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Nonprofiteer
← AMBERWELL HEALTH FOUNDATION

Form 990 for tax year 2022

Filed by AMBERWELL HEALTH FOUNDATION.

Totals

Total revenue
$546,346
Total expenses
$828,653
Contributions and grants received
$0
Grants paid
$750,000
Program service revenue
$0
Investment income
$512,835
Other revenue
$33,511
Total assets, end of year
$14,260,475
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$14,260,475
Program services expenses (Part IX)
$750,000
Management and general expenses
$78,653
Fundraising expenses
$0
Program service expenses (Part III)
$750,000

Program services were 90.5% 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.

  • 3 · Investment income

    total $243,377 · excluded $243,377

  • 7a · Gross sales of assets other than inventory

    securities $5,779,268

  • 7b · Less cost or other basis and sales expenses

    securities $5,509,810

  • 7c · Gain or loss

    securities $269,458

  • 7d · Net gain or loss

    total $269,458 · excluded $269,458

  • 11a · Other revenue: RECOVERY OF INVESTMENT FUNDS

    total $55,105 · excluded $55,105

  • 11b · Other revenue: PARTNERSHIP INCOME

    total -$21,594 · unrelated business -$21,594

  • 11e · Other revenue, total

    $33,511

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $750,000 · program services $750,000

  • 11c · Fees: accounting

    total $1,255 · management and general $1,255

  • 11f · Fees: investment management

    total $77,398 · management and general $77,398

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $223,266 · end of year $127,365

  • 11 · Investments: publicly traded securities

    beginning of year $17,005,160 · end of year $13,821,562

  • 12 · Investments: other securities

    beginning of year $239,680 · end of year $288,272

  • 15 · Other assets

    beginning of year $23,276 · end of year $23,276

  • 27 · Net assets without donor restrictions

    beginning of year $17,491,382 · end of year $14,260,475

Mission and programs · 2022

Mission

SUPPORT FOR AMBERWELL ATCHISON ASSOCIATION IN ITS MISSION AND TO SUPPORT THE HEALTH OF THE COMMUNITY.

  • INVEST THE FOUNDATION CORPUS, PROVIDE CAPITAL EXPENDITURE FUNDS ANNUALLY, AND UPON REQUEST AND APPROVAL, PROVIDE FUNDS FOR NEW PROJECTS.

    Expenses $750,000 · Grants $750,000

As filed on the 2022 return.

Listed in Part VII

  • Jeff Perry

    CEO

    Total calculated
    $537,712
    From this org
    $0
    From related orgs
    $519,608
    Other
    $18,104
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $392,938 related
    Bonus
    $0 + $126,508 related
    Other
    $0 + $162 related
    Deferred
    $0 + $9,150 related
    Nontaxable benefits
    $0 + $8,954 related
    Filer's total
    $0 + $537,712 related

  • Jim Fraser

    CFO THRU 07/22

    Total calculated
    $219,435
    From this org
    $0
    From related orgs
    $198,128
    Other
    $21,307
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $198,128 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $3,266 related
    Nontaxable benefits
    $0 + $18,041 related
    Filer's total
    $0 + $219,435 related

  • Chase Dudzinski

    CFO

    Total calculated
    $188,875
    From this org
    $0
    From related orgs
    $165,681
    Other
    $23,194
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $145,552 related
    Bonus
    $0 + $20,000 related
    Other
    $0 + $129 related
    Deferred
    $0 + $3,125 related
    Nontaxable benefits
    $0 + $20,069 related
    Filer's total
    $0 + $188,875 related

  • Richard N Berger

    CHAIRPERSON

    Total calculated
    $0
    Hours/week
    1

  • Kevin McDermed

    SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • Mark Windsor

    TREASURER

    Total calculated
    $0
    Hours/week
    1

  • Bill Thornton

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • Andrea Bock-Kunz MD

    DIRECTOR THRU 04/22

    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

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 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
COMPENSATION FOR JEFF PERRY IS ESTABLISHED BY AMBERWELL ATCHISON ASSOCIATION, A RELATED ENTITY, USING THE FOLLOWING: INDEPENDENT COMPENSATION CONSULTANT, A COMPENSATION STUDY, FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. JEFF SERVED AS A NON-VOTING MEMBER OF THE FOUNDATION AND CEO OF AMBERWELL ATCHISON.

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.

Provenance

Return type
form_990
Tax year
2022
Filed
12 December 2023
IRS schema version
2022v5.0
Source object
202313469349300101

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