Skip to content
Nonprofiteer
← SUTTER ROSEVILLE MEDICAL CENTER FOUNDATION

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 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 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

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.

  • 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

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.