2017-03-24T09:09:24-05:00 2016-06-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2015-07-01 830230808 WYOMING MEDICAL CENTER FOUNDATION WYOM 3075772973 1233 EAST SECOND STREET CASPER WY 82601 DAX COLLINS BOARD CHAIR 3075772973 2017-03-20 1 DARRYN MCGARVEY P00958683 6123764500 2015 2021-01-29 14:40:06Z DAX COLLINS 1233 EAST SECOND STREET CASPER WY 82601 2950732 0 X WWW.WYOMINGMEDICALCENTERFOUNDATION.ORG X 1976 WY TO SUPPORT THE MISSION OF THE WYOMING MEDICAL CENTER AND THE HEALTH OF THE COMMUNITY. 16 15 0 88 0 0 1643064 1534849 0 0 131517 121375 10691 19904 1785272 1676128 1046858 1814508 0 0 16901 27823 0 0 72152 265759 238436 1329518 2080767 455754 -404639 7056718 7213814 7762 630409 7048956 6583405 THE WYOMING MEDICAL CENTER FOUNDATION ENHANCES EXCELLENCE IN HEALTHCARE DELIVERY AT WYOMING MEDICAL CENTER BY SECURING PRIVATE PHILANTHROPIC RESOURCES, CULTIVATING ENDURING RELATIONSHIPS, AND DELIVERING SUPERIOR DONOR STEWARDSHIP. 0 0 1843967 1788758 0 THROUGHOUT THE FISCAL YEAR, THE WYOMING MEDICAL CENTER FOUNDATION ("WMC FOUNDATION") HAS RAISED FUNDS TO SUPPORT VARIOUS PROJECTS FOR ITS SUPPORTED ORGANIZATION, WYOMING MEDICAL CENTER ("WMC").THIS FISCAL YEAR, THE WMC FOUNDATION FOCUSED ON COLLECTING THE REMAINING PLEDGE BALANCES FOR THE WEST TOWER, FINISHING UP THE $1.5 MILLION FUNDRAISING FOR THE NERD HEALTH AND WELLNESS CENTER LOCATED IN WMC'S NEW WEST TOWER AND KICKING OFF A FUNDRAISER FOR THE MASTERSON PLACE. THE MASTERSON PLACE IS OWNED BY WMC FOUNDATION, BUT IS OPERATED BY WMC. IT IS A "HOME AWAY FROM HOME" FOR PATIENTS AND PATIENT FAMILIES TO STAY WHILE THEY ARE HERE FOR MEDICAL NEEDS. 138834 25750 0 THE ANGELS CANCER CARE PROGRAM'S OBJECTIVE IS TO CONTINUE TO SERVE CANCER PATIENTS UNDERGOING TREATMENT WITH NONMEDICAL NEEDS SUCH AS GAS CARDS, FOOD CARDS, HOTEL VOUCHERS, PROSTHESIS, WIGS AND MORE. LONG-TERM, THE ANGELS CANCER CARE PROGRAM PLANS TO CONTINUE TO SERVE PATIENTS ALONG WITH PROVIDING EDUCATION ON CANCER PREVENTION. THE ANGELS CANCER CARE PROGRAM HAS A RICH HISTORY OF ADDRESSING VARIED CONCERNS OF CANCER PATIENTS. THESE INCLUDE OFFERING EMOTIONAL SUPPORT, FINANCIAL ASSISTANCE, TRANSPORTATION AND MEDICATION RETRIEVAL. THE ANGELS CANCER CARE PROGRAM EDUCATES THE COMMUNITY ABOUT THE PROGRAM WHILE RAISING MUCH NEEDED FUNDS TO SUPPORT PATIENTS CURRENTLY UNDERGOING TREATMENT. 1982801 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 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 16 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 16 15 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 JESSICA ODEN CHAIR 2.00 0.00 X X 0 0 0 DAX COLLINS VICE CHAIR 2.00 0.00 X X 0 0 0 PATRICIA CLOUD SECRETARY/TREASURER 2.00 0.00 X X 0 0 0 JUDY AURELIUS BOARD MEMBER 2.00 0.00 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 VICKIE DIAMOND BOARD MEMBER & CEO OF WMC 2.00 55.00 X 0 755238 55615 DICK DRESANG BOARD MEMBER 2.00 0.00 X 0 0 0 CHERYL GRAFF BOARD MEMBER & WMC EMPLOYEE 2.00 40.00 X 0 94647 56816 JULIE GREINER BOARD MEMBER 2.00 0.00 X 0 0 0 SUSAN MCMURRY BOARD MEMBER 2.00 5.00 X 0 0 0 PAM MILLER BOARD MEMBER 2.00 0.00 X 0 0 0 JOHN PURVIANCE BOARD MEMBER 2.00 0.00 X 0 0 0 ALLEN QUIG BOARD MEMBER 2.00 0.00 X 0 0 0 DEBBIE REID BOARD MEMBER 2.00 0.00 X 0 0 0 KYLE THOMPSON BOARD MEMBER 2.00 0.00 X 0 0 0 JESSI WARING BOARD MEMBER 2.00 0.00 X 0 0 0 KAREN ZABACK BOARD MEMBER 2.00 0.00 X 0 0 0 CARYN LUBERTO EXECUTIVE DIRECTOR 40.00 0.00 X 0 51251 2439 ALISHA HAVENS EXECUTIVE DIRECTOR 40.00 0.00 X 0 90733 25416 0 991869 140286 0 0 1 0 AMUNDSEN ASSOCIATES LLC 212 EAST 2ND STREET CASPER WY 82601 GENERAL CONTRACTOR 185496 1 56502 369000 80000 1029347 369000 1534849 107150 107150 1225000 1210775 14225 14225 14225 83733 56502 63829 19904 19904 1676128 0 0 141279 1788758 1788758 25750 25750 27823 27823 25814 25814 568 568 24552 24552 4750 4750 311 311 56671 56671 FUNDRAISING 72152 72152 GIFTS & ENTERTAINMENT 27318 27318 MISCELLANEOUS 26300 26300 2080767 1982801 25814 72152 803279 1339429 1659662 1805251 80000 2705095 934338 1150823 1770757 3047073 1924597 382092 279991 13789 13789 7056718 7213814 0 57189 7762 573220 7762 630409 X 3197380 3527106 3316051 2520774 535525 535525 7048956 6583405 7056718 7213814 -404639 -60912 0 X 0 1 X 1 0 X X 1 WYOMING MEDICAL CENTER 830279242 3 1 1982801 0 1 1982801 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 13789 X 0 1535525 1000000 60463 60463 2535525 1535525 21480 21480 1535525 1563431 80243 108149 1535525 1511270 52161 99413 99413 1563431 1511270 10478 10478 1511270 0.78900 0.21100 0.00000 0 0 709885 709885 1346331 649681 696650 308969 284657 24312 339910 339910 1770757 DUE TO WYOMING MEDICAL CENTER 573220 573220 X 2166234 2122319 2122319 43915 1632213 1632213 1676128 2144596 63829 63829 2080767 0 2080767 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 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 2,044,859. FUNDRAISING EVENT EXPENSES 63,829. CHANGE IN DISCOUNT AND ALLOWANCES ON PLEDGES 13,631. PART XI, LINE 4B - OTHER ADJUSTMENTS: DONATED CAPITAL 369,000. RESTRICTED CONTRIBUTIONS AND EARNINGS 1,263,213. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 63,829. GIFT OF GALA 140235 56502 83733 6384 16798 6555 34092 140235 56502 83733 6384 16798 6555 34092 63829 19904 1 WYOMING MEDICAL CENTER 1233 EAST SECOND STREET CASPER WY 82601 830279242 501(C)(3) 1788758 WISH LIST PROGRAM, WEST TOWER & WELLNESS CENTER DONATIONS 1 0 MEDICATIONS/EQUIPMENT 16 2496 GAS GIFT CARDS 20 3650 FOOD 7 1006 LODGING 36 9229 WIGS/BRAS 9 1940 UTILITIES 5 1657 OTHER 15 5772 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. GRANT REQUESTS FOR INDIVIDUALS ARE SUBMITTED TO THE FOUNDATION. THE FOUNDATION'S PROGRAM COMMITTEE REVIEWS EACH REQUEST TO SEE IF THE REQUEST QUALIFIES, AND IF SO, ANALYZES THE AMOUNT REQUESTED AND ESTABLISHES A DECISION TO BE PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. THE FOUNDATION PAYS DIRECTLY FOR THESE EXPENSES TO ENSURE THE FUNDS ARE SPENT ON THE ITEMS REQUESTED. 0 0 0 0 0 0 0 0 0 VICKIE DIAMOND BOARD MEMBER & CEO OF WMC 0 618359 0 121000 0 15879 0 28600 0 27015 0 810853 0 0 CHERYL GRAFF BOARD MEMBER & WMC EMPLOYEE 0 93968 0 500 0 179 0 56816 0 0 0 151463 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. X 1 369000 APPRAISAL 0 0 1 0 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 SERVE AS NON-VOTING, EX-OFFICIO MEMBERS. 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 11 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 VICKIE DIAMOND AND CHERYL GRAFF REPRESENT COMPENSATION FOR THEIR SERVICES SOLELY TO WMC. THE COMPENSATION REPORTED FOR ALISHA HAVENS AND CARYN LUBERTO ARE FOR SERVICES RENDERED 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 11A, 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 1 0 0 0 0 0 1 0 0 1 1 1 1 1 1 0 1