Civic Intelligence

Allegiance Health Foundation

EIN 38-3607833 • 501(c)3 • Jackson, MI

Profile

The corporation is organized and operated exclusively for charitable purposes within the meaning of section 501(c)(3) and 170(c)(2) of the internal revenue code of 1986 and shall have the following specifc purposes and powers:to raise funds from the public and from all other sources for the purposes of furthering the charitable purposes of henry ford allegiance health group and other system entities, and improving the general health and welfare of residents in and around jackson county.

205 N East AvenueJackson, MI 49201

n/A

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on the latest valid filing.

Source year 2025

Liabilities / Revenue

Score unavailable

No value available

Liabilities-to-revenue requires both liabilities and revenue on the latest valid filing.

Source year 2025

Net Margin

Score unavailable

No value available

Net margin requires both revenue and expenses on the latest valid filing.

Source year 2025

Top Officer Pay

100th percentile

$818,130

Higher top officer pay than 100% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2025

Asset Growth

Score unavailable

No value available

A valid growth rate could not be computed from the available filing history.

Annualized from 2024 to 2025

Revenue Growth

Score unavailable

No value available

A valid growth rate could not be computed from the available filing history.

Annualized from 2024 to 2025

Assets

Flat

$0

Flat from 2024

Liabilities

Down

$0

Down $165,916 (-100%) from 2024

Net Assets

Up

$0

Up $165,916 (+100%) from 2024

Revenue

Flat

$0

Flat from 2024

Expenses

Flat

$0

Flat from 2024

Net Income

Flat

$0

Flat from 2024

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$3.0M$2.0M$1.0M$0-$1.0MAssets 2011: $1,611,643Liabilities 2011: $486,833Net Assets 2011: $1,124,8102011Assets 2012: $1,565,823Liabilities 2012: $314,285Net Assets 2012: $1,251,5382012Assets 2013: $1,869,397Liabilities 2013: $317,133Net Assets 2013: $1,552,2642013Assets 2014: $1,666,911Liabilities 2014: $354,064Net Assets 2014: $1,312,8472014Assets 2015: $1,655,518Liabilities 2015: $192,147Net Assets 2015: $1,463,3712015Assets 2016: $2,174,224Liabilities 2016: $96,673Net Assets 2016: $2,077,5512016Assets 2017: $2,793,822Liabilities 2017: $21,804Net Assets 2017: $2,772,0182017Assets 2018: $171,995Liabilities 2018: $311,921Net Assets 2018: -$139,9262018Assets 2019: $141,433Liabilities 2019: $285,771Net Assets 2019: -$144,3382019Assets 2020: $146,583Liabilities 2020: $302,440Net Assets 2020: -$155,8572020Assets 2021: $0Liabilities 2021: $165,916Net Assets 2021: -$165,9162021Assets 2022: $0Liabilities 2022: $165,916Net Assets 2022: -$165,9162022Assets 2023: $0Liabilities 2023: $165,916Net Assets 2023: -$165,9162023Assets 2024: $0Liabilities 2024: $165,916Net Assets 2024: -$165,9162024Assets 2025: $0Liabilities 2025: $0Net Assets 2025: $02025

Highlighted filing

2025

Assets$0
Liabilities$0
Net Assets$0

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$4.0M$2.0M$0-$2.0M-$4.0MRevenue 2011: $1,357,364Expenses 2011: $1,583,634Net Income 2011: -$226,2702011Revenue 2012: $2,163,031Expenses 2012: $2,691,343Net Income 2012: -$528,3122012Revenue 2013: $701,999Expenses 2013: $934,927Net Income 2013: -$232,9282013Revenue 2014: $761,047Expenses 2014: $1,511,757Net Income 2014: -$750,7102014Revenue 2015: $626,730Expenses 2015: $1,050,310Net Income 2015: -$423,5802015Revenue 2016: $575,414Expenses 2016: $428,492Net Income 2016: $146,9222016Revenue 2017: $1,810,385Expenses 2017: $1,689,966Net Income 2017: $120,4192017Revenue 2018: $290,987Expenses 2018: $3,570,919Net Income 2018: -$3,279,9322018Revenue 2019: $1,532Expenses 2019: $492,705Net Income 2019: -$491,1732019Revenue 2020: $1,191Expenses 2020: $12,710Net Income 2020: -$11,5192020Revenue 2021: $10,207Expenses 2021: $0Net Income 2021: $10,2072021Revenue 2022: $0Expenses 2022: $0Net Income 2022: $02022Revenue 2023: $0Expenses 2023: $0Net Income 2023: $02023Revenue 2024: $0Expenses 2024: $0Net Income 2024: $02024Revenue 2025: $0Expenses 2025: $0Net Income 2025: $02025

Highlighted filing

2025

Revenue$0
Expenses$0
Net Income$0

Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2025Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.00$0.00$0.00
2024Detailed filing. Detailed filing data is available for this year.$0.00$0.17$0.17$0.00$0.00$0.00
2023Detailed filing. Detailed filing data is available for this year.$0.00$0.17$0.17$0.00$0.00$0.00
2022Detailed filing. Detailed filing data is available for this year.$0.00$0.17$0.17$0.00$0.00$0.00
2021Detailed filing. Detailed filing data is available for this year.$0.00$0.17$0.17$0.01$0.00$0.01
2020Detailed filing. Detailed filing data is available for this year.$0.15$0.30$0.16$0.00$0.01$0.01
2019Detailed filing. Detailed filing data is available for this year.$0.14$0.29$0.14$0.00$0.49$0.49
2018Summary only. Only limited summary data is available for this year.$0.17$0.31$0.14$0.29$3.57$3.28
2017Summary only. Only limited summary data is available for this year.$2.79$0.02$2.77$1.81$1.69$0.12
2016Summary only. Only limited summary data is available for this year.$2.17$0.10$2.08$0.58$0.43$0.15
2015Summary only. Only limited summary data is available for this year.$1.66$0.19$1.46$0.63$1.05$0.42
2014Summary only. Only limited summary data is available for this year.$1.67$0.35$1.31$0.76$1.51$0.75
2013Summary only. Only limited summary data is available for this year.$1.87$0.32$1.55$0.70$0.93$0.23
2012Summary only. Only limited summary data is available for this year.$1.57$0.31$1.25$2.16$2.69$0.53
2011Summary only. Only limited summary data is available for this year.$1.61$0.49$1.12$1.36$1.58$0.23
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2025 to Apr 30, 2025
Signed
Mar 13, 2026
Return Version
2025v4.0
Gross Receipts
$0
Mission and Program Overview

Mission

The corporation is organized and operated exclusively for charitable purposes within the meaning of section 501(c)(3) and 170(c)(2) of the internal revenue code of 1986 and shall have the following specifc purposes and powers:to raise funds from the public and from all other sources for the purposes of furthering the charitable purposes of henry ford allegiance health group and other system entities, and improving the general health and welfare of residents in and around jackson county.

The foundation supports the charitable purpose of henry ford allegiance health group.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts-$0-
Savings and Temporary Cash Investments-$0-
Accounts Receivable-$0-
Other Notes and Loans Receivable, Net-$0-
Pledges and Grants Receivable-$0-
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc-$0-
Investments Other Securities-$0-
Investments Program Related-$0-
Investments in Publicly Traded Securities-$0-
Land, Buildings, and Equipment, Net-$0-
Intangible Assets-$0-
Inventories for Sale or Use-$0-
Loans From Officers Directors-$0-
Prepaid Expenses and Deferred Charges-$0-
Other Assets Total-$0-
Total Assets$0$0→ $0
Liabilities
Accounts Payable and Accrued Expenses$165,916$0▼ $165,916
Grants Payable-$0-
Mortgage Notes Payable Secured by Investment Property-$0-
Unsecured Notes Loans Payable-$0-
Other Liabilities-$0-
Deferred Revenue-$0-
Escrow Account Liability-$0-
Tax Exempt Bond Liabilities-$0-
Total Liabilities$165,916$0▼ $165,916
Net Assets / Fund Balance
Net Assets With Donor Restrictions-$0-
Net Assets Without Donor Restrictions$-165,916$0▲ $165,916
Total Net Assets Fund Balance$-165,916$0▲ $165,916
Total Liabilities and Net Assets / Fund Balance$0$0→ $0
Compensation and Service Providers

Employees

NameTitleOtherTotal
Wendy KimDirector-interim President (start 7/25)$466,723$466,723
Brian KimmdDirector$6,240$6,240

Board Members and Trustees

NameTitle
Sarah ErmatingerDirector-chair
Wendy KimDirector-interim President (start 7/
Emily S MoorheadDirector-president (thru 7/2025)
Cheryl SimonettiDirector
Frank LusebrinkDirector
Jamie GraceDirector
Jay ZiembaDirector
John WaldronDirector
Jordan LevyDirector
Mary ShirkeyDirector
Mumtaz Memon MdDirector
Shawna TelloDirector
Sheila EvertsDirector
Terry LangstonDirector
Carrie GlickDirector-secretary/treasur
Revenue and Support

Revenue Composition

Contributions and Grants
$0
Program Service Revenue
$0
Investment Income
$0
Other Revenue
$0
Change in Net Assets
$0
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$0
Other Expenses$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees-$0-
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees-$0-
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
Yes
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 2

Trustee to trustee business relationship: carrie glick(board member) and jay ziemba ( board member).

Form 990, Part VI, Section A, Line 4

Henry ford allegiance health foundation ("hfaf") filed a certificate of dissolution effective april 30, 2025

Form 990, Part VI, Section A, Line 6

The corporation is organized on a membership basis. The sole corporate member of the corporation is henry ford allegiance health group (formerly allegiance health services). Henry ford allegiance health group is a tax-exempt health system.

Form 990, Part VI, Section A, Line 7A

Approve changes in those provisions of the corporation's bylaws which affect the size, composition, and method of selection of the board of directors, or which affect this article; effect and remove, with or without cause, the corporation's directors.

Form 990, Part VI, Section A, Line 7B

The sole corporate member of the corporation is henry ford allegiance health group ("member"). The member's sole corporate member is henry ford health system dba henry ford health ("hf health"). Hf health shall have the sole authority to take or cause to be taken any of the following actions (the "hf health's reserved powers"). Appoint the board of directors, chairperson, and president of the corporation and its subsidiaries. Remove the board of directors, chairperson and president of the corporation and its subsidiaries. Change the corporate member of the corporation or its subsidiaries, provided such action shall have been approved by a vote of the member's board of directors. Amend these bylaws, the corporation's articles of incorporation or the governing documents of the corporation's subsidiaries, provided hf health first consults with the member's board of directors regarding the proposed amendment. Approve an agreement of (a) merger or consolidation of the corporation or its subsidiaries, or (b) sale, lease, or transfer of substantially all of the assets of the corporation or its subsidiaries, provided such agreement shall have been approved by vote of two-thirds of the member's local directors (as defined in the member's bylaws) and further provided that approval of the local directors shall not be required with respect to certain transactions with respect to hf health's overall health system (including the system) as described in section 6.8(b) of the affiliation agreement dated march 4, 2016 between the member (then known as allegiance health services) and hf health, as amended from time to time. Dissolve the corporation or its subsidiaries or revoke such dissolution, provided such action shall have been approved by a vote of the member's board of directors. Cause the corporation and its subsidiaries to incur, assume or guaranty indebtedness or fulfill other obligations required under hf health debt agreements. Encumber the assets of the corporation and its subsidiaries as security for debts or other lawful engagements securing indebtedness. Authorize the formation or acquisition of new subsidiaries of the corporation following consultation with the member's board of directors. As used herein, "indebtedness" of a person shall mean: (a) obligations of such person relating to indebtedness for borrowed money; (b) obligations of such person evidenced by bonds, notes, debentures or similar instruments; and (c) obligations in the nature of guarantees by, or joint and several liability of, such person with respect to the obligations of any other person of the type described in clauses (a) and (b) above. Responsibilities and reserved powers of the member (henry ford allegiance health group). In addition to doing all things reserved to the member by law, the member of the corporation shall have sole authority to take the following actions with respect to this corporation ("member's reserved powers"), subject however to hf health's reserved powers: adopt the vision, mission and values. Adopt the corporation's operating and capital budgets and approve any non-budgetary expenditures in excess of maximum limits established by the member, approve any change in the method of distribution, or the class of beneficiaries receiving, funds of the corporation.

Form 990, Part VI, Section B, Line 11B

The organization is an affiliate of henry ford health (hf health) and the tax department of hf health prepares the organization's form 990. As part of the preparation and review process prior to filing the return, the following review process is conducted: - review of the entire return with the hf health and organization's senior vice president financial operations, chief financial officer and director of accounting. - review of all compensation matters and disclosures with the compensation committee of the hf health board of directors - review of the return with the hf health audit and compliance committee of the board of directors, including the ceo - final copies of the return are distributed to the foundation's board of directors before the return is filed.

Form 990, Part VI, Section B, Line 12C

The organization is an affiliate of henry ford health (hf health) who oversees the conflict of interest process with regard to the organization. Hf health has a standing conflict of interest committee (the committee) that is responsible for oversight of all conflict of interest matters. The hf health conflict of interest policy applies to all directors and employees. Annually, directors, employees of a management level, researchers, as well as employees associated with procurement, or in certain other predefined roles must complete an annual disclosure designed to identify activities and relationships that could potentially give rise to a conflict of interest. It is the responsibility of the committee to review these disclosures and determine the need for any action to manage the potential conflict. The committee annually reports the results of its activities to the audit and compliance committee of the hf health board of directors.

Form 990, Part VI, Section B, Line 15

The organization is an affiliate of henry ford health (hf health) who has responsibility to oversee the compensation practices of the organization. Hf health has a compensation committee of the board of directors consisting of all external directors. They meet periodically throughout the year. They are charged with approval of the organization's overall compensation and benefit programs as well as the specific review and approval of the compensation of certain employees including the chief executive officer, all officers and key employees of the organization. They directly engage an independent compensation advisor to assist with this process. The process includes evaluation of the individual's performance, utilization of compensation studies of similarly situated positions, as well as comparisons to compensation as reported by other health care organizations. The reasonableness of compensation is evaluated based upon these and other factors. The committee also reviews the compensation disclosures to be made on form 990 in advance of filing.

Form 990, Part VI, Section C, Line 19

It is the practice of the organization to make its governing documents and conflict of interest policy available to any party requesting such information.

FORM 990, PART VII:

Average hours per week devoted to related organizations: many executive employees of henry ford health and affiliates provide services to multiple affiliated entities. Henry ford health and affiliates use estimates for reporting average hours per week in all sections of form 990. Generally 60 hours are reported for the hours associated for the organization that the individual has principal responsibility for. Hours associated with other hospitals or affiliates are reported at between 1 to 5 hours per week.

Filing and Contact Details

Filer

Filer Name
Allegiance Health Foundation
EIN
38-3607833
Phone
5172054800
Address
205 N EAST AVENUE, JACKSON, MI 49201
Doing Business As
Henry Ford Allegiance Health Foundation

Signing Officer

Name
Robin Damschroder
Title
SVP/ Chief Accounting Officer
Phone
5172054800
Signed
2026-03-13

Organization Details

Principal Officer
Robin Damschroder
Formed
2000
Legal Domicile
Mi
Voting Board Members
15
Independent Board Members
12
Employees
0
Volunteers
0
Supplemental Narrative

Additional Explanations

Form 990, Part III, Line 3

Allegiance health foundation filed a certificate of dissolution effective april 30, 2025.

FORM 990, PART XI, LINE 9:

Captial contribution from henry ford allegiance health group 165,916.

FORM 5713- INTERNATIONAL BOYCOTT ACTIVITIES:

A form 5713, international boycott report, has been filed on our behalf by henry ford health (parent of controlled group of which the organization is a member). The organization did not itself have any activities associated with an international boycott country.

Form 990, Part XII, Line 2C

Henry ford allegiance health foundation is included in the consolidated financial statements of henry ford health (the sole member of henry ford allegiance health group). The governing body of henry ford allegiance health has delegated the oversight of its financial statements, including the choice of independent auditors, to its audit committee.

Form 990, Part IV, Line 12

The organization is an element of the external audit report obtained for the consolidated operations of henry ford health.

Financial Statement Notes

PART X, LINE 2:

The system does not have any material uncertain tax positions as of december 31, 2024.

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IRS990/Form990PartVIISectionAGrp/PersonNm9MARY SHIRKEY
IRS990/Form990PartVIISectionAGrp/PersonNm10CHERYL SIMONETTI
IRS990/Form990PartVIISectionAGrp/PersonNm11SHAWNA TELLO
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IRS990/Form990PartVIISectionAGrp/TitleTxt1DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt2DIRECTOR-SECRETARY/TREASUR
IRS990/Form990PartVIISectionAGrp/TitleTxt3DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt4DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt5DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt6DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt7DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt8DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt9DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt10DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt11DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt12DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt13DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt14DIRECTOR-PRESIDENT (THRU 7/2025)
IRS990/Form990PartVIISectionAGrp/TitleTxt15DIRECTOR-INTERIM PRESIDENT (START 7/25)
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IRS990/MissionDesc0THE CORPORATION IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) AND 170(C)(2) OF THE INTERNAL REVENUE CODE OF 1986 AND SHALL HAVE THE FOLLOWING SPECIFC PURPOSES AND POWERS:TO RAISE FUNDS FROM THE PUBLIC AND FROM ALL OTHER SOURCES FOR THE PURPOSES OF FURTHERING THE CHARITABLE PURPOSES OF HENRY FORD ALLEGIANCE HEALTH GROUP AND OTHER SYSTEM ENTITIES, AND IMPROVING THE GENERAL HEALTH AND WELFARE OF RESIDENTS IN AND AROUND JACKSON COUNTY.
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IRS990ScheduleA/SupportedOrgInformationGrp/SupportAmt00
IRS990ScheduleA/SupportedOrgInformationGrp/SupportAmt10
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IRS990ScheduleA/SupportedOrgInformationGrp/SupportedOrganizationName/BusinessNameLine1Txt0HENRY FORD ALLEGIANCE HEALTH
IRS990ScheduleA/SupportedOrgInformationGrp/SupportedOrganizationName/BusinessNameLine1Txt1HENRY FORD ALLEGIANCE HOSPICE
IRS990ScheduleA/SupportedOrgInformationGrp/SupportedOrganizationName/BusinessNameLine1Txt2HENRY FORD ALLEGIANCE CARELINK
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IRS990ScheduleD/FootnoteTextInd0X
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0THE SYSTEM DOES NOT HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2024.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0PART X, LINE 2:
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IRS990ScheduleJ/CompBsdNetEarnsRltdOrgsInd00
IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd00
IRS990ScheduleJ/EquityBasedCompArrngmInd00
IRS990ScheduleJ/InitialContractExceptionInd00
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm0MUMTAZ MEMON MD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm1EMILY S MOORHEAD
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm2WENDY KIM
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt0DIRECTOR
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt1DIRECTOR-PRESIDENT (THRU 7/2025)
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt2DIRECTOR-INTERIM PRESIDENT (START 7/
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt00
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt10
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationFilingOrgAmt20
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IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt1757782
IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt2466723
IRS990ScheduleJ/SeverancePaymentInd00
IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt0CERTAIN MEMBERS OF THE ORGANIZATION'S SENIOR LEADERSHIP TEAM PARTICIPATE IN SUPPLEMENTAL RETIREMENT PROGRAMS THAT RESULT IN REPORTABLE TAXABLE INCOME AS THE BENEFITS ACCRUE, AND/OR AS PAID. IT IS AN ELEMENT OF SOME PLAN DESIGNS TO ABSORB THE ADVANCE TAX IMPACT OF THESE PLANS FOR THE PARTICIPANTS. IN SUCH CASES THE RELATED AMOUNTS ARE REPORTED AS TAXABLE INCOME TO THE INDIVIDUAL AND INCLUDED IN THE DETERMINATION OF REASONABLE COMPENSATION. THE FOLLOWING PROVIDES THE REQUIRED LISTING OF THE PARTICIPATING INDIVIDUALS: SEC 457(B)-NON-QUALIFIED DEFERRED COMPENSATION RETIREMENT PLAN - W.A. FOOTE MEMORIAL HOSPITAL EMPLOYEE EMPLOYER MEDICARE REPORTABLE 2025 CONTR. 2025 CONTR. TAX GROSS-UP W-2 AMOUNTS MUMTAZ MEMON, M.D. 16,750 6,750 162 23,662 SEC 457(F) - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) -W.A. FOOTE MEMORIAL HOSPITAL PARTICIPANT ACCRUAL DISTRIBUTION NON-VESTED REPORTABLE W-2 EMILY MOORHEAD - - 58,741 -
IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc0PART I, LINE 4B
IRS990ScheduleJ/SupplementalNonqualRtrPlanInd01
IRS990ScheduleN/AssetsDistributedInd01
IRS990ScheduleN/AttorneyGeneralNotifiedInd01
IRS990ScheduleN/BondsOutstandingInd00

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