SAUNDERS HEALTH SERVICES FOUNDATION: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
SAUNDERS HEALTH SERVICES FOUNDATION (EIN 47-0763871)
Tax period
2016-08-01 to 2017-07-31
Filed
2018-06-12
IRS object ID
201831639349300753
Schema version
2016v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-06-12T09:34:00-05:00ReturnTs
Tax Period End2017-07-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN470707411PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GLENDA R HARDERS CPABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1112 7TH ST E STE 3AddressLine1Txt
CityWAHOOCityNm
State AbbreviationNEStateAbbreviationCd
ZIP680661701ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-08-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN470763871EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SAUNDERS HEALTH SERVICES FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSAUNBusinessNameControlTxt
Phone4024433207PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 277AddressLine1Txt
CityWAHOOCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68066ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCYNTHIA HOHLPersonNm
Person TitleTREASURERPersonTitleTxt
Phone4024433207PhoneNum
Signature2018-06-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGLENDA R HARDERS CPAPreparerPersonNm
PTINP01347365PTIN
Phone4024433342PhoneNum
Preparation2018-06-12PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCYNTHIA HOHLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11760 CO RD JAddressLine1Txt
CityWAHOOCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68066ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$171,780GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateNELegalDomicileStateCd
Activity Or MissionSUPPORT HEALTH CARE IN THE COMMUNITY SERVED BY SAUNDERS COUNTY MEDICAL CENTERActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$9,651TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$7,686NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$46,736PYContributionsGrantsAmt
CY Contributions Grants$75,165CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$52,383PYInvestmentIncomeAmt
CY Investment Income$54,114CYInvestmentIncomeAmt
PY Other Revenue$36,642PYOtherRevenueAmt
CY Other Revenue$30,886CYOtherRevenueAmt
PY Total Revenue$135,761PYTotalRevenueAmt
CY Total Revenue$160,165CYTotalRevenueAmt
PY Grants And Similar Paid$69,715PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$132,392CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,941PYOtherExpensesAmt
CY Other Expenses$5,983CYOtherExpensesAmt
PY Total Expenses$76,656PYTotalExpensesAmt
CY Total Expenses$138,375CYTotalExpensesAmt
PY Revenues Less Expenses$59,105PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$21,790CYRevenuesLessExpensesAmt
Total Assets BOY$945,148TotalAssetsBOYAmt
Total Assets EOY$1,013,380TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$945,148NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,013,380NetAssetsOrFundBalancesEOYAmt
MissionSUPPORT HEALTH CARE IN THE COMMUNITY SERVED BY SAUNDERS COUNTY MEDICAL CENTERMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$134,616ExpenseAmt
Grant$132,392GrantAmt
DescSUPPORT SAUNDERS COUNTY MEDICAL CENTERDesc
Total Program Service Expenses$134,616TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCYNTHIA HOHLPersonNm
Phone4024433207PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11760 CO RD JAddressLine1Txt
CityWAHOOCityNm
State AbbreviationNEStateAbbreviationCd
ZIP68066ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DEBRA HOHL
PRESIDENTYes (X)$0$0$0
JARED KETNER
SECRETARYYes (X)$0$0$0
CYNTHIA HOHL
TREASURERYes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Membership Dues$340MembershipDuesAmt
All Other Contributions$74,825AllOtherContributionsAmt
Total Contributions$75,165TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,265TotalRevenueColumnAmt
Exclusion$24,265ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$29,849OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$29,849OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,849TotalRevenueColumnAmt
Exclusion$29,849ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$32,850FundraisingGrossIncomeAmt
Fundraising Direct Expenses$11,615FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,235TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescNEBRASKA PURCHASING GROUP LLCDesc
Business561000BusinessCd
Total Revenue Column$9,651TotalRevenueColumnAmt
Unrelated Business Revenue$9,651UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$9,651OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$160,165TotalRevenueColumnAmt
Unrelated Business Revenue$9,651UnrelatedBusinessRevenueAmt
Exclusion$54,114ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$123,260TotalAmt
Program Services$123,260ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$9,132TotalAmt
Program Services$9,132ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$259TotalAmt
Management And General$259ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,100TotalAmt
Management And General$1,100ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
UBIT TAXES PAID$2,400$2,400
SPONSOR BOO WAHOO$2,224$2,224

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$138,375TotalAmt
Program Services$134,616ProgramServicesAmt
Management And General$3,759ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$155,137BOYAmt
EOY$130,271EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$277,267BOYAmt
EOY$279,255EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$364,790BOYAmt
EOY$431,690EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$147,954BOYAmt
EOY$172,164EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$945,148BOYAmt
EOY$1,013,380EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$945,148BOYAmt
EOY$1,013,380EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$945,148BOYAmt
EOY$1,013,380EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$945,148BOYAmt
EOY$1,013,380EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$21,790ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$46,442NetUnrlzdGainsLossesInvstAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedfalseFSAuditedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SAUNDERS MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN476007158EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$123,260SupportAmt
Other Support$2,224OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$123,260SupportSumAmt
Other Support Sum$2,224OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

FieldValueIRS element (for citing)
Book Value$172,164BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$172,164TotalBookValueSecuritiesAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF TOURNAMENTEvent1Nm
Gross Receipts Event1$18,467GrossReceiptsEvent1Amt
Gross Revenue Event1$18,467GrossRevenueEvent1Amt
Other Direct Expenses Event1$6,349OtherDirectExpensesEvent1Amt
Event2AUXILIARY BENEFEvent2Nm
Gross Receipts Event2$14,383GrossReceiptsEvent2Amt
Gross Revenue Event2$14,383GrossRevenueEvent2Amt
Other Direct Expenses Event2$5,266OtherDirectExpensesEvent2Amt
Gross Receipts Total$32,850GrossReceiptsTotalAmt
Gross Revenue Total Events$32,850GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$11,615OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$11,615DirectExpenseSummaryEventsAmt
Net Income Summary$21,235NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
SAUNDERS CO MED CENTER
1760 CO RD JWAHOONE68066476007158GOV$107,376ER SAFE HAVEN
SAUNDERS CO MED CENTER
1760 CO RD JWAHOONE68066476007158GOV$15,884HOSPITAL SUPPORT

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
HEATH FAIR ACADEMY30$4,632
HEALTH SCHOLARSHIPS3$4,500

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTREASURER PRESENTS A COPY OF FORM 990 AND FORM 990-T AT MONTHLY BOARD MEETING.
FORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS ARE AVAILABLE IN THE OFFICES OF THE SAUNDERS MEDICAL CENTER.
FORM 990, PAGE 12, PART XII, LINE 1METHOD OF REPORTING MARKETABLE SECURITES WAS CHANGED FROM COST VALUE TO MARKET VALUE

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