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Nonprofiteer
← PUNXSUTAWNEY MEDICAL SERVICES INC

Form 990 for tax year 2023

Filed by PUNXSUTAWNEY MEDICAL SERVICES INC.

Totals

Total revenue
$839,965
Total expenses
$2,134,773
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$833,856
Investment income
$0
Other revenue
$6,109
Total assets, end of year
$363,643
Total liabilities, end of year
$240,269
Net assets or fund balances, end of year
$123,374
Program services expenses (Part IX)
$2,048,769
Management and general expenses
$86,004
Fundraising expenses
$0
Program service expenses (Part III)
$2,048,769

Program services were 96.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • JOHN G SISK

    PRESIDENT

    Total calculated
    $321,803
    From this org
    $0
    From related orgs
    $299,789
    Other
    $22,014
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $255,723 related
    Bonus
    $0 + $21,566 related
    Other
    $0 + $22,500 related
    Deferred
    $0 + $2,195 related
    Nontaxable benefits
    $0 + $19,819 related
    Filer's total
    $0 + $321,803 related

  • BENEDICT HUGHES

    VICE CHAIR/DIRECTOR OF PRO

    Total calculated
    $170,342
    From this org
    $0
    From related orgs
    $158,264
    Other
    $12,078
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $151,753 related
    Bonus
    $0 + $6,511 related
    Other
    $0
    Deferred
    $0 + $2,195 related
    Nontaxable benefits
    $0 + $9,883 related
    Filer's total
    $0 + $170,342 related

  • TIMOTHY CLARK SIMPSON MD

    CHAIRMAN/PHYSICIAN

    Total calculated
    $584,291
    From this org
    $0
    From related orgs
    $561,062
    Other
    $23,229
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $519,957 related
    Bonus
    $0 + $18,605 related
    Other
    $0 + $22,500 related
    Deferred
    $0 + $1,917 related
    Nontaxable benefits
    $0 + $21,312 related
    Filer's total
    $0 + $584,291 related

  • ROBERT A GONGAWARE

    CFO

    Total calculated
    $361,048
    From this org
    $0
    From related orgs
    $312,538
    Other
    $48,510
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $308,552 related
    Bonus
    $0
    Other
    $0 + $3,986 related
    Deferred
    $0 + $28,801 related
    Nontaxable benefits
    $0 + $19,709 related
    Filer's total
    $0 + $361,048 related

  • STEPHEN A WOLFE

    CEO

    Total calculated
    $933,558
    From this org
    $0
    From related orgs
    $886,903
    Other
    $46,655
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $615,927 related
    Bonus
    $0 + $88,595 related
    Other
    $0 + $182,381 related
    Deferred
    $0 + $26,677 related
    Nontaxable benefits
    $0 + $19,978 related
    Filer's total
    $0 + $933,558 related

  • MICHAEL F ICKOWSKI

    CHIEF FINANCIAL OFFICER

    Total calculated
    $193,547
    From this org
    $0
    From related orgs
    $193,547
    Other
    $0
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $182,891 related
    Bonus
    $0
    Other
    $0 + $10,656 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $193,547 related

  • DANIEL D BLOUGH JR

    FORMER CEO

    Total calculated
    $168,639
    From this org
    $0
    From related orgs
    $166,614
    Other
    $2,025
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $115,862 related
    Bonus
    $0 + $44,910 related
    Other
    $0 + $5,842 related
    Deferred
    $0 + $2,025 related
    Nontaxable benefits
    $0
    Filer's total
    $0 + $168,639 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
THE CEO'S COMPENSATION IS PAID BY INDIANA REGIONAL MEDICAL CENTER. INDIANA REGIONAL MEDICAL CENTER USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B
INDIANA REGIONAL MEDICAL CENTER HAS A SUPPLEMENTAL, NONQUALIFIED RETIREMENT PLAN UNDER IRC SECTION 457(F) FOR PRESIDENT & CEO, STEPHEN A. WOLFE. PAY OUTS TO HIM WERE $138,553, AND CONTRIBUTIONS TO THE PLAN WERE $94,502 DURING CALENDAR YEAR 2023. PUNXSUTAWNEY AREA HOSPITAL HAS A SUPPLEMENTAL, NONQUALIFIED RETIREMENT PLAN UNDER IRC SECTION 457(F) FOR DR. KHABBAZ. DURING 2023, $30,000 WAS CONTRIBUTED TO THE PLAN.

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.

Provenance

Return type
form_990
Tax year
2023
Filed
17 April 2025
IRS schema version
2023v6.0
Source object
202531259349301713

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

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