2014-05-15T15:43:13-05:00 2013-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2012-07-01 810496987 Sheridan Health Care Foundation Inc SHER 4067653700 440 W Laurel Avenue Plentywood MT 59254 Sandra Christensen 4067653700 2014-05-14 1 Kim Hunwardsen CPA P00484560 6122536500 2014-05-14 2012 2015-11-30 17:44:51Z Sandra Christensen 440 W Laurel Avenue Plentywood MT 59254 782279 0 X www.sheridanmemorial.net/foundation X 1994 MT To support Sheridan Memorial Hospital and nursing home. 9 9 0 14 0 0 173655 325602 0 0 1074 25015 -1679 31650 173050 382267 150492 303497 0 0 0 0 0 0 0 0 0 150492 303497 22558 78770 1061452 1160885 0 0 1061452 1160885 X To support Sheridan Memorial Hospital and nursing home by promoting its image in the community and by providing financial contributions through fundraising activities for the expansion and maintenance of the facility and for services provided to our community and surrounding areas. 0 0 303497 303497 Distributions made to Sheridan Memorial Hospital Association, a 501(c)(3) organization, to help fund medical activities. 303497 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 9 9 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Connie Anderson 4067653709 440 W Laurel Avenue Plentywood MT 59254 Paul Hansen 1.00 0.00 X X 0 0 0 Janet McCabe 1.00 0.00 X X 0 0 0 Jandy Jorgenson 1.00 0.00 X X 0 0 0 Sherri McCrory 1.00 0.00 X X 0 0 0 Leeann Jensen 1.00 0.00 X 0 0 0 Bill McCoy 1.00 1.00 X 0 0 0 Jim Maus 1.00 0.00 X 0 0 0 Joan Tommerup 1.00 0.00 X 0 0 0 Beatie Petersen 1.00 0.00 X 0 0 0 Sandra Christensen 1.00 40.00 X 0 57122 16654 0 57122 16654 0 0 0 0 0 325602 325602 15075 15075 405452 395512 9940 9940 9940 36150 4500 31650 31650 382267 0 0 56665 303497 303497 303497 303497 0 0 570511 317812 325000 2109 488832 509556 0 8517 1061452 1160885 0 0 X 882007 884700 141915 162269 37530 113916 1061452 1160885 1061452 1160885 78770 20635 28 0 X 0 1 X 0 0 X 236013 170115 253866 173655 325602 1159251 236013 170115 253866 173655 325602 1159251 1159251 20963 58662 78840 1074 15075 174614 1333865 36150 0.86910 0.84510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 37530 76386 27 27 113916 27195 10335 37530 27075 120 27195 26855 220 27075 0.00000 1.00000 0.00000 0 0 0 X 402902 20635 20635 382267 0 382267 303497 0 303497 0 303497 Description of Intended Use of Endowment Funds: Part V, Line 4: The endowment consists of individual funds established by donors to provide annual funding for specific activities and general operations of the Hospital. Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: The Foundation is organized as a Montana nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from Federal income taxes under Internal Revenue Code Section 501(c)(3). The Foundation is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Foundation is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Foundation has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS. The Foundation believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Foundation would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense, if such interest and penalties are incurred. Christmas Kickoff 36150 36150 4500 36150 36150 4500 4500 31650 1 Sheridan Memorial Hospital Association 440 W Laurel Ave Plentywood MT 59254 810243720 501(c)(3) 303497 General Support 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Sheridan Health Care Foundation, Inc. was established exclusively for the benefit of Sheridan Memorial Hospital Association. The Foundation's Board of Directors includes two members of the Hospital Board and the CEO of the Hospital is the Foundation President. These relationships help to ensure and monitor the appropriate use of funds distributed from the Foundation to the Hospital. Form 990, Part VI, Section A, line 2 Leeann Jensen and Paul Hansen have a family relationship. Form 990, Part VI, Section B, line 11 The board reviews an electronic copy of the Form 990 before the final copy is filed with the IRS. Form 990, Part VI, Section B, line 12c Annually the Foundation Board of Directors sign a conflict of interest policy. Any potential conflicts are made known to the entire board and board members with a conflict must abstain from voting on the conflicted issue. Sheridan Health Care Foundation, Inc. does not compensate the organizations CEO. The CEO was compensated by Sheridan Memorial Hospital Association, but as of June 2012 is compensated by Billings Clinic, an unrelated management company. The compensation reflected in Part VII is the compensation the CEO received from Sheridan Memorial Hospital Association prior to June 2012. Form 990, Part VI, Section C, line 19 All governing documents related to the Sheridan Health Care Foundation are available upon request. Sheridan Memorial Hospital Association 440 W Laurel Ave Plentywood MT 59254 810243720 Hospital MT 501(c)(3) Line 3 N/A 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0