Skip to content
Nonprofiteer
← GOSHEN HEALTH FOUNDATION INC

Form 990 for tax year 2022

Filed by GOSHEN HEALTH FOUNDATION INC.

Totals

Total revenue
$882,292
Total expenses
$575,071
Contributions and grants received
$882,292
Grants paid
$199,809
Program service revenue
$0
Investment income
$0
Other revenue
$0
Total assets, end of year
$6,502,804
Total liabilities, end of year
$82,405
Net assets or fund balances, end of year
$6,420,399
Program services expenses (Part IX)
$575,071
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$575,071

Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • Randal Christophel

    President and CEO

    Total calculated
    $1,105,492
    From this org
    $0
    From related orgs
    $946,559
    Other
    $158,933
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $646,632 related
    Bonus
    $0 + $274,219 related
    Other
    $0 + $25,708 related
    Deferred
    $0 + $127,048 related
    Nontaxable benefits
    $0 + $31,885 related
    Filer's total
    $0 + $1,105,492 related

  • Theresa Gunden as of 72022

    Chair

    Total calculated
    $0
    Hours/week
    1

  • Amy Sink

    Secretary/Treasurer

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • John Leavitt

    Past Chair

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Derald Bontrager

    Director

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Steve Brenneman

    Director (as of 7/2022)

    Total calculated
    $0
    Hours/week
    1

  • Joe Caffee

    Director (as of 7/2022)

    Total calculated
    $0
    Hours/week
    1

  • Eric Essig

    Director

    Total calculated
    $0
    Hours/week
    1

  • Bill Johnson

    Director (as of 7/2022)

    Total calculated
    $0
    Hours/week
    1

  • Wes Herschberger

    Director

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Gordon Lord

    Director

    Total calculated
    $0
    Hours/week
    1

  • Angela Mckee

    Director (until 12/2022)

    Total calculated
    $0
    Hours/week
    1

  • Max Mertz MD

    Director

    Total calculated
    $196,986
    From this org
    $0
    From related orgs
    $175,999
    Other
    $20,987
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $86,146 related
    Bonus
    $0 + $88,953 related
    Other
    $0 + $900 related
    Deferred
    $0 + $7,260 related
    Nontaxable benefits
    $0 + $13,727 related
    Filer's total
    $0 + $196,986 related

  • Lisa Orn DO

    Director

    Total calculated
    $165,657
    From this org
    $0
    From related orgs
    $150,870
    Other
    $14,787
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $113,890 related
    Bonus
    $0 + $36,980 related
    Other
    $0
    Deferred
    $0 + $6,190 related
    Nontaxable benefits
    $0 + $8,597 related
    Filer's total
    $0 + $165,657 related

  • Doug Smoker

    Director (as of 7/2022)

    Total calculated
    $0
    Hours/week
    1

  • Jeff Showalter

    Director

    Total calculated
    $0
    Hours/week
    1

  • Bob Steury

    Director

    Total calculated
    $0
    Hours/week
    1

  • Sharon Welsh

    Director (as of 7/2022)

    Total calculated
    $0
    Hours/week
    1

  • Jim Caskey

    VP of Foundation

    Total calculated
    $302,309
    From this org
    $0
    From related orgs
    $253,960
    Other
    $48,349
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $203,133 related
    Bonus
    $0 + $42,804 related
    Other
    $0 + $8,023 related
    Deferred
    $0 + $25,526 related
    Nontaxable benefits
    $0 + $22,823 related
    Filer's total
    $0 + $302,309 related

  • Lisa Wine as of 12022

    Chief Financial Officer

    Total calculated
    $433,563
    From this org
    $0
    From related orgs
    $362,426
    Other
    $71,137
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $361,271 related
    Bonus
    $0
    Other
    $0 + $1,155 related
    Deferred
    $0 + $49,773 related
    Nontaxable benefits
    $0 + $21,364 related
    Filer's total
    $0 + $433,563 related

  • Ben Bontrager

    Former CFO

    Total calculated
    $103,245
    From this org
    $0
    From related orgs
    $103,245
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $21,777 related
    Bonus
    $0 + $81,468 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $103,245 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)

Part I, Line 3
Goshen Hospital Association, Inc., a related tax-exempt organization of Goshen Health Foundation, Inc., uses the following to establish the compensation of the organization's top management official. - Compensation Committee - Compensation Survey or Study - Independent Compensation Consultant - Approval by the Board or Compensation Committee
Part I, Line 4b
Eligible executives participate in various non-qualified deferred compensation plans organized under code Section 457(f). The exact purpose of each plan varies, but they include: compensation limitation make-up plans, voluntary deferral plans, deferral of a portion of incentive bonus type plans, etc. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals participate in the plan: Jim Caskey Randal Christophel Lisa Wine No non-qualified plan payments were made during the year to any listed persons in Part VII.

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 partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

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

  • Parkmor Drug Inc

    C · Pharmacy Sales · IN · controlled entity

    Directly controlled by Goshen Health System Inc

  • PILR Inc

    C · Development · IN · controlled entity

    Directly controlled by Goshen Health System Inc

  • Radiation Oncology Resources Inc

    C · Healthcare · IN · controlled entity

    Directly controlled by Goshen Health System Inc

Provenance

Return type
form_990
Tax year
2022
Filed
2 November 2023
IRS schema version
2022v5.0
Source object
202303119349304115

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

The source document this was parsed from is served over the API, which is where bulk and document access live.