2016-08-15T13:39:54-05:00 2015-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2014-10-01 431696258 PHELPS COUNTY HOSPITAL FOUNDATION % EDWARD CLAYTON PHEL 5733648899 1000 WEST 10TH STREET ROLLA MO 65401 EDWARD CLAYTON CEO 5733648899 2016-08-15 true Brian D Todd P00422601 4178658701 2014 2016-12-15 16:53:06Z EDWARD CLAYTON 1000 WEST 10TH STREET ROLLA MO 65401 1275642 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. 18 14 11 38 0 0 1006343 1204433 0 0 839 1096 -13542 -11385 993640 1194144 99037 104204 0 0 429335 529378 33052 2595 110372 319833 324117 881257 960294 112383 233850 1936483 2767388 2182685 2779740 -246202 -12352 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 671459 104204 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. 671459 true true false false false false false false false false true false false true true false false false false false false false false true true false false true false true false false false false false false false false false false false false false true false false false true 20 0 true 11 true false false false false false true true false false false false false X 18 14 false false false false false false false true true false false false true true true true true false false false X EDWARD CLAYTON 5733648899 1000 WEST 10TH STREET ROLLA MO 65401 X DEBBIE SCHUETZ MEMBER ENDING 12/14 1.0 0.0 X 0 0 0 MARY GRAHAM MD MEMBER ENDING 12/14 1.0 1.0 X 0 0 0 JOHN DENBO CEO/MEMBER 1.0 40.0 X X 0 285804 26404 TED DAY TREASURER 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 135134 25445 VIRGINIA LOMAX MEMBER ENDING 12/14 1.0 1.0 X 0 0 0 CANDACE CONNELL PRESIDENT 1.0 1.0 X X 0 0 0 CINDY BEGER VICE PRESIDENT 1.0 1.0 X X 0 0 0 OLLIE JACKSON MEMBER 1.0 1.0 X 0 0 0 SAMMY AUXIER MEMBER 1.0 1.0 X 0 0 0 LINDA MITCHELL MEMBER BEGINNING 01/15 1.0 1.0 X 0 0 0 EDWARD CLAYTON MEMBER 1.0 40.0 X 0 230887 36716 AMY MEADOWS MEMBER BEGINNING 01/15 1.0 1.0 X 0 0 0 JEFF SCHRADER MEMBER BEGINNING 01/15 1.0 1.0 X 0 0 0 MOLLY MALONE MEMBER BEGINNING 01/15 1.0 1.0 X 0 0 0 SHAD BECKER MEMBER BEGINNING 01/15 1.0 1.0 X 0 0 0 WALT BRANSON MEMBER BEGINNING 01/15 1.0 1.0 X 0 0 0 STEVE LYNCH MEMBER BEGINNING 01/15 1.0 1.0 X 0 0 0 SANDY MITCHELL MEMBER BEGINNING 01/15 1.0 1.0 X 0 0 0 DR LEROY WOMBOLD MEMBER BEGINNING 01/15 1.0 40.0 X 0 392842 37715 0 1044667 126280 0 false true false 0 266661 40000 897772 1204433 0 1096 1096 0 0 0 0 0 0 70113 266661 81498 -11385 -11385 0 0 0 1194144 -10289 X 104204 104204 0 0 0 0 0 395118 276275 73430 45413 14896 10416 2768 1712 92420 64622 17176 10622 26944 18840 5007 3097 0 315 315 0 0 2595 2595 0 106981 91465 15516 19623 19623 149259 73809 38942 36508 9174 9174 0 0 2429 2429 0 19974 16310 3664 0 0 10461 7315 1944 1202 0 LICENSES, DUES, SUBSCRIPTIONS 3852 3852 MISCELLANEOUS EXPENSES 2049 1922 78 49 960294 671459 178463 110372 0 0 1707937 2537928 0 0 0 40000 0 0 0 0 0 0 0 0 45472 18659 70962 51796 29627 19166 0 0 0 0 0 0 0 0 153447 151635 1936483 2767388 7080 16324 0 0 0 19617 0 0 0 0 0 0 0 0 0 0 2175605 2743799 2182685 2779740 X -246202 -12352 0 0 0 0 -246202 -12352 1936483 2767388 233850 X false false false X X 1 PCRMC 436004435 3 true 104000 0 1 104000 true false false false false false false false false false false false false false false true true false X 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 51796 1666 19166 DUE FROM HOME HEALTH 142448 DUE FROM PMGI 7838 DUE FROM BOND CLINIC 1349 151635 0 DUE TO PCRMC 2743799 2743799 true COPLEY RAFF INC CAMPAIGN false 500000 2595 497405 500000 2595 497405 CANCER GALA 198449 150821 47628 3955 585 23240 6680 5595 GOLF TOURNEY 102940 86470 16470 11222 11535 5420 4988 1 35385 29370 6015 4845 3433 336774 266661 70113 15177 12120 33505 6680 14016 81498 -11385 true PHELPS COUNTY REGIONAL MEDICAL CENTER 1000 W 10TH STREET ROLLA MO 65401 436004435 PHELPS CO RMC 104000 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 0 247350 0 102 0 38352 0 15600 0 10804 0 312208 0 0 LORRIE HARTLEY DIRECTOR 0 130757 0 101 0 4276 0 8434 0 17011 0 160579 0 0 EDWARD CLAYTON MEMBER 0 212009 0 102 0 18776 0 14449 0 22267 0 267603 0 0 DR LEROY WOMBOLD MEMBER BEGINNING 01/15 0 344362 0 25102 0 23378 0 15600 0 22115 0 430557 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. FORM 990, PART I, LINE 1 ORGANIZATION'S SIGNIFICANT ACTIVITIES: THE JOY OF CARING CANCER FUND OFFERS FINANCIAL ASSISTANCE FOR CANCER PATIENTS WHO MAY HAVE DIFFICULTY MANAGING THEIR DAILY ACTIVITIES AND CAPITAL NEEDS RELATED TO CANCER SERVICES. APPROXIMATELY 240 PEOPLE RECEIVED BENEFITS FROM THIS FUND THIS YEAR. COMPREHENSIVE BREAST CENTER PROVIDES WOMEN WITH A CHANCE AGAINST BREAST CANCER, THROUGH MANY COMMUNITY LEADERS' COMMITMENT. A KEY ELEMENT OF THE CENTER IS MAMMOGRAMS. SEVENTEEN PEOPLE WERE SERVED THIS YEAR. THE GUARDIAN ANGEL FUND PROVIDES A PHILANTHROPIC OPPORTUNITY FOR GRATEFUL PATIENTS TO RECOGNIZE A SPECIAL CAREGIVER WHO THEY BELIEVE MADE A DIFFERENCE IN THEIR STAY OR VISIT. THROUGH THIS PROGRAM, OVER 80 EMPLOYEES HAVE BEEN RECOGNIZED BY APPROXIMATELY 200 PATIENTS. 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, 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. FORM 990, PART IX, LINE 11G OTHER FEES FOR SERVICES: CONSULTING $ 105,464 CATERING 1,517 ------------ $ 106,981 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