2017-04-13T17:12:43-05:00 2016-06-30 450250958 EIDE BAILLY LLP 1545 ASSOCIATES DR STE 101 DUBUQUE IA 52002 990 2015-07-01 473010424 MEMORIAL HOSPITAL FOUNDATION MEMO 2173573131 PO BOX 160 CARTHAGE IL 62321 TERESA SMITH CFO 2173573131 2017-04-05 1 CARMEN KRANTZ P00031958 5635561790 2017-04-05 2015 2021-01-29 14:40:06Z ADA BAIR PO BOX 160 CARTHAGE IL 62321 114172 0 X N/A X 2014 IL SUPPORT MEMORIAL HOSPITAL ASSOC AND THE GENERAL HEALTH OF THE CITIZENS OF HANCOCK COUNTY, IL. 16 16 0 16 0 0 0 108126 0 0 0 148 0 -4262 0 104012 0 26350 0 0 0 0 0 0 8519 0 8919 0 35269 0 68743 48298 116880 0 0 48298 116880 ENHANCING THE HEALTH AND WELLNESS OF OUR COMMUNITIES THROUGH CHARITABLE GIVING. 0 0 26350 26350 THE MEMORIAL HOSPITAL FOUNDATION WAS ESTABLISHED IN JANUARY OF 2015 TO SUPPORT MEMORIAL HOSPITAL, HANCOCK COUNTY SENIOR SERVICES AND THE GENERAL HEALTH AND WELL-BEING OF THE CITIZENS OF HANCOCK COUNTY, ILLINOIS. DONATIONS TO THE FOUNDATION ARE USED TO MEET SHORT AND LONG-TERM GOALS FOR THE BENEFIT OF QUALITY LOCAL HEALTHCARE, HEALTH AND WELLNESS PROVISIONS FOR OUR COMMUNITIES, AND TO BUILD STABILITY AND A FINANCIAL LEGACY FOR FUTURE GENERATIONS. 26350 1 1 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 0 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 0 0 0 0 0 X 16 16 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X TERESA SMITH 2173576571 PO BOX 160 CARTHAGE IL 62321 X X JOE ZUMWALT PRESIDENT 0.50 X X 0 0 0 RON STARR VICE PRESIDENT 0.50 X X 0 0 0 CHARLES GILBERT SECRETARY/TREASURER 0.50 X X 0 0 0 ADA BAIR DIRECTOR 0.50 X 0 0 0 KRISTA CARLE DIRECTOR 0.50 X 0 0 0 CALLIE CONNOR DIRECTOR 0.50 X 0 0 0 JOHN DITTMER DIRECTOR 0.50 X 0 0 0 ELAINE FERGUSON DIRECTOR 0.50 X 0 0 0 DAVID FOX DIRECTOR 0.50 X 0 0 0 DON GRIFFITHS DIRECTOR 0.50 X 0 0 0 MATTIE HAAS DIRECTOR 0.50 X 0 0 0 MATT KRAUS DIRECTOR 0.50 X 0 0 0 SHARON MORRISON DIRECTOR 0.50 X 0 0 0 MAYOR JIM NIGHTINGALE DIRECTOR 0.50 X 0 0 0 TERRY POPE DIRECTOR 0.50 X 0 0 0 CASEY YAGER DIRECTOR 0.50 X 0 0 0 ADA BAIR HOSPITAL CEO 0.50 X 0 0 0 TERESA SMITH HOSPITAL CFO 0.50 X 0 0 0 0 0 0 0 0 0 0 0 28909 79217 108126 148 148 5898 28909 10160 -4262 -4262 104012 0 0 -4114 26250 26250 100 100 400 400 410 410 8109 8109 35269 26350 400 8519 48298 116880 48298 116880 0 0 X 48298 116880 48298 116880 48298 116880 68743 -161 0 X 0 0 0 X 48328 108126 156454 48328 108126 156454 34340 122114 148 148 156602 5898 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED GALA 34807 28909 5898 1200 5898 900 2162 34807 28909 5898 1200 5898 900 2162 10160 -4262 1 MEMORIAL HOSPITAL ASSOCIATION PO BOX 160 CARTHAGE IL 62321 370684691 25000 EQUIPMENT PURCHASE 1 0 PART I, LINE 2: THE FOUNDATION BOARD OF DIRECTORS APPROVES AMOUNTS TO OTHER ORGANIZATIONS THAT MAY BENEFIT THE HEALTH OF THE COMMUNITY. THERE IS A CLOSE WORKING RELATIONSHIP BETWEEN THE FOUNDATION AND MEMORIAL HOSPITAL THEREFORE ENSURING THE FUNDS ARE USED APPROPRIATELY. FORM 990, PART VI, SECTION A, LINE 1 THE CORPORATION SHALL HAVE AN EXECUTIVE COMMITTEE THAT IS COMPOSED OF THE FOLLOWING MEMBERS: THE PRESIDENT, VICE PRESIDENT, SECRETARY, AND TREASURER OF THE CORPORATION; THE CHAIRS OF THE CORPORATION'S ANNUAL GIFTS COMMITTEE, MAJOR GIFTS COMMITTEE, ESTATE GIFTS COMMITTEE, AND PERSONNEL COMMITTEE; AND THE IMMEDIATE PAST PRESIDENT OF THE CORPORATION IF SUCH PERSON IS A BOARD MEMBER OR, IF NOT, ONE ADDITIONAL BOARD MEMBER SELECTED BY THE BOARD. THE PRESIDENT OF THE CORPORATION, THE CHIEF EXECUTIVE OFFICER OF MEMORIAL HOSPITAL ASSOCIATION, AND THE CHIEF FINANCIAL OFFICER OF MEMORIAL HOSPITAL ASSOCIATION SHALL SERVE AS EX OFFICIO NON-VOTING MEMBERS OF THE EXECUTIVE COMMITTEE. EXCEPT AS OTHERWISE PROVIDED HEREIN, AND IN ANY BOARD RESOLUTION LIMITING THE POWERS OF THE EXECUTIVE COMMITTEE, SUCH COMMITTEE SHALL, DURING INTERVALS BETWEEN THE MEETINGS OF THE BOARD, POSSESS AND MAY EXERCISE ALL OF THE POWERS OF THE BOARD IN THE MANAGEMENT OF THE CORPORATION'S AFFAIRS. HOWEVER, THE EXECUTIVE COMMITTEE SHALL NOT HAVE THE AUTHORITY OF THE BOARD IN REFERENCE TO ELECTING, APPOINTING, OR REMOVING ANY MEMBER OF THE EXECUTIVE COMMITTEE, BOARD MEMBER, OR OFFICER OF THE CORPORATION; AUTHORIZING THE SALE, LEASE, EXCHANGE, OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S PROPERTY AND ASSETS; AUTHORIZING THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR REVOKING PROCEEDINGS THEREFOR; ADOPTING A PLAN FOR THE DISTRIBUTION OF THE CORPORATION'S ASSETS; OR AMENDING, ALTERING, OR REPEALING ANY RESOLUTION OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL KEEP FULL RECORDS AND ACCOUNTS OF ITS PROCEEDINGS AND TRANSACTIONS. ALL ACTION BY THE EXECUTIVE COMMITTEE SHALL BE REPORTED TO THE BOARD AT ITS MEETING NEXT SUCCEEDING SUCH ACTION AND SHALL BE SUBJECT TO CONTROL, REVISION, AND ALTERATION BY THE BOARD, PROVIDED THAT NO RIGHTS OF THIRD PARTIES SHALL BE PREJUDICIALLY AFFECTED THEREBY. SUBJECT TO THE PROVISIONS CONTAINED HEREIN, THE EXECUTIVE COMMITTEE SHALL FIX ITS OWN RULES OF PROCEDURE AND SHALL MEET AS PROVIDED BY SUCH RULES OR BY RESOLUTIONS OF THE BOARD, AND IT SHALL ALSO MEET AT THE CALL OF THE CHAIR OR ANY TWO MEMBERS OF THE EXECUTIVE COMMITTEE. UNLESS OTHERWISE PROVIDED BY SUCH RULES OR BY SUCH RESOLUTIONS, THE PROVISIONS CONTAINED HEREIN RELATING TO NOTICE REQUIRED TO BE GIVEN OF BOARD MEETINGS SHALL ALSO APPLY TO EXECUTIVE COMMITTEE MEETINGS. A MAJORITY OF THE MEMBERS OF THE EXECUTIVE COMMITTEE THEN IN OFFICE SHALL BE NECESSARY TO CONSTITUTE A QUORUM, AND APPROVAL OF ANY MATTER BY THE EXECUTIVE COMMITTEE SHALL REQUIRE THE AFFIRMATIVE VOTE OF A MAJORITY OF THE MEMBERS PRESENT AT THE MEETING. THE EXECUTIVE COMMITTEE MAY ACT IN WRITING WITHOUT A MEETING, BUT NO SUCH ACTION OF THE EXECUTIVE COMMITTEE SHALL BE EFFECTIVE UNLESS CONCURRED IN BY ALL MEMBERS OF THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7A THREE OF THE BOARD MEMBERS MUST BE MEMBERS OF THE BOARD OF MEMORIAL HOSPITAL ASSOCIATION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS BEFORE IT IS FILED. THE FINAL RETURN IS REVIEWED AND SIGNED BY THE HOSPITAL CFO. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT UPON BECOMING A BOARD MEMBER. THE DISCLOSURE IS UPDATED ANNUALLY. ANY POSSIBLE CONFLICT OF INTEREST IS DISCLOSED TO THE OTHER BOARD MEMBERS AND MADE A MATTER OF RECORD THROUGH AN ANNUAL PROCEDURE AND ALSO WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. DISCLOSURES ARE REVIEWED BY THE BOARD OF DIRECTORS AND ANY MEMBER FOR WHOM CONFLICTS HAVE BEEN IDENTIFIED LEAVES AND ABSTAINS FROM VOTING. APPROPRIATE DOCUMENTATION OF THE HANDLING OF THE CONFLICT IS KEPT TO PROTECT THE INTERESTED PARTY AND MEMORIAL HOSPITAL FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION PROVIDES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENT UPON REQUEST. FORM 990, PART VII: ADA BAIR, HOSPITAL CEO, AND TERESA SMITH, HOSPITAL CFO, ARE COMPENSATED FOR THEIR SERVICES TO MEMORIAL HOSPITAL ASSOCIATION. THEY ARE NOT COMPENSATED FOR THEIR SERVICES TO THE FOUNDATION.