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← WAYNE MEMORIAL HOSPITAL FOUNDATION INC

Form 990 for tax year 2023

Filed by WAYNE MEMORIAL HOSPITAL FOUNDATION INC.

Totals

Total revenue
$766,549
Total expenses
$396,022
Contributions and grants received
$307,573
Grants paid
$190,000
Program service revenue
$0
Investment income
$477,168
Other revenue
-$18,192
Total assets, end of year
$12,707,675
Total liabilities, end of year
$418,788
Net assets or fund balances, end of year
$12,288,887
Program services expenses (Part IX)
$284,833
Management and general expenses
$111,189
Fundraising expenses
$0
Program service expenses (Part III)
$284,833

Program services were 71.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • CINDA TIETJEN

    TRUSTEE/VICE CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • JEFF GOGOLSKI

    TREASURER

    Total calculated
    $0
    Hours/week
    0.5

  • KEVIN BURKE

    ASS'T SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    0.5

  • NANCY PROPST

    CHAIR

    Total calculated
    $0
    Hours/week
    0.5 + 1.6 related

  • PETER BOCHNOVICH

    SECRETARY

    Total calculated
    $0
    Hours/week
    0.5

  • ANTHONY FRIGOLLETTO

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • BRENDAN MURRAY

    INTERNAL TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5 + 0.5 related

  • BROOKE JAMES

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • DIANE WYLAM

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • DR LAUREN RUTKOWSKI

    TRUSTEE END 04/24

    Total calculated
    $0
    Hours/week
    0.5

  • GARY SMEDLEY

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • JEFF OLSOMMER

    TRUSTEE END 06/24

    Total calculated
    $0
    Hours/week
    0.5

  • LEONARD SCHWARTZ

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • MARTHA WILSON

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • JAMES PETTINATO

    CEO

    Total calculated
    $371,905
    From this org
    $0
    From related orgs
    $324,954
    Other
    $46,951
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $302,454 related
    Bonus
    $0
    Other
    $0 + $22,500 related
    Deferred
    $0 + $25,500 related
    Nontaxable benefits
    $0 + $21,451 related
    Filer's total
    $0 + $371,905 related

  • PATRICIA DUNSINGER

    CFO

    Total calculated
    $229,520
    From this org
    $0
    From related orgs
    $217,115
    Other
    $12,405
    Hours/week
    2.4 + 37.6 related

    Schedule J breakdown matched by us

    Base
    $0 + $217,115 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $12,405 related
    Nontaxable benefits
    $0
    Filer's total
    $0 + $229,520 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)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
WAYNE MEMORIAL HEALTH SYSTEM, A RELATED ORGANIZATION, DETERMINES THE COMPENSATION OF THE CEO USING THE FOLLOWING METHODS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE BOARD MAKES THE FINAL DECISION USING THE INFORMATION PROVIDED BY THE CONSULTANT.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
WAYNE MEMORIAL HEALTH SYSTEM, A RELATED ORGANIZATION, COVERS JAMES PETTINATO WITH A 457(F) SUPPLEMENTAL RETIREMENT AGREEMENT (SERP). IN THE CURRENT CALENDAR YEAR ENDING WITHIN THE ORGANIZATION'S FISCAL YEAR THE FOLLOWING CONTRIBUTION WAS MADE: $7,500

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 corporations and trusts

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

Provenance

Return type
form_990
Tax year
2023
Filed
15 May 2025
IRS schema version
2023v6.0
Source object
202521359349312537

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