2017-08-15T13:12:27-05:00 2016-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2015-10-01 431696258 PHELPS COUNTY HOSPITAL FOUNDATION % JANA COOK PHEL 5733648899 1000 WEST 10TH STREET ROLLA MO 65401 EDWARD CLAYTON CEO 2017-04-21 true Brian D Todd P00422601 4178658701 2015 2021-01-29 14:40:06Z EDWARD CLAYTON 1000 WEST 10TH STREET ROLLA MO 65401 940697 false X WWW.PCRMC.COM X 1994 MO SERVES AS THE PHILANTHROPIC ORGANIZATION THAT FACILITATES CHARITABLE DONATIONS TO SUPPORT AND ASSIST PCRMC IN PROVIDING HEALTHCARE. SEE SCHEDULE O FOR MORE DETAIL. 15 11 10 36 0 0 1204433 882236 0 0 1096 1375 -11385 -26156 1194144 857455 104204 84624 0 0 529378 517724 2595 69541 187828 324117 208351 960294 880240 233850 -22785 2767388 3338102 2779740 3360310 -12352 -22208 OUR MISSION IS TO SERVE AS THE PHILANTHROPIC ORGANIZATION THAT FACILITATES CHARITABLE DONATIONS TO SUPPORT AND ASSIST THE MISSIONS OF PHELPS COUNTY REGIONAL MEDICAL CENTER IN PROVIDING FOR THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. false false 564804 84624 THE ORGANIZATION FACILITATES CHARITABLE DONATIONS TO HELP SUPPORT THE MISSIONS AND ACTIVITIES OF PHELPS COUNTY REGIONAL MEDICAL CENTER. CONTRIBUTIONS ARE RECEIVED BY THE ORGANIZATION AND DISTRIBUTED TO PCRMC FOR USE IN ITS MISSION TO PROVIDE FOR THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. 564804 true true false false false false false false false false true false false false true false false false false false false false false true true false false true false true false false false false false false false false true false false false false true false false false true 15 0 true 10 true false false false false false true true false false false false false X 15 11 false false true false false false false true true false false false true true true true true false false false X JANA COOK 5734587916 1000 WEST 10TH STREET ROLLA MO 65401 X JOHN DENBO CEO/MEMBER END 01/16 1.0 40.0 X X 0 327260 25689 TED DAY TREASURER END 01/16; PRESIDENT 1.0 1.0 X X 0 0 0 PATRICIA LEADERS SECRETARY 1.0 1.0 X X 0 0 0 LORRIE HARTLEY DIRECTOR 1.0 40.0 X 0 147264 26967 CANDACE CONNELL PRESIDENT END 01/16; MEMBER 1.0 1.0 X X 0 0 0 CINDY BEGER VICE PRES. END 01/16; MEMBER 1.0 1.0 X X 0 0 0 OLLIE JACKSON MEMBER 1.0 1.0 X 0 0 0 SAMMY AUXIER JR MEMBER; TREASURER BEG 01/16 1.0 1.0 X X 0 0 0 LINDA MITCHELL MEMBER END 08/16 1.0 1.0 X 0 0 0 EDWARD CLAYTON MEMBER/CEO BEG 01/16 1.0 40.0 X X 0 259333 38963 AMY MEADOWS MEMBER 1.0 1.0 X 0 0 0 JEFF SCHRADER MEMBER 1.0 1.0 X 0 0 0 MOLLY MALONE MEMBER END 01/16 1.0 1.0 X 0 0 0 SHAD BECKER MEMBER END 01/16 1.0 1.0 X 0 0 0 WALT BRANSON MEMBER; VICE PRES. BEG 01/16 1.0 1.0 X X 0 0 0 STEVE LYNCH MEMBER 1.0 1.0 X 0 0 0 SANDY MITCHELL MEMBER END 01/16 1.0 1.0 X 0 0 0 DR LEROY WOMBOLD MEMBER END 08/16 1.0 40.0 X 0 399128 34722 KERI BROOKSHIRE-HEAVIN MEMBER 1.0 40.0 X 0 166267 28122 DR CHRISTOPHER SPENCER MEMBER 1.0 40.0 X 0 360955 9411 JASON SHENEFIELD COO/MEMBER BEG 08/16 1.0 40.0 X 0 0 0 0 1660207 163874 0 false true false 0 290805 31384 560047 42610 882236 0 1375 1375 0 0 0 0 0 0 57086 290805 83242 -26156 -26156 0 0 0 857455 -24781 84624 84624 0 0 0 0 0 388326 267550 58783 61993 13785 9497 2087 2201 90431 62305 13689 14437 25182 17350 3812 4020 0 0 2990 2990 0 69541 69541 0 5764 5764 31068 6120 24948 84071 71780 12291 33354 33354 0 0 1744 1744 0 21052 14207 6845 0 0 7923 5459 1199 1265 0 LICENSES, DUES, SUBSCRIPTIONS 12518 12518 MISCELLANEOUS EXPENSES 7867 5886 964 1017 880240 564804 127608 187828 0 0 2537928 3120140 0 0 40000 3400 0 0 0 0 0 0 0 0 18659 41085 70962 46790 19166 24172 0 0 0 0 0 0 0 0 151635 149305 2767388 3338102 16324 8448 0 0 19617 0 0 0 0 0 0 0 0 0 0 0 2743799 3351862 2779740 3360310 X -12352 -22208 0 0 0 0 -12352 -22208 2767388 3338102 -22785 12929 X false false false X X 1 PCRMC 436004435 3 true 84500 0 1 84500 true false false false false false false false false false false false false false false true true false SCHEDULE A, PART I, LINE 11H, COLUMN I NAME OF SUPPORTED ORGANIZATION: THE FULL NAME OF THE SUPPORTED ORGANIZATION IS PHELPS COUNTY REGIONAL MEDICAL CENTER. SCHEDULE A, PART IV, SECTION E, LINE 1C SUPPORT OF A GOVERNMENTAL ENTITY: PHELPS COUNTY HOSPITAL FOUNDATION SUPPORTS PHELPS COUNTY REGIONAL MEDICAL CENTER (PCRMC), A GOVERNMENTAL ENTITY. THE PURPOSE OF THE FOUNDATION IS TO SERVE AS THE PHILANTHROPIC ORGANIZATION THAT FACILITATES CHARITABLE DONATIONS TO SUPPORT AND ASSIST THE MISSION OF PCRMC IN PROVIDING HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. THROUGH PATIENT-CENTERED AND COMMUNITY-FOCUSED INITIATIVES, THE FOUNDATION WORKS IN COOPERATION WITH CLINICIANS, STAFF, PATIENTS, FRIENDS AND DONORS TO ENSURE THE GREATEST NEEDS AND OPPORTUNITIES ARE FUNDED ACROSS PCRMC. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17500 17500 53462 46790 6672 24172 0 DUE TO PCRMC 3351862 3351862 true DIANE BLUMENSON CAMPAIGN false 20500 ANN THOMPSON CAMPAIGN false 11646 RISING TIDE DIRECT CAMPAIGN false 31875 64021 CANCER GALA 191557 155401 36156 3240 1510 25274 6609 4743 GOLF TOURNEY 120600 106170 14430 9443 12549 8190 3729 1 35734 29234 6500 500 4870 2585 347891 290805 57086 13183 14059 38334 6609 11057 83242 -26156 true PHELPS COUNTY REGIONAL MEDICAL CENTER 1000 W 10TH STREET ROLLA MO 65401 436004435 PHELPS CO RMC 84500 SUPPORT PROGRAMS 1 SCHEDULE I, PART I, LINE 2 MONITORING OF GRANT FUNDS: GRANTS ARE PROVIDED TO A RELATED ORGANIZATION AS PART OF THE FOUNDATION'S MISSION. GRANT SPENDING IS MONITORED MONTHLY BY PCRMC ACCOUNTING DEPARTMENT AND FINANCIAL INFORMATION IS FORWARDED TO DIRECTOR OF FOUNDATION TO DETERMINE IF ADDITIONAL GRANT FUNDS ARE NEEDED. false false false false false false false false false JOHN DENBO CEO/MEMBER END 01/16 0 284550 0 102 0 42608 0 15900 0 9789 0 352949 0 0 LORRIE HARTLEY DIRECTOR 0 139109 0 102 0 8053 0 9158 0 17809 0 174231 0 0 EDWARD CLAYTON MEMBER/CEO BEG 01/16 0 238712 0 102 0 20519 0 15900 0 23063 0 298296 0 0 DR LEROY WOMBOLD MEMBER END 08/16 0 331306 0 43102 0 24720 0 15900 0 18822 0 433850 0 0 KERI BROOKSHIRE-HEAVIN MEMBER 0 163607 0 101 0 2559 0 10313 0 17809 0 194389 0 0 DR CHRISTOPHER SPENCER MEMBER 0 250853 0 92102 0 18000 0 0 0 9411 0 370366 0 0 SCHEDULE J, PART I, LINE 3 COMPENSATION DETERMINATION: PHELPS COUNTY REGIONAL MEDICAL CENTER, A RELATED ORGANIZATION, USES A WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE IN DETERMINING THE COMPENSATION OF THE CEO. X 2 42610 FMV false true false SCHEDULE M, PART I, LINE 9B NUMBER OF CONTRIBUTIONS OR ITEMS CONTRIBUTED: THE AMOUNT REPORTED IN COLUMN B IS THE NUMBER OF PERSONS WHO MADE NONCASH CONTRIBUTIONS. FORM 990, PART I, LINE 1 ORGANIZATION'S SIGNIFICANT ACTIVITIES: THE PHELPS COUNTY REGIONAL HEALTH CARE FOUNDATION IS A 501(C)(3) NOT-FOR-PROFIT, PHILANTHROPIC ORGANIZATION THE WAS ESTABLISHED IN 1996. OUR MISSION IS TO SERVE AS THE PHILANTHROPIC ORGANIZATION THAT FACILITATES CHARITABLE DONATIONS TO SUPPORT AND ASSIST THE MISSION OF THE PHELPS COUNTY REGIONAL MEDICAL CENTER. THE FOUNDATION EXISTS TO ENSURE THAT HEALTH CARE DELIVERY IN PHELPS COUNTY AND THE SURROUNDING COMMUNITIES CONTINUES TO BE TRANSFORMATIONAL. THROUGH PATIENT-CENTERED AND COMMUNITY-FOCUSED INITIATIVES, THE FOUNDATION WORKS IN COOPERATION WITH CLINICIANS, STAFF, PATIENTS, FRIENDS AND DONORS TO ENSURE THE GREATEST NEEDS AND OPPORTUNITIES ARE FUNDED ACROSS PHELPS COUNTY REGIONAL MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: FORMERLY, THE CFO & CHIEF OF STAFF OF THE PHELPS COUNTY REGIONAL MEDICAL CENTER, AND THE AUXILIARY BOARD PRESIDENT WERE REQUIRED TO BE EX-OFFICIO MEMBERS OF THE PHELPS COUNTY HOSPITAL FOUNDATION BOARD. WITH THE AMENDMENT OF THE ORGANIZATION'S BYLAWS, THIS REQUIREMENT HAS BEEN REMOVED. IN ADDITION, THE CEO OF THE FOUNDATION CAN MAKE RECOMMENDATIONS OF HOSPITAL EMPLOYEES TO SERVE AS EX-OFFICIO MEMBER(S) OF THE BOARD WITH THE APPROVAL OF THE EXISTING BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON INTERNAL FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE FORM IS REVIEWED BY THE CFO AND CONTROLLER OF THE ORGANIZATION BEFORE BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: ALL EMPLOYEES, DIRECTORS, OFFICERS AND TRUSTEES ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. EACH INDIVIDUAL IS REQUIRED TO SUBMIT ANY POTENTIAL CONFLICTS FOR REVIEW BY THE BOARD AND, IF NECESSARY, GENERAL COUNSEL SO THAT A DETERMINATION OF CONFLICT CAN BE ISSUED. IF A CONFLICT DOES EXIST, THE AFFECTED INDIVIDUAL IS NOT ALLOWED TO VOTE WITH REGARDS TO TRANSACTIONS THAT INVOLVE THE ORGANIZATION AND POTENTIALLY THE CONFLICTED PARTY AND WILL BE EXCUSED FROM THE BOARD SESSION DURING THE VOTING PERIOD. IN ADDITION, THE BOARD MAINTAINS THE RIGHT TO APPOINT AN INDEPENDENT THIRD PARTY TO RESEARCH THE POTENTIAL TRANSACTION AND ANY POSSIBLE ALTERNATIVES. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION REVIEW: THE TOP MANAGEMENT OFFICIAL OF THE ORGANIZATION IS COMPENSATED BY PHELPS COUNTY REGIONAL MEDICAL CENTER, A RELATED ORGANIZATION. HUMAN RESOURCES CONDUCTS AN ORGANIZATION-WIDE COMPENSATION REVIEW BASED ON MARKET DATA COLLECTED FROM COMPETITIVE MARKETS. RECOMMENDED ADJUSTMENTS ARE BASED ON THE DATA COLLECTED AND THE FINANCIAL POSITION OF THE ORGANIZATION. PAY RAISES ARE APPROVED BY THE BOARD OF DIRECTORS, AND DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A BOARD MEMBER COMPENSATION: JOHN DENBO, EDWARD CLAYTON, DR. LEROY WOMBOLD, KERI BROOKSHIRE-HEAVIN, DR. CHRISTOPHER SPENCER, AND LORRIE HARTLEY RECEIVE W-2 COMPENSATION FROM PHELPS COUNTY REGIONAL MEDICAL CENTER FOR THEIR SERVICES AS EMPLOYEES. NO BOARD MEMBERS ARE COMPENSATED FOR THEIR SERVICES AS A BOARD MEMBER. PHELPS COUNTY REGIONAL MEDICAL CENTER 1000 W 10TH STREET ROLLA MO 65401 436004435 HEALTH CARE MO 501(C)(3) 3 NA false false true true false true false false false false false false true false true true true true false false