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ObjectId: 202141399349300509 - Submission: 2021-05-19
TIN: 52-1402373
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
LIFEBRIDGE HEALTH INC
Employer identification number
52-1402373
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
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
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) 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
NEIL MELTZER
PRESIDENT/CEO
(i)
(ii)
999,827
-------------
0
842,880
-------------
0
485,431
-------------
0
388,916
-------------
0
20,227
-------------
0
2,737,281
-------------
0
357,770
-------------
0
2
DAVID KRAJEWSKI
EXEC VP/CFO, PRESIDENT LB PARTNERS
(i)
(ii)
763,808
-------------
0
350,836
-------------
0
147,315
-------------
0
364,121
-------------
0
26,336
-------------
0
1,652,416
-------------
0
90,169
-------------
0
3
JASON WEINER
SVP AND GENERAL COUNSEL
(i)
(ii)
382,090
-------------
0
198,002
-------------
0
11,727
-------------
0
87,237
-------------
0
20,060
-------------
0
699,116
-------------
0
0
-------------
0
4
LESLIE SIMMONS
EXEC VP, PRES CARROLL HOSP, INTERIM
(i)
(ii)
704,152
-------------
0
318,661
-------------
0
156,357
-------------
0
265,490
-------------
0
19,941
-------------
0
1,464,601
-------------
0
100,342
-------------
0
5
JONATHAN RINGO MD
SVP LBH AND PRES./COO SINAI
(i)
(ii)
595,871
-------------
0
225,606
-------------
0
97,379
-------------
0
136,855
-------------
0
30,702
-------------
0
1,086,413
-------------
0
49,481
-------------
0
6
TRESSA SPRINGMANN
SVP/CIO LIFEBRIDGE HEALTH
(i)
(ii)
499,843
-------------
0
220,335
-------------
0
120,391
-------------
0
148,483
-------------
0
25,136
-------------
0
1,014,188
-------------
0
59,813
-------------
0
7
ANTHONY MORRIS
SVP CHIEF REVENUE OFFICER
(i)
(ii)
366,679
-------------
0
146,180
-------------
0
65,083
-------------
0
82,642
-------------
0
20,665
-------------
0
681,249
-------------
0
42,711
-------------
0
8
MATTHEW POFFENROTH MD
SVP, CHIEF PHYSICIAN OFFICER
(i)
(ii)
429,468
-------------
0
110,960
-------------
0
27,796
-------------
0
62,202
-------------
0
24,425
-------------
0
654,851
-------------
0
0
-------------
0
9
JULIE COX
VP & CHIEF DEVELOPMENT OFFICER
(i)
(ii)
267,876
-------------
0
93,624
-------------
0
84,938
-------------
0
63,618
-------------
0
23,882
-------------
0
533,938
-------------
0
48,155
-------------
0
10
JAMES ROBERGE
VP CAPITAL IMPROVEMENTS & SUPPORT SE
(i)
(ii)
278,657
-------------
0
84,253
-------------
0
89,004
-------------
0
56,161
-------------
0
23,901
-------------
0
531,976
-------------
0
26,532
-------------
0
11
TERRENCE CARNEY
VP SUPPLY CHAIN
(i)
(ii)
263,224
-------------
0
83,986
-------------
0
143,743
-------------
0
18,505
-------------
0
2,563
-------------
0
512,021
-------------
0
28,293
-------------
0
12
CHARLES ALBRECHT MD
CHIEF QUALITY OFFICER
(i)
(ii)
0
-------------
325,346
0
-------------
56,393
0
-------------
41,088
0
-------------
64,291
0
-------------
24,191
0
-------------
511,309
0
-------------
28,540
13
NANCY KANE
VP FINANCIAL REPORTING
(i)
(ii)
244,180
-------------
0
76,646
-------------
0
49,011
-------------
0
62,153
-------------
0
21,395
-------------
0
453,385
-------------
0
25,717
-------------
0
14
ANDREW MORRISON
VP TOTAL REWARDS & OPERATIONS
(i)
(ii)
249,835
-------------
0
99,372
-------------
0
22,999
-------------
0
45,192
-------------
0
27,481
-------------
0
444,879
-------------
0
0
-------------
0
15
BRIAN DEFFAA
VP CHIEF MARKETING OFFICER
(i)
(ii)
271,069
-------------
0
81,674
-------------
0
2,489
-------------
0
42,756
-------------
0
26,855
-------------
0
424,843
-------------
0
0
-------------
0
16
STEPHEN YOUNG
VICE PRESIDENT - CHIEF OF STAFF (PY)
(i)
(ii)
237,463
-------------
0
76,065
-------------
0
23,898
-------------
0
37,369
-------------
0
26,396
-------------
0
401,191
-------------
0
21,339
-------------
0
17
LOU DUNAWAY
VP BUDGET & CAPITAL PLANNING/CFO LEV
(i)
(ii)
229,776
-------------
0
66,662
-------------
0
3,718
-------------
0
52,376
-------------
0
19,451
-------------
0
371,983
-------------
0
0
-------------
0
18
DANIEL DURAND
VP CHIEF INNOVATION OFFICER
(i)
(ii)
503,651
-------------
0
84,907
-------------
0
4,331
-------------
0
78,443
-------------
0
13,952
-------------
0
685,284
-------------
0
0
-------------
0
19
JEANETTE LINDER MD
CHIEF-RADIATION ONCOLOGY
(i)
(ii)
727,379
-------------
0
71,790
-------------
0
151,886
-------------
0
114,475
-------------
0
17,556
-------------
0
1,083,086
-------------
0
79,056
-------------
0
20
JONATHAN THIERMAN
CMIO, MED DIR VIRTUAL HOSPITAL
(i)
(ii)
315,946
-------------
0
95,832
-------------
0
12,620
-------------
0
40,596
-------------
0
26,743
-------------
0
491,737
-------------
0
0
-------------
0
21
CHRISTINE DEANGELIS
VP PHYSICIAN NETWORKS & VALUE-BASED
(i)
(ii)
114,794
-------------
0
55,238
-------------
0
429,698
-------------
0
10,965
-------------
0
9,037
-------------
0
619,732
-------------
0
37,618
-------------
0
22
JOSEPH QUINN
SVP CHIEF HR OFFICER
(i)
(ii)
192,711
-------------
0
161,248
-------------
0
341,518
-------------
0
54,319
-------------
0
7,667
-------------
0
757,463
-------------
0
70,711
-------------
0
23
JOEL SULDAN
SVP & GENERAL COUNSEL (FORMER)
(i)
(ii)
2,493
-------------
0
0
-------------
0
402,953
-------------
0
64
-------------
0
165
-------------
0
405,675
-------------
0
117,375
-------------
0
24
BRIAN WHITE
EXECUTIVE VICE PRESIDENT (FORMER)
(i)
(ii)
282,807
-------------
0
0
-------------
0
95,430
-------------
0
2,528
-------------
0
8,994
-------------
0
389,759
-------------
0
72,998
-------------
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
PART I, LINE 1A
ALL BOARD MEMBERS ARE ELIGIBLE FOR COMPLIMENTARY HEALTH CLUB MEMBERSHIPS. THE BOARD MEMBERS WHO SIGN UP AND RECEIVE THE COMPLIMENTARY MEMBERSHIP ARE REPORTED ON PART VII.
PART I, LINES 4A-B
THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT: CHRISTINE DEANGELIS $ 285,003 JOSEPH QUINN $ 231,312 DURING THE YEAR, THE FOLLOWING DIRECTORS AND OFFICERS PARTICIPATED IN A LIFEBRIDGE HEALTH SPONSORED SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: NEIL MELTZER $ 361,442 DAVID KRAJEWSKI $ 337,265 LESLIE SIMMONS $ 241,199 TRESSA SPRINGMANN $ 138,340 ANTHONY MORRIS $ 68,645 JULIE COX $ 44,480 JAMES ROBERGE $ 40,398 STEPHEN YOUNG $ 28,266 NANCY KANE $ 31,139 JOSEPH QUINN $ 51,086 JONATHAN RINGO, MD $ 124,042 JASON WEINER $ 68,318 DANIEL DURAND $ 67,910 CHARLES ALBRECHT, MD $ 38,063 LOU DUNAWAY $ 25,332 ANDREW MORRISON $ 30,688 BRIAN DEFFAA $ 30,800 MATTHEW POFFENROTH, MD $ 48,160 CHRISTINE DEANGELIS $ 9,245 JEANETTE LINDER, MD $ 101,662 JONATHAN THIERMAN $ 34,869 DURING THE YEAR, THE FOLLOWING DIRECTORS AND OFFICERS RECEIVED PAYMENTS AS PART OF THEIR PARTICIPATION IN A LIFEBRIDGE HEALTH SPONSORED SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: BRIAN WHITE $ 87,157 JULIE COX $ 52,763 ANTHONY MORRIS $ 45,439 TRESSA SPRINGMANN $ 74,849 JOEL SULDAN $ 402,248 DAVID KRAJEWSKI $ 105,878 NEIL MELTZER $ 428,403 LESLIE SIMMONS $ 115,877 TERRENCE CARNEY $ 95,602 STEPHEN YOUNG $ 23,556 CHARLES ALBRECHT, MD $ 36,587 NANCY KANE $ 39,862 JONATHAN RINGO, MD $ 76,208 JAMES ROBERGE $ 62,501 JOSEPH QUINN $ 70,711 CHRISTINE DEANGELIS $ 140,145 JEANETTE LINDER, MD $ 115,020
Schedule J (Form 990) 2019
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