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Nonprofiteer
← LAKE HOSPITAL FOUNDATION INC

Form 990 for tax year 2022

Filed by LAKE HOSPITAL FOUNDATION INC.

Totals

Total revenue
$688,702
Total expenses
$1,047,073
Contributions and grants received
$457,980
Grants paid
$654,062
Program services expenses (Part IX)
$997,732
Management and general expenses
$37,477
Fundraising expenses
$11,864
Program service expenses (Part III)
$997,732

Program services were 95.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • GEORGE KOCHIK

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • RICHARD CICERO

    TRUSTEE, SR VP BUSINESS DEVELOPMENT

    Total calculated
    $508,683
    From this org
    $0
    From related orgs
    $468,423
    Other
    $40,260
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $320,207 related
    Bonus
    $0 + $80,457 related
    Other
    $0 + $67,759 related
    Deferred
    $0 + $23,848 related
    Nontaxable benefits
    $0 + $16,412 related
    Filer's total
    $0 + $508,683 related

  • BRIDGET COMBS MD

    TRUSTEE, SECRETARY

    Total calculated
    $292,246
    From this org
    $0
    From related orgs
    $263,934
    Other
    $28,312
    Hours/week
    3 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $262,128 related
    Bonus
    $0 + $1,298 related
    Other
    $0 + $508 related
    Deferred
    $0 + $20,500 related
    Nontaxable benefits
    $0 + $7,812 related
    Filer's total
    $0 + $292,246 related

  • CHET PATEL MD

    TRUSTEE (THRU 6/1/22)

    Total calculated
    $234,981
    From this org
    $0
    From related orgs
    $227,051
    Other
    $7,930
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $225,011 related
    Bonus
    $0 + $8 related
    Other
    $0 + $2,032 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $7,930 related
    Filer's total
    $0 + $234,981 related

  • STEVE TSENGAS PHD

    EMERITUS

    Total calculated
    $0
    Hours/week
    1

  • PHILIP GUBAN

    TRUSTEE, CHAIR

    Total calculated
    $0
    Hours/week
    3

  • TIMOTHY A CAHILL

    TRUSTEE, TREASURER

    Total calculated
    $0
    Hours/week
    3

  • DUANE L LIPPS

    EMERITUS

    Total calculated
    $0
    Hours/week
    1

  • MICHAEL A PERRICO

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • NEIL STEIN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • TINU TADESE MD

    TRUSTEE/PHYSICIAN

    Total calculated
    $405,424
    From this org
    $0
    From related orgs
    $365,425
    Other
    $39,999
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $334,052 related
    Bonus
    $0 + $29,150 related
    Other
    $0 + $2,223 related
    Deferred
    $0 + $10,820 related
    Nontaxable benefits
    $0 + $29,179 related
    Filer's total
    $0 + $405,424 related

  • STEPHEN CAMPBELL

    EMERITUS

    Total calculated
    $0
    Hours/week
    1

  • AMY BILECI-COCCA

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • RAYMOND PAGANINI

    TRUSTEE (THRU 6/1/22)

    Total calculated
    $0
    Hours/week
    1

  • ROBERT SCHIEBLI

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • KATHLEEN THOMPSON

    TRUSTEE (THRU 6/1/22), VICE-CHAIR

    Total calculated
    $0
    Hours/week
    3

  • RONALD BAUMBERGER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • OSCAR FLYNN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    1

  • KATHLEEN TUTTLE

    EMERITUS

    Total calculated
    $0
    Hours/week
    1

  • JEN YORKO

    TRUSTEE (THRU 6/1/22)

    Total calculated
    $0
    Hours/week
    1

  • CAROL NELSON-ROLLINS

    EMERITUS

    Total calculated
    $0
    Hours/week
    1

  • BRADLEY BOND

    TRUSTEE/VP TREASURY

    Total calculated
    $820,185
    From this org
    $0
    From related orgs
    $768,261
    Other
    $51,924
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $434,302 related
    Bonus
    $0 + $224,952 related
    Other
    $0 + $109,007 related
    Deferred
    $0 + $24,400 related
    Nontaxable benefits
    $0 + $27,524 related
    Filer's total
    $0 + $820,185 related

  • MARK FLASH

    EXECUTIVE DIRECTOR

    Total calculated
    $218,244
    From this org
    $202,611
    From related orgs
    $0
    Other
    $15,633
    Hours/week
    40 + 2 related

    Schedule J breakdown matched by us

    Base
    $190,885
    Bonus
    $6,205
    Other
    $5,521
    Deferred
    $5,633
    Nontaxable benefits
    $10,000
    Filer's total
    $218,244

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 — 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, LINE 3
LAKE HOSPITAL FOUNDATION, INC. RELIED ON LAKE HOSPITAL SYSTEM, INC., A RELATED ORGANIZATION, TO ESTABLISH THE COMPENSATION OF ITS EXECUTIVE DIRECTOR. THE METHODS USED BY LAKE HOSPITAL SYSTEM, INC. TO ESTABLISH THE EXECUTIVE DIRECTOR'S COMPENSATION INCLUDE THE FOLLOWING: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -FORM 990 OF OTHER ORGANIZATIONS -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

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
2022
Filed
10 November 2023
IRS schema version
2022v5.0
Source object
202333179349304623

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

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