2014-05-14T13:21:55-05:00 2013-06-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2012-07-01 830230808 Wyoming Medical Center Foundation WYOM 3075772973 1233 East Second Street Casper WY 82601 Karen Zaback 3075772973 2014-05-13 1 KIM C HUNWARDSEN P00484560 6122536500 2014-05-13 2012 2015-11-30 17:44:51Z Karen Zaback 1233 East Second Street Casper WY 82601 2280110 0 X www.wyomingmedicalcenterfoundation.org X 1976 WY To support the mission of the Wyoming Medical Center and the health of the community. 15 13 0 55 0 0 391008 1721765 449289 11092 55206 60582 22982 0 918485 1793439 23142 830189 0 0 432352 0 0 0 0 443560 196691 899054 1026880 19431 766559 5278328 6016604 35209 2815 5243119 6013789 X The 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. 0 0 977633 820940 11092 Throughout 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. 31996 9249 0 Angels 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. 1009629 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 10 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 15 13 1 0 1 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X Nathan Stutte 3075772767 1233 East 2nd St Casper WY 86201 X Miriam Temme 2.00 0.00 X X 0 0 0 Karen Zaback 2.00 0.00 X X 0 0 0 Jessica Oden 2.00 0.00 X X 0 0 0 Bob Barnard 2.00 0.00 X 0 0 0 Patricia Cloud 2.00 0.00 X 0 0 0 Vickie Diamond 2.00 45.00 X 0 626763 27504 Dick Dresang 2.00 0.00 X 0 0 0 Cheryl Graff 2.00 40.00 X 0 87262 31355 Susan McMurry 2.00 5.00 X 0 0 0 John Purviance 2.00 0.00 X 0 0 0 Dax Collins 2.00 0.00 X 0 0 0 Marie Hill 2.00 0.00 X 0 0 0 Deanne Sramek 2.00 0.00 X 0 0 0 Kyle Thompson 2.00 0.00 X 0 0 0 Kate Bailey 2.00 0.00 X 0 0 0 Pam Walker 40.00 0.00 X 0 26635 268 Alisha Havens 40.00 0.00 X 0 42223 0 0 782883 59127 0 0 1 0 0 1721765 1721765 Masterson Place Revenu 721000 11092 11092 11092 22089 22089 525164 486671 38493 38493 38493 1793439 11092 0 60582 809940 809940 20249 20249 26 26 17225 17225 7459 7459 18793 18793 1574 1574 5035 5035 3230 3230 73473 73473 Entertainment 6033 6033 Special Recognition 745 745 Gifts Cards & Vouchers 656 656 Wigs 398 398 62044 62044 1026880 1009629 17251 0 1123700 1399226 757352 1315815 20139 1970091 744989 1285932 1225102 1455805 1898966 621611 163706 13789 13789 5278328 6016604 4008 92 31201 2723 35209 2815 X 3039653 2999048 1640035 2451310 563431 563431 5243119 6013789 5278328 6016604 X 766559 113153 -109042 X 0 1 X 1 0 X X X 0 0 0 Wyoming Medical Center 830279242 3 1 1 1 1009629 1 1009629 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1511270 52161 99413 99413 1563431 1511270 10478 10478 1511270 1111270 400000 93488 93488 1511270 1111270 42331 42331 1111270 0.63960 0.36040 0 0 340885 340885 1348330 502940 845390 280876 242049 38827 1225102 Due to Wyoming Medical Center 2723 2723 X 2643629 113153 737037 850190 1793439 0 1793439 1014556 -12324 -12324 1026880 0 1026880 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. 1 Wyoming Medical Center 1233 E Second St Casper WY 82601 830279242 501(c)(3) 809940 Purchase Equipment 1 0 Scholarships 11 11000 Gas gift cards 32 1350 Food 25 2078 Lodging 120 3400 Wigs 5 645 Utilities 11 499 Meds, Supplies, etc 7 1277 FMV Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule 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. 0 0 0 0 0 0 0 0 0 Vickie Diamond 0 497904 0 116325 0 12534 0 27504 0 1366 0 655633 0 0 Part I, Line 3 The 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. Form 990, Part VI, Section A, line 1 There 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 2 Vickie 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 4 The 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 7a The 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 11 A 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 12c The 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 19 The 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 Organization The 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. Changes in Net Assets or Fund Balances: 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. Wyoming Medical Center 1233 East Second St Casper WY 82601 830279242 Medical Services WY 501(c)(3) Line 3 N/A 0 Hospital Foundation Ventures Inc 1233 East 2nd St Casper WY 82601 830282249 Business Investment WY Wyoming Medical Center Foundation C 564353 339052 1.00000 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 1 Hospital Foundation Ventures Inc S 400000 Actual Amount