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Nonprofiteer
← MERCY HOSPITAL OF FRANCISCAN SISTERS INC

Form 990 for tax year 2022

Filed by MERCY HOSPITAL OF FRANCISCAN SISTERS INC.

Totals

Total revenue
$13,770,760
Total expenses
$15,128,106
Contributions and grants received
$0
Grants paid
$6,000
Program services expenses (Part IX)
$12,466,970
Management and general expenses
$2,661,136
Fundraising expenses
$0
Program service expenses (Part III)
$12,466,970

Program services were 82.4% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ROBERT RITZ

    DIRECTOR; CEO MERCY HEALTH NETWORK

    Total calculated
    $1,988,162
    From this org
    $0
    From related orgs
    $1,923,691
    Other
    $64,471
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,340,299 related
    Bonus
    $0 + $433,955 related
    Other
    $0 + $149,437 related
    Deferred
    $0 + $27,617 related
    Nontaxable benefits
    $0 + $36,854 related
    Filer's total
    $0 + $1,988,162 related

  • JACK DUSENBERY

    DIR & PRES, MERCYONE NE IA THR 4/23

    Total calculated
    $750,828
    From this org
    $0
    From related orgs
    $705,049
    Other
    $45,779
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $569,178 related
    Bonus
    $0 + $120,621 related
    Other
    $0 + $15,250 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $27,479 related
    Filer's total
    $0 + $750,828 related

  • MATTHEW SOJKA MD

    VP, MEDICAL AFFAIRS

    Total calculated
    $504,803
    From this org
    $0
    From related orgs
    $460,897
    Other
    $43,906
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $401,122 related
    Bonus
    $0 + $56,897 related
    Other
    $0 + $2,878 related
    Deferred
    $0 + $13,725 related
    Nontaxable benefits
    $0 + $30,181 related
    Filer's total
    $0 + $504,803 related

  • RACHELLE MAKINDE MD

    DIRECTOR; PHYSICIAN

    Total calculated
    $495,645
    From this org
    $0
    From related orgs
    $449,922
    Other
    $45,723
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $422,630 related
    Bonus
    $0
    Other
    $0 + $27,292 related
    Deferred
    $0 + $11,458 related
    Nontaxable benefits
    $0 + $34,265 related
    Filer's total
    $0 + $495,645 related

  • BRIAN BURNETT MD

    DIRECTOR; PHYSICIAN

    Total calculated
    $422,818
    From this org
    $0
    From related orgs
    $363,552
    Other
    $59,266
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $362,631 related
    Bonus
    $0
    Other
    $0 + $921 related
    Deferred
    $0 + $22,875 related
    Nontaxable benefits
    $0 + $36,391 related
    Filer's total
    $0 + $422,818 related

  • TIMOTHY HUBER

    ASSISTANT TREASURER; VP OF FINANCE

    Total calculated
    $348,273
    From this org
    $0
    From related orgs
    $288,515
    Other
    $59,758
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $247,137 related
    Bonus
    $0 + $36,164 related
    Other
    $0 + $5,214 related
    Deferred
    $0 + $22,697 related
    Nontaxable benefits
    $0 + $37,061 related
    Filer's total
    $0 + $348,273 related

  • KELLY RICHARDS

    CHIEF NURSING OFFICER

    Total calculated
    $306,066
    From this org
    $0
    From related orgs
    $261,858
    Other
    $44,208
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $226,422 related
    Bonus
    $0 + $31,841 related
    Other
    $0 + $3,595 related
    Deferred
    $0 + $20,047 related
    Nontaxable benefits
    $0 + $24,161 related
    Filer's total
    $0 + $306,066 related

  • RYAN MEYER

    VP, SITE ADMINISTRATOR

    Total calculated
    $233,473
    From this org
    $0
    From related orgs
    $197,415
    Other
    $36,058
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $172,505 related
    Bonus
    $0 + $24,770 related
    Other
    $0 + $140 related
    Deferred
    $0 + $8,711 related
    Nontaxable benefits
    $0 + $27,347 related
    Filer's total
    $0 + $233,473 related

  • JILL GROTH

    VP, SITE ADMINISTRATOR

    Total calculated
    $226,332
    From this org
    $190,477
    From related orgs
    $0
    Other
    $35,855
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $162,995
    Bonus
    $23,939
    Other
    $3,543
    Deferred
    $12,054
    Nontaxable benefits
    $23,801
    Filer's total
    $226,332

  • MARIUS BALOLA

    PHARMACIST

    Total calculated
    $156,153
    From this org
    $115,946
    From related orgs
    $0
    Other
    $40,207
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $115,869
    Bonus
    $0
    Other
    $77
    Deferred
    $5,837
    Nontaxable benefits
    $34,370
    Filer's total
    $156,153

  • NICOLE STAHL

    REGISTERED NURSE

    Total calculated
    $151,034
    From this org
    $126,660
    From related orgs
    $0
    Other
    $24,374
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $120,637
    Bonus
    $6,000
    Other
    $23
    Deferred
    $7,416
    Nontaxable benefits
    $16,958
    Filer's total
    $151,034

  • SHAWN SCHOULTZ

    REGISTERED NURSE

    Total calculated
    $147,867
    From this org
    $128,848
    From related orgs
    $0
    Other
    $19,019
    Hours/week
    40

  • MARI SALLEE

    REGISTERED NURSE

    Total calculated
    $132,174
    From this org
    $104,908
    From related orgs
    $0
    Other
    $27,266
    Hours/week
    40

  • KRIS BENGTSON

    REGISTERED NURSE

    Total calculated
    $127,366
    From this org
    $111,339
    From related orgs
    $0
    Other
    $16,027
    Hours/week
    40

  • NANCY SCHAEFER

    ASSISTANT SECRETARY; EXEC ASSISTANT

    Total calculated
    $70,880
    From this org
    $0
    From related orgs
    $65,485
    Other
    $5,395
    Hours/week
    1 + 39 related

  • DAVID DEAVER

    DIRECTOR; CHAIR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • SANDRA BENAK

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • TIM BOETTGER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • SHIRLEY DUNLAP

    DIRECTOR THROUGH 12/22

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • ALAN KRUGER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • CASEY MCLAUGHLIN

    DIRECTOR THROUGH 12/22

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • GREGORY SCHMITZ

    DIRECTOR THROUGH 12/22

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • CAROL TOUSLEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 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 — 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
MERCY HOSPITAL OF FRANCISCAN SISTERS' PRESIDENT IS PAID DIRECTLY BY A RELATED ENTITY, COVENANT MEDICAL CENTER. COVENANT MEDICAL CENTER USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF MERCY HOSPITAL OF FRANCISCAN SISTERS' PRESIDENT: - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B
DURING THE 2022 CALENDAR YEAR, ROBERT RITZ WAS A PARTICIPANT IN THE COMMONSPIRIT HEALTH SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EXECUTIVES. DUE TO THE "SUPER" VESTING RULES UNDER THIS PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS AGE, OR AGE AND YEARS OF SERVICE, ARE ELIGIBLE TO RECEIVE THEIR 2022 CONTRIBUTIONS IN CASH. DURING 2022, THE FOLLOWING PAYMENT WAS MADE PURSUANT TO THE SUPER VESTING RULES AND IS INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: ROBERT RITZ - $127,049

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
13 May 2024
IRS schema version
2022v5.0
Source object
202421349349306687

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