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Nonprofiteer
← GASTON MEMORIAL HOSPITAL FOUNDATION INC

Form 990 for tax year 2023

Filed by GASTON MEMORIAL HOSPITAL FOUNDATION INC.

Totals

Total revenue
$4,058,046
Total expenses
$1,993,280
Contributions and grants received
$2,729,708
Grants paid
$1,468,192
Program services expenses (Part IX)
$1,957,554
Management and general expenses
$35,726
Fundraising expenses
$0
Program service expenses (Part III)
$1,957,554

Program services were 98.2% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • Dr George Adcock lll

    Secretary

    Total calculated
    $734,921
    From this org
    $0
    From related orgs
    $605,913
    Other
    $129,008
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $404,166 related
    Bonus
    $0 + $137,602 related
    Other
    $0 + $64,145 related
    Deferred
    $0 + $104,259 related
    Nontaxable benefits
    $0 + $24,749 related
    Filer's total
    $0 + $734,921 related

  • Mr David O'Connor

    EVP/CFO/Asst. Treasurer/Director

    Total calculated
    $1,140,025
    From this org
    $0
    From related orgs
    $956,025
    Other
    $184,000
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $602,432 related
    Bonus
    $0 + $243,238 related
    Other
    $0 + $110,355 related
    Deferred
    $0 + $159,219 related
    Nontaxable benefits
    $0 + $24,781 related
    Filer's total
    $0 + $1,140,025 related

  • Ms Janie Peak

    Chair

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Mr Jason Austell

    Director

    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
    $2,074,421
    From this org
    $0
    From related orgs
    $1,764,966
    Other
    $309,455
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,025,632 related
    Bonus
    $0 + $515,175 related
    Other
    $0 + $224,159 related
    Deferred
    $0 + $284,284 related
    Nontaxable benefits
    $0 + $25,171 related
    Filer's total
    $0 + $2,074,421 related

  • Ms Leigh Hickman

    CLO/Asst. Sec.

    Total calculated
    $675,066
    From this org
    $0
    From related orgs
    $564,906
    Other
    $110,160
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $376,380 related
    Bonus
    $0 + $127,220 related
    Other
    $0 + $61,306 related
    Deferred
    $0 + $93,072 related
    Nontaxable benefits
    $0 + $17,088 related
    Filer's total
    $0 + $675,066 related

  • Ms Mary Grace Bean

    Director Foundation

    Total calculated
    $158,241
    From this org
    $129,995
    From related orgs
    $0
    Other
    $28,246
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $109,367
    Bonus
    $20,566
    Other
    $62
    Deferred
    $13,808
    Nontaxable benefits
    $14,438
    Filer's total
    $158,241

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
  • 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)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
COMPENSATION PAID TO CEO OF CAROMONT HEALTH, INC. WAS PAID BY GASTON MEMORIAL HOSPITAL, INC D/B/A 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
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
The following individuals received deferred compensation allocations by related organization CaroMont Regional Medical Center from a Supplemental Executive Retirement Plan (SERP): DAVID O'CONNOR - $ 116,019 K. CHRISTOPHER PEEK - $ 241,084 Dr. George Adcock III - $ 62,178 Leigh Hickman - $ 57,768
Schedule J, Part I, Line 6b Compensation contingent on net earnings of a related organization
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
2023
Filed
25 March 2025
IRS schema version
2023v6.0
Source object
202510849349300636

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