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Nonprofiteer
← MERCY HEALTH FOUNDATION INC

Form 990 for tax year 2022

Filed by MERCY HEALTH FOUNDATION INC.

Totals

Total revenue
$1,136,513
Total expenses
$883,034
Contributions and grants received
$827,420
Grants paid
$342,912
Program service revenue
$0
Investment income
$309,093
Other revenue
$0
Total assets, end of year
$14,553,870
Total liabilities, end of year
$206,012
Net assets or fund balances, end of year
$14,347,858
Program services expenses (Part IX)
$397,001
Management and general expenses
$80,901
Fundraising expenses
$405,132
Program service expenses (Part III)
$397,001

Program services were 45.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ANNE STACEY

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • DAVID RUCKER

    TREASURER

    Total calculated
    $0
    Hours/week
    1

  • JORI HARTWIG

    SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • JULIE MASLOWSKI

    PAST CHAIR

    Total calculated
    $0
    Hours/week
    1

  • MICHAEL BERGMAN

    EX-OFFICIO

    Total calculated
    $602,144
    From this org
    $0
    From related orgs
    $556,780
    Other
    $45,364
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $392,032 related
    Bonus
    $0 + $120,000 related
    Other
    $0 + $44,748 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $30,114 related
    Filer's total
    $0 + $602,144 related

  • RACHEL HANSEN

    CHAIR

    Total calculated
    $0
    Hours/week
    1

  • REGINALD NEWSON

    EX-OFFICIO

    Total calculated
    $480,249
    From this org
    $0
    From related orgs
    $435,729
    Other
    $44,520
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $304,658 related
    Bonus
    $0 + $108,900 related
    Other
    $0 + $22,171 related
    Deferred
    $0 + $15,857 related
    Nontaxable benefits
    $0 + $28,663 related
    Filer's total
    $0 + $480,249 related

  • ALICIA DAMBECK

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JAMES STAHL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JENNIFER GELHAR DC

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JOHN MICHAEL LESCHKE MD

    DIRECTOR

    Total calculated
    $178,257
    From this org
    $0
    From related orgs
    $167,453
    Other
    $10,804
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $165,243 related
    Bonus
    $0
    Other
    $0 + $2,210 related
    Deferred
    $0 + $9,038 related
    Nontaxable benefits
    $0 + $1,766 related
    Filer's total
    $0 + $178,257 related

  • KEVIN RAFOLSKY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • MICHAEL J FOLEY MD

    DIRECTOR

    Total calculated
    $638,709
    From this org
    $0
    From related orgs
    $588,792
    Other
    $49,917
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $526,508 related
    Bonus
    $0 + $59,662 related
    Other
    $0 + $2,622 related
    Deferred
    $0 + $19,359 related
    Nontaxable benefits
    $0 + $30,558 related
    Filer's total
    $0 + $638,709 related

  • PATSY BECK

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • THERESA CHENG MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • MATTHEW TYLER HANSELMAN

    CFO, MINISTRY MARKET/INTERIM CEO, MINISTRY MARKET (START 5/2023)

    Total calculated
    $682,503
    From this org
    $0
    From related orgs
    $634,732
    Other
    $47,771
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $390,659 related
    Bonus
    $0 + $120,000 related
    Other
    $0 + $124,073 related
    Deferred
    $0 + $18,015 related
    Nontaxable benefits
    $0 + $29,756 related
    Filer's total
    $0 + $682,503 related

  • JONATHAN SOHN

    FORMER OFFICER (END 9/2021)

    Total calculated
    $1,343,939
    From this org
    $0
    From related orgs
    $1,289,649
    Other
    $54,290
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $536,290 related
    Bonus
    $0 + $660,000 related
    Other
    $0 + $93,359 related
    Deferred
    $0 + $19,825 related
    Nontaxable benefits
    $0 + $34,465 related
    Filer's total
    $0 + $1,343,939 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

  • 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)

Schedule J, Part I, Line 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION
A RELATED ORGANIZATION OF THE FILING ORGANIZATION USES ONE OR MORE OF THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY, AND -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PLEASE REFER TO THE FORM 990, PART VI, LINE 15A DISCLOSURE IN SCHEDULE O FOR ADDITIONAL DETAILS ON HOW COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED.
Schedule J, Part I, Line 4b SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN
ELIGIBLE EXECUTIVES PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO INDIVIDUALS RECEIVED CURRENT YEAR DISTRIBUTIONS.

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.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2022
Filed
30 July 2024
IRS schema version
2022v5.0
Source object
202422129349301262

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