2013-09-06T12:09:15-05:00 2012-12-31 381357951 PLANTE & MORAN PLLC 27400 NORTHWESTERN HIGHWAY SOUTHFIELD MI 48034 990 2012-01-01 383085047 HURLEY FOUNDATION HURL 8102629667 ONE HURLEY PLAZA FLINT MI 485035993 RICHARD R WARMBOLD PHD 8102629524 2013-08-26 1 ROBERT DERY P00048464 8107675350 2012 2016-02-24 21:20:13Z RICHARD R WARMBOLD PHD ONE HURLEY PLAZA FLINT MI 485035993 4290441 0 X WWW.HURLEYFOUNDATION.ORG X 1992 MI ADVANCEMENT OF MEDICAL SCIENCES, EDUCATION, MEDICAL CARE, AND THE DELIVERY THEREOF FOR THE BENEFIT OF RESIDENTS OF THE GREATER FLINT METROPOLITAN AREA. 15 14 0 700 0 0 1462815 1913495 0 0 110849 108733 123711 -74193 1697375 1948035 941510 1512797 0 0 0 0 0 0 280100 489106 371582 1430616 1884379 266759 63656 4426226 4432554 150452 8545 4275774 4424009 TO CONTRIBUTE TO FULFILLING THE HURLEY MEDICAL CENTER MISSION OF "CLINICAL EXCELLENCE. SERVICE TO PEOPLE" WHILE FACILITATING CHARITABLE GIVING THAT CONTRIBUTES TO THE MEDICAL CENTER. 0 0 1520475 1512797 ALLOCATIONS WERE MADE TO HURLEY MEDICAL CENTER FOR VARIOUS MEDICAL CARE PURPOSES. 1520475 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 MI X RICHARD WARMBOLD PHD 8102629524 ONE HURLEY PLAZA FLINT MI 48503 PHILIP W SHALTZ 1.00 X 0 0 0 DONNA DODDS HAMM 1.00 X X 0 0 0 WILLIAM H MOELLER 1.00 X X 0 0 0 SUSAN STEINER BOLHOUSE 1.00 X X 0 0 0 RICHARD R WARMBOLD PHD 40.00 X X 186828 0 13451 MARCUS A RANDOLPH 1.00 X 0 0 0 CARL E MASON 1.00 X 0 0 0 IRA A RUTHERFORD III 1.00 X 0 0 0 MATTHEW T MILLER 1.00 X X 0 0 0 PHILLIP C DUTCHER 1.00 X 0 0 0 SHARON EISEN 1.00 X 0 0 0 MELANY GAVULIC 1.00 X 0 0 0 DR VICTOR B RABINKOV 1.00 X 0 0 0 THEODOSIA ROBERTSON PHD 1.00 X 0 0 0 ANDREW D SUSKI 1.00 X 0 0 0 LYNNE A TAFT-DRAPER 1.00 X 0 0 0 186828 0 13451 1 0 1 1 0 213646 1699849 251612 1913495 85286 85286 2249526 2226079 23447 23447 23447 42134 213646 116327 -74193 -74193 1948035 0 0 34540 1512797 1512797 18691 400 18291 12750 12750 17871 17871 64320 64320 68324 68324 98624 6351 92273 12782 9054 3728 2039 2039 FUNDRAISING EXPENSES 30936 30936 GRANT CENTER EXPENSE 15489 7678 7811 BANK CHARGES 11536 11536 ENDOW INTEREST DISTRIBU 11000 11000 7220 4992 2228 1884379 1520475 83804 280100 347137 89313 549047 464488 21211 77393 3057225 3333219 451606 468141 4426226 4432554 139551 0 10901 8545 150452 8545 X 897068 1057052 1446461 1308809 1932245 2058148 4275774 4424009 4426226 4432554 63656 84579 0 X 0 1 X 0 0 X 2084716 1116606 1327906 1462815 1679315 7671358 2084716 1116606 1327906 1462815 1679315 7671358 1640274 6031084 109274 73540 77767 52428 85286 398295 7987 7987 8077640 697846 0.74660 0.71510 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: LIFE INSURANCE PROCEEDS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3054909 131212 65189 90894 3160416 2578108 65232 457331 45762 3054909 2514919 51080 62918 50809 2578108 3164167 53654 -655769 47133 2514919 3087932 41819 49437 15021 3164167 0.14400 0.65100 0.20500 0 0 0 LIFE INSURANCE POLICIES - CASH SURRENDER VALUE 468141 C 468141 LIABILITY TO LIFE BENEFICIARIES OF CHARITABLE ANNUITIES 8545 8545 X 2615398 84579 512351 596930 2018468 17871 -88304 -70433 1948035 2467163 512351 116327 628678 1838485 17871 28023 45894 1884379 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE BOARD-DESIGNATED ENDOWMENT FUND WAS ESTABLISHED BY THE BOARD IN 1998. THE DESIGNATION OF THESE FUNDS WAS VOLUNTARY AND CAN BE REVISED BY THE GOVERNING BOARD AT ANY TIME. ALL OTHER ENDOWMENTS WERE ESTABLISHED TO SUPPORT DEPARTMENTAL SPECIFIC GENERAL EXPENSES OR EDUCATIONAL EXPENSES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE FOUNDATION IS EXEMPT FROM INCOME TAX UNDER PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3). ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FOUNDATION AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009. PART XI, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES NETTED WITH REVENUE ON 990 -116,327. NONCASH CONTRIBUTIONS 28,023. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES NETTED WITH REVENUE ON 990 116,327. PART XII, LINE 4B - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES FOR THE FMV OF NONCASH CONTRIBUTIONS SOLD 28,023. GOLF CLASSIC 90367 83654 6713 54 28319 7400 BENEFIT BALL 153330 118824 34506 28023 45642 5038 513 1 12083 11168 915 1338 255780 213646 42134 28077 73961 5038 9251 116327 -74193 1 HURLEY MEDICAL CENTER ONE HURLEY PLAZA FLINT MI 48503 386005601 115 1177943 223589 FAIR MARKET VALUE DONATED GIFTS FOR HOSPITAL PATIENTS ALLOCATIONS FOR MEDICAL SERVICES AMERICAN RED CROSS 1401 S GRAND TRAVERSE STREET FLINT MI 48503 530196605 501C3 5000 SPONSORSHIP WOMEN'S HOSPITAL ASSOCIATION OF FLINT MICHIGAN 401 S BALLENGER HWY FLINT MI 48532 381358053 501C3 6000 SPONSORSHIP GENESEE COUNTY FREE MEDICAL CLINIC 2437 WELSH BLVD FLINT MI 48504 382995700 501C3 8000 SPONSORSHIP GENESEE COUNTY MEDICAL SOCIETY 4438 OAK BRIDGE DR SUITE B FLINT MI 48532 381347755 501C6 5000 SPONSORSHIP GENESYS REGIONAL MEDICAL CENTER 1 GENESYS PARKWAY GRAND BLANC MI 48439 382377821 501C3 6000 SPONSORSHIP 5 1 SCHEDULE I, PART 1, LINE 2: DESCRIBE THE ORGANIZATIONS PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS HURLEY FOUNDATION GRANT FUNDS TYPICALLY ARE PROVIDED TO ORGANIZATIONS IN OUR COMMUNITY WHERE STAFF WORK AND LIVE. AS A RESULT WE LEARN ABOUT FOUNDATION SUPPORTED ACTIVITIES, RECEIVE ANNOUNCEMENTS AND AT TIMES ARE SENT PROGRAM INFORMATION. THE STAFF OF HURLEY FOUNDATION ALSO ATTEND AND/OR PARTICIPATE IN EVENTS AND OBSERVE THE GRANTEE. 0 0 0 0 0 0 0 0 0 RICHARD R WARMBOLD PHD 186828 0 0 0 0 0 0 0 13451 0 200279 0 0 0 SUPPLEMENTAL INFORMATION PART III OFFICER WAS PAID DIRECTLY BY AN UNRELATED ORGANIZATION, HURLEY MEDICAL CENTER, EIN 38-6005601. COMPENSATION WAS TREATED AS AN IN-KIND DONATION FROM UNRELATED ORGANIZATION. UNRELATED ORGANIZATION ISSUED A W-2 FOR COMPENSATION. X 1 350 FAIR MARKET VALUE X 227211 FAIR MARKET VALUE X 5 2820 FAIR MARKET VALUE X ENTERTAINMENT ITEMS 35 17115 FAIR MARKET VALUE X ELECTRONICS 5 2182 FAIR MARKET VALUE X SPORTING GOODS 4 1934 FAIR MARKET VALUE 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE FOUNDING MEMBER EMERITUS, PHILLIP DUTCHER, IS NOT A VOTING MEMBER FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PROVIDED TO BOARD PRESIDENT AND ACCOUNTING CONTROLLER FOR REVIEW BEFORE FILING. A FILE COPY IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY SIGNING OF STATEMENTS DECLARING ANY CONFLICT OF INTEREST. IF ANY SITUATION OR CIRCUMSTANCE ARISES WHICH PRESENTS A CONFLICT OF INTEREST OR A POTENTIAL CONFLICT OF INTEREST, MEMBER WILL DISCLOSE SUCH A CONFLICT/POTENTIAL AND REFRAIN FROM ACTIONS INVOLVING SUCH CONFLICTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN OR VERBAL REQUEST.