2014-11-10T15:30:44-06:00 2013-12-31 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2013-01-01 391702534 GEORGE F PEABODY FOUNDATION INC GEOR 9207383000 2600 S HERITAGE WOODS DRIVE APPLETON WI 54915 JOHN LARSON PRESIDENT 9207383000 2014-10-15 1 TERRI REXRODE CPA MST P00096513 9206620016 2014-10-15 2013 2015-11-30 17:44:51Z X X JOHN LARSON 2600 S HERITAGE WOODS DRIVE APPLETON WI 54915 1046945 0 X WWW.THEDACARE.ORG X 1991 WI SUPPORTING ORGANIZATIONS CONTROLLED BY ITS SOLE VOTING MEMBER, APPLETON MEDICAL CENTER, INC., A MEMBER OF THE THEDACARE, INC. GROUP, IN SUPPORT OF LONG-TERM HEALTH CARE. X 10 10 0 0 0 0 187777 33705 0 0 41596 89770 0 0 229373 123475 51037 56798 0 0 0 0 0 0 0 6133 12082 57170 68880 172203 54595 1518329 0 503 0 1517826 0 SUPPORTING ORGANIZATIONS CONTROLLED BY ITS SOLE VOTING MEMBER, APPLETON MEDICAL CENTER, INC., A MEMBER OF THE THEDACARE, INC. GROUP, IN SUPPORT OF LONG-TERM HEALTH CARE. 0 0 55798 55798 SUPPORT OF LONG-TERM CARE RESIDENTS AND RELATED FACILITY NEEDS (24 RESIDENTS). 1000 1000 CNA/EDUCATIONAL SCHOLARSHIPS (2 SCHOLARSHIPS). 56798 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 1 0 1 1 0 0 0 WI X KRISTEN COGSWELL 9207386471 122 EAST COLLEGE AVENUE APPLETON WI 54911 X LARSONJOHN PRESIDENT 1.00 1.00 X X 0 0 0 STRANGEMARY VICE PRESIDENT 1.00 0.00 X X 0 0 0 BIELINSKIJOSEPH SECRETARY 1.00 0.00 X X 0 0 0 KELLERJOHN TREASURER 1.00 1.00 X X 0 0 0 RIESTERJEFF DIRECTOR 1.00 1.00 X 0 0 0 VALKCAROL DIRECTOR 1.00 0.00 X 0 0 0 ARONSONDAVID DIRECTOR 1.00 0.00 X 0 0 0 DIEDERICH MARY K DIRECTOR 1.00 0.00 X 0 0 0 VALENTINERYAN DIRECTOR 1.00 0.00 X 0 0 0 BARKMEIERDIANE DIRECTOR 1.00 0.00 X 0 0 0 0 0 0 0 0 0 0 0 33705 33705 36436 36436 976804 923470 53334 53334 53334 123475 0 0 89770 55798 55798 1000 1000 10500 10500 1582 1582 68880 56798 12082 0 0 134487 0 0 0 0 0 0 0 0 0 1191109 0 192733 0 0 0 0 1518329 0 503 0 503 0 X 176212 0 1042644 0 298970 0 1517826 0 1518329 0 X 54595 182376 -1754797 X X 0 1 X 1 0 X X X 0 0 0 APPLETON MEDICAL CENTER INC 390824015 3 1 1 1 55798 1 55798 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1093971 206261 1243851 56381 1004927 138059 49015 1093971 1080017 -25083 50007 1004927 1009438 123856 53277 1080017 873406 136032 1009438 0 0 0 X 305764 182289 182289 123475 0 123475 0 0 0 0 0 PART V, LINE 4: THE FOUNDATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT ASSETS. ALL FUNDS ARE USED IN SUPPORT OF EFFECTIVE ELDERLY HEALTH CARE. PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE FOUNDATION DETERMINES 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 THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE FOUNDATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2013 OR 2012. FEDERAL TAX RETURNS FOR THE YEARS ENDED 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. 1 THEDACARE INC 122 E COLLEGE AVE APPLETON WI 54912 391509362 501(C)(3) 52753 SUPPORT OF LONG TERM RESIDENTIAL CARE AT PEABODY MANOR, PART OF THE SENIOR CARE DIVISION OF THEDACARE, INC. 1 0 PART I, LINE 2: GRANTS ARE BASED ON CRITERIA ESTABLISHED BY THE BOARD OF DIRECTORS IN SUPPORT OF EFFECTIVE ELDERLY HEALTH CARE. CASH 2013-12-31 8938 ACTUAL COST 464112255 THEDACARE FAMILY OF FOUNDATIONS INC 1818 N MEADE ST PO BOX 1222 APPLETON WI 549129974 501(C)(3) OTHER ACCOUNTS RECEIVABLE 2013-12-31 -552 BOOK VALUE 464112255 THEDACARE FAMILY OF FOUNDATIONS INC 1818 N MEADE ST PO BOX 1222 APPLETON WI 549129974 501(C)(3) INVESTMENTS 2013-12-31 1746411 FAIR MARKET VALUE 464112255 THEDACARE FAMILY OF FOUNDATIONS INC 1818 N MEADE ST PO BOX 1222 APPLETON WI 549129974 501(C)(3) 1 1 0 0 1 1 1 1 0 PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: RYAN VALENTINE, DIRECTOR OF GEORGE F PEABODY FOUNDATION BECAME A DIRECTOR OF THE TRANSFEREE ORGANIZATION, THEDACARE FAMILY OF FOUNDATIONS, INC.CAROL VALK, DIRECTOR OF GEORGE F PEABODY FOUNDATION BECAME A DIRECTOR OF THE TRANSFEREE ORGANIZATION, THEDACARE FAMILY OF FOUNDATIONS, INC. FORM 990, SCHEDULE N DURING 2013, THEDACARE, INC. FORMED A NEW FOUNDATION, THEDACARE FAMILY OF FOUNDATIONS, INC., IN ORDER TO CONSOLIDATE THE ACTIVITIES OF THEIR MULTIPLE FOUNDATIONS INTO ONE ORGANIZATION. ACCORDINGLY, THE FOUNDATION'S BOARD OF DIRECTORS APPROVED A PLAN OF DISSOLUTION WHEREBY EFFECTIVE DECEMBER 31, 2013, IN WHICH THE FOUNDATION'S NET ASSETS WERE TRANSFERRED TO THEDACARE FAMILY OF FOUNDATIONS, INC. FORM 990, PART VI, SECTION A, LINE 6 GEORGE PEABODY FOUNDATION, INC.'S SOLE MEMBER OF THE SINGLE CLASS OF VOTING MEMBERS IS APPLETON MEDICAL CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A APPLETON MEDICAL CENTER, INC. HAS VOTING RIGHTS WITH RESPECT TO THE ELECTION OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B APPLETON MEDICAL CENTER, INC. HAS VOTING RIGHTS WITH RESPECT TO: 1. AMENDMENT OF THE ARTICLES OF INCORPORATION 2. AMENDMENT OF THE BYLAWS OF THIS CORPORATION 3. DISSOLUTION OF THIS CORPORATION 4. ALTERATION OF ANY GIFT OR FUND RESTRICTION BY A TWO-THIRDS VOTE OF MEMBERS AND DIRECTORS FORM 990, PART VI, SECTION B, LINE 11 BOARD OF DIRECTORS REVIEWS FORM 990 DRAFT PRIOR TO FINAL SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12 BOARD MEMBERS ARE REQUIRED TO UPDATE AND SIGN CONFLICT OF INTEREST FORMS ANNUALLY. FORMS ARE REVIEWED ANNUALLY AT A BOARD MEETING. ALL EMPLOYEES AND BOARD MEMBERS ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE CORPORATE COMPLIANCE COMMITTEE REVIEWS THE POTENTIAL CONFLICT AND THE CFO/BOARD OF TRUSTEES REVIEW ALL CONFLICTS. AFTER DISCLOSURE OF THE CONFLICT, THE EMPLOYEE SHALL NOT PARTICIPATE IN THE DECISION WHETHER TO ENGAGE IN THE TRANSACTION IN WHICH THE EMPLOYEE HAS AN INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION PROCESS FOR TOP OFFICIALS OF THE ORGANIZATION IS MANAGED BY THEIR EMPLOYER FOR PAYROLL PURPOSES, THEDACARE, INC., A RELATED ORGANIZATION. MANAGEMENT OF THEDACARE, INC. DETERMINES A FAIR AND REASONABLE COMPENSATION FOR THESE INDIVIDUALS BASED ON MARKET AND COMPARABILITY DATA PROVIDED BY HUMAN RESOURCES. NO OTHER OFFICERS OF THE ORGANIZATION RECEIVE ANY COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 FORM 990 AND RELATED DOCUMENTS ARE AVAILABLE TO ANY MEMBER OF THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: NET ASSETS TRANSFERRED TO THEDACARE FAMILY OF FOUNDATIONS, INC. -1,754,797. FORM 990, PART XII, LINE 2C OVERSIGHT OF THE AUDIT: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THEDACARE INC 122 EAST COLLEGE AVENUE APPLETON WI 54911 391509362 HEALTHCARE WI 501(C)(3) LINE 11C, III-FI N/A 0 THEDA CLARK MEDICAL CENTER INC PO BOX 8025 APPLETON WI 54912 390830664 HOSPITAL WI 501(C)(3) LINE 3 THEDACARE INC 1 THEDACARE MEDICAL CENTER - NEW LONDON INC 1405 MILL STREET NEW LONDON WI 54961 390869788 HOSPITAL WI 501(C)(3) LINE 3 THEDACARE INC 1 RIVERSIDE MEDICAL CENTER INC 800 RIVERSIDE DRIVE WAUPACA WI 54981 390871113 HOSPITAL WI 501(C)(3) LINE 3 THEDACARE INC 1 APPLETON MEDICAL CENTER INC PO BOX 8025 APPLETON WI 54912 390824015 HOSPITAL WI 501(C)(3) LINE 3 THEDACARE INC 1 SHAWANO MEDICAL CENTER INC 309 N BARTLETTE STREET SHAWANO WI 54166 390807068 HOSPITAL WI 501(C)(3) LINE 3 THEDACARE INC 1 THEDA CLARK MEDICAL CENTER FOUNDATION INC 1818 N MEADE STREET APPLETON WI 54911 311550056 FOUNDATION WI 501(C)(3) LINE 11A, I THEDACARE INC 1 APPLETON MEDICAL CENTER FOUNDATION INC 1818 NORTH MEADE STREET APPLETON WI 54911 391459276 FOUNDATION WI 501(C)(3) LINE 7 THEDACARE INC 1 WOLF RIVER AREA HEALTHCARE FOUNDATION INC 1405 MILL STREET NEW LONDON WI 54961 200049796 FOUNDATION WI 501(C)(3) LINE 11A, I NEW LONDON FAMILY MEDICAL CENTER INC 1 COMMUNITY HOSPICE FOUNDATION INC 1818 N MEADE STREET APPLETON WI 54911 391511977 FOUNDATION WI 501(C)(3) LINE 7 THEDACARE INC 1 SHAWANO MEDICAL CENTER FOUNDATION INC 309 N BARTLETTE STREET SHAWANO WI 54166 391539117 FOUNDATION WI 501(C)(3) LINE 11A, I SHAWANO MEDICAL CENTER INC 1 THEDACARE FAMILY OF FOUNDATIONS INC 1818 N MEADE STREET APPLETON WI 54915 464112255 FOUNDATION WA 501(C)(3) LINE 11A, I THEDACARE INC 1 NORTH APPLETON AMBULATORY CARE CENTER BUILDING COMPANY LLC 122 E COLLEGE AVENUE APPLETON WI 54911 262497187 RENTAL WI N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 TRANSFER OF NET ASSETS TO THEDACARE FAMILY FOUNDATIONS INC R 1754797 FMV