efile Public Visual Render
ObjectId: 202331299349304023 - Submission: 2023-05-09
TIN: 91-1858433
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
The Nebraska Medical Center
Employer identification number
91-1858433
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
Yes
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) 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
Dr David W Mercer
DIRECTOR
(i)
(ii)
0
-------------
424,502
0
-------------
178,012
0
-------------
0
0
-------------
26,100
0
-------------
12,198
0
-------------
640,812
0
-------------
0
2
Dr Debra Romberger
DIRECTOR
(i)
(ii)
0
-------------
347,132
0
-------------
174,725
0
-------------
0
0
-------------
26,100
0
-------------
7,187
0
-------------
555,144
0
-------------
0
3
James Linder
CEO
(i)
(ii)
1,320,040
-------------
0
2,020,000
-------------
0
208,934
-------------
0
8,700
-------------
0
5,559
-------------
0
3,563,233
-------------
0
0
-------------
0
4
Stephanie Daubert
CFO
(i)
(ii)
538,092
-------------
0
249,441
-------------
0
26,954
-------------
0
80,800
-------------
0
5,838
-------------
0
901,125
-------------
0
0
-------------
0
5
Jennifer Bartholomew
FACILITIES MANAGEMENT VP
(i)
(ii)
206,109
-------------
0
67,128
-------------
0
19,941
-------------
0
35,925
-------------
0
10,231
-------------
0
339,334
-------------
0
0
-------------
0
6
Cory D Shaw
CHIEF OPERATIONS OFFICER
(i)
(ii)
606,249
-------------
0
258,490
-------------
0
6,000
-------------
0
82,885
-------------
0
12,582
-------------
0
966,206
-------------
0
0
-------------
0
7
Dr Harris A Frankel
CHIEF MEDICAL OFFICER
(i)
(ii)
0
-------------
576,489
0
-------------
237,094
0
-------------
9,030
0
-------------
77,955
0
-------------
1,302
0
-------------
901,870
0
-------------
0
8
Michael A Ash
EVP/CHIEF TRANSFORMATION OFC
(i)
(ii)
0
-------------
597,000
0
-------------
251,286
0
-------------
4,247
0
-------------
26,100
0
-------------
19,338
0
-------------
897,971
0
-------------
0
9
Frank Venuto
CHIEF HUMAN CAPITAL OFFICER
(i)
(ii)
158,691
-------------
0
169,561
-------------
0
237,914
-------------
0
19,575
-------------
0
11,764
-------------
0
597,505
-------------
0
0
-------------
0
10
Dr Suzanne Nuss
CHIEF NURSING OFFICER
(i)
(ii)
374,317
-------------
0
165,304
-------------
0
8,558
-------------
0
61,413
-------------
0
11,784
-------------
0
621,376
-------------
0
0
-------------
0
11
Anna Cramer
CHIEF LEGAL OFFICER
(i)
(ii)
421,806
-------------
0
181,320
-------------
0
24,413
-------------
0
61,425
-------------
0
1,499
-------------
0
690,463
-------------
0
0
-------------
0
12
Brian J Lancaster
INFORMATION TECH VP
(i)
(ii)
396,103
-------------
0
113,412
-------------
0
1,296
-------------
0
42,363
-------------
0
8,380
-------------
0
561,554
-------------
0
0
-------------
0
13
Theresa Franco
CANCER CTR/RAD/IMAG SVCS VP
(i)
(ii)
348,437
-------------
0
100,547
-------------
0
20,049
-------------
0
23,325
-------------
0
11,074
-------------
0
503,432
-------------
0
0
-------------
0
14
Thomas C Macy
AMB CLINICS/CLINICAL PROG VP
(i)
(ii)
340,408
-------------
0
98,257
-------------
0
1,181
-------------
0
42,977
-------------
0
10,881
-------------
0
493,704
-------------
0
0
-------------
0
15
Julie Lazure
ACUTE CARE/PATH SVCS VP
(i)
(ii)
312,474
-------------
0
96,012
-------------
0
23,065
-------------
0
43,090
-------------
0
11,658
-------------
0
486,299
-------------
0
0
-------------
0
16
Matthew Pospisil
PERIOP SVS/BELLEVUE VP
(i)
(ii)
334,901
-------------
0
91,932
-------------
0
2,460
-------------
0
42,873
-------------
0
12,532
-------------
0
484,698
-------------
0
0
-------------
0
17
Bryce Brackle
VP Finance
(i)
(ii)
280,697
-------------
0
74,461
-------------
0
631
-------------
0
32,325
-------------
0
566
-------------
0
388,680
-------------
0
0
-------------
0
18
Kyle Skiermont
PharmD VP
(i)
(ii)
234,242
-------------
0
37,572
-------------
0
0
-------------
0
15,000
-------------
0
4,541
-------------
0
291,355
-------------
0
0
-------------
0
19
Michael A Donner
STAFF PHYSICIAN-PRIMARY
(i)
(ii)
279,954
-------------
0
104,122
-------------
0
610
-------------
0
19,575
-------------
0
11,953
-------------
0
416,214
-------------
0
0
-------------
0
20
Frank S Lococo
CORP MARK & COMM VP
(i)
(ii)
268,777
-------------
0
82,650
-------------
0
13,000
-------------
0
36,105
-------------
0
3,549
-------------
0
404,081
-------------
0
0
-------------
0
21
Jana Danielson
Revenue Cycle VP
(i)
(ii)
251,451
-------------
0
80,677
-------------
0
20,348
-------------
0
37,305
-------------
0
1,800
-------------
0
391,581
-------------
0
0
-------------
0
22
Tammy Winterboer
Quality, Effectiveness, and Exp VP
(i)
(ii)
249,521
-------------
0
78,300
-------------
0
19,887
-------------
0
38,985
-------------
0
8,845
-------------
0
395,538
-------------
0
0
-------------
0
23
Geralynne Schmid
Payer Strategy VP
(i)
(ii)
244,246
-------------
0
79,100
-------------
0
19,989
-------------
0
37,305
-------------
0
9,999
-------------
0
390,639
-------------
0
0
-------------
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 4b Supplemental nonqualified retirement plan
CERTAIN EXECUTIVES DO PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. NO PAYOUT OCCURRED DURING THE YEAR FROM A SUPPLEMENTAL NONQUALIFIED PLAN TO CURRENT OR FORMER* INDIVIDUALS. IN ADDITION, The Nebraska Medical Center (TNMC) HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (AMENDED AND RESTATED JANUARY 1, 2008) WHICH CONSTITUTES AN UNFUNDED, UNSECURED PLAN TO PROVIDE SUPPLEMENTAL RETIREMENT BENEFITS TO A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES UPON SEPARATION OF SERVICE, SUBJECT TO THE TERMS AND CONDITIONS OF THE PLAN. THE BENEFIT IS PAID IN FULL ONE YEAR AFTER EMPLOYMENT SEPARATION, AND THE AMOUNT IS BASED ON THE PARTICIPANT'S ANNUAL COMPENSATION, VALUE OF THE PARTICIPANT'S TNMC QUALIFIED RETIREMENT PLAN BENEFIT, SOCIAL SECURITY BENEFIT, AND NUMBER OF YEARS OF SERVICE. PAYOUTS THAT OCCURRED DURING THE YEAR FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN TO THE FOLLOWING INDIVIDUALS: JAMES LINDER: $200,000 FRANK VENUTO: $194,714 THERESA FRANCO: $20,049
Schedule J, Part I, Line 6a Compensation contingent on net earnings of the organization
THE ORGANIZATION'S FINANCIAL RESULTS ARE TAKEN INTO CONSIDERATION WHEN CALCULATING COMPENSATION IN ADDITION TO OTHER NON-FINANCIAL FACTORS. EXECUTIVE INCENTIVE COMPENSATION IS DETERMINED BY SEVERAL KEY METRICS THAT ARE ESTABLISHED BY THE NEBRASKA MEDICAL CENTER GOVERNING BODY. THESE METRICS ARE INCLUSIVE OF STRATEGIC, FINANCIAL, OPERATIONAL AND QUALITY OUTCOMES. ON AN ANNUAL BASIS, THE NEBRASKA MEDICAL CENTER GOVERNING BODY REVIEWS ACHIEVEMENT OF PRESET TARGETS AND APPROVES INCENTIVES WHEN WARRANTED. THESE PERFORMANCE PAYMENTS ARE SET IN CONSIDERATION OF TOTAL COMPENSATION VS. COMPARED TO MARKET FOR SIMILAR POSITIONS. AS IT WAS DETERMINED THAT IT IS IN THE BEST INTEREST OF THE ORGANIZATION TO HAVE A PORTION OF THEIR BASE PAY SUBJECT TO FORFEITURE UNLESS THE PRE-DETERMINED FINANCIAL AND NON-FINANCIAL FACTORS DISCUSSED ABOVE ARE ACHIEVED. INCENTIVE COMPENSATION RELATED TO FY22 PERFORMANCE WERE PAID TO THE FOLLOWING INDIVIDUALS: JAMES LINDER: $2,020,000 STEPHANIE DAUBERT: $249,441 ANNA CRAMER: $181,320 THERESA FRANCO: $100,547 HARRIS FRANKEL: $237,094 BRIAN LANCASTER: $113,412 JULIE LAZURE: $96,012 THOMAS MACY: $98,257 SUZANNE NUSS: $165,304 BRYCE BRACKLE: $74,461 MICHAEL DONNER: $104,122 MATTHEW E. POSPISIL: $91,932 CORY SHAW: $258,490 FRANK VENUTO: $169,561 KYLE SKIERMONT: $37,572 JANA DANIELSON: $80,677 FRANK S. LOCOCO: $82,650 DAVID W. MERCER: $178,012 DEBRA J. ROMBERGER: $174,725 MICHAEL A. ASH: $251,286 JENNIFER BARTHOLOWMEW: $67,128 TAMMY WINTERBOER: $78,300 GERALYNNE SCHMID: $79,100
Schedule J (Form 990) 2021
Additional Data
Software ID:
21014044
Software Version:
2021v4.2