CRETE AREA HEALTH CARE FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CRETE AREA HEALTH CARE FOUNDATION (EIN 47-0846080)
Tax period
2012-08-01 to 2013-07-31
Filed
2013-12-15
IRS object ID
201313509349300606
Schema version
2012v2.1
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)
Timestamp2013-12-15T08:23:11-06:00Timestamp
Tax Period End Date2013-07-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN470526649EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DANA F COLE & COMPANY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11248 O STREET SUITE 500AddressLine1
CityLINCOLNCity
StateNEState
ZIP Code68508ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-08-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN470846080EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Crete Area Health Care FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCRETNameControl
Phone4028266581Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12910 Betten DriveAddressLine1
CityCreteCity
StateNEState
ZIP Code68333ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMichelle McIntireName
TitleDevelopment DirectorTitle
Phone4028266581Phone
Date Signed2013-11-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRYAN BRUNSName
PTINP00735693PTIN
Phone4024799300Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMichelle McIntireNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12910 Betten DriveAddressLine1
CityCreteCity
StateNEState
ZIP Code68333ZIPCode
FieldValueIRS element (for citing)
Gross Receipts227868GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.creteareamedicalcenter.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2001YearFormation
State Legal DomicileNEStateLegalDomicile
Activity Or Mission DescriptionPreserving and enhancing health care in Saline Co.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year115770ContributionsGrantsPriorYear
Contributions Grants Current Year46976ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year28907InvestmentIncomePriorYear
Investment Income Current Year91569InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year144677TotalRevenuePriorYear
Total Revenue Current Year138545TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year135173GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY121862GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year16934OtherExpensePriorYear
Other Expenses Current Year8689OtherExpensesCurrentYear
Total Expenses Prior Year152107TotalExpensesPriorYear
Total Expenses Current Year130551TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-7430RevenuesLessExpensesPriorYear
Revenues Less Expenses CY7994RevenuesLessExpensesCY
Total Assets BOY2171069TotalAssetsBOY
Total Assets EOY2435406TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2171069NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2435406NetAssetsOrFundBalancesEOY
Mission DescriptionTo solicit and raise funds for the benefit of the Crete Area Medical Center.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense121862Expense
Grants121862Grants
DescriptionGrants to Crete Area Medical CenterDescription
Total Program Service Expense121862TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Michelle McIntireBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4028266581TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12910 Betten DriveAddressLine1
CityCreteCity
StateNEState
ZIP Code68333ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Thomas Klein
President0.00XX000
Mary Yank
Secretary0.00XX000
Jeff Schultz
Treasurer0.00XX000
Bradley T Kalkwarf
Director0.00X000
Ann Kelsall
Director0.00X000
Thomas N Sorensen
Director0.00X000
Alene Lothrop
Director0.00X000
Shirley Siedhoff
Vice-President0.00XX000
Robert Tuma
Director0.00X000
Marva Kasl
Director0.00X000
Dan Papik
Director0.00X000
Karen Morris
Director0.00X000
Walter A Harris
Director0.00X000
Gale Lothrop
Director0.00X000
Deb Bessler
Director0.00X000
Manuel Dimas
Director0.00X000
Jim Fahrnbruch
Director0.00X000
Walt Harris
Director0.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions46976AllOtherContributions
Total Contributions46976TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column77043TotalRevenueColumn
Exclusion$77,043ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities103849Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities89323Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities14526Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column14526TotalRevenueColumn
Exclusion$14,526ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column138545TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$91,569ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total121862Total
Program Services121862ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total985Total
Management And General985ManagementAndGeneral

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionMiscellaneous expensesDescription
Total7704Total
Management And General7704ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total130551Total
Program Services121862ProgramServices
Management And General8689ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY139788BOY
EOY145418EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY15104BOY
EOY326EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2016177BOY
EOY2289662EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2171069BOY
EOY2435406EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY49537BOY
EOY23916EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY90251BOY
EOY379930EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2031281BOY
EOY2031560EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2171069BOY
EOY2435406EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2171069BOY
EOY2435406EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses7994ReconcilationRevenueExpenses
Reconciliation Unrealized Invest256343ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or Review1AccountantCompileOrReview

Accountant Compile Or Review Basis AccountantCompileOrReviewBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
FS Audited0FSAudited
Audit Committee0AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1Crete Area Medical Center Crete NebraskaBusinessNameLine1
FieldValueIRS element (for citing)
EIN470841285EIN
Type Of Organization7TypeOfOrganization
Listed In Governing Doc0ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$121,862Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts121862SumOfAmounts

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2031281BeginningOfYearBalance
Contributions279Contributions
Investment Earnings Or Losses347408InvestmentEarningsOrLosses
Other Expenditures347408OtherExpenditures
End Of Year Balance2031560EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2055133BeginningOfYearBalance
Contributions50000Contributions
Investment Earnings Or Losses30212InvestmentEarningsOrLosses
Other Expenditures104064OtherExpenditures
End Of Year Balance2031281EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1723085BeginningOfYearBalance
Contributions108811Contributions
Investment Earnings Or Losses223237InvestmentEarningsOrLosses
End Of Year Balance2055133EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1420883BeginningOfYearBalance
Contributions144501Contributions
Investment Earnings Or Losses157701InvestmentEarningsOrLosses
End Of Year Balance1723085EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1751851BeginningOfYearBalance
Contributions2000Contributions
Investment Earnings Or Losses-283798InvestmentEarningsOrLosses
Other Expenditures49170OtherExpenditures
End Of Year Balance1420883EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDescription of Intended Use of Endowment Funds:Identifier
Return ReferencePart V, Line 4:ReturnReference
ExplanationPreserve and enhance health care in Saline Co.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Crete Area Medical CenterBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12910 Betten DriveAddressLine1
CityCreteCity
StateNEState
ZIP Code68333ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient470841285EINOfRecipient
Amount Of Cash Grant121862AmountOfCashGrant
Purpose Of GrantSupportPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Section B, line 11After compilation by an independent party, the Form 990 is circulated and approved by the Crete Area Health Care Foundation Executive Board which is comprised of four directors serving as president, vice-president, secretary and treasurer. Ex-officio directors - Crete Area Health Care Foundation Director and Crete Area Medical Center CEO are also present to review Form 990. The remaining Board of Directors receive a full copy of approved Form 990 prior to submittal.
Form 990, Part VI, Section B, line 12cAt the Crete Area Health Care Foundation annual meeting held in November, the Crete Area Medical Center Compliance officer addresses the Foundation board regarding conflicts of interest. At this time, all board memebers are required to disclose any conflicts of interest. Those disclosing a conflict agree to abstain from voting on issues directly related to the conflict. New board members are also screened for any conflicts of interest.
Form 990, Part VI, Section C, line 19Upon request

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