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ObjectId: 202032899349302458 - Submission: 2020-10-15
TIN: 61-1286361
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
19
Open to Public Inspection
Name of the organization
Owensboro Health Inc
Employer identification number
61-1286361
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 on 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 on 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
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), 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) 2019
Page 2
Schedule J (Form 990) 2019
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
Kelley Michael
VP MEDICAL AFFAIRS
(i)
(ii)
195,725
-------------
0
45,236
-------------
0
8,753
-------------
0
10,984
-------------
0
14,404
-------------
0
275,102
-------------
0
0
-------------
0
2
Mcbride Anthony
Board Member
(i)
(ii)
0
-------------
766,558
0
-------------
261,105
0
-------------
2,380
0
-------------
14,000
0
-------------
15,880
0
-------------
1,059,923
0
-------------
0
3
Dufrayne Francis
Chief Medical Officer
(i)
(ii)
419,622
-------------
0
117,776
-------------
206,319
32,480
-------------
0
14,000
-------------
0
26,587
-------------
0
610,465
-------------
206,319
0
-------------
0
4
Hackbarth John
Chief Financial Officer
(i)
(ii)
476,783
-------------
0
163,108
-------------
0
80,363
-------------
0
30,296
-------------
0
20,938
-------------
0
771,488
-------------
0
0
-------------
0
5
Heath Jr Edward L
COO-OHMCH
(i)
(ii)
252,025
-------------
0
77,906
-------------
0
42,582
-------------
0
30,296
-------------
0
27,630
-------------
0
430,439
-------------
0
0
-------------
0
6
Strahan Greg
PRESIDENT AND CEO
(i)
(ii)
849,043
-------------
0
300,502
-------------
0
99,629
-------------
0
30,296
-------------
0
20,938
-------------
0
1,300,408
-------------
0
0
-------------
0
7
Begley II Ernest E
Chief Legal Officer
(i)
(ii)
353,745
-------------
0
123,957
-------------
0
54,858
-------------
0
30,296
-------------
0
29,864
-------------
0
592,720
-------------
0
0
-------------
0
8
Jones Lisa
VP ANCILLARY SERVICES
(i)
(ii)
222,513
-------------
0
69,408
-------------
0
54,000
-------------
0
30,296
-------------
0
20,752
-------------
0
396,969
-------------
0
0
-------------
0
9
Field Jason
Chief Operating Officer OHMG
(i)
(ii)
0
-------------
210,930
0
-------------
66,156
0
-------------
14,273
0
-------------
14,000
0
-------------
25,083
0
-------------
330,442
0
-------------
0
10
Scherm Michael J MD
Former Chief Medical Officer
(i)
(ii)
0
-------------
0
0
-------------
0
231,966
-------------
0
0
-------------
0
0
-------------
0
231,966
-------------
0
0
-------------
0
11
Belec Timothy
VP CIO
(i)
(ii)
309,523
-------------
0
112,714
-------------
0
22,411
-------------
0
14,000
-------------
0
19,422
-------------
0
478,070
-------------
0
0
-------------
0
12
Myer Mitchell Kathleen K
VP Pt Care Svcs and CNO-OHMCH
(i)
(ii)
146,495
-------------
0
44,772
-------------
0
18,034
-------------
0
9,816
-------------
0
17,985
-------------
0
237,102
-------------
0
0
-------------
0
13
Medley Jr Richard W MD
CHIEF MED OFFICER (THRU 7/19)
(i)
(ii)
217,407
-------------
0
106,473
-------------
0
125,389
-------------
0
30,296
-------------
0
4,435
-------------
0
484,000
-------------
0
0
-------------
0
14
Ranallo Russell
VP FINANCE
(i)
(ii)
270,618
-------------
0
83,940
-------------
0
47,976
-------------
0
30,296
-------------
0
27,935
-------------
0
460,765
-------------
0
0
-------------
0
15
Bostic Deborah K
COO-OHRH
(i)
(ii)
377,370
-------------
0
113,474
-------------
0
34,991
-------------
0
14,000
-------------
0
7,328
-------------
0
547,163
-------------
0
0
-------------
0
16
Johnson Stephen M
VP GOVT AND COMMUNITY AFFAIRS
(i)
(ii)
189,386
-------------
0
59,448
-------------
0
18,601
-------------
0
28,649
-------------
0
26,062
-------------
0
322,146
-------------
0
0
-------------
0
17
Suter Mia
Chief Administrative Officer
(i)
(ii)
393,907
-------------
0
132,225
-------------
0
53,707
-------------
0
30,296
-------------
0
6,426
-------------
0
616,561
-------------
0
0
-------------
0
18
Danhauer David E MD
VP CMIO
(i)
(ii)
316,824
-------------
0
97,974
-------------
0
22,295
-------------
0
30,296
-------------
0
25,689
-------------
0
493,078
-------------
0
0
-------------
0
19
Jacildo Ruby
VP Accounting/Controller
(i)
(ii)
184,286
-------------
0
58,069
-------------
0
20,263
-------------
0
27,821
-------------
0
25,619
-------------
0
316,058
-------------
0
0
-------------
0
20
Bryant MD Bill
VP QUALITY AND PATIENT SAFETY
(i)
(ii)
315,150
-------------
0
94,867
-------------
0
35,489
-------------
0
14,000
-------------
0
19,538
-------------
0
479,044
-------------
0
0
-------------
0
21
Sims Joan M
VP Patient Care SVCS and CNO
(i)
(ii)
176,350
-------------
0
52,541
-------------
0
18,223
-------------
0
24,816
-------------
0
2,980
-------------
0
274,910
-------------
0
0
-------------
0
22
Collins Jason
DIRECTOR OF PHARMACY
(i)
(ii)
153,245
-------------
0
28,648
-------------
0
12,420
-------------
0
17,275
-------------
0
8,832
-------------
0
220,420
-------------
0
0
-------------
0
23
Tidwell III James E
VP Population Health
(i)
(ii)
292,696
-------------
0
20,596
-------------
0
11,481
-------------
0
14,000
-------------
0
18,679
-------------
0
357,452
-------------
0
0
-------------
0
24
Taylor Joseph W
Executive Director, Facilities
(i)
(ii)
160,724
-------------
0
25,010
-------------
0
1,649
-------------
0
21,276
-------------
0
22,026
-------------
0
230,685
-------------
0
0
-------------
0
25
Montaven Simone J
Exec Dir of Human Resources
(i)
(ii)
161,741
-------------
0
25,487
-------------
0
5,070
-------------
0
21,684
-------------
0
16,399
-------------
0
230,381
-------------
0
0
-------------
0
26
Hieneman Ramona C
VP COMPLIANCE AND PRIVACY
(i)
(ii)
119,734
-------------
0
10,000
-------------
0
3,608
-------------
0
5,912
-------------
0
2,817
-------------
0
142,071
-------------
0
0
-------------
0
27
Roberts Kenneth W
DIR OF COMPLIANCE AND CONTRACT
(i)
(ii)
144,167
-------------
0
22,171
-------------
0
13,851
-------------
0
20,097
-------------
0
23,463
-------------
0
223,749
-------------
0
0
-------------
0
28
Walker Jr John P
EXEC DIR OF MATERIALS MGMT
(i)
(ii)
148,127
-------------
0
23,119
-------------
0
7,672
-------------
0
20,000
-------------
0
15,264
-------------
0
214,182
-------------
0
0
-------------
0
Schedule J (Form 990) 2019
Page 3
Schedule J (Form 990) 2019
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
Form 990, Schedule J, Part I, Line 1A
TAX INDEMNIFICATION AND GROSS UP PAYMENTS THE ORGANIZATION PROVIDES A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN FOR CERTAIN EXECUTIVE EMPLOYEES. BECAUSE BENEFITS UNDER THE SUPPLEMENTAL PLAN MUST BE INCLUDED IN TAXABLE INCOME WHEN THEY BECOME VESTED, AND AS REQUIRED BY THE SUPPLEMENTAL PLAN'S TERMS, THE ORGANIZATION PROVIDES AN ADDITIONAL BENEFIT THAT COVERS THE TAX LIABILITY WHEN IT IS INCURRED. THE TAX LIABILITY PAYMENTS ARE THEMSELVES INCLUDED IN W-2 INCOME IN THE YEAR MADE TO THE EXECUTIVES, AND ARE INCLUDED IN THE FIGURES DISCLOSED ON SCHEDULE J, PART II. CLUB DUES DURING THE REPORTING PERIOD, THE ORGANIZATION PAID THE CEO AND COO'S MEMBERSHIP DUES IN A SOCIAL CLUB. THE CLUB MEMBERSHIP WAS USED FOR BUSINESS PURPOSES. ANY PERSONAL RELATED EXPENSES ARE TREATED AS TAXABLE WAGE INCOME AND FULLY INCLUDED ON THE RECIPIENT'S FORM W-2.
FORM 990, SCHEDULE J, PART I, LINE 4B
NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN OWENSBORO HEALTH PROVIDES A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN FOR CERTAIN EXECUTIVE EMPLOYEES. PARTICIPATION IN THE PLAN IS SUBJECT TO THE RECOMMENDATION OF THE CHIEF EXECUTIVE OFFICER AND THE APPROVAL OF THE BOARD OF DIRECTORS. AS OF DECEMBER 31, 2019 OWENSBORO HEALTH SHALL CREDIT THE PARTICIPANT'S ACCOUNT WITH AN EMPLOYER CONTRIBUTION. THE PARTICIPANT MUST BE EMPLOYED BY OWENSBORO HEALTH AT THE END OF THE PLAN YEAR IN ORDER TO RECEIVE AN EMPLOYER CONTRIBUTION FOR THAT PLAN YEAR. EMPLOYER CONTRIBUTIONS FOR EACH CONTRIBUTION CLASS YEAR SHALL BE 100% VESTED AS OF THE END OF THE PLAN YEAR WHICH IS FIVE YEARS AFTER THE DATE ON WHICH THE EMPLOYER CONTRIBUTION WAS MADE FOR SUCH CONTRIBUTION CLASS YEAR. 457F PLAN TO EXECUTIVES ERNEST E. BEGLEY $36,297; JOHN HACKBARTH $44,821; EDWARD HEATH $25,445; LISA JONES $30,723; RICHARD W. MEDLEY $39,221; RUSSELL RANALLO $32,347; MICHAEL SCHERM $231,966; GREG STRAHAN $65,204; MIA SUTER $37,874.
FORM 990, SCHEDULE J, PART I, LINE 7
SUCCESS SHARING PLAN THE SUCCESS SHARING PLAN IS A PROGRAM DESIGNED TO FOCUS ON THE ACCOUNTABILITY OF ALL EMPLOYEES TO INFLUENCE THE FINANCIAL, QUALITY, PATIENT SATISFACTION AND EMPLOYEE DEVELOPMENT GOALS, AND TO REINFORCE THE OH CORE COMMITMENTS (RESPECT, INTEGRITY, INNOVATION, SERVICE, EXCELLENCE AND TEAMWORK) WHILE WORKING TO ACHIEVE THESE GOALS. THE PLAN ACHIEVES THIS BY PROVIDING A DIRECT LINK BETWEEN ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES AND THE TOTAL COMPENSATION OF THOSE WHO'S DECISIONS AND ACTIONS ARE ACCOUNTABLE FOR THE OUTCOMES WHICH DRIVE THE ORGANIZATION'S SUCCESS. ELIGIBILITY IS BASED ON HOURS WORKED IN THE YEAR; STAFF EMPLOYEES ARE PAID A PRO-RATED AMOUNT OF A DOLLAR MAXIMUM AND MANAGEMENT IS PAID A FIXED PERCENTAGE OF ANNUAL SALARY BASED ON LEVEL OF MANAGEMENT. PAYMENT IS PREDICATED ON BOARD APPROVAL.
Schedule J (Form 990) 2019
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