HUDSON HOSPITAL FOUNDATION: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- HUDSON HOSPITAL FOUNDATION (EIN 39-1279567)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-15
- IRS object ID
- 202013209349301726
- Schema version
- 2019v5.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-15T19:02:26-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 WELLS FARGO CENTER 90 SOUTH | AddressLine1Txt |
| Address Line2 | 7TH ST | AddressLine2Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391279567 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUDSON HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HUDS | BusinessNameControlTxt |
| Phone | 7155316000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 405 STAGELINE ROAD | AddressLine1Txt |
| City | HUDSON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54016 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOUGLAS E JOHNSON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7155316000 | PhoneNum |
| Signature | 2020-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MONROE JORDAN GIERL | PreparerPersonNm |
| PTIN | P01413237 | PTIN |
| Phone | 6123055000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 198.153.9.216 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-13 | IPDt |
| IP Tm | 11:49:49 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 763097D6A2B3EA9277A508CC789A2C5E6C07E1F2 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 763097D6A2B3EA9277A508CC789A2C5E6C07E1F2 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DOUGLAS E JOHNSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 405 STAGELINE ROAD | AddressLine1Txt |
| City | HUDSON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54016 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,331,540 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HUDSONHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO SUPPORT AND CARRY OUT THE CHARITABLE PURPOSE OF HUDSON HOSPITAL, INC. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 27 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $861,152 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,137,479 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $89,499 | PYInvestmentIncomeAmt |
| CY Investment Income | $150,356 | CYInvestmentIncomeAmt |
| PY Other Revenue | $58,094 | PYOtherRevenueAmt |
| CY Other Revenue | $22,937 | CYOtherRevenueAmt |
| PY Total Revenue | $1,008,745 | PYTotalRevenueAmt |
| CY Total Revenue | $1,310,772 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $90,452 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $103,430 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $80,486 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $378,809 | PYOtherExpensesAmt |
| CY Other Expenses | $350,382 | CYOtherExpensesAmt |
| PY Total Expenses | $469,261 | PYTotalExpensesAmt |
| CY Total Expenses | $453,812 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $539,484 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $856,960 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,948,478 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,215,419 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $156,391 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $119,503 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,792,087 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,095,916 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SUPPORT, ACT FOR THE BENEFIT OF, AND CARRY OUT THE CHARITABLE PURPOSE OF HUDSON HOSPITAL, INC. BY SUPPORTING COMMUNITY HEALTH EDUCATION, PROVIDING HOME CARE ASSISTANCE, AND CONTRIBUTING TO OTHER HEALTH RELATED CHARITABLE ENDEAVORS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $343,236 | ExpenseAmt |
| Grant | $103,430 | GrantAmt |
| Revenue | $8,683 | RevenueAmt |
| Desc | SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS | Desc |
| Total Program Service Expenses | $343,236 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | Yes (1) | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | 0 | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | 0 | TaxableDistributionsInd |
| Distribution To Donor | 0 | DistributionToDonorInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLAS E JOHNSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6514304581 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 405 STAGELINE ROAD | AddressLine1Txt |
| City | HUDSON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54016 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| MATT CARON | |||||||
| DIRECTOR & VICE CHAIR | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BECKY DURHAM | |||||||
| DIRECTOR | 0.25 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TOM GALLAGHER | |||||||
| DIRECTOR | 0.25 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DOUGLAS JOHNSON | |||||||
| CFO | 0.50 | 54.50 | Yes (X) | Yes (X) | $0 | $380,795 | $153,262 |
| MELISSA KOLB | |||||||
| DIRECTOR | 0.25 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| STEVEN KINNEY | |||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| STEPHEN LINES | |||||||
| DIRECTOR & CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KATIE KRANZ | |||||||
| DIRECTOR | 0.25 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| RANDY LAFAIVE | |||||||
| DIRECTOR & TREASURER | 0.25 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARTIN RICHARDS MD | |||||||
| DIRECTOR | 0.25 | 0.00 | Yes (X) | $0 | $490,399 | $57,228 | |
| MIKE SELLMAN | |||||||
| DIRECTOR | 0.25 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS BOROWSKI | |||||||
| INTERIM PRESIDENT (AUG-DEC) | 1.00 | 54.00 | Yes (X) | Yes (X) | $0 | $316,394 | $61,631 |
| JOHN MALMBERG | |||||||
| DIRECTOR | 0.25 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KAREN K RAMBO | |||||||
| PRESIDENT JAN-AUG | 40.00 | 0.00 | Yes (X) | $0 | $153,086 | $16,144 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,340,674 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $288,265 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $112,270 | FundraisingAmt |
| Related Organizations | $337,185 | RelatedOrganizationsAmt |
| All Other Contributions | $688,024 | AllOtherContributionsAmt |
| Total Contributions | $1,137,479 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $150,356 | TotalRevenueColumnAmt |
| Exclusion | $150,356 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $10,960 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $2,277 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $8,683 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,683 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,683 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $32,745 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $112,270 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $18,491 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,254 | TotalRevenueColumnAmt |
| Exclusion | $14,254 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,310,772 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,683 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $164,610 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,430 | TotalAmt |
| Program Services | $93,430 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Program Services | $10,000 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $305,185 | TotalAmt |
| Program Services | $196,412 | ProgramServicesAmt |
| Management And General | $30,090 | ManagementAndGeneralAmt |
| Fundraising | $78,683 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,507 | TotalAmt |
| Program Services | $8,507 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,978 | TotalAmt |
| Program Services | $3,978 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $385 | TotalAmt |
| Program Services | $385 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,803 | TotalAmt |
| Fundraising | $1,803 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21 | TotalAmt |
| Program Services | $21 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MISCELLANEOUS EXPENSE | $26,002 | $26,002 |
| EMPLOYEE AND RECRUITMEN | $2,605 | $2,605 |
| SUBSCRIPTIONS AND DUES | $1,896 | $1,896 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $453,812 | TotalAmt |
| Program Services | $343,236 | ProgramServicesAmt |
| Management And General | $30,090 | ManagementAndGeneralAmt |
| Fundraising | $80,486 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $640,754 | BOYAmt |
| EOY | $1,273,083 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,190 | BOYAmt |
| EOY | $36,975 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,106 | BOYAmt |
| EOY | $140,208 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,500 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,162,428 | BOYAmt |
| EOY | $3,759,653 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,948,478 | BOYAmt |
| EOY | $5,215,419 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,391 | BOYAmt |
| EOY | $119,503 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,391 | BOYAmt |
| EOY | $119,503 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,459,397 | BOYAmt |
| EOY | $3,474,582 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $332,690 | BOYAmt |
| EOY | $1,621,334 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,792,087 | BOYAmt |
| EOY | $5,095,916 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,948,478 | BOYAmt |
| EOY | $5,215,419 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $856,960 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $446,869 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $229,404 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $291,597 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $248,467 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $861,152 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,137,479 | CurrentTaxYearAmt |
| Total | $2,768,099 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $229,404 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $291,597 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $248,467 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $861,152 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,137,479 | CurrentTaxYearAmt |
| Total | $2,768,099 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $1,336,416 | SubstantialContributorsTotAmt |
| Public Support Total170 | $1,431,683 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | -$37,766 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $101,121 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $145,523 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $104,285 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $161,315 | CurrentTaxYearAmt |
| Total | $474,478 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,242,577 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $369,304 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.44150 | PublicSupportCY170Pct |
| Public Support PY170 | 0.49300 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Donor Advised Funds Held | 20 | DonorAdvisedFundsHeldCnt |
| Donor Advised Funds Contri | $681,403 | DonorAdvisedFundsContriAmt |
| Donor Advised Funds Grants | $41,396 | DonorAdvisedFundsGrantsAmt |
| Donor Advised Funds Vl EOY | $1,539,654 | DonorAdvisedFundsVlEOYAmt |
| Disclosed Org Leg Ctrl | Yes (1) | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | Yes (1) | DisclosedForCharitablePrpsInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $81,690 | BeginningYearBalanceAmt |
| End Year Balance | $81,690 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $81,690 | BeginningYearBalanceAmt |
| End Year Balance | $81,690 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $81,690 | BeginningYearBalanceAmt |
| End Year Balance | $81,690 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $81,690 | BeginningYearBalanceAmt |
| End Year Balance | $81,690 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $81,690 | BeginningYearBalanceAmt |
| End Year Balance | $81,690 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | TO SUPPORT THE MISSION OF HUDSON HOSPITAL FOUNDATION, INC. (HHF) |
| PART X, LINE 2: | HHF IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. HP'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2019 OR 2018 FOR UNRECOGNIZED TAX BENEFITS. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $64,345 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $39,960 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $24,385 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $2,150 | CashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $5,880 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $2,994 | FoodAndBeverageEvent1Amt |
| Event2 | WINE TASTING | Event2Nm |
| Gross Receipts Event2 | $80,670 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $72,310 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $8,360 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $3,914 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $3,553 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $145,015 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $112,270 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $32,745 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $2,150 | CashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $5,880 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $6,908 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $3,553 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $18,491 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $14,254 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OPERATION HELP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 4TH ST STE 214 | AddressLine1Txt |
| City | HUDSON | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54016 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 391711703 | RecipientEIN |
| IRC Section | 501C3 | IRCSectionDesc |
| Cash Grant | $5,000 | CashGrantAmt |
| Purpose Of Grant | PROGRAM SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 10 | RecipientCnt |
| Cash Grant | $10,000 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | HUDSON HOSPITAL FOUNDATION, INC. (HHF) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH HHF'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO HHF'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DOUGLAS JOHNSON | ||||||||||||||
| CFO | $0 | $299,890 | $0 | $55,505 | $0 | $25,400 | $0 | $121,094 | $0 | $32,168 | $0 | $534,057 | $0 | $0 |
| MARTIN RICHARDS MD | ||||||||||||||
| DIRECTOR | $0 | $378,478 | $0 | $13,300 | $0 | $98,621 | $0 | $21,000 | $0 | $36,228 | $0 | $547,627 | $0 | $0 |
| THOMAS BOROWSKI | ||||||||||||||
| INTERIM PRESIDENT (AUG-DEC) | $0 | $254,412 | $0 | $51,993 | $0 | $9,989 | $0 | $30,600 | $0 | $31,031 | $0 | $378,025 | $0 | $0 |
| KAREN K RAMBO | ||||||||||||||
| PRESIDENT JAN-AUG | $0 | $73,520 | $0 | $16,460 | $0 | $63,106 | $0 | $3,481 | $0 | $12,663 | $0 | $169,230 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | HUDSON HOSPITAL FOUNDATION (HHF) HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. ALL OFFICERS AND KEY EMPLOYEES ARE PAID BY GROUP HEALTH PLAN, INC (GHI) OR BY REGIONS HOSPITAL (REGIONS), RELATED ORGANIZATIONS. ANY COMPENSATION IS DETERMINED SOLELY BY THE RELATED ORGANIZATIONS. |
| PART I, LINE 4A | A SEVERANCE PAYMENT IN COLUMN B (III) OF SCHEDULE J IS INCLUDED FOR THE FOLLOWING OFFICERS AND DIRECTORS: KAREN K. RAMBO $37,848 |
| PART I, LINE 6 | HHF HAS NO EMPLOYEES. HHF'S PRESIDENT IS EMPLOYED BY HUDSON HOSPITAL, INC. (HOSPITAL), WHICH HAS AN INCENTIVE PROGRAM WHICH INCENTS AND REWARDS THE HOSPITAL'S EMPLOYEES WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC YEAR. HOW THE PROGRAM WORKS: THE HOSPITAL INCENTIVE PROGRAM REWARDS ARE BASED ON POSITION IN THE ORGANIZATION AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATION'S STRATEGIC PLAN AND WILL BE BALANCED. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, EMPLOYEE AND/OR LEADERSHIP DEVELOPMENT, CARE DELIVERY, PATIENT EDUCATION, SIX AIMS, MARKET SHARE, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE, ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. A NET MARGIN THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 990, PART III, LINE 4A: EXEMPT PURPOSE AND ACHIEVEMENTS | HUDSON HOSPITAL FOUNDATION THE PURPOSE OF THE HUDSON HOSPITAL FOUNDATION (HHF) IS TO RAISE PHILANTHROPIC FUNDS FROM ITS CONSTITUENCY IN ORDER TO ADVANCE THE MISSION, VISION, AND VALUES OF HUDSON HOSPITAL, INC. (HOSPITAL), A WISCONSIN LICENSED 25-BED, LEVEL IV CRITICAL ACCESS HOSPITAL LOCATED IN HUDSON, WISCONSIN. ESTABLISHED IN 1977, HHF RAISES FUNDS TO PROVIDE SIGNIFICANT FINANCIAL SUPPORT FOR PROGRAMS AND CAPITAL NEEDS THAT ASSIST THE HOSPITAL WITH PROVIDING EXCEPTIONAL CARE CLOSE TO HOME. I. ORGANIZATION AND GOVERNANCE HHF IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE FAMILY OF HEALTHPARTNERS ORGANIZATIONS "HEALTHPARTNERS". FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED HEALTH CARE ORGANIZATION, PROVIDING HEALTH CARE SERVICES AND HEALTH PLAN FINANCING AND ADMINISTRATION, AND IS THE LARGEST CONSUMER-GOVERNED NONPROFIT HEALTH CARE ORGANIZATION IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTH CARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY. HEALTHPARTNERS, INC. (HPI) IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4) AND IS THE PARENT ENTITY OF HEALTHPARTNERS ORGANIZATIONS REFERRED TO COLLECTIVELY AS "HEALTHPARTNERS". HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS. HEALTHPARTNERS PROVIDES A FULL RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLANS SERVE MORE THAN 1.8 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,800 PHYSICIANS AND DENTISTS, SEVEN OWNED HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, OVER 125 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN SERVING MORE THAN 1.2 MILLION PATIENTS. HEALTHPARTNERS HEALTH PLANS CONTRACT WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS TO SERVE PLAN MEMBERS. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUNDRAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. HEALTHPARTNERS COLLABORATES WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2019 ARE TOTAL COST OF CARE MEASUREMENTS (A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN HEALTHPARTNERS, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS IS DRIVING CHANGE THAT HELPS OUR MEMBERS AND PATIENTS LIVE HEALTHIER LIVES. HEALTHPARTNERS COLLABORATES WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2019 ARE TOTAL COST OF CARE MEASUREMENTS (DEVELOPMENT OF A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL (REGIONS), REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM (LAKEVIEW HEALTH), RAMSEY INTEGRATED HEALTH SERVICES AND RH-WISCONSIN, ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN, ALONG WITH GROUP HEALTH PLAN, INC. (GHI), A MINNESOTA NON-PROFIT CORPORATION AND LICENSED STAFF MODEL HMO RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3), ARE CORPORATE MEMBERS OF THE HOSPITAL, WESTFIELDS HOSPITAL, INC. (WESTFIELDS), A WISCONSIN LICENSED 25-BED, LEVEL IV CRITICAL ACCESS HOSPITAL LOCATED IN NEW RICHMOND, WISCONSIN, AND AMERY REGIONAL MEDICAL CENTER, INC. (ARMC), A WISCONSIN LICENSED 25-BED, LEVEL IV CRITICAL ACCESS HOSPITAL LOCATED IN AMERY, WISCONSIN. THE HOSPITAL, WESTFIELDS, AND ARMC ARE WISCONSIN NONPROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE HOSPITAL IS THE SOLE CORPORATE MEMBER OF HHF. HHF IS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS COMPRISED OF UP TO 13 MEMBERS WHO INCLUDE COMMUNITY REPRESENTATIVES, MEDICAL STAFF AND THE PRESIDENT OF THE HOSPITAL. II. ACTIVITIES HHF STRATEGICALLY PARTNERED WITH MANY ORGANIZATIONS TO IMPROVE CARE LOCALLY AND REGIONALLY IN WESTERN WISCONSIN. THE FOUNDATION RAISES PHILANTHROPIC DOLLARS FROM THE COMMUNITY AND ITS EMPLOYEES TO SUPPORT HOSPITAL AND COMMUNITY HEALTH INITIATIVES. HOSPITAL PROGRAM SUPPORT HEALING ARTS: HEALING ARTS IS A UNIQUE PARTNERSHIP WITH THE PHIPPS CENTER FOR THE ARTS, WHICH INCLUDES ORIGINAL ARTWORK, AROMATHERAPY, AND PET THERAPY. HHF CONTINUES TO RAISE FUNDS LOCALLY FOR THIS PROGRAM WHICH GIVES PATIENTS, FAMILIES, AND VISITORS A MORE HOLISTIC PERSPECTIVE ON WHAT AHEALING ENVIRONMENT IN A HOSPITAL AND CLINIC CAN LOOK LIKE. WE USE THESE FUNDS TO PURCHASE PERMANENT ART AND TO SUSTAIN THE HEALING ARTS PROGRAM THROUGHOUT THE YEAR. HOME MONITORING: IN PARTNERSHIP WITH LIFEASSIST USA, HHF OFFERS A HOME MONITORING PROGRAM FOR SENIORS. THE ELECTRONIC HOME MONITORING SYSTEM, PROVIDED BY LIFEASSIST, WORKS IN CONJUNCTION WITH THE USER'S TELEPHONE SERVICE. IF THE USER NEEDS HELP, HE OR SHE WOULD SIMPLY PUSH A BUTTON (WORN ON A WRISTBAND OR NECKLACE) TO CONTACT THE CARE CENTER, 24 HOURS A DAY, SEVEN DAYS A WEEK. HHF PROVIDES THE COST OF THE PROGRAM EQUIPMENT SO THAT THE SERVICE IS AVAILABLE FOR A NOMINAL MONTHLY FEE. EMERGENCY CENTER EXPANSION: THE HOSPITAL COMMITTED TO DOUBLING THE NUMBER OF TREATMENT ROOMS IN OUR EMERGENCY CENTER DURING 2020. THE 12 TREATMENT ROOMS WILL ADDRESS INCREASING PATIENT VOLUMES DUE TO THE GROWTH OF OUR COMMUNITY. THESE ADDITIONAL ROOMS WILL OFFER SAFE SPACES FOR PATIENTS IN BEHAVIORAL HEALTH CRISES. THE ROOMS WILL ALSO PROVIDE AN AREA TO TREAT PATIENTS WITH TRAUMATIC INJURIES. ALL OUR TREATMENT ROOMS WILL BE LARGER IN SIZE TO SAFELY AND COMFORTABLY ACCOMMODATE PATIENTS AND THEIR FAMILIES. OUR GOAL IS TO TREAT MORE PATIENTS IN SHORTER AMOUNTS OF TIME IN THE SAFEST AND MOST COMFORTING POSSIBLE ENVIRONMENT. HHF COMMITTED TO RAISING $1 MILLION TO SUPPORT THIS $5 MILLION EMERGENCY CENTER EXPANSION. WE RAISED THIS MONEY THROUGH COMMUNITY GRANTS, EVENTS, AND INDIVIDUAL DONATIONS. IN 2020, WE WILL TRANSFER $1 MILLION RAISED TO THE HOSPITAL TO SUPPORT THE EMERGENCY CENTER EXPANSION. |
| FORM 990, PART III, LINE 4A - EXEMPT PURPOSE AND ACHIEVEMENTS | ONE CAMPAIGN: THE HOSPITAL AND ITS CAMPUS PARTNER (HUDSON PHYSICIANS) PARTICIPATED IN AN EMPLOYEE GIVING CAMPAIGN THAT NETTED NEARLY $23,000. THE FUNDS WILL BE USED TO ENHANCE THE EXPERIENCES OF THE PATIENTS, VISITORS AND EMPLOYEES THROUGHOUT THE CAMPUS, AS WELL AS COMMUNITY HEALTH GRANTS. A FEW EXAMPLES OF ACTIVITIES SUPPORTED BY EMPLOYEE CONTRIBUTIONS ARE: 1. PEDIATRIC COLORING BOOKS, TOYS, GAMES, MOVIES AND ELECTRONICS ARE PROVIDED FOR FAMILIES IN THE INFUSION, SPECIALTY, SURGERY, BIRTH CENTER, IMAGING, AND INPATIENT DEPARTMENTS. 2. ONCOLOGY PATIENTS RECEIVE A "FINAL DAY OF CHEMO" CELEBRATION WITH CERTIFICATES OF ACHIEVEMENTS. 3. EMPLOYEE GIFTS DESIGNATED FOR CARDIAC REHABILITATION FUND WERE USED TO PURCHASE AN UPPER EXTREMITY ARM ERGONOMETER. 4. NURSES EDUCATION FUNDS ARE USED TO PROVIDE CONTINUING EDUCATION FOR ALL OUR NURSING STAFF. THIS YEAR, NURSES PARTICIPATED IN ENHANCED SIMULATION TRAINING. THIS SIMULATION TRAINING ALLOWS NURSES TO BE WELL PREPARED FOR EMERGENCY SITUATIONS WITHOUT HAVING TO LEARN BY EXPERIENCING THEM FIRSTHAND. THESE SIMULATION TRAININGS ENSURE OUR NURSES CAN GIVE THE BEST CARE POSSIBLE IN ALL SITUATIONS. BEHAVIORAL HEALTH DE-ESCALATION TRAINING: HHF SECURED $100,000 TO FUND A ST. CROIX VALLEY-WIDE DE-ESCALATION TRAINING FOR ALL EMERGENCY CARE STAFF. HOSPITAL PARTNERS INCLUDE AMERY HOSPITAL & CLINIC, WESTFIELDS HOSPITAL & CLINIC, AND LAKEVIEW HEALTH. IT IS CRITICAL TO PROVIDE BEHAVIORAL HEALTH MANAGEMENT TRAINING FOR EMERGENCY CENTER EMPLOYEES NOT ONLY IN ORDER TO ENSURE SAFE AND RESPECTFUL WORK ENVIRONMENTS, BUT ALSO TO ENRICH THE EXPERIENCE AND LIVES OF PATIENTS LIVING WITH A DIAGNOSED OR UNDIAGNOSED MENTAL ILLNESS. IT IS HHF'S GOAL TO EMPOWER THE PATIENT/PROVIDER RELATIONSHIP WITH EVIDENCE-BASED COMMUNICATION SKILLS AND KNOWLEDGE ABOUT AN ILLNESS THAT IS GROWING AT A REMARKABLE RATE IN OUR COUNTRY. BEHAVIORAL HEALTH MANAGEMENT TRAINING: IMPROVES TRUST BETWEEN PATIENTS AND STAFF ASSISTS WITH PATIENT ASSESSMENT INCREASES THE SAFETY OF PATIENTS AND STAFF IMPROVES WORKING ENVIRONMENTS REDUCES PATIENT AND FAMILY SECLUSION KEEPS COMMUNITY MEMBERS SAFE PROMOTES HEALING AND HEALTHY LIVING METHODS IN TOTAL, THE ST. CROIX VALLEY HOSPITALS INTEND TO TRAIN APPROXIMATELY 200 PROVIDERS AND STAFF A YEAR. THE EMERGENCY PROVIDERS AND STAFF INCLUDE PHYSICIANS, REGISTERED NURSES, EMS, NURSING ASSISTANTS, ER CLERKS AND CAMPUS SECURITY TEAM MEMBERS. WIRELESS FETAL MONITORING HHF WAS AWARDED $50,000 TO SUPPORT THE PURCHASE OF WIRELESS FETAL MONITORS. THESE MONITORS ALLOW WOMEN IN LABOR TO HAVE MUCH MORE PHYSICAL MOVEMENT WHILE ENSURING THE SAFETY OF THEIR UNBORN BABY. SOON-TO-BE MOMS ARE FREE TO WALK, STAND, AND SHIFT POSITIONS DURING THEIR LABOR WITHOUT BEING ATTACHED TO A PIECE OF EQUIPMENT. THIS HAS ALLOWED FOR THESE PATIENTS TO HAVE FEWER PHYSICAL RESTRICTIONS AND MORE CHOICE IN HOW THEY DELIVER THEIR BABIES. OUR NURSES ARE ALSO BENEFITING FROM THE WIRELESS FETAL MONITORS BECAUSE THEY ARE ABLE TO MANEUVER LABORING MOMS WITHOUT THE DISTRACTION AND INCONVENIENCE OF ADDITIONAL WIRES AROUND THEIR PATIENT. OVERALL, THE NEW WIRELESS FETAL MONITORS PROVIDE A MUCH BETTER LABOR EXPERIENCE FOR MOMS AND HUDSON HOSPITAL & CLINIC STAFF. COMMUNITY HEALTH INITIATIVES GOOD SAMARITAN FUND FOR MANY YEARS, HUDSON HOSPITAL & CLINIC STAFF HAVE KNOWN THAT PATIENTS ARE SOMETIMES UNABLE TO PAY FOR URGENT, SUPPORTIVE MEDICAL SERVICES SUCH AS PRESCRIPTIONS, TRANSPORTATION TO MEDICAL APPOINTMENTS, AND SIMILAR NEEDS. OFTEN, STAFF HAS PROVIDED FUNDS TO MEET THESE NEEDS FROM THEIR OWN POCKETS. WE USED PROCEEDS FROM THIS FUND THROUGHOUT 2019 TO PROVIDE FINANCIAL SUPPORT TO PATIENTS. CHRISTIAN COMMUNITY HOMES GRANT HUDSON HOSPITAL FOUNDATION GRANTED CHRISTIAN COMMUNITY HOMES $3,000 TO PURCHASE A TRISHAW FOR THEIR PATIENTS WITH DECREASED MOBILITY. A TRISHAW ALLOWS SENIOR RESIDENTS TO EXPERIENCE RIDING A BICYCLE WITH A TRAINED CAPTAIN WHO ENSURES THEIR SAFETY WHILE RESIDENTS ARE EXPERIENCING THE OUTDOORS. OPERATION HELP GRANT OPERATION HELP OFFERS A DIAPER BANK FOR COMMUNITY MEMBERS WHO ARE IN NEED OF FINANCIAL ASSISTANCE. CLIENTS USING THE DIAPER BANK CAN PICK UP 80 TO 100 DIAPERS EVERY MONTH FOR EACH CHILD IN THEIR FAMILY. IN 2019, WE SUPPORTED THE EXPANSION OF THE DIAPER BANK PROGRAM THAT IS PLANNED FOR 2020. REACH OUT AND READ GRANT HHF SUPPORTS HUDSON PHYSICIANS' REACH OUT AND READ PROGRAM BY FULLY FUNDING THE PURCHASE OF THE PROGRAM'S BOOKS. EVERY CHILD FROM BIRTH TO 5 YEARS OLD RECEIVES A DEVELOPMENTAL AGE- AND LANGUAGE-APPROPRIATE BOOK AT THEIR WELL-CHILD VISIT. THE DISTRIBUTION OF FREE BOOKS TO CHILDREN AND THE ACCOMPANYING DISCUSSION ABOUT READING ALOUD GIVE YOUNG CHILDREN A FOUNDATION FOR SUCCESS. STUDENT SCHOLARSHIPS FOR HEALTH CARE HIGHER EDUCATION EVERY YEAR WE FUND SCHOLARSHIPS FOR HIGH SCHOOL STUDENTS IN OUR COMMUNITY WHO WANT TO PURSUE A FURTHER EDUCATION FOR A CAREER IN HEALTH CARE. IN 2019, WE FUNDED $10,000 IN SCHOLARSHIPS FOR RECENT GRADUATES OF HUDSON HIGH SCHOOL. FINANCIAL NEED IS A SELECTION CRITERION FOR OUR SCHOLARSHIPS. AS SUCH, THESE SCHOLARSHIPS HELP EASE THE FINANCIAL AND EMOTIONAL BURDEN OF PAYING FOR COLLEGE AND ALLOW STUDENTS TO SUCCEED IN THEIR EDUCATIONAL ENDEAVORS |
| FORM 990, PART VI, SECTION A, LINE 4 | THE FOUNDATION BYLAWS WERE AMENDED TO PROVIDE THAT THE PRESIDENT OF THE HOSPITAL IS EX-OFFICIO THE PRESIDENT OF HHF AND TO ADD AN ADDITIONAL DIRECTOR TO THE EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE CORPORATE MEMBER OF HHF IS HUDSON HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | PURSUANT TO BYLAWS, HHF'S BOARD OF DIRECTORS IS COMPRISED OF NOT LESS THAN SEVEN (7) AND NOT MORE THAN FIFTEEN (15) PERSONS APPOINTED BY HUDSON HOSPITAL AS THE SOLE CORPORATE MEMBER OF HHF. |
| FORM 990, PART VI, SECTION A, LINE 7B | HHF'S CORPORATE MEMBER, HUDSON HOSPITAL, MUST APPROVE THE FOLLOWING ACTIONS OF HHF'S BOARD OF DIRECTORS OR INITIATE THESE ACTIONS DIRECTLY: - AMENDMENTS OF THE ARTICLES, BYLAWS OR OTHER GOVERNING DOCUMENTS - SALE, LEASE, MORTGAGE OR PLEDGE OF ANY REAL ESTATE OR INTEREST THEREIN, OR OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS - ADOPTION OF AMENDMENT OF A STRATEGIC PLAN, AND CAPITAL AND OPERATING BUDGETS - APPROVAL OF UNBUDGETED CAPITAL EXPENDITURES - APPROVAL OF BORROWING OR LENDING OF FUNDS OF THE FOUNDATION - MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY AND TRANSFER OR CONTRIBUTION OF ASSETS AND FUNDS TO SEPARATE ENTITIES - ESTABLISHMENT OR DIVESTITURE OF ENTITIES OF WHICH HHF HAS AN EQUITY OR MANAGEMENT INTEREST, OR ESTABLISHMENT OF ANY SIGNIFICANT AND CONTINUING RELATIONSHIP WITH ANY ENTITY - DISSOLUTION AND DISTRIBUTION OF ASSETS |
| FORM 990, PART VI, SECTION B, LINE 11B | HHF'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF HHF. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GHI, THE MANAGEMENT TEAM OF HHF, GHI'S INTERNAL LEGAL DEPARTMENT AND HHF'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF HHF. HHF MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT A MEETING OF THE FULL BOARD OF DIRECTORS. THIS PROCESS IS NOTED AND DOCUMENTED IN THE WRITTEN MINUTES OF THE MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HUDSON HOSPITAL FOUNDATION BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, AND KEY EMPLOYEES ("COVERED PERSONS") BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, COVERED PERSONS ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND ASKED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. THE LEGAL DEPARTMENT OF HEALTHPARTNERS REVIEWS THE QUESTIONNAIRE RESPONSES AND DEVELOPS A REPORT DETAILING ANY POTENTIALLY MATERIAL CONFLICTS FOR THE PRESIDENT AND CHAIR OF THE BOARD. A VERBAL SUMMARY IS ALSO GIVEN TO THE FULL BOARD OR APPROPRIATE COMMITTEE ENDING WITH A REMINDER TO COVERED PERSONS OF THE POLICY'S MANDATE THAT EACH PERSON IS OBLIGATED TO DISCLOSE ANY NEW POTENTIAL CONFLICTS AS THEY MAY ARISE THROUGHOUT THE YEAR. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | HUDSON HOSPITAL FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. ALL OFFICERS AND KEY EMPLOYEES ARE PAID BY HUDSON HOSPITAL A RELATED ORGANIZATION. ANY COMPENSATION DISCLOSED IS PAID AND DETERMINED SOLELY BY THE RELATED ORGANIZATIONS. THEREFORE, PART VI, SECTION B, QUESTION 15 IS NOT APPLICABLE TO HUDSON HOSPITAL FOUNDATION |
| FORM 990, PART VI, SECTION C, LINE 19 | HHF'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM HHF. HHF'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE WISCONSIN SECRETARY OF STATE'S OFFICE. HHF'S CONFLICT OF INTEREST POLICY THROUGH ITS RELATED ORGANIZATION, HUDSON HOSPITAL, CAN BE VIEWED THROUGH THE HUDSONHOSPITAL.ORG WEBSITE. |
| 990, PART VII, SECT A, LN 1A, COL (B): AVERAGE HRS-RELATED ORGANIZATIONS | DIRECTORS AND OFFICERS OF HHF ARE EMPLOYED AND COMPENSATED BY REGIONS HOSPITAL OR HUDSON HOSPITAL. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. |
| FORM 990, PART IX, LINE 11G | EMPLOYMENT SERVICES: PROGRAM SERVICE EXPENSES 187,535. MANAGEMENT AND GENERAL EXPENSES 30,090. FUNDRAISING EXPENSES 78,683. TOTAL EXPENSES 296,308. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,877. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,877. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411693838 | HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(4) | N/A | 0 | ||
| HPI-RAMSEY | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411793333 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| GROUP HEALTH PLAN INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410797853 | STAFF MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HEALTHPARTNERS INC | |
| RH WISCONSIN INC | |||||||||||
| 8171 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 202287016 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| HEALTHPARTNERS INSTITUTE | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411670163 | HEALTHCARE EDUCATION AND RESEARCH | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| CAPITOL VIEW TRANSITIONAL CARE CENTER | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 412011453 | TRANSITIONAL CARE SERVICES, STEP DOWN FROM INPATIENT HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410956618 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411888902 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | HPI - RAMSEY | |
| RHSC INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411891928 | HEALTHCARE STAFFING AND INTENSE REHAB SERVICES | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | HPI - RAMSEY | |
| PHYSICIANS NECK & BACK CLINICS | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 270684883 | SPECIALTY PATIENT CARE | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | GROUP HEALTH PLAN INC | |
| HUDSON HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390804125 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN INC | |
| LAKEVIEW HEALTH FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411386635 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | LAKEVIEW HEALTH | |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410811697 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | LAKEVIEW HEALTH | |
| STILLWATER MEDICAL GROUP | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 830379473 | CLINIC STAFF AND FACILITIES | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | LAKEVIEW HEALTH | |
| LAKEVIEW HEALTH | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 300221189 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | HPI - RAMSEY | |
| WESTFIELDS HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390808442 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | RH-WISCONSIN INC | |
| WESTFIELDS HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391770913 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | WI | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | WESTFIELDS HOSPITAL INC | |
| RAMSEY INTEGRATED HEALTH SERVICES | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411503090 | HOME CARE AND HOSPICE | MN | 501(C)(3) | 0 | 509(A)(2) | HPI - RAMSEY | |
| PARK NICOLLET HEALTH SERVICES | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 363465840 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(2) | HEALTHPARTNERS INC | |
| PARK NICOLLET FOUNDATION | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 237346465 | SUPPORT TO RELATED ENTITIES AND COMMUNITY HEALTH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET METHODIST HOSPITAL | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410132080 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET HEALTH CARE PRODUCTS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 010638901 | DURABLE MEDICAL EQUIPMENT , PHARMACY AND OTHER HEALTH CARE RETAIL SALES | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET CLINIC | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410834920 | CLINIC SERVICES | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PNMC HOLDINGS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411741792 | HEALTHCARE REAL ESTATE | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | PARK NICOLLET HEALTH SERVICES | |
| AMERY REGIONAL MEDICAL CENTER INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390908320 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN INC | |
| AMERY REGIONAL MEDICAL CENTER FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391726539 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | WI | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | AMERY REGIONAL MEDICAL CENTER INC | |
| HUTCHINSON HEALTH | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 841715908 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| HUTCHINSON HEALTH FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 363317820 | PROVIDE SUPPORT TO HOSPITAL | MN | 501(C)(3) | 0 | 509(A)(3) TYPE III | HUTCHINSON HEALTH | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS ADMINISTRATORS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411629390 | THIRD PARTY ADMINISTRATOR | MN | HEALTHPARTNERS INC | C | 0 |
| HEALTHPARTNERS ASSOCIATES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 522365151 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS SERVICES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683568 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS INSURANCE COMPANY | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683523 | MEDICAL AND DENTAL INSURANCE | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| DENTAL SPECIALTIES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 451297583 | PROFESSIONAL DENTAL SERVICES | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411236798 | MEDICAL CLINIC STAFFING | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| PARK NICOLLET ENTERPRISES | |||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411656735 | REAL ESTATE FOR RELATED ORGANIZATIONS | MN | PARK NICOLLET HEALTH SERVICES | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Comments