2020-08-10T15:45:49-05:00 2019-09-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990EZ 2018-10-01 271865510 Mile Bluff Medical Center Foundation MILE 6088476161 1050 Division Street Mauston WI 53948 James O'Keefe President/CEO 6088476161 2020-08-06 1 Kim Hunwardsen CPA P00484560 6122536500 2020-08-05 216.147.181.47 2020-08-06 16:14:14 CD P 9EB6867304309B5BA7CF1F8994B8B429DCF961D0 9EB6867304309B5BA7CF1F8994B8B429DCF961D0 2018 2020-09-23 17:36:50Z X n/a X X 191918 X 171903 4814 2790 6000 6411 18540 -6129 173378 86067 100 9910 20 46757 142854 30524 241142 0 271666 X 236972 267103 14991 19313 251963 286416 10821 14750 241142 271666 X Mile Bluff Medical Center Foundation provides philanthropic opportunities and support to Mile Bluff Medical Center, assisting in fulfilling its mission, adhering to its core values and pursuing its vision to provide the community with exceptional, personalized healthcare services. Mile Bluff Medical Center Foundation strives to build and cultivate community partnerships that ensure lifelong commitments to healthcare advancement, personal well-being and improvement throughout Mile Bluff's six-county service area. 86067 142854 142854 James O'Keefe President/CEO 0.30 0 0 0 Sandy Linsmeyer Treasurer 0.30 0 0 0 Christine Carter Secretary 0.30 0 0 0 Dr Ann Hoffman Director 0.30 0 0 0 Molly Scully Director 0.30 0 0 0 Nora Scully Director 0.30 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 WI James O'Keefe 1050 Division Street Mauston WI 53948 6088476161 0 0 0 0 0 0 0 0 0 0 NONE NONE 1 X X X 1 Mile Bluff Medical Center Inc 390992883 3 1 76567 66287 1 76567 66287 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Schedule A, Part IV, Section A, Line 1: The Foundation was organized and will be operated exclusively to benefit and carry out the purposes of the Medical Center and certain of the Medical Center's related organizations (collectively, the "Supported Organizations"). The Medical Center is a Wisconsin nonstock corporation that is a Code Section 501(c)(3) organization and a public charity described in Code Sections 170(b)(1)(A)(iii) and 509(a)(1). As set forth in the Foundation's Articles of Incorporation, in order for one of the Medical Center's related organizations to qualify as a Supported Organization of the Foundation, the related organization must (1) be described in Code Section 501(c)(3); (2) be a public charity described in Code Section 509(a)(1) or 509(a)(2); and (3) be directly or indirectly controlled by, under common control with, or in control of the Medical Center. Schedule A, Part IV, Section B, Line 1: The Foundation's Supported Organizations serve as its members, will elect all of the Foundation's directors, and have the authority to amend the Foundation's governing documents. At this time, only the Medical Center is acting as a member, and therefore Supported Organization, of the Foundation. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED Golf Outing 32958 26547 6411 700 3829 3710 2701 0 219 Piano Fondue 8111 8111 150 200 874 3000 157 41069 34658 6411 700 3979 3910 3575 3000 376 15540 -9129 Form 990-EZ, Part I, Line 4 - Other Investment Income Description: Interest Income. Amount: 2,790. Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid Activity Classification: Operational support. Grantee Name: Mile Bluff Medical Center, Inc.. Grantee Address: 1050 Division Street Mauston, WI 53948-1997. Grantee Relationship: Supported organization. Amount Given: 76,567. Form 990-EZ, Part I, Line 16 - Other Expenses Description: Supplies. Amount: 17,750. Description: Travel. Amount: 814. Description: Women's Night Out expenses. Amount: 5,010. Description: Dues and subscriptions. Amount: 562. Description: Entertainment/meals. Amount: 41. Description: Promotion/marketing. Amount: 12,090. Description: Nurses Helping Nurses. Amount: 9,936. Description: Men's Night Out expenses. Amount: 554. Total to Form 990-EZ, line 16: 46,757. Part V, Line 35: The revenue include in Part I, line 2 is from a women and men's health initiative. Line 6a is gaming revenue from a raffle held during a fundraising event. Form 990-EZ, Part II, Line 24 - Other Assets Description: Pledges receivable. Beg. of Year Amount: 9,428. End of Year Amount: 13,750. Description: Investment - other security. Beg. of Year Amount: 5,563. End of Year Amount: 5,563. Form 990-EZ, Part II, Line 26 - Other Liabilities Description: Accounts payable. Beg. of Year Amount: 4,120. End of Year Amount: 8,310. Description: Due to Mile Bluff Medical Center. Beg. of Year Amount: 6,701. End of Year Amount: 6,440. The organization did not, during the year, receive any funds, directly,or indirectly, to pay premiums on a personal benefit contract.The organization, did not, during the year, pay any premiums, directly,or indirectly, on a personal benefit contract.