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Nonprofiteer
← WAYNE MEMORIAL HOSPITAL FOUNDATION INC

Form 990 for tax year 2022

Filed by WAYNE MEMORIAL HOSPITAL FOUNDATION INC.

Totals

Total revenue
$664,188
Total expenses
$363,838
Contributions and grants received
$233,270
Grants paid
$54,950
Program service revenue
$142,364
Investment income
$249,375
Other revenue
$39,179
Total assets, end of year
$11,812,629
Total liabilities, end of year
$459,976
Net assets or fund balances, end of year
$11,352,653
Program services expenses (Part IX)
$254,873
Management and general expenses
$108,965
Fundraising expenses
$0
Program service expenses (Part III)
$254,873

Program services were 70.1% 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

    $41,941

  • 1f · All other contributions, gifts and grants

    $191,329

  • 2a · Program service revenue: RENTAL INCOME FROM AFFILIATE

    total $142,273 · related or exempt $142,273

  • 2b · Program service revenue: OTHER REVENUE

    total $91 · related or exempt $91

  • 3 · Investment income

    total $145,228 · excluded $145,228

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0

  • 5 · Royalties

    total $0

  • 6a · Gross rents

    real property $153,753

  • 6b · Less rental expenses

    real property $116,126

  • 6c · Rental income or loss

    real property $37,627 · personal property $0

  • 6d · Net rental income or loss

    total $37,627 · excluded $37,627

  • 7a · Gross sales of assets other than inventory

    securities $1,250,175

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

    securities $1,146,028

  • 7c · Gain or loss

    securities $104,147

  • 7d · Net gain or loss

    total $104,147 · excluded $104,147

  • 8a · Fundraising events: gross income

    $22,182

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

    $41,941

  • 8b · Fundraising events: direct expenses

    $20,630

  • 8c · Net income from fundraising events

    total $1,552 · excluded $1,552

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $0

  • 10c · Net income from sales of inventory

    total $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $54,950 · program services $54,950

  • 2 · Grants to domestic individuals

    total $0

  • 3 · Grants to foreign organizations and individuals

    total $0

  • 4 · Benefits paid to or for members

    total $0

  • 5 · Compensation of officers, directors and key employees

    total $0

  • 6 · Compensation of disqualified persons

    total $0

  • 7 · Other salaries and wages

    total $0

  • 8 · Pension plan contributions

    total $0

  • 9 · Other employee benefits

    total $0

  • 10 · Payroll taxes

    total $0

  • 11a · Fees: management

    total $80,900 · management and general $80,900

  • 11b · Fees: legal

    total $0

  • 11c · Fees: accounting

    total $8,900 · management and general $8,900

  • 11d · Fees: lobbying

    total $0

  • 11e · Fees: professional fundraising services

    total $0

  • 11f · Fees: investment management

    total $0

  • 11g · Fees: other

    total $36,201 · program services $33,034 · management and general $3,167

  • 12 · Advertising and promotion

    total $0

  • 13 · Office expenses

    total $40,267 · program services $36,744 · management and general $3,523

  • 14 · Information technology

    total $0

  • 15 · Royalties

    total $0

  • 16 · Occupancy

    total $79,730 · program services $72,756 · management and general $6,974

  • 17 · Travel

    total $0

  • 18 · Travel or entertainment for public officials

    total $0

  • 19 · Conferences, conventions and meetings

    total $0

  • 20 · Interest

    total $36,000 · program services $32,851 · management and general $3,149

  • 21 · Payments to affiliates

    total $0

  • 22 · Depreciation, depletion and amortization

    total $25,568 · program services $23,332 · management and general $2,236

  • 23 · Insurance

    total $1,322 · program services $1,206 · management and general $116 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $1,910,414 · end of year $2,360,772

  • 3 · Pledges and grants receivable

    beginning of year $562,003 · end of year $157,297

  • 4 · Accounts receivable

    beginning of year $0 · end of year $1,200

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $6,429 · end of year $16,960

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

    $3,811,573

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

    $1,389,817

  • 10c · Land, buildings and equipment, net

    beginning of year $2,464,507 · end of year $2,421,756

  • 11 · Investments: publicly traded securities

    beginning of year $5,769,773 · end of year $6,506,350

  • 12 · Investments: other securities

    beginning of year $300,000 · end of year $300,000

  • 13 · Investments: program-related

    beginning of year $0 · end of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $64,108 · end of year $48,294

  • 17 · Accounts payable and accrued expenses

    beginning of year $3,274 · end of year $4,765

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $33,035

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $445,897 · end of year $422,176

  • 27 · Net assets without donor restrictions

    beginning of year $9,796,926 · end of year $10,822,384

  • 28 · Net assets with donor restrictions

    beginning of year $831,137 · end of year $530,269

Mission and programs · 2022

Mission

WAYNE MEMORIAL HEALTH FOUNDATION WILL DEVELOP, ACQUIRE, AND MANAGE RESOURCES WHICH WILL ASSIST ORGANIZATIONS THAT HELP IMPROVE THE HEALTH STATUS OF THE COMMUNITY.

Activities or mission (Part I)

FUNDRAISING, FUND MANAGEMENT AND RELATED ACTIVITIES TO SUPPORT AND ASSIST RELATED ORGANIZATIONS.

  • DURING THE FOUNDATION'S FISCAL YEAR, JULY 1, 2022 THROUGH JUNE 30, 2023, THE FOUNDATION SUPPORTED ITS MISSION THROUGH SEVERAL ACTIVITIES, INCLUDING GRANTS AND SUPPORT IN VARIOUS WAYS TO WAYNE MEMORIAL HEALTH SYSTEM AND ITS AFFILIATES AND LOCAL ORGANIZATIONS. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.

    Expenses $254,873 · Grants $54,950 · Revenue $142,364

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • James Pettinato

    CEO

    Total calculated
    $386,301
    From this org
    $0
    From related orgs
    $338,430
    Other
    $47,871
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $309,052 related
    Bonus
    $0
    Other
    $0 + $29,378 related
    Deferred
    $0 + $27,610 related
    Nontaxable benefits
    $0 + $20,261 related
    Filer's total
    $0 + $386,301 related

  • Patricia Dunsinger

    CFO

    Total calculated
    $194,873
    From this org
    $0
    From related orgs
    $180,601
    Other
    $14,272
    Hours/week
    2.4 + 37.6 related

    Schedule J breakdown matched by us

    Base
    $0 + $180,601 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $10,895 related
    Nontaxable benefits
    $0 + $3,377 related
    Filer's total
    $0 + $194,873 related

  • Brooke James

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • Cinda Tietjen

    TRUSTEE/VICE CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • Clayton Lacoe

    TREASURER

    Total calculated
    $0
    Hours/week
    0.5

  • Diane Wylam

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • Dr Lauren Rutkowski

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • Jeff Gogoloski

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • Jeff Olsommer

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • Jeffrey Skier

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • Kevin Burke

    TRUSTEE

    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

  • Nancy Propst

    CHAIR

    Total calculated
    $0
    Hours/week
    0.5 + 1.6 related

  • Peter Bochnovich

    ASST SECT/TREAS/SECT

    Total calculated
    $0
    Hours/week
    0.5

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
CEO 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 YEAR THE FOLLOWING CONTRIBUTION WAS MADE: $ 9,310

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.

  • WAYNE HEALTH SERVICES INC

    C-CORPORATION · DME, RENT, PHARM · PA · 99% owned · share of income $1,033,189 · share of assets $2,052,172 · controlled entity

    Directly controlled by WMHF

Provenance

Return type
form_990
Tax year
2022
Filed
15 May 2024
IRS schema version
2022v5.0
Source object
202421369349317652

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