2014-02-15T08:21:24-06:00 2013-06-30 450250985 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2012-07-01 431975486 Friends of FMC Foundation Inc FRIE 4067783331 202 S 4th St W Baker MT 59313 David Stevens 4067783331 2014-02-17 1 Kim C Hunwardsen P00484560 6122536500 2014-02-17 2012 2015-11-30 17:44:51Z David Stevens 202 S 4th St W Baker MT 59313 390720 0 X www.fallonmedical.org X 2002 MT To coordinate Fallon Medical Complex, Inc's fundraising programs. 7 6 0 47 0 0 91006 341667 0 0 13334 25073 -2032 13170 102308 379910 33041 5256 0 0 21196 17771 0 0 10006 7143 20120 61380 43147 40928 336763 527908 868174 0 0 527908 868174 X Friends of FMC Foundation's mission is to help ensure the continuing quality of local healthcare services in the Fallon Medical Complex service area by raising funds for the purpose of enhancing the quality and dignity of life of all persons employed and served by Fallon Medical Complex. "Friends Helping Friends." 0 0 15145 2256 The purpose of Friends of Fallon Medical Complex Foundation is to provide, through all of its funds and activities, direct or indirect benefit to Fallon Medical Complex (FMC), a not-for-profit healthcare corporation, in support of its mission, so long as FMC qualifies as an organization described in Section 501(c)(3) of the Internal Revenue Code. The Foundation obtains and receives contributions, donations, gifts, or bequests entirely for the development of one or more endowment funds, to be used for financial assistance to FMC for medical education, equipment upgrades and purchases, physical plant improvements and additions, personnel programs, and any aspect of promotion and public relations devoted to the delivery of health care services in FMC's service area. 3000 3000 The Friends of Fallon Medical Complex Foundation distributes funds from its capital pool for the purpose of funding scholarships to students from our service area who are pursuing a formal education in a healthcare-related field. The scholarship process is governed by established formal program criteria that define how requests are to be submitted by applicants and how they are to be evaluated by the Board of Directors. During the past fiscal year, the Board awarded three scholarships (worth $1,000 each) to students, all distributed during the year to the scholars college of choice. 18145 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 7 6 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X X Selena Nelson 4067785103 PO Box 820 Baker MT 59313 Michael Griffith 1.00 0.00 X X 0 0 0 David Stevens 1.00 0.00 X X 0 0 0 Rosanne Varner 1.00 0.00 X X 0 0 0 Susan Stevens 1.00 0.00 X X 0 0 0 Gloria Boggs 1.00 0.50 X 0 0 0 Darcy Pankratz 1.00 0.00 X 0 0 0 Doug Varner 1.00 0.50 X 0 0 0 Mike Griffith 1.00 0.00 X 0 0 0 Craig Pinnow 1.00 0.00 X 0 0 0 Karol Zachmann 24.00 16.00 X 0 14154 7487 0 14154 7487 0 0 0 0 0 12735 20846 308086 341667 14605 14605 10468 0 10468 10468 10468 23980 12735 10810 13170 13170 379910 0 0 38243 2256 2256 3000 3000 17771 889 7997 8885 2000 2000 3757 3757 871 871 13444 12000 1227 217 Misc. Fundraising Expen 33 33 Licenses & Taxes 15 15 43147 18145 14996 10006 527808 88 0 0 868086 100 527908 868174 0 0 X 396968 701590 17891 33535 113049 133049 527908 868174 527908 868174 336763 3503 0 X 0 1 X 1 0 X 99573 95114 84381 91006 341667 711741 99573 95114 84381 91006 341667 711741 400655 311086 6333 5116 6870 11770 14605 44694 756435 69901 0.41130 0.54920 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 172588 21012 992 4000 190592 150010 22230 1348 1000 172588 0.22380 0.69810 0.07810 0 0 0 X 394223 3503 3503 390720 -10810 -10810 379910 53957 10810 10810 43147 0 43147 Description of Intended Use of Endowment Funds: Part V, Line 4: Permanently restricted funds are used to provide a source of income to be used for Long Term Care, and/or equipment purchases on behalf of Fallon Medical Complex, and for scholarships. Principal has been invested and the generated income (temporarily restricted) is used for said purpose. Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: The Complex is organized as a nonprofit organization and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. The Complex is also exempt from state income taxes. The Complex is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Complex is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Complex has determined it is not subject to unrelated business income tax and has not filed an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS. The Complex believes it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Complex would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. The Complex is no longer subject to federal or state tax examinations by tax authorities for the years before June 30, 2010. Part XI, Line 4b - Other Adjustments: Fundraising Expenses -10,810. Part XII, Line 2d - Other Adjustments: Fundraising Expenses 10,810. Mammo Whammo 11432 8730 2702 1120 322 1020 204 213 Fantasy Food Fair 8222 8222 667 2455 250 206 6 17061 4005 13056 580 2651 352 770 36715 12735 23980 1700 3640 1020 3011 250 1189 10810 13170 Karol Zachmann Family Member of Board Members Susan Stevens and David Stevens 17771 Wages 0 Form 990, Part VI, Section A, line 2 Karol Zachmann, Susan Stevens, and David Stevens have family relationships. Doug Varner and Rosanne Varner have a family relationship. Form 990, Part VI, Section A, line 8b The organization does not have a committee that acts on behalf of the governing body. Form 990, Part VI, Section B, line 11 Information for the Form 990 is compiled by the executive staff. The corporation accountants prepare the form which is emailed or mailed to the Board of Directors for the review and comment during one of their regular meetings. Form 990, Part VI, Section B, line 12c Our policy requires a duty to disclose any conflicts annually as well as during discussions. Given the occupational diversity of our Board of Directors as well as the relatively small size of our community and service area, virtually all relaionships that may cause potential conflicts of interest are known by one or more members of the board. The Foundation Director is the only paid employee of the Organization. Wages are paid by Fallon Medical Complex, a related organization. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy and financial statements are available for public inspection at the corporation's place of business upon request. Fallon Medical Center PO Box 820 Baker MT 59313 363808993 Critical Access Hospital MT 501(c)(3) Line 3 N/A 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0