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← SHARE FOUNDATION OF COMMUNITY HOSPITALS OF WILLIAMS COUNTY INC

Form 990 for tax year 2023

Filed by SHARE FOUNDATION OF COMMUNITY HOSPITALS OF WILLIAMS COUNTY INC.

Totals

Total revenue
$45,059
Total expenses
$0
Contributions and grants received
$6,740
Grants paid
$0
Program service revenue
$0
Investment income
$38,319
Other revenue
$0
Total assets, end of year
$4,543,422
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$4,543,422
Program services expenses (Part IX)
$0
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
not reported

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.

  • 1f · All other contributions, gifts and grants

    $6,740

  • 3 · Investment income

    total $38,319 · excluded $38,319

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $14,252 · end of year $21,019

  • 11 · Investments: publicly traded securities

    beginning of year $4,127,182 · end of year $4,522,403

  • 28 · Net assets with donor restrictions

    beginning of year $4,141,434 · end of year $4,543,422

Mission and programs · 2023

Mission

TO CONDUCT FUNDRAISING ACTIVITIES TO PROVIDE ASSISTANCE TO COMMUNITY HOSPITALS AND WELLNESS CENTERS, FOR THE UNCOMPENSATED CARE DELIVERED BY COMMUNITY HOSPITALS AND WELLNESS CENTERS.

  • TO PROVIDE ASSISTANCE FOR UNCOMPENSATED CARE DELIVERED BY COMMUNITY HOSPITALS & WELLNESS CENTERS.

As filed on the 2023 return.

Listed in Part VII

  • Chad Tinkel

    DIRECTORY/CHWC PRESIDENT

    Total calculated
    $990,969
    From this org
    $0
    From related orgs
    $900,726
    Other
    $90,243
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $347,866 related
    Bonus
    $0 + $244,487 related
    Other
    $0 + $308,373 related
    Deferred
    $0 + $63,794 related
    Nontaxable benefits
    $0 + $26,449 related
    Filer's total
    $0 + $990,969 related

  • Steve Bumb

    DIRECTOR/CHWC CHIEF OF STAFF

    Total calculated
    $436,182
    From this org
    $0
    From related orgs
    $385,889
    Other
    $50,293
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $343,862 related
    Bonus
    $0 + $40,450 related
    Other
    $0 + $1,577 related
    Deferred
    $0 + $21,998 related
    Nontaxable benefits
    $0 + $28,295 related
    Filer's total
    $0 + $436,182 related

  • Katrina Hester

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Christopher Kannel

    DIRECTOR/CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Cindy Reed

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Russ Davies

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Allyn Luce

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Lars Ellar

    DIRECTOR/TREASURER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Elena West

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Jim Watkins

    DIRECTOR/SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Jeanne' Wickens

    PH CHIEF FINANCIAL OFFICER

    Total calculated
    $2,443,396
    From this org
    $0
    From related orgs
    $2,165,508
    Other
    $277,888
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $834,975 related
    Bonus
    $0 + $187,034 related
    Other
    $0 + $1,143,499 related
    Deferred
    $0 + $239,228 related
    Nontaxable benefits
    $0 + $38,660 related
    Filer's total
    $0 + $2,443,396 related

  • Dena Jacquay

    PH CHIEF ADMINISTRATIVE OFFICER

    Total calculated
    $1,926,311
    From this org
    $0
    From related orgs
    $1,629,814
    Other
    $296,497
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $759,072 related
    Bonus
    $0 + $149,247 related
    Other
    $0 + $721,495 related
    Deferred
    $0 + $239,600 related
    Nontaxable benefits
    $0 + $56,897 related
    Filer's total
    $0 + $1,926,311 related

  • Carolyn Sharrock-Dorsten

    FORMER OFFICER/MCHA PHYSICIAN

    Total calculated
    $427,694
    From this org
    $0
    From related orgs
    $355,933
    Other
    $71,761
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $302,136 related
    Bonus
    $0 + $48,029 related
    Other
    $0 + $5,768 related
    Deferred
    $0 + $36,300 related
    Nontaxable benefits
    $0 + $35,461 related
    Filer's total
    $0 + $427,694 related

  • Christa Pomeroy

    FORMER OFFICER/PH DIRECTOR TREASURY

    Total calculated
    $304,545
    From this org
    $0
    From related orgs
    $267,525
    Other
    $37,020
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $207,232 related
    Bonus
    $0 + $12,500 related
    Other
    $0 + $47,793 related
    Deferred
    $0 + $8,618 related
    Nontaxable benefits
    $0 + $28,402 related
    Filer's total
    $0 + $304,545 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

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Form 990 of other organizations
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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
RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF SHARE FOUNDATION OF COMMUNITY HOSPITALS OF WILLIAMS COUNTY, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC.
PART I, LINE 4B
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS THE FOLLOWING INDIVIDUALS PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION AND THE AMOUNT OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE FOLLOWING INDIVIDUALS VESTED IN A PORTION OF THEIR DEFERRED COMPENSATION PLANS, WHICH IS TREATED AS TAXABLE INCOME TO THE INDIVIDUALS AT THE TIME OF VESTING. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III): DENA JACQUAY $685,401; CHRISTA POMEROY $31,411; CHAD TINKEL $278,519; JEANNE' WICKENS $1,107,767 AMOUNTS LISTED ABOVE THAT HAVE BEEN REPORTED AS DEFERRED COMPENSATION ON PRIOR FORM 990 OF THE ORGANIZATION OR RELATED ORGANIZATIONS WILL ALSO BE REFLECTED IN SCHEDULE J, PART II, COLUMN (F). FOR EXAMPLE, THE AMOUNT OF $1,107,767 REPORTED AS REQUIRED FOR JEANNE' WICKENS WAS A RESULT OF THE VESTING OF SUCH AMOUNT UNDER THE TERMS OF THE RESPECTIVE PLANS. HOWEVER, THESE AMOUNTS WERE PREVIOUSLY REPORTED IN JEANNE' WICKENS' DEFERRED COMPENSATION FROM PRIOR YEARS AS THE AMOUNTS WERE DEFERRED UNDER THE PLANS. AS SUCH, THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) IS AN INDICATION OF AMOUNTS THAT HAVE BEEN REPORTED TWICE, ONCE AS A DEFERRAL AND ONCE AS VESTED. THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. DEFERRALS REPORTED IN SCHEDULE J, PART II, COLUMN (C) INCLUDE: DENA JACQUAY $200,000; CHAD TINKEL $15,217; JEANNE' WICKENS $216,128

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.

  • ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH LLC

    N/A · ORTHOPAEDIC HOSPITAL · IN

  • MANAGED CARE SERVICES LLC

    N/A · HEALTH PLAN ADMINISTRATION · IN

  • FOUNDATION SURGERY AFFILIATE OF FORT WAYNE LLC

    N/A · SURGICAL SERVICES · IN

  • COMMUNITY HOSPITALS AND WELLNESS CENTERS PAIN MANAGEMENT LLC

    N/A · MEDICAL SERVICES · OH

  • EXCEL SPORTS GROUP LLC

    N/A · SPORTS CAMPS & LEAGUES · IN

Related corporations and trusts

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

  • PARKVIEW PROFESSIONAL PROGRAMS INC

    C · REFERENCE LAB · IN

  • WOODLAND PLAZA MEDICAL PARK CONDO ASSOC INC

    C · PROPERTY OWNERS ASSOCIATION · IN

  • PARKVIEW HEALTH SYSTEM INC 457(B) PLAN

    T · TRUST - 457(B) PLAN 003 · IN

  • PARKVIEW HEALTH SYSTEM SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN

    T · TRUST - SERP PLAN 004 · IN

  • PARKVIEW HEALTH SYSTEM INC 457(F) PLAN

    T · TRUST - 457(F) PLAN 005 · IN

  • PARKVIEW HEALTH SYSTEM SUPPLEMENTAL

    T · TRUST - SUPPLEMENTAL PLAN 008 · IN

  • PARKVIEW HEALTH SYSTEM EVPCEO

    T · TRUST - EVP/CEO PLAN 009 · IN

Provenance

Return type
form_990
Tax year
2023
Filed
8 November 2024
IRS schema version
2023v5.1
Source object
202433139349304388

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