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Nonprofiteer
← ESSENTIA INSTITUTE OF RURAL HEALTH

Form 990 for tax year 2022

Filed by ESSENTIA INSTITUTE OF RURAL HEALTH.

Totals

Total revenue
$11,564,234
Total expenses
$11,754,888
Contributions and grants received
$4,630,555
Grants paid
$0
Program service revenue
$3,015,360
Investment income
$90,477
Other revenue
$3,827,842
Total assets, end of year
$5,590,312
Total liabilities, end of year
$1,061,250
Net assets or fund balances, end of year
$4,529,062
Program services expenses (Part IX)
$10,627,849
Management and general expenses
$1,127,039
Fundraising expenses
$0
Program service expenses (Part III)
$10,627,849

Program services were 90.4% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DANIEL NIKCEVICH MD

    BOARD CHAIR

    Total calculated
    $966,567
    From this org
    $0
    From related orgs
    $908,427
    Other
    $58,140
    Hours/week
    2 + 58 related

    Schedule J breakdown matched by us

    Base
    $0 + $768,532 related
    Bonus
    $0
    Other
    $0 + $139,895 related
    Deferred
    $0 + $20,705 related
    Nontaxable benefits
    $0 + $37,435 related
    Filer's total
    $0 + $966,567 related

  • KATHERINE DEAN

    EXECUTIVE DIRECTOR

    Total calculated
    $314,562
    From this org
    $272,392
    From related orgs
    $0
    Other
    $42,170
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $225,477
    Bonus
    $32,966
    Other
    $13,949
    Deferred
    $13,554
    Nontaxable benefits
    $28,616
    Filer's total
    $314,562

  • STEPHEN WARING

    PRINCIPLE SCIENTIST

    Total calculated
    $220,631
    From this org
    $187,156
    From related orgs
    $0
    Other
    $33,475
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $175,764
    Bonus
    $0
    Other
    $11,392
    Deferred
    $8,494
    Nontaxable benefits
    $24,981
    Filer's total
    $220,631

  • JAMIE HAMMER

    RESIDENT PHYSICIAN

    Total calculated
    $195,780
    From this org
    $154,636
    From related orgs
    $0
    Other
    $41,144
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $54,386
    Bonus
    $100,000
    Other
    $250
    Deferred
    $8,137
    Nontaxable benefits
    $33,007
    Filer's total
    $195,780

  • PATRICIA CONWAY

    RESEARCH SCIENTIST III

    Total calculated
    $191,152
    From this org
    $169,629
    From related orgs
    $0
    Other
    $21,523
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $168,955
    Bonus
    $0
    Other
    $674
    Deferred
    $8,542
    Nontaxable benefits
    $12,981
    Filer's total
    $191,152

  • COURTNEY DONAHOE

    RESIDENT PHYSICIAN

    Total calculated
    $169,768
    From this org
    $143,962
    From related orgs
    $0
    Other
    $25,806
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $63,953
    Bonus
    $80,000
    Other
    $9
    Deferred
    $7,497
    Nontaxable benefits
    $18,309
    Filer's total
    $169,768

  • STACI LOKEN

    RESIDENT PHYSICIAN

    Total calculated
    $165,787
    From this org
    $150,002
    From related orgs
    $0
    Other
    $15,785
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $69,912
    Bonus
    $80,000
    Other
    $90
    Deferred
    $3,300
    Nontaxable benefits
    $12,485
    Filer's total
    $165,787

  • LAURIE LEWANDOWSKI

    BOARD DIRECTOR

    Total calculated
    $25,375
    From this org
    $0
    From related orgs
    $25,375
    Other
    $0
    Hours/week
    1 + 4 related

  • WALTER LEINO MD

    BOARD CHAIR THRU 12/22

    Total calculated
    $20,000
    From this org
    $0
    From related orgs
    $20,000
    Other
    $0
    Hours/week
    2 + 3 related

  • ANTHONY SERTICH

    BOARD SECRETARY/TREASURER

    Total calculated
    $7,800
    From this org
    $0
    From related orgs
    $7,800
    Other
    $0
    Hours/week
    2 + 4 related

  • JOSEPH LEONI

    BOARD DIRECTOR THRU 12/22

    Total calculated
    $6,800
    From this org
    $0
    From related orgs
    $6,800
    Other
    $0
    Hours/week
    1 + 4 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 · 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)

PART I, LINE 3
ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA INSTITUTE OF RURAL HEALTH'S EXECUTIVE DIRECTOR'S COMPENSATION: A COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B (III), THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT OF THE VESTED BENEFIT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: DANIEL NIKCEVICH, MD $134,962

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.

Related corporations and trusts

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

  • ESSENTIA HEALTH INSURANCE SERVICES SPC LTD

    C · SELF INSURANCE · CJ · controlled entity

  • MID DAKOTA CLINIC INC

    C · CLINIC OPERATIONS CEASED 9/30/22 · ND · controlled entity

Provenance

Return type
form_990
Tax year
2022
Filed
3 May 2024
IRS schema version
2022v5.0
Source object
202431249349301203

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