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← HEALTHSOURCE FOUNDATION

Form 990 for tax year 2022

Filed by HEALTHSOURCE FOUNDATION.

Totals

Total revenue
$412,652
Total expenses
$471,655
Contributions and grants received
$378,969
Grants paid
$200,000
Program service revenue
$0
Investment income
$19,937
Other revenue
$13,746
Total assets, end of year
$1,635,937
Total liabilities, end of year
$219,825
Net assets or fund balances, end of year
$1,416,112
Program services expenses (Part IX)
$471,655
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$471,655

Program services were 100.0% 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.

  • 1c · Fundraising events

    $101,615

  • 1d · Related organizations

    $120,000

  • 1f · All other contributions, gifts and grants

    $157,354

  • 3 · Investment income

    total $19,937 · excluded $19,937

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0

  • 5 · Royalties

    total $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 6d · Net rental income or loss

    total $0

  • 7d · Net gain or loss

    total $0

  • 8a · Fundraising events: gross income

    $45,531

  • 8a · Fundraising events: contributions included on line 1c

    $101,165

  • 8b · Fundraising events: direct expenses

    $31,785

  • 8c · Net income from fundraising events

    total $13,746 · excluded $13,746

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $0

  • 10c · Net income from sales of inventory

    total $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $200,000 · program services $200,000

  • 2 · Grants to domestic individuals

    total $0

  • 3 · Grants to foreign organizations and individuals

    total $0

  • 4 · Benefits paid to or for members

    total $0

  • 5 · Compensation of officers, directors and key employees

    total $0

  • 6 · Compensation of disqualified persons

    total $0

  • 7 · Other salaries and wages

    total $0

  • 8 · Pension plan contributions

    total $0

  • 9 · Other employee benefits

    total $0

  • 10 · Payroll taxes

    total $0

  • 11a · Fees: management

    total $0

  • 11b · Fees: legal

    total $0

  • 11c · Fees: accounting

    total $0

  • 11d · Fees: lobbying

    total $0

  • 11e · Fees: professional fundraising services

    total $0

  • 11f · Fees: investment management

    total $0

  • 11g · Fees: other

    total $7,140 · program services $7,140

  • 12 · Advertising and promotion

    total $0

  • 13 · Office expenses

    total $26,527 · program services $26,527

  • 14 · Information technology

    total $0

  • 15 · Royalties

    total $0

  • 16 · Occupancy

    total $0

  • 17 · Travel

    total $1,311 · program services $1,311

  • 18 · Travel or entertainment for public officials

    total $0

  • 19 · Conferences, conventions and meetings

    total $250 · program services $250

  • 20 · Interest

    total $0

  • 21 · Payments to affiliates

    total $0

  • 22 · Depreciation, depletion and amortization

    total $0

  • 23 · Insurance

    total $1,105 · program services $1,105

  • 24a · Other expenses: MISCELLANEOUS

    total $25,232 · program services $25,232

  • 24b · Other expenses: COMP & BENEFIT REIMBURSEMENT

    total $207,940 · program services $207,940

  • 24c · Other expenses: ALLOCATED EXP - DEPRECIATION

    total $2,150 · program services $2,150

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $333,623 · end of year $427,783

  • 2 · Savings and temporary cash investments

    beginning of year $1,410,252 · end of year $1,158,154

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $50,000

  • 4 · Accounts receivable

    beginning of year $10,175 · end of year $0

  • 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 $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $0 · end of year $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0 · end of year $0

  • 13 · Investments: program-related

    beginning of year $0 · end of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $6,900 · end of year $219,825

  • 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 $0 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $1,747,150 · end of year $1,416,112

  • 28 · Net assets with donor restrictions

    beginning of year $0 · end of year $0

Mission and programs · 2022

Mission

DESCRIPTION OF ORGANIZATION MISSION THE FOUNDATION'S MISSION IS TO SUPPORT THE ACTIVITIES OF HEALTHSOURCE OF OHIO, A HEALTHCARE PROVIDER ORGANIZATION AS DESCRIBED IN SECTIONS 501(C)(3) AND 509(A)(1) OF THE INTERNAL REVENUE CODE. THE FOUNDATION ACTIVITIES WILL CONSIST OF RAISING FUNDS FOR MAKING GRANTS TO THE SUPPORTED ORGANIZATION.

Activities or mission (Part I)

THE HEALTHSOURCE FOUNDATION IS COMMITTED TO PROVIDING OPPORTUNITIES AND ENCOURAGING EXPRESSIONS OF SUPPORT TO IMPACT THE MISSION OF HEALTHSOURCE OF OHIO.

  • THE HEALTHSOURCE FOUNDATION SHALL BE THE SOLE PHILANTHROPIC FUNDRAISING ARM OF HEALTHSOURCE OF OHIO AND ENDOW THE MISSION OF HEALTHSOURCE OF OHIO, TO - PROMOTE COMMUNITY AWARENESS AND ENGAGEMENT IN THE SUPPORT OF QUALITY PRIMARY HEALTH CARE FOR ALL PERSONS IN THE REGIONS THAT HEALTHSOURCE OF OHIO SERVES; AND - TO EDUCATE THE COMMUNITY ON HEALTHCARE ISSUES AND CONCERNS THAT LIMIT ACCESS TO PRIMARY CARE SERVICES THAT THE COMMUNITY HAS THE OPPORTUNITY TO IMPACT.

    Expenses $471,655 · Grants $200,000

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • KIMBERLY PATTON

    HSO CEO

    Total calculated
    $390,023
    From this org
    $0
    From related orgs
    $351,207
    Other
    $38,816
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $299,783 related
    Bonus
    $0 + $47,860 related
    Other
    $0 + $3,564 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $23,566 related
    Filer's total
    $0 + $390,023 related

  • KONSTANTINOS ELEFTER

    MEMBER

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • STEVE HOOD

    PAST CHAIRPERSON

    Total calculated
    $0
    Hours/week
    1

  • GAIL KOFORD

    CHAIRPERSON

    Total calculated
    $0
    Hours/week
    1

  • SANDY MONGOLD

    MEMBER

    Total calculated
    $0
    Hours/week
    1

  • RANDY RILEY

    VICE CHAIRPERSON

    Total calculated
    $0
    Hours/week
    1

  • KEN SMITH

    MEMBER

    Total calculated
    $0
    Hours/week
    1

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 · Written employment contract
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

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

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.

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

Provenance

Return type
form_990
Tax year
2022
Filed
15 November 2023
IRS schema version
2022v5.0
Source object
202323139349304457

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