2012-10-24T14:58:44-05:00 2011-12-31 381357951 PLANTE & MORAN PLLC 111 E COURT ST SUITE 1A FLINT MI 485021647 990 2011-01-01 383085047 HURLEY FOUNDATION HURL 8102629667 ONE HURLEY PLAZA FLINT MI 485035993 RICHARD R WARMBOLD PHD 8102629524 2012-10-24 1 TADD HARBURN P00099166 8107675350 2011 2016-02-24 21:20:13Z RICHARD R WARMBOLD PHD ONE HURLEY PLAZA FLINT MI 485035993 7596240 0 X WWW.HURLEYFOUNDATION.ORG X 1992 MI ADVANCEMENT OF MEDICAL SCIENCES, EDUCATION, MEDICAL CARE, AND THE DELIVERY THEREOF FOR THE BENEFIT OF RESIDENTS OF THE GREATER FLINT METROPOLITAN AREA. 10 9 0 700 0 0 1327906 1462815 0 0 72304 110849 153312 123711 1553522 1697375 945455 941510 0 0 0 0 0 0 337015 460745 489106 1406200 1430616 147322 266759 4369157 4426226 352979 150452 4016178 4275774 TO CONTRIBUTE TO FULFILLING THE HURLEY MEDICAL CENTER MISSION OF "CLINICAL EXCELLENCE. SERVICE TO PEOPLE" WHILE FACILITATING CHARITABLE GIVING THAT CONTRIBUTES TO THE MEDICAL CENTER. 0 0 949198 941510 148696 ALLOCATIONS WERE MADE TO HURLEY MEDICAL CENTER FOR VARIOUS MEDICAL CARE PURPOSES. 949198 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 X 10 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 MI X RICHARD WARMBOLD PHD 8102629524 ONE HURLEY PLAZA FLINT MI 48503 PHILIP W SHALTZ 1.00 X X 0 0 0 DONNA DODDS HAMM 1.00 X X 0 0 0 WILLIAM H MOELLER 1.00 X X 0 0 0 SUSAN STEINER BOLHOUSE 1.00 X X 0 0 0 RICHARD R WARMBOLD PHD 40.00 X X 189771 0 36679 MARCUS A RANDOLPH 1.00 X 0 0 0 CARL E MASON 1.00 X 0 0 0 PATRICK R WARDELL 1.00 X 0 0 0 IRA A RUTHERFORD III 1.00 X 0 0 0 MATTHEW T MILLER 1.00 X 0 0 0 PHILLIP C DUTCHER 1.00 X 0 0 0 189771 0 36679 1 0 1 1 0 229681 1233134 1462815 52428 52428 5833900 5775479 58421 58421 58421 98401 229681 123386 -24985 -24985 MANAGEMENT FEE ASSESSM 561000 148696 148696 148696 1697375 148696 0 85864 941510 941510 26318 622 25696 10533 872 9661 125578 70 125508 109102 9050 100052 9793 365 9428 2039 2039 MANAGEMENT FEE 148696 82296 66400 GRANT CENTER EXPENSE 34862 7688 27174 BANK CHARGES 10693 10693 ENDOW INTEREST DISTRIBU 6000 6000 5492 5222 270 1430616 949198 144403 337015 314232 347137 479552 549047 8797 21211 3101942 3057225 464634 451606 4369157 4426226 339723 139551 13256 10901 352979 150452 X 1116339 897068 981219 1446461 1918620 1932245 4016178 4275774 4369157 4426226 X 266759 -7163 X 0 1 0 X 0 X 1047075 2084716 1116606 1327906 1462815 7039118 1047075 2084716 1116606 1327906 1462815 7039118 1427705 5611413 154577 109274 73540 77767 52428 467586 332502 7987 340489 7847193 642787 0.71510 0.72310 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: LIFE INSURANCE PROCEEDS RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2578108 65232 457331 45762 3054909 2514919 51080 62918 50809 2578108 3164167 53654 -655769 47133 2514919 3087932 41819 49437 15021 3164167 0.14500 0.63300 0.22200 0 0 0 LIFE INSURANCE POLICIES - CASH SURRENDER VALUE 451606 C 451606 LIABILITY TO LIFE BENEFICIARIES OF CHARITABLE ANNUITIES 10901 10901 1697375 1430616 266759 -7163 -7163 259596 2419341 -7163 788803 781640 1637701 34364 25310 59674 1697375 2159745 788803 123386 912189 1247556 34364 148696 183060 1430616 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE BOARD-DESIGNATED ENDOWMENT FUND WAS ESTABLISHED BY THE BOARD IN 1998. THE DESIGNATION OF THESE FUNDS WAS VOLUNTARY AND CAN BE REVISED BY THE GOVERNING BOARD AT ANY TIME. ALL OTHER ENDOWMENTS WERE ESTABLISHED TO SUPPORT DEPARTMENTAL SPECIFIC GENERAL EXPENSES OR EDUCATIONAL EXPENSES. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE UNITED STATES INTERNAL REVENUE CODE AND IS CLASSIFIED AS OTHER THAN A PRIVATE FOUNDATION. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE FOUNDATION, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2011 AND 2010, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2008. PART XII, LINE 4B - OTHER ADJUSTMENTS: MANAGEMENT FEE INCOME NETTED AGAINST EXPENSE ON FINANCIAL STMTS 148,696. SPECIAL EVENT EXPENSES NETTED WITH REVENUE ON 990 -123,386. PART XIII, LINE 2D - OTHER ADJUSTMENTS: SPECIAL EVENT EXPENSES NETTED WITH REVENUE ON 990 123,386. PART XIII, LINE 4B - OTHER ADJUSTMENTS: MANAGEMENT FEE EXPENSE 148,696. GOLF CLASSIC 101095 85480 15615 32716 9898 BENEFIT BALL 209271 137516 71755 43958 33770 1 17716 6685 11031 3044 328082 229681 98401 79718 43668 123386 -24985 1 HURLEY MEDICAL CENTER ONE HURLEY PLAZA FLINT MI 48503 386005601 115 874878 ALLOCATIONS FOR MEDICAL SERVICES AMERICAN RED CROSS ONE HURLEY PLAZA FLINT MI 48503 381359185 501C3 5000 SPONSORSHIP MCLAREN FOUNDATION 401 S BALLENGER HWY FLINT MI 48532 381358053 501C3 6000 SPONSORSHIP GENESEE COUNTY FREE MEDICAL CLINIC 2437 WELSH BLVD FLINT MI 48504 382995700 501C3 9500 SPONSORSHIP GENESEE COUNTY MEDICAL SOCIETY 4438 OAK BRIDGE DR SUITE B FLINT MI 48532 381347755 501C6 5000 SPONSORSHIP GENESEE COUNTY HEALTH DEPARTMENT 630 S SAGINAW STE 4 FLINT MI 48502 386004849 115 5000 SPONSORSHIP MHA MICHIGAN HEALTH & HOSPITAL ASSOC 6215 WEST ST JOSEPH HWY LANSING MI 48917 381458751 501C6 10792 SPONSORSHIP 5 2 SCHEDULE I, PART 1, LINE 2: DESCRIBE THE ORGANIZATIONS PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS HURLEY FOUNDATION GRANT FUNDS TYPICALLY ARE PROVIDED TO ORGANIZATIONS IN OUR COMMUNITY WHERE STAFF WORK AND LIVE. AS A RESULT WE LEARN ABOUT FOUNDATION SUPPORTED ACTIVITIES, RECEIVE ANNOUNCEMENTS AND AT TIMES ARE SENT PROGRAM INFORMATION. THE STAFF OF HURLEY FOUNDATION ALSO ATTEND AND/OR PARTICIPATE IN EVENTS AND OBSERVE THE GRANTEE. 0 0 0 0 0 0 0 0 0 RICHARD R WARMBOLD PHD 189771 0 0 0 0 0 23228 0 13451 0 226450 0 0 0 SUPPLEMENTAL INFORMATION PART III OFFICER WAS PAID DIRECTLY BY AN UNRELATED ORGANIZATION, HURLEY MEDICAL CENTER, EIN 38-6005601. COMPENSATION WAS TREATED AS AN IN-KIND DONATION FROM UNRELATED ORGANIZATION. UNRELATED ORGANIZATION ISSUED A W-2 FOR COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PROVIDED TO BOARD PRESIDENT AND ACCOUNTING CONTROLLER FOR REVIEW BEFORE FILING. A FILE COPY IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY SIGNING OF STATEMENTS DECLARING ANY CONFLICT OF INTEREST. IF ANY SITUATION OR CIRCUMSTANCE ARISES WHICH PRESENTS A CONFLICT OF INTEREST OR A POTENTIAL CONFLICT OF INTEREST, MEMBER WILL DISCLOSE SUCH A CONFLICT/POTENTIAL AND REFRAIN FROM ACTIONS INVOLVING SUCH CONFLICTS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON WRITTEN OR VERBAL REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -7,163.