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ObjectId: 202403199349316105 - Submission: 2024-11-14
TIN: 52-1532556
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
23
Open to Public Inspection
Name of the organization
ADVENTIST HEALTHCARE INC
Employer identification number
52-1532556
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
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
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) 2023
Page 2
Schedule J (Form 990) 2023
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
TERRY FORDE
PRESIDENT & CEO, AHC
(i)
(ii)
1,009,512
-------------
0
226,933
-------------
0
211,787
-------------
0
30,000
-------------
0
39,578
-------------
0
1,517,810
-------------
0
0
-------------
0
2
ANITA JENKINS
PRESIDENT,HOWARD UNIVERSITY HOSPITAL
(i)
(ii)
513,870
-------------
0
96,493
-------------
0
711,253
-------------
0
30,000
-------------
0
17,800
-------------
0
1,369,416
-------------
0
0
-------------
0
3
PAUL MASSIMIANO MD
PHYSICIAN
(i)
(ii)
1,142,666
-------------
0
0
-------------
0
5,101
-------------
0
30,000
-------------
0
25,818
-------------
0
1,203,585
-------------
0
0
-------------
0
4
SHERIF SELIM MD
PHYSICIAN
(i)
(ii)
688,377
-------------
0
468,366
-------------
0
1,742
-------------
0
21,053
-------------
0
23,717
-------------
0
1,203,255
-------------
0
0
-------------
0
5
JONATHAN RHEE MD
PHYSICIAN
(i)
(ii)
658,696
-------------
0
420,920
-------------
0
2,304
-------------
0
20,500
-------------
0
27,771
-------------
0
1,130,191
-------------
0
0
-------------
0
6
JOHN SACKETT
EVP & COO, AHC
(i)
(ii)
593,349
-------------
0
127,698
-------------
0
292,961
-------------
0
30,000
-------------
0
41,597
-------------
0
1,085,605
-------------
0
0
-------------
0
7
KRISTEN PULIO
SVP & CFO, AHC
(i)
(ii)
508,210
-------------
0
103,619
-------------
0
152,747
-------------
0
169,280
-------------
0
8,254
-------------
0
942,110
-------------
0
96,847
-------------
0
8
ANTHONY STAHL
PRESIDENT, WOMC
(i)
(ii)
465,960
-------------
0
121,581
-------------
0
162,633
-------------
0
159,581
-------------
0
24,895
-------------
0
934,650
-------------
0
116,243
-------------
0
9
DANIEL L COCHRAN
PRESIDENT, SGMC
(i)
(ii)
456,048
-------------
0
76,244
-------------
0
209,797
-------------
0
170,607
-------------
0
17,425
-------------
0
930,121
-------------
0
139,140
-------------
0
10
PATSY MCNEIL
SVP, SYSTEM CHIEF MEDICAL OFFICER
(i)
(ii)
478,423
-------------
0
78,794
-------------
0
162,361
-------------
0
146,659
-------------
0
11,070
-------------
0
877,307
-------------
0
107,269
-------------
0
11
STEVEN BOYCE MD
PHYSICIAN
(i)
(ii)
159,206
-------------
0
0
-------------
0
688,248
-------------
0
173
-------------
0
3,926
-------------
0
851,553
-------------
0
0
-------------
0
12
DENNIS FRIEDMAN MD
PHYSICIAN
(i)
(ii)
675,120
-------------
0
98,169
-------------
0
23,526
-------------
0
26,988
-------------
0
12,434
-------------
0
836,237
-------------
0
0
-------------
0
13
BRENT REITZ
PRESIDENT, POST-ACUTE CARE SRV, AHC
(i)
(ii)
427,586
-------------
0
78,905
-------------
0
154,049
-------------
0
116,000
-------------
0
24,814
-------------
0
801,354
-------------
0
87,107
-------------
0
14
MARISSA LESLIE MD
BOARD(END 4/2023); SYS MED DIR,PSYCH
(i)
(ii)
0
-------------
273,118
0
-------------
29,692
0
-------------
1,313
0
-------------
15,284
0
-------------
9,228
0
-------------
328,635
0
-------------
0
Schedule J (Form 990) 2023
Page 3
Schedule J (Form 990) 2023
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
HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: AS PART OF A RELOCATION PLAN TO THE WASHINGTON, DC AREA, ADVENTIST HEALTHCARE, INC. AND ANITA JENKINS, THE PRESIDENT OF HOWARD UNIVERSITY HOSPITAL, ENTERED INTO A JOINT OWNERSHIP ARRANGEMENT OF A RESIDENTIAL PROPERTY IN THE DISTRICT OF COLUMBIA TO BE USED AS MS. JENKINS' RESIDENCE. THIS ARRANGEMENT WAS ENTERED ON JUNE 1, 2020. ADVENTIST HEALTHCARE CONTRIBUTED HALF THE PROPERTY'S PURCHASE PRICE THROUGH A SINGLE MEMBER LIMITED LIABILITY COMPANY, AND MS. JENKINS PURCHASED THE OTHER HALF PERSONALLY. FOR THE DURATION OF OCCUPANCY, ADVENTIST HEALTHCARE INCLUDES ON MS. JENKINS' FORM W2, AS IMPUTED INCOME, THE FAIR MARKET RENTAL VALUE OF THE PROPERTY ATTRIBUTABLE TO ADVENTIST HEALTHCARE'S OWNERSHIP. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES: ADVENTIST HEALTHCARE OWNS A CORPORATE MEMBERSHIP AT A LOCAL GOLF CLUB. THROUGH THE CORPORATE LEVEL MEMBERSHIP, FOUR ADVENTIST HEALTHCARE EXECUTIVES ARE DESIGNATED TO USE THE MEMBERSHIP IN ORDER TO ADVANCE VARIOUS ADVENTIST HEALTHCARE BUSINESS INTERESTS (RECRUITING, NETWORKING, ETC.). ADVENTIST HEALTHCARE PAYS THE EXECUTIVES A MONTHLY ALLOWANCE AS ADDITIONAL COMPENSATION TO COVER THE MONTHLY MEMBERSHIP DUES, WHICH THE EXECUTIVE PAYS THEMSELVES. THE MONTHLY ALLOWANCES ARE REPORTED AS TAXABLE COMPENSATION.
PART I, LINE 3
PAY PRACTICE: ADVENTIST HEALTHCARE UTILIZES A SINGLE EMPLOYER ID FOR ALL ITS AFFILIATED ENTITIES FOR EMPLOYMENT PURPOSES. AS SUCH, ACTUAL COMPENSATION AND BENEFITS ARE CHARGED TO THE RESPECTIVE ENTITIES AND THE RESULTING COMPENSATION AND BENEFITS ARE REPORTED ON EACH AFFILIATE'S IRS FORM 990 AS IF PAID DIRECTLY BY SUCH AFFILIATE. AS APPLICABLE, THE SAME AND NON-ADDITIVE COMPENSATION AND EMPLOYMENT BENEFIT PLAN CONTRIBUTION AMOUNTS WERE ALSO DISCLOSED IN THE ADVENTIST HEALTHCARE INC. RELATED ENTITIES' RETURNS. INDEPENDENT GUIDELINES: WHEN SETTING COMPENSATION FOR THE OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND THE HIGHEST COMPENSATED EMPLOYEES, ADVENTIST HEALTHCARE FULLY COMPLIES WITH THE PROCEDURAL SAFEGUARDS EMBODIED IN IRS REGULATIONS. COMPENSATION FOR ADVENTIST HEALTHCARE OFFICERS, DIRECTORS, TRUSTEES, AND SENIOR EXECUTIVES IS ENTIRELY SET BY A COMMITTEE OF ADVENTIST HEALTHCARE BOARD OF TRUSTEES. IN SETTING COMPENSATION, THIS COMMITTEE RELIES UPON MARKET COMPARABILITY DATA PROVIDED BY AN INDEPENDENT OUTSIDE COMPENSATION CONSULTANT WHO PROVIDES A SUMMARY OF HEALTH CARE SALARIES AND BENEFITS FOR COMPARABLE SIZED ORGANIZATIONS BOTH NATIONALLY AND IN THE ADVENTIST HEALTHCARE REGION. TO FURTHER ENSURE REASONABLENESS, BOTH COMPENSATION AND BENEFITS ARE TARGETED AT THE 50TH PERCENTILE (OR MEDIAN) OF THE MARKET.
PART I, LINE 4B
CERTAIN EMPLOYEES RECEIVED COMPENSATION FROM A DISTRIBUTION UNDER AN EXECUTIVE RETENTION 457F PLAN, WHICH BECAME EFFECTIVE ON JANUARY 1, 2015. PRE-TAX CONTRIBUTIONS ARE ACCUMULATED ANNUALLY AND ARE DISTRIBUTED ON JANUARY 1ST OF THE 2ND YEAR, IF STILL EMPLOYED, OR SOONER BASED ON CERTAIN EXCEPTIONS. THERE IS TYPICALLY A 2-YEAR DEFERRAL PERIOD BEFORE PAYMENTS ARE RELEASED. CONTRIBUTIONS ACCUMULATED IN 2021 WERE GENERALLY DISTRIBUTED ON JANUARY 1, 2023 IF THE EXECUTIVE IS THEN EMPLOYED AND CONTRIBUTIONS ACCUMULATED IN 2022 WILL GENERALLY BE DISTRIBUTED ON JANUARY 1, 2024 IF THE EXECUTIVE IS THEN EMPLOYED. AMOUNTS LISTED UNDER PART II, COLUMN F INCLUDE PAYOUT AMOUNTS WHICH WERE CONSIDERED DEFERRED COMPENSATION FROM THE 457F PLAN IN OUR PRIOR YEAR RETURNS AND THESE AMOUNTS ARE NOW BEING SHOWN UNDER THE OTHER REPORTABLE INCOME, COLUMN B (III). THE ADVENTIST HEALTHCARE EXECUTIVE RETENTION PLAN PAYS CERTAIN PARTICIPANTS THEIR RETIREMENT PAYMENTS IN DIRECT CASH, RATHER THAN RETENTION BENEFITS OF DEFERRED CASH, AFTER ATTAINING THE PLAN'S RETIREMENT AGE. THE FOLLOWING EXECUTIVES RECEIVED SUPPLEMENTAL RETIREMENT PAYMENTS UNDER THIS PLAN FEATURE: JOHN SACKETT: $168,637 RETIREMENT AGE PAYMENT; ANITA JENKINS: $121,727 RETIREMENT AGE PAYMENT. THE FOLLOWING EMPLOYEE RECEIVED A PAYOUT OF THEIR ENTIRE ACCRUED BENEFIT UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), DUE TO HAVING COMPLETED THE NECESSARY YEARS OF SERVICE AND ATTAINING THE NECESSARY AGE FOR VESTING AND PAYMENT. ANITA JENKINS: $518,000.
PART I, LINE 7
THE ANNUAL INCENTIVE COMPENSATION INCLUDES PAYMENTS BASED ON SATISFACTION OF PRE-DETERMINED PERFORMANCE TARGETS SUCH AS QUALITY/PATIENT SAFETY GOALS, EMPLOYEE AND PATIENT ENGAGEMENT GOALS, ORGANIZATIONAL GROWTH, AND FINANCIAL PERFORMANCE, AMONG OTHER THINGS. THE ANNUAL INCENTIVE COMPENSATION APPLIES TO DIRECTORS AND ABOVE.
SUPPLEMENTAL INFORMATION:
OTHER REPORTABLE COMPENSATION INCLUDES RETENTION PAYMENTS AND LUMP-SUM ADJUSTMENTS IN LIEU OF THE ACROSS-THE-BOARD INCREASE (FOR EMPLOYEES WHO ARE AT OR REACH THE RANGE MAXIMUM FOR THEIR POSITION). OTHER REPORTABLE COMPENSATION ALSO INCLUDES LONG-TERM DISABILITY COVERAGE, CELL PHONE ALLOWANCES, CASH-OUT OF UNUSED PAID TIME OFF (PTO) HOURS, IMPUTED VALUE OF LIFE INSURANCE COVERAGE, AND SEVERANCE, AS APPLICABLE. CERTAIN EXECUTIVES CAN ALSO RECEIVE REPORTABLE COMPENSATION THROUGH A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ONCE THEY HAVE VESTED IN THE PLAN. NON-TAXABLE BENEFITS INCLUDES PRE-TAX PAYROLL DEDUCTIONS (SUCH AS FLEXIBLE MEDICAL SPENDING, DEPENDENT CARE, AND EMPLOYEE HEALTH BENEFIT PREMIUMS), AND THE EMPLOYER PORTION OF CERTAIN EMPLOYEE BENEFITS SUCH AS HEALTH INSURANCE, DENTAL INSURANCE, VISION INSURANCE, AND LIFE INSURANCE, ETC.
Schedule J (Form 990) 2023
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