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← JTD HOSPITAL FOUNDATION

Form 990 for tax year 2022

Filed by JTD HOSPITAL FOUNDATION.

Totals

Total revenue
$399,163
Total expenses
$345,997
Contributions and grants received
$373,825
Grants paid
$322,491
Program service revenue
$0
Investment income
$312
Other revenue
$25,026
Total assets, end of year
$1,084,041
Total liabilities, end of year
$193
Net assets or fund balances, end of year
$1,083,848
Program services expenses (Part IX)
$336,250
Management and general expenses
$9,278
Fundraising expenses
$469
Program service expenses (Part III)
$336,250

Program services were 97.2% 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

    $107,880

  • 1f · All other contributions, gifts and grants

    $265,945

  • 3 · Investment income

    total $312 · excluded $312

  • 8a · Fundraising events: gross income

    $22,114

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

    $107,880

  • 8b · Fundraising events: direct expenses

    $34,127

  • 8c · Net income from fundraising events

    total -$12,013 · excluded -$12,013

  • 9a · Gaming: gross income

    $71,443

  • 9b · Gaming: direct expenses

    $34,404

  • 9c · Net income from gaming

    total $37,039 · excluded $37,039

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $306,991 · program services $306,991

  • 2 · Grants to domestic individuals

    total $15,500 · program services $15,500

  • 11f · Fees: investment management

    total $2,499 · program services $2,499

  • 11g · Fees: other

    total $500 · program services $250 · fundraising $250

  • 13 · Office expenses

    total $13,215 · program services $10,572 · management and general $2,643

  • 14 · Information technology

    total $6,416 · management and general $6,416

  • 17 · Travel

    total $876 · program services $438 · management and general $219 · fundraising $219

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $337,731 · end of year $343,589

  • 3 · Pledges and grants receivable

    beginning of year $100,000 · end of year $100,000

  • 11 · Investments: publicly traded securities

    beginning of year $668,531 · end of year $640,452

  • 17 · Accounts payable and accrued expenses

    end of year $193

  • 27 · Net assets without donor restrictions

    beginning of year $88,723 · end of year $77,860

  • 28 · Net assets with donor restrictions

    beginning of year $1,017,539 · end of year $1,005,988

Mission and programs · 2022

Mission

TO SECURE FUNDS FOR THE BENEFIT OF JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL'S EFFORTS TO MEET THE HEALTH CARE NEEDS OF OUR COMMUNITIES.

Activities or mission (Part I)

THE PRIMARY EXEMPT PURPOSE OF THE JTD HOSPITAL FOUNDATION IS TO RAISE FUNDS FOR JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL, A 501(C)(3) COMMUNITY HOSPITAL. THE FOUNDATION COORDINATES ALL FUNDRAISING ACTIVITIES ON BEHALF OF THE HOSPITAL AND ADMINISTERS ALL DONATED FUNDS.

  • JTD HOSPITAL FOUNDATION COORDINATES THE FUNDRAISING ACTIVITIES FOR JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL. DURING 2022, THE FOUNDATION ACCEPTED AND ADMINISTERED DONATIONS FOR 21 DIFFERENT PROJECTS/FUNDS.

    Expenses $225,750 · Grants $211,991

  • THE FOUNDATION SEEKS FUNDS FOR SCHOLARSHIPS AND AWARDED $15,500 TO STUDENTS IN THE SURROUNDING COMMUNITIES TO HELP ASSURE AN ADEQUATE SUPPLY OF HEALTH CARE PROFESSIONALS.

    Expenses $15,500 · Grants $15,500

  • GRAND LAKE HEALTH SYSTEM RECOGNIZES THE NEED FOR QUALITY END OF LIFE CARE BOTH FOR PATIENTS AND THEIR FAMILIES. THE FOUNDATION RAISED OVER $183,000 TO ASSIST GRAND LAKE HEALTH SYSTEM TO CONTINUE PROVIDING HOSPICE SERVICE TO THE COMMUNITY. OF THIS AMOUNT, $95,000 WAS USED IN 2022 TO HELP SUPPORT THE HOSPICE PROGRAM.

    Expenses $95,000 · Grants $95,000

As filed on the 2022 return.

Listed in Part VII

  • Lana Hinders

    DIRECTOR/CNO HOSPITAL

    Total calculated
    $245,003
    From this org
    $0
    From related orgs
    $200,082
    Other
    $44,921
    Hours/week
    1 + 44 related

    Schedule J breakdown matched by us

    Base
    $0 + $193,082 related
    Bonus
    $0 + $7,000 related
    Other
    $0
    Deferred
    $0 + $21,193 related
    Nontaxable benefits
    $0 + $23,728 related
    Filer's total
    $0 + $245,003 related
  • Robert Leugers

    CHAIR

    Total calculated
    $0
    Hours/week
    1
  • Dan Burke

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1
  • Alan Davis

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Jon Derryberry

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Major Bernhold

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Steve Hartwig

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Diane Piehl

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Tim Quellhorst

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Bruce Swonger

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Linda Vogel

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • John Wilding Do

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Tanya Temple

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Beverly Wilker

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1
  • Cynthia Berning

    PRESIDENT

    Total calculated
    $514,905
    From this org
    $0
    From related orgs
    $483,907
    Other
    $30,998
    Hours/week
    1 + 44 related

    Schedule J breakdown matched by us

    Base
    $0 + $434,767 related
    Bonus
    $0 + $49,140 related
    Other
    $0
    Deferred
    $0 + $6,000 related
    Nontaxable benefits
    $0 + $24,998 related
    Filer's total
    $0 + $514,905 related
  • Tricia Pohl

    TREASURER

    Total calculated
    $264,725
    From this org
    $0
    From related orgs
    $217,895
    Other
    $46,830
    Hours/week
    1 + 44 related

    Schedule J breakdown matched by us

    Base
    $0 + $217,895 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $23,053 related
    Nontaxable benefits
    $0 + $23,777 related
    Filer's total
    $0 + $264,725 related
  • Julie Jacobs

    SECRETARY

    Total calculated
    $111,960
    From this org
    $0
    From related orgs
    $80,342
    Other
    $31,618
    Hours/week
    35 + 10 related
  • Kevin Harlan

    FORMER PRESIDENT

    Total calculated
    $242,771
    From this org
    $0
    From related orgs
    $242,771
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $242,771 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $242,771 related
  • Jeff Vossler

    FORMER CFO

    Total calculated
    $119,758
    From this org
    $0
    From related orgs
    $107,823
    Other
    $11,935
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $100,823 related
    Bonus
    $0 + $7,000 related
    Other
    $0
    Deferred
    $0 + $10,825 related
    Nontaxable benefits
    $0 + $1,110 related
    Filer's total
    $0 + $119,758 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 1A
JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL, A RELATED ORGANIZATION, PROVIDES A PORTION OF YMCA DUES TO THE OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES; HOWEVER, THIS IS AN EMPLOYEE BENEFIT AVAILABLE TO ALL ELIGIBLE EMPLOYEES OF JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL TO PROMOTE COMMUNITY WELLNESS (ONE PERSON LISTED ON PART VII, SECTION A, LINE 1A RECEIVED THIS BENEFIT). THE YMCA DUES WERE NOT INCLUDED IN THE RECIPIENT'S COMPENSATION.
PART I, LINE 4B
KEVIN HARLAN, THE FORMER PRESIDENT, HAS RECEIVED A PAYOUT FROM THE NON QUALIFIED RETIREMENT PLAN OF 242,771 IN THE CURRENT YEAR DUE TO HIS DEPARTURE FROM JOINT TOWNSHIP DISTRICT MEMORIAL HOSPITAL. THE PLAN IS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN MAINTAINED BY A RELATED ORGANIZATION FOR KEY EMPLOYEES OF THE RELATED ORGANIZATION. THERE IS AN INCENTIVE BONUS PLAN AND A PRODUCTION COMPENSATION PLAN. VESTING HAPPENS OVER A 3 OR A 5 YEAR TIME FRAME DEPENDING IF THE CONTRIBUTION WAS MADE TO THE INCENTIVE BONUS PLAN OR THE PRODUCTION COMPENSATION PLAN. THERE ARE CERTAIN CIRCUMSTANCES WHERE A PARTICIPANT WILL FORFEIT ANY AND ALL OF THE COMPANY CONTRIBUTIONS MADE INTO THE PLAN INCLUDING ENGAGING IN ACTIVITIES WHICH ARE DEEMED TO BE SIGNIFICANTLY COMPETITIVE WITH THE COMPANY WITHIN A 50 MILE RADIUS OF ANY EXISTING OFFICE, IF IT IS DEEMED THE PARTICIPANT ACTED IN A DISHONEST WAY, BREACHES HIS OR HER FIDUCIARY OBLIGATIONS, CONVICTED OF A FELONY INVOLVING SIGNIFICANT MORAL TURPITUDE, OR OTHER ACTS WHICH WOULD CAUSE THE COMPANY SUBSTANTIAL HARM.
PART I, LINE 3:
COMPENSATION PAID TO THE ORGANIZATION'S PRESIDENT IS ESTABLISHED BY A RELATED ORGANIZATION AND INCLUDES USE OF A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEYS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.

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.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • JTDMH PAIN MANAGEMENT LLC

    PAIN MANAGEMENT SERVICES · OH

Related corporations and trusts

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

  • JTDM FAMILY PRACTICE INC

    C · PHYSICIANS PROVIDING MEDICAL SERVICES · OH · controlled entity

Provenance

Return type
form_990
Tax year
2022
Filed
3 November 2023
IRS schema version
2022v5.0
Source object
202333189349305543

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