Howard Kern retired from Sentara Healthcare in 2021. His payout: $33.2 million. Sentara is a nonprofit. Tax-exempt. A charity.

How does a charity write a $33 million check to its CEO?

A financial instrument called a SERP. A Supplemental Executive Retirement Plan. Your 401(k) limit: $23,000. Executive SERP limit: None.

This episode breaks down the forensic accounting of nonprofit hospital executive compensation:

THE MECHANISM: How SERPs let tax-exempt hospitals stockpile unlimited retirement funds for executives while regular employees hit IRS caps.

THE CONSULTANTS: SullivanCotter, Pearl Meyer, Gallagher. Three firms that create an upward-only benchmarking spiral. Every board aims for the 75th percentile. The spiral only moves up.

THE NONPROFIT PREMIUM: Maurice Smith at HCSC made $34.4 million. Andrew Witty at UnitedHealth made $26.3 million. The nonprofit CEO out-earned the for-profit CEO. With no shareholders. No accountability.

THE FAIR SHARE DEFICIT: $37.4 billion in tax exemptions. 2.3% spent on charity care. Kaiser Permanente alone has a $2.5 billion deficit.

THE PROTECTION RACKET: The AHA spent $29 million on lobbying in 2024. 55% of their lobbyists are former government officials.

This is Form 990 data. Names. Dollar amounts. Receipts.
Based on the "Good at Business" series from The Rojas Report.

Read the full investigation: dutchrojas.substack.com

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