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← WITHAM MEMORIAL HOSPITAL FOUNDATION INC

Form 990 for tax year 2023

Filed by WITHAM MEMORIAL HOSPITAL FOUNDATION INC.

Totals

Total revenue
$363,533
Total expenses
$252,365
Contributions and grants received
$372,960
Grants paid
$131,700
Program service revenue
$0
Investment income
$65,575
Other revenue
-$75,002
Total assets, end of year
$7,393,629
Total liabilities, end of year
$18,751
Net assets or fund balances, end of year
$7,374,878
Program services expenses (Part IX)
$211,164
Management and general expenses
$8,123
Fundraising expenses
$33,078
Program service expenses (Part III)
$211,164

Program services were 83.7% 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.

  • 1b · Membership dues

    $59,904

  • 1c · Fundraising events

    $219,126

  • 1f · All other contributions, gifts and grants

    $93,930

  • 3 · Investment income

    total $65,575 · excluded $65,575

  • 8a · Fundraising events: gross income

    $200

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

    $219,126

  • 8b · Fundraising events: direct expenses

    $75,202

  • 8c · Net income from fundraising events

    total -$75,002 · excluded -$75,002

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $94,484 · program services $94,484

  • 2 · Grants to domestic individuals

    total $37,216 · program services $37,216

  • 11c · Fees: accounting

    total $11,750 · fundraising $11,750

  • 11f · Fees: investment management

    total $17,751 · program services $702 · fundraising $17,049

  • 11g · Fees: other

    total $83,123 · program services $75,000 · management and general $8,123

  • 13 · Office expenses

    total $4,279 · fundraising $4,279

  • 24e · All other expenses

    total $3,762 · program services $3,762

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,165,350 · end of year $1,265,464

  • 2 · Savings and temporary cash investments

    beginning of year $3,035,672 · end of year $2,678,211

  • 7 · Other notes and loans receivable

    beginning of year $37,595 · end of year $42,569

  • 9 · Prepaid expenses and deferred charges

    beginning of year $10,856 · end of year $5,429

  • 11 · Investments: publicly traded securities

    beginning of year $2,486,006 · end of year $3,401,956

  • 17 · Accounts payable and accrued expenses

    beginning of year $21,427 · end of year $18,751

  • 27 · Net assets without donor restrictions

    beginning of year $5,564,022 · end of year $6,138,454

  • 28 · Net assets with donor restrictions

    beginning of year $1,150,030 · end of year $1,236,424

Mission and programs · 2023

Mission

WITHAM HEALTH SERVICES FOUNDATION IS DEDICATED TO THE HOSPITAL'S QUEST FOR QUALITY CARE. THROUGH FUND DEVELOPMENT, AMBASSADORSHIP AND EDUCATION, WE WILL ASSIST THE HOSPITAL IN MAINTAINING ITS FINANCIAL GROWTH.

Activities or mission (Part I)

TO SUPPORT WITHAM HEALTH SERVICES, INC.

  • SUPPORT PROVIDED FOR PROGRAMS AT WITHAM HEALTH SERVICES.

    Expenses $79,464

  • MEDICAL AND NONMEDICAL PROFESSIONAL LOANS AND SCHOLARSHIPS

    Expenses $131,700 · Grants $131,700

As filed on the 2023 return.

Listed in Part VII

  • Honorable Rebecca McClure

    PRESIDENT

    Total calculated
    $0
    Hours/week
    2

  • Pt Buntin MD

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    2

  • Kelly Petit

    TREASURER

    Total calculated
    $0
    Hours/week
    2

  • Russell Roberts

    SECRETARY

    Total calculated
    $0
    Hours/week
    2

  • Todd Byrd

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • John Garber MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Allyson Gutwein

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Arch Hawkins

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • Michael Hornbecker MD

    BOARD MEMBER

    Total calculated
    $378,059
    From this org
    $0
    From related orgs
    $378,059
    Other
    $0
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $153,510 related
    Bonus
    $0 + $210,549 related
    Other
    $0 + $14,000 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $378,059 related

  • Dr Mark Janicki

    BOARD MEMBER

    Total calculated
    $273,267
    From this org
    $0
    From related orgs
    $240,495
    Other
    $32,772
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $214,551 related
    Bonus
    $0 + $20,000 related
    Other
    $0 + $5,944 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $32,772 related
    Filer's total
    $0 + $273,267 related

  • Jack Jones

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • Gary Lanpher

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Joe Lepage

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Kristi Reynolds

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Cari Ann Guenther

    FOUNDATION COORDINATOR

    Total calculated
    $77,444
    From this org
    $0
    From related orgs
    $56,362
    Other
    $21,082
    Hours/week
    40

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 AND PART II, RELATED PARTY COMPENSATION:
ALL COMPENSATION REPORTED ON SCHEDULE J WAS PAID BY RELATED ORGANIZATION, WITHAM HEALTH SERVICES, INC. ALL POLICIES RELATING TO THE COMPENSATION FOR INDIVIDUALS LISTED ON SCHEDULE J ARE POLICIES OF THE RELATED ORGANIZATION AND NOT WITHAM HEALTH SERVICES FOUNDATION, THE FILING ORGANIZATION. LINE 1A: THE FILING ORGANIZATION DID NOT PROVIDE ANY ITEMS LISTED IN PART I, LINE 1A. LINE 1B AND 2: NOT APPLICABLE. LINE 3: THE ORGANIZATION'S METHOD FOR ESTABLISHING COMPENSATION IS DETERMINED BY APPROVAL FROM THE BOARD OF DIRECTORS, WHICH IS COMPLETED BY THE RELATED ORGANIZATION, WITHAM HEALTH SERVICES. PART II, LINE (1), COLUMN (B) AND (D): THE COMPENSATION REPORTED DURING THE CURRENT YEAR DOES NOT RELATE TO SERVING AS A BOARD MEMBER FOR WITAHM HEALTH SERVICES FOUNDATION.

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
2023
Filed
4 November 2024
IRS schema version
2023v5.1
Source object
202413099349300416

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