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Nonprofiteer
← GASTON MEMORIAL HOSPITAL FOUNDATION INC

Form 990 for tax year 2022

Filed by GASTON MEMORIAL HOSPITAL FOUNDATION INC.

Totals

Total revenue
$1,678,812
Total expenses
$1,552,263
Contributions and grants received
$1,020,867
Grants paid
$1,074,875
Program service revenue
not reported
Investment income
not reported
Other revenue
not reported
Total assets, end of year
not reported
Total liabilities, end of year
not reported
Net assets or fund balances, end of year
not reported
Program services expenses (Part IX)
$1,499,070
Management and general expenses
$53,193
Fundraising expenses
$0
Program service expenses (Part III)
$1,499,070

Program services were 96.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • MR DAVID O'CONNOR

    EVP/CFO/ASST. TREASURER

    Total calculated
    $1,058,707
    From this org
    $0
    From related orgs
    $884,243
    Other
    $174,464
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $580,745 related
    Bonus
    $0 + $194,511 related
    Other
    $0 + $108,987 related
    Deferred
    $0 + $150,741 related
    Nontaxable benefits
    $0 + $23,723 related
    Filer's total
    $0 + $1,058,707 related

  • MS JANIE PEAK

    CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • DR GEORGE ADCOCK III

    SECRETARY

    Total calculated
    $673,841
    From this org
    $0
    From related orgs
    $552,436
    Other
    $121,405
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $387,244 related
    Bonus
    $0 + $110,038 related
    Other
    $0 + $55,154 related
    Deferred
    $0 + $97,727 related
    Nontaxable benefits
    $0 + $23,678 related
    Filer's total
    $0 + $673,841 related

  • MR BOB HOVIS

    DIRECTOR (THROUGH 12/31/22)

    Total calculated
    $30,589
    From this org
    $0
    From related orgs
    $30,589
    Other
    $0
    Hours/week
    1 + 2 related

  • MR JASON AUSTELL

    DIRECTOR (BEGININNG 01/01/23)

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • MR STEVEN WILSON

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • MR K CHRISTOPHER PEEK

    CEO

    Total calculated
    $1,844,813
    From this org
    $0
    From related orgs
    $1,558,081
    Other
    $286,732
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $948,458 related
    Bonus
    $0 + $411,971 related
    Other
    $0 + $197,652 related
    Deferred
    $0 + $263,009 related
    Nontaxable benefits
    $0 + $23,723 related
    Filer's total
    $0 + $1,844,813 related

  • MS LEIGH HICKMAN

    CLO/ASST. SEC.

    Total calculated
    $568,958
    From this org
    $0
    From related orgs
    $465,494
    Other
    $103,464
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $362,901 related
    Bonus
    $0 + $101,731 related
    Other
    $0 + $862 related
    Deferred
    $0 + $87,394 related
    Nontaxable benefits
    $0 + $16,070 related
    Filer's total
    $0 + $568,958 related

  • MS MARY GRACE BEAN

    DIRECTOR FOUNDATION

    Total calculated
    $123,954
    From this org
    $123,954
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

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
  • 6b · Pay contingent on a related organization's net earnings

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
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
COMPENSATION PAID TO CEO OF CAROMONT HEALTH, INC. WAS PAID BY CAROMONT REGIONAL MEDICAL CENTER, A RELATED ORGANIZATION. CAROMONT REGIONAL MEDICAL CENTER UTILIZED THE FOLLOWING METHODS TO DETERMINE APPROPRIATE COMPENSATION FOR CEO THAT HAD INFLUENCE OVER THE ORGANIZATION'S ACTIVITIES: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACTS - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B
THE FOLLOWING INDIVIDUALS RECEIVED DEFERRED COMPENSATION ALLOCATIONS BY RELATED ORGANIZATION CAROMONT REGIONAL MEDICAL CENTER FROM A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP): DAVID O'CONNOR - $ 111,541 K. CHRISTOPHER PEEK - $ 223,809 DR. GEORGE ADCOCK III - $ 59,779 LEIGH HICKMAN - $ 55,268
PART I, LINE 6
EXECUTIVE INCENTIVE COMPENSATION PLAN FOR ALL KEY EMPLOYEES BASED ON THE ACHIEVEMENT OF ANNUAL BUSINESS OBJECTIVES WHICH INCLUDE A FINANCIAL GOAL ATTRIBUTABLE TO OPERATING MARGIN. MANAGER INCENTIVE PLAN BASED ON CONSOLIDATED CORPORATE AND INDIVIDUAL PERFORMANCE GOALS.

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
29 April 2024
IRS schema version
2022v5.0
Source object
202421209349301512

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