Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
Ottawa Regional Hospital & Healthcare Center
 
Employer identification number

36-2604009
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.
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.
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
 
No
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
1Robert C Sehring
 
Vice Chairperson Chief Executive Officer
(i)

(ii)
0
-------------
1,437,099
0
-------------
321,477
0
-------------
186,028
0
-------------
14,171
0
-------------
30,453
0
-------------
1,989,229
0
-------------
0
2Gerald J McShane MD
 
Board Member
(i)

(ii)
0
-------------
272,724
0
-------------
0
0
-------------
1,135
0
-------------
14,153
0
-------------
25,438
0
-------------
313,450
0
-------------
0
3Divya-Devi Joshi
 
Former Chief Executive Officer Children SL
(i)

(ii)
0
-------------
111,270
0
-------------
7,774
0
-------------
10
0
-------------
5,979
0
-------------
1,605
0
-------------
126,638
0
-------------
0
4Mark A Nafziger
 
Former Chief Executive Officer Ambulatory Care
(i)

(ii)
0
-------------
176,996
0
-------------
0
0
-------------
833,206
0
-------------
7,116
0
-------------
4,055
0
-------------
1,021,373
0
-------------
37,352
5David A Schertz
 
Former - Chief Executive Officer Northern Region
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
135,173
0
-------------
0
0
-------------
0
0
-------------
135,173
0
-------------
0
6Dwight D Stapleton
 
Former Vice President Clinical Specialty Services
(i)

(ii)
0
-------------
128,483
0
-------------
0
0
-------------
18
0
-------------
6,451
0
-------------
1,503
0
-------------
136,455
0
-------------
0
7Michael M Allen
 
Chief Financial Officer
(i)

(ii)
0
-------------
660,595
0
-------------
95,206
0
-------------
19,428
0
-------------
14,250
0
-------------
33,446
0
-------------
822,925
0
-------------
0
8Chad E Boore
 
Chief Executive Officer Eastern Region
(i)

(ii)
0
-------------
453,891
0
-------------
62,279
0
-------------
5,613
0
-------------
14,250
0
-------------
33,376
0
-------------
569,409
0
-------------
0
9Robert L Brandfass
 
SVP Chief Legal Officer
(i)

(ii)
0
-------------
567,863
0
-------------
55,255
0
-------------
28,370
0
-------------
14,250
0
-------------
26,238
0
-------------
691,974
0
-------------
0
10Michelle D Conger
 
Chief Strategy Officer
(i)

(ii)
0
-------------
562,032
0
-------------
76,763
0
-------------
25,530
0
-------------
7,777
0
-------------
26,393
0
-------------
698,495
0
-------------
0
11Roxanna Crosser
 
Chief Executive Officer Western Region
(i)

(ii)
0
-------------
406,796
0
-------------
57,637
0
-------------
25,865
0
-------------
3,537
0
-------------
25,023
0
-------------
518,859
0
-------------
0
12Michael A Cruz MD
 
Chief Operating Officer
(i)

(ii)
0
-------------
695,478
0
-------------
99,706
0
-------------
25,295
0
-------------
14,250
0
-------------
35,108
0
-------------
869,838
0
-------------
0
13John R Evancho
 
SVP Chief Compliance Officer
(i)

(ii)
0
-------------
286,974
0
-------------
27,563
0
-------------
5,651
0
-------------
12,271
0
-------------
30,701
0
-------------
363,160
0
-------------
0
14Carol A Friesen
 
Chief Executive Officer Northern Region
(i)

(ii)
0
-------------
485,439
0
-------------
39,345
0
-------------
20,640
0
-------------
11,151
0
-------------
34,860
0
-------------
591,436
0
-------------
0
15David M Hall
 
SVP Info Systems/Chief Information Officer
(i)

(ii)
0
-------------
396,684
0
-------------
36,512
0
-------------
878
0
-------------
14,250
0
-------------
32,788
0
-------------
481,113
0
-------------
0
16Thomas G Hammerton
 
President OSF Healthcare Foundation Chief Development Officer
(i)

(ii)
0
-------------
345,956
0
-------------
52,840
0
-------------
31,519
0
-------------
14,008
0
-------------
33,446
0
-------------
477,769
0
-------------
0
17Stephen E Hippler MD
 
Chief Clinical Officer
(i)

(ii)
0
-------------
664,525
0
-------------
95,009
0
-------------
75,979
0
-------------
14,250
0
-------------
34,641
0
-------------
884,404
0
-------------
0
18James J Mormann
 
Chief Information Officer
(i)

(ii)
0
-------------
607,195
0
-------------
90,640
0
-------------
27,108
0
-------------
14,250
0
-------------
33,531
0
-------------
772,724
0
-------------
0
19August J Querciagrossa
 
Chief Executive Officer Metro Region
(i)

(ii)
0
-------------
322,715
0
-------------
26,093
0
-------------
28,428
0
-------------
6,801
0
-------------
24,100
0
-------------
408,136
0
-------------
0
20Jeffry M Tillery
 
SVP Chief Transformation Officer
(i)

(ii)
0
-------------
589,069
0
-------------
86,561
0
-------------
24,327
0
-------------
14,016
0
-------------
30,440
0
-------------
744,415
0
-------------
0
21Ralph Velazquez MD
 
System Chief Medical Officer
(i)

(ii)
0
-------------
517,495
0
-------------
75,217
0
-------------
33,520
0
-------------
14,250
0
-------------
28,498
0
-------------
668,979
0
-------------
0
22Michael A Wells
 
President CHOI
(i)

(ii)
0
-------------
227,357
0
-------------
0
0
-------------
636
0
-------------
6,995
0
-------------
18,967
0
-------------
253,954
0
-------------
0
23Lori L Wiegand
 
Chief Nursing Officer
(i)

(ii)
0
-------------
418,579
0
-------------
60,982
0
-------------
27,046
0
-------------
14,250
0
-------------
9,743
0
-------------
530,599
0
-------------
0
24Leon A Yeh MD
 
VP Chief Medical Officer Emergency Serv
(i)

(ii)
0
-------------
517,970
0
-------------
0
0
-------------
19,548
0
-------------
14,250
0
-------------
31,702
0
-------------
583,471
0
-------------
0
25Sidharth Chandra MD
 
Physician
(i)

(ii)
276,476
-------------
0
74,175
-------------
0
46
-------------
0
10,086
-------------
0
9,743
-------------
0
370,525
-------------
0
0
-------------
0
26Joseph W Chuprevich MD
 
Physician
(i)

(ii)
496,182
-------------
0
9,259
-------------
0
293
-------------
0
14,250
-------------
0
20,306
-------------
0
540,289
-------------
0
0
-------------
0
27Sherine Hanna MD
 
Physician
(i)

(ii)
512,015
-------------
0
3,400
-------------
0
31,436
-------------
0
14,250
-------------
0
618
-------------
0
561,718
-------------
0
0
-------------
0
28Marianne Mikat-Stevens MD
 
Physician
(i)

(ii)
504,061
-------------
0
1,700
-------------
0
13,657
-------------
0
14,250
-------------
0
10,693
-------------
0
544,361
-------------
0
0
-------------
0
29Shah Parves MD
 
Physician
(i)

(ii)
475,738
-------------
0
850
-------------
0
26,324
-------------
0
14,250
-------------
0
37,339
-------------
0
554,501
-------------
0
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 1a Health or social club dues or initiation fees OSF Healthcare System REIMBURSES CERTAIN EXECUTIVES FOR SOCIAL CLUB DUES PAID BY SUCH EXECUTIVES. ELIGIBILITY FOR CLUB DUES REIMBURSEMENT IS DETERMINED BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF DIRECTORS AND IS TAKEN INTO CONSIDERATION BY THE COMMITTEE IN DETERMINING FAIR MARKET COMPENSATION. SEE FORM 990 - SCHEDULE O - PART VI - LINES 15A AND 15B FOR AN EXPLANATION OF THE ROLE OF THE HUMAN RESOURCES COMMITTEE AND THE MANNER IN WHICH FAIR MARKET COMPENSATION IS DETERMINED. CLUB DUES ARE NOT ELIGIBLE FOR REIMBURSEMENT IF THE CLUB IN QUESTION DISCRIMINATES ON THE BASIS OF RACE, RELIGION, SEX, NATIONAL ORIGIN, OR OTHER PROHIBITED FACTORS. DUES REIMBURSEMENT IS TREATED AND REPORTED AS TAXABLE COMPENSATION.
Schedule J, Part I, Line 4a Severance or change-of-control payment During calendar year 2020, Mark Nafziger received a severance payment in the amount of $792,948 and David Schertz received a severance payment in the amount of $135,173.
Schedule J, Part I, Line 3 SCH J, PART I, LINE 3 THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHO ARE ALL PROFESSED MEMBERS OF A RELIGIOUS CONGREGATION THAT OWNS OR IS ASSOCIATED WITH THE HE HEALTHCARE SYSTEM WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE CHIEF EXECUTIVE OFFICER (CEO) IS NOT A voting MEMBER OF THE COMMITTEE. THE PERFORMANCE OF THE CEO AND HIS ACHIEVEMENT OF ANNUAL GOALS IS EVALUATED EACH YEAR BY THE FULL BOARD OF DIRECTORS. THE COMMITTEE ALSO OBTAINS COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. BASED ON ALL OF THESE FACTORS, THE COMMITTEE SETS THE BASE SALARY AND BENEFITS OF THE CEO AND APPROVES THE EXECUTIVE COMPENSATION PLAN APPLICABLE TO THE CEO. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR THE CEO, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXCESS BENEFIT AMOUNT IS PAID OR FURNISHED.
Schedule J (Form 990) 2020

Additional Data


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