2018-08-07T12:43:09-05:00 2017-09-30 411765929 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2016-10-01 391823757 Tomah Memorial Hospital Foundation TOMA 6083722181 321 Butts Avenue Tomah WI 54660 Joseph Zeps CFO - Tomah Memorial Hospital 6083722181 2018-08-07 1 Kim Hunwardsen CPA P00484560 9529446166 2018-08-07 2016 2022-09-23 18:48:47Z Peter Reichardt 321 Butts Avenue Tomah WI 54660 55627 0 X www.tomahhospital.org X 1996 WI Support of Tomah Memorial Hospital and surrounding community. 9 9 0 9 0 0 35429 40255 0 0 4524 5462 2493 1871 42446 47588 14600 287537 0 0 0 0 0 0 0 2050 2363 16650 289900 25796 -242312 593215 658763 0 276234 593215 382529 The mission of Tomah Memorial Hospital Foundation is to support the community of Tomah and the healthcare providers that serve its residents. 0 0 287537 287537 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 2017 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. 287537 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 1 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 1.00 X 0 0 0 Chris Pokela Director 1.00 X 0 0 0 Jenny McCoy Director 1.00 X 0 0 0 John McMullen Director (thru Mar 2017) 1.00 X 0 0 0 Eric PriseDirector of Public Relations 5.00 X 9105 0 409 9105 0 409 0 0 0 1 0 29150 11105 40255 5462 5462 9400 29150 8039 1361 1361 510 0 510 510 47588 0 0 7333 283037 283037 4500 4500 1700 1700 535 535 128 128 289900 287537 2363 0 593215 658763 593215 658763 1234 275000 0 276234 X 0 0 0 0 593215 382529 593215 382529 593215 658763 -242312 31626 0 X 0 0 0 X 29719 27136 33350 35429 40255 165889 29719 27136 33350 35429 40255 165889 165889 4679 1359 4901 4524 5462 20925 186814 36942 0.88800 0.86690 X Golf outing 38550 29150 9400 3773 3600 666 38550 29150 9400 3773 3600 666 8039 1361 1 Tomah Memorial Hospital 321 Butts Ave Tomah WI 54660 390799566 501(c)(3) 275000 Provide support for hospital upgrades 1 0 Part I, Line 2: The Foundation board discusses and determines the best use of funds for any health related projects within Monroe County. They are committed to providing the healthcare essential to the community and future generations. 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.