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Nonprofiteer
← ST MARYS FOUNDATION INC

Form 990 for tax year 2022

Filed by ST MARYS FOUNDATION INC.

Totals

Total revenue
$2,960,484
Total expenses
$3,959,667
Contributions and grants received
$2,221,257
Grants paid
$3,306,115
Program service revenue
$0
Investment income
$745,651
Other revenue
-$6,424
Total assets, end of year
$26,276,717
Total liabilities, end of year
$439,953
Net assets or fund balances, end of year
$25,836,764
Program services expenses (Part IX)
$3,306,115
Management and general expenses
$197,417
Fundraising expenses
$456,135
Program service expenses (Part III)
$3,306,115

Program services were 83.5% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1c · Fundraising events

    $92,579

  • 1d · Related organizations

    $29,918

  • 1e · Government grants (contributions)

    $191,453

  • 1f · All other contributions, gifts and grants

    $1,907,307

  • 1g · Noncash contributions included above

    $237,139

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $523,281 · excluded $523,281

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7a · Gross sales of assets other than inventory

    securities $222,370

  • 7c · Gain or loss

    securities $222,370 · other assets $0

  • 7d · Net gain or loss

    total $222,370 · excluded $222,370

  • 8a · Fundraising events: gross income

    $23,521

  • 8a · Fundraising events: contributions included on line 1c

    $92,579

  • 8b · Fundraising events: direct expenses

    $29,945

  • 8c · Net income from fundraising events

    total -$6,424 · excluded -$6,424

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $3,173,084 · program services $3,173,084

  • 2 · Grants to domestic individuals

    total $133,031 · program services $133,031

  • 7 · Other salaries and wages

    total $427,825 · management and general $142,608 · fundraising $285,217

  • 9 · Other employee benefits

    total $32,177 · management and general $10,726 · fundraising $21,451

  • 11g · Fees: other

    total $125,561 · program services $0 · management and general $0 · fundraising $125,561

  • 12 · Advertising and promotion

    total $4,417 · management and general $4,417

  • 13 · Office expenses

    total $31,248 · management and general $10,416 · fundraising $20,832

  • 14 · Information technology

    total $4,164 · management and general $1,388 · fundraising $2,776

  • 17 · Travel

    total $447 · management and general $149 · fundraising $298

  • 24a · Other expenses: Bank service charges

    total $5,650 · program services $0 · management and general $5,650

  • 24b · Other expenses: Licenses

    total $54 · program services $0 · management and general $54

  • 24c · Other expenses: Direct Donor Benefit

    total $22,009 · program services $0 · management and general $22,009

  • 24e · All other expenses

    total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $373,043 · end of year -$130,753

  • 3 · Pledges and grants receivable

    beginning of year $1,188,944 · end of year $1,498,055

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 10a · Land, buildings and equipment: cost or other basis

    $0

  • 10b · Land, buildings and equipment: accumulated depreciation

    $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $794,215 · end of year $0

  • 12 · Investments: other securities

    beginning of year $29,156,683 · end of year $24,594,261

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $304,685 · end of year $315,154

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $447,952 · end of year $439,953

  • 27 · Net assets without donor restrictions

    beginning of year $18,333,933 · end of year $13,313,632

  • 28 · Net assets with donor restrictions

    beginning of year $13,035,685 · end of year $12,523,132

Mission and programs · 2022

Mission

THROUGH OUR EXCEPTIONAL HEALTH CARE SERVICES, WE REVEAL THE HEALING PRESENCE OF GOD.

Activities or mission (Part I)

To actively build and sustain community support for the health care and wellness initiatives of SSM Health St. Mary's Hospital - Madison and SSM Health St. Mary's Care Center.

  • PROVIDED FUNDING TO SUPPORT THE HEALTH CARE AND WELLNESS INITIATIVES OF SSM HEALTH ST MARY'S HOSPITAL - MADISON AND SSM HEALTH ST MARY'S CARE CENTER. SEE SCHEDULE O FOR A DESCRIPTION OF SIGNIFICANT PROGRAM SERVICE ACCOMPLISHMENTS.

    Expenses $3,173,084 · Grants $3,173,084

  • PROVIDED EMERGENCY ASSISTANCE SUCH AS HOUSING, UTILITIES, EDUCATION, AND CHILD CARE.

    Expenses $70,831 · Grants $70,831

  • PROVIDED EDUCATION AND SCHOLARSHIPS TO NURSING STUDENT APPLICANTS, INCLUDING EMPLOYEES, WHO MEET ESTABLISHED ELIGIBILITY GUIDELINES.

    Expenses $62,200 · Grants $62,200

As filed on the 2022 return.

Listed in Part VII

  • Jeffrey Tubbs

    Director & Pt Yr Chariperson

    Total calculated
    $0
    Hours/week
    1

  • Joe McNeil

    Director & Treasurer

    Total calculated
    $0
    Hours/week
    1

  • Kellye Golden

    Director & Vice Chair

    Total calculated
    $0
    Hours/week
    1

  • Kimberly Shaul

    Director & Secretary

    Total calculated
    $0
    Hours/week
    1

  • Kyle Nondorf

    Director, Hospital President

    Total calculated
    $920,457
    From this org
    $0
    From related orgs
    $662,981
    Other
    $257,476
    Hours/week
    1 + 42 related

    Schedule J breakdown matched by us

    Base
    $0 + $506,982 related
    Bonus
    $0 + $142,267 related
    Other
    $0 + $13,732 related
    Deferred
    $0 + $215,272 related
    Nontaxable benefits
    $0 + $42,204 related
    Filer's total
    $0 + $920,457 related

  • Timothy Crummy MD

    Pt Yr Director & Chairperson

    Total calculated
    $0
    Hours/week
    1

  • Adam Tierney

    Director

    Total calculated
    $0
    Hours/week
    1

  • Chris Roe

    Director

    Total calculated
    $0
    Hours/week
    1

  • Dan Hounchell

    Director, VP-Product Management, Health Plans

    Total calculated
    $399,251
    From this org
    $0
    From related orgs
    $367,168
    Other
    $32,083
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $255,281 related
    Bonus
    $0 + $61,859 related
    Other
    $0 + $50,028 related
    Deferred
    $0 + $28,581 related
    Nontaxable benefits
    $0 + $3,502 related
    Filer's total
    $0 + $399,251 related

  • Dave Shaw

    Director

    Total calculated
    $0
    Hours/week
    1

  • Eric Helsher

    Director

    Total calculated
    $0
    Hours/week
    1

  • Frank Byrne MD

    Director

    Total calculated
    $0
    Hours/week
    1

  • Jeannie Cullen Schultz

    Director

    Total calculated
    $0
    Hours/week
    1

  • Jeff Mack

    Director

    Total calculated
    $0
    Hours/week
    1

  • Jessica Flesch Buye

    Director

    Total calculated
    $0
    Hours/week
    1

  • Laura Zach

    Director

    Total calculated
    $0
    Hours/week
    1

  • Michael Foley MD

    Director

    Total calculated
    $0
    Hours/week
    1

  • Paul Cuta

    Director

    Total calculated
    $0
    Hours/week
    1

  • Sam Geraci

    Director

    Total calculated
    $0
    Hours/week
    1

  • Sarah Groessl

    Director, Physician at Dean Medical Group

    Total calculated
    $210,762
    From this org
    $0
    From related orgs
    $193,869
    Other
    $16,893
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $192,175 related
    Bonus
    $0
    Other
    $0 + $1,694 related
    Deferred
    $0 + $13,157 related
    Nontaxable benefits
    $0 + $3,736 related
    Filer's total
    $0 + $210,762 related

  • Sarah Kuemmel

    Director

    Total calculated
    $0
    Hours/week
    1

  • Sean Baxter

    Director

    Total calculated
    $0
    Hours/week
    1

  • Tim O'Brien

    Director

    Total calculated
    $0
    Hours/week
    1

  • Dina Boyle

    Executive Director

    Total calculated
    $188,587
    From this org
    $0
    From related orgs
    $132,205
    Other
    $56,382
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $131,538 related
    Bonus
    $0
    Other
    $0 + $667 related
    Deferred
    $0 + $22,101 related
    Nontaxable benefits
    $0 + $34,281 related
    Filer's total
    $0 + $188,587 related

  • Douglas Long

    Assistant Secretary, General Counsel at SSM Health

    Total calculated
    $2,040,754
    From this org
    $0
    From related orgs
    $1,354,027
    Other
    $686,727
    Hours/week
    1 + 72.2 related

    Schedule J breakdown matched by us

    Base
    $0 + $724,576 related
    Bonus
    $0 + $460,492 related
    Other
    $0 + $168,959 related
    Deferred
    $0 + $664,054 related
    Nontaxable benefits
    $0 + $22,673 related
    Filer's total
    $0 + $2,040,753 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, and on a Form 990-PF Part VIII's — 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

  • 1a · Tax indemnification and gross-up payments
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 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 1a Tax indemnification and gross-up payments
An individual listed on Part VII, Section A, received tax indemnification/gross up payments in 2022, which was included in taxable compensation.
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
The Foundation's top management official (Executive Director) is compensated by a related organization that utilized the following to determine compensation: (1) independent compensation consultant; (2) compensation survey or study; (3) approval by the board or compensation committee.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
Pension Restoration Plan: SSM Health (SSMH) provides this supplemental defined benefit nonqualified retirement plan to any employee who is a participant in the SSMH qualified defined benefit plan who earns over the Internal Revenue Service compensation limit. The plan "restores" the benefits to these employees that would have been provided under the SSMH qualified plan if the regulations did not impose compensation limits. An individual can take a distribution from the plan at (1) age 65 or older if the individual is still employed by SSMH or (2) age 55 or older if the individual is no longer employed by SSMH. No individuals listed on Part VII of Form 990 received distributions from the plan in 2022. Capital Accumulation Plan: SSMH provides this supplemental nonqualified retirement plan to executive level employees. The organization contributed a percentage of the employee's base salary into their choice of a select list of investments. The deposits and earnings of the plan are owned by SSMH and are tax-deferred until a distribution is made to the employee. In addition, the plan has special safeguards in place to protect the funds from contingencies, other than insolvency. For contributions made to the plan in 2014 or after, the distribution will occur after the completion of four plan years for all executives that are still actively employed on the distribution date. Any active participant 65 years or older will receive the contribution in the current year. THE FOLLOWING INDIVIDUALS LISTED ON PART VII OF THE FORM 990 RECEIVED DEFERRALS FROM THIS PLAN IN 2022: Kyle Nondorf $48,758 Douglas Long $159,815 The following individuals listed on Part VII of the Form 990 received distributions from this plan in 2022. All distributions received from the plan in the current year were included in the individual's taxable compensation. Kyle Nondorf $12,653

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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2022
Filed
16 November 2023
IRS schema version
2022v5.0
Source object
202343199349329929

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