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Nonprofiteer
← MENDOTA COMMUNITY HOSPITAL

Form 990 for tax year 2023

Filed by MENDOTA COMMUNITY HOSPITAL.

Totals

Total revenue
$64,643,270
Total expenses
$61,053,866
Contributions and grants received
$79,518
Grants paid
$0
Program service revenue
$62,880,648
Investment income
$9,176
Other revenue
$1,673,928
Total assets, end of year
$42,175,757
Total liabilities, end of year
$13,741,412
Net assets or fund balances, end of year
$28,434,345
Program services expenses (Part IX)
$48,035,297
Management and general expenses
$13,018,569
Fundraising expenses
$0
Program service expenses (Part III)
$48,035,297

Program services were 78.7% 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.

  • 1a · Federated campaigns

    $0

  • 1b · Membership dues

    $0

  • 1c · Fundraising events

    $0

  • 1d · Related organizations

    $67,490

  • 1e · Government grants (contributions)

    $0

  • 1f · All other contributions, gifts and grants

    $12,028

  • 1g · Noncash contributions included above

    $0

  • 2a · Program service revenue: PATIENT REVENUE

    total $62,388,852 · related or exempt $62,388,852

  • 2b · Program service revenue: CONTRACTED PHARMACY

    total $491,796 · related or exempt $491,796

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $9,176 · excluded $9,176

  • 6a · Gross rents

    real property $60,886

  • 6c · Rental income or loss

    real property $60,886 · personal property $0

  • 6d · Net rental income or loss

    total $60,886 · excluded $60,886

  • 7a · Gross sales of assets other than inventory

    other assets $0

  • 7b · Less cost or other basis and sales expenses

    other assets $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 7d · Net gain or loss

    total $0 · excluded $0

  • 10a · Gross sales of inventory

    $49,360

  • 10b · Cost of goods sold

    $43,292

  • 10c · Net income from sales of inventory

    total $6,068 · excluded $6,068

  • 11a · Other revenue: CAFETERIA

    total $86,396 · excluded $86,396

  • 11b · Other revenue: AFFILIATE SERVICES

    total $1,502,758 · related or exempt $1,502,758

  • 11d · All other revenue

    total $17,820 · related or exempt $17,820 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $1,606,974

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $25,890,740 · program services $24,158,944 · management and general $1,731,796

  • 8 · Pension plan contributions

    total $578,457 · program services $497,182 · management and general $81,275

  • 9 · Other employee benefits

    total $4,608,981 · program services $4,301,689 · management and general $307,292

  • 10 · Payroll taxes

    total $1,021,026 · program services $909,673 · management and general $111,353

  • 11d · Fees: lobbying

    total $16,096 · management and general $16,096

  • 11g · Fees: other

    total $2,588,978 · program services $2,532,032 · management and general $56,946 · fundraising $0

  • 12 · Advertising and promotion

    total $1,006 · program services $768 · management and general $238

  • 13 · Office expenses

    total $884,283 · program services $617,315 · management and general $266,968

  • 14 · Information technology

    total $26,261 · program services $23,935 · management and general $2,326

  • 16 · Occupancy

    total $617,205 · program services $616,406 · management and general $799

  • 17 · Travel

    total $71,305 · program services $57,945 · management and general $13,360

  • 19 · Conferences, conventions and meetings

    total $22,000 · program services $10,017 · management and general $11,983

  • 20 · Interest

    total $1,841 · program services $1,841

  • 21 · Payments to affiliates

    total $9,150,272 · program services $1,207,184 · management and general $7,943,088

  • 22 · Depreciation, depletion and amortization

    total $975,422 · program services $367,076 · management and general $608,346

  • 23 · Insurance

    total $456,014 · program services $456,014

  • 24a · Other expenses: MEDICAL SUPPLIES AND Pharmaceuticals

    total $5,714,801 · program services $5,714,801 · management and general $0

  • 24b · Other expenses: CONTRACTS AND REPAIRS

    total $3,935,512 · program services $2,459,777 · management and general $1,475,735

  • 24c · Other expenses: BAD DEBTS

    total $1,942,100 · program services $1,942,100 · management and general $0

  • 24d · Other expenses: PROVIDER TAX

    total $1,128,482 · program services $1,128,482 · management and general $0

  • 24e · All other expenses

    total $1,423,084 · program services $1,032,116 · management and general $390,968 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $565 · end of year $466

  • 2 · Savings and temporary cash investments

    beginning of year $219,258 · end of year $137,093

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $6,216,345 · end of year $5,229,197

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $512,017 · end of year $883,610

  • 9 · Prepaid expenses and deferred charges

    beginning of year $2,189 · end of year $195,875

  • 10a · Land, buildings and equipment: cost or other basis

    $43,936,283

  • 10b · Land, buildings and equipment: accumulated depreciation

    $21,395,564

  • 10c · Land, buildings and equipment, net

    beginning of year $18,083,816 · end of year $22,540,719

  • 11 · Investments: publicly traded securities

    beginning of year $241,309 · end of year $212,373

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $12,749,334 · end of year $12,976,424

  • 17 · Accounts payable and accrued expenses

    beginning of year $3,507,342 · end of year $2,373,623

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $11,016,054 · end of year $11,367,789

  • 27 · Net assets without donor restrictions

    beginning of year $21,569,974 · end of year $26,275,792

  • 28 · Net assets with donor restrictions

    beginning of year $1,931,463 · end of year $2,158,553

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $0 · end of year $0

  • 31 · Retained earnings, endowment or other funds

    beginning of year $0 · end of year $0

Mission and programs · 2023

Mission

IN THE SPIRIT OF CHRIST AND THE EXAMPLE OF FRANCIS OF ASSISI, THE MISSION OF OSF HEALTHCARE IS TO SERVE PERSONS WITH THE GREATEST CARE AND LOVE IN A COMMUNITY THAT CELEBRATES THE GIFT OF LIFE.

  • MENDOTA COMMUNITY HOSPITAL is licensed to operate 25 patient beds. The hospital provided $2,699,632 in financial assistance to the community during FISCAL YEAR 2024. The Hospital's services provided during fiscal year 2024 are as follows: Patient days of 2,628, Outpatient visits of 48,190, Patient visits to the emergency room of 8,939.

    Expenses $48,035,297 · Revenue $64,401,226

As filed on the 2023 return.

Listed in Part VII

  • Robert C Sehring

    Vice Chairperson Chief Executive Officer

    Total calculated
    $3,064,020
    From this org
    $0
    From related orgs
    $2,987,377
    Other
    $76,643
    Hours/week
    1 + 44 related

    Schedule J breakdown matched by us

    Base
    $0 + $2,105,362 related
    Bonus
    $0 + $591,647 related
    Other
    $0 + $290,368 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $30,143 related
    Filer's total
    $0 + $3,064,020 related
  • Sister Agnes Joseph Williams OSF

    Assistant Secretary and Treasurer

    Total calculated
    $0
    Hours/week
    1 + 44 related
  • Sister Diane Marie McGrew OSF

    President and Treasurer (Through June 2024)

    Total calculated
    $0
    Hours/week
    1 + 43 related
  • Sister Judith Ann Duvall OSF

    Chairperson

    Total calculated
    $0
    Hours/week
    1 + 44 related
  • Sister Theresa Ann Brazeau OSF

    Secretary

    Total calculated
    $0
    Hours/week
    1 + 44 related
  • Brian J Silverstein MD

    Board Member

    Total calculated
    $45,000
    From this org
    $0
    From related orgs
    $45,000
    Other
    $0
    Hours/week
    1 + 42 related
  • Gerald J McShane MD

    Board Member

    Total calculated
    $247,558
    From this org
    $0
    From related orgs
    $197,752
    Other
    $49,806
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $197,752 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $27,000 related
    Nontaxable benefits
    $0 + $22,806 related
    Filer's total
    $0 + $247,558 related
  • Sister M Angelica Neumann FSGM

    Board Member (Beginning March 2024)

    Total calculated
    $0
    Hours/week
    1 + 43 related
  • Sister M Beata Ziegler FSGM

    Board Member (Beginning March 2024)

    Total calculated
    $0
    Hours/week
    1 + 43 related
  • Sister M Mikela Meidl FSGM

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 43 related
  • Sister Rose Therese Mann OSF

    Board Member

    Total calculated
    $0
    Hours/week
    1 + 44 related
  • August J Querciagrossa

    Chief Executive Officer, Western Region

    Total calculated
    $937,285
    From this org
    $0
    From related orgs
    $811,078
    Other
    $126,207
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $651,504 related
    Bonus
    $0 + $125,009 related
    Other
    $0 + $34,565 related
    Deferred
    $0 + $96,064 related
    Nontaxable benefits
    $0 + $30,143 related
    Filer's total
    $0 + $937,285 related
  • Carol A Friesen

    Chief Executive Officer, Eastern Region

    Total calculated
    $1,119,198
    From this org
    $0
    From related orgs
    $971,996
    Other
    $147,202
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $793,665 related
    Bonus
    $0 + $154,223 related
    Other
    $0 + $24,108 related
    Deferred
    $0 + $111,642 related
    Nontaxable benefits
    $0 + $35,560 related
    Filer's total
    $0 + $1,119,198 related
  • Christopher M Curry

    President, OSF Transitional Care Hospital (Beginning Oct 2023)

    Total calculated
    $76,907
    From this org
    $0
    From related orgs
    $72,267
    Other
    $4,640
    Hours/week
    1 + 41 related
  • David Fergus

    Chief Supply Chain Officer

    Total calculated
    $581,704
    From this org
    $0
    From related orgs
    $521,674
    Other
    $60,030
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $369,525 related
    Bonus
    $0 + $119,888 related
    Other
    $0 + $32,261 related
    Deferred
    $0 + $36,530 related
    Nontaxable benefits
    $0 + $23,500 related
    Filer's total
    $0 + $581,704 related
  • David M Hall

    SVP Info Systems/ Chief Information Officer

    Total calculated
    $758,669
    From this org
    $0
    From related orgs
    $676,609
    Other
    $82,060
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $535,653 related
    Bonus
    $0 + $107,624 related
    Other
    $0 + $33,332 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $35,560 related
    Filer's total
    $0 + $758,669 related
  • Dawn C Trompeter

    President, OSF HealthCare Saint Elizabeth Medical Center/ Saint Paul Medical Center

    Total calculated
    $515,844
    From this org
    $0
    From related orgs
    $456,625
    Other
    $59,219
    Hours/week
    20.5 + 21.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $362,482 related
    Bonus
    $0 + $69,387 related
    Other
    $0 + $24,756 related
    Deferred
    $0 + $45,111 related
    Nontaxable benefits
    $0 + $14,108 related
    Filer's total
    $0 + $515,844 related
  • Derrick Frazier

    President, OSF HealthCare Saint James-John W. Albrecht Medical Center

    Total calculated
    $206,274
    From this org
    $0
    From related orgs
    $194,795
    Other
    $11,479
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $156,069 related
    Bonus
    $0 + $28,240 related
    Other
    $0 + $10,486 related
    Deferred
    $0 + $2,637 related
    Nontaxable benefits
    $0 + $8,842 related
    Filer's total
    $0 + $206,274 related
  • Jacqueline D Kernan

    President, OSF HealthCare Saint Clare Medical Center and OSF HealthCare Saint Luke Medical Center

    Total calculated
    $426,782
    From this org
    $0
    From related orgs
    $370,672
    Other
    $56,110
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $285,637 related
    Bonus
    $0 + $60,720 related
    Other
    $0 + $24,315 related
    Deferred
    $0 + $35,304 related
    Nontaxable benefits
    $0 + $20,806 related
    Filer's total
    $0 + $426,782 related
  • James J Mormann

    Chief Executive Officer, Integrated Solutions

    Total calculated
    $1,056,725
    From this org
    $0
    From related orgs
    $980,082
    Other
    $76,643
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $781,052 related
    Bonus
    $0 + $172,457 related
    Other
    $0 + $26,573 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $30,143 related
    Filer's total
    $0 + $1,056,725 related
  • Jason R Rodeghero

    President, OSF Home Care and Rehab Services

    Total calculated
    $468,327
    From this org
    $0
    From related orgs
    $407,697
    Other
    $60,630
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $344,614 related
    Bonus
    $0 + $62,479 related
    Other
    $0 + $604 related
    Deferred
    $0 + $37,235 related
    Nontaxable benefits
    $0 + $23,395 related
    Filer's total
    $0 + $468,327 related
  • Jeffry M Tillery

    President, OSF Medical Group (Through April 2024)

    Total calculated
    $1,185,950
    From this org
    $0
    From related orgs
    $1,117,994
    Other
    $67,956
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $838,071 related
    Bonus
    $0 + $164,351 related
    Other
    $0 + $115,572 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $21,456 related
    Filer's total
    $0 + $1,185,950 related
  • Jennifer L Ulrich

    Interim President, OSF HealthCare St. Joseph Medical Center (Beginning Nov 2023)

    Total calculated
    $333,976
    From this org
    $0
    From related orgs
    $271,360
    Other
    $62,616
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $237,499 related
    Bonus
    $0 + $33,756 related
    Other
    $0 + $105 related
    Deferred
    $0 + $32,720 related
    Nontaxable benefits
    $0 + $29,896 related
    Filer's total
    $0 + $333,976 related
  • Jerry W Rumph

    President, OSF HealthCare Saint Anthony's Health Center (Through August 2024)

    Total calculated
    $402,580
    From this org
    $0
    From related orgs
    $367,657
    Other
    $34,923
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $291,526 related
    Bonus
    $0 + $60,271 related
    Other
    $0 + $15,860 related
    Deferred
    $0 + $34,793 related
    Nontaxable benefits
    $0 + $130 related
    Filer's total
    $0 + $402,580 related
  • John R Evancho

    SVP Chief Integrity Officer (Through July 2024)

    Total calculated
    $553,159
    From this org
    $0
    From related orgs
    $476,763
    Other
    $76,396
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $399,583 related
    Bonus
    $0 + $74,654 related
    Other
    $0 + $2,526 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $29,896 related
    Filer's total
    $0 + $553,159 related
  • John T Barnhart

    President, Heart of Mary Medical Center & Sacred Heart Medical Center

    Total calculated
    $480,057
    From this org
    $0
    From related orgs
    $424,438
    Other
    $55,619
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $319,448 related
    Bonus
    $0 + $74,963 related
    Other
    $0 + $30,027 related
    Deferred
    $0 + $33,764 related
    Nontaxable benefits
    $0 + $21,855 related
    Filer's total
    $0 + $480,057 related
  • Kathleen M Kinsella

    President, OSF HealthCare Little Company of Mary Medical Center

    Total calculated
    $629,595
    From this org
    $0
    From related orgs
    $567,987
    Other
    $61,608
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $453,638 related
    Bonus
    $0 + $88,811 related
    Other
    $0 + $25,538 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $15,108 related
    Filer's total
    $0 + $629,595 related
  • Kelly A Jefferson

    President, OSF HealthCare St. Francis Hospital & Medical Group

    Total calculated
    $424,598
    From this org
    $0
    From related orgs
    $362,477
    Other
    $62,121
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $296,691 related
    Bonus
    $0 + $51,318 related
    Other
    $0 + $14,468 related
    Deferred
    $0 + $35,075 related
    Nontaxable benefits
    $0 + $27,046 related
    Filer's total
    $0 + $424,598 related
  • Lisa A Schepers

    Interim President, OSF HealthCare Saint Anthony's Health Center (Beginning July 2024)

    Total calculated
    $273,730
    From this org
    $0
    From related orgs
    $229,369
    Other
    $44,361
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $200,315 related
    Bonus
    $0 + $28,614 related
    Other
    $0 + $440 related
    Deferred
    $0 + $23,555 related
    Nontaxable benefits
    $0 + $20,806 related
    Filer's total
    $0 + $273,730 related
  • Lisa DeKezel

    President, OSF HealthCare Holy Family Medical Center and OSF Healthcare St. Mary Medical Center

    Total calculated
    $476,266
    From this org
    $0
    From related orgs
    $407,780
    Other
    $68,486
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $324,104 related
    Bonus
    $0 + $66,198 related
    Other
    $0 + $17,478 related
    Deferred
    $0 + $41,440 related
    Nontaxable benefits
    $0 + $27,046 related
    Filer's total
    $0 + $476,266 related
  • Lori L Wiegand

    Chief Nursing Officer

    Total calculated
    $864,988
    From this org
    $0
    From related orgs
    $808,509
    Other
    $56,479
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $600,847 related
    Bonus
    $0 + $118,432 related
    Other
    $0 + $89,230 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $9,979 related
    Filer's total
    $0 + $864,988 related
  • Lynn A Fulton

    President, OSF HealthCare St. Joseph Medical Center (Through Dec 2023)

    Total calculated
    $489,045
    From this org
    $0
    From related orgs
    $425,461
    Other
    $63,584
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $424,418 related
    Bonus
    $0
    Other
    $0 + $1,043 related
    Deferred
    $0 + $38,152 related
    Nontaxable benefits
    $0 + $25,432 related
    Filer's total
    $0 + $489,045 related
  • Megan L Zakrzewski

    President, OSF HealthCare Children's Hospital of Illinois (Beginning Sept 2024)

    Total calculated
    $0
    Hours/week
    1 + 41 related
  • Melinda B Cooling

    Senior Vice President, Advanced Practice/ Chief Clinician Executive, OSF OnCall Digital Health

    Total calculated
    $518,353
    From this org
    $0
    From related orgs
    $467,340
    Other
    $51,013
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $382,186 related
    Bonus
    $0 + $67,436 related
    Other
    $0 + $17,718 related
    Deferred
    $0 + $23,187 related
    Nontaxable benefits
    $0 + $27,826 related
    Filer's total
    $0 + $518,353 related
  • Michael A Cruz MD

    Chief Operating Officer

    Total calculated
    $1,425,652
    From this org
    $0
    From related orgs
    $1,349,009
    Other
    $76,643
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $991,426 related
    Bonus
    $0 + $224,003 related
    Other
    $0 + $133,580 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $30,143 related
    Filer's total
    $0 + $1,425,652 related
  • Michael A Wells

    President, OSF HealthCare Saint Francis Medical Center

    Total calculated
    $649,287
    From this org
    $0
    From related orgs
    $594,022
    Other
    $55,265
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $510,696 related
    Bonus
    $0 + $81,110 related
    Other
    $0 + $2,216 related
    Deferred
    $0 + $34,459 related
    Nontaxable benefits
    $0 + $20,806 related
    Filer's total
    $0 + $649,287 related
  • Michael M Allen

    Chief Financial Officer

    Total calculated
    $1,376,047
    From this org
    $0
    From related orgs
    $1,205,633
    Other
    $170,414
    Hours/week
    1 + 43 related

    Schedule J breakdown matched by us

    Base
    $0 + $934,328 related
    Bonus
    $0 + $216,168 related
    Other
    $0 + $55,137 related
    Deferred
    $0 + $140,271 related
    Nontaxable benefits
    $0 + $30,143 related
    Filer's total
    $0 + $1,376,047 related
  • Michelle D Conger

    Chief Strategy Officer, OSF Healthcare/ CEO, OSF OnCall Digital Health

    Total calculated
    $1,207,505
    From this org
    $0
    From related orgs
    $1,055,498
    Other
    $152,007
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $854,346 related
    Bonus
    $0 + $166,177 related
    Other
    $0 + $34,975 related
    Deferred
    $0 + $124,961 related
    Nontaxable benefits
    $0 + $27,046 related
    Filer's total
    $0 + $1,207,505 related
  • Ned Hill

    President, OSF HealthCare Sacred Heart Medical Center (Through July 2024)

    Total calculated
    $473,698
    From this org
    $0
    From related orgs
    $412,812
    Other
    $60,886
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $330,429 related
    Bonus
    $0 + $66,816 related
    Other
    $0 + $15,567 related
    Deferred
    $0 + $33,840 related
    Nontaxable benefits
    $0 + $27,046 related
    Filer's total
    $0 + $473,698 related
  • Paula A Carynski

    President, OSF HealthCare Saint Anthony Medical Center

    Total calculated
    $719,705
    From this org
    $0
    From related orgs
    $649,279
    Other
    $70,426
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $515,899 related
    Bonus
    $0 + $100,836 related
    Other
    $0 + $32,544 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $23,926 related
    Filer's total
    $0 + $719,705 related
  • Ralph Velazquez MD

    System Chief Medical Officer

    Total calculated
    $1,041,877
    From this org
    $0
    From related orgs
    $965,234
    Other
    $76,643
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $699,181 related
    Bonus
    $0 + $147,655 related
    Other
    $0 + $118,398 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $30,143 related
    Filer's total
    $0 + $1,041,877 related
  • Robert G Anderson

    Chief Executive Officer, Central Region

    Total calculated
    $990,176
    From this org
    $0
    From related orgs
    $939,288
    Other
    $50,888
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $721,458 related
    Bonus
    $0 + $152,390 related
    Other
    $0 + $65,440 related
    Deferred
    $0 + $29,382 related
    Nontaxable benefits
    $0 + $21,506 related
    Filer's total
    $0 + $990,176 related
  • Robert L Brandfass

    SVP Chief Legal Officer

    Total calculated
    $906,831
    From this org
    $0
    From related orgs
    $830,188
    Other
    $76,643
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $657,312 related
    Bonus
    $0 + $145,161 related
    Other
    $0 + $27,715 related
    Deferred
    $0 + $46,500 related
    Nontaxable benefits
    $0 + $30,143 related
    Filer's total
    $0 + $906,831 related
  • Shawn E Piers MD

    Interim President, OSF Medical Group (Beginning April 2024)

    Total calculated
    $503,417
    From this org
    $0
    From related orgs
    $435,933
    Other
    $67,484
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $380,833 related
    Bonus
    $0 + $54,258 related
    Other
    $0 + $842 related
    Deferred
    $0 + $43,828 related
    Nontaxable benefits
    $0 + $23,656 related
    Filer's total
    $0 + $503,417 related
  • Shelley A Parn

    Chief Human Resources Officer

    Total calculated
    $675,693
    From this org
    $0
    From related orgs
    $586,816
    Other
    $88,877
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $466,775 related
    Bonus
    $0 + $84,623 related
    Other
    $0 + $35,418 related
    Deferred
    $0 + $69,741 related
    Nontaxable benefits
    $0 + $19,136 related
    Filer's total
    $0 + $675,693 related
  • Stephanie H Stovall

    Chief Quality Officer (Beginning Sept 2024)

    Total calculated
    $0
    Hours/week
    1 + 41 related
  • Thomas G Hammerton

    President OSF Healthcare Foundation and Chief Development Officer

    Total calculated
    $742,547
    From this org
    $0
    From related orgs
    $615,658
    Other
    $126,889
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $409,043 related
    Bonus
    $0 + $100,942 related
    Other
    $0 + $105,673 related
    Deferred
    $0 + $97,079 related
    Nontaxable benefits
    $0 + $29,810 related
    Filer's total
    $0 + $742,547 related
  • Tim J Vega

    Chief Population Health Officer (Beginning March 2024)

    Total calculated
    $535,617
    From this org
    $0
    From related orgs
    $469,009
    Other
    $66,608
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $387,603 related
    Bonus
    $0 + $58,421 related
    Other
    $0 + $22,985 related
    Deferred
    $0 + $38,062 related
    Nontaxable benefits
    $0 + $28,546 related
    Filer's total
    $0 + $535,617 related
  • Jodie L Borchelt

    Director Surgical/Inpatient Services, Medical/Surgical Acute

    Total calculated
    $186,911
    From this org
    $143,062
    From related orgs
    $0
    Other
    $43,849
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $136,146
    Bonus
    $6,733
    Other
    $183
    Deferred
    $15,303
    Nontaxable benefits
    $28,546
    Filer's total
    $186,911
  • Katherine R Riva-Foster MD

    Physician

    Total calculated
    $306,961
    From this org
    $273,798
    From related orgs
    $0
    Other
    $33,163
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $256,792
    Bonus
    $11,881
    Other
    $5,125
    Deferred
    $16,938
    Nontaxable benefits
    $16,225
    Filer's total
    $306,961
  • Kristi A Gonzales

    Physician Assistant

    Total calculated
    $230,179
    From this org
    $188,992
    From related orgs
    $0
    Other
    $41,187
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $117,611
    Bonus
    $68,500
    Other
    $2,881
    Deferred
    $19,511
    Nontaxable benefits
    $21,676
    Filer's total
    $230,179
  • Stacy A Piller

    Advanced Practice Nurse

    Total calculated
    $234,007
    From this org
    $174,149
    From related orgs
    $0
    Other
    $59,858
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $118,035
    Bonus
    $48,454
    Other
    $7,660
    Deferred
    $38,052
    Nontaxable benefits
    $21,806
    Filer's total
    $234,007
  • Tiffany Ann Shinnick

    Advanced Practice Nurse

    Total calculated
    $148,427
    From this org
    $126,450
    From related orgs
    $0
    Other
    $21,977
    Hours/week
    40
  • Bradley V Solberg

    Former President, OSF HealthCare Saint James- John W. Albrecht Medical Center

    Total calculated
    $209,332
    From this org
    $0
    From related orgs
    $184,799
    Other
    $24,533
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $143,744 related
    Bonus
    $0 + $40,457 related
    Other
    $0 + $598 related
    Deferred
    $0 + $17,630 related
    Nontaxable benefits
    $0 + $6,903 related
    Filer's total
    $0 + $209,332 related
  • Elizabeth A Davidson

    Former Interim President, OSF Healthcare Saint James-John W. Albrecht Medical Center

    Total calculated
    $292,527
    From this org
    $0
    From related orgs
    $244,392
    Other
    $48,135
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $212,074 related
    Bonus
    $0 + $29,662 related
    Other
    $0 + $2,656 related
    Deferred
    $0 + $27,329 related
    Nontaxable benefits
    $0 + $20,806 related
    Filer's total
    $0 + $292,527 related
  • Erin N Rogers

    Former Interim President, OSF Healthcare Heart of Mary Medical Center

    Total calculated
    $236,181
    From this org
    $0
    From related orgs
    $176,114
    Other
    $60,067
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $167,776 related
    Bonus
    $0 + $7,576 related
    Other
    $0 + $762 related
    Deferred
    $0 + $30,171 related
    Nontaxable benefits
    $0 + $29,896 related
    Filer's total
    $0 + $236,181 related
  • Roxanna Crosser

    Former Chief Executive Officer, Western Region

    Total calculated
    $464,518
    From this org
    $0
    From related orgs
    $422,844
    Other
    $41,674
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $262,563 related
    Bonus
    $0 + $73,872 related
    Other
    $0 + $86,409 related
    Deferred
    $0 + $35,900 related
    Nontaxable benefits
    $0 + $5,774 related
    Filer's total
    $0 + $464,518 related
  • Stephen E Hippler MD

    Former Chief Clinical Officer

    Total calculated
    $645,610
    From this org
    $0
    From related orgs
    $645,610
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $645,610 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $645,610 related
  • Leon A Yeh MD

    VP Chief Medical Officer Emergency Serv

    Total calculated
    $760,592
    From this org
    $0
    From related orgs
    $707,484
    Other
    $53,108
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $598,568 related
    Bonus
    $0 + $86,282 related
    Other
    $0 + $22,634 related
    Deferred
    $0 + $39,000 related
    Nontaxable benefits
    $0 + $14,108 related
    Filer's total
    $0 + $760,592 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

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 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)

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
To aid in retaining key employees, a 457(f) retirement allowance plan is available to executives. Each year the plan provides credits, expressed as dollar amounts, determined by a percentage of each participant's base salary. The percentage for each participant is defined in the plan. The deferred allowance is deposited in an account for each participant and invested in securities selected by the participant from a menu of available options. Vested benefits, with investments gains or losses, are paid to participants as regular taxable income. The plan defines provisions for distribution of benefits in the event of the participant's death or separation of employment prior to the elected vesting date. The amounts below; deferred in the current year and paid in the current year, respectively, are included in the amounts reported on schedule j, part ii, columns b(iii), (c), or (f). Michael Allen $93,771/ $0 Robert Anderson $0/ $24,330 Michelle Conger $82,757/ $0 Roxanna Crosser $0/ $59,022 Michael Cruz $0/ $97,729 Carol Friesen $72,642/ $0 Thomas Hammerton $50,579/ $0 Shelley Parn $39,385 / $0 August Querciagrossa $55,410/ $0 Robert Sehring $0 / $252,790 Jeffry Tillery $0 / $82,511 Ralph Velazquez $0 / $74,159 Lori Wiegand $0 / $59,314
Schedule J, Part I, Line 3 SCH J, PART I, LINE 3
THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF A RELIGIOUS CONGREGATION THAT OWNS OR IS ASSOCIATED WITH THE HEALTHCARE SYSTEM WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS, COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHES THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO EXCESS BENEFIT AMOUNT IS PAID OR FURNISHED.

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.

  • CENTER FOR HEALTH AMBULATORY SURGERY CENTER LLC

    Related · SURGICAL CENTER · IL · 0% owned · share of income $0 · share of assets $0

    Directly controlled by OSF

  • EASTLAND MED PLAZA SURGICENTER LLC

    Related · SURGICAL CENTER · IL · 0% owned · share of income $0 · share of assets $0

    Directly controlled by OSF

  • FT JESSE IMAGING CENTER LLC

    Related · MEDICAL IMAGING · IL · 0% owned · share of income $0 · share of assets $0

    Directly controlled by OSF

  • FOX RIVER CANCER CENTER LLC

    Related · ONCOLOGY · IL · 0% owned · share of income $0 · share of assets $0

    Directly controlled by ORHHC

  • ONCALL IMAGING LLC

    Related · MEDICAL IMAGING · IL · 0% owned · share of income $0 · share of assets $0

    Directly controlled by OSF

  • OLYMPIAN SURGICAL SUITES LLC

    Related · SURGICAL CENTER · IL · 0% owned · share of income $0 · share of assets $0

    Directly controlled by OSF

  • UP CARDIOLOGY PARTNERS LLC

    Related · CARDIOLOGY EQUIPMENT · MI · 0% owned · share of income $0 · share of assets $0

    Directly controlled by OSF

  • 124 ADAMS PROPERTY MANAGEMENT LLC

    Related · REAL ESTATE · IL · 0% owned · share of income $0 · share of assets $0

    Directly controlled by POINTCORE INC

Related corporations and trusts

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

  • POINTCORE INC

    C Corporation · HLTHCARE SVCS · IL

    Directly controlled by OSF

  • ILLINOIS PATHOLOGiST SERVICES LLC

    C Corporation · PATHOLOGY SVCS · IL

    Directly controlled by OSF

  • SOUTHWEST HEALTH SYSTEMS INC

    C Corporation · HEALTHCARE SERVICES · IL

    Directly controlled by OSF

  • OSF AVIATION LLC

    C Corporation · Medical Transportation · IL

    Directly controlled by Pointcore Inc

  • OSF ASSURANCE COMPANY

    C Corporation · Insurance company · VT

    Directly controlled by Pointcore Inc

  • OSF FINANCE COMPANY LLC

    C Corporation · FINANCE COMPANY · IL

    Directly controlled by POINTCORE INC

  • POINTCORE SUPPLY CHAIN SERVICES LLC

    C Corporation · SUPPLY CHAIN SERVICES · IL

    Directly controlled by POINTCORE INC

Provenance

Return type
form_990
Tax year
2023
Filed
6 August 2025
IRS schema version
2023v6.0
Source object
202522189349301972

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