MEMORIAL HEALTH SYSTEM FOUNDATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
MEMORIAL HEALTH SYSTEM FOUNDATION (EIN 84-1576338)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-04
IRS object ID
201721249349300147
Schema version
2015v3.0
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)
Return2017-05-04T12:24:30-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN461497033PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EKS&H LLLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line17979 E TUFTS AVE SUITE 400AddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80237ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN841576338EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE MEMORIAL HEALTH SYSTEM FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMEMOBusinessNameControlTxt
Phone7193654483PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11519 E BOULDER STAddressLine1Txt
CityCOLORADO SPRINGSCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80909ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCARI KARNSPersonNm
Person TitleSENIOR DIRECTORPersonTitleTxt
Phone7193654483PhoneNum
Signature2017-05-02SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDORI J EGGETTPreparerPersonNm
PTINP00645252PTIN
Phone3037409400PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCARI KARNSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11519 E BOULDER STAddressLine1Txt
CityCOLORADO SPRINGSCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80909ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,273,293GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2001FormationYr
Legal Domicile StateCOLegalDomicileStateCd
Activity Or MissionTO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee7TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,435,202PYContributionsGrantsAmt
CY Contributions Grants$1,079,180CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$26,393PYInvestmentIncomeAmt
CY Investment Income$67,412CYInvestmentIncomeAmt
PY Other Revenue-$35,465PYOtherRevenueAmt
CY Other Revenue-$11,831CYOtherRevenueAmt
PY Total Revenue$1,426,130PYTotalRevenueAmt
CY Total Revenue$1,134,761CYTotalRevenueAmt
PY Grants And Similar Paid$1,677,370PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$957,033CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$533,157PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$435,199CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$22,615PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$15,193CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$297,518CYTotalFundraisingExpenseAmt
PY Other Expenses$193,564PYOtherExpensesAmt
CY Other Expenses$205,529CYOtherExpensesAmt
PY Total Expenses$2,426,706PYTotalExpensesAmt
CY Total Expenses$1,612,954CYTotalExpensesAmt
PY Revenues Less Expenses-$1,000,576PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$478,193CYRevenuesLessExpensesAmt
Total Assets BOY$3,787,118TotalAssetsBOYAmt
Total Assets EOY$3,744,580TotalAssetsEOYAmt
Total Liabilities BOY$117,703TotalLiabilitiesBOYAmt
Total Liabilities EOY$533,554TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,669,415NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,211,026NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OTHE MISSION OF MEMORIAL HEALTH SYSTEM FOUNDATION IS TO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM TO PROVIDE THE HIGHEST QUALITY HEALTH CARE. PHILANTHROPIC SUPPORT IS BEING SOUGHT FOR CAPITAL, ENDOWMENT AND PROGRAMMATIC PURPOSES, INCLUDING CANCER, CARDIOLOGY, AND WOMEN'S PROGRAMS AND SERVICES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$391,138ExpenseAmt
Grant$391,138GrantAmt
DescTHE CANCER EQUIPMENT FUND WAS ESTABLISHED TO PURCHASE EQUIPMENT RELATED TO CANCER TREATMENT. DURING FY16, A 3D MAMMOGRAPHY SYSTEM WAS PURCHASED FOR THE HOSPITAL'S RADIOLOGY UNIT AT PRINTERS PARK.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$135,250ExpenseAmt
Grant$135,250GrantAmt
DescTHE CS CHILDREN'S HOSPITAL GENERAL FUND WAS CREATED TO SUPPORT THE CHILDREN'S HOSPITAL AT MEMORIAL HOSPITAL. THE FUNDS ARE DISTRIBUTED UPON SPECIFIC REQUESTS FROM THE COLORADO CHILDREN'S HOSPITAL FOR THE BENEFIT AND CARE OF THE CHILDREN AND FAMILIES OF COLORADO SPRINGS AND COMMUNITIES SERVED BY THE CHILDREN'S HOSPITAL.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$99,413ExpenseAmt
Grant$85,893GrantAmt
DescTHE CARDIOVASCULAR SERVICES GENERAL FUND IS TO BE USED FOR COMMUNITY OUTREACH PROGRAMS, CONTINUING EDUCATION, EQUIPMENT, PATIENT SUPPORT PROGRAMS. DURING FY16, A NEW ULTRASOUND UNIT WAS PURCHASED FOR THE CARDIOVASCULAR AREA OF MEMORIAL HOSPITAL.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$443,507ExpenseAmt
Grant$344,752GrantAmt
DescVARIOUS PATIENT CARE AND STAFF EDUCATION FUNDS.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$443,507TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$344,752TotalOtherProgSrvcGrantAmt
Total Program Service Expenses$1,069,308TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art ContributionYes (1)DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee7EmployeeCnt
Employment Tax Returns Filed0EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STEVE WEBERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7193654483PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11519 E BOULDER STAddressLine1Txt
CityCOLORADO SPRINGSCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80909ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
TATIANA BAILEY
DIRECTOR1.00Yes (X)$0$0$0
MARK BROWN
DIRECTOR1.00Yes (X)$0$0$0
BRADLEY BUTLER
DIRECTOR1.00Yes (X)$0$0$0
MARGARET CARMACK
BOARD CHAIR1.00Yes (X)$0$0$0Yes (X)
DAVID GREENBERG
DIRECTOR1.00Yes (X)$0$0$0
GEORGE HAYES
DIRECTOR1.00Yes (X)$0$0$0
LANA JANC
DIRECTOR1.00Yes (X)$0$0$0
MARY ELLEN MCNALLY
DIRECTOR1.00Yes (X)$0$0$0
KEVIN O'GARA
VICE BOARD CHAIR1.00Yes (X)$0$0$0Yes (X)
BRUCE PANTER
DIRECTOR1.00Yes (X)$0$0$0
BETSY PLANTE
DIRECTOR1.00Yes (X)$0$0$0
ERIC SCOTT
DIRECTOR1.00Yes (X)$0$0$0
J WERNER ZIEGLER
DIRECTOR1.00Yes (X)$0$0$0
CARI KARNS
SR DIRECTOR OF DEVELOPMENT40.00$31,104$0$3,621Yes (X)
ERIN HENNINGER
INTERIM EXEC. DIR. ENDED 9/201540.00$14,296$0$2,870Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$45,400TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$6,491TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$221,330FundraisingAmt
Related Organizations$618,301RelatedOrganizationsAmt
All Other Contributions$239,549AllOtherContributionsAmt
Noncash Contributions$9,101NoncashContributionsAmt
Total Contributions$1,079,180TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$67,531TotalRevenueColumnAmt
Exclusion$67,531ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$119SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$119SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$119TotalRevenueColumnAmt
Exclusion-$119ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$126,582FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$221,330ContriRptFundraisingEventAmt
Fundraising Direct Expenses$138,413FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$11,831TotalRevenueColumnAmt
Exclusion-$11,831ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,134,761TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$55,581ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$768,290TotalAmt
Program Services$768,290ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$188,743TotalAmt
Program Services$188,743ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$118,018TotalAmt
Program Services$29,505ProgramServicesAmt
Management And General$59,008ManagementAndGeneralAmt
Fundraising$29,505FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$262,970TotalAmt
Program Services$44,593ProgramServicesAmt
Management And General$46,917ManagementAndGeneralAmt
Fundraising$171,460FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$9,125TotalAmt
Program Services$1,580ProgramServicesAmt
Management And General$1,695ManagementAndGeneralAmt
Fundraising$5,850FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$39,658TotalAmt
Program Services$6,673ProgramServicesAmt
Management And General$6,969ManagementAndGeneralAmt
Fundraising$26,016FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,428TotalAmt
Program Services$940ProgramServicesAmt
Management And General$1,008ManagementAndGeneralAmt
Fundraising$3,480FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$15,296TotalAmt
Program Services$1,429ProgramServicesAmt
Management And General$8,150ManagementAndGeneralAmt
Fundraising$5,717FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$27,562TotalAmt
Management And General$27,562ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$15,193TotalAmt
Fundraising$15,193FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$21,951TotalAmt
Management And General$21,951ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$10,928TotalAmt
Program Services$1,519ProgramServicesAmt
Management And General$4,131ManagementAndGeneralAmt
Fundraising$5,278FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$8,727TotalAmt
Program Services$548ProgramServicesAmt
Management And General$1,645ManagementAndGeneralAmt
Fundraising$6,534FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$15,250TotalAmt
Program Services$1,288ProgramServicesAmt
Management And General$10,275ManagementAndGeneralAmt
Fundraising$3,687FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$43,354TotalAmt
Program Services$13,006ProgramServicesAmt
Management And General$21,677ManagementAndGeneralAmt
Fundraising$8,671FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$45,390TotalAmt
Program Services$9,078ProgramServicesAmt
Management And General$27,234ManagementAndGeneralAmt
Fundraising$9,078FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,305TotalAmt
Management And General$522ManagementAndGeneralAmt
Fundraising$783FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$7,007TotalAmt
Program Services$1,539ProgramServicesAmt
Management And General$1,777ManagementAndGeneralAmt
Fundraising$3,691FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,886TotalAmt
Program Services$577ProgramServicesAmt
Management And General$1,732ManagementAndGeneralAmt
Fundraising$577FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,116TotalAmt
Management And General$1,116ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
DUES$3,330$1,332$1,998
MISCELLANEOUS$1,427$1,427

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,612,954TotalAmt
Program Services$1,069,308ProgramServicesAmt
Management And General$246,128ManagementAndGeneralAmt
Fundraising$297,518FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$55,846BOYAmt
EOY$141,446EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,480,477BOYAmt
EOY$1,317,231EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$33,613BOYAmt
EOY$18,022EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$32,973BOYAmt
EOY$25,746EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$61,945LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$60,890LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,942BOYAmt
EOY$1,055EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,180,267BOYAmt
EOY$2,241,080EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,787,118BOYAmt
EOY$3,744,580EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$115,103BOYAmt
EOY$518,854EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$2,600BOYAmt
EOY$14,700EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$117,703BOYAmt
EOY$533,554EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$809,454BOYAmt
EOY$712,045EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,665,786BOYAmt
EOY$2,304,806EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$194,175BOYAmt
EOY$194,175EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,669,415BOYAmt
EOY$3,211,026EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,787,118BOYAmt
EOY$3,744,580EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$478,193ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$26,084NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$6,280OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,612,367CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,643,755CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$643,614CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,435,202CurrentTaxYearMinus1YearAmt
Current Tax Year$1,079,180CurrentTaxYearAmt
Total$6,414,118TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,612,367CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,643,755CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$643,614CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,435,202CurrentTaxYearMinus1YearAmt
Current Tax Year$1,079,180CurrentTaxYearAmt
Total$6,414,118TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$2,717,790SubstantialContributorsTotAmt
Public Support Total170$3,696,328PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$21,548CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,547CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$540CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$20,295CurrentTaxYearMinus1YearAmt
Current Tax Year$67,531CurrentTaxYearAmt
Total$124,461TotalAmt
FieldValueIRS element (for citing)
Total Support$6,538,579TotalSupportAmt
Public Support CY1700.56530PublicSupportCY170Pct
Public Support PY1700.57680PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE A, PART II:FormAndLineReferenceDesc
ExplanationTHE 2013 YEAR COLUMN OF SCHEDULE A PART II IS A SHORT YEAR TAX RETURN PERIOD FROM 1/1/2014 TO 6/30/2014.ExplanationTxt

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$240,314BeginningYearBalanceAmt
Investment Earnings Or Losses$3,382InvestmentEarningsOrLossesAmt
End Year Balance$243,696EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$233,177BeginningYearBalanceAmt
Investment Earnings Or Losses$7,137InvestmentEarningsOrLossesAmt
End Year Balance$240,314EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$225,820BeginningYearBalanceAmt
Investment Earnings Or Losses$7,357InvestmentEarningsOrLossesAmt
End Year Balance$233,117EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$204,672BeginningYearBalanceAmt
Investment Earnings Or Losses$21,148InvestmentEarningsOrLossesAmt
End Year Balance$225,820EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$194,127BeginningYearBalanceAmt
Investment Earnings Or Losses$10,545InvestmentEarningsOrLossesAmt
End Year Balance$204,672EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.79680PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.20320TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$61,945OtherCostOrOtherBasisAmt
Depreciation$60,890DepreciationAmt
Book Value$1,055BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,055TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,312,778TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$26,084NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$13,520DonatedServicesAndUseFcltsAmt
Other Revenue$138,413OtherRevenueAmt
Revenue Not Reported$178,017RevenueNotReportedAmt
Revenue Subtotal$1,134,761RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,134,761TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,771,167TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$13,520DonatedServicesUseFcltsAmt
Other Expenses Included$144,693OtherExpensesIncludedAmt
Expenses Not Reported$158,213ExpensesNotReportedAmt
Expenses Subtotal$1,612,954ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,612,954TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO PROVIDE EDUCATION TO OUTREACH PROGRAMS, TRAUMA NURSES, AND BLOOD DONOR TECHS.
PART X, LINE 2:THE FOUNDATION IS A NON-PROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"). ACCORDINGLY, NO PROVISION FOR THE INCOME TAXES IS MADE FOR FEDERAL, STATE OR LOCAL TAXES. IN ADDITION, THE IRS HAS DETERMINED THAT THE FOUNDATION IS NOT A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE CODE. THE FOUNDATION APPLIES A MORE-LIKELY-THAN-NOT MEASUREMENT METHODOLOGY TO REFLECT THE FINANCIAL STATEMENT IMPACT OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. AFTER EVALUATING THE TAX POSITIONS TAKEN, NONE ARE CONSIDERED TO BE UNCERTAIN; THEREFORE, NO AMOUNTS HAVE BEEN RECOGNIZED AS OF JUNE 30, 2016 AND 2015, RESPECTIVELY. IF INCURRED, INTEREST AND PENALTIES ASSOCIATED WITH TAX POSITIONS ARE RECORDED IN THE PERIOD ASSESSED AS GENERAL AND ADMINISTRATIVE EXPENSE. NO INTEREST OR PENALTIES HAVE BEEN ASSESSED AS OF JUNE 30, 2016 AND 2015, RESPECTIVELY.
PART XI, LINE 2D - OTHER ADJUSTMENTS:SPECIAL EVENT EXPENSES 138,413.
PART XII, LINE 2D - OTHER ADJUSTMENTS:SPECIAL EVENT EXPENSES 138,413. PLEDGE WRITE OFFS (PROGRAMS) 6,280.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Agrmt Prof Fundraising ActyYes (1)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

Organization Business Name OrganizationBusinessName

FieldValueIRS element (for citing)
Business Name Line1LYNN WAALKESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11519 E BOULDER STAddressLine1Txt
CityCOLORADO SPRINGSCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80909ZIPCd
FieldValueIRS element (for citing)
ActivityGRANTWRITINGActivityTxt
Fundraiser Control Of Funds0FundraiserControlOfFundsInd
Gross Receipts$48,000GrossReceiptsAmt
Retained By Contractor$15,193RetainedByContractorAmt
Net To Organization$32,807NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Gross Receipts$48,000TotalGrossReceiptsAmt
Total Retained By Contractors$15,193TotalRetainedByContractorsAmt
Total Net To Organization$32,807TotalNetToOrganizationAmt
Licensed StatesCOLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GALAEvent1Nm
Gross Receipts Event1$279,650GrossReceiptsEvent1Amt
Charitable Contri Event1$173,773CharitableContriEvent1Amt
Gross Revenue Event1$105,877GrossRevenueEvent1Amt
Rent Facility Costs Event1$8,821RentFacilityCostsEvent1Amt
Food And Beverage Event1$51,094FoodAndBeverageEvent1Amt
Entertainment Event1$2,750EntertainmentEvent1Amt
Other Direct Expenses Event1$37,857OtherDirectExpensesEvent1Amt
Event2GOLF TOURNAMENTEvent2Nm
Gross Receipts Event2$34,985GrossReceiptsEvent2Amt
Charitable Contri Event2$21,775CharitableContriEvent2Amt
Gross Revenue Event2$13,210GrossRevenueEvent2Amt
Rent Facility Costs Event2$11,359RentFacilityCostsEvent2Amt
Food And Beverage Event2$3,606FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$1,627OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$33,277GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$25,782CharitableContriOtherEventsAmt
Gross Revenue Other Events$7,495GrossRevenueOtherEventsAmt
Food And Beverage Other Events$16,793FoodAndBeverageOtherEventsAmt
Entertainment Other Events$925EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events$3,581OthDirectExpnssOtherEventsAmt
Gross Receipts Total$347,912GrossReceiptsTotalAmt
Charitable Contributions Tot$221,330CharitableContributionsTotAmt
Gross Revenue Total Events$126,582GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$20,180RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$71,493FoodAndBeverageTotalEventsAmt
Entertainment Total Events$3,675EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$43,065OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$138,413DirectExpenseSummaryEventsAmt
Net Income Summary-$11,831NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1UCH - MHSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 E BOULDER STREETAddressLine1Txt
CityCOLORADO SPRINGSCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80909ZIPCd
FieldValueIRS element (for citing)
Recipient EIN460796114RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$768,290CashGrantAmt
Purpose Of GrantFINANCIAL SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)

Grant TypeGrantTypeTxtRecipientRecipientCntCash GrantCashGrantAmt
LIVING EXPENSES554$113,643
EDUCATIONAL33$24,634
LYMPHEDEMA GARMENTS/WIGS56$9,577
MASSAGE THERAPY28$1,889
SCHOLARSHIPS22$39,000

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I , LINE IFormAndLineReferenceDesc
ExplanationTHE FOUNDATION EXECUTIVE DIRECTOR REVIEWS ALL GRANTS AND REQUESTS FOR MONIES. ALL ASSISTANCE PROVIDED TO INDIVIDUALS IS PAID DIRECTLY TO THOSE THAT PROVIDE THE ASSISTANCE. THE FUNDS ARE NOT GIVEN DIRECTLY TO THE INDIVIDUALS. THUS, THE ORGANIZATION IS ABLE TO ENSURE THAT THE FUNDS ARE USED FOR THE INTENDED PURPOSES.ExplanationTxt

Schedule M IRS990ScheduleM

Works Of Art WorksOfArtGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$1,915NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt

Clothing And Household Goods ClothingAndHouseholdGoodsGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$2,171NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt

Food Inventory FoodInventoryGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution3ContributionCnt
Noncash Contributions Rpt F990$525NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$2,780NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)CENTER PIECES FOR GALA EVENT1$1,200FMV
Yes (X)TOYS2$510FMV
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE MEMORIAL HOSPITAL FINANCE DEPARTMENT REVIEWS THE RETURN. A COPY OF THE FORM 990 IS EMAILED TO BOARD MEMBERS PRIOR TO BEING FILED.
FORM 990, PART VI, SECTION B, LINE 12CAT THE ANNUAL BOARD MEETING, THE BOARD IS GIVEN A NEW COPY OF THE CONFLICT OF INTEREST STATEMENT. THE BOARD GOES OVER THE STATEMENT AND EACH BOARD MEMBER MUST SIGN THE DOCUMENT. THUS, EACH MEMBER SIGNS IT ANNUALLY AND IS REMINDED TO BRING ANY POTENTIAL CONFLICT TO THE BOARD'S AND EXECUTIVE DIRECTOR'S ATTENTION. THE BOARD MEMBER MUST ALSO RECUSE HIMSELF OR HERSELF FROM ANY VOTE IF THERE IS A CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15ASALARY SURVEY DATA THAT IS COMPILED BY THIRD PARTIES IS USED TO DETERMINE THE COMPENSATION OF THE EXECUTIVE DIRECTOR. REVIEW AND APPROVAL OF THE SALARY IS DONE BY THE MEMORIAL HOSPITAL AND UCH BOARDS. THE ORGANIZATION MAINTAINS THE APPROPRIATE DOCUMENTATION OF THE PROCESS.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE AVAILABLE AT THE FOUNDATION OFFICE IF THE PUBLIC WISHES TO REVIEW THEM.
FORM 990, PART XI, LINE 9:PROVISION FOR UNCOLLECTIBLE PLEDGES -6,280.

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