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Nonprofiteer
← PELLA HOSPITAL FOUNDATION

Form 990 for tax year 2022

Filed by PELLA HOSPITAL FOUNDATION.

Totals

Total revenue
$512,973
Total expenses
$330,389
Contributions and grants received
$292,599
Grants paid
$307,109
Program service revenue
$0
Investment income
$214,588
Other revenue
$5,786
Total assets, end of year
$6,722,535
Total liabilities, end of year
$3,073
Net assets or fund balances, end of year
$6,719,462
Program services expenses (Part IX)
$307,109
Management and general expenses
$23,280
Fundraising expenses
$0
Program service expenses (Part III)
$307,109

Program services were 93.0% 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

    $21,000

  • 1f · All other contributions, gifts and grants

    $271,599

  • 3 · Investment income

    total $162,193 · excluded $162,193

  • 7a · Gross sales of assets other than inventory

    securities $413,539

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

    securities $361,144

  • 7c · Gain or loss

    securities $52,395

  • 7d · Net gain or loss

    total $52,395 · excluded $52,395

  • 8a · Fundraising events: gross income

    $9,660

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

    $21,000

  • 8b · Fundraising events: direct expenses

    $3,874

  • 8c · Net income from fundraising events

    total $5,786 · excluded $5,786

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $274,634 · program services $274,634

  • 2 · Grants to domestic individuals

    total $32,475 · program services $32,475

  • 11f · Fees: investment management

    total $22,984 · management and general $22,984

  • 24a · Other expenses: BANK FEES

    total $296 · management and general $296

Balance sheet

Part X, book values.

  • 3 · Pledges and grants receivable

    beginning of year $44,222 · end of year $44,222

  • 11 · Investments: publicly traded securities

    beginning of year $5,965,245 · end of year $5,097,096

  • 15 · Other assets

    beginning of year $1,889,343 · end of year $1,581,217

  • 17 · Accounts payable and accrued expenses

    beginning of year $17,894 · end of year $3,073

  • 27 · Net assets without donor restrictions

    beginning of year $1,633,217 · end of year $1,320,370

  • 28 · Net assets with donor restrictions

    beginning of year $6,247,699 · end of year $5,399,092

Mission and programs · 2022

Mission

TO SUPPORT PELLA REGIONAL HEALTH CENTER IN ITS MISSION TO PROVIDE HEALTHCARE AND HEALING SERVICES WITH CHRISTIAN COMPASSION.

Activities or mission (Part I)

TO SUPPORT PELLA REGIONAL HEALTH CENTER IN ITS MISSION TO PROVIDE HEALTHCARE.

  • THE PELLA REGIONAL HEALTH CENTER FOUNDATION WAS ESTABLISHED IN 1994 TO SUPPORT PELLA REGIONAL HEALTH CENTER IN ITS MISSION TO PROVIDE HEALTHCARE AND HEALING SERVICES WITH CHRISTIAN COMPASSION. WITH OUR STORIED HISTORY, THE STRENGTH AND STABILITY THAT WE HAVE BUILT ENSURES A BRIGHT AND PROMISING LONG-TERM FUTURE, NOT ONLY FOR THE FOUNDATION ITSELF, BUT ALSO FOR THE PEOPLE WE SERVE. FROM SENIORS WHO NEED A LITTLE HELP TO CONTINUE LIVING INDEPENDENTLY, TO NEWBORNS WHO ARE DEPENDENT ON MANY; FROM ADULTS BATTLING CHRONIC DISEASE, TO YOUNGSTERS BENEFITING FROM OUR EDUCATIONAL OFFERINGS, WE STRIVE TO REACH EVERY GENERATION IN EVERY COMMUNITY WE SERVE.SEE SCHEDULE O FOR MORE INFORMATION ABOUT THE LEGACY SOCIETY.THE LEGACY SOCIETY, A SELECT GROUP OF FRIENDS OF THE HOSPITAL, IS GROWING IN MEMBERS. BEGINNING IN 2006, A GROUP OF INDIVIDUALS WHO SHARED A VISION FOR THE HOSPITAL AND ACTIVELY PARTICIPATED FINANCIALLY IN ACHIEVING THIS GOAL WERE RECOGNIZED FOR THEIR SIGNIFICANT CONTRIBUTIONS. IT IS AN EXCITING TIME TO BECOME PART OF THE PELLA REGIONAL LEGACY THAT WILL IMPACT AND LEAD HEALTHCARE IN THE SURROUNDING AREAS FOR MANY YEARS TO COME.

    Expenses $307,109 · Grants $307,109

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

Listed in Part VII

  • Jim Brandl

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.2 + 0.5 related

  • Joel Cornilsen

    PRESIDENT

    Total calculated
    $0
    Hours/week
    0.2

  • Kyle Edwards

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    0.2

  • Mike Montgomery

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.2

  • Marilee Sjaardema

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.2

  • Larry Van Maanan

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    0.2

  • Mark Van Roekel

    DIRECTOR

    Total calculated
    $0
    Hours/week
    0.2

  • Corey Veenstra

    FORMER DIRECTOR

    Total calculated
    $0
    Hours/week
    0.2

  • Dr Elizabeth Wooster

    DIRECTOR

    Total calculated
    $363,382
    From this org
    $0
    From related orgs
    $312,585
    Other
    $50,797
    Hours/week
    0.2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $312,585 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $32,497 related
    Filer's total
    $0 + $363,382 related

  • Robert Kroese

    CEO, PELLA REGIONAL HEALTH CENTER

    Total calculated
    $708,801
    From this org
    $0
    From related orgs
    $624,048
    Other
    $84,753
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $624,048 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $58,300 related
    Nontaxable benefits
    $0 + $26,453 related
    Filer's total
    $0 + $708,801 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
PELLA REGIONAL HEALTH CENTER FOUNDATION RELIES ON PELLA REGIONAL HEALTH CENTER, THE SOLE MEMBER OF PELLA HOSPITAL FOUNDATION, TO DETERMINE THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS AND OFFICERS. PELLA REGIONAL HEALTH CENTER UTILIZES A COMPENSATION COMMITTEE, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE COMPENSATION COMMITTEE TO DETERMINE SUCH COMPENSATION.
PART I, LINE 4B
THE FOLLOWING INDIVIDUAL PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN IN 2022 SPONSORED BY PELLA REGIONAL HEALTH CENTER (PRHC), THE SOLE MEMBER OF PELLA HOSPITAL FOUNDATION: ROBERT KROESE. IN JANUARY 2023, THE CURRENT YEAR CONTRIBUTION OF $40,000 WAS MADE BY PRHC ON BEHALF OF THE INDIVIDUAL TO THE PLAN.

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
10 November 2023
IRS schema version
2022v5.0
Source object
202313179349307501

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