JOHNSON COUNTY HEALTH FOUNDATION INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
JOHNSON COUNTY HEALTH FOUNDATION INC (EIN 35-1635296)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202223199349322952
Schema version
2021v4.0
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)
Return2022-11-15T16:44:10-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN352140590PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1HASH CPA GROUP LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 637AddressLine1Txt
CityFRANKLINCityNm
State AbbreviationINStateAbbreviationCd
ZIP461310637ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351635296EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHNSON COUNTY HEALTH FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlJOHNBusinessNameControlTxt
Phone3173463703PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 549AddressLine1Txt
CityFRANKLINCityNm
State AbbreviationINStateAbbreviationCd
ZIP461310549ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDOUG STEWARTPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone3173463703PhoneNum
Signature2022-11-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDOUGPersonFirstNm
Person LastSTEWARTPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDENNIS J HASHPreparerPersonNm
PTINP00381730PTIN
Phone3177382366PhoneNum
Preparation2022-11-11PreparationDt
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1JOHNSON MEMORIAL HOSPITAL FDNBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDOUG STEWARTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 549AddressLine1Txt
CityFRANKLINCityNm
State AbbreviationINStateAbbreviationCd
ZIP46131ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,106,565GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1985FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionTO RAISE CHARITABLE FUNDS TO BENEFIT JOHNSON MEMORIAL HOSPITAL IN IMPROVING THE HEALTH OF OUR COMMUNITYActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers40TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$182,079PYContributionsGrantsAmt
CY Contributions Grants$174,570CYContributionsGrantsAmt
CY Program Service Revenue$41,041CYProgramServiceRevenueAmt
PY Investment Income$56,247PYInvestmentIncomeAmt
CY Investment Income$209,898CYInvestmentIncomeAmt
PY Other Revenue$16,465PYOtherRevenueAmt
CY Other Revenue$64,408CYOtherRevenueAmt
PY Total Revenue$254,791PYTotalRevenueAmt
CY Total Revenue$489,917CYTotalRevenueAmt
PY Grants And Similar Paid$190,124PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$107,835CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$1,750PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$2,500CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$4,194CYTotalFundraisingExpenseAmt
PY Other Expenses$110,522PYOtherExpensesAmt
CY Other Expenses$149,469CYOtherExpensesAmt
PY Total Expenses$302,396PYTotalExpensesAmt
CY Total Expenses$259,804CYTotalExpensesAmt
PY Revenues Less Expenses-$47,605PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$230,113CYRevenuesLessExpensesAmt
Total Assets BOY$2,053,439TotalAssetsBOYAmt
Total Assets EOY$2,371,114TotalAssetsEOYAmt
Total Liabilities BOY$36,108TotalLiabilitiesBOYAmt
Total Liabilities EOY$27,523TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,017,331NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,343,591NetAssetsOrFundBalancesEOYAmt
MissionTO RAISE CHARITABLE FUNDS TO BENEFIT JOHNSON MEMORIAL HOSPITAL IN IMPROVING THE HEALTH OF OUR COMMUNITYMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$39,194ExpenseAmt
Grant$32,718GrantAmt
DescNURSING SCHOLARSHIPS AND EDUCATION GRANTS FOR 19 RECIPIENTS AND FUNDING FOR HOSPITAL EDUCATION REIMBURSEMENT PROGRAM ASSISTED 7 EMPLOYEES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$149,449ExpenseAmt
Grant$75,117GrantAmt
DescSUPPORT OF HEALTHIER COMMUNITY PROGRAMS AND SERVICES, INCLUDING TO PROMOTE AND SUPPORT SERVICES OF THE HOSPITAL AND AFFILIATES, AND ASSIST DEPARTMENTS WITH NEW TECHNOLOGY UPDATES. PROVIDE HOSPITAL STAFF WITH INFORMATION AND RESOURCES FOR PROMOTING HEALTHY LIVING AND PROVIDING QUALITY CARE. PROMOTE AWARENESS, CARING, AND UNITY AMONG HOSPITAL STAFF. PROMOTE LOCAL ORGANIZATIONS THAT PROVIDE PROGRAMS FOR HEALTHY FAMILIES, SCHOOL, AND REHAB SERVICES.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$37,558ExpenseAmt
Revenue$41,041RevenueAmt
DescBEGAN WORKING WITH COMMUNITY LEADERS IN 2014 TO SERVE AS FISCAL AGENT FOR WOMENS OUTDOOR WELLNESS CHALLENGE TRIP. THIS ANNUAL WEEK LONG ADVENTURE TRIP IS AVAILABLE TO ALL WOMEN, AND PROVIDES A WEEK OF ORGANIZED OUTDOOR ACTIVITIES TO MOTIVATE AND ENCOURAGE HEALTHY LIFESTYLES. BY SERVING AS THE FISCAL AGENT, WE GENERATE AWARENESS OF THE FOUNDATION'S MISSION AND DEVELOP RELATIONSHIPS THAT CULTIVATE FUTURE DONORS AND CONNECT WITH CURRENT DONORS. THE SEPTEMBER 2021 TRIP TO MACKINAC ISLAND, MI HAD 52 PARTICIPANTS. THE 2022 TRIP TO ESTES PARK, CO HAD 53 PARTICIPANTS. THERE ARE CURRENTLY 54 REGISTERED FOR THE 2023 TRIP TO UTAH.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$226,201TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundYes (true)DonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
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 EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
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 Members12GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
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 CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKELSEY KASTINGPersonNm
Phone3173463703PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11125 W JEFFERSON STAddressLine1Txt
CityFRANKLINCityNm
State AbbreviationINStateAbbreviationCd
ZIP46131ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
DOUG STEWART
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
DAVID DUNKLE MD
VICE PRESIDE1.00Yes (X)Yes (X)$0$0$040.00
THOMAS THOMPSON
SECRETARY /1.00Yes (X)Yes (X)$0$0$00.00
JERRY ENGLE
DIRECTOR1.00Yes (X)$0$0$02.00
JOHN W AULD JR
DIRECTOR1.00Yes (X)$0$0$0
JEFFREY OWEN
DIRECTOR1.00Yes (X)$0$0$0
SANDI HUDDLESTON
DIRECTOR1.00Yes (X)$0$0$02.00
LYNN GRAY
DIRECTOR1.00Yes (X)$0$0$0
JOHN NORRIS MD
DIRECTOR1.00Yes (X)$0$0$0
ANGELA MORRIS
DIRECTOR1.00Yes (X)$0$0$0
RYAN WHITE MD
DIRECTOR1.00Yes (X)$0$0$0
JENNIFER L PRICE
DIRECTOR1.00Yes (X)$0$0$0
KELSEY KASTING
EXECUTIVE DI40.00Yes (X)$61,212$0$3,500
FieldValueIRS element (for citing)
Total Reportable Comp From Org$61,212TotalReportableCompFromOrgAmt
Total Other Compensation$3,500TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Fundraising$117,700FundraisingAmt
All Other Contributions$56,870AllOtherContributionsAmt
Noncash Contributions$11,490NoncashContributionsAmt
Total Contributions$174,570TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescWOMENS OUTDOOR WELLNESSDesc
Business624100BusinessCd
Total Revenue Column$41,041TotalRevenueColumnAmt
Related Or Exempt Func Income$41,041RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$41,041TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,256TotalRevenueColumnAmt
Exclusion$38,256ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$635,712SecuritiesAmt
Other$99,601OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$563,671SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$72,041SecuritiesAmt
Other$99,601OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$171,642TotalRevenueColumnAmt
Related Or Exempt Func Income$171,642RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$117,385FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$117,700ContriRptFundraisingEventAmt
Fundraising Direct Expenses$52,977FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$64,408TotalRevenueColumnAmt
Exclusion$64,408ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$489,917TotalRevenueColumnAmt
Related Or Exempt Func Income$212,683RelatedOrExemptFuncIncomeAmt
Exclusion$102,664ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$75,117TotalAmt
Program Services$75,117ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$32,718TotalAmt
Program Services$32,718ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$81,621TotalAmt
Program Services$63,665ProgramServicesAmt
Management And General$16,324ManagementAndGeneralAmt
Fundraising$1,632FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$5,780TotalAmt
Program Services$2,568ProgramServicesAmt
Management And General$3,212ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$2,500TotalAmt
Fundraising$2,500FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$14,616TotalAmt
Program Services$5,901ProgramServicesAmt
Management And General$8,715ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$716TotalAmt
Program Services$409ProgramServicesAmt
Management And General$307ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,100TotalAmt
Program Services$2,418ProgramServicesAmt
Management And General$620ManagementAndGeneralAmt
Fundraising$62FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$293TotalAmt
Program Services$176ProgramServicesAmt
Management And General$117ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
WOMENS OUTDOOR WELLNESS$37,558$37,558
POOH BEAR EXPENSE$3,463$3,463
REFLECTION GARDEN EXPENSE$782$782
CATERING$570$456$114

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$970TotalAmt
Program Services$970ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$259,804TotalAmt
Program Services$226,201ProgramServicesAmt
Management And General$29,409ManagementAndGeneralAmt
Fundraising$4,194FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$35,588BOYAmt
EOY$55,299EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,740LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,740LandBldgEquipAccumDeprecAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,883,965BOYAmt
EOY$2,164,921EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$133,886BOYAmt
EOY$150,894EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,053,439BOYAmt
EOY$2,371,114EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,508BOYAmt
EOY$4,693EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$25,600BOYAmt
EOY$22,830EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$36,108BOYAmt
EOY$27,523EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,704,518BOYAmt
EOY$2,004,518EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$312,813BOYAmt
EOY$339,073EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,017,331BOYAmt
EOY$2,343,591EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,053,439BOYAmt
EOY$2,371,114EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$230,113ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$96,147NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1JOHNSON MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN351166081EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$12,272SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$12,272SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSUPPLEMENTAL INFORMATIONFormAndLineReferenceDesc
ExplanationDURING THE TAX YEAR, THE JOHNSON COUNTY HEALTH FOUNDATION SUPPORTED JOHNSON MEMORIAL HOSPITAL BY SUPPORTING THE STAFF AND PROVIDING OTHER OPERATIONS SUPPORT. THEY ALSO ADMINISTERED FUNDS TO UPDATE HOSPITAL DEPARTMENTS AND AFFILIATES WITH NEW TECHNOLOGY TO PROVIDE QUALITY CARE.ExplanationTxt

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

FieldValueIRS element (for citing)
Donor Advised Funds Held1DonorAdvisedFundsHeldCnt
Funds And Other Accounts Held8FundsAndOtherAccountsHeldCnt
Donor Advised Funds Contri$5,026DonorAdvisedFundsContriAmt
Funds And Other Accounts Contri$35,379FundsAndOtherAccountsContriAmt
Donor Advised Funds Grants$13,000DonorAdvisedFundsGrantsAmt
Funds And Other Accounts Grants$23,925FundsAndOtherAccountsGrantsAmt
Donor Advised Funds Vl EOY$18,628DonorAdvisedFundsVlEOYAmt
Funds And Other Accounts Vl EOY$1,201,299FundsAndOtherAccountsVlEOYAmt
Disclosed Org Leg CtrlfalseDisclosedOrgLegCtrlInd
Disclosed For Charitable PrpsYes (true)DisclosedForCharitablePrpsInd

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,740OtherCostOrOtherBasisAmt
Depreciation$2,740DepreciationAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
JCCF ENDOWMENT - GENERAL FD$83,678
JCCF ENDOWMENT - MORGAN TR$59,743
PREPAID EXPENSE - WOW TRIP$7,473
FieldValueIRS element (for citing)
Total Book Value Other Assets$150,894TotalBookValueOtherAssetsAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GALAEvent1Nm
Gross Receipts Event1$172,605GrossReceiptsEvent1Amt
Charitable Contri Event1$99,500CharitableContriEvent1Amt
Gross Revenue Event1$73,105GrossRevenueEvent1Amt
Cash Prizes Event1$2,775CashPrizesEvent1Amt
Non Cash Prizes Event1$5,576NonCashPrizesEvent1Amt
Food And Beverage Event1$1,406FoodAndBeverageEvent1Amt
Entertainment Event1$4,190EntertainmentEvent1Amt
Other Direct Expenses Event1$20,021OtherDirectExpensesEvent1Amt
Event2GOLF TOURNAMENTEvent2Nm
Gross Receipts Event2$41,085GrossReceiptsEvent2Amt
Charitable Contri Event2$14,500CharitableContriEvent2Amt
Gross Revenue Event2$26,585GrossRevenueEvent2Amt
Cash Prizes Event2$2,200CashPrizesEvent2Amt
Non Cash Prizes Event2$2,536NonCashPrizesEvent2Amt
Rent Facility Costs Event2$3,887RentFacilityCostsEvent2Amt
Food And Beverage Event2$2,121FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$619OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$21,395GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$3,700CharitableContriOtherEventsAmt
Gross Revenue Other Events$17,695GrossRevenueOtherEventsAmt
Cash Prizes Other Events$350CashPrizesOtherEventsAmt
Non Cash Prizes Other Events$424NonCashPrizesOtherEventsAmt
Rent Fclty Costs Other Events$1,400RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events$1,516FoodAndBeverageOtherEventsAmt
Entertainment Other Events$100EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events$3,856OthDirectExpnssOtherEventsAmt
Gross Receipts Total$235,085GrossReceiptsTotalAmt
Charitable Contributions Tot$117,700CharitableContributionsTotAmt
Gross Revenue Total Events$117,385GrossRevenueTotalEventsAmt
Cash Prizes Total Events$5,325CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$8,536NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$5,287RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$5,043FoodAndBeverageTotalEventsAmt
Entertainment Total Events$4,290EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$24,496OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$52,977DirectExpenseSummaryEventsAmt
Net Income Summary$64,408NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
ST THOMAS CLINIC
600 PAUL HAND BLVDFRANKLININ461313514493793$7,500OPERATION SUPPORT
JOHNSON MEMORIAL HOSPITAL
1125 W JEFFERSONFRANKLININ46131351166081$6,707OPERATIONS / DEPT.
ADULT & CHILD MENTAL HEALTH CENTER
1860 NORTHWOOD PLAZAFRANKLININ46131351534713$60,910BEHAVIORAL HEALTH
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (4 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
SCHOLAR. - HEALTH FIELD13$13,000
SCHOLAR. - NURSING DEGREE6$13,500
EDUC. ASSIST. - BSN/NURSE7$5,018
SCHOLAR. - ASN/BSN2$1,200

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION REVIEWS APPLICATIONS TO DETERMINE WHICH SCHOLARSHIP RECIPIENTS WOULD MOST BE IN LINE WITH THE ORGANIZATION'S MISSION. ONCE SCHOLARSHIPS ARE AWARDED, THE CHECKS ARE WRITTEN DIRECTLY TO THE SCHOOL TO GUARANTEE THAT FUNDS ARE USED FOR THEIR INTENDED PURPOSE. THE ORGANIZATION WORKS CLOSELY WITH ST. THOMAS CLINIC, JOHNSON MEMORIAL HOSPITAL, AND ADULT & CHILD MENTAL HEALTH CENTER AND CAN OBSERVE THE PROGRAMS FIRST HAND.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE FORM 990 IS DISTRIBUTED TO ALL BOARD MEMBERS WHEN COMPLETE. WHEN THE BOARD MEMBERS ARE SATISFIED WITH ITS CONTENT, THE RETURN IS FILED.
FORM 990, PAGE 6, PART VI, LINE 12CSITUATIONS THAT GIVE RISE TO POSSIBLE CONFLICTS OF INTEREST ARE DISCUSSED AS THEY OCCUR TO DETERMINE THE BEST COURSE OF ACTION. EACH BOARD MEMBER COMPLETES AN ANNUAL CONFLICT OF INTEREST STATEMENT.
FORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND ANNUAL FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1JOHNSON MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11125 W JEFFERSONAddressLine1Txt
CityFRANKLINCityNm
State AbbreviationINStateAbbreviationCd
ZIP46131ZIPCd
FieldValueIRS element (for citing)
EIN351166081EIN
Primary ActivitiesCO HOSPITAPrimaryActivitiesTxt
Legal Domicile StateINLegalDomicileStateCd
Exempt Code SectionGOVTExemptCodeSectionTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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