2016-11-14T11:39:14-06:00 2015-12-31 841483675 RLR LLP 1620 CENTRAL AVE STE 304 CHEYENNE WY 82001 990 2015-01-01 830236858 CHEYENNE REGIONAL MEDICAL CENTER FOUNDATION CHEY 3076337667 214 EAST 23RD STREET CHEYENNE WY 82001 SCOTT FOX EXECUTIVE DIRECTOR 3076337667 2016-11-10 true ROBERT B DICKERSON P00432362 3076315598 2016-11-10 2015 2017-02-10 21:41:12Z SCOTT FOX 214 E 23RD ST CHEYENNE WY 82001 2015342 false X GIVE.CHEYENNEREGIONAL.ORG X 1977 WY THE FOUNDATION INFORMS, DEVELOPS AND STEWARDS RESOURCES TO ENABLE THE CHEYENNE REGIONAL HEALTH SYSTEM TO PROVIDE THE BEST POSSIBLE HEALTH CARE. 19 19 0 150 0 2736646 1743011 0 324666 261033 152074 0 3213386 2004044 0 0 410654 328244 0 17507 2077751 1273747 2488405 1601991 724981 402053 16169652 15463040 356736 151978 15812916 15311062 THE FOUNDATION INFORMS, DEVELOPS AND STEWARDS RESOURCES TO ENABLE THE CHEYENNE REGIONAL HEALTH SYSTEM TO PROVIDE THE BEST POSSIBLE HEALTH CARE. false false 188993 PURCHASE OF MEDICAL EQUIPMENT FOR AND SUPPORT FOR PROGRAMS AND SERVICES AT CHEYENNE REGIONAL HEALTH SYSTEM. THIS INCLUDES EQUIPMENT PURCHASED FOR VARIOUS DEPARTMENTS ACROSS THE HEALTH SYSTEM AS WELL AS PROGRAM AND SERVICE SUPPORT FOR THE DAVIS HOSPICE CENTER, THE CHEYENNE REGIONAL CANCER CENTER AND OTHER SERVICE LINES. 686116 SUPPORT FOR THE CHEYENNE REGIONAL INJURY PREVENTION PROGRAM. THIS INCLUDES PROGRAMS AND SERVICES PROVIDED AS PART OF THE "SAFE COMMUNITIES- AND "SAFE KIDS" PROGRAMS. GOALS OF THESE PROGRAMS INCLUDE REDUCTION IN FATALITIES FOR UNRESTRAINED VEHICLE OCCUPANTS AND TO EDUCATE AND PROTECT FAMILIES ACROSS WYOMING BY ADDRESSING THE PRIMARY CAUSES OF INJURY TO CHILDREN & ADOLESCENTS. 875109 true true false false false false false false false true true false false false false true true false false false false false false false true false false false false true false false false false false false false false false false false false false true false true false true 3 0 false 0 false false false false false true true false false false false X 19 19 false false false false false false false true true false false true true true true true true true true false X THE ORGANIZATION 3076337667 214 E 23RD STREET CHEYENNE WY 82001 CARMALEE ROSE CHAIR 2.00 X X 0 0 0 NATALIE WINEGAR VICE CHAIR 2.00 X X 0 0 0 FRAN NALER TREASURER 2.00 X X 0 0 0 DR HARMON DAVIS SECRETARY 2.00 X X 0 0 0 JOHN BALSER DIRECTOR 1.00 X 0 0 0 DAVID COOK DIRECTOR 1.00 X 0 0 0 DR RICK DAVIS DIRECTOR 1.00 X 0 0 0 WILLIAM DUBOIS DIRECTOR 1.00 X 0 0 0 LAURIE FARKAS DIRECTOR 1.00 X 0 0 0 JACQUELINE FERRALL DIRECTOR 1.00 X 0 0 0 MARCIA GRAHAM DIRECTOR 1.00 X 0 0 0 JOHN GROSS DIRECTOR 1.00 X 0 0 0 DR MARGO KARSTEN DIRECTOR 1.00 X 0 0 0 PATRICK MADIGAN DIRECTOR 1.00 X 0 0 0 DR DAVID LIND DIRECTOR 1.00 X 0 0 0 FRANK MAGAZINE DIRECTOR 1.00 X 0 0 0 CAROL MERRELL DIRECTOR 1.00 X 0 0 0 CAREN MURRAY DIRECTOR 1.00 X 0 0 0 MONA LEE PEARL DIRECTOR 1.00 X 0 0 0 MARIAN SCHULZ ORR DIRECTOR 1.00 X 0 0 0 ERNIE SHRINER DIRECTOR 1.00 X 0 0 0 DR SANDRA SURBRUGG DIRECTOR 1.00 X 0 0 0 STEVE STONE EX - EXEC DI 40.00 X 0 156083 23933 SCOTT FOX EXECUTIVE DI 40.00 X 0 31866 1651 187949 25584 false true false 268903 1474108 1743011 254481 254481 17850 11298 6552 6552 6552 268903 2004044 6552 254481 187949 187949 115108 115108 25187 25187 7240 7240 70345 70345 63848 46341 17507 15394 15394 297 297 868 868 OTHER PROGRAM COSTS 768841 768841 CONTRIBUTIONS TO CRMC 245024 106268 138756 CONTRACTED SERVICES 30960 30960 MISCELLANEOUS 27300 27300 43630 43630 1601991 875109 709375 17507 836508 717940 104965 510964 336665 43407 36463 7812 6944 14784485 14266494 29883 30032 16169652 15463040 19248 39360 268388 76654 69100 35964 356736 151978 X 5452856 4864274 7168579 7287143 3191481 3159645 15812916 15311062 16169652 15463040 402053 -903907 X false true X true false X 1364163 4019504 1893255 2975813 1743011 11995746 1364163 4019504 1893255 2975813 1743011 11995746 11995746 279447 254942 248565 207741 254481 1245176 13240922 0.90600 0.88320 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3191481 25000 -1437 33839 21560 3159645 3204957 5992 19468 3191481 3192426 19336 110737 117542 3204957 3258002 5901 62459 133936 3192426 3333005 234 -22282 52955 3258002 false false 13019 6075 6944 30388 30388 6944 X 1047299 -903907 17507 -886400 1933699 70345 70345 2004044 1549153 17507 17507 1531646 70345 70345 1601991 SCHEDULE D, PAGE 3, PART X THE FOUNDATION IS AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE AND IS GENERALLY NOT SUBJECT TO FEDERAL INCOME TAXES. CONTRIBUTIONS TO THE FOUNDATION ARE DEDUCTIBLE FOR TAX PURPOSES BY THE DONOR, SUBJECT TO THE NORMAL LIMITATIONS IMPOSED BY THE TAXING AUTHORITIES. HOWEVER, THE FOUNDATION IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, AND NOT IN FURTHERANCE OF THE PURPOSES FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS, IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE BASIC FINANCIAL STATEMENTS TAKEN AS A WHOLE. IN ACCORDANCE WITH ASC (ACCOUNTING STANDARDS CODIFICATION) 740 INCOME TAXES (FORMERLY FASB INTERPRETATION 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES) THE FOUNDATION CURRENTLY RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF SUCH POSITIONS ARE PROBABLE OF BEING SUSTAINED. THE FOUNDATIONS TAX YEARS SUBJECT TO EXAMINATION BY THE U.S. FEDERAL, STATE AND LOCAL TAX AUTHORITIES ARE FOR THE FISCAL YEARS ENDING DECEMBER 31, 2012-2015, RESPECTIVELY. SCHEDULE D, PAGE 4, PART XI, LINE 2D RECLASS DIRECT BENEFIT TO DONOR 17,507 SCHEDULE D, PAGE 4, PART XII, LINE 2D RECLASS DIRECT BENEFIT TO DONOR 17,507 DENIM N DIAMOND 268903 268903 268903 268903 false false false false false false false false false STEVE STONE EX - EXEC DIRECTOR 156083 23933 180016 FORM 990, PAGE 1, PART I, LINE 6 NUMBER OF VOLUNTEERS INCLUDE THE MEMBERS OF THE BOARD OF DIRECTORS (ALL VOLUNTEER), VOLUNTEERS SUPPORTING MAJOR EVENTS (SUCH AS THE ANNUAL GALA), AND VOLUNTEERS SUPPORTING OTHER EVENTS/ACTIVITIES THROUGHOUT THE YEAR. FORM 990, PAGE 6, PART VI, LINE 11B THE EXECUTIVE DIRECTOR REVIEWS THE FORM 990. IT IS THEN REVIEWED BY THE FINANCE COMMITTEE. ONCE THE BOARD FINANCE COMMITTEE HAS APPROVED THE FORM 990, IT IS SIGNED AND DISTRIBUTED TO THE FULL BOARD OF DIRECTORS PRIOR TO BEING FILED WITH THE IRS. FORM 990, PAGE 6, PART VI, LINE 12C ORGANIZATION BYLAWS REQUIRE ALL DIRECTORS/STAFF/COMMITTEE MEMBERS MUST REVIEW THE CONFLICT OF INTEREST POLICY AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. SHOULD THE INFORMATION CHANGE MATERIALLY DURING THE YEAR, THEY ARE REQUIRED TO DISCLOSE SUCH CHANGES AND REVISE THEIR ANNUAL DISCLOSURE STATEMENT. FORM 990, PAGE 6, PART VI, LINE 15A THE COMPENSATION FOR THE EXECUTIVE DIRECTOR IS SET BY CHEYENNE REGIONAL MEDICAL CENTER AS THE EXECUTIVE DIRECTOR IS AN EMPLOYEE OF THE MEDICAL CENTER IN ACCORDANCE WITH THE MEMORANDUM OF UNDERSTANDING BETWEEN CRMC AND THE FOUNDATION. FORM 990, PAGE 6, PART VI, LINE 15B ALL EMPLOYEE SALARIES ARE SET BY THE CHEYENNE REGIONAL MEDICAL CENTER IN ACCORDANCE WITH THE MEMORANDUM OF UNDERSTANDING BETWEEN CRMC AND THE FOUNDATION. FORM 990, PAGE 6, PART VI, LINE 19 ALL GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 RECLASS DIRECT BENEFIT TO DONOR 17,507 RECLASS DIRECT BENEFIT TO DONOR -17,507 CHEYENNE REGIONAL MEDICAL CENTER 214 EAST 23RD STREET CHEYENNE WY 82001 836000194 HOSPITAL WY N/A false false true true false false false false false false false false false false false false false false false false CHEYENNE REGIONAL MEDICAL CENTER C 469509 FMV CHEYENNE REGIONAL MEDICAL CENTER B 245024 FMV