Form 990 for tax year 2022
Filed by SUTTER ROSEVILLE MEDICAL CENTER FOUNDATION.
Totals
- Total revenue
- $1,998,872
- Total expenses
- $1,634,541
- Contributions and grants received
- $969,609
- Grants paid
- $717,278
- Program service revenue
- $898,659
- Investment income
- $103,283
- Other revenue
- $27,321
- Total assets, end of year
- $6,098,948
- Total liabilities, end of year
- $298,641
- Net assets or fund balances, end of year
- $5,800,307
- Program services expenses (Part IX)
- $1,154,834
- Management and general expenses
- $479,707
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $1,154,834
Program services were 70.7% 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.
-
1a · Federated campaigns
$4,720
-
1c · Fundraising events
$126,395
-
1f · All other contributions, gifts and grants
$838,494
-
2a · Program service revenue: HOSPITAL SUPPORT
total $898,659 · related or exempt $898,659
-
3 · Investment income
total $66,005 · excluded $66,005
-
4 · Income from investment of tax-exempt bond proceeds
total $0
-
5 · Royalties
total $0
-
6c · Rental income or loss
real property $0 · personal property $0
-
6d · Net rental income or loss
total $0
-
7a · Gross sales of assets other than inventory
securities $37,278
-
7c · Gain or loss
securities $37,278
-
7d · Net gain or loss
total $37,278 · excluded $37,278
-
8a · Fundraising events: gross income
$54,365
-
8a · Fundraising events: contributions included on line 1c
$126,395
-
8b · Fundraising events: direct expenses
$29,304
-
8c · Net income from fundraising events
total $25,061 · excluded $25,061
-
9a · Gaming: gross income
$2,290
-
9b · Gaming: direct expenses
$30
-
9c · Net income from gaming
total $2,260 · excluded $2,260
-
10a · Gross sales of inventory
$0
-
10b · Cost of goods sold
$0
-
10c · Net income from sales of inventory
total $0
-
11e · Other revenue, total
$0
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $717,278 · program services $717,278
-
2 · Grants to domestic individuals
total $0
-
3 · Grants to foreign organizations and individuals
total $0
-
4 · Benefits paid to or for members
total $0
-
5 · Compensation of officers, directors and key employees
total $0
-
6 · Compensation of disqualified persons
total $0
-
7 · Other salaries and wages
total $331,572 · program services $217,843 · management and general $113,729
-
8 · Pension plan contributions
total $0
-
9 · Other employee benefits
total $254,728 · program services $167,356 · management and general $87,372
-
10 · Payroll taxes
total $0
-
11a · Fees: management
total $0
-
11b · Fees: legal
total $0
-
11c · Fees: accounting
total $0
-
11d · Fees: lobbying
total $0
-
11e · Fees: professional fundraising services
total $0
-
11f · Fees: investment management
total $8,056 · management and general $8,056
-
11g · Fees: other
total $0
-
12 · Advertising and promotion
total $0
-
13 · Office expenses
total $17,741 · program services $17,741
-
14 · Information technology
total $439 · program services $439
-
15 · Royalties
total $0
-
16 · Occupancy
total $0
-
17 · Travel
total $963 · program services $963
-
18 · Travel or entertainment for public officials
total $0
-
19 · Conferences, conventions and meetings
total $740 · management and general $740
-
20 · Interest
total $0
-
21 · Payments to affiliates
total $0
-
22 · Depreciation, depletion and amortization
total $0
-
23 · Insurance
total $3,701 · management and general $3,701
-
24a · Other expenses: SUTTER CHARGEBACKS
total $197,265 · management and general $197,265
-
24b · Other expenses: REGIONAL ALLOCATION
total $88,086 · program services $19,242 · management and general $68,844
-
24c · Other expenses: DONOR CULTIVATION
total $13,972 · program services $13,972 · fundraising $0
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $0 · end of year $0
-
2 · Savings and temporary cash investments
beginning of year $531,512 · end of year $874,729
-
3 · Pledges and grants receivable
beginning of year $1,345,301 · end of year $823,959
-
4 · Accounts receivable
beginning of year $1,400 · end of year $13,211
-
5 · Loans and receivables from officers and key people
beginning of year $0 · end of year $0
-
6 · Loans and receivables from disqualified persons
beginning of year $0 · end of year $0
-
7 · Other notes and loans receivable
beginning of year $0 · end of year $0
-
8 · Inventories for sale or use
beginning of year $0 · end of year $0
-
9 · Prepaid expenses and deferred charges
beginning of year $0 · end of year $0
-
10c · Land, buildings and equipment, net
beginning of year $0 · end of year $0
-
11 · Investments: publicly traded securities
beginning of year $4,625,453 · end of year $4,387,049
-
12 · Investments: other securities
beginning of year $0 · end of year $0
-
13 · Investments: program-related
beginning of year $0 · end of year $0
-
14 · Intangible assets
beginning of year $0 · end of year $0
-
15 · Other assets
beginning of year $0 · end of year $0
-
17 · Accounts payable and accrued expenses
beginning of year $626,234 · end of year $297,528
-
18 · Grants payable
beginning of year $0 · end of year $0
-
19 · Deferred revenue
beginning of year $0 · end of year $0
-
20 · Tax-exempt bond liabilities
beginning of year $0 · end of year $0
-
21 · Escrow or custodial account liability
beginning of year $0 · end of year $0
-
22 · Loans and payables to officers and key people
beginning of year $0 · end of year $0
-
23 · Secured mortgages and notes payable
beginning of year $0 · end of year $0
-
24 · Unsecured notes and loans payable
beginning of year $0 · end of year $0
-
25 · Other liabilities
beginning of year $1,450 · end of year $1,113
-
27 · Net assets without donor restrictions
beginning of year $2,355,375 · end of year $2,439,989
-
28 · Net assets with donor restrictions
beginning of year $3,520,607 · end of year $3,360,318
Mission and programs · 2022
Mission
SEE SCHEDULE O
-
SEE SCHEDULE O
Expenses $1,154,834 · Grants $717,278 · Revenue $898,659
As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.
Listed in Part VII
-
Brian AlexanderBRIAN ALEXANDER
Hospital Area CEO, N. Valley
- Total calculated
- $920,023
- From this org
- $0
- From related orgs
- $825,364
- Other
- $94,659
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $610,004 related
- Bonus
- $0 + $136,684 related
- Other
- $0 + $78,676 related
- Deferred
- $0 + $60,965 related
- Nontaxable benefits
- $0 + $33,694 related
- Filer's total
- $0 + $920,023 related
-
Jodi DavisJODI DAVIS
Chief Philanthropy Officer-SH
- Total calculated
- $768,160
- From this org
- $0
- From related orgs
- $691,781
- Other
- $76,379
- Hours/week
- 0 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $479,569 related
- Bonus
- $0 + $139,846 related
- Other
- not reported + $72,366 related
- Deferred
- $0 + $47,865 related
- Nontaxable benefits
- $0 + $28,514 related
- Filer's total
- $0 + $768,160 related
-
Ronnie Yamanaka
CFO Hospt - SRMC/SCH/SAFH/SSMC
- Total calculated
- $546,648
- From this org
- $0
- From related orgs
- $480,958
- Other
- $65,690
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $395,239 related
- Bonus
- $0 + $61,006 related
- Other
- $0 + $24,713 related
- Deferred
- $0 + $45,865 related
- Nontaxable benefits
- $0 + $19,825 related
- Filer's total
- $0 + $546,648 related
-
Suzanne Zolfo
Director of Philanthropy
- Total calculated
- $238,554
- From this org
- $0
- From related orgs
- $208,924
- Other
- $29,630
- Hours/week
- 2 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $178,453 related
- Bonus
- $0 + $29,641 related
- Other
- $0 + $830 related
- Deferred
- $0 + $2,962 related
- Nontaxable benefits
- $0 + $26,668 related
- Filer's total
- $0 + $238,554 related
-
Gary Hubschman
Former CFO Hospt-SRMC/SAFH/SCH
- Total calculated
- $225,598
- From this org
- $0
- From related orgs
- $225,111
- Other
- $487
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0
- Bonus
- $0
- Other
- $0 + $225,111 related
- Deferred
- $0
- Nontaxable benefits
- $0 + $487 related
- Filer's total
- $0 + $225,598 related
-
Anastasia Efstathiu
TRUSTEE
- Total calculated
- $0
- Hours/week
- 1
-
Glen Garabedian
TRUSTEE
- Total calculated
- $0
- Hours/week
- 1
-
Rebecca Gardner
Trustee
- Total calculated
- $0
- Hours/week
- 1
-
Bonnie Marx
TRUSTEE/CHAIR
- Total calculated
- $0
- Hours/week
- 2
-
Richard Osen
TRUSTEE
- Total calculated
- $0
- Hours/week
- 1
-
Larry Payne
TRUSTEE
- Total calculated
- $0
- Hours/week
- 1
-
Tara Simpson
Trustee
- Total calculated
- $0
- Hours/week
- 1
-
Joseph Whitters
TRUSTEE/VICE-CHAIR
- Total calculated
- $0
- Hours/week
- 2
-
David Yee MD
Trustee/Secretary
- Total calculated
- $0
- Hours/week
- 2
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
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
- 7 · Other non-fixed payments
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
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- SCHEDULE J, PART I, LINE 3
- SUPPLEMENTAL COMPENSATION INFORMATION: THE COMPENSATION FOR THE POSITION OF EXECUTIVE DIRECTOR/TOP MANAGEMENT OFFICIAL IS DETERMINED THROUGH A QUANTITATIVE POINT FACTOR REVIEW OF THE KNOW-HOW, PROBLEM SOLVING, AND ACCOUNTABILITY ASSOCIATED WITH A GIVEN POSITION AS IDENTIFIED IN THE DETAILED POSITION DESCRIPTION. ADDITIONALLY, ALL APPLICABLE MARKET SALARY SURVEY DATA IS REVIEWED TO ENSURE THE POSITION IS BOTH INTERNALLY EQUITABLE AND EXTERNALLY COMPETITIVE/MARKET APPROPRIATE. SEE SCHEDULE O NARRATIVE FOR PART VI LINE 15 FOR A FULL DESCRIPTION OF THE COMPENSATION APPROVAL PROCESS.
- SCHEDULE J, PART I, LINE 4A
- SEVERANCE PAYMENTS: GARY HUSCHMAN RECEIVED SEVERANCE PAYMENTS OF $12,123.
- SCHEDULE J, PART I, LINE 4B
- NONQUALIFIED RETIREMENT PLAN: CERTAIN INDIVIDUALS PAID BY SUTTER HEALTH PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF 403(B) EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PENSION PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA PROVIDES 6% TO 12% OF BASE SALARY PLUS ANNUAL INCENTIVE AWARD (COMMENSURATE WITH MANAGEMENT LEVEL). CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457(F)) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65 WITH 22.5 YEARS OF SERVICE. TARGET BENEFIT LEVELS ARE DISCOUNTED FOR YEARS OF SERVICE LESS THAN 22.5 AT AGE 65. UNLIKE SUTTER HEALTH'S QUALIFIED PENSION PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT.
- Schedule J, Part I, Line 7
- NON-FIXED PAYMENTS: SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD. AVERAGE AMOUNT OF SPOT AWARDS TEND TO NOT EXCEED 5% TO 15% OF GROSS ANNUAL SALARY. ANNUAL INCENTIVE PLAN (AIP): THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, OPERATING UNIT AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. LONG TERM PERFORMANCE PLANS SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL LONG TERM PERFORMANCE PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED PRIOR TO PAYMENT BY THE COMPENSATION COMMITTEE.
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
-
SUTTER VALLEY HOSPITALS DBA SRMC
$714,995
PROGRAM SUPPORT
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.
-
California Pacific Medical Center Found
501(c)(3) · Fundraising · CA · controlled entity
Directly controlled by Sutter BH
-
501(c)(3) · Healthcare · CA · controlled entity
Directly controlled by Sutter BH
-
501(c)(3) · Fundraising · CA · controlled entity
Directly controlled by SUTTER VH
-
Mills-Peninsula Hospital Foundation
501(c)(3) · Fundraising · CA · controlled entity
Directly controlled by SUTTER BH
-
501(c)(3) · Healthcare · CA · controlled entity
Directly controlled by SUTTER HLTH
-
Sutter Auburn Faith Hospital Foundation
501(c)(3) · Fundraising · CA · controlled entity
Directly controlled by Sutter VH
-
Sutter Davis Hospital Foundation
501(c)(3) · Fundraising · CA · controlled entity
Directly controlled by Sutter VH
-
501(c)(3) · Hospital · CA · controlled entity
Directly controlled by SUTTER HLTH
-
501(c)(3) · Support. Org. · CA
Directly controlled by NA
-
501(c)(3) · Hospital · CA · controlled entity
Directly controlled by SUTTER HLTH
-
501(c)(4) · Health Plan · CA · controlled entity
Directly controlled by SUTTER HLTH
-
501(c)(3) · Hospital · CA · controlled entity
Directly controlled by SUTTER HLTH
-
Sutter Insurance Services Corporation
501(c)(3) · Insur. Svcs. · HI · controlled entity
Directly controlled by SUTTER HLTH
-
Sutter Medical Center Foundation
501(c)(3) · Fundraising · CA · controlled entity
Directly controlled by Sutter VH
-
Sutter Valley Medical Foundation
501(c)(3) · Healthcare · CA · controlled entity
Directly controlled by SUTTER HLTH
-
Sutter Visiting Nurse Association & Hos
501(c)(3) · Healthcare · CA · controlled entity
Directly controlled by SUTTER HLTH
-
501(c)(3) · Hospital · CA · controlled entity
Directly controlled by SUTTER HLTH
-
501(c)(3) · Fundraising · CA · controlled entity
Directly controlled by Sutter VH
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.
-
Surgery Ctr of ABSMC
Patient Care · CA
-
California Pacific Adv Imaging
Patient Care · CA
-
San Francisco Endoscopy Ctr
Patient Care · CA
-
Sutter Fairfield Surgery Ctr
Patient Care · CA
-
Sutter Amador Surgery Ctr
Patient Care · CA
-
Roseville Endoscopy Ctr
Patient Care · CA
-
Memorial Med Off Bldg Phase II
OFFICE RENTAL · CA
-
Alta CT Services LP
Patient Care · CA
-
Magnetic Imaging LLC
Patient Care · CA
Directly controlled by NA
-
STANISLAUS SURGICAL HOSPITAL LLC
Patient Care · CA
-
ASC OPERATORS SANTA ROSA LLC
CARE MANAGEMENT · CA
-
Divisadero Holdings LLC
CARE MANAGEMENT · CA
-
PENINSULA ENDOSCOPY CENTER LLC
PATIENT CARE · CA
-
South Placer Surgery Center
Patient Care · CA
-
Sacramento Surgery Center Associates LP
Patient Care · CA
-
Fort Sutter Surgery Center
Patient Care · CA
-
Sutter Alhambra Surgery Center
Patient Care · CA
-
Auburn Surgical Center
Patient Care · CA
-
ASC Operators LLC
Care Management · CA
-
D E SHAW ALL COUNTRY GLOBAL ALPHA PLUS
Investment · DE
-
ICG CREDIT OPPORTUNITIES FUND 1A LP
Investment · DE
-
ICG CREDIT OPPORTUNITIES FUND 2A LP
Investment · DE
-
MAKENA REAL ESTATE II LP
Investment · CJ
-
D E SHAW ALL COUNTRY GLOBAL ALPHA LL
Investment · DE
-
ICG CREDIT OPPORTUNITIES FUND LP
Investment · DE
-
ICG SPECIAL OPPORTUNITIES FUND I LP
Investment · DE
Related corporations and trusts
Part IV: related organizations taxable as a corporation or trust.
-
NORTHWOOD EUROPE TE FEEDER LP
C CORP · HOLDING COMPANY · CJ · controlled entity
Directly controlled by NA
-
SUTTER HEALTH DEFERRED COMP PLANS' TRUST
TRUST · RABBI TRUST · CA · controlled entity
Directly controlled by NA
-
Lyxsop Segregated Portfolio 1
c corp · INVESTMENT · CJ · controlled entity
-
Lyxsop Segregated Portfolio 2
c corp · INVESTMENT · CJ · controlled entity
-
AQR REAL RETURN OFFSHORE FUND LP
C Corp · Investment · CJ · controlled entity
-
BRIGADE LEVERAGED CAPITAL STRUCTURE OFFS
C Corp · Investment · CJ · controlled entity
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 2 November 2023
- IRS schema version
- 2022v5.0
- Source object
- 202333189349304923
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