FURP.ORG / PUBLIC DATA EXPLORER

BELOIT HEALTH SYSTEM AUXILIARY INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
BELOIT HEALTH SYSTEM AUXILIARY INC (EIN 39-0928583)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-08-04
IRS object ID
201102239349301800
Schema version
2010v3.2
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

FieldValueIRS element (for citing)
Timestamp2011-08-04T09:21:17-07:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390928583EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BELOIT MEMORIAL HOSPITAL AUXILIARY INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBELONameControl
Phone6083645162Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11969 West Hart RoadAddressLine1
CityBeloitCity
StateWIState
ZIP Code53511ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMarietta AxmearName
TitlePresidentTitle
Phone6083645102Phone
Date Signed2011-07-15DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMarietta AxmearNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11969 West Hart RoadAddressLine1
CityBeloitCity
StateWIState
ZIP Code53511ZIPCode
FieldValueIRS element (for citing)
Gross Receipts407085GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1954YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionProviding support to Beloit Health System and related FoundationActivityOrMissionDescription
Nbr Voting Members Governing Body6NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers400TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1018ContributionsGrantsPriorYear
Contributions Grants Current Year2724ContributionsGrantsCurrentYear
Program Service Revenue Prior Year202588ProgramServiceRevenuePriorYear
Program Service Revenue CY214377ProgramServiceRevenueCY
Investment Income Prior Year3105InvestmentIncomePriorYear
Investment Income Current Year566InvestmentIncomeCurrentYear
Other Revenue Prior Year54691OtherRevenuePriorYear
Other Revenue Current Year61983OtherRevenueCurrentYear
Total Revenue Prior Year261402TotalRevenuePriorYear
Total Revenue Current Year279650TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year40035TotalFundrsngExpCurrentYear
Other Expense Prior Year293943OtherExpensePriorYear
Other Expenses Current Year253178OtherExpensesCurrentYear
Total Expenses Prior Year293943TotalExpensesPriorYear
Total Expenses Current Year253178TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-32541RevenuesLessExpensesPriorYear
Revenues Less Expenses CY26472RevenuesLessExpensesCY
Total Assets BOY241417TotalAssetsBOY
Total Assets EOY268614TotalAssetsEOY
Total Liabilities BOY1439TotalLiabilitiesBOY
Total Liabilities EOY2164TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY239978NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY266450NetAssetsOrFundBalancesEOY
Mission DescriptionProviding support to Beloit Health System and related FoundationMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense114585Expense
Grants0Grants
Revenue201589Revenue
DescriptionLifeline Services: The BMH Auxiliary is able to provide monitors for elderly and disabled citizens of the community in exchange for a subscriber fee. Any income generated by this program will be used for donations to the Beloit Health System Foundation, which supports the Beloit Health System.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense85000Expense
Revenue65269Revenue
DescriptionGifts to Beloit Health System Foundation: Based on income generated from patient services, the gift shop, and various small fundraising events as well as the transfer of monies generated from the Lifeline Program, the Auxiliary is able to donate money to the Beloit Health System Foundation, which main goal is to support the Beloit Health SystemDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense7200Expense
Revenue12792Revenue
DescriptionScholarships: Through tips received at the Hospital Snack Shop and money raised during the Lovelight activity, the Auxiliary is able to award scholarships to graduating seniors within the community of Beloit, WIDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense206785TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org1TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members6NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons0AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement0RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Beloit Memorial Hospital Auxiliary IncBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6083645162TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11969 West Hart RoadAddressLine1
CityBeloitCity
StateWIState
ZIP Code53511ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
Lucile Braden
Director0X000
Maxine Givhan
Director0X000
Betty Johnston
Director0X000
Eleanor Morse
Director0X000
Jane Threinen
Director0X000
Bob Woodard
Director0X000
Marietta Axmear
President0000X
Richard Johnson
Vice President0000X
Joycelyn Ramsden
Secretary0000X
Nancy Schroer
Treasurer0000X
Les Schroeder
Asst Treasurer0000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues1001MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants0GovernmentGrants
All Other Contributions1723AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions2724TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Patient Services900099587358730$0
Lifeline Services9000992015892015890$0
Love Light Event900099691569150$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue214377TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column566TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$566ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other
FieldValueIRS element (for citing)
Gross Income Fundraising Events10640GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses2945FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column7695TotalRevenueColumn
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$7,695ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory178040GrossSalesOfInventory
Cost Of Goods Sold124490CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column53550TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$53,550ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMiscellaneousDescription
Business Code900099BusinessCode
Total Revenue Column738TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$738ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue738TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column279650TotalRevenueColumn
Related Or Exempt Function Income214377RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$62,549ExclusionAmount

Advertising Advertising

FieldValueIRS element (for citing)
Total3185Total
Management And General3185ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2052Total
Management And General2052ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1121Total
Management And General1121ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Giftshop expenses400350040035
Lifeline expenses11458511458500
Scholarships7200720000
Distributions to Foundation850008500000

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total253178Total
Program Services206785ProgramServices
Management And General6358ManagementAndGeneral
Fundraising40035Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY163146BOY
EOY178455EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY78271BOY
EOY90159EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY241417BOY
EOY268614EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1439BOY
EOY2164EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1439BOY
EOY2164EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY239978BOY
EOY266450EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY239978BOY
EOY266450EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY241417BOY
EOY268614EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses26472ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or Review1AccountantCompileOrReview
FS Audited0FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11aForm 990, Part VI, Section B, Line 11aThe Auxiliary's financial statements are compiled by an independent accounting firm. An employee of the Hospital's accounting staff prepares the Auxiliary's Form 990 from those compiled statements. When the 990 is completed, a draft copy of the return is given to the Auxiliary's Executive Committee for review at a regularly scheduled board meeting.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19Statements, documents, and policies are available upon request at the address of the Beloit Memorial Hospital

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Beloit Memorial Hospital Inc
1969 West Hart RoadBeloitWI53511391028081HospitalWI501(c)(3)3N/A0
Beloit Health System Foundation Inc
1969 West Hart RoadBeloitWI53511391477854Support of HospitalWI501(c)(3)3N/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Beloit Health System Foundation IncBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypebTransactionType
Amount Involved85000AmountInvolved
Method Of Amt DeterminationActual cash contributed to Beloit Health System FoundationMethodOfAmtDetermination