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Object ID: 202212249349301441 - Rendered 2024-04-28
TIN: 65-0132406
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
Jupiter Medical Center Foundation Inc
Employer identification number
65-0132406
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
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
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
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) 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
Amit Rastogi MD MHCM
Interim JMCF President (Dec 2020-Aug 2021) / JMC President
(i)
(ii)
0
-------------
554,107
0
-------------
450,000
0
-------------
138,469
0
-------------
4,494
0
-------------
7,451
0
-------------
1,154,521
0
-------------
0
2
LIV VESELY
President JMC Foundation (Thru Dec 2020)
(i)
(ii)
144,600
-------------
0
18,838
-------------
0
324,123
-------------
0
11,541
-------------
0
22,966
-------------
0
522,068
-------------
0
236,102
-------------
0
3
DALE HOCKING
VP & CFO
(i)
(ii)
0
-------------
332,292
0
-------------
125,000
0
-------------
5,637
0
-------------
24,583
0
-------------
23,654
0
-------------
511,166
0
-------------
0
4
Regan Cunningham-Tarpey
Director of Communications & Events
(i)
(ii)
177,307
-------------
0
44,847
-------------
0
335
-------------
0
7,394
-------------
0
38,029
-------------
0
267,912
-------------
0
0
-------------
0
5
ANGELA R SCOTT
DIRECTOR OF DATA ANALYTICS & PROSPECT MANAGEMENT
(i)
(ii)
155,467
-------------
0
29,164
-------------
0
273
-------------
0
6,435
-------------
0
22,032
-------------
0
213,371
-------------
0
0
-------------
0
6
KATHY SULLIVAN
Director of Foundation Administration
(i)
(ii)
145,264
-------------
0
32,395
-------------
0
830
-------------
0
6,044
-------------
0
12,118
-------------
0
196,651
-------------
0
0
-------------
0
7
Laura G Barker
Dir of Major Gifts/Planned Giv
(i)
(ii)
142,807
-------------
0
35,648
-------------
0
167
-------------
0
5,568
-------------
0
150
-------------
0
184,340
-------------
0
0
-------------
0
8
THOMAS J BLISS
Senior Director Major Gifts
(i)
(ii)
141,020
-------------
0
26,078
-------------
0
168
-------------
0
4,664
-------------
0
9,545
-------------
0
181,475
-------------
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
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
THE COMPENSATION COMMITTEE OF THE BOARD OF JUPITER MEDICAL CENTER, INC. DETERMINES THE COMPENSATION OF THE JUPITER MEDICAL CENTER FOUNDATION PRESIDENT. THE COMMITTEE USES AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS, FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH COMPENSATION.
Schedule J, Part I, Line 4a Severance or change-of-control payment
Donald McKenna entered into a severance agreement with Jupiter Medical Center, Inc., a related organization, upon termination of employment. He received total severance payments of $243,034 during calendar year 2020. Liv Vesely entered into a severance agreement with the organization upon termination of employment in December 2020; however, these severance payments did not begin until calendar year 2021.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
THE INDIVIDUALS LISTED BELOW PARTICIPATED IN A RETENTION BONUS PLAN DURING 2020. THESE RETENTION BONUS ARRANGEMENTS ARE TREATED AS DEFERRED COMPENSATION AND ARE TAXED WHEN PAID. THE FOLLOWING INDIVIDUALS RECEIVED PAYOUTS RELATED TO THESE RETENTION BONUS ARRANGEMENTS DURING CALENDAR YEAR 2020. THESE AMOUNTS WERE TAXABLE TO THE INDIVIDUAL AND ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (B)(III): Steven Seeley - $300,000 Liv Vesely - $295,505 THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) PLAN DURING 2020. ACCRUALS INTO THE PLAN DURING CALENDAR YEAR 2020 WERE AS FOLLOWS. THESE AMOUNTS ARE INCLUDED ON SCHEDULE J, PART II, COL (C): AMIT RASTOGI - $4,494 DALE HOCKING - $13,092 STEVEN SEELEY - $13,633 DISTRIBUTIONS OUT OF THE 457(F) PLAN DURING CALENDAR YEAR 2020 WERE AS FOLLOWS. THESE AMOUNTS WERE TAXABLE TO THE INDIVIDUAL AND ARE INCLUDED ON SCHEDULE J, PART II, COL (B)(III): Liv Vesely - $18,838
Schedule J, Part I, Line 7 Non-fixed payments
THE ORGANIZATION OFFERS BONUSES BASED ON THE ACHIEVEMENT OF INDIVIDUAL AND ORGANIZATIONAL GOALS; THIS BONUS IS BASED ON A PERCENTAGE OF BASE SALARY OF THE EMPLOYEE. IN ADDITION, SOME INTERESTED PERSONS RECEIVED AN ADDITIONAL PERFORMANCE BONUS THAT IS NOT BASED ON A FIXED FORMULA.
Schedule J (Form 990) 2020
Additional Data
Software ID:
20011424
Software Version:
2020v4.0