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Nonprofiteer
← MAPLE GROVE HOSPITAL CORPORATION

Form 990 for tax year 2023

Filed by MAPLE GROVE HOSPITAL CORPORATION.

Totals

Total revenue
$274,346,219
Total expenses
$237,665,506
Contributions and grants received
$2,000,165
Grants paid
$0
Program services expenses (Part IX)
$207,337,261
Management and general expenses
$30,328,245
Fundraising expenses
$0
Program service expenses (Part III)
$207,337,261

Program services were 87.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • CAROLYN OGLAND MD

    DIRECTOR

    Total calculated
    $736,507
    From this org
    $0
    From related orgs
    $694,230
    Other
    $42,277
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $577,077 related
    Bonus
    $0 + $79,500 related
    Other
    $0 + $37,653 related
    Deferred
    $0 + $16,250 related
    Nontaxable benefits
    $0 + $26,027 related
    Filer's total
    $0 + $736,507 related

  • DAVID ALBRIGHT

    CHIEF FINANCIAL OFFICER

    Total calculated
    $544,916
    From this org
    $0
    From related orgs
    $511,066
    Other
    $33,850
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $423,077 related
    Bonus
    $0 + $75,000 related
    Other
    $0 + $12,989 related
    Deferred
    $0 + $16,250 related
    Nontaxable benefits
    $0 + $17,600 related
    Filer's total
    $0 + $544,916 related

  • J KEVIN CROSTON MD

    CEO AND BOARD CHAIR

    Total calculated
    $1,995,569
    From this org
    $0
    From related orgs
    $1,452,041
    Other
    $543,528
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,130,000 related
    Bonus
    $0 + $282,500 related
    Other
    $0 + $39,541 related
    Deferred
    $0 + $516,250 related
    Nontaxable benefits
    $0 + $27,278 related
    Filer's total
    $0 + $1,995,569 related

  • DAN FROMM

    TREASURER AND CFO (THROUGH 05/2023)

    Total calculated
    $431,854
    From this org
    $0
    From related orgs
    $386,471
    Other
    $45,383
    Hours/week
    2 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $352,885 related
    Bonus
    $0 + $24,375 related
    Other
    $0 + $9,211 related
    Deferred
    $0 + $16,250 related
    Nontaxable benefits
    $0 + $29,133 related
    Filer's total
    $0 + $431,854 related

  • TREVOR SAWALLISH

    CHIEF OPERATING OFFICER

    Total calculated
    $826,625
    From this org
    $0
    From related orgs
    $802,167
    Other
    $24,458
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $714,977 related
    Bonus
    $0 + $77,997 related
    Other
    $0 + $9,193 related
    Deferred
    $0 + $13,200 related
    Nontaxable benefits
    $0 + $11,258 related
    Filer's total
    $0 + $826,625 related

  • PAMELA DOORENBOS MD

    VP MEDICAL AFFAIRS

    Total calculated
    $415,463
    From this org
    $383,756
    From related orgs
    $0
    Other
    $31,707
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $325,000
    Bonus
    $48,750
    Other
    $10,006
    Deferred
    $16,250
    Nontaxable benefits
    $15,457
    Filer's total
    $415,463

  • ANNAMMA CHANDY

    PATIENT CARE FACILITATOR

    Total calculated
    $279,601
    From this org
    $246,574
    From related orgs
    $0
    Other
    $33,027
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $228,772
    Bonus
    $17,056
    Other
    $746
    Deferred
    $11,812
    Nontaxable benefits
    $21,215
    Filer's total
    $279,601

  • CATHY FEDDERSEN

    PATIENT CARE FACILITATOR

    Total calculated
    $237,138
    From this org
    $206,861
    From related orgs
    $0
    Other
    $30,277
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $192,788
    Bonus
    $13,753
    Other
    $320
    Deferred
    $10,008
    Nontaxable benefits
    $20,269
    Filer's total
    $237,138

  • ROBERT MOSS

    PHARMACIST

    Total calculated
    $219,164
    From this org
    $200,127
    From related orgs
    $0
    Other
    $19,037
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $199,380
    Bonus
    $260
    Other
    $487
    Deferred
    $10,002
    Nontaxable benefits
    $9,035
    Filer's total
    $219,164

  • JULISA ROESSLER

    PATIENT CARE FACILITATOR

    Total calculated
    $237,299
    From this org
    $208,327
    From related orgs
    $0
    Other
    $28,972
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $189,495
    Bonus
    $18,416
    Other
    $416
    Deferred
    $10,220
    Nontaxable benefits
    $18,752
    Filer's total
    $237,299

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 · Independent compensation consultant
  • 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)

PART I, LINE 3
THE CHIEF EXECUTIVE OFFICER IS AN EMPLOYEE OF NORTH MEMORIAL HEALTH CARE. OTHER BOARD MEMBERS LISTED WITH COMPENSATION FROM A RELATED ORGANIZATION ARE OFFICERS AND KEY EMPLOYEES OF NORTH MEMORIAL HEALTH CARE WHO PROVIDE SERVICES TO MAPLE GROVE HOSPITAL AS WELL AS TO ALL OR SOME RELATED ENTITIES AS IDENTIFIED ON SCHEDULE R. AS SUCH, THEIR COMPENSATION LEVELS INCORPORATE SERVICES PROVIDED TO MULTIPLE NORTH MEMORIAL ENTITIES.
PART I, LINE 4B
DR. KEVIN CROSTON RECIEVED A CONTRIBUTION TO HIS 457(F) PLAN OF $500,000 DURING THE TAX YEAR. THIS AMOUNT IS INCLUDED IN COLUMN (C) OF SCHEDULE J, PART II. THE PLAN BECAME FULLY VESTED AS OF 9/8/23.

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
2023
Filed
15 November 2024
IRS schema version
2023v5.1
Source object
202403209349315295

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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