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Nonprofiteer
← MEMORIAL FOUNDATION OF ALLEN HOSPITAL

Form 990 for tax year 2022

Filed by MEMORIAL FOUNDATION OF ALLEN HOSPITAL.

Totals

Total revenue
$5,297,366
Total expenses
$3,645,496
Contributions and grants received
$4,296,572
Grants paid
$2,726,889
Program service revenue
$0
Investment income
$991,761
Other revenue
$9,033
Total assets, end of year
$23,364,359
Total liabilities, end of year
$185,812
Net assets or fund balances, end of year
$23,178,547
Program services expenses (Part IX)
$2,726,889
Management and general expenses
$169,800
Fundraising expenses
$748,807
Program service expenses (Part III)
$2,726,889

Program services were 74.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1c · Fundraising events

    $43,246

  • 1d · Related organizations

    $926,502

  • 1f · All other contributions, gifts and grants

    $3,326,824

  • 1g · Noncash contributions included above

    $391,886

  • 3 · Investment income

    total $504,616 · excluded $504,616

  • 7a · Gross sales of assets other than inventory

    securities $2,147,801

  • 7b · Less cost or other basis and sales expenses

    securities $1,660,656

  • 7c · Gain or loss

    securities $487,145

  • 7d · Net gain or loss

    total $487,145 · excluded $487,145

  • 8a · Fundraising events: gross income

    $9,647

  • 8a · Fundraising events: contributions included on line 1c

    $43,246

  • 8b · Fundraising events: direct expenses

    $7,629

  • 8c · Net income from fundraising events

    total $2,018 · excluded $2,018

  • 9a · Gaming: gross income

    $7,015

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $7,015 · excluded $7,015

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $2,726,889 · program services $2,726,889

  • 7 · Other salaries and wages

    total $555,055 · management and general $83,258 · fundraising $471,797

  • 8 · Pension plan contributions

    total $30,414 · management and general $4,562 · fundraising $25,852

  • 9 · Other employee benefits

    total $63,121 · management and general $9,468 · fundraising $53,653

  • 10 · Payroll taxes

    total $34,387 · management and general $5,158 · fundraising $29,229

  • 11b · Fees: legal

    total $1,850 · fundraising $1,850

  • 11e · Fees: professional fundraising services

    total $56,144 · fundraising $56,144

  • 11f · Fees: investment management

    total $54,368 · management and general $54,368

  • 11g · Fees: other

    total $46,125 · fundraising $46,125

  • 12 · Advertising and promotion

    total $4,791 · fundraising $4,791

  • 13 · Office expenses

    total $6,307 · fundraising $6,307

  • 16 · Occupancy

    total $12,732 · management and general $12,732

  • 17 · Travel

    total $17,149 · fundraising $17,149

  • 19 · Conferences, conventions and meetings

    total $259 · fundraising $259

  • 23 · Insurance

    total $1,874 · fundraising $1,874

  • 24a · Other expenses: MISCELLANEOUS EXPENSE

    total $33,777 · fundraising $33,777

  • 24b · Other expenses: INCOME TAXES

    total $254 · management and general $254

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,763,923 · end of year $1,966,984

  • 2 · Savings and temporary cash investments

    beginning of year $582,564 · end of year $960,276

  • 3 · Pledges and grants receivable

    beginning of year $4,278,297 · end of year $3,877,241

  • 7 · Other notes and loans receivable

    beginning of year $35,538 · end of year $15,929

  • 10a · Land, buildings and equipment: cost or other basis

    $641,874

  • 10b · Land, buildings and equipment: accumulated depreciation

    $22,401

  • 10c · Land, buildings and equipment, net

    beginning of year $299,473 · end of year $619,473

  • 11 · Investments: publicly traded securities

    beginning of year $17,723,104 · end of year $15,579,657

  • 15 · Other assets

    beginning of year $327,730 · end of year $344,799

  • 17 · Accounts payable and accrued expenses

    beginning of year $64,803 · end of year $122,442

  • 25 · Other liabilities

    beginning of year $46,836 · end of year $63,370

  • 27 · Net assets without donor restrictions

    beginning of year $2,029,767 · end of year $1,799,987

  • 28 · Net assets with donor restrictions

    beginning of year $22,869,223 · end of year $21,378,560

Mission and programs · 2022

Mission

ALLEN FOUNDATION STRENGTHENS THE PROGRAMS, SERVICES AND COMMUNITY RELATIONSHIPS OF ALLEN HEALTH SYSTEM.

Activities or mission (Part I)

STRENGTHENS THE PROGRAMS, SERVICES AND COMMUNITY RELATIONSHIPS OF ALLEN HEALTH SYSTEM.

  • Withheld by Nonprofiteer: this text may name a private individual.

    Expenses $2,726,889 · Grants $2,726,889

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here. A text marked withheld matched a screen for wording that may name a private individual, such as an honorific or "in memory of". Most of what it withholds names no one; it is withheld so that what does is never shown.

Listed in Part VII

  • Steve Armbrecht

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Brian Aronson

    BOARD TREASURER/SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • Deb Caughron

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • N Scott Crowley To 0122

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Pamela Delagardelle

    BOARD MEMBER/PRESIDENT/CEO

    Total calculated
    $776,773
    From this org
    $0
    From related orgs
    $671,810
    Other
    $104,963
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $497,754 related
    Bonus
    $0 + $155,204 related
    Other
    $0 + $18,852 related
    Deferred
    $0 + $88,702 related
    Nontaxable benefits
    $0 + $16,261 related
    Filer's total
    $0 + $776,773 related

  • Jeff Guse Arnp

    BOARD MEMBER

    Total calculated
    $293,744
    From this org
    $0
    From related orgs
    $279,596
    Other
    $14,148
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $269,263 related
    Bonus
    $0
    Other
    $0 + $10,333 related
    Deferred
    $0 + $13,810 related
    Nontaxable benefits
    $0 + $338 related
    Filer's total
    $0 + $293,744 related

  • Joan Headington

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Nicholas Hildebrandt

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Wilfred Johnson

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Bob Justis

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Luke Lesyshen

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Helen Melicher

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Donna Miller

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Atul Patel

    BOARD VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • Pradeep Ramesh MD

    BOARD MEMBER

    Total calculated
    $526,126
    From this org
    $0
    From related orgs
    $480,656
    Other
    $45,470
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $432,860 related
    Bonus
    $0 + $47,056 related
    Other
    $0 + $740 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $30,220 related
    Filer's total
    $0 + $526,126 related

  • Lisa Riensche

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Julie Ritland

    BOARD MEMBER

    Total calculated
    $88,603
    From this org
    $0
    From related orgs
    $82,175
    Other
    $6,428
    Hours/week
    1

  • Lance Vanderloo

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    1

  • Robert Yuska

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Mike Lind

    EXECUTIVE DIRECTOR

    Total calculated
    $159,186
    From this org
    $0
    From related orgs
    $136,038
    Other
    $23,148
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $118,091 related
    Bonus
    $0 + $17,887 related
    Other
    $0 + $60 related
    Deferred
    $0 + $5,903 related
    Nontaxable benefits
    $0 + $17,245 related
    Filer's total
    $0 + $159,186 related

  • Zachary French

    VP FINANCE

    Total calculated
    $207,372
    From this org
    $0
    From related orgs
    $192,459
    Other
    $14,913
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $182,277 related
    Bonus
    $0 + $1,977 related
    Other
    $0 + $8,205 related
    Deferred
    $0 + $5,791 related
    Nontaxable benefits
    $0 + $9,122 related
    Filer's total
    $0 + $207,372 related

  • Steven Palmersheim To 1221

    CFO UPC & ACO

    Total calculated
    $480,408
    From this org
    $0
    From related orgs
    $404,542
    Other
    $75,866
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $311,515 related
    Bonus
    $0 + $90,666 related
    Other
    $0 + $2,361 related
    Deferred
    $0 + $47,718 related
    Nontaxable benefits
    $0 + $28,148 related
    Filer's total
    $0 + $480,408 related

  • Dan Carpenter Vp Cso Cfo To 117

    SENIOR VP & CFO-UPH CORP (FR 02/17)

    Total calculated
    $999,529
    From this org
    $0
    From related orgs
    $836,068
    Other
    $163,461
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $619,854 related
    Bonus
    $0 + $198,606 related
    Other
    $0 + $17,608 related
    Deferred
    $0 + $140,839 related
    Nontaxable benefits
    $0 + $22,622 related
    Filer's total
    $0 + $999,529 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 4B
NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED CONTRIBUTIONS IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: DAN CARPENTER $ 125,589, PAMELA DELAGARDELLE $ 73,452, & STEVEN PALMERSHEIM $ 32,468.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • ADVANCED IMAGING CENTER LLC

    DIAGNOSTIC RADIOLOGY CENTER · IA · general or managing partner

  • ANKENY MEDICAL PARK SURGERY CENTER LC

    AMBULATORY SURGERY CENTER · IA · general or managing partner

  • CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC

    CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES · IA · general or managing partner

  • CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY

    ONCOLOGY MANAGEMENT & ADMINISTRATIVE SERVICES · IA · general or managing partner

  • CENTRAL IOWA PHYSIO LLC

    PHYSICAL THERAPY SERVICES · IA · general or managing partner

  • CENTRAL IOWA SURGICAL SERVICES CO-MANAGEMENT CO LLC

    SURGICAL MANAGEMENT & ADMINISTRATIVE SERVICES · IA · general or managing partner

  • DUBUQUE ENDOSCOPY CENTER LC

    AMBULATORY SURGERY CENTER · IA · general or managing partner

  • EASTERN IOWA SLEEP SUPPLY LLC

    MEDICAL EQUIPMENT RETAIL SALES · IA · general or managing partner

  • HEALTH CARE AFFILIATES OF THE TRI-STATES LLC

    PROVIDE ACCESS TO LICENSED SOFTWARE · IA · general or managing partner

  • IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC

    OUTPATIENT DIAGNOSTIC IMAGING · IA · general or managing partner

  • IOWA HEALTH SYSTEM CONTRACTING SERVICES LC

    GROUP PURCHASING · IA · general or managing partner

  • LAKEVIEW SURGERY CENTER LC

    SURGERY CENTER · IA · general or managing partner

  • MR ASSOCIATES LLP

    OWN AND OPERATE MR UNIT · IA · general or managing partner

  • ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC

    AMBULATORY SURGERY CENTER · IA · general or managing partner

  • REHABILITATION THERAPY SERVICES LLC

    REHABILATION THERAPY · IL · general or managing partner

  • THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC

    AMBULATORY SURGERY CENTER. · IA · general or managing partner

  • UNITED MEDICAL PARK ASC LLC DBA THE SURGERY CENTER AT UNITED MEDICAL PARK

    AMBULATORY SURGERY CENTER · IA · general or managing partner

  • UPHT-SCA HOLDINGS LLC

    AMBULATORY SURGERY CENTER INVESTMENT · DE

  • WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC

    ORTHOPEDIC SERVICE LINES MANAGEMENT · IA · general or managing partner

  • WEST LAKES SLEEP CENTER LLC

    SLEEP DISORDER DIAGNOSTIC TESTING FACILITY · IA · general or managing partner

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • ABBE MANAGEMENT CORPORATION

    C · MANAGEMENT SERVICES · IA

  • BELCREST SERVICES LTD

    C · MEDICAL SERVICES · IL

  • BROADBAND INC

    C · INFORMATION TECHNOLOGY MGMT. · IA

  • DELHI POINT CONDO ASSOCIATION

    C · REAL ESTATE MANAGEMENT · IA

  • HCP CORPORATION

    C · REAL ESTATE RENTAL · WI

  • HANSEN CHARITABLE REMAINDER ANNUITY TRUST

    T · INVESTMENT · IA

  • HANSEN CHARITABLE REMAINDER UNITRUST

    T · INVESTMENT · IA

  • HEALTH ADVANTAGE PLUS INC

    C · PHYSICAL THERAPY · IA

  • HEALTH PLUS INC

    C · MANAGED CARE ADMINISTRATION · IL

  • HNC SERVICES

    C · FIBER OPTIC NETWORK SERVICES · IA

  • MEDIMORE INC

    C · MANAGED CARE · IA

  • MERITER HEALTH ENTERPRISES INC

    C · MANAGEMENT SERVICES · WI

  • MERITER MANAGEMENT SERVICES INC

    C · ADMINISTRATIVE SERVICES · WI

  • METHODIST HEALTH VENTURES INC & SUB

    C · PHARMACY/OFFICE STAFFING · IL

  • OPTIMUM HEALTH SOLUTIONS INC

    C · HEALTH & WELLNESS CONSULTING · IA

  • PEKIN PROHEALTH INC

    C · CLINIC · IL

  • PRECEDENCE INC

    C · MANAGED MENTAL CARE · IA

  • PRECEDENCE PLUS INC

    C · MANAGED MENTAL CARE · IA

  • PROVIDER RESOURCE MANAGEMENT INC

    C · RESOURCE MANAGEMENT · IL

  • STL HEALTH RESOURCES CO

    C · PHYSICIAN OFFICE RENTAL · IA

  • TRINITY HEALTH ENTERPRISES INC

    C · RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY · IL

Provenance

Return type
form_990
Tax year
2022
Filed
8 November 2023
IRS schema version
2022v5.0
Source object
202333189349307903

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