2022-05-16T14:45:47-05:00 2021-06-30 461497033 PLANTE & MORAN PLLC 8181 E TUFTS AVE SUITE 600 DENVER CO 80237 990 2020-07-01 841576338 THE MEMORIAL HEALTH SYSTEM FOUNDATION MEMO 7193654483 1400 EAST BOULDER SUITE 2N2019 COLORADO SPRINGS CO 80909 KATE MAIURRO EXECUTIVE DIRECTOR 7193654483 2022-05-11 1 KATE MAIURRO 999009999 RYAN C HARRIS P00614618 3037409400 2022-05-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z KATE MAIURRO 1400 EAST BOULDER SUITE 2N2019 COLORADO SPRINGS CO 80909 1627986 0 X WWW.UCHEALTHMEMORIALCARES.ORG X 2001 CO TO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM. 14 14 4 0 0 0 2468305 1574933 0 0 68180 53053 -5265 0 2531220 1627986 1253767 2418010 0 0 419189 414554 0 0 271573 196363 117444 1869319 2950008 661901 -1322022 4508417 3678098 93818 138735 4414599 3539363 X SEE SCHEDULE OTHE MISSION OF MEMORIAL HEALTH SYSTEM FOUNDATION IS TO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM TO PROVIDE THE HIGHEST QUALITY HEALTH CARE. PHILANTHROPIC SUPPORT IS BEING SOUGHT FOR CAPITAL, ENDOWMENT AND PROGRAMMATIC PURPOSES, INCLUDING CANCER, CARDIOLOGY, AND WOMEN'S PROGRAMS AND SERVICES. 0 0 924975 924975 THIS GENERALIZED FUND OFFSETS EMERGENCY RELATED RELIEF EXPENSES. THIS ENCOMPASSES ANYTHING THAT FALLS IN THAT REALM; MORALE BUILDERS, SUPPLIES, EMPLOYEE PROGRAMS, COMMUNITY FACING PROGRAMS, ETC. FUND WAS ESTABLISHED IN RESPONSE TO COVID-19, BUT IS NOT RESTRICTED TO ONLY COVID-19 RELIEF. AT THE TIME THAT EMERGENCY NEEDS ARE MET, ANY FUNDS REMAINING WILL ROLL-OVER FOR USE IN ANOTHER EMERGENCY SITUATION OR FOR PREPAREDNESS. IN FY21, $924,975 WAS EXPENDED TOWARD COVID 19 ITEMS INCLUDING 6 VENTILATORS FOR $235,490, ISOLATION ROOMS FOR $174,679, ISOLATION CARTS FOR $104,720, LAB INSTRUMENTATION FOR $105,000 AND $305,086 FOR OTHER ITEMS. 500000 500000 THIS FUND WAS ESTABLISHED FOR THE SOLE PURPOSE OF CREATING AN APHERESIS AND PHOTOPHERESIS PROGRAM AT UCHEALTH IN SOUTHERN COLORADO. FUNDS ARE TO BE USED EXCLUSIVELY FOR CONSTRUCTION, STAFF CERTIFICATION, AND APHERESIS OR PHOTOPHERESIS EQUIPMENT. DURING FY21, $500,000 WAS EXPENDED FOR APHERESIS EQUIPMENT AND CONSTRUCTION. 267618 267618 THIS FUND WILL BE USED FOR THE FISCAL YEAR 2019 MEMORIAL HOSPITAL FOUNDATION'S 17TH ANNUAL GALA. DURING FY21, $267,618 RAISED FROM THE GALA WERE EXPENDED TO PURCHASE A MAKO ORTHOPEDIC ROBOT FOR THE GRANDVIEW HOSPITAL. 808893 725417 VARIOUS PATIENT CARE AND STAFF EDUCATION FUNDS. 808893 725417 2501486 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 4 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X STEVE WEBER 7193654483 1400 EAST BOULDER SUITE 2N2019 COLORADO SPRINGS CO 80909 BRUCE PANTER BOARD CHAIR 1.00 X X 0 0 0 ANN SIMPSON BOARD VICE CHAIR 1.00 X X 0 0 0 DEB MAHAN SECRETARY 1.00 X X 0 0 0 DAVID BROCKWAY TREASURER 1.00 X X 0 0 0 PATRICIA CONE INDIVIDUAL TRUSTEE 1.00 X 0 0 0 RYAN DOHERTY INDIVIDUAL TRUSTEE 1.00 X 0 0 0 ANDREA HURLBERT INDIVIDUAL TRUSTEE 1.00 X 0 0 0 JARED MAY INDIVIDUAL TRUSTEE 1.00 X 0 0 0 CHRISTINE O'BRIEN INDIVIDUAL TRUSTEE 1.00 X 0 0 0 JOHN SWENSON INDIVIDUAL TRUSTEE 1.00 X 0 0 0 CHERISE SELLEY INDIVIDUAL TRUSTEE 1.00 X 0 0 0 ERIC SCOTT INDIVIDUAL TRUSTEE 1.00 X 0 0 0 AMY SUFAK INDIVIDUAL TRUSTEE 1.00 X 0 0 0 JOSEPH MASLAK INDIVIDUAL TRUSTEE 1.00 X 0 0 0 JOEL YUHAS INDIVIDUAL TRUSTEE 1.00 X 0 0 0 KATE MAIURRO EXECUTIVE DIRECTOR 40.00 X 115886 0 23101 115886 0 23101 1 0 0 0 0 497490 1077443 7700 1574933 53053 53053 1627986 0 0 53053 2241521 2241521 176489 176489 172622 34524 51787 86311 200220 32902 32915 134403 2028 203 304 1521 37142 6232 6132 24778 2542 420 421 1701 24938 24938 24363 996 22305 1062 2240 2240 12706 2114 4149 6443 26182 5236 15710 5236 183 73 110 1402 140 421 841 86 17 52 17 1729 1729 HOSPITAL SERVICES 14945 14945 MISCELLANEOUS 7017 692 407 5918 DUES 1185 474 711 CONTINUING EDUCATION 468 187 281 2950008 2501486 176949 271573 975457 114521 1003265 872884 126729 51263 22651 10029 61945 61938 93 7 2380222 2629394 4508417 3678098 93818 138735 93818 138735 X 953647 1388126 3460952 2151237 4414599 3539363 4508417 3678098 X -1322022 460676 -13890 X 0 1 X 1 0 X 1185902 1482045 1648788 2468305 1574933 8359973 1185902 1482045 1648788 2468305 1574933 8359973 4355964 4004009 62083 64847 82052 68180 53053 330215 8690188 0.46080 0.47220 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 306441 72958 379399 294863 11578 306441 277255 17608 294863 264719 12536 277255 243696 21023 264719 0.51180 0.48820 0 0 61945 61938 7 7 X 2063724 460676 460676 1603048 24938 24938 1627986 2938960 13890 13890 2925070 24938 24938 2950008 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO PROVIDE EDUCATION TO OUTREACH PROGRAMS, TRAUMA NURSES, AND BLOOD DONOR TECHS. PART X, LINE 2: THE FOUNDATION IS A NOT-FOR-PROFIT CORPORATION, IS EXEMPT FROM TAX UNDER THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3), AND QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION; HOWEVER, INCOME FROM ACTIVITIES NOT DIRECTLY RELATED TO THE FOUNDATION'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THERE WAS NO TAX ON UNRELATED BUSINESS INCOME DURING THE YEARS ENDED JUNE 30, 2021 AND 2020. MANAGEMENT IS REQUIRED TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND TO RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS TAKEN AN UNCERTAIN POSITION THAT PROBABLY WOULD NOT BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES. THE FOUNDATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AND THAT NONE WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. IF INCURRED, INTEREST AND PENALTIES ASSOCIATED WITH TAX POSITIONS WOULD BE RECORDED IN THE PERIOD ASSESSED AS GENERAL AND ADMINISTRATIVE EXPENSES. NO INTEREST OR PENALTIES HAVE BEEN ASSESSED AS OF JUNE 30, 2021. PART XII, LINE 2D - OTHER ADJUSTMENTS: PLEDGE WRITE OFFS (PROGRAMS) 13,890. 1 UCH - MHS 1400 E BOULDER STREET SUITE 2N2019 COLORADO SPRINGS CO 80909 460796114 501(C)(3) 2233821 7700 FMV CLOTHING & HOUSEHOLD ITEMS, TOYS, FOOD, AND EVENT ITEMS FINANCIAL SUPPORT 1 LIVING EXPENSES 1350 135607 EDUCATIONAL 3 894 WIGS 51 9109 SCHOLARSHIPS 17 30879 PART I, LINE 2: THE FOUNDATION'S EXECUTIVE DIRECTOR REVIEWS ALL GRANTS AND REQUESTS FOR MONIES. ALL ASSISTANCE PROVIDED TO INDIVIDUALS IS PAID DIRECTLY TO THOSE THAT PROVIDE THE ASSISTANCE. THE FUNDS ARE NOT GIVEN DIRECTLY TO THE INDIVIDUALS. THUS, THE ORGANIZATION IS ABLE TO ENSURE THAT THE FUNDS ARE USED FOR THE INTENDED PURPOSES. SCHEDULE I, PART I, LINE I THE FOUNDATION'S EXECUTIVE DIRECTOR REVIEWS ALL GRANTS AND REQUESTS FOR MONIES. ALL ASSISTANCE PROVIDED TO INDIVIDUALS IS PAID DIRECTLY TO THOSE THAT PROVIDE THE ASSISTANCE. THE FUNDS ARE NOT GIVEN DIRECTLY TO THE INDIVIDUALS. THUS, THE ORGANIZATION IS ABLE TO ENSURE THAT THE FUNDS ARE USED FOR THE INTENDED PURPOSES. X 1 7500 FMV X 200 FMV 0 1 0 FORM 990, PART VI, SECTION B, LINE 11B THE MEMORIAL HOSPITAL FINANCE DEPARTMENT REVIEWS THE RETURN. A COPY OF THE FORM 990 IS EMAILED TO BOARD MEMBERS PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C AT THE ANNUAL BOARD MEETING, THE BOARD IS GIVEN A NEW COPY OF THE CONFLICT OF INTEREST STATEMENT. THE BOARD GOES OVER THE STATEMENT AND EACH BOARD MEMBER MUST SIGN THE DOCUMENT. THUS, EACH MEMBER SIGNS IT ANNUALLY AND IS REMINDED TO BRING ANY POTENTIAL CONFLICT TO THE BOARD'S AND EXECUTIVE DIRECTOR'S ATTENTION. THE BOARD MEMBER MUST ALSO RECUSE HIMSELF OR HERSELF FROM ANY VOTE IF THERE IS A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A SALARY SURVEY DATA THAT IS COMPILED BY THIRD PARTIES IS USED TO DETERMINE THE COMPENSATION OF THE EXECUTIVE DIRECTOR. REVIEW AND APPROVAL OF THE SALARY IS DONE BY THE MEMORIAL HOSPITAL AND UCH BOARDS. THE ORGANIZATION MAINTAINS THE APPROPRIATE DOCUMENTATION OF THE PROCESS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE AT THE FOUNDATION OFFICE IF THE PUBLIC WISHES TO REVIEW THEM. FORM 990, PART XI, LINE 9: PROVISION FOR UNCOLLECTIBLE PLEDGES -13,890.