2021-03-28T18:01:57-05:00 2020-06-30 450250985 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2019-07-01 431975486 Friends of FMC Foundation Inc FRIE 4067783331 PO Box 820 Baker MT 59313 Rosanne Varner President of Board 4067783331 2021-03-28 1 Kim C Hunwardsen P00484560 6122536500 2021-03-28 2019 2022-09-23 18:48:47Z Rosanne Varner PO Box 820 Baker MT 59313 60824 0 X www.fallonmedical.org X 2002 MT To coordinate Fallon Medical Complex, Inc's fundraising programs. 7 6 0 31 0 0 38129 9400 0 0 43808 20694 11162 9256 93099 39350 21512 7982 0 0 0 0 0 0 0 13083 12742 34595 20724 58504 18626 1357259 1386008 0 0 1357259 1386008 To help ensure the continuing quality of local healthcare services for our community. "Friends Helping Friends" 0 0 6732 6732 The purpose of Friends of Fallon Medical Complex Foundation is to provide, through all of its funds and activities, direct or indirect benefit to Fallon Medical Complex (FMC), a not-for-profit healthcare corporation, in support of its mission, so long as FMC qualifies as an organization described in Section 501(c)(3) of the Internal Revenue Code. The Foundation obtains and receives contributions, donations, gifts, or bequests entirely for the development of one or more endowment funds, to be used for financial assistance to FMC for medical education, equipment upgrades and purchases, physical plant improvements and additions, personnel programs, and any aspect of promotion and public relations devoted to the delivery of health care services in FMC's service area. 1250 1250 The Friends of Fallon Medical Complex Foundation distributes funds from its capital pool for the purpose of funding scholarships to students from our service area that are pursuing a formal education in a healthcare-related field. The scholarship process is governed by established formal program criteria that define how requests are to be submitted by applicants and how they are to be evaluated by the Board of Directors. The board awarded 4 scholarships of $500, one $500 was awarded during the year, the other 3 were awarded $250 per semester and 3 ($250) were paid out during this fiscal year. The remaining $250 for each recipient will be disbursed next fiscal year. 7982 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 7 6 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X Marjorie Losing 4067785303 PO Box 820 Baker MT 59313 Karol Zachmann Foundation Director 19.00 21.00 X 0 44457 20060 Cori Thurlow Secretary/Treasurer 0.50 40.00 X X 0 40288 2188 Rosanne Varner President 0.50 0.00 X X 0 0 0 Craig Pinnow Vice President 0.50 0.00 X X 0 0 0 Kim Cuppy Director 0.50 0.00 X 0 0 0 Doug Varner Director 0.50 0.50 X 0 0 0 Mike Griffith Director 0.50 0.00 X 0 0 0 David Stevens Director 0.50 0.00 X 0 0 0 0 84745 22248 0 0 0 0 0 7700 1055 645 1055 9400 32804 32804 12110 -12110 -12110 -12110 18620 7700 9364 9256 9256 39350 0 0 29950 6732 6732 1250 1250 420 420 2900 2900 9391 9391 -931 -931 1054 1054 -92 -92 20724 7982 12742 0 1357259 1386008 1357259 1386008 0 0 X 1025200 964855 332059 421153 1357259 1386008 1357259 1386008 18626 10123 0 X 0 1 X 1 0 X 24411 25354 20480 38129 9400 117774 24411 25354 20480 38129 9400 117774 27116 90658 26721 22670 26083 33100 32804 141378 259152 112105 0.34980 0.35850 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 255821 2754 258575 244418 10000 1403 255821 243715 703 244418 243034 681 243715 230502 10000 2532 243034 0.16260 0.74660 0.09080 0 0 0 X 90655 10123 31818 41941 48714 -9364 -9364 39350 61906 31818 9364 41182 20724 0 20724 Part V, Line 4: Permanently restricted funds are used to provide a source of income to be used for Long Term Care, and/or equipment purchases on behalf of Fallon Medical Complex, and for scholarships. Principal has been invested and the generated income (temporarily restricted) is used for said purpose. Part X, Line 2: The Foundation believes it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Foundation would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 4b - Other Adjustments: Fundraising expenses in revenue for tax purposes -9,364. Part XII, Line 2d - Other Adjustments: Fundraising expenses in revenue for tax purposes 9,364. Luncheon 16177 6073 10104 50 1424 16177 6073 10104 50 1424 1474 8630 1 Fallon Medical Center 202 S 4th St W Baker MT 59313 363808993 501(c)(3) 6732 General Support 1 0 Part I, Line 2: The Hospital has a formal process in place in order to request funds from the Foundation. The Foundation board of directors must approve any amounts requested by the Hospital. In this process the Hospital must describe what they are requesting. Form 990, Part VI, Section A, line 2 Karol Zachmann and David Stevens have a family relationship. Doug Varner and Rosanne Varner have a family relationship. Doug Varner has a business relationship with Karol Zachmann and Cori Thurlow. Form 990, Part VI, Section A, line 8b The organization does not have a committee that acts on behalf of the governing body. Form 990, Part VI, Section B, line 11b Information for the Form 990 is compiled by the executive staff. The corporation's accountants prepare the form which is emailed or mailed to the Board of Directors for the review and comment during one of their regular meetings prior to filing with the IRS. Form 990, Part VI, Section B, line 12c The Organization's conflict of interest policy requires a duty to disclose any conflicts annually as well as during discussions. The policy covers all members of the board. Board Members complete a questionnaire annually addressing potential areas of conflicts. Conflicts are determined by each individual. If a conflict arises, the board member abstains from voting on matters that gave rise to the conflict. Form 990, Part VI, Section B, line 15 The Foundation Director is paid by Fallon Medical Complex, a related organization, for her services to both the Foundation and the Fallon Medical Complex. Fallon Medical Complex uses the Montana Hospital Association (MHA) annual compensation data to help determine compensation for employees including the Foundation director. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy and financial statements are available for public inspection at the corporation's place of business upon request. Fallon Medical Center 202 S 4th St W Baker MT 59313 363808993 Critical Access Hospital MT 501(c)(3) Line 3 N/A 0 0 1 1 0 0 0 0 0 0 0 1 0 1 1 1 1 0 0 0