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Nonprofiteer
← PARKVIEW WABASH HOSPITAL FOUNDATION INC

Form 990 for tax year 2023

Filed by PARKVIEW WABASH HOSPITAL FOUNDATION INC.

Totals

Total revenue
$356,117
Total expenses
$360,073
Contributions and grants received
$227,545
Grants paid
$324,334
Program services expenses (Part IX)
$324,619
Management and general expenses
$32,836
Fundraising expenses
$2,618
Program service expenses (Part III)
$324,619

Program services were 90.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DENA JACQUAY

    DIRECTOR/PH CHIEF ADMIN OFFICER

    Total calculated
    $1,926,311
    From this org
    $0
    From related orgs
    $1,629,814
    Other
    $296,497
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $759,072 related
    Bonus
    $0 + $149,247 related
    Other
    $0 + $721,495 related
    Deferred
    $0 + $239,600 related
    Nontaxable benefits
    $0 + $56,897 related
    Filer's total
    $0 + $1,926,311 related

  • DEBRA POTEMPA

    DIRECTOR/MARKET PRESIDENT

    Total calculated
    $379,538
    From this org
    $0
    From related orgs
    $312,151
    Other
    $67,387
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $273,549 related
    Bonus
    $0 + $32,597 related
    Other
    $0 + $6,005 related
    Deferred
    $0 + $51,313 related
    Nontaxable benefits
    $0 + $16,074 related
    Filer's total
    $0 + $379,538 related

  • CYNTHIA PETERS

    DIRECTOR/PH EPIC CARE ANALYST II

    Total calculated
    $131,374
    From this org
    $0
    From related orgs
    $107,442
    Other
    $23,932
    Hours/week
    1 + 39 related

  • ROGER CROMER

    DIRECTOR

    Total calculated
    $4,250
    From this org
    $0
    From related orgs
    $4,250
    Other
    $0
    Hours/week
    1 + 1 related

  • LANCE AGNESS

    DIRECTOR/CHAIR

    Total calculated
    $0
    Hours/week
    1

  • MARK FRANTZ

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • KATHY JONES

    DIRECTOR/SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    1

  • BILL LEONHARD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • GEORGE SCHNEIDER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JEANNE' WICKENS

    PH CHIEF FINANCIAL OFFICER

    Total calculated
    $2,443,396
    From this org
    $0
    From related orgs
    $2,165,508
    Other
    $277,888
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $834,975 related
    Bonus
    $0 + $187,034 related
    Other
    $0 + $1,143,499 related
    Deferred
    $0 + $239,228 related
    Nontaxable benefits
    $0 + $38,660 related
    Filer's total
    $0 + $2,443,396 related

  • MICHAEL PACKNETT

    FORMER OFFICER/RETIRED PH CEO

    Total calculated
    $5,063,462
    From this org
    $0
    From related orgs
    $5,034,209
    Other
    $29,253
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $66,747 related
    Bonus
    $0 + $351,881 related
    Other
    $0 + $4,615,581 related
    Deferred
    $0 + $26,400 related
    Nontaxable benefits
    $0 + $2,853 related
    Filer's total
    $0 + $5,063,462 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

  • 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
RELATED ORGANIZATION, PARKVIEW HEALTH SYSTEM, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF PARKVIEW WABASH HOSPITAL FOUNDATION, INC.'S CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC. INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS COMPENSATION SURVEY OR STUDY APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE OF RELATED ORGANIZATION PARKVIEW HEALTH SYSTEM, INC.
PART I, LINE 4B
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS THE FOLLOWING INDIVIDUALS PARTICIPATE IN SUPPLEMENTAL NONQUALIFIED DEFERRED COMPENSATION PLANS. BENEFITS EARNED UNDER THE PLANS WILL FUND THE EMPLOYEES' EVENTUAL RETIREMENT BENEFIT. THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR THE EMPLOYEES' YEARS OF SERVICE TO THE ORGANIZATION AND THE AMOUNT OF THE BENEFITS MAY VARY FROM YEAR TO YEAR. THE FOLLOWING INDIVIDUALS VESTED IN A PORTION OF THEIR DEFERRED COMPENSATION PLANS, WHICH IS TREATED AS TAXABLE INCOME TO THE INDIVIDUALS AT THE TIME OF VESTING. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III): DENA JACQUAY $685,401; MICHAEL PACKNETT $4,613,104; JEANNE' WICKENS $1,101,767 AMOUNTS LISTED ABOVE THAT HAVE BEEN REPORTED AS DEFERRED COMPENSATION ON PRIOR FORM 990 WILL ALSO BE REFLECTED IN SCHEDULE J, PART II, COLUMN (F). FOR EXAMPLE, THE AMOUNT OF $4,613,104 REPORTED AS REQUIRED FOR MR. PACKNETT WAS A RESULT OF THE VESTING OF SUCH AMOUNT UNDER THE TERMS OF THE RESPECTIVE PLANS. HOWEVER, THESE AMOUNTS WERE PREVIOUSLY REPORTED IN MR. PACKNETT'S DEFERRED COMPENSATION OVER MORE THAN 10 YEARS AS THE AMOUNTS WERE DEFERRED UNDER THE PLANS. AS SUCH, THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) IS AN INDICATION OF AMOUNTS THAT HAVE BEEN REPORTED TWICE, ONCE AS A DEFERRAL AND ONCE AS VESTED. THE FOLLOWING INDIVIDUALS HAVE AN AMOUNT INCLUDED IN SCHEDULE J, PART II, COLUMN (C) FOR AN AMOUNT EARNED BUT NOT YET VESTED UNDER ONE OF PARKVIEW'S DEFERRED COMPENSATION PLANS. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL EACH EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE PLANS VEST AT THE TIME SET FORTH IN THE PLAN DOCUMENTS AND ARE FORFEITED IF THE EMPLOYEES TERMINATE EMPLOYMENT BEFORE SATISFYING THOSE PLAN CONDITIONS. DEFERRALS REPORTED IN SCHEDULE J, PART II, COLUMN (C) INCLUDE: DENA JACQUAY $200,000; DEBRA POTEMPA $47,648; JEANNE' WICKENS $216,128

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
2023
Filed
5 November 2024
IRS schema version
2023v5.1
Source object
202413109349302046

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

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