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
2021
Open to Public Inspection
Name of the organization
THOMAS JEFFERSON UNIVERSITY HOSPITALS INC
 
Employer identification number

23-2829095
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
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
1CHARLES J YEO MD FACS
TRUSTEE
(i)

(ii)
0
-------------
1,318,264
0
-------------
286,732
0
-------------
36,080
0
-------------
1,732
0
-------------
18,062
0
-------------
1,660,870
0
-------------
0
2RICHARD J WEBSTER RN MSN
TRUSTEE - PRESIDENT TJUH
(i)

(ii)
674,421
-------------
0
214,126
-------------
0
161,383
-------------
0
12,803
-------------
0
11,816
-------------
0
1,074,549
-------------
0
115,178
-------------
0
3VIJAY M RAO MD FACR
TRUSTEE
(i)

(ii)
0
-------------
807,387
0
-------------
125,752
0
-------------
13,555
0
-------------
1,205
0
-------------
9,182
0
-------------
957,081
0
-------------
0
4SANDRA BROOKS MD MBA
TRUSTEE - CHIEF MED OFFICER
(i)

(ii)
541,627
-------------
0
171,859
-------------
0
21,009
-------------
0
0
-------------
0
27,754
-------------
0
762,249
-------------
0
0
-------------
0
5ANTHONY J DIMARINO MD
TRUSTEE
(i)

(ii)
0
-------------
603,313
0
-------------
47,500
0
-------------
12,344
0
-------------
4,311
0
-------------
20,428
0
-------------
687,896
0
-------------
0
6SHARON M GALUP
SVP, PAYER STRATEGY & CONTRACT
(i)

(ii)
442,979
-------------
0
139,960
-------------
0
33,023
-------------
0
1,190
-------------
0
11,739
-------------
0
628,891
-------------
0
9,935
-------------
0
7NEIL G LUBARSKY CPA CGMA
FORMER OFFICER
(i)

(ii)
0
-------------
0
 
-------------
0
600,517
-------------
0
288
-------------
0
0
-------------
0
600,805
-------------
0
0
-------------
0
8RODNEY BELL MD
TRUSTEE
(i)

(ii)
0
-------------
378,289
0
-------------
50,304
0
-------------
10,568
0
-------------
3,987
0
-------------
17,596
0
-------------
460,744
0
-------------
0
9GERALD A ISENBERG MD
TRUSTEE - MED STAFF PRES
(i)

(ii)
0
-------------
381,124
0
-------------
42,968
0
-------------
14,855
0
-------------
1,674
0
-------------
18,388
0
-------------
459,009
0
-------------
0
10VICTORIA SCHUNEMANN MD
NEUROSURGEON
(i)

(ii)
45,601
-------------
287,704
30,000
-------------
0
11,711
-------------
51,494
0
-------------
0
4,303
-------------
2,935
91,615
-------------
342,133
0
-------------
0
11PAMELA KOLB
VP, CLINICAL & SUPPORT SVCS
(i)

(ii)
310,136
-------------
0
78,995
-------------
0
10,788
-------------
0
1,293
-------------
0
17,021
-------------
0
418,233
-------------
0
0
-------------
0
12ALEX KHARITON RTT MBA
VP, CANCER SERVICES
(i)

(ii)
274,146
-------------
0
93,661
-------------
0
18,284
-------------
0
0
-------------
0
23,099
-------------
0
409,190
-------------
0
0
-------------
0
13CHRISTOPHER TOMLINSON
VP, CLNICAL LAB/PATHOLOGY
(i)

(ii)
284,015
-------------
0
76,628
-------------
0
2,705
-------------
0
843
-------------
0
27,262
-------------
0
391,453
-------------
0
0
-------------
0
14MARY BETH EDGER
TRUSTEE; EX-OFFICIO
(i)

(ii)
257,127
-------------
0
67,644
-------------
0
9,659
-------------
0
1,219
-------------
0
18,180
-------------
0
353,829
-------------
0
0
-------------
0
15JEFFREY N DOUCETTE DPN RN
FORMER OFFICER
(i)

(ii)
130,328
-------------
0
0
-------------
0
1,187
-------------
0
115
-------------
0
7,222
-------------
0
138,852
-------------
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
CORE FORM, PART VII AND SCHEDULE J TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM 2021 FORMS W-2.
SCHEDULE J, PART I; QUESTION 1 THE ORGANIZATION MAINTAINS A FLEXIBLE BENEFIT PROGRAM ("PERQUISITE PROGRAM") FOR CERTAIN MEMBERS OF ITS SENIOR LEADERSHIP TEAM. THIS PROGRAM PROVIDES A FIXED DOLLAR AMOUNT, AND ENABLES PARTICIPATING EMPLOYEES TO ALLOCATE THE AMOUNT AMONG CERTAIN TAXABLE BENEFIT OPTIONS (I.E., ADDITIONAL LIFE INSURANCE COVERAGES, LONG-TERM CARE INSURANCE AND FINANCIAL OR TAX PLANNING ASSISTANCE) OR TO NON-QUALIFIED DEFERRED COMPENSATION OPTIONS. THE ELECTIONS ARE MADE BEFORE THE YEAR IN WHICH THE PROGRAM AMOUNT IS PROVIDED. THE AMOUNTS ALLOCATED TO TAXABLE BENEFIT OPTIONS ARE INCLUDED WITHIN THE EMPLOYEES' FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES FOR THE YEAR IN WHICH THE ALLOCATIONS ARE EFFECTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE ORGANIZATION'S PERQUISITE PROGRAM: RICHARD J. WEBSTER, RN, MSN; SANDRA BROOKS, M.D., MBA AND SHARON M. GALUP.
SCHEDULE J, PART I; QUESTION 4A THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS DURING CALENDAR YEAR 2021 WHICH WERE INCLUDED IN THE INDIVIDUAL'S 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: NEIL G. LUBARSKY, CPA, CGMA, $479,400.
SCHEDULE J, PART I; QUESTION 4B THE AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES CURRENT YEAR VESTING IN AN INTERNAL REVENUE CODE SECTION 457(F) PLAN (NON-QUALIFIED DEFERRED COMPENSATION PLAN) AS THE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: RICHARD J. WEBSTER, RN, MSN, $87,418 AND SHARON M. GALUP, $13,761 AND PAMELA KOLB, $147. THE AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN B(III) FOR THE FOLLOWING INDIVIDUAL INCLUDES CURRENT YEAR VESTING IN A LONG-TERM INCENTIVE PLAN, AS THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNT OUTLINED HEREIN WAS INCLUDED IN HIS 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: RICHARD J. WEBSTER, RN, MSN, $39,000. THE DEFERRED COMPENSATION AMOUNT REFLECTED IN SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUAL INCLUDES UNVESTED BENEFITS IN A LONG-TERM INCENTIVE PLAN, WHICH IS SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THIS INDIVIDUAL MAY NEVER ACTUALLY RECEIVE THIS UNVESTED BENEFIT AMOUNT. THE AMOUNT OUTLINED HEREIN WAS NOT INCLUDED IN HIS 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: RICHARD J. WEBSTER, RN, MSN, $9,625.
SCHEDULE J, PART I; QUESTION 7 CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2021 WHICH WAS INCLUDED IN SCHEDULE J, PART II, COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2021 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. EMPLOYEE BONUSES ARE BASED UPON THE ATTAINMENT OF QUALITY GOALS, STRATEGIC OPERATIONAL INITIATIVES AND FINANCIAL PERFORMANCE. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT.
SCHEDULE J, PART II; COLUMN F THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (F) INCLUDE VESTED BENEFITS IN A DEFERRED COMPENSATION PLAN AS THESE AMOUNTS WERE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF FORFEITURE. THESE AMOUNTS WERE REPORTED AS DEFERRED COMPENSATION ON PRIOR YEARS' FORMS 990 AND ARE NOW BEING REPORTED AGAIN ON THIS YEAR'S FORM 990. THESE HAVE BEEN TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES.
Schedule J (Form 990) 2021

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