2013-11-11T17:45:25-06:00 2012-12-31 STOCKMAN KAST RYAN & CO LLP 102 N CASCADE AVENUE SUITE 400 COLORADO SPRINGS CO 80903 990 2012-01-01 841576338 THE MEMORIAL HEALTH SYSTEM FOUNDATION % STEVE WEBER MEMO 7193654483 1519 E BOULDER ST Suite COLORADO SPRINGS CO 80909 CARY BLANCHETTE 7193654483 2013-11-07 true DOREEN B MERZ 7196301186 2012 2016-02-24 21:20:13Z Cary Blanchette 1519 E BOULDER COLORADO SPRINGS CO 80909 4906102 false X N/A X 2001 CO TO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM. 12 12 5 0 0 1652735 1612367 0 0 18656 17650 -44200 -32926 1627191 1597091 787898 695215 0 0 550181 617287 0 0 385440 235948 61216 1574027 1373718 53164 223373 4372863 4591986 36231 25597 4336632 4566389 X THE MEMORIAL HEALTH SYSTEM FOUNDATION SEEKS TO BECOME THE PRIMARY PHILANTHROPIC RESOURCE TO ELEVATE THE COMMUNITY'S HEALTH OF CURRENT AND FUTURE GENERATIONS. CONTINUED ON SCHEDULE O false false 159108 112609 CHILD LIFE: FUNDS TO ASSIST THE CHILD LIFE PROGRAM AND THERAPISTS. CHILD LIFE PROGRAM PROVIDES CRITICAL EMOTIONAL AND EDUCATIONAL SUPPORT TO CHILDREN AND THEIR FAMILIES DURING TREATMENT IN INPATIENT PEDIATRIC UNITS, OUTPATIENT CLINICS, AND THE EMERGENCY DEPARTMENTS. 70945 70945 EMPLOYEE ASSISTANCE: FUNDS DONATED BY EMPLOYEES FOR EMPLOYEE EMERGENCY ASSISTANCE. THE PURPOSE OF THE EMPLOYEE ASSISTANCE FUND IS TO PROVIDE FINANCIAL ASSISTANCE TO ELIGIBLE EMPLOYEES OF MEMORIAL HOSPITAL WHO ARE EXPERIENCING SEVERE FINANCIAL DISTRESS RESULTING FROM AN EXTRAORDINARY EMERGENCY OR CATASTROPHIC EVENT. THE FUND IS ADMINISTERED BY THE MEMORIAL HOSPITAL EMPLOYEE ASSISTANCE FUND COMMITTEE. 84962 60132 KOHLS CARES FOR CAR SAFETY: 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. SEE SCHEDULE O FOR CONTINUATION 467588 451529 OTHER 467588 451529 782603 true true false false false false false false false true true false false false false true true false false false false false false false true false false true true true false false false false false false false false true false false false false true false false false true 2 0 5 false false false false false true true false false false false X 12 12 false false false false false false false true true false false true true true true false true true true false X STEVE WEBER 7193654483 1519 E BOULDER COLORADO SPRINGS CO 80909 David I Greenberg MD 1.0 X 0 0 0 Mary Ellen McNally 1.0 X X Joseph Camiolo 1.0 X Peggy Carmack 1.0 X X William Crouch MD 1.0 X X Mike Edmonds Ph D 1.0 X Lana Janc 1.0 X Thomas Naughton 1.0 X Kevin O'Gara 1.0 X X Annette Seagraves 1.0 X X Karen Anthony 1.0 X Ronald Rubin 1.0 X Mike Scialdone 1.0 X Larry McEvoy 1.0 X Deborah Lafferty 1.0 X Darlene Larson 1.0 X Cary Blanchette 40.0 X 143783 32842 William Stohlmann 40.0 X 112046 27298 255829 0 60140 2 false true false 0 190911 719664 701792 154642 1612367 0 21548 21548 0 0 0 0 0 3224137 3228035 -3898 -3898 -3898 48050 190911 80976 -32926 -32926 0 0 0 1597091 -15276 519473 519473 175742 175742 0 0 302788 13284 81262 208242 0 253430 51121 77440 124869 0 61069 16572 14843 29654 0 0 868 868 5375 5375 0 0 0 0 6172 6172 11967 1799 3936 6232 10681 3204 5341 2136 0 0 2108 843 1265 0 0 0 0 2210 442 1326 442 0 CONTINUING EDUCATION 7316 2926 4390 MISCELLANEOUS 7902 7902 EMPLOYEE GIVING CAMPAIGN EQUIPMENT RENTAL 4830 966 2898 966 1787 715 1072 1373718 782603 205675 385440 50865 54924 4059368 4306413 0 0 60225 19268 0 0 0 0 0 0 0 0 5250 4857 50542 48690 3028 1852 194127 204672 0 0 0 0 0 0 0 0 4372863 4591986 35211 25597 0 0 1020 0 0 0 0 0 0 0 0 0 0 0 0 0 36231 25597 X 753993 711622 3388464 3660592 194175 194175 4336632 4566389 4372863 4591986 X 223373 14941 -8557 X X false true X true false X X X false false false MEMORIAL HEALTH SYSTEM 846002995 03 true true true 613042 1 613042 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 194127 10545 204672 197646 -3519 194127 205009 12637 20000 197646 181500 23509 205009 212665 -31165 181500 0.94871 0.05129 false false 50542 48690 1852 1852 0 0 X 1752809 14941 59801 80976 155718 1597091 1597091 1523052 59801 89533 149334 1373718 1373718 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 believes that it does not have any uncertain tax positions that are material to the financial statements. PART XII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENTS EXPENSES RECLASS: $80,976 PART XIII, LINE 2D SPECIAL EVENTS EXPENSES RECLASS: $80,976 WRITE-OFF OF PLEDGES RECEIVABLE: $8,557 PATRICIA WOODS 1322 N25th st CS GRANT WRITING false Tess Powers 1009 Pioneer Lane CS GRANT WRITING false GALA 205253 168913 36340 37939 7653 3295 17697 GOLF TOURNAMENT 33708 21998 11710 1940 7537 3585 1330 0 0 0 0 0 0 0 0 0 0 238961 190911 48050 0 1940 45476 11238 3295 19027 80976 -32926 true MEMORIAL HEALTH SYSTEMS 2502 E PIKES PEAK AVE COLORADO SPRINGS CO 80909 846002995 501(C)(3) 519473 FINANCIAL SUPPORT 1 0 Circle of Hope 234 53205 Employee Assistance 41 70945 Renee's Friends 17 6096 Grace Fund 5 10102 Colo Spgs Children's General Fund 2 553 Pediatric's Family Support Fund 6 2506 Rehab Patient Care Unit 1 1809 Circle of Hope Komen 52 30526 SCHEDULE I, PART I, LINE 2: THE FOUNDATION EXECUTIVE DIRECTOR REVIEWS ALL GRANTS AND REQUESTS FOR MONIESY X X X X false false false false false false false false false Cary Blanchette 143783 16573 16269 176625 X 8162 MARKET VALUE X 24330 MAREKT VALUE X TOYS 116 122150 MARKET VALUE false false false FORM 990, PART III, LINE 1 CONTINUED: THE 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: NEONATAL INTENSIVE CARE UNIT EXPANSION, DIGITAL MAMMOGRAPHY EQUIPMENT, COOLING CAP AND CANCER, CARDIOLOGY, CHILDREN'S HOSPITAL AND WOMEN'S PROGRAMS AND SERVICES. FORM 990, PART IV, LINE 4C KOHL'S CARES FOR CAR SAFETY CONTINUED: OUR MEMBERS INCLUDE CHILD PASSENGER SAFETY SEAT TECHNICIANS AND ARE AVAILABLE TO CONDUCT CAR SEAT CHECKS AT A VARIETY OF LOCATIONS THROUGHOUT THE COMMUNITY. WE SPEAK TO THOUSANDS OF PEOPLE A YEAR AND CAN PROVIDE EDUCATION AT EVENTS UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 11: ONCE THE 990 IS PREPARED, THE EXECUTIVE DIRECTOR ADVISES THE BOARD MEMBERS THAT IT IS READY FOR REVIEW. A COPY OF THE 990 IS AVAILABLE IN THE FOUNDATION OFFICE. 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 HIM/HERSELF FROM ANY VOTE IF THERE IS A CONFLICT. FORM 990, PART VI, SECTION B, LINE 15: MEMORIAL HEALTH SYSTEM'S HUMAN RESOURCE DEPARTMENT AND CEO WORK TOGETHER TO DETERMINE THE COMPENSATION FOR THE FOUNDATION CEO WITH THE ADVICE AND CONSENT OF THE FOUNDATION EXECUTIVE COMMITTEE. OTHER KEY EMPLOYEES OF THE FOUNDATION ARE COMPENSATED BASED ON THE HEALTH SYSTEM'S COMPENSATION POLICIES. 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: ($8,557) FORM 990, PART XII, LINE 2C: NO CHANGES TO OVERSIGHT PROCESS. MEMORIAL HEALTH SYSTEMS 1400 EAST BOULDER COLORADO SPRINGS CO 80909 846002995 HOSPITAL CO N/A NA false false true false false false false false false false true false false false false false true false false Memorial Health System B 613042 FMV MEMORIAL HEALTH SYSTEM K 46859 FMV MEMORIAL HEALTH SYSTEM P 719200 FMV