2017-06-09T15:08:41-05:00 2016-09-30 450250958 EIDE BAILLY LLP 1545 ASSOCIATES DR STE 101 DUBUQUE IA 52002 990EZ 2015-10-01 271865510 Mile Bluff Medical Center Foundation MILE 6088476161 1050 Division Street Mauston WI 53948 James O'Keefe President/CEO 6088476161 2017-05-31 1 Carmen Krantz P00031958 5635561790 2017-05-31 2015 2021-01-29 14:40:06Z X n/a X X 137119 X 114732 16937 857 4593 8613 -4020 128506 46058 712 41153 87923 40583 160681 0 201264 X 154623 186030 13148 23736 167771 209766 7090 8502 160681 201264 X Mile Bluff Medical Center Foundation provides philanthropic opportunities and support to Mile Bluff Medical Center, assisting in fulfilling its mission, adhering to its core values and pursuing its vision to provide the community with exceptional, personalized healthcare services. Mile Bluff Medical Center Foundation strives to build and cultivate community partnerships that ensure lifelong commitments to healthcare advancement, personal well-being and improvement throughout Mile Bluff's six-county service area. 46058 87923 87923 James O'Keefe President/CEO 0.25 0 0 0 Molly Scully Secretary 0.25 0 0 0 Sandy Linsmeyer Treasurer 0.25 0 0 0 Christine Carter Director 0.25 0 0 0 Nora Scully Director 0.25 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 WI James O'Keefe 1050 Division Street Mauston WI 53948 6088476161 0 0 0 0 0 0 0 0 0 0 NONE NONE 1 X X X 1 Mile Bluff Medical Center Inc 390992883 3 1 48346 0 1 48346 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Schedule A, Part IV, Section A, Line 1: The Foundation was organized and will be operated exclusively to benefit and carry out the purposes of the Medical Center and certain of the Medical Center's related organizations (collectively, the "Supported Organizations"). The Medical Center is a Wisconsin nonstock corporation that is a Code Section 501(c)(3) organization and a public charity described in Code Sections 170(b)(1)(A)(iii) and 509(a)(1). As set forth in the Foundation's Articles of Incorporation, in order for one of the Medical Center's related organizations to qualify as a Supported Organization of the Foundation, the related organization must (1) be described in Code Section 501(c)(3); (2) be a public charity described in Code Section 509(a)(1) or 509(a)(2); and (3) be directly or indirectly controlled by, under common control with, or in control of the Medical Center. Schedule A, Part IV, Section B, Line 1: The Foundation's Supported Organizations serve as its members, will elect all of the Foundation's directors, and have the authority to amend the Foundation's governing documents. At this time, only the Medical Center is acting as a member, and therefore Supported Organization, of the Foundation. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED Annual Golf Outing 30242 25649 4593 700 2077 4593 1243 30242 25649 4593 700 2077 4593 1243 8613 -4020 Form 990-EZ, Part I, Line 4 - Other Investment Income Description: Interest Income. Amount: 857. Form 990-EZ, Part I, Line 10 - Grants and Similar Amounts Paid Activity Classification: Operational support. Grantee Name: Mile Bluff Medical Center, Inc.. Grantee Address: 1050 Division Street Mauston, WI 53948-1997. Grantee Relationship: Supported organization. Amount Given: 44,308. Form 990-EZ, Part I, Line 16 - Other Expenses Description: Supplies. Amount: 3,813. Description: Continuing education. Amount: 206. Description: Travel. Amount: 118. Description: Women's Night Out expenses. Amount: 14,432. Description: Dues and subscriptions. Amount: 369. Description: Entertainment/meals. Amount: 5,355. Description: Marketing. Amount: 7,285. Description: Nurses Helping Nurses. Amount: 9,575. Total to Form 990-EZ, line 16: 41,153. Form 990-EZ, Part II, Line 24 - Other Assets Description: Pledges receivable. Beg. of Year Amount: 7,589. End of Year Amount: 18,177. Description: Investment - other security. Beg. of Year Amount: 5,559. End of Year Amount: 5,559. Form 990-EZ, Part II, Line 26 - Other Liabilities Description: Accounts payable. Beg. of Year Amount: 553. End of Year Amount: 1,960. Description: Due to Mile Bluff Medical Center. Beg. of Year Amount: 6,537. End of Year Amount: 6,542. The organization did not, during the year, receive any funds, directly,or indirectly, to pay premiums on a personal benefit contract.The organization, did not, during the year, pay any premiums, directly,or indirectly, on a personal benefit contract.