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Nonprofiteer
← SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC

Form 990 for tax year 2023

Filed by SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC.

Totals

Total revenue
$68,105
Total expenses
$45,114
Contributions and grants received
$27,005
Grants paid
$4,000
Program service revenue
$0
Investment income
$40,167
Other revenue
$933
Total assets, end of year
$1,233,574
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$1,233,574
Program services expenses (Part IX)
$43,059
Management and general expenses
$2,055
Fundraising expenses
$0
Program service expenses (Part III)
$43,059

Program services were 95.4% 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.

  • 1c · Fundraising events

    $9,562

  • 1f · All other contributions, gifts and grants

    $17,443

  • 1g · Noncash contributions included above

    $2,454

  • 3 · Investment income

    total $40,167 · excluded $40,167

  • 8a · Fundraising events: gross income

    $2,972

  • 8a · Fundraising events: contributions included on line 1c

    $9,562

  • 8b · Fundraising events: direct expenses

    $3,897

  • 8c · Net income from fundraising events

    total -$925 · excluded -$925

  • 9a · Gaming: gross income

    $1,997

  • 9b · Gaming: direct expenses

    $139

  • 9c · Net income from gaming

    total $1,858 · excluded $1,858

Functional expenses

Part IX, the statement of functional expenses.

  • 2 · Grants to domestic individuals

    total $4,000 · program services $4,000

  • 11g · Fees: other

    total $41,114 · program services $39,059 · management and general $2,055

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $1,106,713 · end of year $1,233,574

  • 27 · Net assets without donor restrictions

    beginning of year $979,304 · end of year $1,082,357

  • 28 · Net assets with donor restrictions

    beginning of year $127,409 · end of year $151,217

Mission and programs · 2023

Mission

AS AN AFFILIATE OF COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL.

Activities or mission (Part I)

THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH.

  • THE FOUNDATION WAS FOUNDED AND EXISTS TO SUPPORT HEALTHCARE SERVICES PROVIDED IN COLFAX COUNTY, NEBRASKA BY ALEGENT HEALTH MEMORIAL HOSPITAL IN SCHUYLER, NEBRASKA. THE FOUNDATION, THROUGH ITS FINANCIAL CONTRIBUTIONS TO THE HOSPITAL, HELPS TO PROMOTE THE CONTINUED AVAILABILITY OF QUALITY, AFFORDABLE HEALTH SERVICES TO THE RESIDENTS OF COLFAX COUNTY AND SURROUNDING, PRIMARILY RURAL, AREAS.

    Expenses $43,059 · Grants $4,000

As filed on the 2023 return.

Listed in Part VII

  • EVERT KUIPER

    FORMER PRESIDENT & CEO CHI HEALTH

    Total calculated
    $2,835,767
    From this org
    $0
    From related orgs
    $2,787,233
    Other
    $48,534
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $749,566 related
    Bonus
    $0
    Other
    $0 + $2,037,667 related
    Deferred
    $0 + $20,045 related
    Nontaxable benefits
    $0 + $28,489 related
    Filer's total
    $0 + $2,835,767 related

  • JEANETTE WOJTALEWICZ

    FORMER CFO, CHI HEALTH

    Total calculated
    $1,357,202
    From this org
    $0
    From related orgs
    $1,344,835
    Other
    $12,367
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $128,679 related
    Bonus
    $0 + $132,479 related
    Other
    $0 + $1,083,677 related
    Deferred
    $0 + $9,698 related
    Nontaxable benefits
    $0 + $2,669 related
    Filer's total
    $0 + $1,357,202 related

  • TIM SCHNACK

    MARKET CFO (BEG 05/24)

    Total calculated
    $417,768
    From this org
    $0
    From related orgs
    $369,715
    Other
    $48,053
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $290,959 related
    Bonus
    $0 + $74,901 related
    Other
    $0 + $3,855 related
    Deferred
    $0 + $19,529 related
    Nontaxable benefits
    $0 + $28,524 related
    Filer's total
    $0 + $417,768 related

  • KATHY BERTOLINI

    VP PHILANTHROPY

    Total calculated
    $406,336
    From this org
    $0
    From related orgs
    $358,469
    Other
    $47,867
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $268,178 related
    Bonus
    $0 + $86,599 related
    Other
    $0 + $3,692 related
    Deferred
    $0 + $19,278 related
    Nontaxable benefits
    $0 + $28,589 related
    Filer's total
    $0 + $406,336 related

  • NICK OTOOL

    INTERIM CFO, CHI HEALTH (END 05/24)

    Total calculated
    $399,969
    From this org
    $0
    From related orgs
    $349,020
    Other
    $50,949
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $252,554 related
    Bonus
    $0 + $96,047 related
    Other
    $0 + $419 related
    Deferred
    $0 + $16,660 related
    Nontaxable benefits
    $0 + $34,289 related
    Filer's total
    $0 + $399,969 related

  • CONNIE PETERS

    BOARD SECRETARY, AND CHI HEALTH SCHUYLER PRESIDENT

    Total calculated
    $340,135
    From this org
    $0
    From related orgs
    $311,802
    Other
    $28,333
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $197,374 related
    Bonus
    $0 + $102,615 related
    Other
    $0 + $11,813 related
    Deferred
    $0 + $15,936 related
    Nontaxable benefits
    $0 + $12,397 related
    Filer's total
    $0 + $340,135 related

  • NOLAN SAMEK

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • ZACH JOHNSON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • KEVIN HOFFART

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • MONICA HARNEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • CHRISTINA BYWATER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • LARRY MCGOWAN

    PRESIDENT

    Total calculated
    $0
    Hours/week
    1

  • ERIC GOODRICH

    TREASURER

    Total calculated
    $0
    Hours/week
    1

  • JEFF DIDIER

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    1

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
DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE EXECUTIVE DIRECTOR OF SCHUYLER MEMORIAL HOSPITAL FOUNDATION, THE VP OF PHILANTHROPY, WAS ESTABLISHED BY CHI HEALTH, A RELATED ORGANIZATION. CHI HEALTH USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
SCHEDULE J, PART I, LINE 4A - SEVERANCE OR CHANGE-OF-CONTROL PAYMENTS:
CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2023 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): EVERT KUIPER, $2,025,542 AND JEANETTE WOJTALEWICZ, $1,083,464.
SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN:
DURING THE 2023 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2023 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II. DURING 2023, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: CONNIE PETERS, $9,404.
SCHEDULE J, PART II
SCHUYLER MEMORIAL HOSPITAL FOUNDATION, INC. FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2023.

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.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2023
Filed
14 May 2025
IRS schema version
2023v6.0
Source object
202511349349303081

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