UPLAND HILLS HEALTH FOUNDATION INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
UPLAND HILLS HEALTH FOUNDATION INC (EIN 26-0596045)
Tax period
2013-10-01 to 2014-09-30
Filed
2015-08-17
IRS object ID
201542299349303549
Schema version
2013v4.0
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)
Return2015-08-17T16:17:20-05:00ReturnTs
Tax Period End2014-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13703 OAKWOOD HILLS PARKWAY/PO BOXAddressLine1
Address Line2690AddressLine2
CityEAU CLAIRECity
StateWIState
ZIP Code547020690ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN260596045EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UPLAND HILLS HEALTH FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlUPLABusinessNameControlTxt
Phone6089308000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 COMPASSION WAYAddressLine1
CityDODGEVILLECity
StateWIState
ZIP Code53533ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonARTHUR K PUSTINAPersonNm
Person TitleVICE PRESIDENT OF FINANCEPersonTitleTxt
Phone6089308000PhoneNum
Signature2015-08-17SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPAUL M TRACZEK CPAPreparerPersonNm
PTINP01368830PTIN
Phone7158323407PhoneNum
Preparation2015-08-17PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLISA SCHNEDLERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 COMPASSION WAYAddressLine1
CityDODGEVILLECity
StateWIState
ZIP Code53533ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$101,805GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.UPLANDHILLSHEALTH.ORG/FOUNDATIONWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2007FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO SOLICIT, RECEIVE, AND ACCEPT GIFTS AND BEQUESTS ON BEHALF OF UPLAND HILLS HEALTH, INC.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers29TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$87,059PYContributionsGrantsAmt
CY Contributions Grants$89,984CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$7,861PYInvestmentIncomeAmt
CY Investment Income$6,337CYInvestmentIncomeAmt
PY Other Revenue$1,529PYOtherRevenueAmt
CY Other Revenue$2,457CYOtherRevenueAmt
PY Total Revenue$96,449PYTotalRevenueAmt
CY Total Revenue$98,778CYTotalRevenueAmt
PY Grants And Similar Paid$77,466PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$11,121CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,135PYOtherExpensesAmt
CY Other Expenses$40CYOtherExpensesAmt
PY Total Expenses$80,601PYTotalExpensesAmt
CY Total Expenses$11,161CYTotalExpensesAmt
PY Revenues Less Expenses$15,848PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$87,617CYRevenuesLessExpensesAmt
Total Assets BOY$1,018,193TotalAssetsBOYAmt
Total Assets EOY$1,120,399TotalAssetsEOYAmt
Total Liabilities BOY$203,331TotalLiabilitiesBOYAmt
Total Liabilities EOY$217,920TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$814,862NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$902,479NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE PRIMARY PURPOSE OF THE UPLAND HILLS HEALTH FOUNDATION, INC. IS TO RECORD AND FACILITATE PHILANTHROPIC GIVING FOR UPLAND HILLS HEALTH, INC. BY SERVING AS THE GATEWAY FOR ALL PHILANTHROPY, THE FOUNDATION OFFICE WILL MAINTAIN A COMPLETE GIVING HISTORY FOR DONORS TO UPLAND HILLS HEALTH, ENSURING THAT CONTRIBUTORS ARE APPROPRIATELY ACKNOWLEDGED, AND THAT THE PHILANTHROPY FIGURES PRESENTED TO EXTERNAL SOURCES ARE AS COMPLETE AS POSSIBLE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$11,121ExpenseAmt
Grant$11,121GrantAmt
DescTHE UPLAND HILLS HEALTH FOUNDATION, INC. IS OPERATED TO PROVIDE SUPPORT AND PERFORM FUNCTIONS FOR UPLAND HILLS HEALTH, INC., WHICH PROVIDES HEALTH CARE SERVICES TO THE RESIDENTS OF IOWA COUNTY, WISCONSIN, AND THE SURROUNDING AREAS.Desc
Total Program Service Expenses$11,121TotalProgramServiceExpensesAmt
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 Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
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 Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
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 Members11GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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 PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ARTHUR K PUSTINABusinessNameLine1
FieldValueIRS element (for citing)
Phone6089308000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 COMPASSION WAYAddressLine1
CityDODGEVILLECity
StateWIState
ZIP Code53533ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerInd
DICK JOSH
DIRECTOR1.00Yes (X)$0$0$0
BRAD LAUFENBERG
DIRECTOR1.00Yes (X)$0$0$01.00
MARK MASTERS
DIRECTOR1.00Yes (X)$0$0$0
DAVID WILKE
DIRECTOR1.00Yes (X)$0$0$0
MARTHA BOYER
DIRECTOR1.00Yes (X)$0$0$0
ANDREA POTTERTON
DIRECTOR1.00Yes (X)$0$0$0
DEBRA MORGAN
PRESIDENT1.00Yes (X)$0$0$0Yes (X)
SKIP LEE
VICE PRESIDENT1.00Yes (X)$0$0$0Yes (X)
GEORGE STAUFFER
TREASURER1.00Yes (X)$0$0$0Yes (X)
MARY JO CENITI
SECRETARY1.00Yes (X)$0$0$0Yes (X)
LISA SCHNEDLER
PRESIDENT/CEO - UHH1.00Yes (X)$0$122,014$26,11151.00Yes (X)
ARTHUR K PUSTINA
VP OF FINANCE - UHH1.00$0$139,459$17,20453.80Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$261,473TotReportableCompRltdOrgAmt
Total Other Compensation$43,315TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$16,476RelatedOrganizationsAmt
All Other Contributions$73,508AllOtherContributionsAmt
Noncash Contributions$1,000NoncashContributionsAmt
Total Contributions$89,984TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,337TotalRevenueColumnAmt
Exclusion$6,337ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$5,484FundraisingGrossIncomeAmt
Fundraising Direct Expenses$3,027FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,457TotalRevenueColumnAmt
Exclusion$2,457ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$98,778TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$8,794ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$11,121TotalAmt
Program Services$11,121ProgramServicesAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$40TotalAmt
Management And General$40ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$11,161TotalAmt
Program Services$11,121ProgramServicesAmt
Management And General$40ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$977,523BOYAmt
EOY$1,094,129EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$40,670BOYAmt
EOY$26,270EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,018,193BOYAmt
EOY$1,120,399EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$203,331BOYAmt
EOY$217,920EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$203,331BOYAmt
EOY$217,920EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$122,117BOYAmt
EOY$213,156EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$482,363BOYAmt
EOY$478,941EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$210,382BOYAmt
EOY$210,382EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$814,862BOYAmt
EOY$902,479EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,018,193BOYAmt
EOY$1,120,399EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$87,617ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
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$453,088CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$168,067CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$131,362CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$87,059CurrentTaxYearMinus1YearAmt
Current Tax Year$89,984CurrentTaxYearAmt
Total$929,560TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$453,088CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$168,067CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$131,362CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$87,059CurrentTaxYearMinus1YearAmt
Current Tax Year$89,984CurrentTaxYearAmt
Total$929,560TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$21,870SubstantialContributorsTotAmt
Public Support Total170$907,690PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,782CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,074CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,718CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,861CurrentTaxYearMinus1YearAmt
Current Tax Year$6,337CurrentTaxYearAmt
Total$36,772TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,631CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,364CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,872CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,529CurrentTaxYearMinus1YearAmt
Current Tax Year$2,457CurrentTaxYearAmt
Total$15,853TotalAmt
FieldValueIRS element (for citing)
Total Support$982,185TotalSupportAmt
Public Support CY1700.92420PublicSupportCY170Pct
Public Support PY1700.92430PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

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$213,859BeginningYearBalanceAmt
Investment Earnings Or Losses$1,088InvestmentEarningsOrLossesAmt
End Year Balance$214,947EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$213,277BeginningYearBalanceAmt
Contributions$1,000ContributionsAmt
Investment Earnings Or Losses$1,504InvestmentEarningsOrLossesAmt
Other Expenditures-$1,922OtherExpendituresAmt
End Year Balance$213,859EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$210,220BeginningYearBalanceAmt
Contributions$2,000ContributionsAmt
Investment Earnings Or Losses$1,057InvestmentEarningsOrLossesAmt
End Year Balance$213,277EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$208,412BeginningYearBalanceAmt
Contributions$1,016ContributionsAmt
Investment Earnings Or Losses$792InvestmentEarningsOrLossesAmt
End Year Balance$210,220EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$75,366BeginningYearBalanceAmt
Contributions$131,000ContributionsAmt
Investment Earnings Or Losses$2,046InvestmentEarningsOrLossesAmt
End Year Balance$208,412EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.97880PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.02120TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO UPLAND HILLS HEALTH, INC.Desc
Amt$217,920Amt
FieldValueIRS element (for citing)
Total Liability$217,920TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:UPLAND HILLS HEALTH FOUNDATION, INC.'S ENDOWMENT FUND CONSISTS OF TWO FUNDS HELD IN THE NAMES OF THE INDIVIDUAL DONORS. THESE FUNDS WERE ESTABLISHED TO PROVIDE INCOME FOR THE FOUNDATION TO HELP SUPPORT SPECIFIC PROGRAMS OF UPLAND HILLS HEALTH, INC.
PART X, LINE 2:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, UPLAND HILLS HEALTH FOUNDATION, INC. ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. UPLAND HILLS HEALTH FOUNDATION, INC. HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF SEPTEMBER 30, 2014 OR 2013. FEDERAL TAX RETURNS FOR TAX YEARS ENDED SEPTEMBER 30, 2011, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.

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 Line1UPLAND HILLS HEALTH INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 COMPASSION WAYAddressLine1
CityDODGEVILLECity
StateWIState
ZIP Code53533ZIPCode
FieldValueIRS element (for citing)
Recipient EIN421017512RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$11,121CashGrantAmt
Valuation Method UsedCASH DONATEDValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc
Purpose Of GrantTO ASSIST IN THE DELIVERY OF HEALTHCARE SERVICES TO INDIVIDUALS IN THE DODGEVILLE AREA.PurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationUPLAND HILLS HEALTH FOUNDATION, INC'S BOARD OF DIRECTORS REVIEWS REQUESTS FOR DONATIONS FROM OR OFFERS TO PROVIDE ASSISTANCE TO UPLAND HILLS HEALTH, INC. TO FURTHER THE MISSION OF UPLAND HILLS HEALTH, INC. THESE GRANTS ARE APPROVED BY THE FOUNDATION'S BOARD OF DIRECTORS DURING ITS REGULARLY SCHEDULED BOARD OF DIRECTORS' MEETINGS THROUGHOUT THE YEAR.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonARTHUR K PUSTINAPersonNm
TitleVP OF FINANCE - UHHTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$131,860CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$2,199BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$5,400OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$5,340DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$11,864NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$156,663TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationCOMPENSATION PLANS AND POLICIES FOR THE OFFICERS NOTED ARE DETERMINED AND REVIEWED BY UPLAND HILLS HEALTH FOUNDATION, INC.'S PARENT ORGANIZATION, UPLAND HILLS HEALTH, INC. PROCEDURES OF UPLAND HILLS HEALTH, INC. INCLUDE COMPENSATION SURVEYS, WRITTEN EMPLOYMENT AGREEMENTS, AND APPROVAL BY THE BOARD OF DIRECTORS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6UPLAND HILLS HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF UPLAND HILLS HEALTH FOUNDATION, INC.
FORM 990, PART VI, SECTION A, LINE 7AUPLAND HILLS HEALTH, INC., THE SOLE CORPORATE MEMBER OF UPLAND HILLS HEALTH FOUNDATION, INC., CAN APPOINT OR REMOVE MEMBERS OF THE GOVERNING BODY AND CAN ALSO DETERMINE THE NUMBER OF GOVERNING MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BCHANGES TO THE GOVERNING DOCUMENTS OF UPLAND HILLS HEALTH FOUNDATION, INC. REQUIRE APPROVAL OF ITS SOLE CORPORATE MEMBER UPLAND HILLS HEALTH, INC.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF FORM 990 WAS PROVIDED TO THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FINAL SUBMISSION. RESPONSES ON THE 990 ARE ALSO REVIEWED BY THE VICE PRESIDENT OF FINANCE OF UPLAND HILLS HEALTH, INC. PRIOR TO ITS SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CUPLAND HILLS HEALTH FOUNDATION, INC. REQUIRES OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST-COMPENSATED EMPLOYEES TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. THESE STATEMENTS ARE THEN REVIEWED BY THE BOARD OF DIRECTORS, NOTING ANY RELATIONSHIPS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. IF BOARD MEMBERS HAVE CONFLICTS OF INTEREST THAT ARE NOTED, THESE MEMBERS ARE ASKED TO ABSTAIN FROM VOTING ON THOSE MATTERS.
FORM 990, PART VI, SECTION B, LINE 15THE TWO OFFICERS OF UPLAND HILLS HEALTH FOUNDATION, INC. ARE EMPLOYED BY UPLAND HILLS HEALTH, INC. THE COMPENSATION LISTED IN FORM 990, PART VII RELATES TO ALL THE SERVICES THEY PERFORM AS AN EMPLOYEE OF UPLAND HILLS HEALTH, INC. THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. HAS ESTABLISHED A PROCESS TO REVIEW THE COMPENSATION OF THE OFFICERS. COMPARATIVE DATA FROM WAGE SURVEYS, AREA LABOR ADJUSTMENTS, AND MARKET RATES IN OTHER AREA FACILITIES ARE USED IN DETERMINING COMPENSATION. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. REVIEWS AND APPROVES ANY EXCEPTIONS TO ACROSS-THE-BOARD RAISES AND STANDARD NEW HIRE WAGES. DURING THE REVIEW PROCESS, DECISIONS AFFECTING COMPENSATION AND CONTRACTS ARE ONLY REVIEWED AND APPROVED BY INDIVIDUALS WHO DO NOT HAVE NOTED CONFLICTS. THE DECISIONS AND DELIBERATION ARE ALSO DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS UPON APPROVAL BY THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19UPLAND HILLS HEALTH FOUNDATION, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS BUSINESS LOCATION DURING NORMAL BUSINESS HOURS.
FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT:THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS BY AN INDEPENDENT ACCOUNTANT. THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. ALSO APPROVES THE SELECTION OF THE INDEPENDENT AUDITORS AND HISTORICALLY HAS USED A PROCESS OF SOLICITATION OF SEALED BIDS FROM INDEPENDENT AUDIT FIRMS WITH HEALTHCARE AUDIT EXPERIENCE EVERY FIVE YEARS SO THAT THE AUDIT FIRM REVIEW IS DONE ON A REGULAR BASIS. THIS PROCESS AND PROCEDURES HAVE NOT CHANGED IN THE CURRENT YEAR.
FORM 990, PART VI, LINE 14, DOCUMENT RETENTION AND DESTRUCTION POLICY:UPLAND HILLS HEALTH FOUNDATION, INC. ANSWERED "NO" TO THE QUESTION REGARDING A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY, BECAUSE THIS SPECIFIC ORGANIZATION DOES NOT HAVE SUCH A POLICY IN PLACE. HOWEVER, UPLAND HILLS HEALTH FOUNDATION, INC. FOLLOWS THE WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY OF UPLAND HILLS HEALTH, INC.
FORM 990, PART VII, SECTION A, RELATED PARTY OFFICERS:EXPLANATION OF HOURS WORKED: THE TWO OFFICERS OF UPLAND HILLS HEALTH FOUNDATION, INC. ARE EMPLOYED BY UPLAND HILLS HEALTH, INC. IN ADDITION TO THE HOURS WORKED AS AN OFFICER OF UPLAND HILLS FOUNDATION, INC., THEY ALSO WORK A MINIMUM OF AN AVERAGE OF 40 HOURS PER WEEK PERFORMING OTHER SERVICES FOR UPLAND HILLS HEALTH, INC. THE HOURS LISTED ON THE FORM 990 RELATE TO THEIR ROLE AS AN OFFICER, WHILE THE COMPENSATION LISTED RELATES TO ALL THE SERVICES THEY PERFORM AS AN EMPLOYEE OF UPLAND HILLS HEALTH, INC. DETAIL OF HOURS WORKED/SERVED: LISA SCHNEDLER, PRESIDENT & CEO OF UPLAND HILLS HEALTH, INC. WORKED APPROXIMATELY 52.00 HOURS PER WEEK AS FOLLOWS: UPLAND HILLS HEALTH, INC. - 51.00 HOURS UPLAND HILLS HEALTH FOUNDATION, INC. - 1 HOUR A. KARL PUSTINA, VICE PRESIDENT OF FINANCE OF UPLAND HILLS HEALTH, INC., WORKED APPROXIMATELY 54.80 HOURS PER WEEK AS FOLLOWS: UPLAND HILLS HEALTH, INC. - 53.80 HOURS UPLAND HILLS HEALTH FOUNDATION, INC. - 1 HOUR BRAD LAUFENBERG, BOARD MEMBER, PROVIDED AN AVERAGE OF 2.0 HOURS OF SERVICE PER WEEK AS FOLLOWS: UPLAND HILLS HEALTH, INC. - 1 HOUR UPLAND HILLS HEALTH FOUNDATION, INC. - 1 HOUR

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1UPLAND HILLS HEALTH HOLDINGS LLCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 COMPASSION WAYAddressLine1
CityDODGEVILLECity
StateWIState
ZIP Code53533ZIPCode
FieldValueIRS element (for citing)
EIN800809494EIN
Primary ActivitiesPARTNERSHIP FOR DURABLE MEDICAL EQUIPMENT PROVIDED TO PATIENTSPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Total Income$0TotalIncomeAmt
End Of Year Assets$0EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1UPLAND HILLS HEALTH INCBusinessNameLine1

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1UPLAND HILLS HEALTH INCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 COMPASSION WAYAddressLine1
CityDODGEVILLECity
StateWIState
ZIP Code53533ZIPCode
FieldValueIRS element (for citing)
EIN421017512EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 3PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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