JOHNSON COUNTY HEALTH FOUNDATION INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
JOHNSON COUNTY HEALTH FOUNDATION INC (EIN 35-1635296)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-13
IRS object ID
202013189349300431
Schema version
2019v5.0
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)
Return2020-11-13T07:25:40-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

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 Begin2019-01-01TaxPeriodBeginDt

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
Signature2020-11-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDENNIS J HASHPreparerPersonNm
PTINP00381730PTIN
Phone3177382366PhoneNum
Preparation2020-11-13PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address52.38.98.93IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-13IPDt
IP Tm08:20:55IPTm
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdCB537E27ADC87E3C8E55C9509B74770110284007AtSubmissionCreationDeviceId
At Submission Filing Device Id9589093AFECC01655EDC1F7423558E938B18E2B2AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

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$1,105,280GrossReceiptsAmt
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$169,966PYContributionsGrantsAmt
CY Contributions Grants$171,172CYContributionsGrantsAmt
PY Program Service Revenue$51,505PYProgramServiceRevenueAmt
CY Program Service Revenue$47,098CYProgramServiceRevenueAmt
PY Investment Income$123,380PYInvestmentIncomeAmt
CY Investment Income$26,862CYInvestmentIncomeAmt
PY Other Revenue$53,507PYOtherRevenueAmt
CY Other Revenue$14,267CYOtherRevenueAmt
PY Total Revenue$398,358PYTotalRevenueAmt
CY Total Revenue$259,399CYTotalRevenueAmt
PY Grants And Similar Paid$104,024PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$166,248CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$5,250CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$6,819CYTotalFundraisingExpenseAmt
PY Other Expenses$263,161PYOtherExpensesAmt
CY Other Expenses$150,984CYOtherExpensesAmt
PY Total Expenses$367,185PYTotalExpensesAmt
CY Total Expenses$322,482CYTotalExpensesAmt
PY Revenues Less Expenses$31,173PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$63,083CYRevenuesLessExpensesAmt
Total Assets BOY$1,649,837TotalAssetsBOYAmt
Total Assets EOY$1,909,444TotalAssetsEOYAmt
Total Liabilities BOY$51,374TotalLiabilitiesBOYAmt
Total Liabilities EOY$38,378TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,598,463NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,871,066NetAssetsOrFundBalancesEOYAmt
MissionTO RAISE CHARITABLE FUNDS TO BENEFIT JOHNSON MEMORIAL HOSPITAL IN IMPROVING THE HEALTH OF OUR COMMUNITYMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$35,121ExpenseAmt
Grant$29,851GrantAmt
DescNURSING SCHOLARSHIPS AND EDUCATION GRANTS FOR 25 RECIPIENTS, AND FUNDING FOR HOSPITAL EDUCATION REIMBURSEMENT PROGRAM ASSISTED 12 EMPLOYEES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$209,929ExpenseAmt
Grant$136,397GrantAmt
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$43,392ExpenseAmt
Revenue$47,098RevenueAmt
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. IN AUGUST 2019, 54 WOMEN PARTICIPATED IN THE WELLNESS TRIP TO SANTA FE, NEW MEXICO. DURING THE TRIP AN INFORMAL PRESENTATION ABOUT THE FOUNDATION WAS GIVEN. AFTERWARDS, APPROXIMATELY 54 WOMEN REGISTERED TO PARTICIPATE IN THE AUGUST 2020 TRIP TO MACKINAC ISLAND, MICHIGAN. THE 2020 TRIP WAS POSTPONED AND RESCHEDULED TO 2021 DUE TO THE COVID-19 PANDEMIC.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$288,442TotalProgramServiceExpensesAmt
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 Document6IRPDocumentCnt
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 (14 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$0
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
JEFF QUALLS MD
DIRECTOR1.00Yes (X)$0$0$0
JENNIFER L PRICE-TENNELL
DIRECTOR1.00Yes (X)$0$0$0
JENNIFER L PRICE-TENNELL
EXECUTIVE DI40.00Yes (X)$15,032$0$779
KELSEY KASTING
EXECUTIVE DI40.00Yes (X)$36,292$0$3,069
FieldValueIRS element (for citing)
Total Reportable Comp From Org$51,324TotalReportableCompFromOrgAmt
Total Other Compensation$3,848TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Fundraising$132,215FundraisingAmt
All Other Contributions$38,957AllOtherContributionsAmt
Noncash Contributions$13,000NoncashContributionsAmt
Total Contributions$171,172TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescWOMENS OUTDOOR WELLNESSDesc
Business624100BusinessCd
Total Revenue Column$47,098TotalRevenueColumnAmt
Related Or Exempt Func Income$47,098RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$47,098TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,364TotalRevenueColumnAmt
Exclusion$27,364ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$667,261SecuritiesAmt
Other$53,047OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$720,810SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$53,549SecuritiesAmt
Other$53,047OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$502TotalRevenueColumnAmt
Related Or Exempt Func Income-$502RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$139,338FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$132,215ContriRptFundraisingEventAmt
Fundraising Direct Expenses$125,071FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,267TotalRevenueColumnAmt
Exclusion$14,267ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$259,399TotalRevenueColumnAmt
Related Or Exempt Func Income$46,596RelatedOrExemptFuncIncomeAmt
Exclusion$41,631ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$136,397TotalAmt
Program Services$136,397ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$29,851TotalAmt
Program Services$29,851ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$74,695TotalAmt
Program Services$58,262ProgramServicesAmt
Management And General$14,939ManagementAndGeneralAmt
Fundraising$1,494FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$6,020TotalAmt
Program Services$2,712ProgramServicesAmt
Management And General$3,308ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$5,250TotalAmt
Fundraising$5,250FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$11,977TotalAmt
Program Services$4,525ProgramServicesAmt
Management And General$7,452ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,000TotalAmt
Program Services$2,000ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,006TotalAmt
Program Services$570ProgramServicesAmt
Management And General$436ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,752TotalAmt
Program Services$2,927ProgramServicesAmt
Management And General$750ManagementAndGeneralAmt
Fundraising$75FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$484TotalAmt
Program Services$290ProgramServicesAmt
Management And General$194ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
WOMENS OUTDOOR WELLNESS$43,392$43,392
POOH BEAR EXPENSE$5,498$5,498
FOREIGN TAXES PAID$745$745
CATERING$711$569$142

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$704TotalAmt
Program Services$704ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$322,482TotalAmt
Program Services$288,442ProgramServicesAmt
Management And General$27,221ManagementAndGeneralAmt
Fundraising$6,819FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$31,261BOYAmt
EOY$47,347EOYAmt
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$1,499,534BOYAmt
EOY$1,737,331EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$119,042BOYAmt
EOY$124,766EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,649,837BOYAmt
EOY$1,909,444EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$27,611BOYAmt
EOY$12,778EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$23,763BOYAmt
EOY$25,600EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$51,374BOYAmt
EOY$38,378EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,311,607BOYAmt
EOY$1,576,588EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$286,856BOYAmt
EOY$294,478EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,598,463BOYAmt
EOY$1,871,066EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,649,837BOYAmt
EOY$1,909,444EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$63,083ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$335,686NetUnrlzdGainsLossesInvstAmt
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$43,729SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$43,729SupportSumAmt
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$4,680DonorAdvisedFundsContriAmt
Funds And Other Accounts Contri$23,042FundsAndOtherAccountsContriAmt
Donor Advised Funds Grants$13,354DonorAdvisedFundsGrantsAmt
Funds And Other Accounts Grants$34,122FundsAndOtherAccountsGrantsAmt
Donor Advised Funds Vl EOY$21,135DonorAdvisedFundsVlEOYAmt
Funds And Other Accounts Vl EOY$957,454FundsAndOtherAccountsVlEOYAmt
Disclosed Org Leg CtrlfalseDisclosedOrgLegCtrlInd
Disclosed For Charitable PrpsYes (true)DisclosedForCharitablePrpsInd

Other Land Buildings OtherLandBuildingsGrp

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$72,633
JCCF ENDOWMENT - MORGAN TR$51,883
PREPAID EXPENSE - WOW TRIP$250
FieldValueIRS element (for citing)
Total Book Value Other Assets$124,766TotalBookValueOtherAssetsAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GALAEvent1Nm
Gross Receipts Event1$208,187GrossReceiptsEvent1Amt
Charitable Contri Event1$110,175CharitableContriEvent1Amt
Gross Revenue Event1$98,012GrossRevenueEvent1Amt
Cash Prizes Event1$100CashPrizesEvent1Amt
Non Cash Prizes Event1$3,825NonCashPrizesEvent1Amt
Rent Facility Costs Event1$10,547RentFacilityCostsEvent1Amt
Food And Beverage Event1$62,982FoodAndBeverageEvent1Amt
Entertainment Event1$6,424EntertainmentEvent1Amt
Other Direct Expenses Event1$22,116OtherDirectExpensesEvent1Amt
Event2GOLF TOURNAMENTEvent2Nm
Gross Receipts Event2$41,962GrossReceiptsEvent2Amt
Charitable Contri Event2$18,040CharitableContriEvent2Amt
Gross Revenue Event2$23,922GrossRevenueEvent2Amt
Cash Prizes Event2$1,600CashPrizesEvent2Amt
Non Cash Prizes Event2$2,193NonCashPrizesEvent2Amt
Rent Facility Costs Event2$4,340RentFacilityCostsEvent2Amt
Food And Beverage Event2$3,639FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$542OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$21,404GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$4,000CharitableContriOtherEventsAmt
Gross Revenue Other Events$17,404GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events$6,763OthDirectExpnssOtherEventsAmt
Gross Receipts Total$271,553GrossReceiptsTotalAmt
Charitable Contributions Tot$132,215CharitableContributionsTotAmt
Gross Revenue Total Events$139,338GrossRevenueTotalEventsAmt
Cash Prizes Total Events$1,700CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$6,018NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$14,887RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$66,621FoodAndBeverageTotalEventsAmt
Entertainment Total Events$6,424EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$29,421OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$125,071DirectExpenseSummaryEventsAmt
Net Income Summary$14,267NetIncomeSummaryAmt

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$40,958OPERATIONS / DEPT.
ADULT & CHILD MENTAL HEALTH CENTER
1860 NORTHWOOD PLAZAFRANKLININ46131351534713$87,939BEHAVIORAL HEALTH
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt

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

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
SCHOLAR. - HEALTH FIELD13$13,354
SCHOLAR. - NURSING DEGREE5$8,000
EDUC. ASSIST. - BSN/NURSE12$3,697
SCHOLAR. - ASN/BSN6$4,800

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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