0
117,324
-------------
0
13,882
-------------
0
93,558
-------------
0
1,200
-------------
0
662,028
-------------
0
0
-------------
0
13
Chuck Scully
SVP/CIO
(i)
(ii)
389,156
-------------
0
85,139
-------------
0
7,890
-------------
0
77,692
-------------
0
8,545
-------------
0
568,422
-------------
0
0
-------------
0
14
Rich Silver MD
SVP POPULATION MANAGEMENT
(i)
(ii)
477,445
-------------
0
141,491
-------------
0
10,493
-------------
0
114,886
-------------
0
15,125
-------------
0
759,440
-------------
0
0
-------------
0
15
DAVID RIZIK
MEDICAL DIRECTOR
(i)
(ii)
926,286
-------------
0
10,500
-------------
0
13,573
-------------
0
10,600
-------------
0
24,952
-------------
0
985,911
-------------
0
0
-------------
0
16
FRANK MITCHELL III
MEDICAL DIRECTOR
(i)
(ii)
513,134
-------------
0
269,287
-------------
0
10,906
-------------
0
10,600
-------------
0
17,675
-------------
0
821,602
-------------
0
0
-------------
0
17
JAMES SWAIN
BARIATRIC SURGEON
(i)
(ii)
372,518
-------------
0
377,281
-------------
0
4,129
-------------
0
10,600
-------------
0
15,472
-------------
0
780,000
-------------
0
0
-------------
0
18
JOSEPH FARES
PHYSICIAN - PN
(i)
(ii)
673,971
-------------
0
0
-------------
0
5,585
-------------
0
10,600
-------------
0
11,105
-------------
0
701,261
-------------
0
0
-------------
0
19
JOHN NEIL
SVP - CHIEF PHYS EXEC
(i)
(ii)
554,356
-------------
0
53,166
-------------
0
6,388
-------------
0
89,230
-------------
0
20,853
-------------
0
723,993
-------------
0
0
-------------
0
Schedule J (Form 990) 2016
Page 3
Schedule J (Form 990) 2016
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 1
TAX GROSS-UP PAYMENTS - THESE ARE PAYMENTS FOR: 1) EMPLOYEES RECEIVING A TAXABLE AWARD, GIFT, OR GIFT CERTIFICATE; 2) PAYMENTS MADE ON BEHALF OF STAFF TO VENDORS DUE TO A CRISIS; OR 3) GROUP TERM LIFE EXCESS BENEFIT OF $50,000. IT IS AVAILABLE TO ANY RANK OF EMPLOYEE. SCHEDULE J, PART I, LINE 4A ALAN KELLY RECEIVED SEVERANCE PAYMENTS OF $308,549 DURING THE YEAR WHICH HAVE BEEN INCLUDED AS OTHER COMPENSATION AS REPORTED IN SCHEDULE J, PART II, COLUMN B(III).
Schedule J, Part I, Line 4B
HONORHEALTH OFFERS CERTAIN EXECUTIVES A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IT IS INTENDED THAT THIS PLAN BE AN INELIGIBLE DEFERRED COMPENSATION PLAN UNDER THE PROVISIONS OF CODE SECTION 457(F) AND BE OPERATED IN COMPLIANCE WITH CODE SECTION 409A. THE DESIGN OF THE SERP IS SUCH THAT IT PROVIDES A MECHANISM FOR RESTORATION OF DEFERRED RETIREMENT THAT OTHERWISE WOULD BE LOST TO THE EXECUTIVES DUE TO MANDATORY CAP ON DEFERRALS WITHIN THE QUALIFIED RETIREMENT PLAN OFFERED TO OTHER EMPLOYEES OF HONORHEALTH. THE SERP IS ALSO DESIGNED TO DISCOURAGE EXECUTIVE TURNOVER, WHICH COULD HAMPER ORGANIZATIONAL STABILITY AND SUSTAINABILITY, THROUGH THE AGE AND SERVICE REQUIREMENTS THAT AN EXECUTIVE MUST MEET IN ORDER TO RECEIVE BENEFITS FROM THIS PLAN. THE ANNUAL VALUE OF EACH EXECUTIVE'S PARTICIPATION IN THE PLAN IS TAKEN INTO CONSIDERATION AS PART OF THE CALCULATION OF TOTAL COMPENSATION WHEN TESTED AGAINST THE MARKET FOR REASONABLENESS. DEFERRED COMPENSATION, REPORTED IN SCHEDULE J, PART II, COLUMN (C), INCLUDES THE INCREASE IN VALUE OF THE SERP ACCOUNT, INCLUDING TAX DEFERRED CONTRIBUTIONS AND EARNINGS, FOR THE FOLLOWING INDIVIDUALS: DAVID DAMORE $27,616 STEPHANIE JACKSON $59,327 TODD LAPORTE $136,440 MICHELLE PABIS $22,073 BRUCE PEARSON $115,036 ALICE POPE $37,694 KIMBERLY POST $82,958 CHARLES SCULLY $77,692 RICHARD SILVER, MD $104,286 JOHN NEIL $78,630 THE FOLLOWING INDIVIDUALS EXPERIENCED A TAXABLE VESTING EVENT DURING THE YEAR AS FOLLOWS. THESE AMOUNTS WERE INCLUDED IN COLUMN (B)(III) AS TAXABLE WAGES. ANY PORTION OF THE DISTRIBUTION THAT WAS PREVIOUSLY REPORTED ON A PRIOR 990 AS DEFERRED HAS BEEN REPORTED IN COLUMN (F). NOTE THAT DISTRIBUTIONS WERE ACCUMULATED OVER MANY YEARS OF SERVICE TO THE ORGANIZATION. THOMAS SADVARY $109,081 DAVID LAMPARTER $45,877 NATHAN ANSPACH $222,653 WENDY CRAWFORD $21,923 RHONDA FORSYTH $455,859 BRUCE PEARSON $38,417
SCHEDULE J, PART I, LINE 7
CERTAIN EXECUTIVES AND MANAGEMENT TEAM MEMBERS ARE ELIGIBLE FOR DISCRETIONARY INCENTIVE BONUSES DETERMINED THROUGH A REVIEW OF SYSTEM AND INDIVIDUAL ACCOMPLISHED GOALS.
Schedule J (Form 990) 2016
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