Instrumentl eFile Render
Object ID: 202233159349304188 - Rendered 2024-05-03
TIN: 43-1747502
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
21
Open to Public Inspection
Name of the organization
Saint Lukes Health System Inc
Employer identification number
43-1747502
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) 2021
Schedule J (Form 990) 2021
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
GINA LAWSON DO
FORMER VP
(i)
(ii)
0
-------------
636,266
0
-------------
106,848
0
-------------
54,431
0
-------------
61,598
0
-------------
28,580
0
-------------
887,722
0
-------------
0
2
MELINDA ESTES MD
DIRECTOR- PRESIDENT & CEO
(i)
(ii)
1,749,692
-------------
0
975,159
-------------
0
259,050
-------------
0
273,136
-------------
0
24,061
-------------
0
3,281,098
-------------
0
213,225
-------------
0
3
RYAN MCNELLIS MD
DIRECTOR
(i)
(ii)
0
-------------
302,113
0
-------------
35,617
0
-------------
886
0
-------------
15,950
0
-------------
31,702
0
-------------
386,268
0
-------------
0
4
MARIE GRIFFIN MD
DIRECTOR
(i)
(ii)
0
-------------
295,340
0
-------------
39,000
0
-------------
1,893
0
-------------
15,950
0
-------------
10,204
0
-------------
362,387
0
-------------
0
5
A MICHAEL BORKON
DIRECTOR
(i)
(ii)
0
-------------
931,344
0
-------------
21,000
0
-------------
658,987
0
-------------
38,500
0
-------------
14,933
0
-------------
1,664,764
0
-------------
0
6
TAYLOR WARWICK
FORMER VP AMBULATORY SERVICES TERM END 3/19
(i)
(ii)
0
-------------
294,804
0
-------------
84,284
0
-------------
19,036
0
-------------
35,651
0
-------------
21,938
0
-------------
455,714
0
-------------
16,000
7
JAMIE LUARK
VP EDUCATION
(i)
(ii)
245,359
-------------
0
71,864
-------------
0
24,856
-------------
0
42,390
-------------
0
22,114
-------------
0
406,582
-------------
0
18,000
-------------
0
8
CYNTHIA CHRISTENSEN
VP CONTROLLER
(i)
(ii)
304,128
-------------
0
79,625
-------------
0
40,659
-------------
0
51,851
-------------
0
12,390
-------------
0
488,653
-------------
0
23,762
-------------
0
9
CHARLES V ROBB
SENIOR VP & CFO
(i)
(ii)
671,852
-------------
0
311,608
-------------
0
439,783
-------------
0
558,589
-------------
0
25,058
-------------
0
2,006,889
-------------
0
198,847
-------------
0
10
DEBORAH GASH
SENIOR VP CHIEF DIGITAL OFFICER
(i)
(ii)
493,327
-------------
0
242,808
-------------
0
58,542
-------------
0
156,550
-------------
0
24,420
-------------
0
975,647
-------------
0
96,767
-------------
0
11
J CHRIS PERRYMAN MD
SENIOR VP CHIEF MEDICAL OFFICER
(i)
(ii)
0
-------------
577,800
0
-------------
127,541
0
-------------
186,825
0
-------------
64,300
0
-------------
11,533
0
-------------
967,998
0
-------------
0
12
DIANE TRIMBLE
CHIEF NURSING OFFICER
(i)
(ii)
372,696
-------------
0
140,255
-------------
0
48,866
-------------
0
122,356
-------------
0
24,133
-------------
0
708,306
-------------
0
27,724
-------------
0
13
DORIS ROGERS
SENIOR VP HUMAN RESOURCES
(i)
(ii)
402,238
-------------
0
134,525
-------------
0
33,901
-------------
0
118,764
-------------
0
28,529
-------------
0
717,957
-------------
0
18,775
-------------
0
14
DENISE MOGG
VP CAPACITY MGMT RETIRED 8/2021
(i)
(ii)
200,769
-------------
0
73,914
-------------
0
75,690
-------------
0
5,800
-------------
0
1,617
-------------
0
357,790
-------------
0
19,044
-------------
0
15
JULIE QUIRIN
SENIOR VP HOSPITAL OPERATIONS
(i)
(ii)
781,766
-------------
0
380,989
-------------
0
131,419
-------------
0
287,290
-------------
0
23,220
-------------
0
1,604,683
-------------
0
197,038
-------------
0
16
TIMOTHY VAN ZANDT
VP PUBLIC AFFAIRS
(i)
(ii)
293,501
-------------
0
87,314
-------------
0
30,328
-------------
0
39,383
-------------
0
14,324
-------------
0
464,851
-------------
0
21,981
-------------
0
17
DAVID SAFLEY
VP-MEDICAL AFFAIRS QUALITY
(i)
(ii)
0
-------------
532,737
0
-------------
52,000
0
-------------
2,088
0
-------------
17,400
0
-------------
26,745
0
-------------
630,971
0
-------------
0
18
SHELBY FRIGON
VP REVENUE CYCLE
(i)
(ii)
302,181
-------------
0
79,625
-------------
0
24,430
-------------
0
39,950
-------------
0
30,741
-------------
0
476,927
-------------
0
20,000
-------------
0
19
GREG TEALE
VP PHARMACY
(i)
(ii)
258,720
-------------
0
58,250
-------------
0
1,710
-------------
0
32,984
-------------
0
30,323
-------------
0
381,987
-------------
0
0
-------------
0
20
MIKHAIL KOSIBOROD MD
VP RESEARCH
(i)
(ii)
0
-------------
839,487
0
-------------
2,000
0
-------------
2,292
0
-------------
15,950
0
-------------
29,509
0
-------------
889,238
0
-------------
0
21
MICHAEL MAIN MD
SENIOR VP
(i)
(ii)
0
-------------
672,439
0
-------------
102,000
0
-------------
12,991
0
-------------
18,850
0
-------------
13,127
0
-------------
819,407
0
-------------
0
22
JEREMY BECHTOLD
VP FACILITIES & CONSTRUCTION
(i)
(ii)
283,938
-------------
0
86,864
-------------
0
23,625
-------------
0
37,810
-------------
0
27,257
-------------
0
459,494
-------------
0
19,933
-------------
0
23
KAREN KRAMER
VP FINANCE
(i)
(ii)
320,202
-------------
0
87,389
-------------
0
25,908
-------------
0
37,954
-------------
0
19,717
-------------
0
491,169
-------------
0
22,000
-------------
0
24
REBECCA SESLER
CHIEF MARKETING OFFICER
(i)
(ii)
340,438
-------------
0
107,000
-------------
0
46,876
-------------
0
94,356
-------------
0
30,209
-------------
0
618,879
-------------
0
24,840
-------------
0
25
MAGGIE NEUSTADT
VP RISK & CLAIMS MGMT
(i)
(ii)
264,370
-------------
0
73,415
-------------
0
1,676
-------------
0
34,115
-------------
0
17,324
-------------
0
390,900
-------------
0
0
-------------
0
26
JANE PECK
VP CLINICAL SERVICE LINES
(i)
(ii)
0
-------------
380,000
0
-------------
102,914
0
-------------
38,431
0
-------------
43,450
0
-------------
3,026
0
-------------
567,821
0
-------------
0
27
MICHAEL DARLING
VP SUPPLY CHAIN
(i)
(ii)
318,746
-------------
0
92,000
-------------
0
31,024
-------------
0
37,770
-------------
0
34,296
-------------
0
513,837
-------------
0
19,338
-------------
0
28
JAN MURRAY
SENIOR VP, CHIEF LEGAL OFFICER
(i)
(ii)
666,295
-------------
0
323,828
-------------
0
209,060
-------------
0
92,788
-------------
0
11,849
-------------
0
1,303,819
-------------
0
81,188
-------------
0
29
LINDSEY STRINGER
VP PLANNING
(i)
(ii)
168,030
-------------
0
27,500
-------------
0
605
-------------
0
20,988
-------------
0
8,964
-------------
0
226,087
-------------
0
0
-------------
0
30
PAIGE STRACK
VP ETHICS & COMPLIANCE
(i)
(ii)
261,582
-------------
0
2,000
-------------
0
1,393
-------------
0
31,995
-------------
0
10,821
-------------
0
307,791
-------------
0
0
-------------
0
31
RANDAL MEYER
VP MGD CARE CONTRACTING
(i)
(ii)
347,615
-------------
0
92,000
-------------
0
28,110
-------------
0
39,600
-------------
0
32,817
-------------
0
540,142
-------------
0
21,840
-------------
0
32
MICHAEL VANDERHOEF
SENIOR VP DEVELOPMENT
(i)
(ii)
71,421
-------------
0
169,035
-------------
0
56,528
-------------
0
5,800
-------------
0
6,786
-------------
0
309,569
-------------
0
89,011
-------------
0
33
MARGARET DONNELLY
VP POST ACUTE CARE SERVICES
(i)
(ii)
302,756
-------------
0
88,940
-------------
0
34,425
-------------
0
36,400
-------------
0
23,901
-------------
0
486,421
-------------
0
22,400
-------------
0
34
LAEL HOLLOWAY
VP INTERNAL AUDIT
(i)
(ii)
291,962
-------------
0
2,000
-------------
0
20,133
-------------
0
31,771
-------------
0
29,678
-------------
0
375,544
-------------
0
16,400
-------------
0
35
JOHN WOOD
VP CHIEF OPERATIONAL TRANSFORMATION
(i)
(ii)
381,994
-------------
0
110,675
-------------
0
2,958
-------------
0
41,450
-------------
0
27,680
-------------
0
564,756
-------------
0
0
-------------
0
36
DAPHNE BASCOM MD
VP POPULATION HEALTH
(i)
(ii)
0
-------------
450,930
0
-------------
100,973
0
-------------
9,457
0
-------------
47,846
0
-------------
10,929
0
-------------
620,136
0
-------------
0
37
EMILY FALKENRATH
VP QUALITY, PATIENT SFTY, REGULATORY
(i)
(ii)
140,481
-------------
0
2,000
-------------
0
625
-------------
0
2,113
-------------
0
25,754
-------------
0
170,974
-------------
0
0
-------------
0
38
MICHELLE RENNOLDS
VP-CAPACITY MGMT
(i)
(ii)
70,362
-------------
83,040
0
-------------
0
0
-------------
409
0
-------------
8,026
2,226
-------------
16,588
72,588
-------------
108,063
0
-------------
0
39
ROGER ZAREMBA
CHIEF TECHNOLOGY OFFICER
(i)
(ii)
261,347
-------------
0
60,127
-------------
0
2,079
-------------
0
15,950
-------------
0
31,795
-------------
0
371,297
-------------
0
0
-------------
0
40
JOSEPH OMALLEY
ASSOC CHIEF INFORMATION OFFICER
(i)
(ii)
235,360
-------------
0
49,954
-------------
0
1,289
-------------
0
18,850
-------------
0
23,529
-------------
0
328,982
-------------
0
0
-------------
0
41
JAMIE ALLEN
SENIOR COUNSEL
(i)
(ii)
295,930
-------------
0
64,939
-------------
0
2,346
-------------
0
36,100
-------------
0
15,261
-------------
0
414,575
-------------
0
0
-------------
0
42
COURTNEY STARNES
ASSOC CHIEF INFORMATION OFFICER
(i)
(ii)
225,255
-------------
0
49,954
-------------
0
554
-------------
0
11,204
-------------
0
16,372
-------------
0
303,339
-------------
0
0
-------------
0
43
DAVID MADDOX
CHIEF INFORMATION OFFICER SECURITY
(i)
(ii)
262,604
-------------
0
52,430
-------------
0
1,392
-------------
0
11,600
-------------
0
21,155
-------------
0
349,181
-------------
0
0
-------------
0
Schedule J (Form 990) 2021
Schedule J (Form 990) 2021
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 4a Severance or change-of-control payment
SEVERANCE PAYMENT INCLUDED IN SCH J, PART II, B(III) OTHER REPORTABLE COMPENSATION: MICHAEL BORKON - $658,987
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
457(F) PARTICIPANT AND AMOUNT INCLUDED IN COLUMN C FOR THE PLAN: CHARLES ROBB: $452,179 JULIE QUIRIN: $59,086 MELINDA ESTES: $0 FOR THE VARIOUS 457(F) PLANS, A PARTICIPANT'S BENEFIT IS PAID AT VESTING. VESTING GENERALLY OCCURS AT RETIREMENT AGE AND MAY BE SUBJECT TO CERTAIN RESTRICTIVE COVENANTS.
Schedule J, Part I, Line 7 Non-fixed payments
THE ORGANIZATION HAS ADOPTED A MANAGEMENT INCENTIVE COMPENSATION PLAN FOR CERTAIN MEMBERS OF SENIOR AND MIDDLE MANAGEMENT TO PROMOTE EFFECTIVE MANAGEMENT OF OPERATIONS, QUALITY OF CARE AND SERVICE, AND OPTIMAL USE OF RESOURCES. THE INCENTIVES ARE CALCULATED AS A PERCENTAGE OF BASE SALARY CONTINGENT ON ACHIEVING QUALITY, PATIENT SATISFACTION, EMPLOYEE ENGAGEMENT, FINANCIAL AND OTHER OPERATIONAL PERFORMANCE TARGETS ESTABLISHED BY THE BOARD'S COMPENSATION COMMITTEE ON AN ANNUAL BASIS. INCENTIVE AWARDS ARE PAID AT THE DISCRETION OF THE BOARD OF DIRECTORS AND DO NOT ACCRUE TO THE BENEFIT OF THE INDIVIDUALS UNTIL AFTER FINANCIAL RESULTS HAVE BEEN DETERMINED FOR THE CALENDAR YEAR. THIS INCENTIVE COMPENSATION IS EVALUATED AS PART OF THE REVIEW OF MARKET COMPETITIVE DATA AND REASONABLENESS OF OVERALL COMPENSATION AND BENEFITS. SENIOR SYSTEM MANAGEMENT IS ALSO ELIGIBLE FOR INCENTIVE COMPENSATION FOR ACHIEVING LONG-TERM GOALS THAT PROMOTE EFFECTIVE MANAGEMENT OF OPERATIONS, QUALITY OF CARE AND SERVICE, AND OPTIMAL USE OF RESOURCES IN MEETING COMMUNITY NEEDS. THESE INCENTIVES ARE TIED TO 3 YEAR PERFORMANCE CYCLES AND ARE CALCULATED AS A PERCENTAGE OF BASE SALARY AT THE TIME OF PAYMENT. THE BOARD OF DIRECTORS OVERSEES THIS PLAN AND EVALUATES THE COMPENSATION FOR REASONABLENESS. THIS INCENTIVE COMPENSATION IS EVALUATED AS PART OF THE REVIEW OF MARKET COMPETITIVE DATA AND REASONABLENESS OF OVERALL COMPENSATION AND BENEFITS.
Schedule J, Part II RELATED ORG COMPENSATION
TAYLOR WARWICK AND GINA LAWSON RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS FOR SERVICES RENDERED TO THE RELATED ORGANIZATIONS. MARIE GRIFFIN, MICHAEL BORKON, AND RYAN MCNELLIS DID NOT RECEIVE COMPENSATION FOR DUTIES AS DIRECTORS OF THE FILING ORGANIZATION BUT RECEIVED COMPENSATION FROM RELATED ORGANIZATIONS FOR SERVICES RENDERED TO THE RELATED ORGANIZATIONS. J. CHRIS PERRYMAN, DAVID SAFLEY, MIKHAIL KOSIBOROD, JANE PECK, MICHAEL MAIN AND DAPHNE BASCOM RECEIVED COMPENSATION FROM A RELATED ORGANIZATION FOR SERVICES RENDERED TO THE FILING ORGANIZATION AND THE RELATED ORGANIZATION. Michael VanDerhoef is compensated by the organization for services provided TO THE FILING ORGANIZATION AND THE RELATED ORGANIZATION.
Schedule J (Form 990) 2021
Additional Data
Software ID:
21014044
Software Version:
2021v4.2