2024-11-12T17:24:27-06:00 2023-12-31 990 2023-01-01 371064809 PROTESTANT MEMORIAL MEDICAL CENTER INC SELF-INSURANCE PROGRAM PROT 3142862057 4500 MEMORIAL DRIVE BELLEVILLE IL 622265399 CHARLES V ROBB VP & CHIEF FINANCIAL OFFICER 6182575602 2024-11-12 1 2023 2024-10-15 13:58:12Z X CHARLES V ROBB 4500 MEMORIAL DRIVE BELLEVILLE IL 622265399 13009822 0 X N/A X 1978 IL PROTESTANT MEMORIAL MEDICAL CENTER, INC.,SELF-INSURANCE PROGRAM PROVIDES FUNDING OF MEDICAL MALPRACTICE CLAIMS AND EXPENSES FOR PROTESTANT MEMORIAL MEDICAL CENTER, INC., A RELATED SEC.501(C)(3) ORGANIZATION. X 16 13 0 0 0 0 0 0 0 0 -142351 457767 0 0 -142351 457767 0 0 0 0 0 0 0 0 0 8588 7947 8588 7947 -150939 449820 8260233 0 0 0 8260233 0 PROTESTANT MEMORIAL MEDICAL CENTER, INC.,SELF-INSURANCE PROGRAM FORMERLY FUNDED THE MEDICAL MALPRACTICE CLAIMS AND EXPENSES AGAINST PROTESTANT MEMORIAL MEDICAL CENTER, INC. A RELATED SEC. 501(C)(3)ORGANIZATION. 0 0 0 0 0 FUNDING OF MEDICAL MALPRACTICE CLAIMS AND EXPENSES 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 16 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X PROTESTANT MEMORIAL MED CENTER INC VP FINANCE 3142862057 4500 MEMORIAL DRIVE BELLEVILLE IL 622265399 MOOSA HANS DIRECTOR 1.00 4.00 X 0 807745 12627 MCMANUS MICHAEL PRESIDENT, DIRECTOR 1.00 40.00 X X 0 582051 48495 RAMOS-PARDO BEATRIZ MD DIRECTOR 1.00 40.00 X 0 368233 5966 COOK KEITH DIRECTOR 1.00 0.00 X 0 0 0 DYER ROB REV DIRECTOR 1.00 0.00 X 0 0 0 GANIM RANDALL DIRECTOR 1.00 0.00 X 0 0 0 HOERING EDWARD DIRECTOR 1.00 0.00 X 0 0 0 JACKSON RACHEL DIRECTOR 1.00 0.00 X 0 0 0 OLIVER STACI DIRECTOR 1.00 0.00 X 0 0 0 PORTER ANN DIRECTOR 1.00 0.00 X 0 0 0 SCHROEDER KURT DIRECTOR 1.00 0.00 X 0 0 0 STEPHENS RONALD DIRECTOR 1.00 0.00 X 0 0 0 BOYER GERI VICE CHAIRMAN, DIRECTOR 1.00 0.00 X X 0 0 0 ECKERT CHRIS VICE CHAIRMAN, DIRECTOR 1.00 0.00 X X 0 0 0 GASSER SUSAN VICE CHAIRMAN, DIRECTOR 1.00 0.00 X X 0 0 0 THAXTON VALERIE CHAIRMAN, DIRECTOR 1.00 0.00 X X 0 0 0 BARTO NICK SR VICE PRESIDENT & CFO 1.00 40.00 X 0 2090557 213003 KOESTERER SUSAN VP FINANCE, SECRETARY 1.00 40.00 X 0 356290 136990 0 4204876 417081 0 0 1 0 0 209069 209069 12800753 12552055 248698 248698 248698 457767 0 0 457767 7947 7947 7947 0 7947 0 0 0 0 0 0 0 0 0 0 0 2276831 0 5983402 0 0 0 0 8260233 0 0 0 X 8260233 0 8260233 0 8260233 0 X 449820 -184871 -8525182 X 0 1 X 1 0 X X 1 PROTESTANT MEMORIAL MEDICAL CENTER INC 370635502 3 1 7947 0 1 7947 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 SCHEDULE A, PART I, LINE 12G SUPPORT PROVIDED TO PROTESTANT MEMORIAL MEDICAL CENTER, INC. ON BEHALF OF ITS SUBSIDIARIES AND AFFILIATES LISTED IN EXHIBIT A OF THE AMENDED AND RESTATED TRUST AGREEMENT FOR PROTESTANT MEMORIAL MEDICAL CENTER INC.,SELF-INSURANCE PROGRAM. 0 1 0 0 0 0 0 0 0 BARTO NICK SR VICE PRESIDENT & CFO 0 1204678 0 820515 0 65364 0 30270 0 182733 0 2303560 0 0 MOOSA HANS DIRECTOR 0 754193 0 46368 0 7184 0 0 0 12627 0 820372 0 0 MCMANUS MICHAEL PRESIDENT, DIRECTOR 0 388244 0 188013 0 5794 0 0 0 48495 0 630546 0 9887 KOESTERER SUSAN VP FINANCE, SECRETARY 0 272865 0 81361 0 2064 0 96272 0 40718 0 493280 0 0 RAMOS-PARDO BEATRIZ MD DIRECTOR 0 298239 0 65150 0 4844 0 0 0 5966 0 374199 0 0 PART I, LINE 4B DURING 2023, THE FOLLOWING INDIVIDUALS RECEIVED SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN PAYMENTS/ACCRUALS FROM THE ORGANIZATION AS REPORTED IN THE DETAILS OF COMPENSATION AND BENEFITS (SEE FORM 990, PART VII AND SCHEDULE J, PART II): BARTO, NICK $181,500 MCMANUS, MICHAEL $49,436 KOESTERER, SUSAN $27,909 PUBLICLY TRADED SECURITIES AND OTHER INVESTMENT ASSETS 2023-11-30 8525182 CURRENT MARKET VALUE OF PUBLICLY TRADED SECURITIES 431617558 BJC HEALTH SYSTEM (DBA BJC HEALTHCARE) 4901 FOREST PARK AVE SUITE 1200 SAINT LOUIS MO 63108 SEC 501(C)(3) 1 1 0 0 1 1 1 1 0 PART I, LINE 2E: PERSON(S) INVOLVED: RANDALL GANIM, NICK BARTO PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: GANIM WAS DIRECTOR OF PROTESTANT MEMORIAL MEDICAL CENTER INC. SELF INSURANCE PROGRAM (TRUST) AND IS CURRENTLY DIRECTOR OF BJC HEALTH SYSTEM.NICK BARTO WAS OFFICER OF PROTESTANT MEMORIAL MEDICAL CENTER INC. SELF INSURANCE PROGRAM (TRUST) AND IS CURRENTLY EXEC VP/CFO/TREASURER OF BJC HEALTH SYSTEM. PART I, LINE 6C: TRUST NOTIFIED FORM 990, PART VI, SECTION B, LINE 11B DIRECTORS OF PROTESTANT MEMORIAL MEDICAL CENTER, INC.,SELF-INSURANCE PROGRAM ARE PROVIDED A COPY OF THE TAX RETURN PRIOR TO FILING. ANY DISCREPANCIES OR QUESTIONS ARE THEN SUBMITTED TO THE VICE PRESIDENT OF FINANCE. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND DIRECTORS OF PROTESTANT MEMORIAL MEDICAL CENTER, INC.,SELF-INSURANCE PROGRAM COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. TRANSACTIONS DISCLOSED ON THE STATEMENTS ARE REVIEWED BY THE BOARD. THE BOARD OR A DUALLY CONSTITUTED COMMITTEE THEREOF SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE UTILIZES THE SERVICES OF AN INDEPENDENT CONSULTANT TO DEVELOP THE HOSPITAL SURVEY DATA TO COMPARE SALARIES AND BENEFITS FOR ALL CORPORATE OFFICERS (CEO AND VICE PRESIDENTS). BASED ON THE SURVEY RESULTS, THE COMPENSATION COMMITTEE ESTABLISHES COMPENSATION FOR THE ENSUING YEAR. FORM 990, PART VI, SECTION C, LINE 18 UPON FILING FORM 990 AND SUPPORTING SCHEDULES, PUBLIC DISCLOSURE COPIES ARE AVAILABLE FOR PUBLIC INSPECTION IN THE OFFICE OF THE PRESIDENT OF PROTESTANT MEMORIAL MEDICAL CENTER, INC.,SELF-INSURANCE PROGRAM DURING REGULAR BUSINESS HOURS OF 8:30 AM-5:00 P.M. COPIES ARE PROVIDED UPON REQUEST FOR A NOMINAL FEE. WRITTEN REQUESTS ARE HONORED WITHIN 30 DAYS. REQUESTS IN PERSON ARE PROVIDED ON THE DAY OF REQUEST. PROTESTANT MEMORIAL MEDICAL CENTER, INC., SELF-INSURANCE PROGRAM PROVIDES FOR PUBLIC INSPECTION THE MOST RECENT THREE YEARS OF FILINGS. FORM 990, PART VI, SECTION C, LINE 19 PROTESTANT MEMORIAL MEDICAL CENTER, INC.,SELF-INSURANCE PROGRAM DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: TRANSFERRED ASSETS TO BJC HEALTH SYSTEM DBA BJC HEALTHCARE -8,525,182. 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