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ObjectId: 201803199349309910 - Submission: 2018-11-15
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.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
17
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) 2017
Page 2
Schedule J (Form 990) 2017
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
Todd Laporte
DIRECTOR/CEO, HONORHEALTH
(i)
(ii)
756,821
-------------
0
280,448
-------------
0
24,798
-------------
0
113,804
-------------
0
25,027
-------------
0
1,200,898
-------------
0
0
-------------
0
2
Rhonda Forsyth
FORMER PRESIDENT
(i)
(ii)
16,635
-------------
0
690,919
-------------
0
933,241
-------------
0
3,763
-------------
0
0
-------------
0
1,644,558
-------------
0
0
-------------
0
3
Thomas Sadvary
DIR/CEO, HH (THRU 4/17)/SR ADV
(i)
(ii)
1,106,041
-------------
0
515,335
-------------
0
135,106
-------------
0
10,800
-------------
0
15,833
-------------
0
1,783,115
-------------
0
0
-------------
0
4
Nathan Anspach
FORMER CEO, PHYSICIAN NETWORK
(i)
(ii)
272,537
-------------
0
151,370
-------------
0
261,253
-------------
0
10,564
-------------
0
13,436
-------------
0
709,160
-------------
0
0
-------------
0
5
Gary Baker
SVP/CEO, SSMC, JCLMC & HHSOMC
(i)
(ii)
469,576
-------------
0
143,947
-------------
0
11,668
-------------
0
75,736
-------------
0
17,902
-------------
0
718,829
-------------
0
0
-------------
0
6
Jon Bartlett
FORMER VP/CEO, HH JCL
(i)
(ii)
416,311
-------------
0
30,000
-------------
0
52,854
-------------
0
35
-------------
0
18,713
-------------
0
517,913
-------------
0
0
-------------
0
7
Wendy Crawford
SVP/CHIEF HR & MKTG OFFICER
(i)
(ii)
427,842
-------------
0
105,639
-------------
0
69,887
-------------
0
10,800
-------------
0
23,179
-------------
0
637,347
-------------
0
0
-------------
0
8
David Damore
SVP/CHIEF LEGAL OFFICER
(i)
(ii)
466,895
-------------
0
115,415
-------------
0
9,373
-------------
0
47,285
-------------
0
15,783
-------------
0
654,751
-------------
0
0
-------------
0
9
David Rizik MD
MEDICAL DIRECTOR
(i)
(ii)
925,940
-------------
0
42,000
-------------
0
13,883
-------------
0
11,789
-------------
0
25,011
-------------
0
1,018,623
-------------
0
0
-------------
0
10
John Harrington Jr
FORMER SVP/CEO, DVMC
(i)
(ii)
225,109
-------------
0
139,932
-------------
0
458,151
-------------
0
9,076
-------------
0
82
-------------
0
832,350
-------------
0
182,641
-------------
0
11
Stephanie Jackson
SVP/CHIEF QUALITY OFFICER
(i)
(ii)
423,953
-------------
0
111,783
-------------
0
9,504
-------------
0
65,235
-------------
0
17,777
-------------
0
628,252
-------------
0
0
-------------
0
12
Alan Kelly
FORMER SVP/CHIEF LEGAL OFFICER
(i)
(ii)
0
-------------
0
0
-------------
0
420,014
-------------
0
0
-------------
0
0
-------------
0
420,014
-------------
0
0
-------------
0
13
David Lamparter
VP/ENTERPRISE PROJ MGMT
(i)
(ii)
8,880
-------------
0
103,471
-------------
0
494,871
-------------
0
1,421
-------------
0
0
-------------
0
608,643
-------------
0
0
-------------
0
14
John Neil
SVP/CHIEF PHYSICIAN EXECUTIVE
(i)
(ii)
593,934
-------------
0
157,484
-------------
0
71,827
-------------
0
95,802
-------------
0
27,391
-------------
0
946,438
-------------
0
0
-------------
0
15
James Swain MD
BARIATRIC SURGEON
(i)
(ii)
372,381
-------------
0
388,147
-------------
0
4,028
-------------
0
20,031
-------------
0
15,482
-------------
0
800,069
-------------
0
0
-------------
0
16
Frank Mitchell III MD
MEDICAL DIRECTOR
(i)
(ii)
602,335
-------------
0
111,737
-------------
0
11,347
-------------
0
15,269
-------------
0
22,913
-------------
0
763,601
-------------
0
0
-------------
0
17
Joseph Fares MD
PHYSICIAN - PN
(i)
(ii)
685,782
-------------
0
0
-------------
0
5,233
-------------
0
10,800
-------------
0
18,685
-------------
0
720,500
-------------
0
0
-------------
0
18
Mehul Patel MD
PHYSICIAN - PN
(i)
(ii)
677,537
-------------
0
0
-------------
0
2,478
-------------
0
10,800
-------------
0
32,781
-------------
0
723,596
-------------
0
0
-------------
0
19
Bruce Pearson
SVP/OPP STRAT & TRANS OFFICER
(i)
(ii)
465,006
-------------
0
180,244
-------------
0
355,226
-------------
0
10,800
-------------
0
15,889
-------------
0
1,027,165
-------------
0
203,632
-------------
0
20
Alice Pope
SVP/CFO
(i)
(ii)
561,933
-------------
0
155,685
-------------
0
14,521
-------------
0
77,109
-------------
0
16,652
-------------
0
825,900
-------------
0
0
-------------
0
21
Kimberly Post
SVP/CEO HOSPITALS/CCO
(i)
(ii)
504,464
-------------
0
155,270
-------------
0
18,354
-------------
0
86,626
-------------
0
0
-------------
0
764,714
-------------
0
0
-------------
0
22
David Price
VP/CEO, STPMC & DVMC
(i)
(ii)
320,220
-------------
0
99,196
-------------
0
67,518
-------------
0
56,362
-------------
0
21,071
-------------
0
564,367
-------------
0
51,869
-------------
0
23
Charles Scully
SVP/CIO
(i)
(ii)
397,318
-------------
0
109,819
-------------
0
8,200
-------------
0
40,836
-------------
0
17,494
-------------
0
573,667
-------------
0
0
-------------
0
24
Richard Silver MD
SVP/CEO, POP HEALTH & CCO
(i)
(ii)
533,336
-------------
0
137,900
-------------
0
351,022
-------------
0
10,800
-------------
0
22,429
-------------
0
1,055,487
-------------
0
245,565
-------------
0
Schedule J (Form 990) 2017
Page 3
Schedule J (Form 990) 2017
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 THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAY DURING 2017 (INCLUDED IN SCHEDULE J, PART II, COLUMN B(III)): NATHAN ANSPACH $202,028 JON BARTLETT $26,250 RHONDA FORSYTH $870,029 JOHN HARRINGTON JR. $213,420 ALAN KELLY $420,014 DAVID LAMPARTER $468,230 BRUCE PEARSON $65,971
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. 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. Wendy Crawford $43,955 John Harrington Jr. $186,770 Bruce Pearson $207,751 David Price $58,466 Richard Silver, MD $340,129
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) 2017
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