Form 990 for tax year 2022
Filed by SWEDISHAMERICAN HEALTH SYSTEM CORPORATION.
Totals
- Total revenue
- $85,163
- Total expenses
- $1,228,453
- Contributions and grants received
- $0
- Grants paid
- $0
- Program service revenue
- $0
- Investment income
- $0
- Other revenue
- $85,163
- Total assets, end of year
- $39,669,975
- Total liabilities, end of year
- $8,448,581
- Net assets or fund balances, end of year
- $31,221,394
- Program services expenses (Part IX)
- $1,198,861
- Management and general expenses
- $29,592
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $1,198,861
Program services were 97.6% 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.
-
11a · Other revenue: Three Rivers Partners,
total $85,163 · related or exempt $85,163
-
11e · Other revenue, total
$85,163
Functional expenses
Part IX, the statement of functional expenses.
-
11c · Fees: accounting
total $29,592 · management and general $29,592
-
11g · Fees: other
total $37,165 · program services $37,165
-
13 · Office expenses
total $26 · program services $26
-
24a · Other expenses: Organizational Costs
total $1,161,670 · program services $1,161,670
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $461,983 · end of year $200
-
12 · Investments: other securities
beginning of year $37,996,757 · end of year $37,996,757
-
13 · Investments: program-related
beginning of year $1,673,018 · end of year $1,673,018
-
25 · Other liabilities
beginning of year $7,681,911 · end of year $8,448,581
-
27 · Net assets without donor restrictions
beginning of year $32,449,847 · end of year $31,221,394
Mission and programs · 2022
Mission
Through excellence in healthcare and compassionate service, we care for our community.
-
Regional Division, Inc. is the parent corporation of SwedishAmerican Health System Corporation. SwedishAmerican Health System Corporation is the parent corporation of SwedishAmerican Hospital, SwedishAmerican Foundation, SwedishAmerican Self Insurance Trust and SwedishAmerican Realty Corporation, which are exempt organizations. SwedishAmerican Health System Corporation is also the parent of State & Charles, Inc. and SARI Insurance Company (disclosed on Schedule R) which are for profit entities. The purpose of SwedishAmerican Health System Corporation is to manage and direct the activities of these entities.
Expenses $1,198,861 · Revenue $85,163
As filed on the 2022 return.
Listed in Part VII
-
Elizabeth Bolt
Director
- Total calculated
- $2,026,683
- From this org
- $0
- From related orgs
- $1,822,826
- Other
- $203,857
- Hours/week
- 2 + 55 related
Schedule J breakdown matched by us
- Base
- $0 + $962,880 related
- Bonus
- $0 + $406,895 related
- Other
- $0 + $453,051 related
- Deferred
- $0 + $165,875 related
- Nontaxable benefits
- $0 + $37,982 related
- Filer's total
- $0 + $2,026,683 related
-
Peter D Newcomer MD MMM
Director
- Total calculated
- $1,122,292
- From this org
- $0
- From related orgs
- $940,501
- Other
- $181,791
- Hours/week
- 2 + 55 related
Schedule J breakdown matched by us
- Base
- $0 + $602,328 related
- Bonus
- $0 + $338,173 related
- Other
- $0
- Deferred
- $0 + $180,355 related
- Nontaxable benefits
- $0 + $1,436 related
- Filer's total
- $0 + $1,122,292 related
-
Travis Andersen
President & CEO
- Total calculated
- $1,099,595
- From this org
- $0
- From related orgs
- $1,014,145
- Other
- $85,450
- Hours/week
- 2 + 46 related
Schedule J breakdown matched by us
- Base
- $0 + $685,014 related
- Bonus
- $0 + $210,627 related
- Other
- $0 + $118,504 related
- Deferred
- $0 + $60,071 related
- Nontaxable benefits
- $0 + $25,379 related
- Filer's total
- $0 + $1,099,595 related
-
Allen D Williams MD
Director
- Total calculated
- $397,811
- From this org
- $0
- From related orgs
- $333,058
- Other
- $64,753
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $325,237 related
- Bonus
- $0 + $5,600 related
- Other
- $0 + $2,221 related
- Deferred
- $0 + $24,400 related
- Nontaxable benefits
- $0 + $40,353 related
- Filer's total
- $0 + $397,811 related
-
Tiffanie Ferry MD
Director (until 12/31/22)
- Total calculated
- $284,294
- From this org
- $0
- From related orgs
- $229,949
- Other
- $54,345
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $209,627 related
- Bonus
- $0 + $10,000 related
- Other
- $0 + $10,322 related
- Deferred
- $0 + $15,062 related
- Nontaxable benefits
- $0 + $39,283 related
- Filer's total
- $0 + $284,294 related
-
Jeffrey J Kaney Sr
Chmn of the Board (until 8/31/22)
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Daniel T Ross
Chmn of the Board (as of 9/1/22)
- Total calculated
- $0
- Hours/week
- 2 + 8 related
-
Eric Fulcomer PhD
1st Vice Chmn/Secy (until 12/31/22)
- Total calculated
- $0
- Hours/week
- 2 + 8 related
-
Jeffrey S Hultman
1st Vice Chmn/Secy (as of 1/1/23)
- Total calculated
- $0
- Hours/week
- 2 + 8 related
-
Thomas R Walsh
Audit/Compliance Chairman
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Patrick T Derry
Quality/Safety Chmn (until 12/31/22)
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Anqunette Parham
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Frank E Walter
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Helen Chung Hill
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Kathleen Kelly MD
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Michael Broski
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Marco T Lenis
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Steven C Sjogren
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Patricia DeWane
VP, CFO, & Treasurer
- Total calculated
- $629,264
- From this org
- $0
- From related orgs
- $566,671
- Other
- $62,593
- Hours/week
- 2 + 46 related
Schedule J breakdown matched by us
- Base
- $0 + $384,070 related
- Bonus
- $0 + $177,799 related
- Other
- $0 + $4,802 related
- Deferred
- $0 + $54,710 related
- Nontaxable benefits
- $0 + $7,883 related
- Filer's total
- $0 + $629,264 related
-
Timothy Flynn MD
President, SA Medical Group
- Total calculated
- $572,337
- From this org
- $0
- From related orgs
- $515,532
- Other
- $56,805
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $375,489 related
- Bonus
- $0 + $109,771 related
- Other
- $0 + $30,272 related
- Deferred
- $0 + $48,610 related
- Nontaxable benefits
- $0 + $8,195 related
- Filer's total
- $0 + $572,337 related
-
Ann Gantzer
VP Patient Svcs/CNO (until 9/23/22)
- Total calculated
- $525,056
- From this org
- $0
- From related orgs
- $487,186
- Other
- $37,870
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $262,925 related
- Bonus
- $0 + $136,116 related
- Other
- $0 + $88,145 related
- Deferred
- $0 + $5,902 related
- Nontaxable benefits
- $0 + $31,968 related
- Filer's total
- $0 + $525,056 related
-
Julia Zimmerman
VP Strategic Growth
- Total calculated
- $407,228
- From this org
- $0
- From related orgs
- $343,935
- Other
- $63,293
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $244,658 related
- Bonus
- $0 + $82,585 related
- Other
- $0 + $16,692 related
- Deferred
- $0 + $19,896 related
- Nontaxable benefits
- $0 + $43,397 related
- Filer's total
- $0 + $407,228 related
-
Sal Ababneh
COO & President of UWNI Hospitals
- Total calculated
- $360,349
- From this org
- $0
- From related orgs
- $314,281
- Other
- $46,068
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $208,532 related
- Bonus
- $0 + $40,000 related
- Other
- $0 + $65,749 related
- Deferred
- $0 + $19,878 related
- Nontaxable benefits
- $0 + $26,190 related
- Filer's total
- $0 + $360,349 related
-
William Mewes
Interim VP Patient Services & CNO
- Total calculated
- $262,326
- From this org
- $0
- From related orgs
- $210,358
- Other
- $51,968
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $194,886 related
- Bonus
- $0 + $15,472 related
- Other
- $0
- Deferred
- $0 + $13,766 related
- Nontaxable benefits
- $0 + $38,202 related
- Filer's total
- $0 + $262,326 related
-
Rosa Jeschke
VP Human Resources
- Total calculated
- $196,378
- From this org
- $0
- From related orgs
- $176,285
- Other
- $20,093
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $171,122 related
- Bonus
- $0
- Other
- $0 + $5,163 related
- Deferred
- $0 + $13,963 related
- Nontaxable benefits
- $0 + $6,130 related
- Filer's total
- $0 + $196,378 related
-
James Cole DO
VP Medical Affairs/CMO
- Total calculated
- $365,422
- From this org
- $0
- From related orgs
- $304,466
- Other
- $60,956
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $304,466 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $60,893 related
- Nontaxable benefits
- $0 + $63 related
- Filer's total
- $0 + $365,422 related
-
Thomas O'Connor
Former President & CEO
- Total calculated
- $761,147
- From this org
- $0
- From related orgs
- $761,147
- Other
- $0
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $50,986 related
- Bonus
- $0
- Other
- $0 + $710,161 related
- Deferred
- $0
- Nontaxable benefits
- $0
- Filer's total
- $0 + $761,147 related
-
Michael Polizzotto
Former CMO/CIO
- Total calculated
- $546,914
- From this org
- $0
- From related orgs
- $491,231
- Other
- $55,683
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $371,875 related
- Bonus
- $0 + $29,711 related
- Other
- $0 + $89,645 related
- Deferred
- $0 + $18,453 related
- Nontaxable benefits
- $0 + $37,230 related
- Filer's total
- $0 + $546,914 related
-
Jedediah Cantrell
Former VP Operations
- Total calculated
- $160,367
- From this org
- $0
- From related orgs
- $150,775
- Other
- $9,592
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $59,096 related
- Bonus
- $0
- Other
- $0 + $91,679 related
- Deferred
- $0 + $438 related
- Nontaxable benefits
- $0 + $9,154 related
- Filer's total
- $0 + $160,367 related
-
Celia Shaughnessy
Former VP Human Resources
- Total calculated
- $105,800
- From this org
- $0
- From related orgs
- $105,800
- Other
- $0
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $105,800 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0
- Nontaxable benefits
- $0
- Filer's total
- $0 + $105,800 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
- 3 · Compensation committee
- 3 · Independent compensation consultant
- 3 · Compensation survey or study
- 3 · Approval by the board or compensation committee
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
Answered no
- 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
- All compensation is determined by the Executive Compensation Committee of SwedishAmerican Health System Corporation and is paid by SwedishAmerican Hospital. All compensation decisions are made by independent persons. With respect to the President & CEO and other Officers, SwedishAmerican Health System Corporation follows a compensation approval procedure annually that involves approval of proposed and final compensation arrangements by SwedishAmerican Health System Corporation's Executive Compensation Committee using comparability data, as well as contemporaneous documentation of compensation decisions in the minutes.
- Part I, Lines 4a-b
- Severance payments during 2022 include: Tom O'Connor - $710,161. These payments are reported as taxable compensation on Part II, column (B)(iii). Contributions to the 457(f) plan during 2022 include: Peter Newcomer - $119,355; Elizabeth Bolt - $143,610; Travis Andersen - $59,719; Patricia DeWane - $30,310; Timothy Flynn MD -$24,210; Sal Ababneh - $19,878; Rosa Jeschke - $13,963. Payments from the 457(f) plan during 2022 include: Elizabeth Bolt - $432,157; Michael Polizzotto - $88,726; Ann Gantzer - $86,178; Julia Zimmerman - $14,725; Jedediah Cantrell - $91,176. These payments are reported as taxable income on Part II, column (B) (iii). Part II, Column F: The amounts shown in column F were reported as deferred compensation in prior years but paid out in the current year. The amounts are also included in column (B) (iii).
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.
-
501(c)(3) · Reproductive endocrinology and infertility services · WI
-
501(c)(3) · Research and innovation · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
501(c)(3) · Health care services and training · WI
-
501(c)(3) · Regional Parent Corp. to manage and direct activities of entities · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
SwedishAmerican Health Foundation
501(c)(3) · Supports fundraising for SwedishAmerican Hospital · IL · controlled entity
Directly controlled by SwedishAmerican Health System Corporation
-
501(c)(3) · Hospital · IL · controlled entity
Directly controlled by SwedishAmerican Health System Corporation
-
SwedishAmerican Hospital Self Insurance Trust
501(c)(3) · Hospital Malpractice Trust · VT · controlled entity
Directly controlled by SwedishAmerican Hospital
-
SwedishAmerican Realty Corporation
501(c)(2) · Title Holding Company · IL · controlled entity
Directly controlled by SwedishAmerican Health System Corporation
-
501(c)(3) · Support Organization · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
University of Wisconsin Hospital and Clinics Authority
501(c)(3) · Hospital and Clinics · WI
-
University of Wisconsin Medical Foundation
501(c)(3) · Physician Services · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
501(c)(3) · Accountable Care Organization · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
501(c)(3) · Infusion Therapy · WI
Directly controlled by University of WI Hospital and Clinics Authority
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 · Information Technology Services · IL · 50% owned · share of income $85,163 · share of assets $3,137,999 · general or managing partner
Directly controlled by SAHS Corporation
-
Chartwell Wisconsin Enterprises LLC
N/A · Parent Entity of CW and CMW-HR · WI
-
N/A · Real Estate · WI
-
N/A · Outpatient Health Services · IL
-
N/A · Real Estate · WI
Related corporations and trusts
Part IV: related organizations taxable as a corporation or trust.
-
C · Health Services · IL · controlled entity
-
Quartz Health Benefit Plans Corporation
C · Health Maintenance Organization · WI
-
Quartz Health Insurance Corporation
C · Health Maintenance Organization · WI
-
C · Insurance · WI
-
C · Holding Company · WI
-
C · Captive Insurance Company · VT · 100% owned · controlled entity
Directly controlled by SAHS Corporation
-
C · Holding Company · IL · 100% owned · share of income $18,352,241 · share of assets $13,767,714 · controlled entity
Directly controlled by SAHS Corporation
-
SwedishAmerican Health Management Corp
C · Management Services · IL · controlled entity
-
C · Dialysis Services · WI
-
Charitable Remainder Unitrusts (5)
T · Trust · IL · controlled entity
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 2 May 2024
- IRS schema version
- 2022v5.0
- Source object
- 202431289349300848
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