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Nonprofiteer
← WAGNER COMMUNITY MEMORIAL HOSPITAL

Form 990 for tax year 2022

Filed by WAGNER COMMUNITY MEMORIAL HOSPITAL.

Totals

Total revenue
$14,711,701
Total expenses
$14,404,623
Contributions and grants received
$123,825
Grants paid
$789
Program service revenue
$14,520,393
Investment income
$63,533
Other revenue
$3,950
Total assets, end of year
$17,783,840
Total liabilities, end of year
$3,965,663
Net assets or fund balances, end of year
$13,818,177
Program services expenses (Part IX)
$12,389,540
Management and general expenses
$2,015,083
Fundraising expenses
$0
Program service expenses (Part III)
$12,389,540

Program services were 86.0% 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.

  • 1e · Government grants (contributions)

    $122,025

  • 1f · All other contributions, gifts and grants

    $1,800

  • 2a · Program service revenue: PATIENT SERVICE FEES

    total $14,206,894 · related or exempt $14,206,894

  • 2b · Program service revenue: PHARMACY REVENUE

    total $268,902 · related or exempt $268,902

  • 2f · All other program service revenue

    total $44,597 · related or exempt $44,597

  • 3 · Investment income

    total $5,560 · excluded $5,560

  • 6a · Gross rents

    real property $3,950

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $3,950

  • 6d · Net rental income or loss

    total $3,950 · excluded $3,950

  • 7a · Gross sales of assets other than inventory

    securities $1,020,169

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

    securities $962,196

  • 7c · Gain or loss

    securities $57,973

  • 7d · Net gain or loss

    total $57,973 · excluded $57,973

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $789 · program services $789

  • 5 · Compensation of officers, directors and key employees

    total $538,534 · program services $206,512 · management and general $332,022

  • 6 · Compensation of disqualified persons

    total $111,051 · program services $111,051

  • 7 · Other salaries and wages

    total $7,153,128 · program services $6,580,248 · management and general $572,880

  • 8 · Pension plan contributions

    total $297,172 · program services $275,918 · management and general $21,254

  • 9 · Other employee benefits

    total $948,404 · program services $861,046 · management and general $87,358

  • 10 · Payroll taxes

    total $529,480 · program services $470,226 · management and general $59,254

  • 11c · Fees: accounting

    total $91,294 · management and general $91,294

  • 11g · Fees: other

    total $1,109,133 · program services $666,977 · management and general $442,156

  • 12 · Advertising and promotion

    total $40,637 · management and general $40,637

  • 13 · Office expenses

    total $412,095 · program services $311,699 · management and general $100,396

  • 14 · Information technology

    total $33,954 · program services $33,954

  • 16 · Occupancy

    total $177,851 · program services $177,851

  • 17 · Travel

    total $43,625 · program services $40,837 · management and general $2,788

  • 19 · Conferences, conventions and meetings

    total $37,144 · program services $32,817 · management and general $4,327

  • 20 · Interest

    total $138,524 · program services $138,524

  • 22 · Depreciation, depletion and amortization

    total $787,032 · program services $734,363 · management and general $52,669

  • 23 · Insurance

    total $75,386 · program services $66,912 · management and general $8,474

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $1,389,881 · program services $1,389,881

  • 24b · Other expenses: REPAIRS AND MAINTENANCE

    total $332,668 · program services $283,304 · management and general $49,364

  • 24c · Other expenses: DUES AND SUBSCRIPTIONS

    total $19,776 · program services $5,575 · management and general $14,201

  • 24e · All other expenses

    total $137,065 · program services $1,056 · management and general $136,009

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $934,225 · end of year $554,896

  • 4 · Accounts receivable

    beginning of year $2,355,045 · end of year $2,682,469

  • 8 · Inventories for sale or use

    beginning of year $161,331 · end of year $146,211

  • 9 · Prepaid expenses and deferred charges

    beginning of year $101,073 · end of year $86,665

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

    $14,925,906

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

    $9,083,697

  • 10c · Land, buildings and equipment, net

    beginning of year $5,754,101 · end of year $5,842,209

  • 12 · Investments: other securities

    beginning of year $7,463,097 · end of year $7,070,704

  • 13 · Investments: program-related

    beginning of year $438,362 · end of year $537,112

  • 15 · Other assets

    beginning of year $83,889 · end of year $863,574

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,003,434 · end of year $851,704

  • 23 · Secured mortgages and notes payable

    beginning of year $3,206,494 · end of year $3,113,959

  • 27 · Net assets without donor restrictions

    beginning of year $13,081,195 · end of year $13,818,177

Mission and programs · 2022

Mission

WAGNER COMMUNITY MEMORIAL HOSPITAL'S MISSION IS TO PROVIDE CARE AND TREATMENT OF THE SICK; PROVIDE CARE AND SUPPORT OF THE AGED, DISABLED, AND INDIGENT; AND TO PROVIDE FOR THOSE IN NEED OF HOSPITALIZATION REGARDLESS OF RACE, COLOR, CREED, OR ABILITY TO PAY.

Activities or mission (Part I)

TO PROVIDE HEALTHCARE SERVICES.

  • WCMH IS A 15 BED CRITICAL ACCESS HOSPITAL EQUIPPED WITH EXTENSIVE ADVANCED SERVICES, INCLUDING AREAS FOR MEDICAL/SURGICAL, PEDIATRIC, INTENSIVE/CORONARY CARE, AND SWING BED/LONG TERM CARE. THE CLINIC IS ADJACENT TO THE HOSPITAL MAKING IT CONVENIENT TO SEE HOSPITAL PATIENTS, AND SHARE LABORATORY SERVICES AND OTHER DIAGNOSTIC EQUIPMENT. OUTREACH SERVICES INCLUDE OB/GYN, PEDIATRICS, ORTHOPEDIC SURGERY, GENERAL SURGERY, UROLOGY, PODIATRY, ENT & AUDIOLOGY. THE PEOPLE OF THE COMMUNITY TRULY BELIEVE IN HAVING ACCESS TO CARE AND SUPPORT THEIR LOCAL MEDICAL PROVIDERS. THE FACILITY SERVES AS THE INPATIENT UNIT FOR THE LOCAL INDIAN HEALTH SERVICES CLINIC AND WORKS COLLABORATIVELY WITH THE IHS PHYSICIANS AND LEADERS TO CARE FOR THE NATIVE AMERICAN POPULATION. WCMH EXPERIENCED 415 INPATIENT DAYS, 584 SWING BED DAYS, 2,091 EMERGENCY DEPARTMENT VISITS, AND 5,227 CLINIC VISITS.

    Expenses $12,389,540 · Grants $789 · Revenue $14,520,393

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

Listed in Part VII

  • David Kotab

    PRESIDENT

    Total calculated
    $0
    Hours/week
    0.5

  • Chad Peters

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    0.5

  • Karen Soulek

    SECRETARY/TREASURY

    Total calculated
    $0
    Hours/week
    0.5

  • Mitchel Breen

    DIRECTOR UNTIL 03/2022

    Total calculated
    $0
    Hours/week
    0.5

  • Rachel Woods

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • Michele Juffer

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • Kathe Henke

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.5

  • Bryan Slaba

    CEO/ADMINISTRATOR

    Total calculated
    $306,059
    From this org
    $267,211
    From related orgs
    $0
    Other
    $38,848
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $267,211
    Bonus
    $0
    Other
    $0
    Deferred
    $13,631
    Nontaxable benefits
    $25,217
    Filer's total
    $306,059

  • Brittney Barron

    VP OF PATIENT SERVICES

    Total calculated
    $189,931
    From this org
    $152,133
    From related orgs
    $0
    Other
    $37,798
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $152,133
    Bonus
    $0
    Other
    $0
    Deferred
    $8,002
    Nontaxable benefits
    $29,796
    Filer's total
    $189,931

  • Mikeala Koenig

    PHYSICIAN

    Total calculated
    $250,951
    From this org
    $216,518
    From related orgs
    $0
    Other
    $34,433
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $216,518
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $34,433
    Filer's total
    $250,951

  • Jessica Vanderham

    NURSE PRACTITIONER

    Total calculated
    $219,779
    From this org
    $178,454
    From related orgs
    $0
    Other
    $41,325
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $178,454
    Bonus
    $0
    Other
    $0
    Deferred
    $9,421
    Nontaxable benefits
    $31,903
    Filer's total
    $219,778

  • Jordan Weber

    PHYSICIANS ASSISTANT

    Total calculated
    $240,710
    From this org
    $208,102
    From related orgs
    $0
    Other
    $32,608
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $208,102
    Bonus
    $0
    Other
    $0
    Deferred
    $10,743
    Nontaxable benefits
    $21,865
    Filer's total
    $240,710

  • Tianna Smith

    PHYSICIAN

    Total calculated
    $198,796
    From this org
    $197,338
    From related orgs
    $0
    Other
    $1,458
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $197,338
    Bonus
    $0
    Other
    $0
    Deferred
    $1,458
    Nontaxable benefits
    $0
    Filer's total
    $198,796

  • Ryan Kocer

    NURSE PRACTITIONER

    Total calculated
    $202,413
    From this org
    $163,317
    From related orgs
    $0
    Other
    $39,096
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $163,317
    Bonus
    $0
    Other
    $0
    Deferred
    $8,643
    Nontaxable benefits
    $30,453
    Filer's total
    $202,413

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

  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 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

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.

Provenance

Return type
form_990
Tax year
2022
Filed
15 March 2024
IRS schema version
2022v5.0
Source object
202430759349302258

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