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Nonprofiteer
← ST MARYS HOSPITAL FOUNDATION

Form 990 for tax year 2023

Filed by ST MARYS HOSPITAL FOUNDATION.

Totals

Total revenue
$186,895
Total expenses
$358,480
Contributions and grants received
$186,216
Grants paid
$355,155
Program services expenses (Part IX)
$358,480
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$358,480

Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • JEANETTE WOJTALEWICZ

    FORMER CFO, CHI HEALTH

    Total calculated
    $1,357,202
    From this org
    $0
    From related orgs
    $1,344,835
    Other
    $12,367
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $128,679 related
    Bonus
    $0 + $132,479 related
    Other
    $0 + $1,083,677 related
    Deferred
    $0 + $9,698 related
    Nontaxable benefits
    $0 + $2,669 related
    Filer's total
    $0 + $1,357,202 related

  • STACY BLUM MD

    FORMER BOARD CHAIR/PHYSICIAN

    Total calculated
    $568,637
    From this org
    $0
    From related orgs
    $510,130
    Other
    $58,507
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $508,870 related
    Bonus
    $0
    Other
    $0 + $1,260 related
    Deferred
    $0 + $19,175 related
    Nontaxable benefits
    $0 + $39,332 related
    Filer's total
    $0 + $568,637 related

  • BRETT MEYER

    FORMER BOARD CHAIR/PHYSICIAN

    Total calculated
    $523,494
    From this org
    $0
    From related orgs
    $502,762
    Other
    $20,732
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $501,747 related
    Bonus
    $0
    Other
    $0 + $1,015 related
    Deferred
    $0 + $19,000 related
    Nontaxable benefits
    $0 + $1,732 related
    Filer's total
    $0 + $523,494 related

  • DANIEL DEFREECE MD

    EX-OFFICIO BM, PRESIDENT, ST. MARY'S HOSPITAL

    Total calculated
    $469,594
    From this org
    $0
    From related orgs
    $397,399
    Other
    $72,195
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $252,743 related
    Bonus
    $0 + $132,482 related
    Other
    $0 + $12,174 related
    Deferred
    $0 + $32,409 related
    Nontaxable benefits
    $0 + $39,786 related
    Filer's total
    $0 + $469,594 related

  • TIM SCHNACK

    MARKET CFO (BEG 05/24)

    Total calculated
    $417,768
    From this org
    $0
    From related orgs
    $369,715
    Other
    $48,053
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $290,959 related
    Bonus
    $0 + $74,901 related
    Other
    $0 + $3,855 related
    Deferred
    $0 + $19,529 related
    Nontaxable benefits
    $0 + $28,524 related
    Filer's total
    $0 + $417,768 related

  • KATHY BERTOLINI

    VP PHILANTHROPY

    Total calculated
    $406,336
    From this org
    $0
    From related orgs
    $358,469
    Other
    $47,867
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $268,178 related
    Bonus
    $0 + $86,599 related
    Other
    $0 + $3,692 related
    Deferred
    $0 + $19,278 related
    Nontaxable benefits
    $0 + $28,589 related
    Filer's total
    $0 + $406,336 related

  • NICK O'TOOL

    INTERIM CFO, CHI HEALTH (END 05/24)

    Total calculated
    $399,969
    From this org
    $0
    From related orgs
    $349,020
    Other
    $50,949
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $252,554 related
    Bonus
    $0 + $96,047 related
    Other
    $0 + $419 related
    Deferred
    $0 + $16,660 related
    Nontaxable benefits
    $0 + $34,289 related
    Filer's total
    $0 + $399,969 related

  • JORDAN GUSTAFSON

    BOARD MEMBER/PHYS ASST

    Total calculated
    $289,264
    From this org
    $0
    From related orgs
    $245,589
    Other
    $43,675
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $244,717 related
    Bonus
    $0 + $800 related
    Other
    $0 + $72 related
    Deferred
    $0 + $16,508 related
    Nontaxable benefits
    $0 + $27,167 related
    Filer's total
    $0 + $289,264 related

  • PAOLA HINCAPIE

    VICE CHAIR/RN

    Total calculated
    $112,898
    From this org
    $0
    From related orgs
    $70,862
    Other
    $42,036
    Hours/week
    1 + 40 related

  • TRACI REUTER

    EX-OFFICIO BM/FOUNDATION DIRECTOR

    Total calculated
    $93,336
    From this org
    $0
    From related orgs
    $54,103
    Other
    $39,233
    Hours/week
    40

  • DEAN THOMSON MD

    CHAIR

    Total calculated
    $13,182
    From this org
    $0
    From related orgs
    $12,736
    Other
    $446
    Hours/week
    1 + 10 related

  • BRANDEN BENDER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • JESSICA CRUNK

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • TERRY FOSTER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • JOHN HOGELAND

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • PATRICIA HOLMES

    SECRETARY/TREASURER

    Total calculated
    $0
    Hours/week
    1

  • ADAM HOWARD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • DIANE LANT

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • SUE LITTLE

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • DEBBIE SALANSKY

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • DUANE SMITH

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • JIM KUHN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

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
DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED BY COMMONSPIRIT HEALTH, A RELATED ORGANIZATION. COMMONSPIRIT HEALTH USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; (4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART 1, LINE 4A:
CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. CERTAIN REPORTABLE INDIVIDUALS ARE COVERED BY A NON-EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 2 WEEKS TO 52 WEEKS OF BASE COMPENSATION, DEPENDING ON THE EMPLOYEE'S POSITION AND TENURE, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING THE 2023 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): JEANETTE WOJTALESICZ, $1,083,464.
PART 1, LINE 4B:
DURING THE 2023 CALENDAR YEAR, COMMONSPIRIT HEALTH ("COMMONSPIRIT") MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. DURING 2023 THE FOLLOWING DISTRIBUTIONS WERE MADE BY COMMONSPIRIT FROM THE DEFERRED COMPENSATION PLAN: DANIEL DEFREECE, $9,979. DUE TO THE "SUPER" VESTING RULES UNDER COMMONSPIRIT'S DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2023 CONTRIBUTIONS IN CASH. THESE CASH PAYOUTS ARE INCLUDED IN THE PARTICIPANT'S REPORTABLE COMPENSATION IN COLUMN (III) OTHER REPORTABLE COMPENSATION ON SCHEDULE J PART II.
SCHEDULE J, PART II
ST. MARY'S HOSPITAL FOUNDATION FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE COMMONSPIRIT TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES COMMONSPIRIT SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND COMMONSPIRIT'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL, AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2023.

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
14 May 2025
IRS schema version
2023v6.0
Source object
202541349349310729

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

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