MEMORIAL HEALTH SYSTEM FOUNDATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MEMORIAL HEALTH SYSTEM FOUNDATION (EIN 84-1576338)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-08-06
- IRS object ID
- 201242199349301024
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-06T15:16:52-05:00 | 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 | STOCKMAN KAST RYAN & CO LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 102 N CASCADE AVENUE SUITE 400 | AddressLine1 |
| City | COLORADO SPRINGS | City |
| State | CO | State |
| ZIP Code | 80903 | 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 | 841576338 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE MEMORIAL HEALTH SYSTEM FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % STEVE WEBER | InCareOfName |
| Name Control | MEMO | NameControl |
| Phone | 7193654483 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1519 EAST BOULDER | AddressLine1 |
| City | COLORADO SPRINGS | City |
| State | CO | State |
| ZIP Code | 80909 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | cary blanchette | Name |
| Title | executive director | Title |
| Date Signed | 2012-08-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DOREEN B MERZ | Name |
| Phone | 7196301186 | 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 | STEVE WEBER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1519 EAST BOULDER | AddressLine1 |
| City | COLORADO SPRINGS | City |
| State | CO | State |
| ZIP Code | 80909 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1729469 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2001 | YearFormation |
| State Legal Domicile | CO | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1536017 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1652735 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 11717 | InvestmentIncomePriorYear |
| Investment Income Current Year | 18656 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -45195 | OtherRevenuePriorYear |
| Other Revenue Current Year | -44200 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1502539 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1627191 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 879103 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 787898 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 483599 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 550181 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 16236 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 449791 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 255604 | OtherExpensePriorYear |
| Other Expenses Current Year | 235948 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1634542 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1574027 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -132003 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 53164 | RevenuesLessExpensesCY |
| Total Assets BOY | 4404976 | TotalAssetsBOY |
| Total Assets EOY | 4372863 | TotalAssetsEOY |
| Total Liabilities BOY | 55644 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 36231 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4349332 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4336632 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MEMORIAL HEALTH SYSTEM FOUNDATION SEEKS TO BECOME THE PRIMARY PHILANTHROPIC RESOURCE TO ELEVATE THE COMMUNITY'S HEALTH OF CURRENT AND FUTURE GENERATIONS. THE MISSION OF MEMORIAL HEALTH SYSTEM FOUNDATION IS TO PROVIDE PHILANTHROPIC RESOURCES TO ASSIST MEMORIAL HEALTH SYSTEM TO PROVIDE THE HIGHEST QUALITY HEALTH CARE. PHILANTHROPIC SUPPORT IS BEING SOUGHT FOR CAPITAL, ENDOWMENT AND PROGRAMMATIC PURPOSES INCLUDING: NEONATAL INTENSIVE CARE UNIT EXPANSION, DIGITAL MAMMOGRAPHY EQUIPMENT, COOLING CAP AND CANCER, CARDIOLOGY, CHILDREN'S HOSPITAL AND WOMEN'S PROGRAMS AND SERVICES. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 177758 | Expense |
| Grants | 133145 | Grants |
| Description | CHILD LIFE: FUNDS TO ASSIST THE CHILD LIFE PROGRAM AND THERAPISTS. CHILD LIFE PROGRAM PROVIDES CRITICAL EMOTIONAL AND EDUCATIONAL SUPPORT TO CHILDREN AND THEIR FAMILIES DURING TREATMENT IN INPATIENT PEDIATRIC UNITS, OUTPATIENT CLINICS, AND THE EMERGENCY DEPARTMENTS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 70711 | Expense |
| Grants | 52964 | Grants |
| Description | HEALING ARTS: FUNDS TO ENCOURAGE THE USE OF FINE ARTS IN HEALING. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 69016 | Expense |
| Grants | 51694 | Grants |
| Description | COLORADO SPRINGS CHILDREN'S HOSPITAL: FUNDS TO BE USED FOR THE MEMORIAL HOSPITAL CHILDREN'S HOSPITAL AT MEMORIAL HEALTH SYSTEMS FOR AREAS OF GREATEST NEED. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 557983 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 550093 | TotalOfOtherProgramServiceGrnt |
| Total Program Service Expense | 875468 | 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 | true | 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 | true | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| 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 | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 8 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | 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 |
| 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 | false | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | STEVE WEBER | NamePerson |
| Telephone Number | 7193654483 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1519 EAST BOULDER | AddressLine1 |
| City | COLORADO SPRINGS | City |
| State | CO | State |
| ZIP Code | 80909 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| DAVID GREENBERG MD | |||||||
| DIRECTOR | 1.0 | X | |||||
| MARGARET CARMACK | |||||||
| TREASURER | 1.0 | X | X | ||||
| MARY ELLEN MCNALLY | |||||||
| BOARD CHAIR | 1.0 | X | X | ||||
| KEVIN O'GARA | |||||||
| VICE-CHAIR | 1.0 | X | X | ||||
| LAWRENCE MCEVOY II MD | |||||||
| EX-OFFICIO | 1.0 | X | |||||
| THOMAS NAUGHTON | |||||||
| DIRECTOR | 1.0 | X | |||||
| ANNETTE SEAGRAVES | |||||||
| DIRECTOR | 1.0 | X | |||||
| DARLENE LARSON | |||||||
| EX-OFFICIO | 1.0 | X | |||||
| JOSEPH CAMIOLO | |||||||
| DIRECTOR | 1.0 | X | |||||
| WILLIAM CROUCH | |||||||
| SECRETARY | 1.0 | X | X | ||||
| LANA JANC | |||||||
| DIRECTOR | 1.0 | X | |||||
| KAREN ANTHONY | |||||||
| DIRECTOR | 1.0 | X | |||||
| RONALD RUBIN | |||||||
| DIRECTOR | 1.0 | X | |||||
| MIKE EDMONDS PH D | |||||||
| DIRECTOR | 1.0 | X | |||||
| CARY BLANCHETTE | |||||||
| EXECUTIVE DIRECTOR | 40.0 | X | 134639 | 0 | 38966 | ||
| WILLIAM STOHLMANN | |||||||
| DIR OF PLANNING & CAMPAIGN MGM | 40.0 | 95815 | 32851 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 230454 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 71817 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 191564 | FundraisingEvents |
| Related Organizations | 694638 | RelatedOrganizations |
| Government Grants | 13223 | GovernmentGrants |
| All Other Contributions | 753310 | AllOtherContributions |
| Noncash Contributions | 268111 | NoncashContributions |
| Total Contributions | 1652735 | TotalContributions |
| Total Program Service Revenue | 0 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16820 | TotalRevenueColumn |
| Exclusion | $16,820 | 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 |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 9380 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7544 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1836 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1836 | TotalRevenueColumn |
| Exclusion | $1,836 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 50534 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 191564 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 94734 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -44200 | TotalRevenueColumn |
| Exclusion | -$44,200 | ExclusionAmount |
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 | 1627191 | TotalRevenueColumn |
| Exclusion | -$25,544 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 655749 | Total |
| Program Services | 655749 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 132149 | Total |
| Program Services | 132149 | ProgramServices |
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 | 173605 | Total |
| Management And General | 69442 | ManagementAndGeneral |
| Fundraising | 104163 | Fundraising |
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 | 278881 | Total |
| Program Services | 57671 | ProgramServices |
| Management And General | 76286 | ManagementAndGeneral |
| Fundraising | 144924 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95240 | Total |
| Program Services | 21604 | ProgramServices |
| Management And General | 30436 | ManagementAndGeneral |
| Fundraising | 43200 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2455 | Total |
| Program Services | 747 | ProgramServices |
| Management And General | 1088 | ManagementAndGeneral |
| Fundraising | 620 | Fundraising |
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 | 515 | Total |
| Management And General | 515 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5000 | Total |
| Management And General | 5000 | 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 | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 166801 | Total |
| Management And General | 42218 | ManagementAndGeneral |
| Fundraising | 124583 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10336 | Total |
| Fundraising | 10336 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27125 | Total |
| Program Services | 5309 | ProgramServices |
| Management And General | 9244 | ManagementAndGeneral |
| Fundraising | 12572 | Fundraising |
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 | 1159 | Total |
| Management And General | 464 | ManagementAndGeneral |
| Fundraising | 695 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5215 | Total |
| Program Services | 1565 | ProgramServices |
| Management And General | 1043 | ManagementAndGeneral |
| Fundraising | 2607 | Fundraising |
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 | 3120 | Total |
| Program Services | 624 | ProgramServices |
| Management And General | 1872 | ManagementAndGeneral |
| Fundraising | 624 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | FundraisingFundraising | Program ServicesProgramServices |
|---|---|---|---|---|
| CONTINUING EDUCATION | 9005 | 3602 | 5403 | |
| MISCELLANEOUS | 7407 | 7407 | ||
| EMPLOYEE GIVING CAMPAIGN | 29 | 9 | 17 | 3 |
| EQUIPMENT RENTAL | 236 | 142 | 47 | 47 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1574027 | Total |
| Program Services | 875468 | ProgramServices |
| Management And General | 248768 | ManagementAndGeneral |
| Fundraising | 449791 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40680 | BOY |
| EOY | 50865 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3964069 | BOY |
| EOY | 4059368 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 184625 | BOY |
| EOY | 60225 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11808 | BOY |
| EOY | 5250 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 50542 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 47514 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6148 | BOY |
| EOY | 3028 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 197646 | BOY |
| EOY | 194127 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4404976 | BOY |
| EOY | 4372863 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50644 | BOY |
| EOY | 35211 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5000 | BOY |
| EOY | 1020 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55644 | BOY |
| EOY | 36231 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 923965 | BOY |
| EOY | 753993 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3231192 | BOY |
| EOY | 3388464 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 194175 | BOY |
| EOY | 194175 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4349332 | BOY |
| EOY | 4336632 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4404976 | BOY |
| EOY | 4372863 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 53164 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -65864 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| 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 |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type3 Func Int | X | SupportingOrg509a3Type3FuncInt |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 846002995 | EIN |
| Type Of Organization | 03 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | true | SupportedOrganizationNotified |
| Organized In US | true | OrganizedInUS |
| Amount | $787,898 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 787898 | SumOfAmounts |
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) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 197646 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -3519 | InvestmentEarningsOrLosses |
| End Of Year Balance | 194127 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 205009 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 12637 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 20000 | GrantsOrScholarships |
| End Of Year Balance | 197646 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 181500 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 23509 | InvestmentEarningsOrLosses |
| End Of Year Balance | 205009 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 212665 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -31165 | InvestmentEarningsOrLosses |
| End Of Year Balance | 181500 | 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 |
| Land | Land | |
| Buildings | Buildings | |
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 50542 | OtherCostOrOtherBasis |
| Depreciation | 47514 | Depreciation |
| Book Value | 3028 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 3028 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
| Total Of Amounts | 0 | TotalOfAmounts |
| Total Revenue | 1627191 | TotalRevenue |
| Total Expenses | 1574027 | TotalExpenses |
| Excess Or Deficit For Year | 53164 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -16880 | NetUnrealizedGLOnInvestments |
| Other | -$48,984 | OtherAmount |
| Total Adjustments | -65864 | TotalAdjustments |
| Excess Or Deficit Per FS | -12700 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 1751845 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -16880 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 46800 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | 94734 | OtherRevenues |
| Revenue Not Rptd F990 | 124654 | RevenueNotRptdF990 |
| Revenue Subtotal | 1627191 | RevenueSubtotal |
| Total Revenue Per Form990 | 1627191 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 1764545 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 46800 | DonatedServicesUseOfFacilities |
| Other Expenses Included | 143718 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 190518 | ExpensesNotRptdF990 |
| Expenses Subtotal | 1574027 | ExpensesSubtotal |
| Total Expenses Per Form990 | 1574027 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART V, LINE 4: | THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO PROVIDE EDUCATION TO OUTREACH PROGRAMS, TRAUMA NURSES, AND BLOOD DONOR TECHS. |
| PART XII, LINE 2B - OTHER ADJUSTMENTS: | SPECIAL EVENTS EXPENSES Reclass 94,734 |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENTS EXPENSES Reclass 94,734 write off of pledges receivable reclassed to Net Assets 48,984 |
| Part X Line 2 | The Foundation believes that it does not have any uncertain tax positions that are material to the financial statements. |
| Part XI line 8 | Write off of prior year pledges receivable. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| Email Solicitations | X | EmailSolicitations |
| Phone Solicitations | X | PhoneSolicitations |
| In Person Solicitations | X | InPersonSolicitations |
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Solicitation Of Govt Grants | X | SolicitationOfGovtGrants |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | true | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation (2 entries)
| Name Of IndividualNameOfIndividual | ActivityActivity | Fundraiser Control Of FundsFundraiserControlOfFunds | Gross ReceiptsGrossReceipts | Amount Retained By ContractorAmountRetainedByContractor | Net To OrganizationNetToOrganization |
|---|---|---|---|---|---|
| PATRICIA WOODS 1322 N25th st CS | GRANT WRITING | false | 237350 | 31996 | 205354 |
| Tess Powers 1009 Pioneer Lane CS | GRANT WRITING | false | 145472 | 19373 | 126099 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 382822 | TotalGrossReceipts |
| Total Retained By Contractors | 51369 | TotalRetainedByContractors |
| Total Net To Organization | 331453 | TotalNetToOrganization |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GALA | NameOfEvent1 |
| Gross Receipts Event1 | 204373 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 171989 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 32384 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 4856 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 34400 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 3150 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 25831 | OtherDirectExpensesEvent1 |
| Name Of Event2 | GOLF TOURNAMENT | NameOfEvent2 |
| Gross Receipts Event2 | 37725 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 19575 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 18150 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 3610 | NonCashPrizesEvent2 |
| Food And Beverage Event2 | 8289 | FoodAndBeverageEvent2 |
| Other Direct Expenses Event2 | 14597 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Total | 242098 | GrossReceiptsTotal |
| Charitable Contributions Total | 191564 | CharitableContributionsTotal |
| Gross Revenue Total Events | 50534 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 3610 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 4856 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 42689 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 3150 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 40428 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 94733 | DirectExpenseSummaryEvents |
| Net Income Summary | -44199 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HEALTH SYSTEMS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 846002995 | EINOfRecipient |
| Amount Of Cash Grant | 387637 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 268111 | AmountOfNonCashAssistance |
| Method Of Valuation | FMV | MethodOfValuation |
| Description Of Non Cash Assistance | BOOKS, TOYS, CLOTHES | DescriptionOfNonCashAssistance |
| Purpose Of Grant | TO ASSIST MEMORIAL HEALTHCARE IN PROVIDING THE HIGHEST QUALITY HEALTH CARE. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII (8 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|---|
| CIRCLE OF HOPE - LIVING EXPENSES | 254 | 49452 | |||
| CIRCLE OF HOPE KOMEN - LIVING EXPENSES | 56 | 20355 | |||
| EMPLOYEE ASSISTANCE - LIVING EXPENSES | 18 | 30634 | |||
| RENEE'S FRIENDS - LIVING EXPENSES | 16 | 3569 | |||
| PEDIATRICS FAMILY SUPPORT - LIVING EXPENSES | 2 | 3730 | |||
| GRACE FUND - LIVING EXPENSES | 3 | 9506 | |||
| FARMERS INSURANCE CAR SEAT FUND | 28 | 2933 | FMV | INFANT CAR SEATS | |
| USAA SAFETY SEAT FUND - CAR SEATS | 159 | 11970 | FMV | INFANT CARE SEATS |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE I, PART I, LINE 2: | Identifier |
| Explanation | THE FOUNDATION EXECUTIVE DIRECTOR REVIEWS ALL GRANTS AND REQUESTS FOR MONIES. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | CARY BLANCHETTE | NamePerson |
| Base Compensation Filing Org | 134639 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 0 | BonusFilingOrg |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Deferred Comp Filing Org | 18852 | DeferredCompFilingOrg |
| Nontaxable Benefits Filing Org | 20114 | NontaxableBenefitsFilingOrg |
| Total Compensation Filing Org | 173605 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArt | |
| Art Historical Treasures | ArtHistoricalTreasures | |
| Art Fractional Interest | ArtFractionalInterest |
Books And Publications BooksAndPublications
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 2571 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenues |
Clothing And Household Goods ClothingAndHouseholdGoods
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Noncash Contribs Rptd F990 | 27526 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | MAREKT VALUE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cars And Other Vehicles | CarsAndOtherVehicles | |
| Boats And Planes | BoatsAndPlanes | |
| Intellectual Property | IntellectualProperty | |
| Securities Publicly Traded | SecuritiesPubliclyTraded | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStock | |
| Securities Prtnrshp Trust Intrsts | SecuritiesPrtnrshpTrustIntrsts | |
| Securities Miscellaneous | SecuritiesMiscellaneous | |
| Qualified Contrib Hist Struct | QualifiedContribHistStruct | |
| Qualified Contrib Other | QualifiedContribOther | |
| Real Estate Residential | RealEstateResidential | |
| Real Estate Commercial | RealEstateCommercial | |
| Real Estate Other | RealEstateOther | |
| Collectibles | Collectibles | |
| Food Inventory | FoodInventory | |
| Drugs And Medical Supplies | DrugsAndMedicalSupplies | |
| Taxidermy | Taxidermy | |
| Historical Artifacts | HistoricalArtifacts | |
| Scientific Specimens | ScientificSpecimens | |
| Archaeological Artifacts | ArchaeologicalArtifacts |
Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | TOYS | 199 | 141857 | MARKET VALUE |
| X | OTHER | 24 | 96157 | MARKET VALUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| 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 (6 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11: | ONCE THE 990 IS PREPARED, THE EXECUTIVE DIRECTOR ADVISES THE BOARD MEMBERS THAT IT IS READY FOR REVIEW. A COPY OF THE 990 IS AVAILABLE IN THE FOUNDATION OFFICE. |
| FORM 990, PART VI, SECTION B, LINE 12C: | AT THE ANNUAL BOARD MEETING, THE BOARD IS GIVEN A NEW COPY OF THE CONFLICT OF INTEREST STATEMENT. THE BOARD GOES OVER THE STATEMENT AND EACH BOARD MEMBER MUST SIGN THE DOCUMENT. THUS, EACH MEMBER SIGNS IT ANNUALLY AND IS REMINDED TO BRING ANY POTENTIAL CONFLICT TO THE BOARD'S AND EXECUTIVE DIRECTOR'S ATTENTION. THE BOARD MEMBER MUST ALSO RECUSE HIM/HERSELF FROM ANY VOTE IF THERE IS A CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15: | MEMORIAL HEALTH SYSTEM'S HUMAN RESOURCE DEPARTMENT AND CEO WORK TOGETHER TO DETERMINE THE COMPENSATION FOR THE FOUNDATION CEO WITH THE ADVICE AND CONSENT OF THE FOUNDATION EXECUTIVE COMMITTEE. OTHER KEY EMPLOYEES OF THE FOUNDATION ARE COMPENSATED BASED ON THE HEALTH SYSTEM'S COMPENSATION POLICIES. |
| FORM 990, PART VI, SECTION C, LINE 19: | DOCUMENTS ARE AVAILABLE AT THE FOUNDATION OFFICE IF THE PUBLIC WISHES TO REVIEW THEM. |
| FORM 990, PART XI, LINE 5, CHANGES IN NET ASSETS: | NET UNREALIZED LOSS ON INVESTMENTS: -16,880 Write-off of prior year pledges receivable: -48,984 |
| FORM 990, PART XII, LINE 2C: | NO CHANGES TO OVERSIGHT PROCESS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HEALTH SYSTEMS | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1400 EAST BOULDER | AddressLine1 |
| City | COLORADO SPRINGS | City |
| State | CO | State |
| ZIP Code | 80909 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 846002995 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivities |
| Legal Domicile State | CO | LegalDomicileState |
| Public Charity Status | N/A | 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 | false | 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 | true | 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 | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MEMORIAL HEALTH SYSTEM | ||
| B | 655748 | FMV |
| MEMORIAL HEALTH SYSTEM | ||
| J | 46800 | FMV |
| MEMORIAL HEALTH SYSTEM | ||
| P | 741438 | FMV |
Comments