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Nonprofiteer
← ASPIRUS MEDFORD FOUNDATION INC

Form 990 for tax year 2022

Filed by ASPIRUS MEDFORD FOUNDATION INC.

Totals

Total revenue
$214,616
Total expenses
$302,057
Contributions and grants received
$86,480
Grants paid
$231,969
Program services expenses (Part IX)
$231,969
Management and general expenses
$70,088
Fundraising expenses
$0
Program service expenses (Part III)
$231,969

Program services were 76.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • BRENT ARNDT

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • PATRICIA KRAUSE

    TREASURER

    Total calculated
    $0
    Hours/week
    1

  • KRIS O'LEARY

    SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • SUE ACKERMAN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • JANE DESTAERCKE

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • BRENDA HEDLUND

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • TIM RAU

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • CHERYL STELIGA

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • AMANDA LANGE

    EXECUTIVE DIRECTOR

    Total calculated
    $126,546
    From this org
    $0
    From related orgs
    $80,247
    Other
    $46,299
    Hours/week
    4 + 36 related

  • DALE HUSTEDT

    MEDFORD HOSPITAL PRESIDENT

    Total calculated
    $468,765
    From this org
    $0
    From related orgs
    $375,459
    Other
    $93,306
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $279,433 related
    Bonus
    $0 + $60,753 related
    Other
    $0 + $35,273 related
    Deferred
    $0 + $18,056 related
    Nontaxable benefits
    $0 + $75,250 related
    Filer's total
    $0 + $468,765 related

  • GREG SHAW

    MEDFORD HOSPITAL CFO

    Total calculated
    $251,757
    From this org
    $0
    From related orgs
    $220,782
    Other
    $30,975
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $191,783 related
    Bonus
    $0 + $27,247 related
    Other
    $0 + $1,752 related
    Deferred
    $0 + $12,702 related
    Nontaxable benefits
    $0 + $18,273 related
    Filer's total
    $0 + $251,757 related

  • SIDNEY SCZYGELSKI

    SR. 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 + $649,844 related
    Bonus
    $0 + $1,057,601 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

  • WILLIAM CARROLL

    VP-INFORMATION TECHNOLOGY

    Total calculated
    $370,543
    From this org
    $0
    From related orgs
    $321,116
    Other
    $49,427
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $267,466 related
    Bonus
    $0 + $51,102 related
    Other
    $0 + $2,548 related
    Deferred
    $0 + $18,436 related
    Nontaxable benefits
    $0 + $30,991 related
    Filer's total
    $0 + $370,543 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

None.

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

The filer's explanations (Part III)

PART I, LINE 1B
THE ORGANIZATION RELIES ON A RELATED ORGANIZATION TO DETERMINE AND APPROVE COMPENSATION. THE FOLLOWING ARE UTILIZED IN SUCH PROCESS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4
SCHEDULE J, PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT 457(F) DISTRIBUTION: S. SCZYGELSKI $195,109 D. HUSTEDT $28,030 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

  • ASPIRUS MEDFORD HOSPITAL & CLINICS INC

    $231,969

    NOVASURE MACHINE (SURGICAL), SIMULATOR/MANIKIN (SKILLS LAB), URINALYSIS AUTOMATION SYSTEM (LAB), A COLONOSCOPE (SURGICAL) AND SURGICAL LIGHTS (SURGICAL)

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
14 May 2024
IRS schema version
2022v5.0
Source object
202401369349304215

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