Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic Attach to Form 990.
medium right arrow graphic Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2022
Open to Public Inspection
Name of the organization
Hillcrest Physician Services
 
Employer identification number

74-2967081
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
 
 
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
 
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) 2022
Page 2

Schedule J (Form 990) 2022
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
1John Ackley MD
Physician
(i)

(ii)
775,724
-------------
0
788,544
-------------
0
78,960
-------------
0
54,400
-------------
0
34,298
-------------
0
1,731,926
-------------
0
54,482
-------------
0
2Scott Hecox MD
Director
(i)

(ii)
802,278
-------------
0
545,128
-------------
0
68,368
-------------
0
54,400
-------------
0
30,279
-------------
0
1,500,453
-------------
0
48,778
-------------
0
3Andrew Brochu MD
Physician
(i)

(ii)
591,532
-------------
0
551,958
-------------
0
49,348
-------------
0
54,400
-------------
0
27,023
-------------
0
1,274,261
-------------
0
48,754
-------------
0
4David Ferguson MD
Director
(i)

(ii)
794,453
-------------
0
274,681
-------------
0
53,696
-------------
0
54,400
-------------
0
34,260
-------------
0
1,211,490
-------------
0
52,795
-------------
0
5Anthony Cahill MD
Physician
(i)

(ii)
511,852
-------------
0
472,759
-------------
0
31,178
-------------
0
54,400
-------------
0
33,840
-------------
0
1,104,029
-------------
0
10,268
-------------
0
6Jacob Davis MD
Physician
(i)

(ii)
782,267
-------------
0
132,273
-------------
0
42,084
-------------
0
54,400
-------------
0
26,802
-------------
0
1,037,826
-------------
0
20,963
-------------
0
7Bradley Gilliam MD
Physician
(i)

(ii)
504,365
-------------
0
260,462
-------------
0
73,427
-------------
0
54,400
-------------
0
26,979
-------------
0
919,633
-------------
0
52,404
-------------
0
8Johnny D Howton MD
Director
(i)

(ii)
498,351
-------------
0
158,668
-------------
0
52,863
-------------
0
45,250
-------------
0
27,294
-------------
0
782,426
-------------
0
40,149
-------------
0
9Adam W Ylitalo DO
Director
(i)

(ii)
526,602
-------------
0
77,361
-------------
0
72,773
-------------
0
54,400
-------------
0
26,708
-------------
0
757,844
-------------
0
51,724
-------------
0
10David Myers MD
Director
(i)

(ii)
0
-------------
599,242
0
-------------
32,121
0
-------------
43,877
0
-------------
54,460
0
-------------
10,627
0
-------------
740,327
0
-------------
43,179
11Charles Williams
President/CEO
(i)

(ii)
0
-------------
407,294
0
-------------
156,089
0
-------------
59,166
0
-------------
64,462
0
-------------
32,068
0
-------------
719,079
0
-------------
0
12Jon M Ellis MD
Director
(i)

(ii)
522,785
-------------
0
1,325
-------------
0
44,753
-------------
0
54,400
-------------
0
26,726
-------------
0
649,989
-------------
0
42,255
-------------
0
13Umad Ahmad MD
Director/Chair
(i)

(ii)
0
-------------
421,322
0
-------------
107,100
0
-------------
21,225
0
-------------
16,442
0
-------------
27,095
0
-------------
593,184
0
-------------
0
14Marc S Elieson MD
Director
(i)

(ii)
191,795
-------------
230,360
12,703
-------------
63,408
188
-------------
219
6,360
-------------
7,420
11,653
-------------
13,595
222,699
-------------
315,002
0
-------------
0
15Shellie Mach
Secretary/Treasurer
(i)

(ii)
0
-------------
209,548
0
-------------
56,286
0
-------------
20,848
0
-------------
12,146
0
-------------
29,451
0
-------------
328,279
0
-------------
0
16Matthew Rohrer
VP Clinic Operations
(i)

(ii)
0
-------------
189,205
0
-------------
51,475
0
-------------
781
0
-------------
10,021
0
-------------
26,838
0
-------------
278,320
0
-------------
0
Schedule J (Form 990) 2022
Page 3

Schedule J (Form 990) 2022
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 3 Process for determining compensation: The organization, a controlled affiliate of Baylor Scott & White Holdings, recognizes that those chosen to lead the organization are vital to its ongoing success and growth. Thus, it must attract, retain and engage the highest quality officers and key employees to lead the organization and help the organization maintain its national reputation for achieving high targets for medical quality, patient safety, and patient satisfaction. A significant portion of the organization's officers and key employees' total compensation is based on significant performance achievements. This strategy places a greater emphasis on the importance of the organization achieving targeted improvements in the areas of people, quality, patient satisfaction and financial stewardship, annually. Total executive compensation is part of an integrated talent management strategy developed by the Baylor Scott & White Holdings Board of Trustees and its Compensation Committee to attract, motivate, and retain the best leadership resources for the organization. Executive compensation is determined pursuant to guidelines outlined in the intermediate sanction rules under IRC Section 4958 including taking steps to meet the rebuttable presumption standard of reasonableness under Treasury Regulation 53.4958-6, as summarized below. When making compensation decisions, the organization compares itself to similarly-sized, and structured businesses including other integrated health care service systems and other similarly-sized organizations, both locally and nationally. Each year the Baylor Scott & White Holdings Board of Trustees and the Compensation Committee, on behalf of the organization through reserved powers explicitly held by Baylor Scott & White Holdings, works directly with an independent compensation consultant(s) to identify reasonable and competitive market rates as well as provide an annual review of the total compensation of the organization's top management officials and other officers and key employees to ensure total compensation is within a fair market range. The annual review included reviewing certain officers and key employees listed on the Form 990 during the current tax year. The Compensation Committee is made up of members of the Baylor Scott & White Holdings Board of Trustees, who are independent, community volunteers. Guided by the information provided by the independent compensation consultant(s), the Compensation Committee approves the annual process and methodology for setting fair market salary ranges, earned incentives, and/or benefit offerings for the organization's President, other officers and/or key employees to be comparable to similar organizations for similar services and/or positions. Furthermore, the Compensation Committee is charged with the responsibility of reviewing annually the major elements of the executive compensation program to assure designs remain consistent with the business needs, market practices, and compensation philosophy. As part of the decision-making process, the Compensation Committee will often meet in executive session to discuss and review recommendations made by the independent compensation consultant(s). No officer or key employee whose compensation is being reviewed is present during these discussions. All decisions are properly documented in the minutes of the meetings.
Part I, Line 4b In order to recruit and retain key talent, BSW Holdings and certain tax exempt affiliates (BSWH) offers a supplemental non-qualified retirement plan to eligible employees. The plan provides an annual benefit (based on a percentage of compensation) to the employee that is paid to the employee on a future date upon vesting in the plan. The following individual(s) participated in and/or received payments (noted in parenthesis) from BSWH's supplemental non-qualified retirement plan during the tax year: Adam W. Ylitalo, D.O. ($51,724), Andrew Brochu, M.D. ($48,754), Anthony Cahill, M.D. ($10,268), Bradley Gilliam, M.D. ($52,404), Charles Williams, David Ferguson, M.D. ($52,795), David Myers, M.D. ($43,179), Jacob Davis, M.D. ($20,963), John Ackley, M.D., ($54,482), Johnny D. Howton, M.D. ($40,149), Jon M. Ellis, M.D. ($42,255), Marc S. Elieson, M.D. and Scott Hecox, M.D. ($48,778).
Part I, Line 7 The organization has adopted and implemented BSW Holdings', the organization's ultimate parent, Annual Incentive Program to provide a market competitive total cash compensation incentive program that is designed to attract and retain key leaders and establish greater individual accountability and alignment to business performance. Payout targets are based upon a percentage of base pay and are developed by independent third party expert(s) using comparable market competitive data within the bounds of reasonableness and that are reviewed and approved by BSW Holdings' governing body. Payout levels are based upon a combination of system, entity, and individual performance using various metrics related to quality, patient satisfaction, employee retention, and financial stewardship. BSW Holdings' governing body may approve modifications to annual incentive awards provided under the program consistent with market comparability data.
Form 990, Schedule J, Part III Supplemental Information: Governing Body Compensation The members of the governing body serve in a limited role in their capacity as a board member and may receive compensation from the organization for these duties as a member of the governing body. However, the members do receive a majority of their compensation from the organization in their capacity as employed physicians.
Schedule J (Form 990) 2022

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