MEMORIAL HOSPITAL FOUNDATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL HOSPITAL FOUNDATION (EIN 47-3010424)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-08-30
- IRS object ID
- 202232429349301703
- Schema version
- 2021v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-30T13:32:17-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 473010424 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Memorial Hospital Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MEMO | BusinessNameControlTxt |
| Phone | 2173578573 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 160 | AddressLine1Txt |
| City | Carthage | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62321 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Teresa Smith | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 2173578573 | PhoneNum |
| Signature | 2022-08-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Teresa | PersonFirstNm |
| Person Last | Smith | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2022-08-29 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Ada Bair | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 160 | AddressLine1Txt |
| City | Carthage | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62321 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $197,549 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2014 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | Support Memorial Hospital Assoc and the general health of the citizens of Hancock County, IL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $189,300 | PYContributionsGrantsAmt |
| CY Contributions Grants | $145,325 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,956 | PYInvestmentIncomeAmt |
| CY Investment Income | $10,322 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$806 | PYOtherRevenueAmt |
| CY Other Revenue | $3,764 | CYOtherRevenueAmt |
| PY Total Revenue | $191,450 | PYTotalRevenueAmt |
| CY Total Revenue | $159,411 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $42,425 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,826 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,684 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,614 | PYOtherExpensesAmt |
| CY Other Expenses | $8,036 | CYOtherExpensesAmt |
| PY Total Expenses | $62,039 | PYTotalExpensesAmt |
| CY Total Expenses | $14,862 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $129,411 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $144,549 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $290,737 | TotalAssetsBOYAmt |
| Total Assets EOY | $462,577 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $290,737 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $462,577 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Enhancing the health and wellness of our communities through charitable giving. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,178 | ExpenseAmt |
| Grant | $6,826 | GrantAmt |
| Revenue | $3,764 | RevenueAmt |
| Desc | The Memorial Hospital Foundation was established to support Memorial Hospital, Hancock County Senior Services and the general health and well-being of the citizens of Hancock County, Illinois. Donations to the foundation are used to meet short and long-term goals for the benefit of quality local healthcare, health and wellness provisions for our communities, and to build stability and a financial legacy for future generations. | Desc |
| Total Program Service Expenses | $13,178 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Teresa Smith | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2173578573 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 160 | AddressLine1Txt |
| City | Carthage | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62321 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| Ron Starr | ||||||
| President | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Callie Connor | ||||||
| Vice President | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Charles Gilbert | ||||||
| Secretary/Treasurer | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Terry Pope | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Joe Zumwalt | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| David Fox | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Sharon Morrison | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Casey Yager | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Jim Nightingale | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Monica Crim | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Krista Carle | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| John Dittmer | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Elaine Ferguson | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Mattie Haas | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Mary Jo Scheetz | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Shellie Wear | ||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Ada Bair | ||||||
| Director/Hospital CEO | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Teresa Smith | ||||||
| Hospital CFO | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $145,325 | AllOtherContributionsAmt |
| Total Contributions | $145,325 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,700 | TotalRevenueColumnAmt |
| Exclusion | $4,700 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,622 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,622 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,622 | TotalRevenueColumnAmt |
| Exclusion | $5,622 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $41,902 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $38,138 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,764 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,764 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $159,411 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,764 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $10,322 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,826 | TotalAmt |
| Program Services | $6,826 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| Caring Back Club Activi | $6,352 | $6,352 | |
| Campaign expenses | $1,501 | $1,501 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183 | TotalAmt |
| Fundraising | $183 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,862 | TotalAmt |
| Program Services | $13,178 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $1,684 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $290,737 | BOYAmt |
| EOY | $462,577 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $290,737 | BOYAmt |
| EOY | $462,577 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $290,737 | BOYAmt |
| EOY | $462,577 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $290,737 | BOYAmt |
| EOY | $462,577 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $290,737 | BOYAmt |
| EOY | $462,577 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $144,549 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $27,291 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $110,047 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $41,674 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $91,205 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $189,300 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $145,325 | CurrentTaxYearAmt |
| Total | $577,551 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $110,047 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $41,674 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $91,205 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $189,300 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $145,325 | CurrentTaxYearAmt |
| Total | $577,551 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $101,796 | SubstantialContributorsTotAmt |
| Public Support Total170 | $475,755 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $474 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,374 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,299 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,956 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,700 | CurrentTaxYearAmt |
| Total | $10,803 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,922 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus2 Years | $18,826 | CurrentTaxYearMinus2YearsAmt |
| Total | $41,748 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $630,102 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $41,902 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.75500 | PublicSupportCY170Pct |
| Public Support PY170 | 0.75180 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II | FormAndLineReferenceDesc |
| Explanation | The organization has chosen to change their tax year to a December 31st year end, starting with the short period 7/1/18 - 12/31/18. The 2017 column is for the 6 month period ending 12/31/18. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $233,372 | BeginningYearBalanceAmt |
| Contributions | $41,325 | ContributionsAmt |
| Investment Earnings Or Losses | $37,343 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $312,040 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $104,037 | BeginningYearBalanceAmt |
| Contributions | $122,229 | ContributionsAmt |
| Investment Earnings Or Losses | $7,106 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $233,372 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $88,100 | BeginningYearBalanceAmt |
| Contributions | $4,008 | ContributionsAmt |
| Investment Earnings Or Losses | $11,929 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $104,037 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $92,139 | BeginningYearBalanceAmt |
| Contributions | $10,000 | ContributionsAmt |
| Investment Earnings Or Losses | -$4,039 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $10,000 | AdministrativeExpensesAmt |
| End Year Balance | $88,100 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $86,453 | ContributionsAmt |
| Investment Earnings Or Losses | $5,686 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $92,139 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1a | The Corporation has an Executive Committee composed of the following members: the President, Vice President(s), Secretary, and Treasurer of the Corporation; the CEO of Memorial Hospital; and the immediate past President of the Corporation's Board of Directors, if such person is a Board Member or, if not, one (1) additional Director selected by the Board. Except as otherwise provided herein, and in any Board resolution limiting the powers of the Executive Committee, such committee shall, during intervals between the meetings of the board, possess and may exercise all of the powers of the Board in the management of the Corporation's affairs. However, the Executive Committee shall not have the authority to: (a) adopt a plan for the distribution of the assets of the Corporation, for dissolution or revoking proceedings therefor; (b) elect, appoint, or remove any member of the Executive Committee, Director, or Officer of the Corporation or fix compensation of any member of the committee, if any; (c) fill vacancies on the Board or on any of its committees; (d) adopt, amend, or repeal the Bylaws or Articles of Incorporation or amend, alter, or repeal any resolution of the Board; (e) adopt a plan of merger or adopt a plan of consolidation with another Corporation; or (f) authorize the sale, lease, exchange, or mortgage of all or substantially all of the Corporation's property and assets. The Executive Committee shall be responsible for overseeing the hiring, firing and other personnel decisions of the Corporation and shall have such powers and other duties as the Board may designate from time to time. The Executive Committee shall keep full records and accounts of its proceedings and transactions. All actions by the Executive Committee shall be reported to the Board at its next meeting following such action, and such action shall be subject to the control, revision, and alteration by the Board, provided that no rights of third parties shall be prejudicially affected thereby. Subject to the provisions contained herein, the Executive Committee shall fix its own rules of procedure and shall meet as provided by such rules, or upon the Board's resolution, a call of the Chair or any two (2) members of the Executive Committee. Unless otherwise provided by such Executive Committee rules or resolutions, the following shall apply to Executive Committee meetings: (a) notice required for a meeting shall be the same as the notice for Board meetings; (b) a majority of the members of the Executive Committee shall be necessary to constitute a quorum; (c) approval of any action by the Executive Committee shall require the affirmative vote of a majority of the members present at the meeting; (d) the Executive Committee may act in writing without a meeting upon a unanimous vote of the Executive Committee. |
| Form 990, Part VI, Section A, line 4 | Article I: The income, principal and activities of the Corporation are dedicated to charitable purposes for the support of Memorial Hospital Association and Hancock County Senior Services Association. Hancock County Senior Services Association was added. The Corporation shall not engage in any activities other than services exclusively for the benefit of Memorial Hospital Association and Hancock County Senior Services Association. Hancock county Senior Services Association was added. Article IV: Three of the board members must be members of the Board of Memorial Hospital Association, including specifically the CEO of Memorial Hospital Association. Previously a board member could serve no more than 3 consecutive terms. Amended bylaws indicate board members may serve more than one term (consecutive or otherwise) as determined by the Board from time-to-time. In the event of a vacancy, a Director elected or appointed to fill a vacancy shall be elected or appointed for the unexpired term of his or her predecessor. Article V: The amended Bylaws state officers include any designated Assistance Secretary or Assistant Treasurer. The Secretary now has the authority to certify the Bylaws. Article IX: Regarding the Conflict of Interest Policy, the Board, in its sole discretion, shall determine whether any such interest is substantial and whether to either prohibit or waive the Conflict of Interest. Article XI: The fiscal year was updated to reflect the change to January 1 to December 31. Article XV: Any alteration, amendment or repeal of the Bylaws should first be submitted to and approved by two-thirds of the Board of Directors of Memorial Hospital Association. |
| Form 990, Part VI, Section A, line 7a | The Board of Directors shall be comprised of at least eight (8) but not more than twenty (20) Directors, at least three (3) of whom must be members of the Board of Memorial Hospital Association including specifically the CEO of Memorial Hospital Association. |
| Form 990, Part VI, Section A, line 7b | Any alteration, amendment or repeal of the Bylaws should first be submitted to and approved by two-thirds of the Board of Directors of Memorial Hospital Association. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is reviewed by the Board of Directors before it is filed. The final return is reviewed and signed by the Hospital CFO. |
| Form 990, Part VI, Section B, line 12c | Board members and officers are required to sign a conflict of interest statement annually. Any possible conflict of interest is disclosed to the other Board members and made a matter of record through an annual procedure and also when the interest becomes a matter of Board action. The Board, in its sole discretion, shall determine whether any such interest is substantial and whether to either prohibit or waive the conflict of interest. Disclosures are reviewed by the Board of Directors and any Member for whom conflicts have been identified shall abstain from any final discussions pertaining to the matter and shall abstain from voting on any issue in which the conflict of interest is involved. Appropriate documentation of the handling of the conflict is kept to protect the interested party and Memorial Hospital Foundation. |
| Form 990, Part VI, Section C, line 19 | The Foundation provides the governing documents, conflict of interest policy and financial statement upon request. |
| Form 990, Part VII: | Ada Bair, Hospital CEO, and Teresa Smith, Hospital CFO, are compensated for their services to Memorial Hospital Association. They are not compensated for their services to the Foundation. |
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