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Nonprofiteer
← ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION

Form 990 for tax year 2023

Filed by ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION.

Totals

Total revenue
$1,886,622
Total expenses
$1,174,704
Contributions and grants received
$1,870,396
Grants paid
$501,490
Program service revenue
$0
Investment income
$54,554
Other revenue
-$38,328
Total assets, end of year
$2,106,807
Total liabilities, end of year
$440,438
Net assets or fund balances, end of year
$1,666,369
Program services expenses (Part IX)
$501,490
Management and general expenses
$610,868
Fundraising expenses
$62,346
Program service expenses (Part III)
$501,490

Program services were 42.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • SUE ANDERSEN

    BOARD MEMBER

    Total calculated
    $1,105,940
    From this org
    $0
    From related orgs
    $963,560
    Other
    $142,380
    Hours/week
    0.25 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $475,281 related
    Bonus
    $0 + $474,926 related
    Other
    $0 + $13,353 related
    Deferred
    $0 + $95,566 related
    Nontaxable benefits
    $0 + $46,814 related
    Filer's total
    $0 + $1,105,940 related

  • MATTHEW D RICHARDSON

    DIVISION VP/CFO

    Total calculated
    $580,147
    From this org
    $0
    From related orgs
    $518,167
    Other
    $61,980
    Hours/week
    0.25 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $333,887 related
    Bonus
    $0 + $182,642 related
    Other
    $0 + $1,638 related
    Deferred
    $0 + $35,666 related
    Nontaxable benefits
    $0 + $26,314 related
    Filer's total
    $0 + $580,147 related

  • KENNETH DALEBOUT

    BOARD MEMBER/FOUNDATION PRESIDENT

    Total calculated
    $405,116
    From this org
    $0
    From related orgs
    $337,409
    Other
    $67,707
    Hours/week
    8 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $254,356 related
    Bonus
    $0 + $80,307 related
    Other
    $0 + $2,746 related
    Deferred
    $0 + $39,209 related
    Nontaxable benefits
    $0 + $28,498 related
    Filer's total
    $0 + $405,116 related

  • MONTISA PHELAN LOPEZ

    VICE PRESIDENT PHILANTHROPY

    Total calculated
    $162,526
    From this org
    $0
    From related orgs
    $115,787
    Other
    $46,739
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $105,361 related
    Bonus
    $0 + $9,965 related
    Other
    $0 + $461 related
    Deferred
    $0 + $15,624 related
    Nontaxable benefits
    $0 + $31,115 related
    Filer's total
    $0 + $162,526 related

  • MICHAEL BOYER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • RYAN CAMERON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • ANDREA CHAVEZ

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • DENNIS DELZEIT

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • DENISE EL-EFFENDI

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • MELISSA A FACE

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • KATHY FISSORI JOHNSON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • CINDY GRESSER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • JAMIE HARDISTY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • TIMOTHY JENSEN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • MICHAEL MORRISON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • KATHY ROINESTAD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • ANTHONY SALAS

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • STEPHANIE VENTURA

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    0.25

  • JEFF ZAMBO

    BOARD MEMBER (THRU 6/30/24)

    Total calculated
    $0
    Hours/week
    0.25

  • SANDRA LEE DEWAR

    CHAIR

    Total calculated
    $0
    Hours/week
    0.25

  • ROB RAILSBACK

    VICE-CHAIR

    Total calculated
    $0
    Hours/week
    0.25

  • KEVIN WILKINSON

    SECRETARY

    Total calculated
    $0
    Hours/week
    0.25

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 ORGANIZATION RELIED ON A RELATED ORGANIZATION, COMMONSPIRIT, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE COMMONSPIRIT BOARD OF STEWARDSHIP TRUSTEES ("BOARD"); (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; AND (4) APPROVAL BY THE BOARD OR HUMAN RESOURCES AND COMPENSATION COMMITTEE. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A FOR ADDITIONAL INFORMATION. SCHEDULE J, PART I, LINE 4A CERTAIN LISTED PERSONS PARTICIPATE IN A SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 TO 24 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. NO PAYMENTS OCCURRED DURING 2023 PURSUANT TO THE PLAN ARRANGEMENTS.
PART I, LINE 4B
CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. NO PAYMENTS OCCURRED DURING 2023 PURSUANT TO THE PLAN ARRANGEMENTS. COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS OTHER REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)).
SCHEDULE J, PART III - SUPPLEMENTAL DISCLOSURES
THE ORGANIZATION DOES NOT EMPLOY ANY PERSONNEL, HOWEVER, DIGNITY HEALTH FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST THE ORGANIZATION IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES IT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONGTERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND THE ORGANIZATION'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONGTERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONGTERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2023.

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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2023
Filed
6 May 2025
IRS schema version
2023v6.0
Source object
202531269349300603

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