Instrumentl eFile Render
Object ID: 202143159349301799 - Rendered 2024-04-27
TIN: 34-0714585
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
20
Open to Public Inspection
Name of the organization
THE CLEVELAND CLINIC FOUNDATION
Employer identification number
34-0714585
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
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
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) 2020
Schedule J (Form 990) 2020
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
COSGROVE MD DELOS
FORMER CEO (RETIRED)
(i)
(ii)
193,998
-------------
0
0
-------------
0
9,792,211
-------------
0
59,604
-------------
0
0
-------------
0
10,045,813
-------------
0
2,178,355
-------------
0
2
DONLEY MD BRIAN
FORMER OFF, CC LONDON - CEO
(i)
(ii)
0
-------------
955,720
0
-------------
0
0
-------------
1,981,121
0
-------------
28,500
0
-------------
827,115
0
-------------
3,792,456
0
-------------
0
3
MIHALJEVIC MD TOMISLAV
DIRECTOR, PRESIDENT & CEO
(i)
(ii)
3,253,529
-------------
0
0
-------------
0
324,168
-------------
0
28,500
-------------
0
18,025
-------------
0
3,624,222
-------------
0
0
-------------
0
4
MASARYK MD THOMAS
PHYSICIAN (2020 RETIREE)
(i)
(ii)
658,404
-------------
0
0
-------------
0
1,894,761
-------------
0
278,301
-------------
0
18,900
-------------
0
2,850,366
-------------
0
0
-------------
0
5
MCHUGH LINDA
FORMER OFFICER
(i)
(ii)
929,274
-------------
0
0
-------------
0
91,800
-------------
0
1,465,841
-------------
0
17,425
-------------
0
2,504,340
-------------
0
0
-------------
0
6
PIRAINO MD DAVID
PHYSICIAN (2020 RETIREE)
(i)
(ii)
613,579
-------------
0
0
-------------
0
1,711,148
-------------
0
117,265
-------------
0
20,475
-------------
0
2,462,467
-------------
0
0
-------------
0
7
TUZCU MD E MURAT
PHYSICIAN
(i)
(ii)
1,183,506
-------------
0
0
-------------
0
572,884
-------------
0
506,564
-------------
0
126,548
-------------
0
2,389,502
-------------
0
0
-------------
0
8
SURI MD RAKESH
CEO CCAD
(i)
(ii)
1,343,387
-------------
0
0
-------------
0
776,533
-------------
0
28,500
-------------
0
139,448
-------------
0
2,287,868
-------------
0
0
-------------
0
9
SABANEGH MD EDMUND
PRES, CC MAIN CAMPUS, REG HOSPS, FHC
(i)
(ii)
1,028,398
-------------
0
0
-------------
0
102,144
-------------
0
1,078,500
-------------
0
18,168
-------------
0
2,227,210
-------------
0
0
-------------
0
10
SCHILS MD JEAN
PHYSICIAN (2020 RETIREE)
(i)
(ii)
351,723
-------------
0
0
-------------
0
1,498,188
-------------
0
93,258
-------------
0
9,370
-------------
0
1,952,539
-------------
0
0
-------------
0
11
PEACOCK WILLIAM
CHIEF OF OPERATIONS
(i)
(ii)
1,729,990
-------------
0
0
-------------
0
169,591
-------------
0
30,704
-------------
0
17,574
-------------
0
1,947,859
-------------
0
0
-------------
0
12
WIEDEMANN MD HERBERT
DIRECTOR, CHIEF OF STAFF
(i)
(ii)
1,038,369
-------------
0
0
-------------
0
88,263
-------------
0
769,625
-------------
0
19,685
-------------
0
1,915,942
-------------
0
0
-------------
0
13
GLASS STEVEN C
CFO & TREASURER
(i)
(ii)
1,642,654
-------------
0
0
-------------
0
160,194
-------------
0
39,062
-------------
0
18,900
-------------
0
1,860,810
-------------
0
0
-------------
0
14
NAJM MD HANI
PHYSICIAN
(i)
(ii)
1,604,054
-------------
0
0
-------------
0
157,716
-------------
0
28,500
-------------
0
18,900
-------------
0
1,809,170
-------------
0
0
-------------
0
15
SVENSSON MD LARS
FORMER KEY EMPLOYEE - CHAIR HVI
(i)
(ii)
1,583,229
-------------
0
0
-------------
0
160,446
-------------
0
28,500
-------------
0
18,575
-------------
0
1,790,750
-------------
0
0
-------------
0
16
ROWAN DAVID
SECRETARY, CHIEF LEGAL OFF
(i)
(ii)
1,587,718
-------------
0
0
-------------
0
170,103
-------------
0
8,550
-------------
0
18,836
-------------
0
1,785,207
-------------
0
0
-------------
0
17
ERZURUM MD SERPIL
CHIEF RESEARCH & ACADEMIC OFFICER
(i)
(ii)
724,519
-------------
0
0
-------------
0
50,143
-------------
0
439,841
-------------
0
1,250
-------------
0
1,215,753
-------------
0
0
-------------
0
18
HULL MD TRACY
DIRECTOR, PHYSICIAN
(i)
(ii)
614,586
-------------
0
0
-------------
0
39,154
-------------
0
430,259
-------------
0
20,993
-------------
0
1,104,992
-------------
0
0
-------------
0
19
HANCOCK DNP KELLY
CHIEF CAREGIVER OFFICER
(i)
(ii)
940,571
-------------
0
0
-------------
0
90,826
-------------
0
50,971
-------------
0
18,900
-------------
0
1,101,268
-------------
0
0
-------------
0
20
YOUNG MD JAMES P
CHIEF ACADEMIC OFFICER
(i)
(ii)
886,890
-------------
0
0
-------------
0
102,705
-------------
0
28,500
-------------
0
18,164
-------------
0
1,036,259
-------------
0
0
-------------
0
21
MALONE JR MD DONALD
PRES, OHIO HOSPITALS & FHCS
(i)
(ii)
495,008
-------------
0
0
-------------
0
46,988
-------------
0
355,410
-------------
0
18,325
-------------
0
915,731
-------------
0
0
-------------
0
22
HAMILTON THOMAS
FORMER OFFICER
(i)
(ii)
461,225
-------------
0
0
-------------
0
33,216
-------------
0
175,520
-------------
0
19,829
-------------
0
689,790
-------------
0
0
-------------
0
23
DAVIS MARLEINA
ASST. SECRETARY
(i)
(ii)
553,404
-------------
0
0
-------------
0
28,025
-------------
0
45,182
-------------
0
17,650
-------------
0
644,261
-------------
0
0
-------------
0
24
LONGVILLE TIMOTHY
CAO & CONTROLLER
(i)
(ii)
475,361
-------------
0
0
-------------
0
21,903
-------------
0
97,516
-------------
0
19,778
-------------
0
614,558
-------------
0
0
-------------
0
25
MODLIN MD CHARLES
DIRECTOR (PART YR), PHYSICIAN
(i)
(ii)
414,832
-------------
0
0
-------------
0
17,393
-------------
0
28,500
-------------
0
18,722
-------------
0
479,447
-------------
0
0
-------------
0
26
FOLDVARY-SCHAEFER MD NANCY
DIRECTOR, PHYSICIAN
(i)
(ii)
420,882
-------------
0
0
-------------
0
13,405
-------------
0
22,062
-------------
0
17,472
-------------
0
473,821
-------------
0
0
-------------
0
27
MEEHAN MICHAEL J
RECORDING SECRETARY
(i)
(ii)
350,061
-------------
0
0
-------------
0
41,519
-------------
0
40,947
-------------
0
18,293
-------------
0
450,820
-------------
0
0
-------------
0
28
OBLANDER JASON
ASST. SECRETARY
(i)
(ii)
240,828
-------------
0
0
-------------
0
6,885
-------------
0
9,094
-------------
0
16,541
-------------
0
273,348
-------------
0
0
-------------
0
Schedule J (Form 990) 2020
Schedule J (Form 990) 2020
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
LISTED BENEFITS THE BENEFITS CHECKED IN PART I, QUESTION 1A, WERE PROVIDED TO CERTAIN PERSONS LISTED IN FORM 990, PART VII, SECTION A ON AN EXCEPTION BASIS ONLY FOR AN APPROPRIATE BUSINESS PURPOSE. ANY REIMBURSEMENT OF THE EXPENSES LISTED MET CLEVELAND CLINIC'S WRITTEN POLICY REGARDING SUBSTANTIATION AND REIMBURSEMENT. WHERE REQUIRED BY IRS RULES AND REGULATIONS, THE LISTED BENEFITS WERE INCLUDED IN TAXABLE INCOME.
PART I, LINES 4A-B
SCHEDULE J, PART I, LINE 4A, SEVERANCE PAYMENTS: SEVERANCE PAYMENTS ACCRUED IN 2020 BUT NOT YET PAID ARE REPORTED IN PART VII, COLUMN F AND SCHEDULE J, PART II, COLUMN C FOR THE FOLLOWING INDIVIDUALS: LINDA MCHUGH - $1,425,000 EDMUND SABANEGH, MD - $1,050,000 SCHEDULE J, PART I, LINE 4B, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THOMAS MASARYK, MD - PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. FOR MEDICARE TAX PURPOSES, $1,848,215 OF INCOME REPORTED IN PART VII AND SCHEDULE J REPRESENTS THE AMOUNT VESTED IN THE PLAN. DAVID PIRAINO, MD - PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. FOR MEDICARE TAX PURPOSES, $1,646,814 OF INCOME REPORTED IN PART VII AND SCHEDULE J REPRESENTS THE AMOUNT VESTED IN THE PLAN. JEAN SCHILS, MD - PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. FOR MEDICARE TAX PURPOSES, $1,475,988 OF INCOME REPORTED IN PART VII AND SCHEDULE J REPRESENTS THE AMOUNT VESTED IN THE PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN AND RECEIVED PAYMENTS FROM SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS: DELOS COSGROVE, MD - $2,178,355 JEAN SCHILS, MD - $44,622 THE FOLLOWING INDIVIDUALS PARTICIPATE IN A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN AND/OR A QUALIFIED DEFINED BENEFIT PLAN AND THE ANNUAL INCREASE OR DECREASE IN THE ACTUARIAL VALUE IS INCLUDED IN SCHEDULE J, PART II, COLUMN C, RETIREMENT AND OTHER DEFERRED COMPENSATION: DELOS M. COSGROVE, MD - $59,604 INCREASE, MARLEINA DAVIS - $17,032 INCREASE, SERPIL ERZURUM, MD - $411,341 INCREASE, STEVEN GLASS - $10,562 INCREASE, THOMAS HAMILTON - $147,020 INCREASE, KELLY HANCOCK - $22,471 INCREASE, TRACY HULL, MD - $401,759 INCREASE, TIMOTHY LONGVILLE - $64,948 INCREASE, DONALD MALONE, MD - $326,910 INCREASE, THOMAS MASARYK - 249,801 INCREASE, LINDA MCHUGH - $12,341 INCREASE, MICHAEL J. MEEHAN - $12,447 INCREASE, E. MURAT TUZCU, MD - $478,064 INCREASE, JASON OBLANDER - $1,664 INCREASE, WILLIAM PEACOCK $2,204 INCREASE, DAVID PIRAINO, MD - $88,765 INCREASE, JEAN SCHILS, MD - $65,508 INCREASE AND HERBERT WIEDEMANN, MD - $741,125 INCREASE. FORM 990, PART VII, SECTION A AND SCHEDULE J THE COMPENSATION OF DR. BRIAN DONLEY AND DR. E. MURAT TUZCU AS REPORTED ON PART VII, SECTION A AND SCHEDULE J INCLUDES REGULAR WAGES AND TAXABLE EXPATRIATE BENEFITS. DR. DELOS COSGROVE'S COMPENSATION AS REPORTED ON PART VII, SECTION A AND SCHEDULE J INCLUDES AN AMOUNT RELATED TO THE FORGIVENESS OF A LOAN ON A SPLIT DOLLAR LIFE INSURANCE PLAN, AS APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS.
Schedule J (Form 990) 2020
Additional Data
Software ID:
Software Version: