CHEYENNE REGIONAL MEDICAL CENTER FOUNDATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- CHEYENNE REGIONAL MEDICAL CENTER FOUNDATION (EIN 83-0236858)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-10-09
- IRS object ID
- 201202839349300955
- Schema version
- 2011v1.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-10-09T15:39:57-07:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUER WOODLEY CPAs LLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 E PIKES PEAK AVE STE 305 | AddressLine1 |
| City | COLORADO SPRINGS | City |
| State | CO | State |
| ZIP Code | 809033674 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 830236858 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHEYENNE REGIONAL MEDICAL CENTER | BusinessNameLine1 |
| Business Name Line2 | FOUNDATION | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHEY | NameControl |
| Phone | 3076337667 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 214 EAST 23RD STREET | AddressLine1 |
| City | CHEYENNE | City |
| State | WY | State |
| ZIP Code | 82001 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TED ADAMS | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Date Signed | 2012-10-09 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Roxanne Ostlund CPA | Name |
| Phone | 3077789933 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TED ADAMS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 214 EAST 23RD STREET | AddressLine1 |
| City | CHEYENNE | City |
| State | WY | State |
| ZIP Code | 82001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 4610405 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CRMCFOUNDATIONWY.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1977 | YearFormation |
| State Legal Domicile | WY | StateLegalDomicile |
| Activity Or Mission Description | TO ASSIST IN THE DEVELOPMENT, GROWTH, AND OPERATION OF THE CHEYENNE REGIONAL MEDICAL CENTER. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 27 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 27 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 150 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1510272 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1364163 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 584224 | InvestmentIncomePriorYear |
| Investment Income Current Year | 309513 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 2094496 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1673676 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 321058 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 89626 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 210728 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1056629 | OtherExpensePriorYear |
| Other Expenses Current Year | 1453535 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1377687 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1543161 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 716809 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 130515 | RevenuesLessExpensesCY |
| Total Assets BOY | 11888103 | TotalAssetsBOY |
| Total Assets EOY | 11496839 | TotalAssetsEOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 11888103 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 11496839 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO ASSIST IN THE DEVELOPMENT, GROWTH, AND OPERATION OF THE CHEYENNE REGIONAL MEDICAL CENTER. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 733055 | Expense |
| Description | PURCHASE OF MEDICAL EQUIPMENT AND RELATED EXPENSES IN SUPPORT OF THE CHEYENNE REGIONAL MEDICAL CENTER DEVELOPMENT AND THE CONSTRUCTION OF THE DAVIS HOSPICE CENTER. | Description |
| Total Program Service Expense | 733055 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | true | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 27 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 27 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | CRMC FOUNDATION | NamePerson |
| Telephone Number | 3076337667 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 214 EAST 23RD STREET | AddressLine1 |
| City | CHEYENNE | City |
| State | WY | State |
| ZIP Code | 82001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (28 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| JIM MUELLER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DALE STEENBERGEN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CARMALEE ROSE | ||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X |
| BRENT WEIGNER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SANDRA SURBRUGG | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ERNIE SHRINER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SUE MILLER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CAROL MERRELL | ||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X |
| JOHN LUCAS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| TOM LONG | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| FRAN NALER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| TRISHA KIMZEY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ARLINE COHEN HARRIS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JAMES HARPER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JOHN GROSS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DAVE FOREMAN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| GUS FLEISCHLI | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| WILLIAM DUBOIS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SUSAN PAINTER | ||||||
| EX-OFFICIO MEM | 1.00 | X | 0 | 0 | 0 | |
| HARVEY DESELMS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| RICK DAVIS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ANDREA COOK | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| BILL LARSON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JOHN BALSER | ||||||
| VICE-CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X |
| MARK ANDERSON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| TOM STUCKEY | ||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X |
| JACQUELINE FERRALL | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| TED ADAMS | ||||||
| EXECUTIVE DIREC | 40.00 | 0 | 0 | 0 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 354626 | FundraisingEvents |
| Government Grants | 270276 | GovernmentGrants |
| All Other Contributions | 739261 | AllOtherContributions |
| Noncash Contributions | 86704 | NoncashContributions |
| Total Contributions | 1364163 | TotalContributions |
| Total Program Service Revenue | 0 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 279447 | TotalRevenueColumn |
| Exclusion | $279,447 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2966795 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2936729 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 30066 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 30066 | TotalRevenueColumn |
| Related Or Exempt Function Income | 30066 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrbtns Rprtd Fundraising Events | 354626 | CntrbtnsRprtdFundraisingEvents |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1673676 | TotalRevenueColumn |
| Related Or Exempt Function Income | 30066 | RelatedOrExemptFunctionIncome |
| Exclusion | $279,447 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83895 | Total |
| Management And General | 83895 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5731 | Total |
| Management And General | 5731 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13355 | Total |
| Management And General | 13355 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13770 | Total |
| Management And General | 13770 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93234 | Total |
| Management And General | 93234 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 382293 | Total |
| Management And General | 171565 | ManagementAndGeneral |
| Fundraising | 210728 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5331 | Total |
| Management And General | 5331 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7885 | Total |
| Management And General | 7885 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6421 | Total |
| Management And General | 6421 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1339 | Total |
| Management And General | 1339 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 496 | Total |
| Management And General | 496 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| Printing and Publications | 35610 | 35610 | |
| MISCELLANEOUS | 140584 | 6669 | 133915 |
| INJURY PREVENTION | 342675 | 342675 | |
| CUSTOMER RELATIONS | 59134 | 59134 | |
| CRMC CONTRIBUTIONS | 319960 | 63495 | 256465 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31448 | Total |
| Management And General | 31448 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1543161 | Total |
| Program Services | 733055 | ProgramServices |
| Management And General | 599378 | ManagementAndGeneral |
| Fundraising | 210728 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 824138 | BOY |
| EOY | 789536 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120636 | BOY |
| EOY | 77996 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1200 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 43407 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 32205 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12541 | BOY |
| EOY | 11202 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10899442 | BOY |
| EOY | 10591782 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30146 | BOY |
| EOY | 26323 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11888103 | BOY |
| EOY | 11496839 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | 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 | 4500847 | BOY |
| EOY | 4043940 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4054251 | BOY |
| EOY | 4194896 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3333005 | BOY |
| EOY | 3258003 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11888103 | BOY |
| EOY | 11496839 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11888103 | BOY |
| EOY | 11496839 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 130515 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -521779 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
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 | 1408187 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1647399 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1473667 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1510272 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1364163 | CurrentTaxYear |
| Total | 7403688 | Total |
Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1408187 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1647399 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1473667 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1510272 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1364163 | CurrentTaxYear |
| Total | 7403688 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 0 | AmountsSubstContributorsTotal |
| Public Support Total170 | 7403688 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 770528 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 467902 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 307989 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 293676 | CurrentTaxYearMinus1Year |
| Current Tax Year | 279447 | CurrentTaxYear |
| Total | 2119542 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 9523230 | TotalSupport |
| Public Support Pertcentage170 | 0.77740 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.73060 | 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
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3333005 | BeginningOfYearBalance |
| Contributions | 234 | Contributions |
| Investment Earnings Or Losses | -22282 | InvestmentEarningsOrLosses |
| Other Expenditures | 52955 | OtherExpenditures |
| End Of Year Balance | 3258002 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3139767 | BeginningOfYearBalance |
| Contributions | 1600 | Contributions |
| Investment Earnings Or Losses | 353583 | InvestmentEarningsOrLosses |
| Other Expenditures | 161945 | OtherExpenditures |
| End Of Year Balance | 3333005 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2831391 | BeginningOfYearBalance |
| Contributions | 24935 | Contributions |
| Investment Earnings Or Losses | 513240 | InvestmentEarningsOrLosses |
| Other Expenditures | 229799 | OtherExpenditures |
| End Of Year Balance | 3139767 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13019 | OtherCostOrOtherBasis |
| Depreciation | 2604 | Depreciation |
| Book Value | 10415 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 30388 | OtherCostOrOtherBasis |
| Depreciation | 29601 | Depreciation |
| Book Value | 787 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 11202 | TotalOfBookValueLandBuildings |
| Total Revenue | 1673676 | TotalRevenue |
| Total Expenses | 1543161 | TotalExpenses |
| Excess Or Deficit For Year | 130515 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -521779 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -521779 | TotalAdjustments |
| Excess Or Deficit Per FS | -391264 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1673676 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 1673676 | RevenueSubtotal |
| Total Revenue Per Form990 | 1673676 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 2064940 | TotExpensesEtcAuditedFinclStmt |
| Losses Reported | 521779 | LossesReported |
| Expenses Not Rptd F990 | 521779 | ExpensesNotRptdF990 |
| Expenses Subtotal | 1543161 | ExpensesSubtotal |
| Total Expenses Per Form990 | 1543161 | TotalExpensesPerForm990 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agreement Ref Fundraising | false | AgreementRefFundraising |
| Licensed States | WY | LicensedStates |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | DENIM 'N DIAMONDS | NameOfEvent1 |
| Gross Receipts Event1 | 354626 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 354626 | CharitableContributionsEvent1 |
| Gross Receipts Total | 354626 | GrossReceiptsTotal |
| Charitable Contributions Total | 354626 | CharitableContributionsTotal |
Schedule M IRS990ScheduleM
Real Estate Other RealEstateOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 1000 | NoncashContribsRptdF990 |
Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | DENIM N DIAMOND | 1 | 80891 | COST |
| X | DAVIS HOSPICE | 1 | 4813 | COST |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | ALL GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part VI, Line 15b | Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | ALL EMPLOYEE SALARIES ARE SET BY THE CHEYENNE REGIONAL MEDICAL CENTER. |
| Form 990, Part VI, Line 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | DIRECTORS ARE TO NOTIFY THE BOARD AS SOON AS A POSSIBLE CONFLICT OF INTEREST ARISES. |
| Form 990, Part VI, Line 11 | Form 990, Part VI, Line 11: Form 990 Review Process | THE EXECUTIVE DIRECTOR REVIEWS THE FORM 990. IT IS THEN REVIEWED BY THE FINANCE COMMITTEE. ONCE THE FINANCE COMMITTEE HAS APPROVED THE FORM 990 IT IS TAKEN TO THE FULL BOARD FOR APPROVAL. WHEN THE FORM 990 HAS BEEN APPROVED BY THE FULL BOARD, IT IS SIGNED AND FILED WITH THE IRS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHEYENNE REGIONAL MEDICAL CENTER | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 214 EAST 23RD STREET | AddressLine1 |
| City | CHEYENNE | City |
| State | WY | State |
| ZIP Code | 82001 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 836000194 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivities |
| Legal Domicile State | WY | LegalDomicileState |
| Exempt Code Section | 501C3 | ExemptCodeSection |
| Public Charity Status | 3 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| CHEYENNE REGIONAL MEDICAL CENTER | ||
| c | 392514 | FMV |
| CHEYENNE REGIONAL MEDICAL CENTER | ||
| b | 319960 | FMV |
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