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TIN: 45-3791176
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.
Information about Schedule J (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
16
Open to Public Inspection
Name of the organization
Sanford Group Return
Employer identification number
45-3791176
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 in 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 in 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
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
Yes
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
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) 2016
Schedule J (Form 990) 2016
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
1
Maria Bell MD
Trustee/Sanford Physician
(i)
(ii)
712,251
-------------
0
0
-------------
0
60,611
-------------
0
13,250
-------------
0
25,256
-------------
0
811,368
-------------
0
0
-------------
0
2
Mark Lundeen MD
Trustee/Sanford Physician
(i)
(ii)
813,747
-------------
0
0
-------------
0
1,672
-------------
0
13,250
-------------
0
14,198
-------------
0
842,867
-------------
0
0
-------------
0
3
Mark Paulson MD
Chair/Sanford Physician
(i)
(ii)
249,769
-------------
0
0
-------------
0
-5,425
-------------
0
12,488
-------------
0
20,665
-------------
0
277,497
-------------
0
0
-------------
0
4
Michael LeBeau MD
Trustee/Sanford Physician
(i)
(ii)
1,410,371
-------------
0
0
-------------
0
-5,908
-------------
0
13,250
-------------
0
20,820
-------------
0
1,438,533
-------------
0
0
-------------
0
5
Kelby K Krabbenhoft
Sanford President & CEO
(i)
(ii)
1,481,306
-------------
0
629,600
-------------
0
74,490
-------------
0
0
-------------
0
21,578
-------------
0
2,206,974
-------------
0
0
-------------
0
6
Kelby K Krabbenhoft Deferred Comp
Sanford President & CEO
(i)
(ii)
0
-------------
0
0
-------------
0
0
-------------
0
825,962
-------------
0
0
-------------
0
825,962
-------------
0
0
-------------
0
7
JoAnn L Kunkel
Chief Financial Officer
(i)
(ii)
620,190
-------------
0
180,000
-------------
0
89,649
-------------
0
13,250
-------------
0
23,426
-------------
0
926,515
-------------
0
0
-------------
0
8
Nate White
Chief Operating Officer
(i)
(ii)
797,500
-------------
0
234,000
-------------
0
109,102
-------------
0
13,250
-------------
0
25,448
-------------
0
1,179,300
-------------
0
0
-------------
0
9
Richard G Adcock
Chief Innovation Officer
(i)
(ii)
589,427
-------------
0
177,000
-------------
0
81,844
-------------
0
13,250
-------------
0
25,058
-------------
0
886,579
-------------
0
0
-------------
0
10
Kim Patrick
Chief Legal Officer
(i)
(ii)
482,183
-------------
0
142,650
-------------
0
90,373
-------------
0
13,250
-------------
0
23,934
-------------
0
752,390
-------------
0
0
-------------
0
11
Bill Marlette
Treasurer
(i)
(ii)
563,456
-------------
0
190,000
-------------
0
123,641
-------------
0
0
-------------
0
1,680
-------------
0
878,777
-------------
0
0
-------------
0
12
Bill Marlette Deferred Comp
Treasurer
(i)
(ii)
0
-------------
0
0
-------------
0
0
-------------
0
197,936
-------------
0
0
-------------
0
197,936
-------------
0
0
-------------
0
13
Al Hurley
VP Operations Bismarck
(i)
(ii)
309,349
-------------
0
53,975
-------------
0
41,371
-------------
0
13,250
-------------
0
13,208
-------------
0
431,153
-------------
0
0
-------------
0
14
Allison Suttle MD
Senior VP Chief Medical Of
(i)
(ii)
515,956
-------------
0
121,250
-------------
0
53,710
-------------
0
13,250
-------------
0
25,160
-------------
0
729,326
-------------
0
0
-------------
0
15
Bradley J Schipper
VP Operations Sioux Falls
(i)
(ii)
433,486
-------------
0
64,110
-------------
0
43,112
-------------
0
13,250
-------------
0
25,058
-------------
0
579,016
-------------
0
0
-------------
0
16
Bruce D Viessman
VP Finance Health Network
(i)
(ii)
288,466
-------------
0
300
-------------
0
31,076
-------------
0
13,250
-------------
0
21,646
-------------
0
354,738
-------------
0
0
-------------
0
17
Bryan Nermoe
Exec VP Bemidji
(i)
(ii)
435,331
-------------
0
147,000
-------------
0
38,963
-------------
0
14,901
-------------
0
19,004
-------------
0
655,199
-------------
0
0
-------------
0
18
Cole Turner
VP Finance Sioux Falls
(i)
(ii)
278,417
-------------
0
300
-------------
0
22,123
-------------
0
13,250
-------------
0
23,783
-------------
0
337,873
-------------
0
0
-------------
0
19
Craig Boyer
VP Finance Bemidji
(i)
(ii)
238,528
-------------
0
35,400
-------------
0
24,093
-------------
0
12,281
-------------
0
22,050
-------------
0
332,352
-------------
0
0
-------------
0
20
Craig Lambrecht
Exec VP Bismarck
(i)
(ii)
734,950
-------------
0
201,250
-------------
0
103,758
-------------
0
13,250
-------------
0
22,976
-------------
0
1,076,184
-------------
0
0
-------------
0
21
Daniel W Blue
Exec VP Clinic
(i)
(ii)
656,731
-------------
0
162,500
-------------
0
118,399
-------------
0
13,250
-------------
0
25,002
-------------
0
975,882
-------------
0
0
-------------
0
22
Douglas Okland
VP Clinic Finance
(i)
(ii)
281,370
-------------
0
300
-------------
0
34,003
-------------
0
13,250
-------------
0
4,070
-------------
0
332,993
-------------
0
0
-------------
0
23
Ellen Cooke
VP Operations Fargo
(i)
(ii)
430,491
-------------
0
63,495
-------------
0
55,382
-------------
0
13,250
-------------
0
10,560
-------------
0
573,178
-------------
0
0
-------------
0
24
Eric Hilmoe
VP Operations Health Netwo
(i)
(ii)
299,888
-------------
0
15,300
-------------
0
38,963
-------------
0
13,250
-------------
0
750
-------------
0
368,151
-------------
0
0
-------------
0
25
Jesse Tischer
Exec VP Health Network
(i)
(ii)
451,846
-------------
0
118,700
-------------
0
62,663
-------------
0
13,250
-------------
0
21,084
-------------
0
667,543
-------------
0
0
-------------
0
26
Joy Johnson
VP Operations Bemidji
(i)
(ii)
312,238
-------------
0
46,335
-------------
0
37,880
-------------
0
13,250
-------------
0
13,232
-------------
0
422,935
-------------
0
0
-------------
0
27
Kirk Cristy
VP Finance Bismarck
(i)
(ii)
275,689
-------------
0
10,300
-------------
0
43,349
-------------
0
13,250
-------------
0
8,133
-------------
0
350,721
-------------
0
0
-------------
0
28
Matthew Hocks
Senior VP Clinic
(i)
(ii)
435,246
-------------
0
105,150
-------------
0
43,894
-------------
0
13,250
-------------
0
24,254
-------------
0
621,794
-------------
0
0
-------------
0
29
Michael E Farritor
VP Clinic Sioux Falls
(i)
(ii)
446,775
-------------
0
20,300
-------------
0
54,954
-------------
0
13,250
-------------
0
25,900
-------------
0
561,179
-------------
0
0
-------------
0
30
Michelle A Bruhn
Senior VP Finance Health S
(i)
(ii)
428,074
-------------
0
105,000
-------------
0
51,931
-------------
0
13,250
-------------
0
3,324
-------------
0
601,579
-------------
0
0
-------------
0
31
Michelle M Micka
Senior VP Finance Corp Con
(i)
(ii)
305,775
-------------
0
73,750
-------------
0
28,994
-------------
0
13,250
-------------
0
24,070
-------------
0
445,839
-------------
0
0
-------------
0
32
Paul Hanson
Exec VP Sioux Falls
(i)
(ii)
610,766
-------------
0
157,000
-------------
0
89,768
-------------
0
13,250
-------------
0
23,008
-------------
0
893,792
-------------
0
0
-------------
0
33
Paul Richard
Exec VP Fargo
(i)
(ii)
610,766
-------------
0
157,000
-------------
0
96,949
-------------
0
13,250
-------------
0
23,068
-------------
0
901,033
-------------
0
0
-------------
0
34
Randy Bury
Senior VP Operations
(i)
(ii)
610,766
-------------
0
150,000
-------------
0
75,455
-------------
0
0
-------------
0
9,114
-------------
0
845,335
-------------
0
0
-------------
0
35
Randy Bury Deferred Comp
Senior VP Operations
(i)
(ii)
0
-------------
0
0
-------------
0
0
-------------
0
19,065
-------------
0
0
-------------
0
19,065
-------------
0
0
-------------
0
36
Tiffany Lawrence
VP Finance Fargo
(i)
(ii)
330,387
-------------
0
10,300
-------------
0
37,371
-------------
0
13,250
-------------
0
19,598
-------------
0
410,906
-------------
0
0
-------------
0
37
Scott Pham
Physician
(i)
(ii)
2,900,891
-------------
0
0
-------------
0
-4,967
-------------
0
13,250
-------------
0
25,256
-------------
0
2,934,430
-------------
0
0
-------------
0
38
Tomasz P Stys
Physician
(i)
(ii)
2,546,030
-------------
0
0
-------------
0
-924
-------------
0
13,250
-------------
0
22,706
-------------
0
2,581,062
-------------
0
0
-------------
0
39
Adam T Stys
Physician
(i)
(ii)
2,371,907
-------------
0
0
-------------
0
2,405
-------------
0
13,250
-------------
0
22,298
-------------
0
2,409,860
-------------
0
0
-------------
0
40
William C Brunner
Physician
(i)
(ii)
2,648,579
-------------
0
0
-------------
0
-4,403
-------------
0
13,250
-------------
0
22,706
-------------
0
2,680,132
-------------
0
0
-------------
0
41
Timothy Lindley
Physician
(i)
(ii)
2,333,095
-------------
0
0
-------------
0
-6,060
-------------
0
13,250
-------------
0
22,066
-------------
0
2,362,351
-------------
0
0
-------------
0
42
David Link thru 116
Frmr Chief Strategy Officer
(i)
(ii)
11,538
-------------
0
0
-------------
0
4,160,647
-------------
0
0
-------------
0
1,867
-------------
0
4,174,052
-------------
0
0
-------------
0
43
Brenda Larsen
Frmr VP Ops Bsmck thru 12/15
(i)
(ii)
272,774
-------------
0
300
-------------
0
24,544
-------------
0
13,250
-------------
0
25,850
-------------
0
336,718
-------------
0
0
-------------
0
44
Daniel Olson
Frmr Exec VP Bemidji thru 12 15
(i)
(ii)
364,000
-------------
0
0
-------------
0
39,845
-------------
0
13,250
-------------
0
21,729
-------------
0
438,824
-------------
0
0
-------------
0
45
Richard Giesel
Frmr Exec VP Health Netw thru 1/16
(i)
(ii)
6,539
-------------
0
0
-------------
0
881,184
-------------
0
0
-------------
0
0
-------------
0
887,723
-------------
0
0
-------------
0
46
Cecily Tucker
Frmr VP Fin D&R thru 12/12
(i)
(ii)
263,498
-------------
0
300
-------------
0
64,733
-------------
0
13,190
-------------
0
2,748
-------------
0
344,469
-------------
0
0
-------------
0
Schedule J (Form 990) 2016
Schedule J (Form 990) 2016
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
On Part I, Questions Regarding Compensation, Sanford checked several of the items as provided to listed persons: First Class or Charter Travel - Charter travel for business purposes is provided for individuals as needed and as cost appropriate, in accordance with written policies. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford. Travel for Companions - Limited travel for companions is required for certain annual meetings. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford. Tax Indemnification and gross-up payments - Certain compensation may be grossed up to include appropriate tax amounts. Health or social club dues or initiation fees - All Sanford employees are eligible for discounted wellness memberships, a portion of these discounts and other club dues are included as fringe benefits, and taxed as such. Part I, Line 3: The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2017.
Part I, Lines 4a-c
Part I, Line 4a: The following individuals participated in a severance arrangement and received payments during the year: Richard Giesel $881,184. Part I, Line 4b: Certain executives participate in a defined contribution SERP Plan. David Link received a payout from this plan of $4,161,341. Part I, Line 4c: Certain executives participate in a KEYSOP Plan. Cecily Tucker recieved a payout from this plan of $36,560.
Part I, Line 6
Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is based on production.
Part I, Line 7
Certain employees are eligible for a discretionary incentive bonus. Bonuses are paid based on the achievement of financial and other goals.
Schedule J (Form 990) 2016
Additional Data
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