CROSSROADS HEALTH FOUNDATION: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
CROSSROADS HEALTH FOUNDATION (EIN 39-1883528)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-05-27
IRS object ID
202511479349301301
Schema version
2024v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-05-27T15:14:11-04:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN364059951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PADGETT BUSINESS SERVICESBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11409 6TH AVEAddressLine1Txt
CityMOLINECityNm
State AbbreviationILStateAbbreviationCd
ZIP61265ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391883528EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CROSSROADS HEALTH FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCROSBusinessNameControlTxt
Phone5636594233PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11118 11TH STAddressLine1Txt
CityDEWITTCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52742ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK WITTEPersonNm
Person TitleCHAIRMANPersonTitleTxt
Phone5636594233PhoneNum
Signature2025-05-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN FRANZEN EAPreparerPersonNm
PTINP00050698PTIN
Phone3092771260PhoneNum
Preparation2025-05-27PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name ChangeYes (X)NameChangeInd
Principal OfficerMARK WITTEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11118 11TH STAddressLine1Txt
CityDEWITTCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52742ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$574,282GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressCROSSROADSHEALTHFOUNDATION.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionPARTNERING WITH OUR RURAL COMMUNITIES TO PROMOTE HEALTH AND WELLNESS FOR ALL.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee2TotalEmployeeCnt
Total Volunteers17TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$90,614PYContributionsGrantsAmt
CY Contributions Grants$412,681CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$33,768PYInvestmentIncomeAmt
CY Investment Income$64,078CYInvestmentIncomeAmt
PY Other Revenue$97,237PYOtherRevenueAmt
CY Other Revenue$66,120CYOtherRevenueAmt
PY Total Revenue$221,619PYTotalRevenueAmt
CY Total Revenue$542,879CYTotalRevenueAmt
PY Grants And Similar Paid$779,238PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$280,227CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$69,006PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$72,257CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$55,288CYTotalFundraisingExpenseAmt
PY Other Expenses$62,947PYOtherExpensesAmt
CY Other Expenses$56,850CYOtherExpensesAmt
PY Total Expenses$911,191PYTotalExpensesAmt
CY Total Expenses$409,334CYTotalExpensesAmt
PY Revenues Less Expenses-$689,572PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$133,545CYRevenuesLessExpensesAmt
Total Assets BOY$1,803,594TotalAssetsBOYAmt
Total Assets EOY$2,043,305TotalAssetsEOYAmt
Total Liabilities BOY$2,756TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,638TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,800,838NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,041,667NetAssetsOrFundBalancesEOYAmt
MissionPARTNERING WITH OUR RURAL COMMUNITIES TO PROMOTE HEALTH AND WELLNESS FOR ALL.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$302,243ExpenseAmt
Grant$280,227GrantAmt
DescTHE PRIMARY EXEMPT PURPOSE OF THE CROSSROADS HEALTH FOUNDATION IS TO PARTNER WITH OUR RURAL COMMUNITIES TO PROMOTE HEALTH AND WELLNESS FOR ALL.Desc
Total Program Service Expenses$302,243TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee2EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonROBIN KROGMANPersonNm
Phone5636594233PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11118 11TH STAddressLine1Txt
CityDEWITTCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52742ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
CORINA ANDRESEN
DIRECTOR1.00Yes (X)$0$0$0
MIKE BARNES
VICE CHAIRMA2.00Yes (X)$0$0$0Yes (X)
DIANE CLAEYS
DIRECTOR1.00Yes (X)$0$0$0
WILL FROESCHLE
DIRECTOR1.00Yes (X)$0$0$0
ADAM GRAVERT
DIRECTOR1.00Yes (X)$0$0$0
PAT HENRICKSEN
SECRETARY2.00Yes (X)$0$0$0Yes (X)
ROGER HILL
DIRECTOR1.00Yes (X)$0$0$0
MIKE JACOBS
DIRECTOR1.00Yes (X)$0$0$0
TONY MANATT
DIRECTOR1.00Yes (X)$0$0$0
JIM NELSON
DIRECTOR1.00Yes (X)$0$0$0
HEATHER OHNEMUS
DIRECTOR1.00Yes (X)$0$0$0
KATHY ROLLINGS
DIRECTOR1.00Yes (X)$0$0$0
MARY RUETER
DIRECTOR1.00Yes (X)$0$0$0
STEVE THAYER
DIRECTOR1.00Yes (X)$0$0$0
MYRNA TUBBS
DIRECTOR1.00Yes (X)$0$0$0
BARRY VOSLER
TREASURER2.00Yes (X)$0$0$0Yes (X)
MARK WITTE
CHAIRMAN2.00Yes (X)$0$0$0Yes (X)
ROBIN KROGMAN
FOUNDATION D40.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$412,681AllOtherContributionsAmt
Total Contributions$412,681TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$47,132TotalRevenueColumnAmt
Exclusion$47,132ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$16,946OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$16,946OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,946TotalRevenueColumnAmt
Exclusion$16,946ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$97,523FundraisingGrossIncomeAmt
Fundraising Direct Expenses$31,403FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$66,120TotalRevenueColumnAmt
Exclusion$66,120ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$542,879TotalRevenueColumnAmt
Exclusion$130,198ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$269,951TotalAmt
Program Services$269,951ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$10,276TotalAmt
Program Services$10,276ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$65,454TotalAmt
Program Services$4,114ProgramServicesAmt
Management And General$30,670ManagementAndGeneralAmt
Fundraising$30,670FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,796TotalAmt
Management And General$898ManagementAndGeneralAmt
Fundraising$898FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,007TotalAmt
Program Services$315ProgramServicesAmt
Management And General$2,346ManagementAndGeneralAmt
Fundraising$2,346FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$4,168TotalAmt
Management And General$4,168ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$13,601TotalAmt
Management And General$13,601ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,175TotalAmt
Program Services$9,175ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,337TotalAmt
Program Services$1,337ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$120TotalAmt
Management And General$120ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$3,274TotalAmt
Program Services$1,046ProgramServicesAmt
Fundraising$2,228FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,952TotalAmt
Program Services$2,952ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtFundraisingFundraisingAmtProgram ServicesProgramServicesAmt
LIFE INSURANCE PREMIUMS$19,146$19,146
OTHER MIS EXP$2,150$2,150
PURCHASES FOR OTHERS$927$927

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$409,334TotalAmt
Program Services$302,243ProgramServicesAmt
Management And General$51,803ManagementAndGeneralAmt
Fundraising$55,288FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$16,828BOYAmt
EOY$288,432EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$244,086BOYAmt
EOY$48,567EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,542,680BOYAmt
EOY$1,706,306EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,803,594BOYAmt
EOY$2,043,305EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,756BOYAmt
EOY$1,638EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,756BOYAmt
EOY$1,638EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$546,300BOYAmt
EOY$881,572EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,254,538BOYAmt
EOY$1,160,095EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,800,838BOYAmt
EOY$2,041,667EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,803,594BOYAmt
EOY$2,043,305EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$133,545ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$107,284NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,709,364CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,998,292CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$92,963CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$90,614CurrentTaxYearMinus1YearAmt
Current Tax Year$412,681CurrentTaxYearAmt
Total$4,303,914TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,709,364CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,998,292CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$92,963CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$90,614CurrentTaxYearMinus1YearAmt
Current Tax Year$412,681CurrentTaxYearAmt
Total$4,303,914TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$4,303,914PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,830CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$24,454CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$31,138CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$37,284CurrentTaxYearMinus1YearAmt
Current Tax Year$47,132CurrentTaxYearAmt
Total$164,838TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$125,331CurrentTaxYearMinus1YearAmt
Current Tax Year$97,523CurrentTaxYearAmt
Total$222,854TotalAmt
FieldValueIRS element (for citing)
Total Support$4,691,606TotalSupportAmt
Public Support CY1700.91740PublicSupportCY170Pct
Public Support PY1700.93700PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART II, LINE 10FormAndLineReferenceDesc
ExplanationOTHER INCOME 125,331ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$462,192BeginningYearBalanceAmt
Investment Earnings Or Losses$105,375InvestmentEarningsOrLossesAmt
End Year Balance$567,567EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$556,064BeginningYearBalanceAmt
Investment Earnings Or Losses-$93,872InvestmentEarningsOrLossesAmt
End Year Balance$462,192EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$488,501BeginningYearBalanceAmt
Investment Earnings Or Losses$67,563InvestmentEarningsOrLossesAmt
End Year Balance$556,064EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$420,667BeginningYearBalanceAmt
Investment Earnings Or Losses$67,834InvestmentEarningsOrLossesAmt
End Year Balance$488,501EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF OUTINGEvent1Nm
Gross Receipts Event1$75,085GrossReceiptsEvent1Amt
Gross Revenue Event1$75,085GrossRevenueEvent1Amt
Other Direct Expenses Event1$20,644OtherDirectExpensesEvent1Amt
Event2WPFTCEvent2Nm
Gross Receipts Event2$22,438GrossReceiptsEvent2Amt
Gross Revenue Event2$22,438GrossRevenueEvent2Amt
Other Direct Expenses Event2$10,759OtherDirectExpensesEvent2Amt
Gross Receipts Total$97,523GrossReceiptsTotalAmt
Gross Revenue Total Events$97,523GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$31,403OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$31,403DirectExpenseSummaryEventsAmt
Net Income Summary$66,120NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
WELLSPIRE LLC
5508 NW 88TH ST STE 120JOHNSTONIA50131833724025501$169,951SUPPORT HEALTHCARE
GENESIS HEALTH SERVICES FOUNDATION
1230 E RUSHOLME STDAVENPORTIA52803421421670501$100,000SUPPORT HEALTHCARE
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
EDUCATION ASSISTANCE5$7,500
HELMETS FOR KIDS225$2,776

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE RETURN IS REVIEWED BY THE CROSSROADS HEALTH FOUNDATION EXECUTIVE BOARD, ANY REVISIONS NOTED ARE CORRECTED AND THEN THE FINAL RETURN IS SIGNED BY AN EXECUTIVE OF THE BOARD.
FORM 990, PAGE 6, PART VI, LINE 12CANY COVERED PERSON, DEFINDED AS ANY DIRECTOR, OFFICER, MEMBER OF THE BOARD OR BOARD COMMITTEE OF CROSSROADS HEALTH FOUNDATION (CHF), SHOULD DISCLOSE AN INTEREST OR POTENTIAL INTEREST AS SOON AS THEY BECOME AWARE OF A POTERNTIAL 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 RELATIONSHIP THAT PERSONALLY COULD GIVE RISE TO AN INTEREST OR CONFLICT INVOLVING CHF, 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 INTEREST MAY MAKE A FORM 990, PART VI, LINE 12C - ENFORCEMENT OF CONFLICTS POLICY 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 AGRESSIVELY 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 TRANSACTION OR ARRANGEMENT.
FORM 990, PAGE 6, PART VI, LINE 15ACOMPENSATION PROCESS FOR THE TOP OFFICIAL IS REVIEWED BY THE EXECUTIVE BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 19THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

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