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Nonprofiteer
← MERCY MEDICAL FOUNDATION

Form 990 for tax year 2022

Filed by MERCY MEDICAL FOUNDATION.

Totals

Total revenue
$1,127,385
Total expenses
$786,935
Contributions and grants received
$203,939
Grants paid
$752,694
Program service revenue
$0
Investment income
$230,577
Other revenue
$692,869
Total assets, end of year
$14,887,673
Total liabilities, end of year
$798,168
Net assets or fund balances, end of year
$14,089,505
Program services expenses (Part IX)
$752,694
Management and general expenses
$34,241
Fundraising expenses
$0
Program service expenses (Part III)
$752,694

Program services were 95.6% 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

    $30,690

  • 1f · All other contributions, gifts and grants

    $173,249

  • 1g · Noncash contributions included above

    $4,969

  • 3 · Investment income

    total $111,307 · excluded $111,307

  • 5 · Royalties

    total $732,717 · excluded $732,717

  • 7a · Gross sales of assets other than inventory

    securities $119,270

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

    securities $0

  • 7c · Gain or loss

    securities $119,270

  • 7d · Net gain or loss

    total $119,270 · excluded $119,270

  • 8a · Fundraising events: gross income

    $19,536

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

    $30,690

  • 8b · Fundraising events: direct expenses

    $64,916

  • 8c · Net income from fundraising events

    total -$45,380 · excluded -$45,380

  • 9a · Gaming: gross income

    $7,800

  • 9b · Gaming: direct expenses

    $2,268

  • 9c · Net income from gaming

    total $5,532 · excluded $5,532

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $752,694 · program services $752,694

  • 11g · Fees: other

    total $2,982 · management and general $2,982

  • 13 · Office expenses

    total $5,579 · management and general $5,579

  • 16 · Occupancy

    total $1,328 · management and general $1,328

  • 17 · Travel

    total $73 · management and general $73

  • 19 · Conferences, conventions and meetings

    total $493 · management and general $493

  • 20 · Interest

    total $2,283 · management and general $2,283

  • 22 · Depreciation, depletion and amortization

    total $469 · management and general $469

  • 24a · Other expenses: MISCELLANEOUS EXPENSES

    total $15,930 · management and general $15,930

  • 24b · Other expenses: REPAIRS AND MAINTENANCE

    total $4,920 · management and general $4,920

  • 24c · Other expenses: DUES & SUBSCRIPTIONS

    total $184 · management and general $184

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $3,596,963 · end of year $3,866,259

  • 9 · Prepaid expenses and deferred charges

    end of year $250,000

  • 10a · Land, buildings and equipment: cost or other basis

    $377,961

  • 10b · Land, buildings and equipment: accumulated depreciation

    $195,786

  • 10c · Land, buildings and equipment, net

    beginning of year $182,644 · end of year $182,175

  • 12 · Investments: other securities

    beginning of year $9,864,300 · end of year $10,219,658

  • 14 · Intangible assets

    beginning of year $31,224 · end of year $31,224

  • 15 · Other assets

    beginning of year $338,357 · end of year $338,357

  • 17 · Accounts payable and accrued expenses

    end of year $262,486

  • 25 · Other liabilities

    beginning of year $170,081 · end of year $535,682

  • 27 · Net assets without donor restrictions

    beginning of year $7,704,118 · end of year $8,166,090

  • 28 · Net assets with donor restrictions

    beginning of year $6,139,289 · end of year $5,923,415

Mission and programs · 2022

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)

MERCY MEDICAL FOUNDATION SERVES AS THE FUNDRAISING ARM OF MERCY MEDICAL CENTER AND COORDINATES GIFTS OF ENERGY, TALENTS AND FINANCIAL RESOURCES TO BUILD HEALTHIER COMMUNITIES IN OUR REGION.

  • SEE SCHEDULE O

    Expenses $752,694 · Grants $752,694

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • MATT GRIMSHAW

    FORMER EX-OFFICIO/MARKET PRESIDENT

    Total calculated
    $790,966
    From this org
    $0
    From related orgs
    $746,327
    Other
    $44,639
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $456,489 related
    Bonus
    $0 + $267,194 related
    Other
    $0 + $22,644 related
    Deferred
    $0 + $17,929 related
    Nontaxable benefits
    $0 + $26,710 related
    Filer's total
    $0 + $790,966 related

  • NICK O'TOOL

    DIVISION VP FINANCE

    Total calculated
    $304,710
    From this org
    $0
    From related orgs
    $257,678
    Other
    $47,032
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $207,354 related
    Bonus
    $0 + $49,872 related
    Other
    $0 + $452 related
    Deferred
    $0 + $16,380 related
    Nontaxable benefits
    $0 + $30,652 related
    Filer's total
    $0 + $304,710 related

  • JOSEPH RUARK

    CFO/VP OF FINANCE MMC

    Total calculated
    $247,899
    From this org
    $0
    From related orgs
    $208,111
    Other
    $39,788
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $180,560 related
    Bonus
    $0 + $22,487 related
    Other
    $0 + $5,064 related
    Deferred
    $0 + $13,421 related
    Nontaxable benefits
    $0 + $26,367 related
    Filer's total
    $0 + $247,899 related

  • DAN BJERKNES

    PRESIDENT MERCY WILLISTON (THRU 8/1/22)

    Total calculated
    $216,037
    From this org
    $0
    From related orgs
    $163,502
    Other
    $52,535
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $152,814 related
    Bonus
    $0 + $50 related
    Other
    $0 + $10,638 related
    Deferred
    $0 + $30,024 related
    Nontaxable benefits
    $0 + $22,511 related
    Filer's total
    $0 + $216,037 related

  • LORRIE ANTOS

    INTERIM PRESIDENT MERCY WILLISTON

    Total calculated
    $186,182
    From this org
    $0
    From related orgs
    $174,696
    Other
    $11,486
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $154,913 related
    Bonus
    $0 + $17,573 related
    Other
    $0 + $2,210 related
    Deferred
    $0 + $10,107 related
    Nontaxable benefits
    $0 + $1,379 related
    Filer's total
    $0 + $186,182 related

  • ANNA WOLF

    BOARD MEMBER/NURSE PRACT

    Total calculated
    $164,148
    From this org
    $0
    From related orgs
    $155,262
    Other
    $8,886
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $146,935 related
    Bonus
    $0 + $6,000 related
    Other
    $0 + $2,327 related
    Deferred
    $0 + $3,358 related
    Nontaxable benefits
    $0 + $5,528 related
    Filer's total
    $0 + $164,148 related

  • DUBI CUMMINGS

    FOUNDATION DIRECTOR (THRU 9/23/22)

    Total calculated
    $77,415
    From this org
    $0
    From related orgs
    $69,985
    Other
    $7,430
    Hours/week
    40

  • JAMES BERVIG

    CHAIR

    Total calculated
    $0
    Hours/week
    1

  • JENNIFER BINGEMAN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • SCOTT ELLIS

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • BRITTANY FOUST

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • CATHY KRUSE

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • HEIDI LEE

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    1

  • KIRK SCHOEPP

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 4 related

  • GARRICK HYDE

    PRESIDENT MERCY WILLISTON

    Total calculated
    $0
    Hours/week
    1 + 40 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)

PART I, LINE 3
DURING THE CALENDAR YEAR 2022, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY MERCY MEDICAL CENTER ("MMC"), A RELATED ORGANIZATION. MMC USED THE FOLLOWING 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.
PART I, LINE 4A:
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. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. NO REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2022 CALENDAR YEAR.
PART I, LINE 4B:
DURING THE 2022 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. DURING 2022 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: DANIEL BJERKNES, $10,117. 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 2022 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 2022, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: MATTHEW GRIMSHAW $22,644.
PART II:
MERCY MEDICAL FOUNDATION 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 2022.

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
9 May 2024
IRS schema version
2022v5.0
Source object
202411309349301836

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