MEMORIAL HEALTH SYSTEM FOUNDATION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL HEALTH SYSTEM FOUNDATION (EIN 84-1576338)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-17
- IRS object ID
- 201433219349304913
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-17T11:36:49-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 461497033 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EKS&H LLLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7979 E TUFTS AVE SUITE 400 | AddressLine1 |
| City | DENVER | City |
| State | CO | State |
| ZIP Code | 80237 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 841576338 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MEMORIAL HEALTH SYSTEM FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MEMO | BusinessNameControlTxt |
| Phone | 7193654483 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1519 E BOULDER ST | AddressLine1 |
| City | COLORADO SPRINGS | City |
| State | CO | State |
| ZIP Code | 80909 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CARY BLANCHETTE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7193654483 | PhoneNum |
| Signature | 2014-11-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | RYAN C HARRIS | PreparerPersonNm |
| PTIN | P00614618 | PTIN |
| Phone | 3037409400 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CARY BLANCHETTE | PrincipalOfficerNm |
| Gross Receipts | $1,744,162 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 7 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,643,755 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $10,647 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | -$1,144 | CYOtherRevenueAmt |
| PY Total Revenue | $0 | PYTotalRevenueAmt |
| CY Total Revenue | $1,653,258 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $754,288 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $573,213 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $448,389 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $0 | PYOtherExpensesAmt |
| CY Other Expenses | $237,482 | CYOtherExpensesAmt |
| PY Total Expenses | $0 | PYTotalExpensesAmt |
| CY Total Expenses | $1,564,983 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $0 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $88,275 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,591,986 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,680,052 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $25,597 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,674 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,566,389 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,672,378 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE OTHE MISSION OF MEMORIAL HEALTH SYSTEM FOUNDATION IS TO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM TO PROVIDE THE HIGHEST QUALITY HEALTH CARE. PHILANTHROPIC SUPPORT IS BEING SOUGHT FOR CAPITAL, ENDOWMENT AND PROGRAMMATIC PURPOSES, INCLUDING CANCER, CARDIOLOGY, AND WOMEN'S PROGRAMS AND SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $204,856 | ExpenseAmt |
| Grant | $204,856 | GrantAmt |
| Desc | THE CS CHILDREN'S HOSPITAL GENERAL FUND WAS CREATED TO SUPPORT THE CHILDREN'S HOSPITAL AT MEMORIAL HOSPITAL. THE FUNDS ARE DISTRIBUTED UPON SPECIFIC REQUESTS FROM THE COLORADO CHILDREN'S HOSPITAL FOR THE BENEFIT AND CARE OF THE CHILDREN AND FAMILIES OF COLORADO SPRINGS AND COMMUNITIES SERVED BY THE CHILDREN'S HOSPITAL. DURING 2013, 68 INDIVIDUALS WERE GIVEN ASSISTANCE FOR LIVING EXPENSES SUCH AS RENT, UTILITIES AND TRANSPORTATION. IN ADDITION, A COOL CAP UNIT, PHOTOTHERAPY LIGHT AND 55 NUTRITION WARMERS WERE PURCHASED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $121,662 | ExpenseAmt |
| Grant | $121,662 | GrantAmt |
| Desc | THE ISOLETTE FUND WAS CREATED TO PURCHASE A NEW TRAVEL ISOLETTE TO REPLACE AN AGING AND OBSOLETE ISOLETTE IN THE MHS TRANSPORT DEPARTMENT. THE NEW ISOLETTE WAS SPECIFICALLY DESIGNED TO FUNCTION IN AN AMBULANCE WHILE TRANSPORTING AN INFANT. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $98,917 | ExpenseAmt |
| Grant | $98,917 | GrantAmt |
| Desc | THE MEMORIAL HEALTH SYSTEM FOUNDATION HAS PARTNERED WITH KOHL'S CARES FOR CAR SAFETY TO HELP PREVENT INJURY TO CHILDREN AGES 0 TO 14 YEARS OF AGE. OUR MEMBERS INCLUDE CHILD PASSENGER SAFETY SEAT TECHNICIANS ARE ARE AVAILABLE TO CONDUCT CAR SEAT CHECKS AT A VARIETY OF LOCATIONS THROUGHOUT THE COMMUNITY. WE SPEAK TO THOUSANDS OF PEOPLE PER YEAR AND CAN PROVIDE EDUCATION AT EVENTS UPON REQUEST. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $438,765 | ExpenseAmt |
| Grant | $328,853 | GrantAmt |
| Desc | VARIOUS PATIENT CARE AND STAFF EDUCATION FUNDS | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $438,765 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $328,853 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $864,200 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | Yes (1) | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 7 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Excess Business Holdings | 0 | ExcessBusinessHoldingsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEVE WEBER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7193654483 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1519 E BOULDER ST | AddressLine1 |
| City | COLORADO SPRINGS | City |
| State | CO | State |
| ZIP Code | 80909 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| DAVID I GREENBERG MD | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARY ELLEN MCNALLY | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ROBERT KILEY MD | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| PEGGY CARMACK | ||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| MARK BROWN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LANA JANC | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS NAUGHTON | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KEVIN O'GARA | ||||||
| BOARD CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| MIKE SCIALDONE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BETSY PLANTE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARLENE CHELL | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CARY BLANCHETTE | ||||||
| EXEC. DIR. | 40.00 | $136,776 | $0 | $23,996 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $136,776 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $23,996 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $159,606 | FundraisingAmt |
| Related Organizations | $811,697 | RelatedOrganizationsAmt |
| All Other Contributions | $672,452 | AllOtherContributionsAmt |
| Noncash Contributions | $163,270 | NoncashContributionsAmt |
| Total Contributions | $1,643,755 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,547 | TotalRevenueColumnAmt |
| Exclusion | $14,547 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,900 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$3,900 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,900 | TotalRevenueColumnAmt |
| Exclusion | -$3,900 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $85,860 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $159,606 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $87,004 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,144 | TotalRevenueColumnAmt |
| Exclusion | -$1,144 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,653,258 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9,503 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $638,224 | TotalAmt |
| Program Services | $638,224 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,064 | TotalAmt |
| Program Services | $116,064 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,772 | TotalAmt |
| Management And General | $64,309 | ManagementAndGeneralAmt |
| Fundraising | $96,463 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $341,727 | TotalAmt |
| Program Services | $75,440 | ProgramServicesAmt |
| Management And General | $63,942 | ManagementAndGeneralAmt |
| Fundraising | $202,345 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,688 | TotalAmt |
| Program Services | $2,257 | ProgramServicesAmt |
| Management And General | $2,099 | ManagementAndGeneralAmt |
| Fundraising | $6,332 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,720 | TotalAmt |
| Program Services | $11,977 | ProgramServicesAmt |
| Management And General | $11,139 | ManagementAndGeneralAmt |
| Fundraising | $33,604 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,306 | TotalAmt |
| Program Services | $698 | ProgramServicesAmt |
| Management And General | $649 | ManagementAndGeneralAmt |
| Fundraising | $1,959 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,000 | TotalAmt |
| Management And General | $5,000 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,250 | TotalAmt |
| Management And General | $1,250 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,994 | TotalAmt |
| Management And General | $45,251 | ManagementAndGeneralAmt |
| Fundraising | $60,743 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,639 | TotalAmt |
| Program Services | $1,187 | ProgramServicesAmt |
| Management And General | $3,075 | ManagementAndGeneralAmt |
| Fundraising | $9,377 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,410 | TotalAmt |
| Program Services | $1,190 | ProgramServicesAmt |
| Management And General | $6,939 | ManagementAndGeneralAmt |
| Fundraising | $12,281 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,605 | TotalAmt |
| Program Services | $5,817 | ProgramServicesAmt |
| Management And General | $9,695 | ManagementAndGeneralAmt |
| Fundraising | $7,093 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,056 | TotalAmt |
| Program Services | $8,411 | ProgramServicesAmt |
| Management And General | $25,234 | ManagementAndGeneralAmt |
| Fundraising | $8,411 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,111 | TotalAmt |
| Management And General | $844 | ManagementAndGeneralAmt |
| Fundraising | $1,267 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,937 | TotalAmt |
| Program Services | $2,345 | ProgramServicesAmt |
| Management And General | $7,683 | ManagementAndGeneralAmt |
| Fundraising | $3,909 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,951 | TotalAmt |
| Program Services | $590 | ProgramServicesAmt |
| Management And General | $1,771 | ManagementAndGeneralAmt |
| Fundraising | $590 | FundraisingAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| MISCELLANEOUS | $4,872 | $2,451 | $2,421 |
| DUES | $2,657 | $1,063 | $1,594 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,564,983 | TotalAmt |
| Program Services | $864,200 | ProgramServicesAmt |
| Management And General | $252,394 | ManagementAndGeneralAmt |
| Fundraising | $448,389 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,924 | BOYAmt |
| EOY | $18,366 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,306,413 | BOYAmt |
| EOY | $4,324,164 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,268 | BOYAmt |
| EOY | $92,266 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,857 | BOYAmt |
| EOY | $10,166 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $61,945 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $52,676 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,852 | BOYAmt |
| EOY | $9,269 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $204,672 | BOYAmt |
| EOY | $225,821 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,591,986 | BOYAmt |
| EOY | $4,680,052 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,597 | BOYAmt |
| EOY | $2,674 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,597 | BOYAmt |
| EOY | $7,674 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $711,622 | BOYAmt |
| EOY | $720,655 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,660,592 | BOYAmt |
| EOY | $3,757,548 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $194,175 | BOYAmt |
| EOY | $194,175 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,566,389 | BOYAmt |
| EOY | $4,672,378 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,591,986 | BOYAmt |
| EOY | $4,680,052 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $88,275 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $19,503 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,789 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,694,182 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,536,017 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,652,735 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,612,367 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,643,755 | CurrentTaxYearAmt |
| Total | $8,139,056 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,694,182 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,536,017 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,652,735 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,612,367 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,643,755 | CurrentTaxYearAmt |
| Total | $8,139,056 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $2,669,107 | SubstantialContributorsTotAmt |
| Public Support Total170 | $5,469,949 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,439 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,757 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,820 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,548 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,547 | CurrentTaxYearAmt |
| Total | $89,111 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $8,228,167 | TotalSupportAmt |
| Public Support CY170 | 0.66480 | PublicSupportCY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $204,672 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $21,148 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $225,820 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $194,127 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $10,545 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $204,672 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $197,646 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$3,519 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $194,127 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $205,009 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $12,637 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $20,000 | GrantsOrScholarshipsAmt |
| End Year Balance | $197,646 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $181,500 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $23,509 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $205,009 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.85990 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.14010 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $61,945 | OtherCostOrOtherBasisAmt |
| Depreciation | $52,676 | DepreciationAmt |
| Book Value | $9,269 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,269 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,791,196 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $19,503 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $32,681 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $87,004 | OtherRevenueAmt |
| Revenue Not Reported | $139,188 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,652,008 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $1,250 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $1,250 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,653,258 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,685,207 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $32,681 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $88,793 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $121,474 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,563,733 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $1,250 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $1,250 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,564,983 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO PROVIDE EDUCATION TO OUTREACH PROGRAMS, TRAUMA NURSES, AND BLOOD DONOR TECHS. |
| PART X, LINE 2: | THE FOUNDATION APPLIES A MORE-LIKELY-THAN-NOT MEASUREMENT METHODOLOGY TO REFLECT THE FINANCIAL STATEMENT IMPACT OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. AFTER EVALUATING THE TAX POSITIONS TAKEN, NONE ARE CONSIDERED TO BE UNCERTAIN; THEREFORE, NO AMOUNTS HAVE BEEN RECOGNIZED AS OF DECEMBER 31, 2013. IF INCURRED, INTEREST AND PENALTIES ASSOCIATED WITH TAX POSITIONS ARE RECORDED IN THE PERIOD ASSESSED AS GENERAL AND ADMINISTRATIVE EXPENSES. NO INTEREST OR PENALTIES HAVE BEEN ASSESSED AS OF DECEMBER 31, 2013. TAX YEARS THAT REMAIN SUBJECT TO EXAMINATION INCLUDE 2009 THROUGH THE CURRENT YEAR FOR STATE TAX REPORTING PURPOSES AND 2010 THROUGH THE CURRENT YEAR FOR FEDERAL TAX REPORTING PURPOSES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES: $87,004 |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | WRITE OFF OF PLEDGES RECEIVABLE: $1,789 SPECIAL EVENT EXPENSES: $87,004 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GALA | NameOfEvent1Amt |
| Gross Receipts Event1 | $210,916 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $137,068 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $73,848 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $37,352 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $5,175 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $7,757 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $16,728 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | GOLF TOURNAMENT | NameOfEvent2Amt |
| Gross Receipts Event2 | $34,550 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $22,538 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $12,012 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $12,012 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $6,306 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $1,674 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $245,466 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $159,606 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $85,860 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $49,364 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $11,481 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $7,757 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $18,402 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $87,004 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$1,144 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UCH - MHC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 E BOULDER STREET | AddressLine1 |
| City | COLORADO SPRINGS | City |
| State | CO | State |
| ZIP Code | 80909 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 460796114 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $638,224 | CashGrantAmt |
| Purpose Of Grant | FINANCIAL SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| LIVING EXPENSES | 142 | $86,979 |
| COLORADO SPRINGS CHILDREN'S GENERAL FUND | 68 | $9,268 |
| WOMEN'S SERVICES | 77 | $4,733 |
| PIKES PEAK COMMUNITY FUND | 25 | $5,334 |
| SCHOLARSHIPS | 7 | $9,750 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE I | FormAndLineReferenceDesc |
| Explanation | THE FOUNDATION EXECUTIVE DIRECTOR REVIEWS ALL GRANTS AND REQUESTS FOR MONIES. ALL ASSISTANCE PROVIDED TO INDIVIDUALS IS PAID DIRECTLY TO THOSE THAT PROVIDE THE ASSISTANCE. THE FUNDS ARE NOT GIVEN DIRECTLY TO THE INDIVIDUALS. THUS, THE ORGANIZATION IS ABLE TO ENSURE THAT THE FUNDS ARE USED FOR THE INTENDED PURPOSES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CARY BLANCHETTE | PersonNm |
| Title | EXEC. DIR. | TitleTxt |
| Base Compensation Filing Org | $136,776 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $4,126 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $19,870 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $160,772 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule M IRS990ScheduleM
Works Of Art WorksOfArtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $5,246 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Books And Publications BooksAndPublicationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $2,113 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $13,305 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Cars And Other Vehicles CarsAndOtherVehiclesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $500 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | TOYS | Desc |
| Contribution | 51 | ContributionCnt |
| Noncash Contributions Rpt F990 | $142,106 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE MEMORIAL HOSPITAL FINANCE DEPARTMENT REVIEWS THE RETURN. A COPY OF THE FORM 990 IS EMAILED TO BOARD MEMBERS PRIOR TO BEING FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | AT THE ANNUAL BOARD MEETING, THE BOARD IS GIVEN A NEW COPY OF THE CONFLICT OF INTEREST STATEMENT. THE BOARD GOES OVER THE STATEMENT AND EACH BOARD MEMBER MUST SIGN THE DOCUMENT. THUS, EACH MEMBER SIGNS IT ANNUALLY AND IS REMINDED TO BRING ANY POTENTIAL CONFLICT TO THE BOARD'S AND EXECUTIVE DIRECTOR'S ATTENTION. THE BOARD MEMBER MUST ALSO RECUSE HIMSELF OR HERSELF FROM ANY VOTE IF THERE IS A CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15A | SALARY SURVEYS DATA THAT IS COMPILED BY THIRD PARTIES IS USED TO DETERMINE THE COMPENSATION OF THE EXECUTIVE DIRECTOR. REVIEW AND APPROVAL OF THE SALARY IS DONE BY THE MEMORIAL HOSPITAL AND UCH BOARDS. THE ORGANIZATION MAINTAINS THE APPROPRIATE DOCUMENTATION OF THE PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE AT THE FOUNDATION OFFICE IF THE PUBLIC WISHES TO REVIEW THEM. |
| FORM 990, PART XI, LINE 9: | WRITE OFF OF PLEDGES RECEIVABLE -1,789. |
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