2019-03-20T09:57:24-05:00 2018-06-30 461497033 PLANTE & MORAN PLLC 8181 E TUFTS AVE SUITE 600 DENVER CO 80237 990 2017-07-01 841576338 THE MEMORIAL HEALTH SYSTEM FOUNDATION MEMO 7193654483 175 SOUTH UNION BLVD NO 240 COLORADO SPRINGS CO 80910 CARI KARNS SENIOR DIRECTOR 7193654483 2019-03-18 1 DORI J EGGETT P00645252 3037409400 2019-03-18 208.42.238.142 2019-03-18 10:43:16 MD P DC0456A352FA9E307B2AB963C1AA5BCE91C5D552 C6E4C47366026390A9CD5C2EB00C82EA640792D2 2017 2019-02-21 02:37:17Z CARI KARNS 175 SOUTH UNION BLVD NO 240 COLORADO SPRINGS CO 80910 1704271 0 X N/A X 2001 CO TO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM. 14 14 6 0 0 0 1185902 1482045 0 0 62083 64847 -12097 -69072 1235888 1477820 554495 863724 0 0 482887 437775 6621 0 243504 203315 199280 1247318 1500779 -11430 -22959 3336753 3560441 42761 250052 3293992 3310389 X SEE SCHEDULE OTHE MISSION OF MEMORIAL HEALTH SYSTEM FOUNDATION IS TO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM TO PROVIDE THE HIGHEST QUALITY HEALTH CARE. PHILANTHROPIC SUPPORT IS BEING SOUGHT FOR CAPITAL, ENDOWMENT AND PROGRAMMATIC PURPOSES, INCLUDING CANCER, CARDIOLOGY, AND WOMEN'S PROGRAMS AND SERVICES. 0 0 224830 224830 THE UCHEALTH COMMUNITY EDUCATION CENTER-COLORADO SPRINGS IS DESIGNED TO IMPROVE CLINICAL LEARNING AND PATIENT CARE THROUGH THE USE OF NEW TECHNOLOGIES AND MEDICAL SCENARIOS. THE FACILITY OPENED ITS DOORS IN 2018 TO ENHANCE AND EXPAND TRAINING THROUGH A HIGH-FIDELITY SIMULATION LAB AND EXPANDED CLASSROOM SPACE FOR NURSING, PARAMEDIC, AND EMERGENCY MEDICAL TECHNICIAN INSTRUCTION. THE FACILITY IS ALSO USED FOR COMMUNITY OUTREACH PROGRAMS. THE FOUNDATION MADE AN INITIAL INVESTMENT OF $224,830 TO FUND PHASE I DEVELOPMENT OF THE CEC, INCLUDING EQUIPMENT AND PROGRAM DEVELOPMENT. 130670 130670 THE MATERNAL CHILD SERVICE LINE ENCOMPASSES ALL ASPECTS OF CARE FROM PRE- TO POST-PARTUM, INCLUDING MATERNAL FETAL MEDICINE, THE BIRTH CENTER, AND THE MOTHER BABY UNIT. FOUNDATION DOLLARS SUPPORT COMMUNITY OUTREACH PROGRAMS, CONTINUING EDUCATION, EQUIPMENT, AND PATIENT SUPPORT PROGRAMS WITHIN THE SOUTH REGION. DURING FY18, 2 PORTABLE ULTRASOUND UNITS WERE PURCHASED FOR $85,246, 5 PHOTOTHERAPY BEDS FOR $15,971 AND A NEWBORN AND PATIENT CHANNEL SUBSCRIPTION FOR $5,539. 97000 97000 QUALITY IMPROVEMENT OVERSEES INITIATIVES RELATED TO PATIENT SAFETY AND OUTCOMES. DURING FY18, THE FOUNDATION FUNDED A UV DISINFECTION SYSTEM FOR ENVIRONMENTAL SERVICES TO ASSIST WITH CLEANING PATIENT ROOMS AND OPERATING ROOMS, REDUCING THE INCIDENCE OF HOSPITAL ACQUIRED INFECTIONS. 544991 411224 VARIOUS PATIENT CARE AND STAFF EDUCATION FUNDS. 544991 411224 997491 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 3 0 6 1 0 0 0 0 0 1 1 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 0 X STEVE WEBER 7193654483 175 SOUTH UNION BLVD SUITE 240 COLORADO SPRINGS CO 80910 BRADLEY BUTLER BOARD CHAIR 1.00 X X 0 0 0 BRUCE PANTER VICE CHAIR 1.00 X X 0 0 0 MARGARET CARMACK DIRECTOR 1.00 X 0 0 0 MARK BROWN DIRECTOR 1.00 X 0 0 0 DAVID GREENBERG DIRECTOR 1.00 X 0 0 0 ANDREA HURLBERT DIRECTOR 1.00 X 0 0 0 LANA JANC DIRECTOR 1.00 X 0 0 0 MARY ELLEN MCNALLY DIRECTOR 1.00 X 0 0 0 CHRISTINE O'BRIEN DIRECTOR 1.00 X 0 0 0 BETSY PLANTE DIRECTOR 1.00 X 0 0 0 ATHENA ROE DIRECTOR 1.00 X 0 0 0 ERIC SCOTT DIRECTOR 1.00 X 0 0 0 ANN SIMPSON DIRECTOR 1.00 X 0 0 0 JOEL YUHAS DIRECTOR 1.00 X 0 0 0 CARI KARNS SR DIRECTOR OF DEVELOPMENT 40.00 X 130815 0 13133 130815 0 13133 1 0 0 0 0 298333 603347 580365 30220 1482045 64847 64847 157379 298333 226451 -69072 -69072 1477820 0 0 -4225 643939 643939 219785 219785 161664 48500 80832 32332 220174 43704 41056 135414 4509 1103 639 2767 48276 9402 9232 29642 3152 598 560 1994 1604 1604 25143 25143 21235 21235 16892 3988 8619 4285 2612 164 493 1955 14255 566 12350 1339 27941 8382 13970 5589 64710 12942 38826 12942 85 34 51 9862 1749 2196 5917 171 34 103 34 1304 1304 PRINTING 10542 2635 7907 DUES 2227 891 1336 MISCELLANEOUS 697 697 1500779 997491 259784 243504 98450 384706 1123786 951520 23350 56000 14868 13904 61945 61518 598 427 2075701 2153884 3336753 3560441 31511 250052 11250 0 42761 250052 X 790228 740595 2309589 2375619 194175 194175 3293992 3310389 3336753 3560441 X -22959 42306 -2950 X 0 1 X 1 0 X 643614 1435202 1079180 1185902 1482045 5825943 643614 1435202 1079180 1185902 1482045 5825943 2949146 2876797 540 20295 67531 62083 64847 215296 6041239 0.47620 0.44920 X FORM 990, SCHEDULE A, PART II: THE 2013 YEAR COLUMN OF SCHEDULE A, PART II IS A SHORT-YEAR TAX RETURN PERIOD FROM 1/1/2014 TO 6/30/2014 264719 12536 277255 243696 21023 264719 240314 3382 243696 233177 7137 240314 225820 7357 233117 0.70030 0.29970 0 0 61945 61518 427 427 X 1783630 42306 37053 226451 305810 1477820 0 1477820 1767233 37053 229401 266454 1500779 0 1500779 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO PROVIDE EDUCATION TO OUTREACH PROGRAMS, TRAUMA NURSES, AND BLOOD DONOR TECHS. PART X, LINE 2: THE FOUNDATION IS A NON-PROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"). ACCORDINGLY, NO PROVISION FOR THE INCOME TAXES IS MADE FOR FEDERAL, STATE OR LOCAL TAXES. IN ADDITION, THE IRS HAS DETERMINED THAT THE FOUNDATION IS NOT A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE CODE. THE FOUNDATION APPLIES A MORE-LIKELY-THAN-NOT MEASUREMENT METHODOLOGY TO REFLECT THE FINANCIAL STATEMENT IMPACT OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. AFTER EVALUATING THE TAX POSITIONS TAKEN, NONE ARE CONSIDERED TO BE UNCERTAIN; THEREFORE, NO AMOUNTS HAVE BEEN RECOGNIZED AS OF JUNE 30, 2018 AND 2017, RESPECTIVELY. IF INCURRED, INTEREST AND PENALTIES ASSOCIATED WITH TAX POSITIONS ARE RECORDED IN THE PERIOD ASSESSED AS GENERAL AND ADMINISTRATIVE EXPENSE. NO INTEREST OR PENALTIES HAVE BEEN ASSESSED AS OF JUNE 30, 2018 AND 2017, RESPECTIVELY. PART XI, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES 226,451. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES 226,451. PLEDGE WRITE OFFS (PROGRAMS) 2,950. CO GALA 425070 277351 147719 108696 50660 56233 GOLF TOURNAMENT 30642 20982 9660 6480 3524 858 2 455712 298333 157379 6480 112220 50660 57091 226451 -69072 1 UCH-MHS 1400 E BOULDER ST COLORDO SPRINGS CO 80909 460796114 501(C)(3) 613711 30228 FMV HOUSEHOLD & CLOTHING ITEMS, TOYS, FOOD, AND GIFT CARDS FINANCIAL SUPPORT 1 LIVING EXPENSES 1179 135328 EDUCATIONAL 71 16470 LYMPHEDEMA GARMENTS/WIGS 214 13245 1700 FAIR MARKET VALUE MASSAGE THERAPY 18 1650 SCHOLARSHIPS 18 42500 DIGNACAP TREATMENTS 4 1238 CAR SEATS 133 7654 SCHEDULE I, PART I, LINE I THE FOUNDATION'S EXECUTIVE DIRECTOR REVIEWS ALL GRANTS AND REQUESTS FOR MONIES. ALL ASSISTANCE PROVIDED TO INDIVIDUALS IS PAID DIRECTLY TO THOSE THAT PROVIDE THE ASSISTANCE. THE FUNDS ARE NOT GIVEN DIRECTLY TO THE INDIVIDUALS. THUS, THE ORGANIZATION IS ABLE TO ENSURE THAT THE FUNDS ARE USED FOR THE INTENDED PURPOSES. X 27 270 FMV X 4312 FMV X 1 15000 FMV X 134 703 FMV X 24 1700 FMV X GIFT CARDS 211 5885 FMV X TOYS 136 2350 FMV 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE MEMORIAL HOSPITAL FINANCE DEPARTMENT REVIEWS THE RETURN. A COPY OF THE FORM 990 IS EMAILED TO BOARD MEMBERS PRIOR TO BEING FILED. FORM 990, PART VI, SECTION B, LINE 12C AT THE ANNUAL BOARD MEETING, THE BOARD IS GIVEN A NEW COPY OF THE CONFLICT OF INTEREST STATEMENT. THE BOARD GOES OVER THE STATEMENT AND EACH BOARD MEMBER MUST SIGN THE DOCUMENT. THUS, EACH MEMBER SIGNS IT ANNUALLY AND IS REMINDED TO BRING ANY POTENTIAL CONFLICT TO THE BOARD'S AND EXECUTIVE DIRECTOR'S ATTENTION. THE BOARD MEMBER MUST ALSO RECUSE HIMSELF OR HERSELF FROM ANY VOTE IF THERE IS A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A SALARY SURVEY DATA THAT IS COMPILED BY THIRD PARTIES IS USED TO DETERMINE THE COMPENSATION OF THE EXECUTIVE DIRECTOR. REVIEW AND APPROVAL OF THE SALARY IS DONE BY THE MEMORIAL HOSPITAL AND UCH BOARDS. THE ORGANIZATION MAINTAINS THE APPROPRIATE DOCUMENTATION OF THE PROCESS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE AT THE FOUNDATION OFFICE IF THE PUBLIC WISHES TO REVIEW THEM. FORM 990, PART XI, LINE 9: PROVISION FOR UNCOLLECTIBLE PLEDGES -2,950.