2019-05-02T13:37:01-05:00 2018-06-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2017-07-01 830230808 WYOMING MEDICAL CENTER FOUNDATION WYOM 3075772973 1233 EAST SECOND STREET CASPER WY 82601 JUDY AURELIUS BOARD CHAIR 3075772973 2019-04-25 1 DARRYN MCGARVEY P00958683 6123764500 67.137.57.251 2019-04-25 07:03:25 PD P 487AB1A67A5D20F4613B23BD8ED7DDEFEAED86AA 5361518973D1A559921F7DF4214214CF34F86A31 2017 2019-02-21 02:37:17Z JUDY AURELIUS 1233 EAST SECOND STREET CASPER WY 82601 2143700 0 X WWW.WYOMINGMEDICALCENTERFOUNDATION.ORG X 1976 WY TO ENHANCE EXCELLENCE IN HEALTHCARE DELIVERY AT WYOMING MEDICAL CENTER. 13 11 0 69 0 0 895907 1840400 0 0 23196 253983 -10259 21100 908844 2115483 1360508 115284 0 0 21052 0 0 0 20493 226127 103694 1607687 218978 -698843 1896505 6425962 7864291 351456 10617 6074506 7853674 X OUR MISSION IS TO ENHANCE EXCELLENCE IN HEALTHCARE DELIVERY AT WYOMING MEDICAL CENTER BY SECURING PRIVATE PHILANTHROPIC RESOURCES, CULTIVATING ENDURING RELATIONSHIPS, AND DELIVERING SUPERIOR DONOR STEWARDSHIP. OUR PURPOSE IS TO HELP RAISE THE FUNDS NEEDED FOR VARIOUS PROJECTS THAT WILL IMPROVE OUR HOSPITAL WHILE BENEFITING THE PATIENTS AND COMMUNITY WE SERVE.WYOMING MEDICAL CENTER FOUNDATION ASPIRES TO BE THE PREMIER STRATEGIC PARTNER WITH WYOMING MEDICAL CENTER IN ITS PURSUIT AS THE LEADER IN SAFETY AND SERVICE. IN DOING SO WMCF WILL: - SUPPORT PATIENT CARE THROUGH ENHANCED WRAP-AROUND COMMUNITY RESOURCES;- SUPPORT THE WMC THROUGH ASSISTANCE WITH INFRASTRUCTURE, TECHNOLOGY, AND EQUIPMENT NEEDS; AND- CREATE A CULTURE OF GIVING THAT IS EMPLOYEE DRIVEN. 0 0 173715 115284 0 THROUGHOUT THE FISCAL YEAR, WYOMING MEDICAL CENTER FOUNDATION ("WMC FOUNDATION") HAS RAISED FUNDS TO SUPPORT VARIOUS PROJECTS FOR ITS SUPPORTED ORGANIZATION, WYOMING MEDICAL CENTER ("WMC").THIS FISCAL YEAR, WMC FOUNDATION FOCUSED FUNDRAISING EFFORTS FOR THE CONSTRUCTION OF A NEW MASTERSON PLACE, THE HOSPITALITY HOME RUN BY THE FOUNDATION. THIS "HOME AWAY FROM HOME" PROVIDES PATIENTS AND THEIR FAMILIES AN AFFORDABLE PLACE TO STAY WHEN THEY ARE IN CASPER FOR MEDICAL NEEDS. 173715 1 1 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 10 0 0 0 0 0 0 0 1 1 0 0 0 0 X 13 11 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X JEANNE EHLEBRACHT 3075777837 1233 EAST SECOND STREET CASPER WY 82601 X DAX COLLINS CHAIR 2.00 0.00 X X 0 0 0 JUDY AURELIUS VICE CHAIR 2.00 0.00 X X 0 0 0 KYLE THOMPSON SECRETARY/TREASURER 2.00 0.00 X X 0 0 0 BOB BARNARD BOARD MEMBER 2.00 0.00 X 0 0 0 SCOTT BROWNELL BOARD MEMBER 2.00 0.00 X 0 0 0 MICHELE CHULICK BOARD MEMBER & CEO OF WMC 2.00 55.00 X 0 300479 1366 VICKIE DIAMOND BOARD MEMBER FORMER CEO OF WMC (THROUGH AUG 2017) 2.00 55.00 X 0 794139 44917 DICK DRESANG BOARD MEMBER (THROUGH MARCH 2018) 2.00 0.00 X 0 0 0 SUSAN MCMURRY BOARD MEMBER 2.00 0.00 X 0 0 0 PAM MILLER BOARD MEMBER 2.00 0.00 X 0 0 0 MARY PATTI NELSON BOARD MEMBER & WMC EMPLOYEE (THRU MAY '18) 2.00 40.00 X 0 129038 5167 JOHN PURVIANCE BOARD MEMBER 2.00 0.00 X 0 0 0 DEBBIE REID BOARD MEMBER 2.00 0.00 X 0 0 0 LISA WARREN BOARD MEMBER 2.00 0.00 X 0 0 0 CARYN DOWELL EXECUTIVE DIRECTOR 40.00 0.00 X 0 140756 32765 0 1364412 84215 0 0 1 0 0 61283 1779117 1840400 60181 60181 193802 0 193802 193802 193802 49317 61283 28217 21100 21100 2115483 0 0 275083 115284 115284 24770 24770 4226 4226 3482 3482 44392 44392 FUNDRAISING 20493 20493 GIFTS & ENTERTAINMENT 3862 3862 MISCELLANEOUS 2469 2469 218978 173715 24770 20493 992637 2318471 1270559 1105368 2956865 1031004 1757186 1925861 2202920 2274802 188871 226000 13789 13789 6425962 7864291 14066 8686 337390 1931 351456 10617 X 3507679 3681801 2031302 3636348 535525 535525 6074506 7853674 6425962 7864291 1896505 -117337 0 X 0 1 X 1 0 X X 1 WYOMING MEDICAL CENTER 830279242 3 1 173715 0 1 173715 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 13789 X 0 2310525 133519 133519 2310525 2535525 213140 438140 2310525 1535525 1000000 60463 60463 2535525 1535525 21480 21480 1535525 1563431 80243 108149 1535525 0.76820 0.23180 0.00000 0 0 709885 709885 1346331 732305 614026 308969 298699 10270 591680 591680 1925861 DUE TO WYOMING MEDICAL CENTER 1931 1931 X 538654 292555 292555 246099 1869384 1869384 2115483 247195 28217 28217 218978 0 218978 PART III, LINE 4: THE FOUNDATION HOLDS A STATUE THAT IS MAINTAINED IN A MAIN HALLWAY OF WYOMING MEDICAL CENTER. THE FOUNDATION WILL HAVE TO RETURN THE STATUE TO ITS OWNER UPON REQUEST. PART V, LINE 4: THE FOUNDATION HAS AN ENDOWMENT ON WHICH THE INVESTMENT EARNINGS ARE AVAILABLE TO BE USED FOR FOUNDATION GENERAL OPERATING EXPENSES. PART X, LINE 2: THE FOUNDATION IS ORGANIZED AS A WYOMING NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE FOUNDATION IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. THE FOUNDATION HAS DETERMINED IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAS NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. THE FOUNDATION BELIEVES IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE FOUNDATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION 264,338. FUNDRAISING EVENT EXPENSES 28,217. PART XI, LINE 4B - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS AND EARNINGS 1,857,341. CHANGE IN DISCOUNT AND ALLOWANCES ON PLEDGES 12,043. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 28,217. GIFT OF GALA 110600 61283 49317 14217 1078 12922 110600 61283 49317 14217 1078 12922 28217 21100 1 WYOMING MEDICAL CENTER 1233 EAST SECOND STREET CASPER WY 82601 830279242 501(C)(3) 115284 WISH LIST PROGRAM, WEST TOWER & WELLNESS CENTER DONATIONS 1 0 PART I, LINE 2: GRANTS TO OTHER ORGANIZATIONS ARE LIMITED TO THE ORGANIZATION'S SUPPORTED ORGANIZATION, WYOMING MEDICAL CENTER, IN SUPPORT OF ITS CHARITABLE PURPOSE. BOTH ORGANIZATIONS ARE UNDER COMMON MANAGEMENT, WHO ENSURE THAT ALL GRANTED FUNDS ARE USED FOR APPROPRIATE PURPOSES. 0 0 0 0 0 0 0 0 0 MICHELE CHULICK BOARD MEMBER & CEO OF WMC 0 260827 0 0 0 39652 0 0 0 1366 0 301845 0 0 VICKIE DIAMOND BOARD MEMBER FORMER CEO OF WMC (THROUGH AUG 2017) 0 644538 0 142000 0 7601 0 28800 0 16117 0 839056 0 0 CARYN DOWELL EXECUTIVE DIRECTOR 0 128566 0 11744 0 446 0 5377 0 27388 0 173521 0 0 PART I, LINE 3 THE EXECUTIVE DIRECTOR IS COMPENSATED BY WYOMING MEDICAL CENTER, A RELATED ORGANIZATION, FOR THE SERVICES AS THE TOP MANAGEMENT OFFICIAL. WYOMING MEDICAL CENTER USED A COMPENSATION SURVEY OR STUDY AND A WRITTEN EMPLOYMENT CONTRACT TO ESTABLISH THE EXECUTIVE DIRECTOR'S COMPENSATION. FORM 990, PART VI, SECTION A, LINE 1 THE FOUNDATION'S EXECUTIVE COMMITTEE INCLUDES THE FOUNDATION BOARD PRESIDENT, VICE PRESIDENT, TREASURER, AND SECRETARY. THE EXECUTIVE DIRECTOR OF THE FOUNDATION SERVES AS A NON-VOTING, EX-OFFICIO MEMBER. THE EXECUTIVE COMMITTEE ACTS ON BEHALF OF THE BOARD OF DIRECTORS WHEN THE BOARD IS NOT IN SESSION BUT IS ACCOUNTABLE TO THE BOARD FOR ITS ACTIONS. THESE ACTIONS MUST BE APPROVED BY A VOTE BY THE BOARD OF DIRECTORS AT THE NEXT BOARD MEETING FOLLOWING THE ACTION. FORM 990, PART VI, SECTION A, LINE 7A THE FOUNDATION'S BOARD INCLUDES THE CEO OF WYOMING MEDICAL CENTER. FORM 990, PART VI, SECTION B, LINE 11B A PUBLIC ACCOUNTING FIRM WAS CONTRACTED TO PREPARE THE FORM 990. THE FORM 990 WAS REVIEWED BY THE SECRETARY/TREASURER AND THE EXECUTIVE DIRECTOR OF THE FOUNDATION. THE FORM 990 WAS PRESENTED TO THE BOARD FOR APPROVAL AND, UPON APPROVAL, WAS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION MONITORS VOTING BOARD MEMBERS BY REQUIRING EACH MEMBER TO SUBMIT A CONFLICT OF INTEREST FORM AT THE BEGINNING OF EVERY FISCAL YEAR OR WHEN JOINING THE BOARD. THE EXECUTIVE DIRECTOR REVIEWS THE CONFLICT FORMS. IF IT'S UNCLEAR WHETHER A CONFLICT EXISTS, THE BOARD OF DIRECTORS MAKES THE DETERMINATION. WHEN VOTING ON PROJECTS WHERE AN INDIVIDUAL BOARD MEMBER HAS A CONFLICT, THEY WILL ABSTAIN FROM VOTING. THE EXECUTIVE DIRECTOR AND STAFF MUST DISCLOSE ANY CONFLICTS WITHIN THE CONFINES OF THE WYOMING MEDICAL CENTER POLICIES AS EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR IS COMPENSATED BY WYOMING MEDICAL CENTER, AND THE COMPENSATION IS DETERMINED BY WYOMING MEDICAL CENTER'S HUMAN RESOURCES DEPARTMENT BY UTILIZING COMPARABILITY DATA. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: THE RELATED ORGANIZATION, WYOMING MEDICAL CENTER ("WMC"), COMPENSATES THOSE INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A. WYOMING MEDICAL CENTER FOUNDATION ("WMC FOUNDATION") DOES NOT REIMBURSE WMC FOR THESE SERVICES. THE COMPENSATION REPORTED FOR MICHELE CHULICK AND PATTI NELSON REPRESENTS COMPENSATION FOR THEIR SERVICES SOLELY TO WMC. THE COMPENSATION REPORTED FOR CARYN DOWELL REPRESENTS COMPENSATION FOR HER SERVICES TO WMC FOUNDATION. WYOMING MEDICAL CENTER 1233 EAST SECOND STREET CASPER WY 82601 830279242 MEDICAL SERVICES WY 501(C)(3) LINE 3 N/A 0 WYMEDCO CARE INC 1233 EAST SECOND STREET CASPER WY 82601 830279267 SUPPORT IN THE NONPROFIT MISSION OF WMC WY 501(C)(3) LINE 12A, I WYOMING MEDICAL CENTER 0 CENTRAL WYOMING OUTPATIENT SURGERY CENTER LLC 1201 EAST 3RD STREET CASPER WY 82601 830331130 MEDICAL SERVICES WY N/A NORTH PLATTE PATHOLOGY 111 SOUTH JEFFERSON STREET CASPER WY 82601 453676843 MEDICAL SERVICES WY N/A WYMEDCO VENTURES INC 1233 EAST SECOND STREET CASPER WY 82601 830281137 MEDICAL SERVICES WY N/A C 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 1