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ObjectId: 202203189349318995 - Submission: 2022-11-14
TIN: 61-1028725
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
21
Open to Public Inspection
Name of the organization
Norton Healthcare Inc
Employer identification number
61-1028725
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
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) 2021
Page 2
Schedule J (Form 990) 2021
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, 1099-MISC compensation, and/or 1099-NEC
(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
Russell F Cox
President & CEO/Trustee
(i)
(ii)
1,277,682
-------------
0
850,949
-------------
0
537,946
-------------
0
181,585
-------------
0
35,328
-------------
0
2,883,490
-------------
0
183,280
-------------
0
2
Robert B Azar
Sr VP Chief Legal Officer/Secretary
(i)
(ii)
493,194
-------------
0
257,754
-------------
0
116,353
-------------
0
120,137
-------------
0
14,693
-------------
0
1,002,131
-------------
0
70,756
-------------
0
3
Michael W Gough
Exec VP and COO
(i)
(ii)
873,877
-------------
0
501,896
-------------
0
265,002
-------------
0
122,482
-------------
0
30,993
-------------
0
1,794,250
-------------
0
127,756
-------------
0
4
Adam Kempf
Sr VP, CFO/Treasurer
(i)
(ii)
529,098
-------------
0
278,616
-------------
0
129,027
-------------
0
129,625
-------------
0
31,727
-------------
0
1,098,093
-------------
0
75,796
-------------
0
5
Tracy Williams
Former Sr VP & CNO & Learning Officer
(i)
(ii)
0
-------------
0
113,522
-------------
0
479,525
-------------
0
31,006
-------------
0
13,152
-------------
0
637,205
-------------
0
472,691
-------------
0
6
Gladys Abarca-Lopez
Sr VP Chief HR Officer
(i)
(ii)
405,598
-------------
0
218,327
-------------
0
115,601
-------------
0
93,972
-------------
0
27,829
-------------
0
861,327
-------------
0
58,181
-------------
0
7
Dana Allen
Sys VP Chief Mktg & Communication Officer
(i)
(ii)
311,047
-------------
0
169,395
-------------
0
93,167
-------------
0
42,700
-------------
0
16,551
-------------
0
632,859
-------------
0
47,432
-------------
0
8
Mary Jo Bean
Sr VP Planning & Bus Analysis
(i)
(ii)
328,254
-------------
0
181,480
-------------
0
99,957
-------------
0
85,150
-------------
0
35,307
-------------
0
730,147
-------------
0
49,132
-------------
0
9
Kathleen Exline
Sys VP Perf Excel & Care Continium
(i)
(ii)
324,498
-------------
0
116,349
-------------
0
56,251
-------------
0
67,433
-------------
0
28,088
-------------
0
592,619
-------------
0
36,752
-------------
0
10
James Frazier MD
VP Medical Affairs
(i)
(ii)
395,445
-------------
0
148,366
-------------
0
92,681
-------------
0
85,558
-------------
0
30,007
-------------
0
752,056
-------------
0
49,872
-------------
0
11
Shelly Gast
Sys VP Mngd Care & Payor Strategy
(i)
(ii)
309,790
-------------
0
111,996
-------------
0
52,409
-------------
0
64,745
-------------
0
21,270
-------------
0
560,210
-------------
0
35,584
-------------
0
12
Steven Heilman MD
Sr VP & Chief Innovation Officer
(i)
(ii)
394,112
-------------
0
148,206
-------------
0
99,505
-------------
0
93,988
-------------
0
32,130
-------------
0
767,941
-------------
0
49,816
-------------
0
13
Steven Hester MD
Div President Provider Ops & Sys CMO
(i)
(ii)
694,126
-------------
0
361,670
-------------
0
137,674
-------------
0
190,832
-------------
0
33,375
-------------
0
1,417,676
-------------
0
92,420
-------------
0
14
Cheryl Martin
Sys VP & Chief Nursing Officer
(i)
(ii)
332,660
-------------
0
91,622
-------------
0
75,812
-------------
0
36,358
-------------
0
11,488
-------------
0
547,940
-------------
0
0
-------------
0
15
Mary Lynn Meyer
Sr VP WCCP/ CDO
(i)
(ii)
222,968
-------------
142,097
0
-------------
185,806
0
-------------
77,916
0
-------------
88,814
0
-------------
20,901
222,968
-------------
515,535
0
-------------
51,004
16
Steve Ready
Sr VP & CIO
(i)
(ii)
478,511
-------------
0
253,552
-------------
0
117,186
-------------
0
134,418
-------------
0
30,226
-------------
0
1,013,893
-------------
0
64,233
-------------
0
17
Scott Watkins
Sr VP Operations
(i)
(ii)
408,379
-------------
0
218,722
-------------
0
115,497
-------------
0
118,110
-------------
0
32,762
-------------
0
893,471
-------------
0
60,040
-------------
0
18
Douglas Winkelhake
Division President
(i)
(ii)
608,800
-------------
0
317,668
-------------
0
148,567
-------------
0
170,046
-------------
0
30,353
-------------
0
1,275,433
-------------
0
85,828
-------------
0
19
William Allen
Sys VP Pharmacy
(i)
(ii)
262,045
-------------
0
100,136
-------------
0
103,938
-------------
0
41,127
-------------
0
11,884
-------------
0
519,131
-------------
0
0
-------------
0
20
Jennifer Evans MD
Sys VP Women's & Pediatric Svc Line
(i)
(ii)
387,832
-------------
0
124,426
-------------
0
84,287
-------------
0
82,177
-------------
0
22,178
-------------
0
700,900
-------------
0
46,794
-------------
0
21
Helena Schulz
Sys VP Treasurer
(i)
(ii)
293,858
-------------
0
105,808
-------------
0
50,786
-------------
0
63,048
-------------
0
22,526
-------------
0
536,027
-------------
0
35,564
-------------
0
22
Kimberly Tharp-Barrie
Sys VP NHC Institute for Education & Development
(i)
(ii)
265,703
-------------
0
100,122
-------------
0
141,024
-------------
0
33,839
-------------
0
11,971
-------------
0
552,658
-------------
0
31,888
-------------
0
23
Stephen Wyatt MD
Chief Research Executive
(i)
(ii)
358,989
-------------
0
96,538
-------------
0
40,613
-------------
0
24,135
-------------
0
6,336
-------------
0
526,611
-------------
0
8,890
-------------
0
Schedule J (Form 990) 2021
Page 3
Schedule J (Form 990) 2021
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 1a Discretionary spending account
DISCRETIONARY SPENDING ACCOUNTS ARE TREATED AS TAXABLE COMPENSATION. THE ORGANIZATION PROVIDES A DISCRETIONARY SPENDING ACCOUNT FOR ELIGIBLE NORTON HEALTHCARE, Inc. EXECUTIVES, EFFECTIVE OCTOBER 1, 2007. NORTON HEALTHCARE PROVIDES BENEFITS TO ITS IDENTIFIED EXECUTIVE STAFF TO PROVIDE A TOTAL COMPENSATION PACKAGE THAT IS COMPETITIVE WITH THE MARKET AND WHICH CONFORMS TO THE PHILOSOPHY AND GUIDELINES SET OUT BY THE BOARD OF TRUSTEES, THROUGH THE EXECUTIVE COMPENSATION PHILOSOPHY AND PROGRAMS. THROUGH THE DISCRETIONARY SPENDING ACCOUNT POLICY, EXECUTIVES ARE FREE TO CHOOSE WHATEVER BENEFITS THEY FIND MOST USEFUL OR IMPORTANT TO THEM AND NORTON HEALTHCARE DOES NOT REIMBURSE FOR THE COST OF THOSE BENEFITS, AS THEY ARE PART OF THE DISCRETIONARY SPENDING ACCOUNT. THE INTERESTED PERSONS LISTED BELOW RECEIVED THE BENEFIT OF A DISCRETIONARY SPENDING ACCOUNT IN 2021: Russell F. Cox - $30,000 Michael G. Gough - $30,000 Robert B. Azar - $17,500 Adam Kempf - $15,000 Tracy Williams - $17,500 Steve Hester - $17,500 Scott Watkins - $15,000 Gladys Abarca-Lopez - $15,000 Steve Ready - $15,000 James Frazier - $10,000 Steve Heilman - $15,000 Shelly Gast - $10,000 Douglas Winklehake - $17,500 Dana Allen - $15,000 Mary Jo Bean - $15,000 Helena Schulz - $10,000 Cheryl Martin - $10,000 Jennifer Evans - $10,000 Kathleen Exline - $10,000 William Allen - $10,000 Kimberly Tharp-Barrie - $10,000
Schedule J, Part I, Line 4a Severance or change-of-control payment
Severance payment was received during 2021 by Former Key Employee, Tracy Williams in the amount of $472,691. Other compensation included in Schedule J Column B(iii)
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
THE FOLLOWING INTERESTED PERSONS PARTICIPATED IN OR RECEIVED PAYMENT FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS AS DESCRIBED IN IRC SECTION 457(F). THE INTERESTED PERSONS BELOW MAY HAVE PARTICIPATED IN ONE OR MORE OF THE FOLLOWING PLANS: THE EXECU-PLUS BENEFIT PLAN, DEFINED BENEFIT AND DEFINED CONTRIBUTION RESTORATION PLANS, AND THE PHYSICIAN DEFERRED PLAN. THE "PAY CREDIT" OUTLINED BELOW REPRESENTS A REASONABLE ESTIMATE OF THE ANNUAL INCREASE IN ACTUARIAL VALUE OF THE PLANS; AND THEREFORE, REPRESENTS THE ORGANIZATION'S CONTRIBUTION TO THE VALUE OF THE BENEFITS. NAME - PAY CREDIT Russell F. Cox - $158,135 Michael W. Gough - $99,514 Robert Azar - $101,168 Adam Kempf - $110,872 Mary Lynn Meyer - $68,124 Dana Allen - $25,004 Mary Jo Bean - $66,137 Jennifer Evans - $64,777 Shelly Gast - $46,974 Kathleen Exline - $49,528 James Frazier - $67,871 Steven Heilman - $76,292 Steven Hester - $165,014 Cheryl, Martin - $18,958 Steve Ready - $108,721 Scott Watkins - $90,683 Tracy Williams - $12,555 Douglas Winkelhake - $142,061 Stephen Wyatt - $9,635 Helena Schulz - $43,417 William Allen - $17,927 Gladys Abarca-Lopez - $79,472 Kimberly Tharp-Barrie - $14,114 THE "PAYMENT RECEIVED" OUTLINED BELOW REPRESENTS CASH PAYMENTS THAT THE EMPLOYEE RECEIVED DURING 2021 AND CAN BE COMPRISED OF Current and or PRIOR YEARS EMPLOYEE AND EMPLOYER CONTRIBUTIONS. NAME - PAYMENT RECEIVED Russell F. Cox - $183,280 Michael W. Gough - $127,756 Robert Azar - $71,561 Adam Kempf - $89,619 Mary Lynn Meyer - $51,584 Dana Allen - $47,432 Mary Jo Bean - $56,778 Jennifer Evans - $47,316 Shelly Gast - $35,989 Kathleen Exline - $37,170 James Frazier - $57,482 Steven Heilman - $58,695 Steven Hester - $93,472 Cheryl Martin - $44,764 Steve Ready - $75,585 Scott Watkins - $75,187 Tracy Williams - $58,370 Douglas Winkelhake - $105,287 Stephen Wyatt - $8,890 Helena Schulz - $38,225 William Allen - $65,390 Gladys Abarca-Lopez - $58,820 Kimberly Tharp-Barrie - $106,175
Schedule J, Part I, Line 7 Non-fixed payments
In 2021, Norton Healthcare, Inc. (NHC) had in place a Variable Compensation Plan for Executives, eligibility under which extended to employees holding a full-time position as Senior Officer, Officer, System Director or other designated Director level position. Under the plan, a variable compensation pool amount is approved by the Board of Trustees. Each participant's performance is evaluated relative to the goals and objectives documented as part of the participant's plan; and an award is determined for the participant, based on achievement of the goals and objectives, subject to the funding of the variable compensation pool. At the end of each year, the Committee on Executive Compensation and Benefits determines an appropriate award for the NHC's President & Chief Executive Officer, and the President & Chief Executive Officer recommends appropriate awards for other senior executives to the Committee on Executive Compensation and Benefits for its review and approval.
Schedule J (Form 990) 2021
Additional Data
Software ID:
21014044
Software Version:
2021v4.2