BUCHANAN COUNTY HEALTH TRUST INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
BUCHANAN COUNTY HEALTH TRUST INC (EIN 42-1340993)
Tax period
2013-05-01 to 2014-04-30
Filed
2014-09-12
IRS object ID
201432559349300128
Schema version
2013v3.0
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)
Return2014-09-12T10:50:06-05:00ReturnTs
Tax Period End2014-04-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN450250958PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13999 PENNSYLVANIA AVE SUITE 100AddressLine1
CityDUBUQUECity
StateIAState
ZIP Code52002ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-05-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421340993EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Buchanan County Health Trust IncBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlBUCHBusinessNameControlTxt
Phone3193347204PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11600 1st Street EastAddressLine1
CityIndependenceCity
StateIAState
ZIP Code506443155ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDon SabinPersonNm
Person TitlePresidentPersonTitleTxt
Phone3193347204PhoneNum
Signature2014-09-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCarmen KrantzPreparerPersonNm
PTINP00031958PTIN
Phone5635561790PhoneNum
Preparation2014-09-08PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDon SabinPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11600 1st Street EastAddressLine1
CityIndependenceCity
StateIAState
ZIP Code506443155ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$73,781GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addressn/aWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1989FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionEnsure all citizens maintain access to quality health careActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$25,276PYContributionsGrantsAmt
CY Contributions Grants$25,380CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$12,665PYInvestmentIncomeAmt
CY Investment Income$38,401CYInvestmentIncomeAmt
PY Other Revenue$2,493PYOtherRevenueAmt
CY Other Revenue-$265CYOtherRevenueAmt
PY Total Revenue$40,434PYTotalRevenueAmt
CY Total Revenue$63,516CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$19,629PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,213CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,775PYOtherExpensesAmt
CY Other Expenses$3,048CYOtherExpensesAmt
PY Total Expenses$21,404PYTotalExpensesAmt
CY Total Expenses$17,261CYTotalExpensesAmt
PY Revenues Less Expenses$19,030PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$46,255CYRevenuesLessExpensesAmt
Total Assets BOY$1,539,674TotalAssetsBOYAmt
Total Assets EOY$1,584,914TotalAssetsEOYAmt
Total Liabilities BOY$22,444TotalLiabilitiesBOYAmt
Total Liabilities EOY$21,429TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,517,230NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,563,485NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionBuchanan County Health Trust is organized exclusively to benefit and support the medical and health care needs for persons within Buchanan County and other exempt organizations.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$15,621ExpenseAmt
DescBuchanan County Health Trust originated with the foresight of providing funds for health-related projects across Buchanan County. Gifts help ensure that all citizens maintain access to quality health care. Gifts to the Health Trust are not spent, but instead added to our endowment. The interest generated is then used to support organizations that are dedicated to improving the health of all Buchanan County citizens.Since its inception, the total fund balance has grown to approximately $1.5 million. To date, the Trust has provided approximately $475,000 in grants to more than 130 health-related projects.The Buchanan County Health Trust holds an annual dinner and auction fundraiser. In 2013, the event had gross receipts over $31,000.Desc
Total Program Service Expenses$15,621TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
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 Entity0RelatedEntityInd
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 Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
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 Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Ben StevensBusinessNameLine1
FieldValueIRS element (for citing)
Phone3193320880PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11600 1st Street EastAddressLine1
CityIndependenceCity
StateIAState
ZIP Code506443155ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Don Sabin
President0.30Yes (X)Yes (X)$0$0$0
Paul Gudenkauf
Vice President0.30Yes (X)Yes (X)$0$0$0
Tami Young
Secretary/Treasurer0.30Yes (X)Yes (X)$0$0$0
Susie Toale
Director0.30Yes (X)$0$0$0
Denise Rorabaugh
Director0.30Yes (X)$0$0$0
John Christensen
Director0.30Yes (X)$0$0$0
Dr Erica Smith
Director0.30Yes (X)$0$0$0
Sherri Kavalier
Director0.30Yes (X)$0$0$0
Judy Ferreter
Director0.30Yes (X)$0$0$0
Susie Bevans
Director0.30Yes (X)$0$0$0
Danielle Gearhart
Director until January 20140.30Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$21,585FundraisingAmt
All Other Contributions$3,795AllOtherContributionsAmt
Total Contributions$25,380TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,401TotalRevenueColumnAmt
Exclusion$38,401ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$10,000FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$21,585ContriRptFundraisingEventAmt
Fundraising Direct Expenses$10,265FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$265TotalRevenueColumnAmt
Exclusion-$265ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$63,516TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$38,136ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$14,213TotalAmt
Program Services$14,213ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,640TotalAmt
Management And General$1,640ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$134TotalAmt
Program Services$134ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,274TotalAmt
Program Services$1,274ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,261TotalAmt
Program Services$15,621ProgramServicesAmt
Management And General$1,640ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,539,674BOYAmt
EOY$1,432,181EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$152,733EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,539,674BOYAmt
EOY$1,584,914EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$19,629BOYAmt
EOY$18,614EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$2,815BOYAmt
EOY$2,815EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,444BOYAmt
EOY$21,429EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,517,230BOYAmt
EOY$1,563,485EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,517,230BOYAmt
EOY$1,563,485EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,539,674BOYAmt
EOY$1,584,914EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$46,255ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
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$68,531CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$38,822CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$30,432CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$25,276CurrentTaxYearMinus1YearAmt
Current Tax Year$25,380CurrentTaxYearAmt
Total$188,441TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$68,531CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$38,822CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$30,432CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$25,276CurrentTaxYearMinus1YearAmt
Current Tax Year$25,380CurrentTaxYearAmt
Total$188,441TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$16,843SubstantialContributorsTotAmt
Public Support Total170$171,598PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$40,603CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,883CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,167CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$12,665CurrentTaxYearMinus1YearAmt
Current Tax Year$38,401CurrentTaxYearAmt
Total$125,719TotalAmt
FieldValueIRS element (for citing)
Total Support$314,160TotalSupportAmt
Gross Receipts Rltd Activities$43,791GrossReceiptsRltdActivitiesAmt
Public Support CY1700.54620PublicSupportCY170Pct
Public Support PY1700.49670PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1Dinner/AuctionNameOfEvent1Amt
Gross Receipts Event1$31,585GrossReceiptsEvent1Amt
Charitable Contri Event1$21,585CharitableContriEvent1Amt
Gross Revenue Event1$10,000GrossRevenueEvent1Amt
Other Direct Expenses Event1$10,265OtherDirectExpensesEvent1Amt
Gross Receipts Total$31,585GrossReceiptsTotalAmt
Charitable Contributions Tot$21,585CharitableContributionsTotAmt
Gross Revenue Total Events$10,000GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$10,265OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$10,265DirectExpenseSummaryEventsAmt
Net Income Summary-$265NetIncomeSummaryAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 8bThe Organization does not have committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11The Form 990 is presented and reviewed by all board members before it is filed. The 990 is also reviewed by the Associate Administrator - CFO of Buchanan County Health Center.
Form 990, Part VI, Section B, line 12cAll board members are required to annually complete a conflict of interest form and disclose to the board any interest in a contract or other transactions that could cause a conflict of interest. The board then determines by majority vote whether the disclosure shows that a conflict of interest exists or can reasonably be construed to exist. If a conflict exists, the board member is not allowed to vote on or use personal influence or participate in the discussion or deliberations with respect to the contract or transaction. The board member may be asked to leave the meeting and the discussion and determination is documented in the minutes.
Form 990, Part VI, Section C, line 19The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request.

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