2012-08-14T10:40:34-05:00 2011-12-31 420714325 MCGLADREY LLP PO BOX 5946 MADISON WI 537050946 990 2011-01-01 391702534 GEORGE F PEABODY FOUNDATION INC GEOR 9207399181 P O BOX 2553 APPLETON WI 54912 JOHN LARSON 9207399181 2012-08-10 1 JAMES G GRAHAM P00006111 6088332612 2011 2016-02-24 21:20:13Z JOHN LARSON 3913 WEST PROSPECT AVE APPLETON WI 54914 588417 0 X NA X 1991 WI SUPPORTING ORGANIZATIONS CONTROLLED BY ITS SOLE VOTING MEMBER, APPLETON MEDICAL CENTER, INC., A MEMBER OF THE THEDACARE, INC. GROUP, IN SUPPORT OF LONG-TERM HEALTH CARE. 10 10 0 10 0 0 7785 8100 0 0 -152175 -22796 0 0 -144390 -14696 74010 52007 0 0 0 0 0 0 0 13078 10768 87088 62775 -231478 -77471 1335230 1249460 395 301 1334835 1249159 SUPPORTING ORGANIZATIONS CONTROLLED BY ITS SOLE VOTING MEMBER, APPLETON MEDICAL CENTER, INC., A MEMBER OF THE THEDACARE, INC. GROUP, IN SUPPORT OF LONG-TERM HEALTH CARE. 0 0 51007 SUPPORT OF LONG-TERM CARE RESIDENTS AND RELATED FACILITY NEEDS (24 RESIDENTS). 1000 CNA/EDUCATIONAL SCHOLARSHIPS (2 SCHOLARSHIPS). 52007 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X MARY DIEDERICH 9207590614 N2118 SHAWN CT KAUKAUNA WI 54130 X JOHN A LARSON 1.00 X X 0 0 0 MARY STRANGE 0.30 X X 0 0 0 JOSEPH BIELINSKI 0.50 X X 0 0 0 JOHN C KELLER 0.50 X X 0 0 0 JEFFREY RIESTER 0.30 X 0 0 0 CAROL VALK 0.30 X 0 0 0 DAVID ARONSON 0.30 X 0 0 0 MARY K DIEDERICH 0.50 X 0 0 0 RYAN VALENTINE 0.30 X 0 0 0 DIANE BARKMEIER 0.30 X 0 0 0 0 0 0 0 0 0 0 0 6000 2100 8100 18546 18546 561771 603113 -41342 -41342 -41342 -14696 0 0 -22796 52007 52007 9300 9300 1300 1300 168 168 62775 52007 10768 0 11051 7589 1137106 1047041 187073 194830 1335230 1249460 395 301 395 301 X 2452 -2452 1033413 952641 298970 298970 1334835 1249159 1335230 1249460 X -77471 -8205 X X 0 1 1 X 0 X X X 0 0 0 APPLETON MEDICAL CENTER INC 390824015 3 1 51007 1 51007 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1080017 -25083 50007 1004927 1009438 123856 53277 1080017 873406 136032 1009438 1194012 -320606 873406 0.30000 0.70000 0 0 0 ALTERNATIVE INVESTMENTS - OFFSHORE FEEDER 194830 F 194830 -14696 62775 -77471 -8205 -8205 -85676 -22901 -8205 -8205 -14696 0 -14696 62775 0 62775 0 62775 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE FOUNDATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT ASSETS. ALL FUNDS ARE USED IN SUPPORT OF EFFECTIVE ELDERLY HEALTH CARE. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE FOUNDATION FOLLOWS FASB GUIDANCE ON INCOME TAXES, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THIS GUIDANCE, THE FOUNDATION MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. EXAMPLES OF TAX POSITIONS INCLUDE THE TAX-EXEMPT STATUS OF THE FOUNDATION, AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. AT DECEMBER 31, 2011 AND 2010, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES. 1 THEDACARE INC 122 E COLLEGE AVE APPLETON WI 54912 391509362 501(C)(3) 51007 ACTUAL CASH VALUE SUPPORT OF LONG TERM RESIDENTIAL CARE AT PEABODY MANOR, PART OF THE SENIOR CARE DIVISON OF THEDACARE, INC. 1 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANTS ARE BASED ON CRITERIA ESTABLISHED BY THE BOARD OF DIRECTORS IN SUPPORT OF EFFECTIVE ELDERLY HEALTH CARE. FORM 990, PART VI, SECTION B, LINE 11 BOARD OF DIRECTORS REVIEWS FORM 990 DRAFT PRIOR TO FINAL SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE REQUIRED TO UPDATE AND SIGN CONFLICT OF INTEREST FORMS ANNUALLY. FORMS ARE REVIEWED ANNUALLY AT A BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 15A THE COMPENSATION PROCESS FOR TOP OFFICIALS OF THE ORGANIZATION IS MANAGED BY THEIR EMPLOYER FOR PAYROLL PURPOSES, THEDACARE, INC., A RELATED ORGANIZATION. MANAGEMENT OF THEDACARE, INC. DETERMINES A FAIR AND REASONABLE COMPENSATION FOR THESE INDIVIDUALS BASED ON MARKET AND COMPARABILITY DATA PROVIDED BY HUMAN RESOURCES. NO OTHER OFFICERS RECEIVE ANY COMPENSATION FOR SERVICES RENDERED TO THE ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 FORM 990 AND RELATED DOCUMENTS ARE AVAILABLE TO ANY MEMBER OF THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -8,205. FORM 990, PART XII, LINE 2C: THE PROCESS WAS NOT CHANGED DURING THE YEAR. THEDACARE INC 122 E COLLEGE AVE APPLETON WI 54912 391509362 HEALTH CARE WI 501(C)(3) LINE 11C, III-FI THEDACARE INC 0 APPLETON MEDICAL CENTER INC 1818 N MEADE ST APPLETON WI 54911 390824015 HOSPITAL WI 501(C)(3) LINE 3 THEDACARE INC 0 THEDA CLARK MEDICAL CENTER INC 130 SECOND ST NEENAH WI 54956 390830664 HOSPITAL WI 501(C)(3) LINE 3 THEDACARE INC 0 APPLETON MEDICAL CENTER FOUNDATION INC 1818 N MEADE ST APPLETON WI 54911 391459276 CHARITABLE FOUNDATION WI 501(C)(3) LINE 7 THEDACARE INC 0 COMMUNITY HOSPICE FOUNDATION INC 1818 N MEADE ST APPLETON WI 54911 391511977 FOUNDATION WI 501(C)(3) LINE 7 THEDACARE INC 0 NEW LONDON FAMILY MEDICAL CENTER INC 1405 MILL ST NEW LONDON WI 54961 390869788 HOSPITAL WI 501(C)(3) LINE 3 THEDACARE INC 0 RIVERSIDE MEDICAL CENTER INC 800 RIVERSIDE DR WAUPACA WI 54981 390871113 HOSPITAL WI 501(C)(3) LINE 3 THEDACARE INC 0 THEDA CLARK MEDICAL CENTER FOUNDATION INC 130 SECOND ST NEENAH WI 54956 311550056 FOUNDATION WI 501(C)(3) LINE 11A, I THEDACARE INC 0 WOLF RIVER AREA HEALTHCARE FOUNDATION INC 1405 MILL ST NEW LONDON WI 54961 200049796 FOUNDATION WI 501(C)(3) LINE 11B, II THEDACARE INC 0 SHAWANO MEDICAL CENTER FOUNDATION INC N6192 WOLF RIVER RD SHAWANO WI 54166 391539117 FOUNDATION WI 501(C)(3) LINE 11D, III THEDACARE INC 0 SHAWANO MEDICAL CENTER INC 309 N BARTLETTE ST SHAWANO WI 54166 390807068 HOSPITAL WI 501(C)(3) LINE 3 THEDACARE INC 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0