2022-11-15T15:17:23-06:00 2021-12-31 FORVIS LLP 3102 WEST END AVENUE SUITE 800 NASHVILLE TN 372031382 990 2021-01-01 822980765 JENNIE STUART HEALTH FOUNDATION INC % TRACEY CLARK JENN 2708870198 PO BOX 608 HOPKINSVILLE KY 42241 TRACEY CLARK EXECUTIVE DIRECTOR 2708870181 2022-11-15 true TRACEY CLARK 999009999 JEFF SMITH P00289876 6159883600 2022-11-14 3 2021 2022-09-23 18:48:47Z TRACEY PATE CLARK PO BOX 608 HOPKINSVILLE KY 42241 335123 false X JENNIESTUARTHEALTH.ORG/FOUNDATION X 2017 KY TO INSPIRE MEANINGFUL GIVING THAT WILL HELP JENNIE STUART MEDICAL CENTER ACCOMMODATE THE GROWING HEALTH CARE NEEDS OF OUR COMMUNITY. 9 8 2 8 0 203006 319116 0 0 11703 16007 0 0 214709 335123 0 12605 0 0 80969 121174 0 0 96442 40344 70648 121313 204427 93396 130696 861486 1068867 1813 0 859673 1068867 TO IMPROVE QUALITY OF LIFE IN THE COMMUNITIES SERVED BY JENNIE STUART MEDICAL CENTER BY ENSURING ACCESS TO EXCEPTIONAL HEALTH CARE AND SUPPORTING INITIATIVES THAT PROMOTE WELL-BEING. false false 79899 THE JENNIE STUART HEALTH FOUNDATION WAS CREATED TO WORK COLLABORATIVELY WITH MEMBERS OF THE COMMUNITY WHO SEEK TO PARTNER WITH JENNIE STUART MEDICAL CENTER IN FUNDRAISING AND TO FURTHER PROMOTE INNOVATION AND ACCESS TO CARE. THE FOUNDATION'S VISION IS TO INSPIRE MEANINGFUL GIVING THAT WILL ALLOW JENNIE STUART HEALTH TO ACCOMMODATE THE GROWING HEALTH CARE NEEDS OF OUR COMMUNITIES AND TO EXPAND SERVICES IN RESPONSE TO ADVANCES IN MEDICINE AND TECHNOLOGY. 79899 true true false false false false false false false false false false false false false false false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 0 0 2 true false false false false false false false false false false false false X 9 8 false false false false true true true true true false false true true true true true true true false false KY X X TRACEY CLARK 2708870181 PO BOX 608 HOPKINSVILLE KY 422410608 TRACEY CLARK EXECUTIVE DIRECTOR 20.0 0.0 X 99635 0 21539 ERIC LEE SECRETARY/JSMC CEO 1.0 40.0 X X 0 0 0 BRECK CAYCE BOARD MEMBER 1.0 0.0 X 0 0 0 TRACEY WILLIAMS CHAIR 1.0 0.0 X X 0 0 0 JOHN MADDUX BOARD MEMBER 1.0 0.0 X 0 0 0 DR RATILAL GAJERA BOARD MEMBER 1.0 0.0 X 0 0 0 LORI HARPER TREASURER 1.0 0.0 X X 0 0 0 ELIZABETH MCCOY VICE CHAIR 1.0 0.0 X X 0 0 0 DERRICK WATSON BOARD MEMBER 1.0 0.0 X 0 0 0 LESLIE CARROLL BOARD MEMBER 1.0 0.0 X 0 0 0 99635 0 21539 0 false false true 0 158077 161039 319116 0 16007 16007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335123 16007 12605 12605 0 0 0 121174 36353 24235 60586 0 0 0 0 0 0 0 0 0 0 0 19413 19413 17846 5354 12492 6812 3406 3406 0 0 0 545 545 0 0 0 0 0 0 DUES & SUBSCRIPTIONS 445 445 MISC EXP 25587 25587 204427 79899 28086 96442 88414 175135 773072 893732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 861486 1068867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1813 0 1813 0 X 82329 76815 777344 992052 859673 1068867 861486 1068867 130696 78498 X false true X true false X X X 1 JENNIE STUART MEDICAL CENTER 610482973 3 true 0 0 1 0 0 true false false false false false false false false false false false false false false true false SCHEDULE A, PART IV, SECTION B, LINE 1 BOARD MEMBER ELECTIONS ------------------------ ALL APPOINTMENTS/TERMINATIONS TO THE FOUNDATION'S BOARD OF DIRECTORS ARE APPROVED BY THE FOUNDATION BOARD, BUT THEN MUST BE RATIFIED BY THE SOLE MEMBER'S BOARD OF TRUSTEES. THE SOLE MEMBER, JSMC, IS THE FOUNDATION'S SUPPORTED ORGANIZATION. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X false false false false false false false false false ERIC LEE SECRETARY/JSMC CEO SCHEDULE J, PART II COMPENSATION FROM UNRELATED ORGANIZATION ------------------------------------------ THE HOSPITAL (JSMC) CONTRACTS THE SERVICES OF ERIC LEE (THE HOSPITAL'S CEO) WITH QHR (FORMERLY QUORUM HEALTH RESOURCES, INC.), AN UNRELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6, 7A & 7B ORGANIZATION MEMBERS -------------------- JENNIE STUART HEALTH FOUNDATION'S SOLE MEMBER IS JENNIE STUART MEDICAL CENTER, INC., (JSMC), PER ARTICLES OF INCORPORATION AND BYLAWS. ALL APPOINTMENTS/TERMINATIONS TO THE FOUNDATION'S BOARD OF DIRECTORS ARE APPROVED BY THE FOUNDATION BOARD, BUT THEN MUST BE RATIFIED BY THE SOLE MEMBER'S BOARD OF TRUSTEES. BECAUSE THE FOUNDATION IS A SUPPORTING ORGANIZATION FOR JSMC AND JSMC IS THE SOLE MEMBER OF THE FOUNDATION, BOARD APPOINTMENTS, BYLAW AND/OR ARTICLE AMENDMENTS, AND HIRING/TERMINATION OF THE EXECUTIVE DIRECTOR ARE SUBJECT TO RATIFICATION BY THE JSMC BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990 ------------------------------- THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTANT AND PROVIDED TO THE FULL BOARD PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12A, 13, & 14 CONFLICT OF INTEREST AND OTHER GOVERNING POLICIES ------------------------------------------------- BOARD MEMBERS ARE REQUIRED TO COMPLETE A STATEMENT OF INTEREST ANNUALLY. ONCE REVIEWED, IF A DISCLOSURE IS MADE, IT MUST BE APPROVED BY THE NON-INTERESTED BOARD MEMBERS. BOARD MEMBERS WITH DISCLOSED INTEREST ARE PROHIBITED FROM VOTING ON ISSUES RELATED TO THEIR INTEREST. ADDITIONALLY, THE FOUNDATION IS IN THE PROCESS OF CREATING A WRITTEN WHISTLEBLOWER POLICY AND RECORD RETENTION POLICY. FORM 990, PART VI, SECTION B, LINE 15A & 15B MANAGEMENT COMPENSATION REVIEW -------------------------------------- THE FOUNDATION'S BOARD OF DIRECTORS CONDUCTED A REVIEW WHEN THE EXECUTIVE DIRECTOR WAS HIRED IN 2018. ANNUAL PERFORMANCE REVIEWS CONDUCTED BY THE BOARD OF DIRECTORS ALSO INCLUDES DECISIONS AS TO MERIT INCREASES OR ANY OTHER COMPENSATION CHANGES. THE HOSPITAL (JSMC) BOARD OF TRUSTEES REVIEWS AND APPROVES THE FOUNDATION'S ANNUAL BUDGET, WHICH INCLUDES ANY CHANGES TO THE EXECUTIVE DIRECTOR'S COMPENSATION. THE EXECUTIVE DIRECTOR IS PAID BY JSMC, A RELATED ORGANIZATION. NO OTHER OFFICERS ARE COMPENSATED FOR FOUNDATION ACTIVITY. JENNIE STUART MEDICAL CENTER 320 W 18TH STREET HOPKINSVILLE KY 42240 610482973 HOSPITAL KY 501(C)(3) 3 NA false false false true false false false false false false false false true true true true false true false true JENNIE STUART MEDICAL CENTER C 151664 FMV JENNIE STUART MEDICAL CENTER S 54424 FMV