2020-11-12T15:24:05-06:00 2019-12-31 621517792 PYA P C 2220 SUTHERLAND AVE KNOXVILLE TN 37919 990 2019-01-01 480862732 SUSAN B ALLEN MEMORIAL HOSPITAL FOUNDATION SUSA 3163213300 720 WEST CENTRAL EL DORADO KS 67042 LEONARD HERNANDEZ PRESIDENT AND CEO 3163213300 2020-11-12 1 DEBORAH O ERNSBERGER P00364912 8656730844 50.228.55.2 2020-11-12 15:24:01 ES P 14A939F37EE00550E3D549020679067564A57D08 AF23F2A68CFF53983216DF8908F842EE3670BFA3 2019 2021-01-29 14:40:06Z LEONARD HERNANDEZ 720 WEST CENTRAL EL DORADO KS 67042 411503 0 X SBAMHFOUNDATION.COM X 1977 KS PHILANTHROPIC PRIORITIES AT THE SUSAN B. ALLEN MEMORIAL HOSPITAL FOUNDATION REFLECT A FOCUS ON FULFILLING THE NEEDS OF SUSAN B. ALLEN MEMORIAL HOSPITAL. 12 12 0 12 0 0 384497 216151 0 0 264321 167291 19260 -11508 668078 371934 125570 116669 0 0 0 0 0 0 20953 36785 39540 162355 156209 505723 215725 2639871 3017525 152866 49808 2487005 2967717 SEE SCHEDULE O 0 0 116669 116669 IN 2019, DONOR SUPPORT OF NUMEROUS PROJECTS PROVIDED VALUABLE FUNDING TO ADVANCE OUR MISSION OF TAKING CARE OF THE COMMUNITY. SUSAN B. ALLEN IS PROUD TO CONTINUE TO OFFER NEW INITIATIVES TO CONTINUE TO PROVIDE EXCELLENT PATIENT CARE TO OUR COMMUNITY MEMBERS. 116669 1 1 0 0 0 1 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 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 12 12 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 KS X CINDI STRACK 3163213300 720 WEST CENTRAL EL DORADO KS 67042 STEVE FUNK PRESIDENT 1.00 X X 0 0 0 DAN DAVIS VICE PRESIDENT 1.00 X X 0 0 0 MICHAEL DENTON SECRETARY/TREASURER 1.00 X X 0 0 0 EMILY CONNELL PAST PRESIDENT 1.00 X X 0 0 0 KATIE BANKS-TODD DIRECTOR 1.00 X 0 0 0 MICHAEL CLIFTON DIRECTOR 1.00 1.00 X 0 0 0 BARBARA DANKERT DIRECTOR 1.00 X 0 0 0 JOYCE DEMO DIRECTOR 1.00 X 0 0 0 RYAN LIESS DIRECTOR 1.00 X 0 0 0 ASHLYN LINDSKOG DIRECTOR 1.00 X 0 0 0 JUSTIN PARSONS DIRECTOR 1.00 X 0 0 0 MICHAEL SCHWANKE DIRECTOR 1.00 X 0 0 0 HOLLY LANDON EXECUTIVE DIRECTOR, SBAMH FOUNDATION 40.00 X 0 42656 5363 JONATHAN IMMORDINO CHIEF FINANCIAL OFFICER 1.00 40.00 X 0 72256 4804 DIANE DEBLON CHIEF FINANCIAL OFFICER 1.00 40.00 X 0 44404 5303 JAMES KIRKBRIDE CHIEF EXECUTIVE OFFICER 1.00 40.00 X 0 328168 9560 0 487484 25030 0 0 1 0 0 138407 77744 216151 55727 55727 111564 0 111564 111564 111564 28061 138407 39569 -11508 -11508 371934 0 0 155783 116669 116669 10527 10527 FUNDRAISING EXPENSE 20953 20953 BANK FEES 3318 3318 TRANSPORTATION EXPENSE 2487 2487 DONOR APPRECIATION EXPE 1718 1718 537 537 156209 116669 18587 20953 541941 343083 4000 8460 2093930 2665982 2639871 3017525 152866 49808 152866 49808 X 1671205 2043241 815800 924476 2487005 2967717 2639871 3017525 X 215725 259987 5000 X 0 1 X 1 0 X X X 1 SUSAN B ALLEN MEMORIAL HOSPITAL 480581968 3 1 116669 0 1 116669 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 181093 1 1 1963579 5300 573174 10527 2531526 2141962 9966 -178045 10304 1963579 1887242 20087 243725 9092 2141962 1568899 220239 105714 7610 1887242 1570557 94805 -15692 73371 7400 1568899 0.77900 0.17500 0.04600 0 0 0 X 791822 259987 129177 44569 433733 358089 13845 13845 371934 311110 129177 39569 168746 142364 13845 13845 156209 PART V, LINE 4: EARNINGS FROM THE ENDOWMENT FUNDS ARE USED TO FUND THE PURCHASE OF EQUIPMENT AND PROGRAM SUPPORT FOR SUSAN B. ALLEN MEMORIAL HOSPITAL. PART X, LINE 2: THE HOSPITAL AND FOUNDATION ARE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND A SIMILAR PROVISION OF STATE LAW. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL AND FOUNDATION HAVE NO UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2019 OR 2018. AT DECEMBER 31, 2019, TAX RETURNS FOR YEARS 2016 THROUGH 2018 ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE 39,569. CONTRIBUTIONS IN NET ASSETS 5,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE 39,569. GALA 160661 133200 27461 5006 21300 500 10672 CAR SHOW 5807 5207 600 450 1641 166468 138407 28061 5006 21300 950 12313 39569 -11508 1 SUSAN B ALLEN MEMORIAL HOSPITAL 720 WEST CENTRAL EL DORADO KS 67042 480581968 501(C)(3) 116669 FINANCIAL SUPPORT 1 PART I, LINE 2: ALL GRANT REQUESTS ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. ALL GRANTS ARE MADE TO SUSAN B. ALLEN MEMORIAL HOSPITAL, A RELATED 501(C)(3) ORGANIZATION. 0 0 0 0 1 0 0 0 0 JAMES KIRKBRIDE CHIEF EXECUTIVE OFFICER 0 233736 0 82833 0 11599 0 8310 0 1250 0 337728 0 0 SCHEDULE J, PART I, LINE 5B JAMES KIRKBRIDE'S COMPENSATION IS PAID BY SUSAN B. ALLEN MEMORIAL HOSPITAL. FORM 990, PART III, LINE 1 THE SUSAN B. ALLEN MEMORIAL HOSPITAL FOUNDATION IS DEDICATED TO HELPING THE HOSPITAL FULFILL ITS MISSION OF PROVIDING COMPASSIONATE, PROFESSIONAL HEALTHCARE TO THE COMMUNITIES WE SERVE. ACTING AS THE FUNDRAISING ARM OF SUSAN B. ALLEN MEMORIAL HOSPITAL (SBAMH), THE FOUNDATION ACCEPTS CHARITABLE GIFTS TO BE USED FOR MAINTAINING AND IMPROVING THE PROGRAMS AND SERVICES AT THE HOSPITAL THAT WILL HAVE A POSITIVE IMPACT ON THE HEALTH OF OUR COMMUNITIES. FORM 990, PART VI, SECTION A, LINE 6 SUSAN B. ALLEN MEMORIAL HOSPITAL IS THE SOLE MEMBER OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, SUSAN B. ALLEN MEMORIAL HOSPITAL, HAS THE RIGHT TO ELECT BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE HOSPITAL MEMBER HAS THE RIGHT TO APPROVE: AMENDMENT TO THE ARTICLES OF INCORPORATION OF THE CORPORATION; AMENDMENT OF THE BYLAWS OF THE CORPORATION; ANY MERGER, SALE OF SUBSTANTIALLY ALL OF THE ASSETS OR DISSOLUTION OF THE CORPORATION; INCURRING ANY DEBT BY THE CORPORATION; AND THE RIGHT TO ELECT OR REMOVE BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY SUSAN B. ALLEN MEMORIAL HOSPITAL (SOLE MEMBER) ACCOUNTING/FOUNDATION STAFF, CFO AND CEO. ANY QUESTIONS OR CONCERNS HAD ARE ADDRESSED AND ANY CLARIFICATION OR CORRECTIONS THAT NEED TO BE MADE ARE MADE. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD OF DIRECTORS IS REQUIRED AT THE TIME OF HIRE OR ELECTION, AND ANNUALLY THEREAFTER, TO REVIEW THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY RELATIONSHIPS, POSITIONS OR CIRCUMSTANCES OF WHICH A CONFLICT OF INTEREST MAY ARISE. THE ANNUAL REVIEW AND MONITORING OF THE CONFLICT OF INTEREST POLICY IS A PART OF THE FOUNDATION'S CORPORATE COMPLIANCE PLAN. ANY POTENTIAL CONFLICTS DISCLOSED ON THE INTEREST DISCLOSURE STATEMENTS ARE REPORTED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CONTRIBUTIONS IN NET ASSETS 5,000. SUSAN B ALLEN MEMORIAL HOSPITAL 720 WEST CENTRAL EL DORADO KS 67042 480581968 HOSPITAL KS 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 1 1 0 1 0