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Nonprofiteer
← USC ARCADIA HOSPITAL FOUNDATION

Form 990 for tax year 2022

Filed by USC ARCADIA HOSPITAL FOUNDATION.

Totals

Total revenue
$5,473,045
Total expenses
$6,148,845
Contributions and grants received
$4,930,094
Grants paid
$4,482,195
Program services expenses (Part IX)
$4,482,195
Management and general expenses
$536,261
Fundraising expenses
$1,130,389
Program service expenses (Part III)
$4,482,195

Program services were 72.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DAN F AUSMAN

    HOSPITAL PRES. (UNTIL 4/07/23)

    Total calculated
    $1,305,407
    From this org
    $0
    From related orgs
    $1,291,367
    Other
    $14,040
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $852,328 related
    Bonus
    $0 + $428,371 related
    Other
    $0 + $10,668 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $14,040 related
    Filer's total
    $0 + $1,305,407 related

  • WILLIAM GRIGG

    ASST. TREASURER

    Total calculated
    $628,322
    From this org
    $0
    From related orgs
    $605,132
    Other
    $23,190
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $457,872 related
    Bonus
    $0 + $141,716 related
    Other
    $0 + $5,544 related
    Deferred
    $0 + $9,150 related
    Nontaxable benefits
    $0 + $14,040 related
    Filer's total
    $0 + $628,322 related

  • MICHAEL D DRIEBE

    PRESIDENT

    Total calculated
    $353,067
    From this org
    $0
    From related orgs
    $336,880
    Other
    $16,187
    Hours/week
    38 + 2 related

    Schedule J breakdown matched by us

    Base
    $0 + $239,782 related
    Bonus
    $0 + $90,499 related
    Other
    $0 + $6,599 related
    Deferred
    $0 + $9,027 related
    Nontaxable benefits
    $0 + $7,160 related
    Filer's total
    $0 + $353,067 related

  • JAY HARVILL

    Director - Planned Gifts

    Total calculated
    $201,780
    From this org
    $0
    From related orgs
    $176,037
    Other
    $25,743
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $171,336 related
    Bonus
    $0 + $3,100 related
    Other
    $0 + $1,601 related
    Deferred
    $0 + $5,497 related
    Nontaxable benefits
    $0 + $20,246 related
    Filer's total
    $0 + $201,780 related

  • CLARA DRISCOLL

    DIR - PLND Gifts & FDN RELAT

    Total calculated
    $177,722
    From this org
    $0
    From related orgs
    $165,667
    Other
    $12,055
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $158,452 related
    Bonus
    $0 + $3,100 related
    Other
    $0 + $4,115 related
    Deferred
    $0 + $4,895 related
    Nontaxable benefits
    $0 + $7,160 related
    Filer's total
    $0 + $177,722 related

  • GLORIA RICO

    DIR-Donor ENG. & SPEC. EVENTS

    Total calculated
    $146,679
    From this org
    $0
    From related orgs
    $129,758
    Other
    $16,921
    Hours/week
    40

  • CHAO-YI MONICA CHEN

    Manager-Donor Systems

    Total calculated
    $117,041
    From this org
    $0
    From related orgs
    $106,809
    Other
    $10,232
    Hours/week
    40

  • GINA KUGELMAN

    ASST. SECRETARY

    Total calculated
    $104,514
    From this org
    $0
    From related orgs
    $88,825
    Other
    $15,689
    Hours/week
    40

  • GRACE HUANG MD

    SEE SCHEDULE O FOR TITLE

    Total calculated
    $9,991
    From this org
    $0
    From related orgs
    $9,991
    Other
    $0
    Hours/week
    2

  • STEPHEN SOLDO MD

    SEE SCHEDULE O FOR TITLE

    Total calculated
    $4,771
    From this org
    $0
    From related orgs
    $4,771
    Other
    $0
    Hours/week
    2

  • PATTY NIJJAR

    SEE SCHEDULE O FOR TITLE

    Total calculated
    $0
    Hours/week
    2

  • RICHARD BUKATA MD

    SEE SCHEDULE O FOR TITLE

    Total calculated
    $0
    Hours/week
    2

  • TOM HOFFMAN

    SEE SCHEDULE O FOR TITLE

    Total calculated
    $0
    Hours/week
    2

  • JEROME YUAN

    SEE SCHEDULE O FOR TITLE

    Total calculated
    $0
    Hours/week
    2

  • JULIE ROYBAL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • KEVIN ZHANG

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • IKENNA MMEJE

    HOSPITAL PRES. (AS OF 3/13/23)

    Total calculated
    $0
    Hours/week
    1 + 39 related

  • TOM BRADY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • SHIRLEY CHI MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • GANG DING

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • KIN HUI

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • SHARON KWAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • NATALIE POOLE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • MELINDA ROGERS

    SEE SCHEDULE O FOR TITLE

    Total calculated
    $0
    Hours/week
    2

  • MICKEY SEGAL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • DOUG VAN KIRK

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2 + 2 related

  • ALAN B WHITMAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • SUSAN WOO

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2

  • LIZ BRUNY

    DIRECTOR (AS OF 1/1/23)

    Total calculated
    $0
    Hours/week
    2

  • REBECCA IGLESIAS

    DIRECTOR (AS OF 1/1/23)

    Total calculated
    $0
    Hours/week
    2

  • RALPH LIU

    DIRECTOR (AS OF 1/1/23)

    Total calculated
    $0
    Hours/week
    2

  • REV PHIL WOOD

    DIRECTOR (AS OF 1/1/23)

    Total calculated
    $0
    Hours/week
    2

  • KAREN ZHANG

    DIRECTOR (AS OF 5/17/23)

    Total calculated
    $0
    Hours/week
    2

  • SHERRY WANG

    DIRECTOR (AS OF 1/18/23)

    Total calculated
    $0
    Hours/week
    2

  • KANDY KNUNN

    EX-OFFICIO (UNTIL 12/31/22)

    Total calculated
    $0
    Hours/week
    2

  • BARBARA MILLER

    EX-OFFICIO (AS OF 1/1/23)

    Total calculated
    $0
    Hours/week
    2

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)

SCHEDULE J, PART I, LINE 3
COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: THE ORGANIZATION'S PRESIDENT IS PAID BY ITS TAX EXEMPT PARENT, USC ARCADIA HOSPITAL (USCAH), AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. PLEASE SEE SCHEDULE O NARRATIVE FOR FORM 990, PART VI, LINES 15A AND 15B FOR A DESCRIPTION OF THE PROCESS.
SCHEDULE J, PART I, LINE 4B
USC ARCADIA HOSPITAL (USCAH) HAS A FUNDED NONCONTRIBUTORY DEFINED SPLIT-DOLLAR LIFE INSURANCE ARRANGEMENTS FOR CERTAIN EXECUTIVE OFFICERS. LIFE INSURANCE PREMIUM PAYMENTS ARE PAID ON BEHALF OF EACH PARTICIPANT AND ARE SCHEDULED TO BE REPAID TO USCAH FROM THE DEATH BENEFIT ASSOCIATED WITH EACH LIFE INSURANCE CONTRACT. USCAH MAY RECEIVE PROCEEDS FROM THE DEATH BENEFITS IN EXCESS OF THE LOAN AMOUNTS. THE PREMIUM LOANS ARE SECURED THROUGH COLLATERAL AGREEMENTS ON THE CASH VALUE AND DEATH BENEFIT FOR EACH INSURANCE CONTRACT. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THIS PLAN: - DAN AUSMAN - MICHAEL DRIEBE - WILLIAM GRIGG NO INDIVIDUALS RECEIVED PAYMENTS FROM THE PLAN DURING THE YEAR.
SCHEDULE J, PART II
DURING 2022, THE INDIVIDUALS REPORTED ON SCHEDULE J, PART II WERE PAID BY USC ARCADIA HOSPITAL, A RELATED ORGANIZATION.

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
2022
Filed
14 May 2024
IRS schema version
2022v5.0
Source object
202411369349309961

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

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