FURP.ORG / PUBLIC DATA EXPLORER

NATRONA COLLECTIVE HEALTH TRUST: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NATRONA COLLECTIVE HEALTH TRUST (EIN 83-0230808)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201431349349301303
Schema version
2012v2.1
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)
Timestamp2014-05-14T13:21:55-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN450250958EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Eide Bailly LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1800 Nicollet Mall Ste 1300AddressLine1
CityMinneapolisCity
StateMNState
ZIP Code554027033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN830230808EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Wyoming Medical Center FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWYOMNameControl
Phone3075772973Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11233 East Second StreetAddressLine1
CityCasperCity
StateWYState
ZIP Code82601ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKaren ZabackName
TitleChairTitle
Phone3075772973Phone
Date Signed2014-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKIM C HUNWARDSENName
PTINP00484560PTIN
Phone6122536500Phone
Date Prepared2014-05-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKaren ZabackNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11233 East Second StreetAddressLine1
CityCasperCity
StateWYState
ZIP Code82601ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2280110GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.wyomingmedicalcenterfoundation.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1976YearFormation
State Legal DomicileWYStateLegalDomicile
Activity Or Mission DescriptionTo support the mission of the Wyoming Medical Center and the health of the community.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers55TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year391008ContributionsGrantsPriorYear
Contributions Grants Current Year1721765ContributionsGrantsCurrentYear
Program Service Revenue Prior Year449289ProgramServiceRevenuePriorYear
Program Service Revenue CY11092ProgramServiceRevenueCY
Investment Income Prior Year55206InvestmentIncomePriorYear
Investment Income Current Year60582InvestmentIncomeCurrentYear
Other Revenue Prior Year22982OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year918485TotalRevenuePriorYear
Total Revenue Current Year1793439TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year23142GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY830189GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year432352SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year443560OtherExpensePriorYear
Other Expenses Current Year196691OtherExpensesCurrentYear
Total Expenses Prior Year899054TotalExpensesPriorYear
Total Expenses Current Year1026880TotalExpensesCurrentYear
Revenues Less Expenses Prior Year19431RevenuesLessExpensesPriorYear
Revenues Less Expenses CY766559RevenuesLessExpensesCY
Total Assets BOY5278328TotalAssetsBOY
Total Assets EOY6016604TotalAssetsEOY
Total Liabilities BOY35209TotalLiabilitiesBOY
Total Liabilities EOY2815TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5243119NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY6013789NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe Wyoming Medical Center Foundation enhances excellence in healthcare delivery at Wyoming Medical Center by securing private philanthropic resources, cultivating enduring relationships, and delivering superior donor stewardship.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense977633Expense
Grants820940Grants
Revenue11092Revenue
DescriptionThroughout the fiscal year the Foundation has raised funds to support various projects for its supported organization, WMC (Wyoming Medical Center).The WMC Foundation's overall goal is to raise $3 million towards the new McMurry West Tower. Throughout the past year the Foundation raised over $1 million to be designated towards the new patient tower of the hospital which is a $43.5 million project. The new McMurry West Tower will enhance services provided to the more than 85,000 patients that Wyoming Medical Center serves on a yearly basis. To date, the Foundation has commitments towards the project totaling $2.6 million. Our goal is to be completed with the campaign by summer of 2014.The WMC Foundation raises funds to continue to support the Masterson Place, a 30 bed hospitality home utilized for patients and families who travel to Casper, Wyoming to receive medical treatment and need a place to stay. The Masterson Place offers families a $40.00/night rate, however if they are unable to afford the $40.00 rate, the WMC Foundation helps to scholarship patients in need. This past year the goal for the Masterson Place was to serve over 5,500 patients and families at the Masterson Place. The Masterson Place exceeded its goal and served over 5,800 patients and families in need with over 800 of those being cancer patients that travel to Casper for chemo/radiation treatment.The WMC Foundation also raised funds in the fiscal year 2013 to support the completion of the WMC Emergency Room. In fiscal year 2013 the Foundation disbursed $750,000 for this project.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense31996Expense
Grants9249Grants
Revenue0Revenue
DescriptionAngels Cancer Care Program: The Angels program provides support to cancer patients that are currently receiving treatment. The Angel volunteers are cancer survivors, friends, family and community members. Support for cancer patients can be medication, wigs, food and gas cards, hotel stay, meals, and more. This past year the Angels' goal was to serve 500 patients undergoing treatment with direct needs. The Angels exceeded their goal and served a total of 1,198 cancer patients as well as held several fundraisers to raise over $60,000 for the program.Description
FieldValueIRS element (for citing)
Total Program Service Expense1009629TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109610NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Nathan StutteBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3075772767TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11233 East 2nd StAddressLine1
CityCasperCity
StateWYState
ZIP Code86201ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Miriam Temme
Board Chair2.000.00XX000
Karen Zaback
Vice Chair2.000.00XX000
Jessica Oden
Secretary/Treasurer2.000.00XX000
Bob Barnard
Board Member2.000.00X000
Patricia Cloud
Board Member2.000.00X000
Vickie Diamond
Board Member/CEO WMC2.0045.00X062676327504
Dick Dresang
Board Member2.000.00X000
Cheryl Graff
Board Member2.0040.00X08726231355
Susan McMurry
Board Member2.005.00X000
John Purviance
Board Member2.000.00X000
Dax Collins
Board Member2.000.00X000
Marie Hill
Board Member2.000.00X000
Deanne Sramek
Board Member2.000.00X000
Kyle Thompson
Board Member2.000.00X000
Kate Bailey
Board Member2.000.00X000
Pam Walker
Interim Executive Director (Jul-Aug)40.000.00X026635268
Alisha Havens
Development Director (Aug-Jun)40.000.00X0422230
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs782883TotalReportableCompFrmRltdOrgs
Total Other Compensation59127TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions1721765AllOtherContributions
Total Contributions1721765TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionMasterson Place RevenuDescription
Business Code721000BusinessCode
Total Revenue Column11092TotalRevenueColumn
Related Or Exempt Function Income11092RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue11092TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column22089TotalRevenueColumn
Exclusion$22,089ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities525164Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities486671Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities38493Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column38493TotalRevenueColumn
Exclusion$38,493ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1793439TotalRevenueColumn
Related Or Exempt Function Income11092RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$60,582ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total809940Total
Program Services809940ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total20249Total
Program Services20249ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total26Total
Management And General26ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total17225Total
Management And General17225ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total7459Total
Program Services7459ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total18793Total
Program Services18793ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1574Total
Program Services1574ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total5035Total
Program Services5035ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total3230Total
Program Services3230ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total73473Total
Program Services73473ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Entertainment60336033
Special Recognition745745
Gifts Cards & Vouchers656656
Wigs398398

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total62044Total
Program Services62044ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1026880Total
Program Services1009629ProgramServices
Management And General17251ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1123700BOY
EOY1399226EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY757352BOY
EOY1315815EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY20139BOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1970091LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec744989LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1285932BOY
EOY1225102EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1455805BOY
EOY1898966EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY621611BOY
EOY163706EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY13789BOY
EOY13789EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5278328BOY
EOY6016604EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4008BOY
EOY92EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY31201BOY
EOY2723EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY35209BOY
EOY2815EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3039653BOY
EOY2999048EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1640035BOY
EOY2451310EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY563431BOY
EOY563431EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5243119BOY
EOY6013789EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5278328BOY
EOY6016604EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses766559ReconcilationRevenueExpenses
Reconciliation Unrealized Invest113153ReconciliationUnrealizedInvest
Reconcilation Other Changes-109042ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1Wyoming Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
EIN830279242EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$1,009,629Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts1009629SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1511270BeginningOfYearBalance
Contributions52161Contributions
Investment Earnings Or Losses99413InvestmentEarningsOrLosses
Other Expenditures99413OtherExpenditures
End Of Year Balance1563431EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1511270BeginningOfYearBalance
Investment Earnings Or Losses10478InvestmentEarningsOrLosses
Other Expenditures10478OtherExpenditures
End Of Year Balance1511270EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1111270BeginningOfYearBalance
Contributions400000Contributions
Investment Earnings Or Losses93488InvestmentEarningsOrLosses
Other Expenditures93488OtherExpenditures
End Of Year Balance1511270EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1111270BeginningOfYearBalance
Investment Earnings Or Losses42331InvestmentEarningsOrLosses
Other Expenditures42331OtherExpenditures
End Of Year Balance1111270EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.63960BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.36040PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis340885OtherCostOrOtherBasis
Book Value340885BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1348330OtherCostOrOtherBasis
Depreciation502940Depreciation
Book Value845390BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis280876OtherCostOrOtherBasis
Depreciation242049Depreciation
Book Value38827BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1225102TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue to Wyoming Medical CenterDescription
Amount$2,723Amount
FieldValueIRS element (for citing)
Total Of Amounts2723TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt2643629TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments113153NetUnrealizedGainsInvestments
Other Revenues737037OtherRevenues
Revenue Not Rptd F990850190RevenueNotRptdF990
Revenue Subtotal1793439RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9901793439TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1014556TotExpensesEtcAuditedFinclStmt
Other Expenses Included-12324OtherExpensesIncluded
Expenses Not Rptd F990-12324ExpensesNotRptdF990
Expenses Subtotal1026880ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9901026880TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4:The Foundation has an endowment on which the investment earnings are available to be used for Foundation general operating expenses.
Description of Uncertain Tax Positions Under FIN 48:Part X, Line 2:The Foundation is organized as a Wyoming nonprofit corporation and has been recognized by the Internal Revenue Service 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 Organization has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. The Foundation will recognize future accrued interest and penalties related to unrecognized tax liabilities in income tax expense if incurred.
Part XI, Line 2d - Other Adjustments:Net Assets Released from Restrictions on Financial Statements 858,403. Revenue of Subsidiary Hospital Foundation Ventures Inc in Consolidated Audit -70,229. Change in Valuation of Discount on Pledges -51,137.
Part XII, Line 2d - Other Adjustments:Expense of Subsidiary Hospital Foundation Ventures Inc in Consolidated Audit -12,324.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Wyoming Medical CenterBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11233 E Second StAddressLine1
CityCasperCity
StateWYState
ZIP Code82601ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient830279242EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant809940AmountOfCashGrant
Purpose Of GrantPurchase EquipmentPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (7 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuation
Scholarships1111000
Gas gift cards321350
Food252078
Lodging1203400
Wigs5645
Utilities11499
Meds, Supplies, etc71277FMV

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: Grant requests are submitted to the Foundation. The Foundation's program committee reviews the requests to see if the request qualifies, and if so, analyzes the amount requested and establishes a decision to be presented to the Board of Directors for approval.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonVickie DiamondNamePerson
TitleBoard Member/CEO WMCTitle
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs497904CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs116325BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs12534OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs27504DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs1366NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs655633TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 3ReturnReference
ExplanationThe Development Director is reviewed under the Wyoming Medical Center's process that includes a 360 evaluation, a Wyoming Medical Center evaluation form and the percentage raise is based on this score. Additionally, the Development Director's performance and compensation is reviewed by the Executive Committee led by the Board Chair regarding the goals set at the beginning of the fiscal year. A predetermined bonus is prorated based on the accomplishments within the strategic plan and the Development Director's goals for the year. Every 12-18 months, Wyoming Medical Center will conduct a market survey to determine if there are potential market adjustments based on similar jobs and if there are any market increases. This process was undertaken in August 2012.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 1There shall be an Executive Committee of the Foundation that includes the Foundation Board President, Vice President, Treasurer, and Secretary. The Vice President of External Affairs and Development Director of the Foundation shall serve as non-voting, ex-officio members. The Executive Committee shall act on behalf of the Board of Directors when the Foundation Board is not in session but shall be accountable to the Foundation Board for its actions. These actions must be approved by a vote by the Board of Directors at the immediate Foundation Board Meeting following the action.
Form 990, Part VI, Section A, line 2Vickie Diamond is the CEO of WMC, of which employed Cheryl Graff, Pam Walker and Alisha Havens. Therefore Vickie has a business relationship with each of these individuals. Vickie Diamond is the CEO of WMC, of which Susan McMurry serves as a Board Member on the WMC Board.
Form 990, Part VI, Section A, line 4The Bylaws were updated in the fiscal year. The significant changes include the following: 1) The maximum amount of board members was changed from twenty five to fifteen. 2) The Board of Directors is required to include the CEO of Wyoming Medical Center, the current President of the Wyoming Medical Center Volunteer Services and a minimum of eight members from the general public. These eight board members no longer have to be appointed under the Memorandum of Understanding between Wyoming Medical Center and Wyoming Medical Center Foundation. 3) The President of the Foundation duties are to advise the business of the Corporation. The President no longer has the general and direct management of the Foundation. The direct management of the Foundation and the Foundation staff will be under the direction of Wyoming Medical Center per Memorandum of Understanding signed in 2012. 4) The Foundation Bylaws now allow for an Executive Committee that can act on behalf of the governing Board when the Foundation Board is not in session. These actions are then approved at the next Board of Directors meeting.
Form 990, Part VI, Section A, line 7aThe Foundation's Board includes the CEO of Wyoming Medical Center and the current President of the Wyoming Medical Center Volunteer Services.
Form 990, Part VI, Section B, line 11A public accounting firm was contracted to prepare the Form 990. The Form 990 will be reviewed by the Secretary/Treasurer and the Development Director of the Foundation. The Form 990 will be presented to the Board for approval and, upon approval, will be filed with the IRS.
Form 990, Part VI, Section B, line 12cThe Foundation monitors voting Board Members by requiring each Member to submit a conflict of interest form at the beginning of every fiscal year or when joining the Board. The Development Director reviews the conflict forms. When voting on projects where an individual board member has a conflict, they will abstain from voting. The Development Director and staff must disclose any conflicts within the confines of the Wyoming Medical Center policies as employees.
The Development Director is compensated from Wyoming Medical Center, and the compensation is determined by Wyoming Medical Center's Human Resources Department by utilizing comparability data.
Form 990, Part VI, Section C, line 19The Foundation makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part VII, Compensation from Related OrganizationThe related organization, WMC, compensates those individuals listed in Part VII. The Foundation does not reimburse WMC for these services. The compensation reported for Vickie Diamond and Cheryl Graff represent compensation for their services solely to WMC. The compensation reported for Pam Walker and Alisha Havens are for services rendered to the Foundation.
Form 990, Part XI, line 9:Change in Valuation of Discount on Pledges -51,137. Change in Value of Subsidiary Hospital Foundation Ventures Inc. -457,905. Equity Transfer from Hospital Foundation Ventures, Inc. to WMC 400,000.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Wyoming Medical CenterBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11233 East Second StAddressLine1
CityCasperCity
StateWYState
ZIP Code82601ZIPCode
FieldValueIRS element (for citing)
EIN830279242EIN
Primary ActivitiesMedical ServicesPrimaryActivities
Legal Domicile StateWYLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity StatusLine 3PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Hospital Foundation Ventures IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11233 East 2nd StAddressLine1
CityCasperCity
StateWYState
ZIP Code82601ZIPCode
FieldValueIRS element (for citing)
EIN830282249EIN
Primary ActivityBusiness InvestmentPrimaryActivity
Legal Domicile StateWYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Wyoming Medical Center FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Share Of Total Income564353ShareOfTotalIncome
Share Of EOY Assets339052ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Hospital Foundation Ventures IncBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeSTransactionType
Amount Involved400000AmountInvolved
Method Of Amt DeterminationActual AmountMethodOfAmtDetermination