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Nonprofiteer
← OSMOND GENERAL HOSPITAL INC

Form 990 for tax year 2022

Filed by OSMOND GENERAL HOSPITAL INC.

Totals

Total revenue
$9,750,643
Total expenses
$8,859,920
Contributions and grants received
$664,233
Grants paid
$2,500
Program services expenses (Part IX)
$7,470,246
Management and general expenses
$1,389,674
Fundraising expenses
$0
Program service expenses (Part III)
$7,470,246

Program services were 84.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • LON M KNIEVEL

    MEMBER/CEO

    Total calculated
    $208,903
    From this org
    $171,506
    From related orgs
    $0
    Other
    $37,397
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $171,470
    Bonus
    $0
    Other
    $36
    Deferred
    $7,155
    Nontaxable benefits
    $30,242
    Filer's total
    $208,903

  • TIM KINT

    PRESIDENT

    Total calculated
    $0
    Hours/week
    4

  • DOUG KETELSEN

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    4

  • THERESA STAPELMAN

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    2

  • DOUG KOEHLER

    MEMBER

    Total calculated
    $0
    Hours/week
    2

  • STEPHANIE ANDERSON

    MEMBER

    Total calculated
    $0
    Hours/week
    2

  • KEVIN LAUCK PA

    MEMBER

    Total calculated
    $0
    Hours/week
    2

  • WILLIAM HEFNER

    MEMBER

    Total calculated
    $0
    Hours/week
    2

  • WALTER ASCHOFF

    MEMBER

    Total calculated
    $0
    Hours/week
    2

  • JODI ASCHOFF

    CFO

    Total calculated
    $95,446
    From this org
    $83,689
    From related orgs
    $0
    Other
    $11,757
    Hours/week
    40

  • DR KELLY BULLOCK

    DOCTOR

    Total calculated
    $149,575
    From this org
    $119,698
    From related orgs
    $0
    Other
    $29,877
    Hours/week
    40

  • ALICIA VANDERWALLE

    NURSE PRACTITIONER

    Total calculated
    $169,099
    From this org
    $140,998
    From related orgs
    $0
    Other
    $28,101
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $140,962
    Bonus
    $0
    Other
    $36
    Deferred
    $0
    Nontaxable benefits
    $28,101
    Filer's total
    $169,099

  • BOBBIE JO MILLER

    NURSE PRACTITIONER

    Total calculated
    $149,624
    From this org
    $141,145
    From related orgs
    $0
    Other
    $8,479
    Hours/week
    40

  • SAMANTHA KIZZIRE

    CLINIC/HOSPITAL APRN

    Total calculated
    $148,979
    From this org
    $115,095
    From related orgs
    $0
    Other
    $33,884
    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 — 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 · Form 990 of other organizations
  • 3 · Written employment contract
  • 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

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
2022
Filed
30 January 2024
IRS schema version
2022v5.0
Source object
202420319349301712

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