2019-07-30T13:24:48-05:00 2018-09-30 411765929 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2017-10-01 391823757 Tomah Memorial Hospital Foundation TOMA 6083722181 321 Butts Avenue Tomah WI 54660 Joseph Zeps CFO - Tomah Memorial Hospital 6083722181 2019-07-29 1 Kim Hunwardsen CPA P00484560 9529446166 2019-07-29 199.247.44.58 2019-07-29 13:42:11 CD P D8A1E5117AA53286D53F57459EBB2DE5C7CA50FC F9BEE9501A3B4F00F190E63700B8BF2BC70C7B96 2017 2019-02-21 02:37:17Z Peter Reichardt 321 Butts Avenue Tomah WI 54660 46265 0 X www.tomahhospital.org X 1996 WI Support of Tomah Memorial Hospital and surrounding community. 9 9 0 11 0 0 40255 29210 0 0 5462 6576 1871 2949 47588 38735 287537 15787 0 0 0 0 0 0 0 2363 2282 289900 18069 -242312 20666 658763 644758 276234 220000 382529 424758 The mission of Tomah Memorial Hospital Foundation is to support the community of Tomah and the healthcare providers that serve its residents. 0 0 15787 15787 Tomah Memorial Hospital Foundation's focus of support continues to center on community-based wellness, facility upgrades, and the development of programs that benefit the local hospital and surrounding communities. During its 2018 fiscal year, the Foundation provided support to various community and healthcare organizations, including area PTO groups, a local food pantry, youth leadership programs, the county health department, and a free healthcare clinic. Additionally, the Foundation granted scholarships to several area students that are pursuing careers in the healthcare field. 15787 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 WI X Joseph Zeps 6083740307 321 Butts Avenue Tomah WI 54660 Peter Reichardt President 1.00 X X 0 0 0 Brian Eirschele Vice President 1.00 X X 0 0 0 Kate Schanhofer Secretary 1.00 X X 0 0 0 Deb Welch Treasurer 1.00 X X 0 0 0 Jeremy Haldeman Director 1.00 X 0 0 0 Derek Burnstad Director 1.00 X 0 0 0 Joellyn Edgerton Director (until March 2018) 1.00 X 0 0 0 Chris Pokela Director (until March 2018) 1.00 X 0 0 0 Jenny McCoy Director 1.00 X 0 0 0 Erin Dawley Director (began March 2018) 1.00 X 0 0 0 Tonya Gnewikow Director (began March 2018) 1.00 X 0 0 0 Eric PriseDirector of Public Relations 5.00 X 9982 0 448 9982 0 448 0 0 0 1 0 21166 8044 29210 6576 6576 9259 21166 7530 1729 1729 1220 0 1220 1220 38735 0 0 9525 11287 11287 4500 4500 1800 1800 122 122 270 270 Dues and fees 90 90 18069 15787 2282 0 658763 644758 658763 644758 1234 275000 220000 276234 220000 X 0 0 0 0 382529 424758 382529 424758 658763 644758 20666 21563 0 X 0 0 0 X 27136 33350 35429 40255 29210 165380 27136 33350 35429 40255 29210 165380 165380 1359 4901 4524 5462 6576 22822 188202 39482 0.87870 0.88800 X Golf outing 30425 21166 9259 660 3269 3601 30425 21166 9259 660 3269 3601 7530 1729 0 0 0 0 0 0 0 0 0 Schedule J, Compensation from Unrelated Organization: Eric Prise, Director of Public Relations, is compensated by Tomah Memorial Hospital, an unrelated organization, for services provided to the Hospital and Foundation. Eric spends approximately 10% of his time on the Foundation. The compensation on Part VII reflects the time spent on the Foundation. Form 990, Part VI, Section A, line 8b The Organization does not have committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The 990 is provided to the board members before it is filed. The CFO of Tomah Memorial Hospital reviews the Form 990. Form 990, Part VI, Section B, line 12c Officers and board members complete a conflict of interest policy annually. The Board reviews any potential conflicts. If the Board determined a conflict existed, the person involved would abstain from voting on any matter related to the conflict. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy and financial statements are available to the public upon request.