CALDWELL MEMORIAL HOSPITAL FOUNDATION INC: Form 990, tax year 2015
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- Organization
- CALDWELL MEMORIAL HOSPITAL FOUNDATION INC (EIN 58-1935514)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2016-10-28
- IRS object ID
- 201633029349300618
- Schema version
- 2015v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-10-28T09:04:24-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 561588934 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMITH STEVENS & FORD PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | POST OFFICE BOX 1225 | AddressLine1Txt |
| City | LENOIR | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 286451225 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581935514 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALDWELL MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CALD | BusinessNameControlTxt |
| Phone | 8287575525 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1890 | AddressLine1Txt |
| City | LENOIR | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28645 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VIRGINIA N HOYLE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8287575525 | PhoneNum |
| Signature | 2016-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID F STEVENS | PreparerPersonNm |
| PTIN | P00189144 | PTIN |
| Phone | 8287588431 | PhoneNum |
| Preparation | 2016-10-28 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | VIRGINIA N HOYLE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 MULBERRY STREET SW | AddressLine1Txt |
| City | LENOIR | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28645 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,856,774 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | caldwellmemorialfoundation.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | HEALTH AND HUMAN SERVICES | ActivityOrMissionDesc |
| Voting Members Governing Body | 19 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,615,590 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,348,019 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $248,076 | PYInvestmentIncomeAmt |
| CY Investment Income | $318,246 | CYInvestmentIncomeAmt |
| PY Other Revenue | $182 | PYOtherRevenueAmt |
| CY Other Revenue | -$85,079 | CYOtherRevenueAmt |
| PY Total Revenue | $1,863,848 | PYTotalRevenueAmt |
| CY Total Revenue | $1,581,186 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $633,693 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,050,498 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $96,265 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $342,034 | PYOtherExpensesAmt |
| CY Other Expenses | $263,778 | CYOtherExpensesAmt |
| PY Total Expenses | $975,727 | PYTotalExpensesAmt |
| CY Total Expenses | $1,314,276 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $888,121 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $266,910 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,943,183 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,517,803 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,943,183 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,517,803 | NetAssetsOrFundBalancesEOYAmt |
| Mission | HEALTH AND HUMAN SERVICES | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,151,275 | ExpenseAmt |
| Grant | $1,050,498 | GrantAmt |
| Revenue | $318,246 | RevenueAmt |
| Desc | FUNDS WERE EXPENDED FOR THE BENEFIT OF CALDWELL MEMORIAL HOSPITAL. VARIOUS ITEMS WERE DONATED TO THE HOSPITAL. | Desc |
| Total Program Service Expenses | $1,151,275 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | Yes (1) | NondeductibleContributionsInd |
| Nondeductible Contri Discl | Yes (1) | NondeductibleContriDisclInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 19 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARY KEPPER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8287575525 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 MULBERRY STREET SW | AddressLine1Txt |
| City | LENOIR | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28645 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| STEVE LAMBRECHTS | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RICK COFFEY | ||||||
| VICE-PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SHERRY FORD | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| WAYNE KELLER | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JON BLAIR | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BEN BOAZ | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| FRANCES DELK | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ROBERT FLOYD | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| REGGY GREENE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GENE HENDRICKS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TERRY HUNT | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JEFFREY KEVERLINE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LUCY MCCARL | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DONALD MCNEILL | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TIM PALMER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LEE PENNELL | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SANDY ROSSBOROUGH | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TOM SMITH | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| RODNEY STALHEIM | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ALLEN STEWART | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BRUCE VANDERBLOEMEN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BARBARA WEILLER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| VIRGINIA HOYLE | ||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $0 | $63,946 | $15,877 | |
| LAURA EASTON | ||||||
| EX-OFFICIO MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GARY SHORE | ||||||
| EX-OFFICIO MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID MASTERS | ||||||
| EX-OFFICIO MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| NANCY HAVRILACK | ||||||
| EX-OFFICIO MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $63,946 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $15,877 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $200,087 | FundraisingAmt |
| All Other Contributions | $1,147,932 | AllOtherContributionsAmt |
| Total Contributions | $1,348,019 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $262,455 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $262,455 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,246,300 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,190,509 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $55,791 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,791 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $55,791 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $200,087 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $85,079 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$85,079 | TotalRevenueColumnAmt |
| Exclusion | -$85,079 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,581,186 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $318,246 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$85,079 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,050,498 | TotalAmt |
| Program Services | $1,050,498 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,500 | TotalAmt |
| Program Services | $6,500 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,107 | TotalAmt |
| Program Services | $54,107 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,965 | TotalAmt |
| Program Services | $3,700 | ProgramServicesAmt |
| Fundraising | $96,265 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,265 | TotalAmt |
| Program Services | $2,265 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,992 | TotalAmt |
| Program Services | $2,992 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,600 | TotalAmt |
| Program Services | $2,600 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| CONTRACT LABOR | $59,868 | $59,868 | |
| PROGRAM DISBURSEMENTS | $28,513 | $28,513 | |
| LICENSES AND PERMITS | $3,657 | $3,657 | |
| BAD DEBTS | $2,700 | $2,700 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $611 | TotalAmt |
| Program Services | $100 | ProgramServicesAmt |
| Management And General | $511 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,314,276 | TotalAmt |
| Program Services | $1,151,275 | ProgramServicesAmt |
| Management And General | $66,736 | ManagementAndGeneralAmt |
| Fundraising | $96,265 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $687,184 | BOYAmt |
| EOY | $453,481 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,470,215 | BOYAmt |
| EOY | $9,990,671 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,785,784 | BOYAmt |
| EOY | $1,073,651 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,943,183 | BOYAmt |
| EOY | $11,517,803 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,788,215 | BOYAmt |
| EOY | $9,318,826 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $473,033 | BOYAmt |
| EOY | $517,042 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,681,935 | BOYAmt |
| EOY | $1,681,935 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,943,183 | BOYAmt |
| EOY | $11,517,803 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,943,183 | BOYAmt |
| EOY | $11,517,803 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $266,910 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$455,671 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$236,619 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,342,389 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,343,792 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $785,534 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,615,590 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,348,019 | CurrentTaxYearAmt |
| Total | $9,435,324 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,342,389 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,343,792 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $785,534 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,615,590 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,348,019 | CurrentTaxYearAmt |
| Total | $9,435,324 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $9,435,324 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $140,142 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $72,545 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $254,146 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $248,258 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $262,456 | CurrentTaxYearAmt |
| Total | $977,547 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $10,412,871 | TotalSupportAmt |
| Public Support CY170 | 0.90610 | PublicSupportCY170Pct |
| Public Support PY170 | 0.95210 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,681,935 | BeginningYearBalanceAmt |
| End Year Balance | $1,681,935 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,681,935 | BeginningYearBalanceAmt |
| End Year Balance | $1,681,935 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,681,935 | BeginningYearBalanceAmt |
| End Year Balance | $1,681,935 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,621,235 | BeginningYearBalanceAmt |
| Contributions | $4,500 | ContributionsAmt |
| Investment Earnings Or Losses | $56,200 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,681,935 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,672,744 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$51,509 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,621,235 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| EQUITY FUND | $390,840 | F |
| INTERMEDIATE BOND FUND | $682,811 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,073,651 | TotalBookValueSecuritiesAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL AND FOUNDATION HAVE DETERMINED THAT THEY DO NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF JUNE 30, 2016. FISCAL YEARS ENDING ON OR AFTER JUNE 30, 2013 REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAX AUTHORITIES. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALDWELL MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1880 | AddressLine1Txt |
| City | LENOIR | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28645 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 560554202 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $1,050,498 | CashGrantAmt |
| Valuation Method Used | BOOK | ValuationMethodUsedDesc |
| Purpose Of Grant | HOSPITAL NEEDS - FAMILY BIRTHPLACE, MCCREARY CANCER CENTER & BLOWING ROCK MEDICAL CENTER | PurposeOfGrantTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART 1V | FormAndLineReferenceDesc |
| Explanation | THE FOUNDATION IS THE PHILANTHROPIC ARM OF THE COMMUNITY HOSPITAL AND THEIR MISSION IS TO SUPPLEMENT, ENHANCE, AND ENRICH THE FACILITIES, PROGRAMS AND SERVICES PROVICED BY UNC CALDWELL (CALDWELL MEMORIAL HOSPITAL). | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11 | THE FORM 990 FOR THE FOUNDATION HAS BEEN PROVIDED TO THE BOARD OF DIRECTORS FOR THEIR REVIEW. |
| Form 990, Part VI, Section B, line 12c | THE STAFF OF THE FOUNDATION REVIEWS THE CONFLICT OF INTEREST STATEMENTS AND MONITORS ANY CHANGES. |
| Form 990, Part VI, Section B, line 15a | EXECUTIVE DIRECTOR IS PAID BY THE HOSPITAL AND CHOSEN BY THE BOARD |
| Form 990, Part VI, Section C, line 19 | ALL DOCUMENTS ARE AVAILABLE TO THE PUBLIC ON REQUEST |
| Form 990, Part XI, line 9: | DISCOUNT ON RECEIVABLES -236,619. |
| Form 990, Part XII, Line 2c: | DURING THE CURRENT YEAR THE FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS. THE FINANCE COMMITTEE IS RESPONSIBLE FOR THE OVERSITE OF THE REVIEWED FINANCIAL STATEMENTS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALDWELL MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1890 | AddressLine1Txt |
| City | LENOIR | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28645 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 560554202 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | PUBLIC CHARITY | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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