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Nonprofiteer
← HOSPITAL SISTERS HEALTHCARE-WEST INC

Form 990 for tax year 2022

Filed by HOSPITAL SISTERS HEALTHCARE-WEST INC.

Totals

Total revenue
$1,072,248
Total expenses
$863,075
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$695,959
Management and general expenses
$167,116
Fundraising expenses
$0
Program service expenses (Part III)
$695,959

Program services were 80.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ANDREW J BAGNALL

    Chair & Division CEO - Wisconsin (until 11/1/22)

    Total calculated
    $875,624
    From this org
    $0
    From related orgs
    $842,889
    Other
    $32,735
    Hours/week
    0.3 + 59.8 related

    Schedule J breakdown matched by us

    Base
    $0 + $416,871 related
    Bonus
    $0 + $146,870 related
    Other
    $0 + $279,148 related
    Deferred
    $0 + $5,318 related
    Nontaxable benefits
    $0 + $27,417 related
    Filer's total
    $0 + $875,624 related

  • JOHN WAGNER

    CEO/PRESIDENT - SJCF

    Total calculated
    $495,914
    From this org
    $0
    From related orgs
    $396,392
    Other
    $99,522
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $286,504 related
    Bonus
    $0 + $80,804 related
    Other
    $0 + $29,084 related
    Deferred
    $0 + $67,058 related
    Nontaxable benefits
    $0 + $32,464 related
    Filer's total
    $0 + $495,914 related

  • BRIAN CHARLIER

    BOARD MEMBER

    Total calculated
    $973,920
    From this org
    $0
    From related orgs
    $837,002
    Other
    $136,918
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $606,838 related
    Bonus
    $0 + $103,319 related
    Other
    $0 + $126,845 related
    Deferred
    $0 + $111,693 related
    Nontaxable benefits
    $0 + $25,225 related
    Filer's total
    $0 + $973,920 related

  • PATRICIA ALLEN

    Division CFO - Wisconsin

    Total calculated
    $695,496
    From this org
    $0
    From related orgs
    $541,100
    Other
    $154,396
    Hours/week
    3 + 57 related

    Schedule J breakdown matched by us

    Base
    $0 + $414,598 related
    Bonus
    $0 + $44,684 related
    Other
    $0 + $81,818 related
    Deferred
    $0 + $126,563 related
    Nontaxable benefits
    $0 + $27,833 related
    Filer's total
    $0 + $695,496 related

  • TODD Smart

    Treasurer

    Total calculated
    $410,831
    From this org
    $0
    From related orgs
    $329,569
    Other
    $81,262
    Hours/week
    0.3 + 59.8 related

    Schedule J breakdown matched by us

    Base
    $0 + $267,686 related
    Bonus
    $0 + $38,335 related
    Other
    $0 + $23,548 related
    Deferred
    $0 + $45,254 related
    Nontaxable benefits
    $0 + $36,008 related
    Filer's total
    $0 + $410,831 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 — 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

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Form 990 of other organizations
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 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
PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022 THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Patricia Allen -- $37,240 Todd Smart -- $25,135 John Wagner -- $34,987 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022 THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Andy Bagnall -- $134,905

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

No itemized grants to organizations 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.

Provenance

Return type
form_990
Tax year
2022
Filed
10 May 2024
IRS schema version
2022v5.0
Source object
202411319349304746

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