Totals
- Total revenue
- $615,790
- Total expenses
- $761,885
- Contributions and grants received
- $469,852
- Grants paid
- $267,970
- Program services expenses (Part IX)
- $267,970
- Management and general expenses
- $27,115
- Fundraising expenses
- $466,800
- Program service expenses (Part III)
- $267,970
Program services were 35.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Listed in Part VII
-
Travis Andersen
President & CEO
- Total calculated
- $1,099,595
- From this org
- $0
- From related orgs
- $1,014,145
- Other
- $85,450
- Hours/week
- 2 + 46 related
Schedule J breakdown matched by us
- Base
- $0 + $685,014 related
- Bonus
- $0 + $210,627 related
- Other
- $0 + $118,504 related
- Deferred
- $0 + $60,071 related
- Nontaxable benefits
- $0 + $25,379 related
- Filer's total
- $0 + $1,099,595 related
-
Allen Williams MD
Director
- Total calculated
- $397,811
- From this org
- $0
- From related orgs
- $333,058
- Other
- $64,753
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $325,237 related
- Bonus
- $0 + $5,600 related
- Other
- $0 + $2,221 related
- Deferred
- $0 + $24,400 related
- Nontaxable benefits
- $0 + $40,353 related
- Filer's total
- $0 + $397,811 related
-
Tiffanie Ferry MD
Director (until 12/31/22)
- Total calculated
- $284,294
- From this org
- $0
- From related orgs
- $229,949
- Other
- $54,345
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $209,627 related
- Bonus
- $0 + $10,000 related
- Other
- $0 + $10,322 related
- Deferred
- $0 + $15,062 related
- Nontaxable benefits
- $0 + $39,283 related
- Filer's total
- $0 + $284,294 related
-
Jeffrey J Kaney Sr
Chmn of the Board (until 8/31/22)
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Daniel T Ross
Chmn of the Board (as of 9/1/22)
- Total calculated
- $0
- Hours/week
- 2 + 8 related
-
Eric Fulcomer PhD
1st Vice Chmn/Secy (until 12/31/22)
- Total calculated
- $0
- Hours/week
- 2 + 8 related
-
Jeffrey S Hultman
1st Vice Chmn/Secy (as of 1/1/23)
- Total calculated
- $0
- Hours/week
- 2 + 8 related
-
Thomas R Walsh
Audit/Compliance Chairman
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Patrick T Derry
Quality/Safety Chmn (until 12/31/22)
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Michael Broski
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Helen Chung Hill
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Kathleen Kelly MD
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Marco T Lenis
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Anqunette Parham
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Steven C Sjogren
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Frank Walter
Director
- Total calculated
- $0
- Hours/week
- 2 + 6 related
-
Patricia DeWane
VP, CFO, & Treasurer
- Total calculated
- $629,264
- From this org
- $0
- From related orgs
- $566,671
- Other
- $62,593
- Hours/week
- 2 + 46 related
Schedule J breakdown matched by us
- Base
- $0 + $384,070 related
- Bonus
- $0 + $177,799 related
- Other
- $0 + $4,802 related
- Deferred
- $0 + $54,710 related
- Nontaxable benefits
- $0 + $7,883 related
- Filer's total
- $0 + $629,264 related
-
Timothy Flynn MD
President, SA Medical Group
- Total calculated
- $572,337
- From this org
- $0
- From related orgs
- $515,532
- Other
- $56,805
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $375,489 related
- Bonus
- $0 + $109,771 related
- Other
- $0 + $30,272 related
- Deferred
- $0 + $48,610 related
- Nontaxable benefits
- $0 + $8,195 related
- Filer's total
- $0 + $572,337 related
-
Ann Gantzer
VP Patient Svcs/CNO (until 9/23/22)
- Total calculated
- $525,056
- From this org
- $0
- From related orgs
- $487,186
- Other
- $37,870
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $262,925 related
- Bonus
- $0 + $136,116 related
- Other
- $0 + $88,145 related
- Deferred
- $0 + $5,902 related
- Nontaxable benefits
- $0 + $31,968 related
- Filer's total
- $0 + $525,056 related
-
Julia Zimmerman
VP Strategic Growth
- Total calculated
- $407,228
- From this org
- $0
- From related orgs
- $343,935
- Other
- $63,293
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $244,658 related
- Bonus
- $0 + $82,585 related
- Other
- $0 + $16,692 related
- Deferred
- $0 + $19,896 related
- Nontaxable benefits
- $0 + $43,397 related
- Filer's total
- $0 + $407,228 related
-
Sal Ababneh
COO & President of UWNI Hospitals
- Total calculated
- $360,349
- From this org
- $0
- From related orgs
- $314,281
- Other
- $46,068
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $208,532 related
- Bonus
- $0 + $40,000 related
- Other
- $0 + $65,749 related
- Deferred
- $0 + $19,878 related
- Nontaxable benefits
- $0 + $26,190 related
- Filer's total
- $0 + $360,349 related
-
William Mewes
Interim VP Patient Services & CNO
- Total calculated
- $262,326
- From this org
- $0
- From related orgs
- $210,358
- Other
- $51,968
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $194,886 related
- Bonus
- $0 + $15,472 related
- Other
- $0
- Deferred
- $0 + $13,766 related
- Nontaxable benefits
- $0 + $38,202 related
- Filer's total
- $0 + $262,326 related
-
Rosa Jeschke
VP Human Resources
- Total calculated
- $196,378
- From this org
- $0
- From related orgs
- $176,285
- Other
- $20,093
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $171,122 related
- Bonus
- $0
- Other
- $0 + $5,163 related
- Deferred
- $0 + $13,963 related
- Nontaxable benefits
- $0 + $6,130 related
- Filer's total
- $0 + $196,378 related
-
James Cole DO
VP Medical Affairs/CMO
- Total calculated
- $365,422
- From this org
- $0
- From related orgs
- $304,466
- Other
- $60,956
- Hours/week
- 2 + 44 related
Schedule J breakdown matched by us
- Base
- $0 + $304,466 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0 + $60,893 related
- Nontaxable benefits
- $0 + $63 related
- Filer's total
- $0 + $365,422 related
-
Barbera Aaby
Executive Director (as of 1/1/23)
- Total calculated
- $0
- Hours/week
- 40
-
Thomas O'Connor
Former President & CEO
- Total calculated
- $761,147
- From this org
- $0
- From related orgs
- $761,147
- Other
- $0
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $50,986 related
- Bonus
- $0
- Other
- $0 + $710,161 related
- Deferred
- $0
- Nontaxable benefits
- $0
- Filer's total
- $0 + $761,147 related
-
Michael Polizzotto
Former CMO/CIO
- Total calculated
- $546,914
- From this org
- $0
- From related orgs
- $491,231
- Other
- $55,683
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $371,875 related
- Bonus
- $0 + $29,711 related
- Other
- $0 + $89,645 related
- Deferred
- $0 + $18,453 related
- Nontaxable benefits
- $0 + $37,230 related
- Filer's total
- $0 + $546,914 related
-
Jedediah Cantrell
Former VP Operations
- Total calculated
- $160,367
- From this org
- $0
- From related orgs
- $150,775
- Other
- $9,592
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $59,096 related
- Bonus
- $0
- Other
- $0 + $91,679 related
- Deferred
- $0 + $438 related
- Nontaxable benefits
- $0 + $9,154 related
- Filer's total
- $0 + $160,367 related
-
Celia Shaughnessy
Former VP Human Resources
- Total calculated
- $105,800
- From this org
- $0
- From related orgs
- $105,800
- Other
- $0
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + $105,800 related
- Bonus
- $0
- Other
- $0
- Deferred
- $0
- Nontaxable benefits
- $0
- Filer's total
- $0 + $105,800 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 — 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
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
Answered no
- 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
- All compensation is determined by the Executive Compensation Committee of SwedishAmerican Health System Corporation and is paid by SwedishAmerican Hospital. All compensation decisions are made by independent persons. With respect to the Executive Director and other Officers, SwedishAmerican Health System Corporation follows a compensation approval procedure annually that involves approval of proposed and final compensation arrangements by SwedishAmerican Health System Corporation's Executive Compensation Committee using comparability data, as well as contemporaneous documentation of compensation decisions in the minutes.
- Part I, Lines 4a-b
- Severance payments during 2022 include: Tom O'Connor - $710,161. These payments are reported as taxable compensation on Part II, column (B)(iii). Contributions to the 457(f) plan during 2022 include: Travis Andersen - $59,719; Patricia DeWane - $30,310; Timothy Flynn MD - $24,210; Sal Ababneh - $19,878; Rose Jeschke - $13,963. Payments from the 457(f) plan during 2022 include: Michael Polizzotto - $88,726; Ann Gantzer - $86,178; Julia Zimmerman - $14,725; Jedediah Cantrell - $91,176. These payments are reported as taxable income on Part II, column (B) (iii). Part II, Column F: The amounts shown in column F were reported as deferred compensation in prior years but paid out in the current year. The amounts are also included in column (B) (iii).
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
-
$267,970
Funding to hospital departments for patient care and well-being; reimburse chaplaincy wages
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.
-
501(c)(3) · Reproductive endocrinology and infertility services · WI
-
501(c)(3) · Research and innovation · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
501(c)(3) · Health care services and training · WI
-
501(c)(3) · Regional Parent Corp. to manage and direct activities of entities · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
SwedishAmerican Health System Corporation
501(c)(3) · Parent Corporation to manage and direct activites of entities · IL
Directly controlled by Regional Division Inc
-
501(c)(3) · Hospital · IL · controlled entity
Directly controlled by SwedishAmerican Health System Corporation
-
SwedishAmerican Hospital Self Insurance Trust
501(c)(3) · Hospital Malpractice Trust · VT · controlled entity
Directly controlled by SwedishAmerican Hospital
-
SwedishAmerican Realty Corporation
501(c)(2) · Title Holding Company · IL · controlled entity
Directly controlled by SwedishAmerican Health System Corporation
-
501(c)(3) · Support Organization · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
University of Wisconsin Hospital and Clinics Authority
501(c)(3) · Hospital and Clinics · WI
-
University of Wisconsin Medical Foundation
501(c)(3) · Physician Services · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
501(c)(3) · Accountable Care Organization · WI
Directly controlled by University of WI Hospital and Clinics Authority
-
501(c)(3) · Infusion Therapy · WI
Directly controlled by University of WI Hospital and Clinics Authority
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 2 May 2024
- IRS schema version
- 2022v5.0
- Source object
- 202441289349300029
Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.
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