Is Mission Hospitals CEO’s $724,345 pay fair compensation for a non-profit hospital?

Jason Sandford

Jason Sandford is a reporter, writer, blogger and photographer interested in all things Asheville.

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This Wall Street Journal story caught my eye. It notes that an Internal Revenue Service official has warned non-profits to be mindful of executive compensation in the current atmosphere of public anger over big bonuses paid to AIG and other Wall Street companies that have received taxpayer bailout cash.

Here’s the part of the story that caught my attention:

Lois Lerner, the IRS’s director of tax-exempt organizations, told a gathering of lawyers representing charities Monday that scrutiny of nonprofits’ pay practices is likely to increase. …

Ms. Lerner said a recent IRS report on nonprofit hospital pay “raised some eyebrows.” The report, which surveyed 489 institutions, found pay for the top official at nonprofit hospitals averaged $490,000 a year. Among a select 20 hospitals that paid relatively higher amounts, the compensation figure averaged $1.4 million. The IRS declined to name the hospitals.

Nonprofit pay packages pale in comparison to some of those doled out to Wall Street executives. But a series of charity scandals in the past few years has focused attention on executive pay. …

Ms. Lerner of the IRS said the agency’s redesign of charities’ annual tax form – known as Form 990 – will make it easier for people to find information on executive pay. That makes it incumbent for charities to pay close attention to their pay policies, she said. The new form provides “a lot more information” on executive pay, she said.

I decided to look up the 990 tax form of Mission Hospitals to see what its chief executive was paid. I was surprised to see that Joe Damore was paid $724,345. He also received $92,297 in contributions to an employee benefit plan and deferred compensation. There’s probably even more to his compensation package in terms of other perks.

On the form, Mission Hospitals reported $1.2 billion in revenue. Wow.

Other key personnel, and their pay:

Charles Ayscue, CFO: $168,441

Brian Aston, COO: $222,284

Dale Fell, chief medical officer: $388,438

Donald Jennings, chief information officer: $260,218

Maria Roloff, vice president of human resources: $227,742

I’m no expert on non-profits or our health care system. But the more I look at what’s going on, the more questions I have.

How can Mission Hospitals be a “non-profit” with $1.2 billion in revenue?

Why should the massive hospital complex get a free pass on paying taxes?

With people dying because they can’t get access to health care, should Joe Damore be pulling down more than $800,000 in salary and benefits?

How much free health care did Mission Hospitals, a non-profit, give away to the people of Western North Carolina?

Should Mission Hospitals continue to be allowed to operate as a monopolistic company?

I have so many questions, and few answers. But I do know that the health care system in our country is topsy-turvy, and it’s high time that the situation be fixed.

Click here to read the Mission Hospitals 990 tax form for the fiscal year that ended in September 2007, the latest report available. The information is publicly available at


Jason Sandford

Jason Sandford is a reporter, writer, blogger and photographer interested in all things Asheville.

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  1. Vanessa Wingler November 14, 2016

    Why am I not surprised to see Frank Fords name on this list. He and his wife Marcia Ziff, who works at a Concord NC hospital cheated my company out of $8600 when they refused to pay the balance for a remodeling project at their home.

  2. Lance carter January 19, 2016

    Have to commend the dedication of Mission
    staff in spite of frustration with administration
    it never is reflected in their professionalism
    and care.

  3. Mel January 18, 2016

    Seven years ago I worked for Mission as an experienced RN. Turns out that with my of 2 children and a stay-at-home dad, we qualified for food stamps in my full time employment. Looks like the situation had not changed. Unfortunately Mission will continue to hemorrhage well qualified employees and the wonderful people of WNC will suffer less than adequate care. I find it amazing that Ron Paulson claims Mission will discontinue it’s contract with AllCare anesthesia since its a for-profit entity yet continue to gladly accept such large paychecks and ‘incentives’.

  4. Mike O April 21, 2011

    "Donald Jennings" is better known as "Arlo Jennings"

    $260,218 is WAY too much…especially considering he got his "PhD" from a diploma mill !!

  5. high-cost care December 5, 2009

    I must respond to the employees posting to this site. I am a former MSJ employee who was laid off quite unceremoniously over ten years ago during a series of layoffs, through no fault of my own, after more than a decade of dedicated, high-hour, very stressful service in a 10-minute meeting. I was surrounded, while at the hospital, by many people who were ungrateful for the utterly plush salaries and benefits they had along with a handful who were grateful. I never lost the gratitude for what I had while there, even during the most stressful moments. After leaving Mission, I remained in Asheville due to family ties and have had to write a check monthly for absurdly high medical insurance out of pocket, which increases sickeningly every year. The person posting to this site referring to Mission’s “low-cost” medical care is completely out of touch with the financial pain you cause thousands in this community (and millions across the country). This year’s medical insurance notice has informed me, a healthy person, that my monthly premium will be $521.00 a month in January 2010 for one person. My premium (in other words, my “portion” of your demands for compensation) now exceeds my monthly mortgage payment. The equivalent of two car payments. What should be a contribution to an IRA, but is not. I understand now, being on the other side, what I never gave a thought to, I am ashamed to say, when I worked for an excellent salary and benefits at the hospital, i.e. someone actually has to pay for the employees’ salaries/benefits at Mission (premium payers and taxpayers). Individuals making far less money than you. Small business owners who have to cut employees if the remaining ones are to have medical coverage at all. People on fixed incomes, many of whom drop coverage because they simply cannot afford it any more, even though being uncovered is unthinkable today. And God help the unemployed, of which you are not one.

    In any business, the single greatest cost is salaries. You make too much money. It is that simple, and it is true across the country in healthcare. Are there some unfair inequities, such as the difference between a surgeon’s income and a family practice physician’s income? Of course. But the bottom line for most of Mission’s employees is that if you do not stop demanding yearly increases and better benefits, including the ridiculous match, unrivaled in the state, that you already have, socialized medicine will put a stop to it for you, and no sane, intelligent, educated person wants socialized medicine with its catastrophic consequences. Stop complaining, stop demanding, be grateful for what you have, and adjust your lifestyle. I know better than anyone how stressful working at Mission can be, but it could be so much worse. I would have worked for less, and said so. My dreams of a comfortable retirement died the day I was laid off from your hospital.

    1. josh December 18, 2013

      Really? you’re complaining about how high your medical premiums are, and even sympathizing with the unemployed but then call anyone who thinks socialized medicine is a better alternative unintelligent, insane, and uneducated? Perhaps you should educate yourself on it seeing as how every other advanced country has “socialized” medicine and with it better results and lower costs. Hard to feel bad for you and your situation when you made a comment like that

  6. scared September 21, 2009

    I pray mission hospital is unable to acquire the hospital in haywood county.
    I for one like to see competition, not a mission monopoly.
    maybe a UNION for the employees would be an option. Joey Damore would certainley not approve of that.

  7. fed up RN August 25, 2009

    Not that it’s all about money…….while it’s true that staff did not receive any increase in pay this year due to "the current economic crisis and it’s impact on Mission"….let’s be fair, some did receive increases in pay, why just several months ago Mr. Damore himself received a very handsome six figure increase in his salary putting him right around $865,000…..makes a nice foundation for "rebuilding trust" don’t you think?!

  8. foolhardy August 18, 2009

    senior management doesnt understand, there is more to leadership than looking in the rearview mirror at a dashboard

  9. hoping August 13, 2009

    Please do not stop posting peoples responses… are our last hope for a voice!

  10. sideline observer August 11, 2009

    The blame for this travesty runs deep. Certain board members knew of Damore’s record in Michigan, then allowed him to come here and do exactly what he had done there. It’s all going to come out, and it’s going to be ugly. The sad thing is unless action is taken quickly to change the administration, the hospital’s ratings will be at risk, they will lose more key personnel, and AVL will be left with an institution it will take years to rebuild. Up until the last month, the board has totally abrogated its responsibility. They are now stuck with a contract they will have to break to get rid of JD, renewed with the knowledge that the ship was in dire danger because of the administration’s actions referenced above. Unless actions are taken quickly, this will all get out and further denegrate both his and the directors’ images. …and the citizens will (justifiably) start asking questions that certain very prominent board members will be unable to answer to anyone’s (including their own) satisfaction.

  11. anon August 9, 2009

    I am hoping that this forum will reach someone with enough power to begin an investigation into the threatening and intimidating manners of the current senior leadership. You will not have to look hard. Take one day and call in random directors for interviews. You will find a group of intelligent, and caring individuals who are finally left with no recourse except to talk openly to those willing to listen concerning the horrors that they are forced to perpetrate in the names of Joe Damore and Brian Aston. The directors and managers are very afraid of losing their jobs but are at the point where the alternative is nauseating! We are forced to waste our time on the "Joe note of the day" or the "Joe project of the week" in lieu of taking care of our duties to our departmental employees and patients. We are threatened in writing about losing our jobs if we speak in any negative terms about the current administration. We are unable to replace any staff without approval from Brian Aston himself! It takes an excruciating amount of paperwork just to replace someone who has left because they can no longer work these hard shifts with less and less help! Again ask the directors and you will be shown an overwhelming amount of documented evidence to back this statement up. Several directors have already been written up under these trumped up, and completely fabricated "corrective action" documents. You will find many, even vice presidents who were not willing to roll over and stick it to the employees, and were subjected to these types of actions. I implore the board to take the time to come in and talk to the clinical directors and be certain to include ancillary services such as respiratory, lab, physical therapy, radiology, pharmacy, and sleep lab. I think that at the end of the day you will be praying for a good lawyer to get Mission out of the mess that Joe Damore, Brian Aston, Maria Roloff, Kristi Sink, and Frank Ford have gotten this hospital into.

  12. Fed up employee August 9, 2009

    I am shocked that anyone is still shocked at this news! Joe Damore has been allowed, yes allowed, by the board to hire incompetent, non-clinical vice presidents who are destroying every clinical department. The atmosphere is like that of Rome. Plots, and sub plots, devised by this leadership group of individuals ignorant of any true health care experience. Ask Brian Aston how many departments he has "re-aligned" under his command. Unfortunately, he will probably not be able to answer so maybe you should ask him how many he has not "re-aligned." To say there is an environment of distrust is a grand understatement! Trust is a thing of the past for the poor health care employees hanging on at this institution. The vice president of human resources, Maria Roloff, has displayed an indifference to the employees of Mission that, imho, borders on criminal. This gaggle of people who call themselves senior leadership is nothing more than a gang of common thieves. They are stealing this health care institution and driving away it’s incredibly talented workers right out from under the nose of this community. Wake up Asheville and smell the stench that is Joe Damore and his minions!

  13. fed up RN July 16, 2009

    This fine community of Western North Carolina has no idea what’s really going on inside Mission Hospital. What was once a tight knit community of people working to help people has become a dark, sinister place where you don’t know who you can trust. The director and architect of one of this states top, if not the top, trauma departments has recently been forced to resign after committing the past ten years of his life to improving the health, patient outcomes and overall morale of this community. The secretaries at Mission Hospital have not had a raise in ten years, yes I said ten. The RN’s are grossly underpaid which has led to the VA Medical Center being the employer of choice in WNC for experienced nurses. We now have nurses with less than 2 years experience training other nurses. Honestly, if you have a loved one hospitalized at Mission my advice is to not leave them alone, a family member should be present at all times to ensure their safety. I strongly support further investigation into the slimy practices of Joe Damore, CEO and Brian Aston, COO.

  14. Brad June 7, 2009

    It’s called a free market, people!

    Sure, try to attract an experienced healthcare executive to take care of the area’s biggest hospital, offer them $100,000 and see what you get. In the not-for-profit sector, executives can’t get the share options and other performance-based compensation that’s offered by for-profit companies so $800,000 is about the going rate.

    We can’t all be CEO’s and surgeons and most of us choose careers that we know are never going to get these high salaries. It doesn’t give us the right to complain about those who DO get to these positions.

    If you want to vent at someone, try the wealthy talentless rap artists, tv and movie "stars" and recipients of outrageous punitive damages from lawsuits.

    1. Mare February 4, 2012

      This comment is out of context.

  15. Asheville Native June 4, 2009

    It has been over two months since Jordan Schrader’s March 26th Asheville Citizen Times (ACT) article on House Bill 212. The wording of that article and the spin being put on this “pilot program” is just another example of how powerful the Mission Monopoly is and how little interest there is in reporting the truth about health issues in Western North Carolina. Representative Bruce Goforth is the unwitting, dare I say uninformed or even misguided, pawn in the larger war being waged for control of the healthcare market in the greater Asheville area.
    Maybe we should not be too quick to blame Representative Goforth and ACT knowing that Mission is the largest advertiser for the ACT and has used its own financial power to bully the Chamber of Commerce into putting Mission’s CEO, Joe Damore, on its Board of Directors. Few organizations have had the courage that matched the Asheville Buncombe Community Christian Ministries (Mission withdrew its funding when ABCCM decided it was not a good idea to turnover control of its free clinics to Mission). Most local employers and even citizens are reluctant to challenge or even admit the bullying (dare we use the word coercion?) that results from Mission’s financial position in our fair city. Mission’s own Board of Directors cannot be ignorant of the threats delivered by Mission’s executives against local merchants, providers, and other hospitals (check with Chat Norville, retired CEO of Care Partners about his public shouting match with Joe Damore). Mission’s domineering tactics no doubt contributed to its recent rejection of Mission by Haywood Regional Medical Center and WestCare Health Systems.
    House Bill 212 proposes a “pilot project” allowing large employers to pool their money and offer health insurance to smaller companies. This bill is actually designed to give Mission (and its “partners”) a waiver from existing rules and regulations. Association plans have had such poor success in the past that the legislature and the NC Department of Insurance put strict controls into place to protect the citizens of North Carolina from the abuses and losses typical in such plans. In 2008, an association plan failed in Sylva costing the local hospital and physicians over $500,000 in unpaid claims and causing untold misery to the over 200 citizens affected by the untimely demise. However, Mission wants this plan and continues to lobby strongly for a waiver (which means they wanted to break the law). We already suffer because the Attorney General’s office ignores Mission’s continued abuse the Certificate of Public Authority granted as part of the merger of Mission and St. Joseph’s hospitals. Do we really want to give additional power to the Mission Monopoly? For those who did not tune in, on April 22nd, Mr. Damore, on WCQS public radio, stated that competition does not mean lower prices and better quality for healthcare in our community. What this really means is that competition is not good for Mission, a supposedly nonprofit organization.
    Some communications claimed the Asheville City and Buncombe County governments are part of this proposed pool. The facts are that the County made it very clear, in writing, that they wanted no part of this pool. The City, with a direct contract forced on them by Mission, very tactfully stated publicly that they could not see how to finance such a plan within the confines of the current budget and financial climate. The Chamber is reluctant to even present opposing viewpoints from its own membership for fear of losing Mission’s financial support.
    While other insurance carriers stand meekly aside, knowing that eventually they have to renegotiate their contracts, only Blue Cross has come out against Bill 212. Even Blue Cross wouldn’t say exactly what Mission is planning. I shudder to think what will happen if Mission, already with a monopoly on tertiary hospital services in our western counties, is allowed to develop and sell its own, closed shop HMO insurance plan to unwitting small businesses in Western North Carolina. This “pilot project” is simply a stepping stone toward a goal that has been on Mission’s agenda since Mr. Damore’s arrival in 2004.
    I hope you will seek out the facts and form your own opinions. I hope you will perform some actual research on the subject. You might check Mr. Damore’s resume. You definitely should talk to several of the twenty or so large, local physician practices that are being forced to sign provider contracts with Mission against their wishes and better judgment. Even if you can’t get at all the facts, you will at least get a feel for just how intimidated these large, successful businesses are. Mission already directly controls the job future for over 10,000 employees and probably indirectly influences the employment of three times that number of people whose jobs are subject to Mission’s whims? Mission already controls the pricing for tertiary services. Mission’s strategy, designed to allow them to dictate the fees for surgeons, anesthesiologists, radiologists, orthopedics, and other specialists, is well underway. Do we really want to give them control of our health insurance?

  16. citizens of western nc would be surprised if they could see how this hospital spends money and yet the care is not what it used to be; the new administration does not care for employees or patients; they talk of health care reform; if the ceo continues to get this type of salary, who wins; certainly not the patient;

  17. Mad employee April 27, 2009

    We were denied raises in January. They are not hiring to replace employees who have left. We are overworked and underpaid. Patients are not getting the care they deserve because us nurses are stretched thin. We were told they could not afford a raise because their stocks did not do well, but, they continue to spend money. We now have a talking elevator, a $30,000 bed that helps translate from English to Spanish, yes I said a BED! They have also purchased the Matthews Ford property. They are continuing to spend to get the new building up and runnig. We are getting lip service about how "poor" they are. They say these projects were already budgeted for. I say "stop the spending." The recession has not been a surprise, we could see it coming, why couldn’t someone that makes almost a million dollars a year see it coming. The employess at Mission are expendible. Tthe higher ups do not care about employees or patients, only their salary and the bottom line.

  18. jk April 10, 2009

    This region is very fortunate to have Mission Hospital. Be careful you dont kill the goose that lays the golden egg for this community. Take Mission Hospital away and jobs, healthcare, and the economy of the region go to the wayside.

  19. Nonprofit April 9, 2009

    An organization is nonprofit because the board of directors are not compensated for their service and don’t receive a share of the excess revenue over expenses (i.e. profits or dividends).
    Unless they are/do unreasonably, in which case the nonprofit status should be challenged or at least questioned.
    Having a gob of gross revenue does not weaken the nonprofit status. Any organization which has 6,000 employees and treats thousands of patients each year with highly technical equipment and skilled care will have high gross revenues.
    The better question is what are their net revenues over expenses, how are their executives and board members compensated (the issue which you’ve started to cover very well), and what else do they do with all that revenue.
    Having high gross revenues is no problem at all if they are a large organization, and if the way they spend those revenues is necessary and reasonable for their tax-exempt purpose.
    Now, if their net of revenues minus expenses is $1.2 billion, that would be shocking, but I’ll bet this number is the gross revenue.

  20. eemilla April 9, 2009

    Thanks for this tidbit. It is shocking to think that they deserve non-profit status with such a huge profit for one year. Between the hospitals and the insurance companies healthcare will remain poor and inadequate. Much too much is spent on invasive procedures because there is no prevention and discussion between doctor and patient. I normally spend about fifteen minutes once a year with my doctor; with that level of involvement it is ludicrous to expect that doctor should be able to decide the best course of care for me and my body.

  21. Miss Daisy April 8, 2009

    The lack of choice in the area is scary. We might as well have socialized medicine because we don’t have access, choice or service now. The so called health so called care so called system is on the verge of collapse. Thankfully Mission isn’t the worst hospital, but it wouldn’t matter is it was. It’s what we have. Change used to be scary. Now staying the course is scary.

    People get care in the emergency room. They don’t get any preventive care or maintenance. We’ll give someone a kidney transplant once they need one, but we won’t prevent or treat their diabetes. Our health stats are bottom of the barrel for developed countries. Almost third world. We can do better. We don’t turn anyone away but we take care of them in the most inefficient expensive way possible.

    The author is not cherry picking. And Mission does give away a shit ton of care. And we can do better.

  22. Anon April 8, 2009

    From one who has devoted their life to the non-profit field:

    Executive Director pay is usually set by the Board of Directors upon hiring, based on history/experience (which can be manipulated) and is often grossly higher than even the second in command.

    The ED (who should be working the hardest), in my experience, then works fewer hours, enjoys a more flexible schedule, and often cannot be relied upon to do the job he/she was hired to do. The role of an ED is as the mouthpiece of an organization. They should be selling the organization, what it can do and what it has already done, tirelessly drumming up support and $$ for the organization, as well as keeping to Board appraised of the organization’s actions. There are, of course, many exceptions and I am trying not to make a gross exaggeration here. Only report what I’ve seen.

    It is no different than the overpaid CEOs of large corporations, only on a slightly smaller scale. Non-profit does not mean devoid of corruption, it only takes a different from.

  23. Spiffy April 8, 2009

    If you want to know the real score, check out Mission Hospital’s bad debt from people who come in without health insurance of any kind. Poor people, immigrants, new arrivals to the area and others without coverage find care in the emergency room. I’m a fairly low-level employee and I see this occur every day.

    The author is cherry-picking.

  24. Jenny Graves April 8, 2009

    I think readers would find the high salaries paid to executives at the Asheville Chamber of Commerce totally outrageous too.

    CEO Rick Lutovsky reportedly is paid very handsomely for cutting ribbons. There are also a lot of "fat cats"on the payroll of the Chamber who do very little real work for the region.

    Someone should look into the Chamber since the are recipients of county and city funds.

  25. Jenny Graves April 8, 2009

    This is excellent investigative reporting. We will never, ever see such reporting in the Citizen-Times! Great job!

    Not just the CEO’s comp, but the others administrators is way too high as well. I doubt any medical staff members are paid anywhere near that level in WNC practices.

    I am wondering what the hospital’s official response will be to this. Do you plan to follow-up with them, or the Chairman of the Mission Board to ask for justification? Please do so, as the newspaper will certainly not.

  26. Deborah April 8, 2009

    What the eff???
    Too much for a WNC CEO?

    Uh — YEAH!

    Sorry for venting, but I am still paying off bills to Mission from years ago when my daughter broke her leg.

    This was a good one Ash.
    I am shocked, appaled and disgusted.

    No wonder average people can’t afford health care anymore.

    This CEO’s salary is a damn outrage!

  27. tarheel fan April 8, 2009

    The CEO at Carolina’s in Charlotte made $3.5 Million and the one at Novant in Winston makes over $2.5 million Amazing salaries.

  28. Aed April 8, 2009

    Meanwhile Mission employees are having hours cut, overtime cut, hiring freezes (denied by management), and annual wage increases have been put on hold. The employees are being reminded every day that corners are being cut and we should be lucky we still have jobs.

  29. Bryan Freebron April 7, 2009

    i need to change companies.

  30. 007 April 7, 2009

    Would you want that job? I think they are worth the pay. There are so many regulations within the medical field, I would not want that burden on my back.

  31. Information nation April 7, 2009

    How else do you keep from making a profit!!!

  32. Ash April 7, 2009

    not surprising, thanks for your comment, though i wouldn’t necessarily consider this tidbit real reporting. it’s more like me thinking out loud about the possibilities of a local story. but i do think there’s something here. just not sure what.

  33. not suprising April 7, 2009

    Interesting (and disturbing) numbers. Ash.
    You’ve got to ask yourself: Will we ever see this kind of reporting in the local newspaper? No. Because It caters to the hospital for much of its revenue, from employment to its "healthy lifestyle" content. Which is really ironic when you consider the fact that it’s mostly healthy living for the newspaper if catering to the hospital pays off.
    You’re on the edge of local Independent media reporting, Ash.
    Keep it up.


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