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Nonprofiteer
← GRINNELL REGIONAL MEDICAL CENTER

Form 990 for tax year 2022

Filed by GRINNELL REGIONAL MEDICAL CENTER.

Totals

Total revenue
$62,426,887
Total expenses
$63,157,388
Contributions and grants received
$2,811,418
Grants paid
$511,830
Program services expenses (Part IX)
$55,954,166
Management and general expenses
$7,203,222
Fundraising expenses
$0
Program service expenses (Part III)
$55,954,166

Program services were 88.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • RYAN ALBRIGHT MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • PEGGY BROWN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • JACOB BOYER PC-A

    BOARD MEMBER

    Total calculated
    $237,791
    From this org
    $226,820
    From related orgs
    $0
    Other
    $10,971
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $162,396
    Bonus
    $64,234
    Other
    $190
    Deferred
    $10,756
    Nontaxable benefits
    $215
    Filer's total
    $237,791

  • DARWIN COPEMEN

    BOARD TREASURER

    Total calculated
    $0
    Hours/week
    1

  • JENNIFER HAVENS

    BOARD MEMBER/CEO

    Total calculated
    $306,365
    From this org
    $0
    From related orgs
    $268,250
    Other
    $38,115
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $0 + $230,030 related
    Bonus
    $0 + $37,962 related
    Other
    $0 + $258 related
    Deferred
    $0 + $12,531 related
    Nontaxable benefits
    $0 + $25,584 related
    Filer's total
    $0 + $306,365 related

  • RACHEL KINNICK

    BOARD SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • SALLY LANG

    BOARD CHAIR

    Total calculated
    $130
    From this org
    $0
    From related orgs
    $130
    Other
    $0
    Hours/week
    1

  • ALY MALY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • AMY MILLER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • HENRY MORISADA RIETZ PHD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • SID RAMSEY BOARD MEMBERVP

    MARKETING & BUSINESS DEV-CIHC

    Total calculated
    $444,812
    From this org
    $0
    From related orgs
    $407,236
    Other
    $37,576
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $326,230 related
    Bonus
    $0 + $51,697 related
    Other
    $0 + $29,309 related
    Deferred
    $0 + $27,450 related
    Nontaxable benefits
    $0 + $10,126 related
    Filer's total
    $0 + $444,812 related

  • SARAH SMITH

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • TRACI SMITH

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • DAVID STARK

    BOARD MEMBER/CEO-CIHC

    Total calculated
    $1,775,138
    From this org
    $0
    From related orgs
    $1,646,674
    Other
    $128,464
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $573,849 related
    Bonus
    $0 + $172,266 related
    Other
    $0 + $900,559 related
    Deferred
    $0 + $102,789 related
    Nontaxable benefits
    $0 + $25,675 related
    Filer's total
    $0 + $1,775,138 related

  • DOUGLAS VAN DAELE MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • KYLE WILCOX

    VP FINANCE

    Total calculated
    $212,408
    From this org
    $193,922
    From related orgs
    $0
    Other
    $18,486
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $179,496
    Bonus
    $14,372
    Other
    $54
    Deferred
    $9,547
    Nontaxable benefits
    $8,939
    Filer's total
    $212,408

  • LAURA JUEL

    VP NURSING & CLINICAL SERVICES

    Total calculated
    $228,062
    From this org
    $182,406
    From related orgs
    $0
    Other
    $45,656
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $151,374
    Bonus
    $30,962
    Other
    $70
    Deferred
    $9,831
    Nontaxable benefits
    $35,825
    Filer's total
    $228,062

  • MICHAEL LINE MD

    CHIEF MEDICAL OFFICER

    Total calculated
    $341,886
    From this org
    $0
    From related orgs
    $296,449
    Other
    $45,437
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $0 + $295,530 related
    Bonus
    $0
    Other
    $0 + $919 related
    Deferred
    $0 + $13,725 related
    Nontaxable benefits
    $0 + $31,712 related
    Filer's total
    $0 + $341,886 related

  • SCOTT DOYLE CRNA ARNP

    ANESTHESIOLOGY

    Total calculated
    $304,917
    From this org
    $270,806
    From related orgs
    $0
    Other
    $34,111
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $256,808
    Bonus
    $13,500
    Other
    $498
    Deferred
    $13,139
    Nontaxable benefits
    $20,972
    Filer's total
    $304,917

  • STEPHEN ELLESTAD DO

    PHYSICIAN

    Total calculated
    $322,728
    From this org
    $306,661
    From related orgs
    $0
    Other
    $16,067
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $300,992
    Bonus
    $0
    Other
    $5,669
    Deferred
    $15,050
    Nontaxable benefits
    $1,017
    Filer's total
    $322,728

  • SUMIN LI MD

    PHYSICIAN

    Total calculated
    $328,327
    From this org
    $285,683
    From related orgs
    $0
    Other
    $42,644
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $270,663
    Bonus
    $0
    Other
    $15,020
    Deferred
    $13,860
    Nontaxable benefits
    $28,784
    Filer's total
    $328,327

  • KATHRYN OGBURN CRNA

    ANESTHESIOLOGY

    Total calculated
    $280,853
    From this org
    $257,626
    From related orgs
    $0
    Other
    $23,227
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $246,990
    Bonus
    $10,000
    Other
    $636
    Deferred
    $12,814
    Nontaxable benefits
    $10,413
    Filer's total
    $280,853

  • KRISTIN PHELPS PA-C

    FAMILY MEDICINE

    Total calculated
    $259,883
    From this org
    $229,034
    From related orgs
    $0
    Other
    $30,849
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $172,480
    Bonus
    $56,494
    Other
    $60
    Deferred
    $11,667
    Nontaxable benefits
    $19,182
    Filer's total
    $259,883

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

  • 3 · Independent compensation consultant
  • 3 · Written employment contract
  • 3 · Approval by the board or compensation committee
  • 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 4B
NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED CONTRIBUTIONS IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: DAVID STARK $87,539. NONQUALIFIED RETIREMENT PLAN DISTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED PLAN: DAVID STARK $ 883,999. PAYOUTS ARE MADE WITH VESTED FUNDS, AS ESTABLISHED BY PLAN DOCUMENTS.

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
202323189349307122

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

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