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Nonprofiteer
← MADISON COMMUNITY HOSPITAL

Form 990 for tax year 2022

Filed by MADISON COMMUNITY HOSPITAL.

Totals

Total revenue
$35,718,300
Total expenses
$34,307,837
Contributions and grants received
$128,389
Grants paid
$112,500
Program services expenses (Part IX)
$27,783,820
Management and general expenses
$6,524,017
Fundraising expenses
$0
Program service expenses (Part III)
$27,783,820

Program services were 81.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ROBERT SUMMERER

    SURGEON

    Total calculated
    $613,689
    From this org
    $582,231
    From related orgs
    $0
    Other
    $31,458
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $582,231
    Bonus
    $0
    Other
    $0
    Deferred
    $15,250
    Nontaxable benefits
    $16,851
    Filer's total
    $614,332

  • BENJAMIN LISCANO

    MD OF FAMILY MEDICINE

    Total calculated
    $491,452
    From this org
    $453,253
    From related orgs
    $0
    Other
    $38,199
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $453,253
    Bonus
    $0
    Other
    $0
    Deferred
    $15,250
    Nontaxable benefits
    $23,894
    Filer's total
    $492,397

  • LAURA HOEFERT

    MD OF FAMILY MEDICINE

    Total calculated
    $435,607
    From this org
    $412,885
    From related orgs
    $0
    Other
    $22,722
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $412,885
    Bonus
    $0
    Other
    $0
    Deferred
    $15,250
    Nontaxable benefits
    $8,417
    Filer's total
    $436,552

  • MITCHELL POPPENS

    PHYSICIAN ASSISTANT

    Total calculated
    $431,856
    From this org
    $400,882
    From related orgs
    $0
    Other
    $30,974
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $400,882
    Bonus
    $0
    Other
    $0
    Deferred
    $15,250
    Nontaxable benefits
    $16,540
    Filer's total
    $432,672

  • JUSTIN CLEM

    MD OF FAMILY MEDICINE

    Total calculated
    $422,134
    From this org
    $382,361
    From related orgs
    $0
    Other
    $39,773
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $382,361
    Bonus
    $0
    Other
    $0
    Deferred
    $15,250
    Nontaxable benefits
    $25,474
    Filer's total
    $423,085

  • TAMARA MILLER

    CEO

    Total calculated
    $378,623
    From this org
    $349,243
    From related orgs
    $0
    Other
    $29,380
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $264,397
    Bonus
    $84,846
    Other
    $0
    Deferred
    $15,250
    Nontaxable benefits
    $15,195
    Filer's total
    $379,688

  • TERESA MALLETT

    CFO

    Total calculated
    $197,792
    From this org
    $173,967
    From related orgs
    $0
    Other
    $23,825
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $173,967
    Bonus
    $0
    Other
    $0
    Deferred
    $9,021
    Nontaxable benefits
    $15,512
    Filer's total
    $198,500

  • ROBERT VAN LIERE

    PRESIDENT

    Total calculated
    $0
    Hours/week
    0.5

  • ROBIN SCHWEBACH

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    0.5

  • BETTY VANDERWERFF

    TREASURER

    Total calculated
    $0
    Hours/week
    0.5

  • LOIS NIEDERT

    SECRETARY

    Total calculated
    $0
    Hours/week
    0.5

  • DAN BROWN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • DAN TALLEY

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • BRADY WIEBE

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • SANDY SCHWADER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • JEFF MINNAERT

    TRUSTEE FROM 09/2022

    Total calculated
    $0
    Hours/week
    0.5

  • RYAN KAPPENMAN

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • LAURA JOHNSON

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

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

  • 3 · Compensation committee
  • 3 · Form 990 of other organizations
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 5a · Pay contingent on this organization's revenues

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 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 5
CEO BONUS IS CALCULATED BASED ON REVENUE GROWTH, EBITA, QUALITY GOALS AND TOP CAH AWARDS. HER BONUS FOR 2022 WAS $84,846.

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

Provenance

Return type
form_990
Tax year
2022
Filed
20 March 2024
IRS schema version
2022v5.0
Source object
202410889349300236

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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