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ObjectId: 202123169349306822 - Submission: 2021-11-12
TIN: 75-0800628
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
20
Open to Public Inspection
Name of the organization
Children's Health Clinical Operations
Employer identification number
75-0800628
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
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
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
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) 2020
Page 2
Schedule J (Form 990) 2020
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
Christopher J Durovich
Former Officer and Director (CHST Pres. & CEO)
(i)
(ii)
0
-------------
1,367,076
0
-------------
1,616,060
0
-------------
1,079,328
0
-------------
32,423
0
-------------
41,039
0
-------------
4,135,926
0
-------------
0
2
Richard P Goode
Former Officer
(i)
(ii)
0
-------------
0
0
-------------
0
0
-------------
1,830,749
0
-------------
0
0
-------------
0
0
-------------
1,830,749
0
-------------
0
3
James Herring
Former Officer
(i)
(ii)
0
-------------
117,692
0
-------------
234,014
0
-------------
19,257
0
-------------
19,500
0
-------------
473
0
-------------
390,936
0
-------------
0
4
Claud Kern Wildenthal MD PhD
Former Officer
(i)
(ii)
0
-------------
372,163
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
0
0
-------------
372,163
0
-------------
0
5
David T Berry
President
(i)
(ii)
0
-------------
622,506
0
-------------
283,091
0
-------------
218,451
0
-------------
208,430
0
-------------
31,993
0
-------------
1,364,471
0
-------------
0
6
Jeremiah Radandt
EVP Fin & CFO
(i)
(ii)
0
-------------
568,835
0
-------------
229,425
0
-------------
49,032
0
-------------
187,563
0
-------------
41,534
0
-------------
1,076,389
0
-------------
0
7
Amy Yeager
EVP, CLO & Secretary
(i)
(ii)
0
-------------
432,519
0
-------------
158,686
0
-------------
5,400
0
-------------
127,949
0
-------------
39,348
0
-------------
763,901
0
-------------
0
Schedule J (Form 990) 2020
Page 3
Schedule J (Form 990) 2020
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 3 Arrangement used to establish the top management official's compensation
Childrens Health Clinical Operations (The "Corporation") has no employees. Certain individuals identified herein as Officers of the Corporation are employed and compensated by a related organization, Children's Health System of Texas (CHST). The Individuals perform services for the Corporation, and in some cases other related organizations, by arrangement between CHST and such organization(s). Therefore, compensation decisions for the officers were determined by the related organization following CHST compensation's policy. in their duties as officer of the corporation, they have no influence over the compensation process performed by CHST. The CHST process for determining executive compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for executives. The Committee is comprised of independent, non-employee directors. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness and defines the desired peer groups for compensation surveys. The HR Committee engages the services of an independent compensation consultant for executive compensation. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to CHST executives include: - Cash compensation (i.e., base salary, short-term and long-term incentive compensation, and/or other cash compensation), determined in consideration of competitive market practices, organizational and individual performance, recruitment and retention considerations, and other relevant factors. - Standard benefits, assisting in each executive's medical, dental, disability, life insurance, time off, and retirement needs, reflective of the employment status (i.e., full or part time) of the executive. - Supplemental benefits, including supplemental insurance, retirement benefits, and/or other supplemental benefits determined by the Committee to be appropriate and reasonable in relation to marketplace practices. Compensation and benefits decisions are made in consideration of each executive's position, responsibilities, skills, effort, and performance, in relation to documented practices within the appropriate comparator group(s). PEER GROUP: The Committee has defined its primary peer group for executives as not-for-profit health care organizations similar in size, structure, and complexity. This group will include leading pediatric health systems as well as integrated health systems and academic medical centers. - Data will be compiled in a manner consistent with the IRS Intermediate Sanctions rules of federal tax law, to reflect what is "ordinarily paid to like executives by like enterprises under like circumstances." - In certain circumstances, market data from additional comparator groups (e.g., research institutions, insurance industry, and general industry companies) may also be referenced. - The specific nature of the role at CHST will be considered when adding comparator groups outside of the primary peer group, and the Committee will discuss and agree on the appropriateness of adding comparator groups whenever the specific nature of the CHST role requires additional comparator groups to be used.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
Savings Restoration Plan: Employees who received taxable income from the Savings Restoration Plan include: Christopher Durovich - $157,933 Executive Defined Contribution Retirement Plan (EDCRP): Employees who received taxable income from the EDCRP include: David Berry - $182,830, Christopher Durovich - $660,818, James Herring - $17,654, and Jeremiah Radandt - $41,723. Employees who participated in and have contributions to the EDCRP include: David Berry - $197,030, Christopher Durovich - $12,923, Jeremiah Radandt - $176,163, and Amy Yeager - $116,549.
Schedule J (Form 990) 2020
Additional Data
Software ID:
20011424
Software Version:
2020v4.0