HUDSON HOSPITAL FOUNDATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- HUDSON HOSPITAL FOUNDATION (EIN 39-1279567)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201343179349305319
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-13T15:47:04-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 135665207 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 WELLS FARGO CENTER 90 SOUTH | AddressLine1 |
| Address Line2 | 7TH ST | AddressLine2 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391279567 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUDSON HOSPITAL FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HUDS | NameControl |
| Phone | 7155316000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 405 STAGELINE ROAD | AddressLine1 |
| City | HUDSON | City |
| State | WI | State |
| ZIP Code | 54016 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DOUGLAS E JOHNSON | Name |
| Title | CFO | Title |
| Phone | 7155316000 | Phone |
| Date Signed | 2013-11-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JASON DIVINE | Name |
| PTIN | P01076050 | PTIN |
| Phone | 6123055000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DOUGLAS E JOHNSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 405 STAGELINE ROAD | AddressLine1 |
| City | HUDSON | City |
| State | WI | State |
| ZIP Code | 54016 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 459169 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HUDSONHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1977 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 16 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 141422 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 182806 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -28985 | InvestmentIncomePriorYear |
| Investment Income Current Year | 177082 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 64934 | OtherRevenuePriorYear |
| Other Revenue Current Year | 74059 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 177371 | TotalRevenuePriorYear |
| Total Revenue Current Year | 433947 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 52962 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 67667 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 10398 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 104404 | OtherExpensePriorYear |
| Other Expenses Current Year | 137829 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 157366 | TotalExpensesPriorYear |
| Total Expenses Current Year | 205496 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 20005 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 228451 | RevenuesLessExpensesCY |
| Total Assets BOY | 1942837 | TotalAssetsBOY |
| Total Assets EOY | 2149272 | TotalAssetsEOY |
| Total Liabilities BOY | 196323 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1746514 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2149272 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO SUPPORT, ACT FOR THE BENEFIT OF, AND CARRY OUT THE CHARITABLE PURPOSE OF HUDSON HOSPITAL, INC. BY SUPPORTING COMMUNITY HEALTH EDUCATION, PROVIDING HOME CARE ASSISTANCE, AND CONTRIBUTING TO OTHER HEALTH RELATED CHARITABLE ENDEAVORS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 81558 | Expense |
| Grants | 67667 | Grants |
| Revenue | 25745 | Revenue |
| Description | SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS | Description |
| Total Program Service Expense | 81558 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 1 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLAS E JOHNSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6514304581 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 405 STAGELINE ROAD | AddressLine1 |
| City | HUDSON | City |
| State | WI | State |
| ZIP Code | 54016 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (13 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | OfficerOfficer |
|---|---|---|---|---|---|---|---|
| RYAN CARI | |||||||
| DIRECTOR | 1.00 | X | 92 | 0 | 0 | ||
| DAVE GRAMBOW | |||||||
| DIRECTOR & SECRETARY | 1.00 | X | 92 | 0 | 0 | ||
| GENE HABERMAN | |||||||
| DIRECTOR | 1.00 | X | 92 | 0 | 0 | ||
| NICK HATHWORTHY | |||||||
| DIRECTOR | 1.00 | X | 92 | 0 | 0 | ||
| KIM HEINEMANN | |||||||
| DIRECTOR | 0.20 | X | 92 | 0 | 0 | ||
| ALAN KIECKER | |||||||
| DIRECTOR | 1.00 | X | 92 | 0 | 0 | ||
| MIKE LEVERTY | |||||||
| DIRECTOR & TREASURER | 1.00 | X | 92 | 0 | 0 | ||
| RICHARD O'CONNOR | |||||||
| DIRECTOR & CHAIR | 1.50 | X | 92 | 0 | 0 | ||
| LINDA ROBERTSON | |||||||
| DIRECTOR | 1.00 | X | 92 | 0 | 0 | ||
| STEPHEN SCHMITZ MD | |||||||
| DIRECTOR | 1.00 | X | 92 | 0 | 0 | ||
| LINDA ZEITS | |||||||
| DIRECTOR & VICE CHAIR | 1.00 | X | 92 | 0 | 0 | ||
| MARIAN M FURLONG | |||||||
| DIRECTOR | 0.50 | X | 92 | 296406 | 74382 | 49.50 | |
| KAREN K RAMBO | |||||||
| DIRECTOR & PRESIDENT | 40.00 | X | 92 | 104499 | 14335 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1196 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 400905 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 88717 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 10590 | FundraisingEvents |
| All Other Contributions | 172216 | AllOtherContributions |
| Total Contributions | 182806 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 177082 | TotalRevenueColumn |
| Exclusion | $177,082 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | 32428 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | 6683 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | 25745 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 25745 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25745 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 66853 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 10590 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 18539 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 48314 | TotalRevenueColumn |
| Exclusion | $48,314 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 433947 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25745 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $225,396 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67667 | Total |
| Program Services | 67667 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89475 | Total |
| Program Services | 1071 | ProgramServices |
| Management And General | 88404 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7764 | Total |
| Fundraising | 7764 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13890 | Total |
| Program Services | 6681 | ProgramServices |
| Management And General | 4575 | ManagementAndGeneral |
| Fundraising | 2634 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1985 | Total |
| Management And General | 1985 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6139 | Total |
| Program Services | 6139 | ProgramServices |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | ADMINISTRATIVE EXPENSE | Description |
| Total | 18576 | Total |
| Management And General | 18576 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 205496 | Total |
| Program Services | 81558 | ProgramServices |
| Management And General | 113540 | ManagementAndGeneral |
| Fundraising | 10398 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 234974 | BOY |
| EOY | 83138 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 157457 | BOY |
| EOY | 77161 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 223741 | BOY |
| EOY | 168564 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 37923 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 17443 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26621 | BOY |
| EOY | 20480 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1300044 | BOY |
| EOY | 1725020 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 74909 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1942837 | BOY |
| EOY | 2149272 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 196323 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 196323 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1378255 | BOY |
| EOY | 1719634 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 286569 | BOY |
| EOY | 347948 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81690 | BOY |
| EOY | 81690 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1746514 | BOY |
| EOY | 2149272 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1942837 | BOY |
| EOY | 2149272 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 228451 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 174307 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 87892 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 157800 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 118223 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 130107 | CurrentTaxYearMinus1Year |
| Current Tax Year | 172216 | CurrentTaxYear |
| Total | 666238 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 87892 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 157800 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 118223 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 130107 | CurrentTaxYearMinus1Year |
| Current Tax Year | 172216 | CurrentTaxYear |
| Total | 666238 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 666238 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 35358 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 164894 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 157511 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | -28995 | CurrentTaxYearMinus1Year |
| Current Tax Year | 177082 | CurrentTaxYear |
| Total | 505850 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 1172088 | TotalSupport |
| Gross Receipts From Admissions Etc | 398935 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.56840 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.62900 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number DA Fs Held | 19 | NumberDAFsHeld |
| Donor Advised Contributions | 80605 | DonorAdvisedContributions |
| Grants Paid From Donor Funds | 19226 | GrantsPaidFromDonorFunds |
| Aggregate DAF Value | 347948 | AggregateDAFValue |
| Disclosed Orgs Legal Control | 1 | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | 1 | DisclosedForCharitablePurposes |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 81690 | BeginningOfYearBalance |
| End Of Year Balance | 81690 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 81690 | BeginningOfYearBalance |
| End Of Year Balance | 81690 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 81690 | BeginningOfYearBalance |
| End Of Year Balance | 81690 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 81690 | BeginningOfYearBalance |
| End Of Year Balance | 81690 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 81690 | BeginningOfYearBalance |
| End Of Year Balance | 81690 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 37923 | OtherCostOrOtherBasis |
| Depreciation | 17443 | Depreciation |
| Book Value | 20480 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 20480 | TotalOfBookValueLandBuildings |
| Tot Revenue Etc Audited Fincl Stmt | 459169 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 459169 | RevenueSubtotal |
| Other Revenues Not Included | -25222 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -25222 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 433947 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 230718 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 25222 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 25222 | ExpensesNotRptdF990 |
| Expenses Subtotal | 205496 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 205496 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | TO SUPPORT THE MISSION OF HUDSON HEALTH FOUNDATION, INC. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | GOLF TOURNAMENT EXPENSE -14,195. WINE TASTING EVENT EXPENSE -4,344. LIFELINE UNIT EXPENSE -6,683. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | GOLF TOURNAMENT EXPENSE 14,195. WINE TASTING EVENT EXPENSE 4,344. LIFELINE UNIT EXPENSE 6,683. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 54283 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 3840 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 50443 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 14195 | OtherDirectExpensesEvent1 |
| Name Of Event2 | WINE TASTING | NameOfEvent2 |
| Gross Receipts Event2 | 23160 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 6750 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 16410 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 4344 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 77443 | GrossReceiptsTotal |
| Charitable Contributions Total | 10590 | CharitableContributionsTotal |
| Gross Revenue Total Events | 66853 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 18539 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 18539 | DirectExpenseSummaryEvents |
| Net Income Summary | 48314 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| HUDSON HOSPITAL INC | |||||||
| 405 STAGELINE ROAD | HUDSON | WI | 54016 | 390804125 | 501(C)(3) | 20642 | EQUIPMENT, PROGRAM SUPPORT & MEMORIALS |
| ST CROIX VALLEY YMCA | |||||||
| 2211 VINE STREET | HUDSON | WI | 54016 | 501(C)(3) | 20000 | PROGRAM SUPPORT | |
| ST CROIX EMS | |||||||
| 505 THIRD STREET | HUDSON | WI | 54016 | 501(C)(3) | 15000 | PROGRAM SUPPORT | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: HUDSON HOSPITAL FOUNDATION, INC. (HHF) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH HHF'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO HHF'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARIAN M FURLONG | NamePerson |
| Title | DIRECTOR | Title |
| Base Compensation Filing Org | 0 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 237893 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Bonus Related Orgs | 58513 | BonusRelatedOrgs |
| Other Compensation Filing Org | 92 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 43096 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 31286 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 92 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 370788 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 6 | ReturnReference |
| Explanation | HUDSON HOSPITAL FOUNDATION, INC. (HHF) HAS NO EMPLOYEES. HHF'S PRESIDENT IS EMPLOYED BY HUDSON HOSPITAL, INC. (HOSPITAL), WHICH HAS AN INCENTIVE PROGRAM WHICH INCENTS AND REWARDS THE HOSPITAL'S EMPLOYEES WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC YEAR. HOW THE PROGRAM WORKS: THE HOSPITAL BOARD OF DIRECTORS HAVE AUTHORITY FOR THE PROGRAM AND APPROVE EACH LEVEL OF THE PROGRAM ON AN ANNUAL BASIS. THE HOSPITAL INCENTIVE PROGRAM REWARDS ARE BASED ON POSITION IN THE ORGANIZATION AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATIONS STRATEGIC PLAN. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, EMPLOYEE AND/OR LEADERSHIP DEVELOPMENT, CARE DELIVERY, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE, ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. INCENTIVE PROGRAM GOALS FOR EACH YEAR WILL TYPICALLY BE DETERMINED BY OCTOBER OF THE PREVIOUS YEAR. SPECIFIC MEASURES FOR THE SELECTED GOAL AREAS WILL BE OUTLINED EACH YEAR IN A SUPPLEMENTAL DOCUMENT AND WILL BE COMMUNICATED TO PARTICIPANTS DURING THE FIRST QUARTER OF THE EACH YEAR. THE ACTUAL ANNUAL PAYMENT IS DETERMINED BY THE LEVEL OF GOAL ATTAINMENT. STEWARDSHIP GOALS ARE TIED TO BUDGET. A NET MARGIN THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE HOSPITAL. ADDITIONALLY, THERE IS A CAP ON THE AMOUNT OF NET MARGIN USED UNDER THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| EXEMPT PURPOSE AND ACHIEVEMENTS | FORM 990, PART III, LINE 4A | THE PURPOSE OF THE HUDSON HOSPITAL FOUNDATION (HHF) IS TO RAISE PHILANTHROPIC FUNDS FROM ITS CONSTITUENCY IN ORDER TO ADVANCE THE MISSION, VISION, AND VALUES OF HUDSON HOSPITAL, INC. (THE HOSPITAL). ESTABLISHED IN 1977, HHF RAISES FUNDS TO PROVIDE SIGNIFICANT FINANCIAL SUPPORT FOR PROGRAMS AND CAPITAL NEEDS THAT ASSIST THE HOSPITAL WITH PROVIDING EXCEPTIONAL CARE CLOSE TO HOME. I. ORGANIZATION AND GOVERNANCE HHF IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). HHF'S SOLE CORPORATE MEMBER IS THE HOSPITAL, WHICH IS ALSO A NON-PROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C) (3). HHF IS PART OF THE HEALTHPARTNERS FAMILY OF ORGANIZATIONS (HEALTHPARTNERS). HEALTHPARTNERS, INC. (HPI), A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) WHICH IS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4), IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL AND REGIONS HOSPITAL'S SISTER ORGANIZATIONS, REGIONS HOSPITAL FOUNDATION (RHF), CAPITOL VIEW TRANSITIONAL CARE CENTER (CVTCC), STILLWATER HEALTH SYSTEM (LAKEVIEW HEALTH) AND RAMSEY INTEGRATED HEALTH SERVICES (RIHS), ALL OF WHICH ARE MINNESOTA NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HPI-RAMSEY IS ALSO THE SOLE CORPORATE MEMBER OF RH-WISCONSIN, INC., A WISCONSIN NON-STOCK CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HPI IS ALSO THE SOLE CORPORATE MEMBER OF THE FOLLOWING ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C) (3): HEALTHPARTNERS RESEARCH AND EDUCATION (D/B/A HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH (HPIER)), RHSC, INC., GROUP HEALTH PLAN, INC. (GHI) (A MINNESOTA STAFF MODEL HMO) WHICH IS ITSELF THE SOLE CORPORATE MEMBER OF PHYSICIANS NECK & BACK CLINICS (PNBC). RH-WISCONSIN, INC. AND GHI ARE CORPORATE MEMBERS OF THE HOSPITAL AND WESTFIELDS HOSPITAL, INC., WHICH ARE WISCONSIN NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN, INC. IS ALSO THE SOLE CORPORATE MEMBER OF WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY (WWEMSC), AN AMBULANCE SERVICE WHICH IS A WISCONSIN NON-PROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). TOGETHER, ALL OF THESE RELATED ORGANIZATIONS COMPRISE THE HEALTHPARTNERS FAMILY OF ORGANIZATIONS (HEALTHPARTNERS), WHICH IS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT COMBINES THE PROVISION AND FINANCING OF HEALTH CARE SERVICES, FOR THE PURPOSE OF IMPROVING THE HEALTH OF ITS VARIOUS ENTITIES' MEMBERS, PATIENTS, AND THE BROADER COMMUNITY. HHF IS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS COMPRISED OF 13 MEMBERS WHO INCLUDE COMMUNITY REPRESENTATIVES, MEDICAL STAFF AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (CEO) OF HUDSON. II. ACTIVITIES PROGRAM SUPPORT - PEDIATRIC CARE: HHF PARTNERED WITH MULTIPLE ORGANIZATIONS IN 2012 RESULTING IN NEW OPPORTUNITIES FOR THE COMMUNITY AND MORE PROGRAMMATIC FUNDS TO IMPROVE HEALTH CARE LOCALLY. MINNESOTA VIKING, CHAD GREENWAY AND HIS LEAD THE WAY FOUNDATION DEVELOPED A PROGRAM FOR PEDIATRIC PATIENTS IN HOSPITALS CALLED "CHAD'S LOCKER." THIS LIFE-SIZED LOCKER IS FILLED WITH ELECTRONICS FOR YOUNG PATIENTS AND THEIR FAMILIES TO BORROW DURING THEIR MEDICAL VISIT OR STAY AT THE HOSPITAL. THE LOCKER, WHICH WILL BE UNVEILED IN SPRING 2013, WILL BE ONE OF THREE LOCKERS DISBURSED TO HOSPITALS AND THE FIRST IN WESTERN WISCONSIN. - SPECIALTY CARE: A GRANT WAS PROVIDED BY HHF TO CREATE A LIFE-SIZE "PACKER-VIKING" THEME MURAL IN THE PEDIATRIC CHEMOTHERAPY & INFUSION CENTER PATIENT ROOM. - EMERGENCY CARE: IN 2012, HHF WAS GRANTED $35,000 FOR CAPITAL EQUIPMENT IMPROVEMENTS FOR EMERGENCY CARE, WHICH INCLUDED POWERED STRETCHERS AND CARDIOLOGY TECHNOLOGY. - HEALING ARTS: HHF MADE A MAJOR EFFORT TO RAISE FUNDS FOR A BOARD DESIGNATED HEALING ARTS ENDOWMENT IN ORDER TO HAVE FUTURE PROGRAM RESOURCES. HHF RAISED OVER $25,000 FOR THIS PROGRAM. HEALING ARTS IS A UNIQUE PARTNERSHIP WITH THE PHIPPS CENTER FOR THE ARTS, WHICH INCLUDES ORIGINAL ARTWORK, MUSIC THERAPY, HEALING TOUCH, AROMATHERAPY, AND PET THERAPY. - HOME MONITORING: HHF CHANGED VENDORS TO LIFE ASSIST USA FOR ITS HOME MONITORING PROGRAM FOR SENIORS. THE ELECTRONIC HOME MONITORING SYSTEM WORKS IN CONJUNCTION WITH THE USER'S TELEPHONE SERVICE. IF THE USER NEEDS HELP, HE OR SHE WOULD SIMPLY PUSH A BUTTON (WORN ON A WRISTBAND OR NECKLACE) TO CONTACT THE HOSPITAL OR CARE CENTER, 24 HOURS A DAY, SEVEN DAYS A WEEK. THIS SERVICE IS AVAILABLE FOR A NOMINAL MONTHLY FEE. - HEART2HEART: HEART2HEART IS A COLLABORATION BETWEEN THE HOSPITAL, HHF, ST. CROIX EMS & RESCUE AND THE HUDSON SCHOOL DISTRICT. THE GOAL OF THIS PROGRAM IS TO REDUCE THE TIME TO DEFIBRILLATION AND INCREASE THE CHANCE OF SURVIVAL FOR PEOPLE WITH HEART-RELATED EMERGENCIES IN AND AROUND THE HUDSON AREA. HHF SPONSORED THE CPR/AED EDUCATION OF 450 SIXTH GRADERS ATTENDING THE HUDSON SCHOOL MIDDLE SCHOOL IN AN EFFORT FOR EACH STUDENT TO THEN TRAIN UP TO FOUR FAMILY MEMBERS. STUDENTS RECEIVED COURSE CREDIT FOR THIS EFFORT. COMMUNITY GIVING IN 2012, HHF ALSO PARTNERED WITH THE HUDSON YMCA, ST. CROIX EMS & RESCUE, FREE CLINIC OF PIERCE AND ST. CROIX COUNTY, AND HEALTHIER TOGETHER. LARGE GRANTS, TOTALING $60,000, WERE AWARDED TO THESE ORGANIZATIONS TO PROVIDE HEALTHY LIVING EDUCATION, DIABETES & HEART PREVENTION EDUCATION, PRESCRIPTION DRUGS TO FREE CLINIC PATIENTS, FARM TO SCHOOL PILOT FOR HUDSON SCHOOL DISTRICT, POWERED PATIENT STRETCHERS, AND AN AUTOMATED CHEST COMPRESSION DEVICE FOR HEART EMERGENCIES. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE CORPORATE MEMBER OF HHF IS THE HOSPITAL. | |
| FORM 990, PART VI, SECTION A, LINE 7A | PURSUANT TO BYLAWS, HHF'S BOARD OF DIRECTORS IS COMPRISED OF NOT LESS THAN SEVEN (7) AND NOT MORE THAN FIFTEEN (15) PERSONS APPOINTED BY THE HOSPITAL AS THE SOLE CORPORATE MEMBER OF HHF. | |
| FORM 990, PART VI, SECTION A, LINE 7B | HHF'S CORPORATE MEMBER, THE HOSPITAL, MUST APPROVE THE FOLLOWING ACTIONS OF HHF'S BOARD OF DIRECTORS OR INITIATE THESE ACTIONS DIRECTLY: - AMENDMENTS OF THE ARTICLES, BYLAWS OR OTHER GOVERNING DOCUMENTS - SALE, LEASE, MORTGAGE OR PLEDGE OF ANY REAL ESTATE OR INTEREST THEREIN, OR OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS - ADOPTION OF AMMENDMENT OF A STRATEGIC PLAN, AND CAPITAL AND OPERATING BUDGETS - APPROVAL OF UNBUDGETED CAPITAL EXPENDITURES - APPROVAL OF BORROWING OR LENDING OF FUNDS OF THE FOUNDATION - MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY AND TRANSFER OR CONTRIBUTION OF ASSETS AND FUNDS TO SEPERATE ENTITIES - ESTABLISHMNENT OR DIVESTITURE OF ENTITIES OF WHICH HHF HAS AN EQUITY OR MANAGEMENT INTEREST, OR ESTABLISHMENT OF ANY SIGNIFICANT AND CONTINUING RELATIONSHIP WITH ANY ENTITY - DISSOLUTION AND DISTRIBUTION OF ASSETS | |
| FORM 990, PART VI, SECTION B, LINE 11 | HHF'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF HHF. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GHI, THE MANAGEMENT TEAM OF HHF, GHI'S INTERNAL LEGAL DEPARTMENT AND HHF'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF HHF. HHF MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT A MEETING OF THE FULL BOARD OF DIRECTORS. THIS PROCESS IS NOTED AND DOCUMENTED IN THE WRITTEN MINUTES OF THE MEETING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | AS REQUIRED BY THE BYLAWS OF HHF, THE BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS AND KEY EMPLOYEES ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND REQUESTED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNSEL WILL SUMMARIZE THE FINDINGS FOLLOWING REVIEW OF THE QUESTIONNAIRE AND SUBMIT A REPORT TO THE CHAIR, THE HOSPITAL PRESIDENT AND HHF'S PRESIDENT. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY. | |
| FORM 990, PART VI, SECTION B, LINE 15 | HHF HAS NO EMPLOYEES. HHF'S PRESIDENT IS EMPLOYED BY THE HOSPITAL, A RELATED ORGANIZATION. HOSPITAL COMPENSATION PROGRAM: KEY POINTS: - SALARY RANGES ARE DETERMINED BY UTILIZING PUBLISHED SALARY SURVEY DATA AND LOCAL JOB MARKET INFORMATION (TYPICALLY HRRAM'S ANNUAL SURVEY). - RANGES ARE UPDATED ANNUALLY DURING MAY BY THE HOSPITAL'S HR DEPARTMENT. - RANGES ARE POSITION SPECIFIC AND ARE 95-100% OF THE TWIN CITY MARKET OR 100% OF THE WISCONSIN DATA (THE HIGHER OF THE TWO). - THE HOSPITAL COMPENSATION DEPARTMENT IS REFERENCED FOR NON-MATCHING POSITIONS WITH HRRAM DATA. - WISCONSIN HOSPITAL ASSOCIATION SALARY SURVEY IS ALSO REFERENCED FOR SENIOR LEADERS AND EXECUTIVE POSITIONS. - PLACEMENT IN THE RANGE IS DETERMINED BY JOB DESCRIPTION REQUIREMENTS, INCLUDING EDUCATION, TRAINING, EXPERIENCE, LENGTH OF TIME IN THE POSITION, AND PERFORMANCE IN THE POSITION. | |
| FORM 990, PART VI, SECTION C, LINE 19 | HHF'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM HHF. HHF'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE WISCONSIN SECRETARY OF STATE'S OFFICE. HHF'S CONFLICT OF INTEREST POLICY THROUGH IT'S RELATED ORGANIZATION, THE HOSPITAL, CAN BE VIEWED THROUGH THE HUDSONHOSPITAL.ORG WEBSITE. | |
| AVERAGE HOURS - RELATED ORGANIZATIONS | FORM 990, PART VII, SECTION A, LINE 1A, COLUMN (B) | DIRECTORS AND OFFICERS OF HHF ARE EMPLOYED AND COMPENSATED BY REGIONS HOSPITAL OR THE HOSPITAL. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 9: | HUDSON HOSPITAL, INC. NET ASSET TRANSFER 174,307. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (20 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411693838 | HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(4) | N/A | 1 | ||
| HPI-RAMSEY | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411793333 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 1 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| GROUP HEALTH PLAN INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410797853 | STAFF MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(3) | 1 | 170(B)(1) (A)(III) | HEALTHPARTNERS INC | |
| HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411670163 | HEALTHCARE EDUCATION & RESEARCH | MN | 501(C)(3) | 1 | 509(A)(3) TYPE I | GROUP HEALTH PLAN INC | |
| CAPITOL VIEW TRANSITIONAL CARE CENTER | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 412011453 | POST HOSPITALIZATION PATIENT CARE | MN | 501(C)(3) | 1 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410956618 | HOSPITAL | MN | 501(C)(3) | 1 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411888902 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | MN | 501(C)(3) | 1 | 170(B)(1) (A)(VI) | HPI - RAMSEY | |
| RHSC INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411891928 | HEALTHCARE STAFFING | MN | 501(C)(3) | 1 | 509(A)(3) TYPE II | HEALTHPARTNERS INC | |
| WESTFIELDS HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390808442 | HOSPITAL | WI | 501(C)(3) | 1 | 170(B)(1) (A)(III) | RH-WISCONSIN | |
| WESTFIELDS HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 371770913 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | WI | 501(C)(3) | 1 | 509(A)(3) TYPE I | WESTFIELDS HOSPITAL INC | |
| RH-WISCONSIN | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 202287016 | CORPORATE PLANNING AND OVERSIGHT | WI | 501(C)(3) | 1 | 509(A)(3) TYPE II | HPI - RAMSEY | |
| PHYSICIANS NECK AND BACK CLINICS | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 270684883 | SPECIALTY PATIENT CARE | MN | 501(C)(3) | 1 | 509(A)(3) TYPE II | GROUP HEALTH PLAN INC | |
| HUDSON HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390804125 | HOSPITAL | WI | 501(C)(3) | 1 | 170(B)(1) (A)(III) | RH-WISCONSIN | |
| WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 263616590 | PROVIDE MEDICAL TRANSPORT SERVICES | WI | 501(C)(3) | 1 | 509(A)(3) TYPE II | RH-WISCONSIN | |
| LAKEVIEW MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411386635 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | MN | 501(C)(3) | 1 | 509(A)(3) TYPE II | STILLWATER HEALTH SYSTEM | |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410811697 | HOSPITAL | MN | 501(C)(3) | 1 | 170(B)(1) (A)(III) | STILLWATER HEALTH SYSTEM | |
| ST CROIX VALLEY HEALTHCARE & RESEARCH FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411923524 | FOUNDATION | MN | 501(C)(3) | 1 | PF | STILLWATER HEALTH SYSTEM | |
| STILLWATER MEDICAL GROUP | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 830379473 | PHYSICIANS GROUP | MN | 501(C)(3) | 1 | 509(A)(2) | STILLWATER HEALTH SYSTEM | |
| STILLWATER HEALTH SYSTEM | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 300221189 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 1 | 509(A)(3) TYPE II | HPI - RAMSEY | |
| RAMSEY INTEGRATED HEALTH SERVICES | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411503090 | IN-HOME PATIENT CARE | MN | 501(C)(3) | 1 | 509(A)(2) | HPI - RAMSEY | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS ADMINISTRATORS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411629390 | THIRD PARTY ADMINISTRATOR | MN | HEALTHPARTNERS INC | C | 1 |
| HEALTHPARTNERS ASSOCIATES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 522365151 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 1 |
| HEALTHPARTNERS SERVICES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683568 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 1 |
| HEALTHPARTNERS VENTURES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411838197 | DEVELOP HEALTHCARE BUSINESS OPPORTUNITIES | MN | HEALTHPARTNERS INC | C | 1 |
| HEALTHPARTNERS INSURANCE COMPANY | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683523 | MEDICAL AND DENTAL INSURANCE | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 1 |
| DENTAL SPECIALTIES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 451297583 | DENTAL CLINIC STAFFING | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 1 |
| HEALTHPARTNERS CENTRAL MINNESOTA CLINICS | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411236798 | MEDICAL CLINIC STAFFING AND MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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