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Nonprofiteer
← MEMORIAL HOSPITAL INC

Form 990 for tax year 2023

Filed by MEMORIAL HOSPITAL INC.

Totals

Total revenue
$41,450,526
Total expenses
$41,096,760
Contributions and grants received
$94,668
Grants paid
$0
Program service revenue
$41,267,508
Investment income
-$2,519
Other revenue
$90,869
Total assets, end of year
$52,285,487
Total liabilities, end of year
$406,943
Net assets or fund balances, end of year
$51,878,544
Program services expenses (Part IX)
$32,086,221
Management and general expenses
$9,010,539
Fundraising expenses
$0
Program service expenses (Part III)
$32,086,221

Program services were 78.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • MARK BUGHER

    CHAIR - PART YEAR

    Total calculated
    $24,924
    From this org
    $0
    From related orgs
    $24,924
    Other
    $0
    Hours/week
    1 + 9 related

  • COLLEEN HOERNEMAN

    CHAIR

    Total calculated
    $6,500
    From this org
    $0
    From related orgs
    $6,500
    Other
    $0
    Hours/week
    1 + 9 related

  • MARK BRADLEY

    VICE CHAIR

    Total calculated
    $13,000
    From this org
    $0
    From related orgs
    $13,000
    Other
    $0
    Hours/week
    1 + 5 related

  • RUWAN DISSANAYAKE MD

    SECRETARY - PART YEAR

    Total calculated
    $395,013
    From this org
    $0
    From related orgs
    $370,856
    Other
    $24,157
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $240,464 related
    Bonus
    $0 + $114,060 related
    Other
    $0 + $16,332 related
    Deferred
    $0 + $3,614 related
    Nontaxable benefits
    $0 + $20,543 related
    Filer's total
    $0 + $395,013 related

  • JOHN BALTUS

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    1

  • SUSAN TURNEY MD

    BOARD MEMBER/MCHS CEO - PART YEAR

    Total calculated
    $3,507,040
    From this org
    $0
    From related orgs
    $3,125,033
    Other
    $382,007
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,225,308 related
    Bonus
    $0 + $450,000 related
    Other
    $0 + $1,449,725 related
    Deferred
    $0 + $361,730 related
    Nontaxable benefits
    $0 + $20,277 related
    Filer's total
    $0 + $3,507,040 related

  • BRIAN HOERNEMAN MD

    BOARD MEMBER/INTERIM MCHS CEO

    Total calculated
    $888,868
    From this org
    $0
    From related orgs
    $848,741
    Other
    $40,127
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $741,668 related
    Bonus
    $0 + $73,943 related
    Other
    $0 + $33,130 related
    Deferred
    $0 + $9,900 related
    Nontaxable benefits
    $0 + $30,227 related
    Filer's total
    $0 + $888,868 related

  • WILLIAM MELMS MD

    BOARD MEMBER/MCHS CMO - PART YEAR

    Total calculated
    $1,074,914
    From this org
    $0
    From related orgs
    $1,053,823
    Other
    $21,091
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $206,266 related
    Bonus
    $0 + $152,673 related
    Other
    $0 + $694,884 related
    Deferred
    $0 + $9,900 related
    Nontaxable benefits
    $0 + $11,191 related
    Filer's total
    $0 + $1,074,914 related

  • SAMANTHA KLEBE DO

    BOARD MEMBER/MCHS CMO

    Total calculated
    $545,008
    From this org
    $0
    From related orgs
    $515,015
    Other
    $29,993
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $466,567 related
    Bonus
    $0 + $21,085 related
    Other
    $0 + $27,363 related
    Deferred
    $0 + $9,900 related
    Nontaxable benefits
    $0 + $20,093 related
    Filer's total
    $0 + $545,008 related

  • DOUG MATHISON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • EDWARD FERNANDEZ MD

    BOARD MEMBER

    Total calculated
    $579,436
    From this org
    $0
    From related orgs
    $536,206
    Other
    $43,230
    Hours/week
    1 + 56 related

    Schedule J breakdown matched by us

    Base
    $0 + $349,775 related
    Bonus
    $0 + $148,993 related
    Other
    $0 + $37,438 related
    Deferred
    $0 + $9,900 related
    Nontaxable benefits
    $0 + $33,330 related
    Filer's total
    $0 + $579,436 related

  • MARGARET MINERICK

    BOARD MEMBER - PART YEAR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • DAVID HOLMES

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • CATHY BUKOWSKI

    MCHS CFO- PART YEAR

    Total calculated
    $749,233
    From this org
    $0
    From related orgs
    $725,840
    Other
    $23,393
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $571,918 related
    Bonus
    $0 + $9,200 related
    Other
    $0 + $144,722 related
    Deferred
    $0 + $9,900 related
    Nontaxable benefits
    $0 + $13,493 related
    Filer's total
    $0 + $749,233 related

  • JEANETTE WOJTALEWICZ

    INTERIM MCHS CFO

    Total calculated
    $116,564
    From this org
    $0
    From related orgs
    $116,564
    Other
    $0
    Hours/week
    1 + 54 related

  • RYAN NEVILLE

    FORMER PRESIDENT & CEO

    Total calculated
    $422,479
    From this org
    $0
    From related orgs
    $403,364
    Other
    $19,115
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $133,824 related
    Bonus
    $0 + $6,570 related
    Other
    $0 + $262,970 related
    Deferred
    $0 + $5,656 related
    Nontaxable benefits
    $0 + $13,459 related
    Filer's total
    $0 + $422,479 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

  • 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
THE MARSHFIELD CLINIC HEALTH SYSTEM'S (MCHS) INDEPENDENT COMPENSATION COMMITTEE (THE COMMITTEE) HAS FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS EMPLOYED BY ANY OF THE ORGANIZATIONS IN THE SYSTEM. THE COMMITTEE USES COMBINATIONS OF THE FOLLOWING TO EVALUATE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE, AND WRITTEN EMPLOYMENT CONTRACTS.
PART I, LINES 4A-B
LINE 4A: IN 2023, SUSAN TURNEY, MD RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $614,466, WILLIAM MELMS, MD RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $610,615, CATHY BUKOWSKI RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $82,431, AND RYAN NEVILLE RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $212,846. LINE 4B: THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AND RECEIVED A DISTRIBUTION FROM OR HAD AMOUNTS VEST IN THE PLAN: SUSAN TURNEY, MD - $275,424 THE FOLLOWING INDIVIDUALS PARTICATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN BUT DID NOT RECEIVE A DISTRIBUTION OR HAVE AN AMOUNT VEST IN THE PLAN. UNDER THE PLAN, AMOUNTS DO NOT VEST UNTIL TWO YEARS AFTER SEPARATION FROM THE ORGANIZATION: RUWAN DISSANAYAKE, MD BRIAN HOERNEMAN, MD SAMANTHA KLEBE, DO WILLIAM MELMS, MD EDWARD FERNANDEZ, MD CATHY BUKOWSKI RYAN NEVILLE

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.

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.

Provenance

Return type
form_990
Tax year
2023
Filed
11 November 2024
IRS schema version
2023v5.1
Source object
202423189349305827

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

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