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Nonprofiteer
← COMMUNITY HOSPITAL ASSOCIATION INC

Form 990 for tax year 2023

Filed by COMMUNITY HOSPITAL ASSOCIATION INC.

Totals

Total revenue
$49,777,208
Total expenses
$49,427,078
Contributions and grants received
$2,085,080
Grants paid
$0
Program service revenue
$47,582,708
Investment income
$24,160
Other revenue
$85,260
Total assets, end of year
$32,125,877
Total liabilities, end of year
$26,801,135
Net assets or fund balances, end of year
$5,324,742
Program services expenses (Part IX)
$46,358,338
Management and general expenses
$2,898,042
Fundraising expenses
$170,698
Program service expenses (Part III)
$46,358,338

Program services were 93.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • Betsy Deibel

    Director

    Total calculated
    $0
    Hours/week
    1

  • Brian Warnock

    Vice Chair

    Total calculated
    $0
    Hours/week
    1

  • Cynthia Clark

    Director

    Total calculated
    $0
    Hours/week
    1

  • Dave Bennett

    Director

    Total calculated
    $0
    Hours/week
    1

  • Dean Sandvik

    Treasurer

    Total calculated
    $0
    Hours/week
    1

  • Deborah Bateman

    Director

    Total calculated
    $0
    Hours/week
    1

  • Dennis Lauterbach

    Director

    Total calculated
    $0
    Hours/week
    1

  • Ed Kientz

    Chairman

    Total calculated
    $0
    Hours/week
    1

  • Jeanie Hankins

    Director

    Total calculated
    $0
    Hours/week
    1

  • John Summers

    Secretary

    Total calculated
    $0
    Hours/week
    1

  • Penny Marin

    Director

    Total calculated
    $0
    Hours/week
    1

  • Virginia Collier

    Director

    Total calculated
    $0
    Hours/week
    1

  • David Woodruff

    CFO (Beg Dec)

    Total calculated
    $10,116
    From this org
    $10,096
    From related orgs
    $0
    Other
    $20
    Hours/week
    39 + 1 related

  • Jackie Lundblad

    CEO

    Total calculated
    $304,337
    From this org
    $266,486
    From related orgs
    $0
    Other
    $37,851
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $264,984
    Bonus
    $721
    Other
    $781
    Deferred
    $10,754
    Nontaxable benefits
    $29,743
    Filer's total
    $306,983

  • Patti Clavette

    CFO (Jan-Dec)

    Total calculated
    $180,836
    From this org
    $152,061
    From related orgs
    $0
    Other
    $28,775
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $150,380
    Bonus
    $500
    Other
    $1,181
    Deferred
    $3,031
    Nontaxable benefits
    $27,891
    Filer's total
    $182,983

  • Brian Schuele

    Director of Pharmacy Services

    Total calculated
    $189,814
    From this org
    $155,280
    From related orgs
    $0
    Other
    $34,534
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $153,105
    Bonus
    $1,471
    Other
    $704
    Deferred
    $3,339
    Nontaxable benefits
    $33,351
    Filer's total
    $191,970

  • Jodie Allen

    CNO

    Total calculated
    $156,621
    From this org
    $153,530
    From related orgs
    $0
    Other
    $3,091
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $151,904
    Bonus
    $500
    Other
    $1,126
    Deferred
    $3,071
    Nontaxable benefits
    $933
    Filer's total
    $157,534

  • Peter Stachowicz

    COO

    Total calculated
    $206,557
    From this org
    $190,341
    From related orgs
    $0
    Other
    $16,216
    Hours/week
    39 + 1 related

    Schedule J breakdown matched by us

    Base
    $189,233
    Bonus
    $500
    Other
    $608
    Deferred
    $3,023
    Nontaxable benefits
    $14,464
    Filer's total
    $207,828

  • Todd Kravetz MD - Chief of

    Staff, Clinical Medical Director

    Total calculated
    $411,595
    From this org
    $362,956
    From related orgs
    $0
    Other
    $48,639
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $283,131
    Bonus
    $77,269
    Other
    $2,556
    Deferred
    $14,775
    Nontaxable benefits
    $39,033
    Filer's total
    $416,764

  • Diane Bejerano

    Family Physician (Jan-Oct)

    Total calculated
    $296,866
    From this org
    $285,913
    From related orgs
    $0
    Other
    $10,953
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $212,005
    Bonus
    $71,169
    Other
    $2,739
    Deferred
    $10,932
    Nontaxable benefits
    $5,189
    Filer's total
    $302,034

  • Juan Vazquez

    Patient Accounts Manager

    Total calculated
    $200,372
    From this org
    $178,423
    From related orgs
    $0
    Other
    $21,949
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $162,782
    Bonus
    $14,686
    Other
    $955
    Deferred
    $4,006
    Nontaxable benefits
    $22,536
    Filer's total
    $204,965

  • Mandi Filla

    Family Physician

    Total calculated
    $229,480
    From this org
    $211,847
    From related orgs
    $0
    Other
    $17,633
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $211,847
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $18,876
    Filer's total
    $230,723

  • Matthew Jones

    Family Nurse Practitioner

    Total calculated
    $188,210
    From this org
    $188,190
    From related orgs
    $0
    Other
    $20
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $147,922
    Bonus
    $39,620
    Other
    $648
    Deferred
    $0
    Nontaxable benefits
    $1,861
    Filer's total
    $190,051

  • Richard Melde

    Family Nurse Practitioner

    Total calculated
    $195,753
    From this org
    $195,733
    From related orgs
    $0
    Other
    $20
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $160,106
    Bonus
    $35,627
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $1,336
    Filer's total
    $197,069

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

  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

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 1a
Description of health club dues: Wickenburg Community Hospital reimburses employees for health club dues which are recorded in the individuals' taxable compensation. However, the health club benefit ended on 10/31/2023. Golf club dues were paid to the golf club by the organization, but are not paid for a specific employee.

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.

Provenance

Return type
form_990
Tax year
2023
Filed
11 October 2024
IRS schema version
2023v5.1
Source object
202402859349300640

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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