2022-05-13T17:19:09-04:00 2021-12-31 420808359 Ohnward Tax and Accounting 107 East Quarry Street Maquoketa IA 52060 990 2021-01-01 391883528 DEWITT COMMUNITY HOSPITAL FOUNDATION DEWI 1118 11TH ST DE WITT IA 52742 MARK WITTE CHAIRMAN OF THE 5636594233 2022-05-12 true MARK WITTE John Franzen P00050698 5636527810 2022-05-13 0 00 AAL1 IAL1 2021 2022-09-23 18:48:47Z 2170397 false X WWW.GENESISHEALTH.COM/GIVE X 1997 IA SEE SCHEDULE O. 21 21 3 21 0 0 1709364 1998292 0 30484 126187 21793 22453 1761641 2146932 1072718 1565234 0 65659 67106 0 37067 36425 19069 1174802 1651409 586839 495523 2771758 3328855 6452 5284 2765306 3323571 X SEE SCHEDULE O. false false 1573444 1565234 THE PRIMARY EXEMPT PURPOSE OF THE DEWITT COMMUNITY HOSPITAL FOUNDATION IS TO PROVIDE FUNDING FOR SPECIFIC ITEMS AND OR PROGRAMS OF GENESIS MEDICAL CENTER, DEWITT NOT OTHERWISE PROVIDED FOR BY ITS OPERATIONAL BUDGET. 1573444 true true false false false false false false true false false false false false false false false false false false false false false true false false true true false false false false false false false false false false false false false false false false false false true 0 0 true 3 true false false false false false false false false false false false false false false false false false X 21 21 false false false false false false false true true false false true true true true true true true false false X ROBIN KROGMAN 5636594233 1118 11TH ST DE WITT IA 52742 X MARY RUETER DIRECTOR 0.10 0.00 X 0 0 0 STEVE THAYER DIRECTOR 0.10 0.00 X 0 0 0 KATHY ROLLINGS DIRECTOR 0.10 0.00 X 0 0 0 TONY MANATT DIRECTOR 0.10 0.00 X 0 0 0 JIM NELSON DIRECTOR 0.10 0.00 X 0 0 0 TRACI PAULSEN DIRECTOR 0.10 0.00 X 0 0 0 WILL FROESCHLE DIRECTOR 0.10 0.00 X 0 0 0 HEATHER OHNEMUS DIRECTOR 0.10 0.00 X 0 0 0 CURT COLEMAN EX OFFICIO-NON VOTE 0.10 0.00 X 0 0 0 ADAM GRAVERT DIRECTOR 0.10 0.00 X 0 0 0 MYRNA TUBBS DIRECTOR 0.10 0.00 X 0 0 0 DIANE CLAEYS DIRECTOR 0.10 0.00 X 0 0 0 JEAN BORMANN DIRECTOR 0.10 0.00 X 0 0 0 CORINA ANDERSEN DIRECTOR 0.10 0.00 X 0 0 0 ILENE DECKERT DIRECTOR 0.10 0.00 X 0 0 0 TAMMY LAURSEN DIRECTOR 0.10 0.00 X 0 0 0 MIKE JACOBS DIRECTOR 0.10 0.00 X 0 0 0 ROGER HILL DIRECTOR 0.10 0.00 X 0 0 0 MIKE BARNES VICE CHAIR 0.50 0.00 X X 0 0 0 MARK WITTE CHAIRMAN OF THE BOARD 0.50 0.00 X X 0 0 0 PAT HENRICKSEN SECRETARY 0.50 0.00 X X 0 0 0 BARRY VOSLER TREASURER 0.50 0.00 X X 0 0 0 ROBIN KROGMAN FOUNDATION DIRECTOR 40.00 0.00 X 0 0 0 0 0 0 0 false false false 1998292 1998292 24454 24454 101733 101733 101733 101733 45918 23465 22453 22453 2146932 0 0 148640 1550028 1550028 15206 15206 57100 28550 28550 3230 3230 2161 1081 1080 4615 2431 2184 5606 5606 5253 5253 1330 1330 354 354 2289 2289 OUTSIDE SERVICES 3935 3935 DUES & SUBSCRIPTIONS 280 280 SUPPLIES 22 22 1651409 1573444 40898 37067 411578 596838 985545 1170352 1374635 1561665 2771758 3328855 6452 5284 6452 5284 X 1067476 1781736 1697830 1541835 2765306 3323571 2771758 3328855 495523 62742 0 X false false false X 100754 51659 214141 1709364 1998292 4074210 100754 51659 214141 1709364 1998292 4074210 482008 3592202 27286 34473 33207 24830 24454 144250 4218460 342925 0.85150 0.58550 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 488501 67563 556064 420667 67834 488501 344907 75760 420667 373402 -28495 344907 317760 55642 373402 false false GOLF OUTING 37158 37158 18127 WPFTC 760 760 5338 1 8000 8000 45918 45918 23465 23465 22453 false GENESIS HEALTH SYSTEM- IOWA 1118 11TH ST DE WITT IA 52742 421418847 501 13398 SUPPORT HEALTHCARE WELLSPIRE LLC 5508 NW 88TH ST STE 120 JOHNSTON IA 50131 833724025 501 1536225 SUPPORT HEALTHCARE GENESIS HEALTH SERVICES FOUNDATION 1230 E RUSHOLME ST DAVENPORT IA 52803 421421670 501 PHILANTHROPY SERVICES EDUCATION ASSISTANCE 9 10457 HELMETS FOR KIDS 386 3460 MAMMOGRAM COST PROVIDED TO THOSE IN NEED 20 1289 Form 990 governing body review Part VI line 11 FORM 990, PART VI, LINE 11B - ORGANIZATIONS PROCESS TO REVIEW FORM 990 PRIOR TO FILING FORM 990 RETURN OF ORGANIZAION EXEMPT FROM INCOME TAX. THE RETURN IS REVIEWED BY THE DEWITT COMMUNITY HOSPITAL FOUNDATION EXECUTIVE BOARD. ANY REVISIONS NOTED ARE CORRECTED AND THEN THE FINAL RETURN IS SIGNED BY AN EXECUTIVE OF THE BOARD. Conflict of interest policy compliance Part VI line 12c FORM 990, PART VI, LINE 12C - ENFORCEMENT OF CONFLICTS POLICY.ANY COVERED PERSON, DEFINED AS ANY DIRECTOR, OFFICER, MEMBER OF THE BOARD OR BOARD COMMITTEE OF DEWITT COMMUNITY HOSPITAL FOUNDATION (DCHF), SHOULD DISCLOSE AN INTEREST OR POTENTIAL INTEREST AS SOON AS THEY BECOME AWARE OF A POTENTIAL TRANSACTION THAT COULD BE CONSIDERED A POTENTIAL CONFLICT BY THE DIRECTOR, THE BOARD, OR COMMITTEE OF THE BOARD. COVERED PERSONS ARE REQUIRED ANNUALLY TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILY, OR BUSINESS RELATIONS THAT REASONABLY COULD GIVE RISE TO AN INTEREST OR CONFLICT INVOLVING DCHF, AND ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS FAMILIAR WITH AND IS IN COMPLIANCE WITH THE LETTER AND SPIRIT OF THIS POLICY. ANY COVERED PERSON FOUND TO HAVE A CONFLICT OF INTERST MAY MAKE A FORM 990, PART VI, LINE 12C - ENFORCEMENT OF CONFLICTS POLICY- CONTUINUED..PRESENTATION AT THE BOARD OR COMMITTEE MEETING TO PRESENT INFORMATION AND ADDRESS ANY QUESTIONS RAISED BY OTHER DIRECTORS OR COMMITTEE MEMBERS. SAID PERSON SHALL NOT BE ALLOWED TO ACTIVELY AND AGGRESSIVELY ADVOCATE IN HIS OR HER OWN BEHALF NOR SHALL SUCH COMMUNICATION AND DISCUSSION BE WITH/THRU ANOTHER DIRECTOR. AFTER SUCH PRESENTATION, THE PERSON SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE APPLICABLE TRANSACTON OR ARRANGEMENT. CEO executive director top management comp Part VI line 15a COMPENSATION PROCESS FOR THE TOP OFFICIAL IS REVIEWED BY THE EXECUTIVE BOARD OF DIRECTORS. Governing documents etc available to public Part VI line 19 FORM 990, PART VI, LINE 19 - GOVERNING DOCUMENTS DISCLOSURE EXPLANATION.THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC, UPON REQUEST. Part III response or note to any other line in Part III FORM 990 - ORGANIZATIONS MISSIONTHE MISSION OF THE DEWITT COMMUNITY HOSPITAL FOUNDATION IS TO SUPPORT THE MISSION OF GENESIS MEDICAL CENTER, DEWITT AND OTHER HEALTH CARE RELATED NEEDS, BY PROMOTING HEALTH CARE AWARENESS AND CREATING OPPORTUNITIES FOR FINANCIAL GIVING.