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← JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION

Form 990 for tax year 2022

Filed by JENNIE EDMUNDSON MEMORIAL HOSPITAL FOUNDATION.

Totals

Total revenue
$1,476,986
Total expenses
$1,006,329
Contributions and grants received
$1,334,257
Grants paid
$975,089
Program service revenue
$0
Investment income
$101,277
Other revenue
$41,452
Total assets, end of year
$5,734,093
Total liabilities, end of year
$36,985
Net assets or fund balances, end of year
$5,697,108
Program services expenses (Part IX)
$986,799
Management and general expenses
$19,530
Fundraising expenses
$0
Program service expenses (Part III)
$986,799

Program services were 98.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • LEISHA HAMMER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • KATE MCGANN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • TERI WILSON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • BARB WALSH

    SECRETARY & TREASURER

    Total calculated
    $0
    Hours/week
    1

  • TAMI DOLL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • EDWARD LYNN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • MIKALA HOLTZ

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JOHN PAUL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • GRANT DEAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JEN CARLSON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • KATHY TISHER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JANET WHITSON

    VICE CHAIRMAN

    Total calculated
    $0
    Hours/week
    1

  • SCOTT HARTMAN

    CHAIRMAN

    Total calculated
    $0
    Hours/week
    1

  • PAT ANDERSEN

    IMMEDIATE PAST CHAIRMAN

    Total calculated
    $0
    Hours/week
    1

  • PAT AHRENS MD

    DIRECTOR

    Total calculated
    $570,991
    From this org
    $0
    From related orgs
    $510,445
    Other
    $60,546
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $475,247 related
    Bonus
    $0 + $14,284 related
    Other
    $0 + $20,914 related
    Deferred
    $0 + $30,610 related
    Nontaxable benefits
    $0 + $31,714 related
    Filer's total
    $0 + $572,769 related

  • DIANE HUGHES

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • CODY FORRISTALL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JOHN MARSHALL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • STACEY TAMS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JEFFREY FRANCIS

    CFO

    Total calculated
    $762,390
    From this org
    $0
    From related orgs
    $631,955
    Other
    $130,435
    Hours/week
    4 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $520,672 related
    Bonus
    $0 + $14,154 related
    Other
    $0 + $97,129 related
    Deferred
    $0 + $99,231 related
    Nontaxable benefits
    $0 + $31,826 related
    Filer's total
    $0 + $763,012 related

  • DAVID BURD

    PRESIDENT

    Total calculated
    $388,656
    From this org
    $0
    From related orgs
    $346,220
    Other
    $42,436
    Hours/week
    4 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $294,226 related
    Bonus
    $0 + $31,080 related
    Other
    $0 + $20,914 related
    Deferred
    $0 + $17,010 related
    Nontaxable benefits
    $0 + $26,048 related
    Filer's total
    $0 + $389,278 related

  • TARA SLEVIN

    VICE PRESIDENT

    Total calculated
    $220,353
    From this org
    $0
    From related orgs
    $188,437
    Other
    $31,916
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $151,955 related
    Bonus
    $0 + $15,540 related
    Other
    $0 + $20,942 related
    Deferred
    $0 + $23,878 related
    Nontaxable benefits
    $0 + $8,575 related
    Filer's total
    $0 + $220,890 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
SEE SCHEDULE O, PART VI, SECTION B, LINE 15 EXPLANATION REGARDING THE METHODS USED BY A RELATED ORGANIZATION TO ESTABLISH COMPENSATION.
PART I, LINE 4B
THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NEBRASKA METHODIST HEALTH SYSTEM NONQUALIFIED PLAN DURING 2022 AND RECEIVED CONTRIBUTIONS, PLAN ACCRUALS OR PLAN DISTRIBUTIONS IN THE FOLLOWING AMOUNTS: DAVID BURD $1,660 ACCRUAL JEFFREY FRANCIS $77,881 ACCRUAL; $93,756 PLAN DISTRIBUTION TARA SLEVIN $6,295 ACCRUAL PATRICK AHRENS, MD $10,889 ACCRUAL

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 corporations and trusts

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

Provenance

Return type
form_990
Tax year
2022
Filed
13 November 2023
IRS schema version
2022v5.0
Source object
202313179349310841

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