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← ASPIRUS MERRILL HOSPITAL FOUNDATION INC

Form 990 for tax year 2022

Filed by ASPIRUS MERRILL HOSPITAL FOUNDATION INC.

Totals

Total revenue
$147,795
Total expenses
$17,260
Contributions and grants received
$124,762
Grants paid
$9,415
Program service revenue
$0
Investment income
$22,533
Other revenue
$500
Total assets, end of year
$818,143
Total liabilities, end of year
$3,145
Net assets or fund balances, end of year
$814,998
Program services expenses (Part IX)
$9,699
Management and general expenses
$2,729
Fundraising expenses
$4,832
Program service expenses (Part III)
$9,699

Program services were 56.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $13,550

  • 1f · All other contributions, gifts and grants

    $111,212

  • 3 · Investment income

    total $22,533 · excluded $22,533

  • 8a · Fundraising events: gross income

    $500

  • 8b · Fundraising events: direct expenses

    $0

  • 8c · Net income from fundraising events

    total $500 · excluded $500

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $9,415 · program services $9,415

  • 7 · Other salaries and wages

    total $1,053 · management and general $1,053

  • 9 · Other employee benefits

    total $464 · management and general $464

  • 11f · Fees: investment management

    total $1,186 · management and general $1,186

  • 17 · Travel

    total $79 · program services $79

  • 24a · Other expenses: FUNDRAISING EXPENSES

    total $4,832 · fundraising $4,832

  • 24b · Other expenses: FOOD EXPENSE

    total $205 · program services $205

  • 24c · Other expenses: LICENSES AND FEES

    total $26 · management and general $26

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $120,262 · end of year $176,958

  • 4 · Accounts receivable

    beginning of year $26 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $394,370

  • 13 · Investments: program-related

    beginning of year $549,068 · end of year $246,058

  • 15 · Other assets

    beginning of year $712 · end of year $757

  • 25 · Other liabilities

    beginning of year $3,837 · end of year $3,145

  • 27 · Net assets without donor restrictions

    beginning of year $539,321 · end of year $568,945

  • 28 · Net assets with donor restrictions

    beginning of year $126,910 · end of year $246,053

Mission and programs · 2022

Mission

WE HEAL PEOPLE, PROMOTE HEALTH AND STRENGTHEN COMMUNITIES.

  • ASPIRUS MERRILL FOUNDATION IS THE PRIMARY, TRUSTED ADVOCATE FOR ASPIRUS MERRILL HOSPITAL'S CHARITY AND FUNDRAISING NEEDS. THE MISSION OF THE ASPIRUS MERRILL HOSPITAL FOUNDATION IS TO PROMOTE AND SUPPORT THE MISSION OF ASPIRUS MERRILL HOSPITAL OF FURTHERING THE HEALTH OF THE COMMUNITY BY CONTINUALLY IMPROVING THE HEALTH AND WELL-BEING OF ALL PEOPLE, ESPECIALLY THE POOR, IN THE COMMUNITIES WE SERVE. SOME EXAMPLES INCLUDE PROVIDING TRANSPORTATION TO PATIENTS, PROVIDING DENTAL SERVICES TO THOSE IN NEED, PROVIDING HEALTH CARE TO THOSE IN RURAL AREAS, AND ASSISTING EMPLOYEES IN NEED.

    Expenses $9,699 · Grants $9,415

As filed on the 2022 return.

Listed in Part VII

  • Miranda Sedlacek

    CHAIR

    Total calculated
    $0
    Hours/week
    1

  • Lindsey Lucero

    VICE CHAIR (THRU 12/23)/NURSE PRACT.

    Total calculated
    $107,672
    From this org
    $0
    From related orgs
    $107,672
    Other
    $0
    Hours/week
    1 + 50 related

  • Ramona Hornischer

    TREASURER

    Total calculated
    $0
    Hours/week
    1

  • Trina Knospe

    SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • Kurt Rust

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Susan Ryman

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Danielle Wilcenski

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Matthew Heywood

    PRESIDENT & CEO ASPIRUS

    Total calculated
    $2,111,048
    From this org
    $0
    From related orgs
    $1,799,938
    Other
    $311,110
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,228,335 related
    Bonus
    $0 + $567,185 related
    Other
    $0 + $4,418 related
    Deferred
    $0 + $18,619 related
    Nontaxable benefits
    $0 + $292,491 related
    Filer's total
    $0 + $2,111,048 related

  • Sidney C Sczygelski

    SENIOR VP OF FINANCE & CFO

    Total calculated
    $2,055,582
    From this org
    $0
    From related orgs
    $1,911,464
    Other
    $144,118
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $649,845 related
    Bonus
    $0 + $1,057,600 related
    Other
    $0 + $204,019 related
    Deferred
    $0 + $20,794 related
    Nontaxable benefits
    $0 + $123,324 related
    Filer's total
    $0 + $2,055,582 related

  • James Matheson

    BOARD MEMBER/SVP-CHIEF STRAT. OFF.

    Total calculated
    $650,294
    From this org
    $0
    From related orgs
    $539,401
    Other
    $110,893
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $386,985 related
    Bonus
    $0 + $110,566 related
    Other
    $0 + $41,850 related
    Deferred
    $0 + $17,683 related
    Nontaxable benefits
    $0 + $93,210 related
    Filer's total
    $0 + $650,294 related

  • Dawn Gapko

    VP- CHIEF ADMINISTRATIVE OFFICER

    Total calculated
    $283,782
    From this org
    $0
    From related orgs
    $249,445
    Other
    $34,337
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $213,334 related
    Bonus
    $0 + $34,126 related
    Other
    $0 + $1,985 related
    Deferred
    $0 + $6,514 related
    Nontaxable benefits
    $0 + $27,823 related
    Filer's total
    $0 + $283,782 related

  • Jane Bentz

    FOUNDATION DIRECTOR

    Total calculated
    $105,816
    From this org
    $0
    From related orgs
    $88,282
    Other
    $17,534
    Hours/week
    1 + 50 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
FOR THE PURPOSES OF DETERMINING COMPENSATION, ASPIRUS MERRILL HOSPITAL FOUNDATION, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH COMPENSATION OF OFFICERS AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABLISHING COMPENSATION FOR SUCH INDIVIDUAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B
SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $195,109 J. MATHESON $32,339 KEY EMPLOYEES OF THE ORGANIZATION OR A PARTICIPATING AFFILIATE ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. THE PLAN YEAR IS JANUARY 1 TO DECEMBER 31ST. EMPLOYER CONTRIBUTIONS: THE CONTRIBUTION MADE BY THE EMPLOYER IS A THREE-TIERED STRUCTURE DEPENDING UPON THE EXECUTIVE'S POSITION, WHICH ARE AS FOLLOWS: 13% FOR SENIOR VICE PRESIDENT OR PRESIDENT, 15% FOR SVP & CHIEF FINANCIAL OFFICER, AND 20% FOR THE PRESIDENT & CHIEF EXECUTIVE OFFICER. IF A PARTICIPANT TERMINATES DURING THE YEAR, THE PARTICIPANT'S EXECUTIVE ALLOWANCE IS PRORATED BASED ON THE NUMBER OF FULL CALENDAR MONTHS FROM THE BEGINNING OF THE PLAN YEAR TO THE BEGINNING OF THE CALENDAR YEAR MONTH CLOSEST TO THE CHANGE OR TERMINATION OF EMPLOYMENT. DISTRIBUTIONS: CONTINUATION OF EMPLOYMENT THROUGH THE DEFERRED VESTING DATE; THE DATE ON WHICH THE PARTICIPANT'S EMPLOYMENT IS TERMINATED AS A RESULT OF DEATH OR DISABILITY; 24 MONTHS FROM THE DATE ON WHICH THE PARTICIPANT INCURS AN INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE OR THE DATE THAT IS 24 MONTHS FOLLOWING THE PARTICIPANT'S SEPARATION FROM SERVICE, BUT ONLY IF THE PARTICIPANT'S INTEREST HAS NOT BEEN FORFEITED FOR COMPETITION DURING SUCH 24 MONTH PERIOD AND THE PARTICIPANT HAS NOT ENGAGED IN COMPETITION AFTER HIS OR HER SEPARATION FROM SERVICE AND PRIOR TO HIS OR HER DEATH, THE PARTICIPANT SHALL BE VESTED AT HIS OR HER DATE OF DEATH.

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.

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.

  • WESTERN UPPER MICHIGAN EYE CARE LLC

    EYE CARE SERVICES · MI

  • THE WESTWOOD CONFERENCE CENTER LLC

    REAL ESTATE INVESTMENT · WI

Related corporations and trusts

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

  • ASPIRUS NETWORK INC

    C · HEALTH CARE SERVICES · WI

  • ASPIRUS KEWEENAW ENTERPRISES INC

    C · PHARMACY · MI

  • ASPIRUS HEALTH VENTURES

    C · HEALTH INSURANCE PLAN · WI

  • ASPIRUS ARISE HEALTH PLAN OF WI INC

    C · HEALTH INSURANCE PLAN · WI

  • ASPIRUS ARISE HEALTH PLAN OF MI INC

    C · HEALTH INSURANCE PLAN · MI

  • ASPIRUS CAMPUS CONDOMINIUM OWNERS ASSOCIATION INC

    C · ASSOCIATION · WI

Provenance

Return type
form_990
Tax year
2022
Filed
14 May 2024
IRS schema version
2022v5.0
Source object
202441369349301589

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