2024-04-15T10:53:07-05:00 2023-05-31 450250958 EIDE BAILLY LLP 345 N REID PL STE 400 SIOUX FALLS SD 571037034 990 2022-06-01 731719218 MADELIA HEALTH FOUNDATION MADE 5076423255 121 DREW AVE SE MADELIA MN 56062 ALEXANDRA KIECKER EXECUTIVE DIRECTOR 5076423255 2024-04-12 1 ALEXANDRA KIECKER 999009999 1 LAURIE HANSON CPA P00851848 6053391999 2024-04-12 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z DAVID WALZ 121 DREW AVE SE MADELIA MN 56062 130896 0 X WWW.MCHOSPITAL.ORG X 2004 MN TO SUPPORT THE MISSION OF MADELIA HEALTH, INCORPORATED. 11 10 0 35 0 0 61165 103358 0 0 11638 27538 0 0 72803 130896 66173 7772 0 0 40454 58836 0 0 67944 29230 12836 135857 79444 -63054 51452 1034846 1122696 56872 111495 977974 1011201 MADELIA HEALTH FOUNDATION EXISTS TO BE STEWARDS OF DONATIONS GIVEN TO SUPPORT THE STATE-OF-THE-ART HEALTH SERVICES PROVIDED BY MADELIA HEALTH. THE FOUNDATION SERVES AS THE BRIDGE BETWEEN MADELIA HEALTH, ITS PATIENTS, AREA FRIENDS AND SUPPORTERS. 0 0 11500 7772 0 MADELIA HEALTH FOUNDATION EXISTS TO BE STEWARDS OF DONATIONS GIVEN TO SUPPORT THE STATE-OF-THE-ART HEALTH SERVICES PROVIDED BY MADELIA HEALTH. THE FOUNDATION, SERVES AS THE BRIDGE BETWEEN MADELIA HEALTH, ITS PATIENTS, AREA FRIENDS AND SUPPORTERS. 11500 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 0 0 0 MN X ALEXANDRA KIECKER 5076423255 121 DREW AVENUE SOUTHEAST MADELIA MN 56062 JIM HOPMAN BOARD CHAIR 0.20 0.00 X X 0 0 0 JENNIFER BUTLER DIRECTOR/VICE CHAIR BEG 11/22 0.20 0.00 X X 0 0 0 MELANIE KNAAK-GUYER TREASURER 0.20 0.00 X X 0 0 0 GLENDA ARNDT SECRETARY BEG 09/2022 0.20 0.00 X X 0 0 0 BRIAN MCCABE MCH GOVERNING BOARD PRESIDENT 0.20 1.00 X X 0 0 0 PHIL CARTER BOARD MEMEBER 0.20 0.00 X 0 0 0 KELSEY FORBES BOARD MEMEBER BEG 11/22 0.20 0.00 X 0 0 0 EMMA ASKELAND BOARD MEMBER BEG 01/23 0.20 0.00 X 0 0 0 CONNIE MILLER BOARD MEMBER 0.20 0.00 X 0 0 0 DAVID WALZ MCH CEO-EX OFFICIO MEMBER BEG 01/23 0.20 40.00 X X 0 0 0 CARINA PACE BOARD MEMBER BEG 03/23 0.20 0.00 X 0 0 0 JOELEEN KRIER SECRETARY UNTIL 12/22 0.20 0.00 X X 0 0 0 JAKE REDDEN MCH CEO-EX OFFICIO UNTIL 11/22 0.20 40.00 X X 0 233975 0 SARA SCHAUER EXECUTIVE DIRECTOR UNTIL 09/22 32.00 0.00 X 0 25609 1024 BRUCE CARVEN MCH CFO 0.20 40.00 X 0 140684 0 ALLIE KIECKER VICE CHAIR/EXEC DIRECTOR BEG 11/2022 32.00 0.00 X 0 8671 0 0 408939 1024 0 0 1 0 0 103358 103358 27538 27538 130896 0 0 27538 X 7772 7772 55400 55400 3436 3436 1501 1501 3528 3528 3977 3977 3173 3173 102 102 GIFTS 555 555 79444 11500 0 67944 284947 383116 10853 10853 0 0 749899 739580 1034846 1122696 56872 111495 56872 111495 X 618025 651252 359949 359949 977974 1011201 1034846 1122696 51452 -18225 0 X 0 0 0 X X 1 MADELIA HEALTH INC 410758512 3 1 7772 3728 1 7772 3728 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 415694 390 18439 7000 427523 359949 55745 415694 359949 61458 359949 235949 124000 359949 235949 235949 0.00000 0.41000 0.59000 0 0 10853 10853 0 0 DUE TO RELATED PARTY 111495 111495 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS ARE TO BE PERIODICALLY DETERMINED BY THE FOUNDATION BOARD OF DIRECTORS TO SUPPORT THE PURPOSE OF THE FOUNDATION. 1 MADELIA HEALTH 121 DREW AVE SE MADELIA MN 56062 410758512 501(C)(3) 7772 0 FUNDING FOR EQUIPMENT, SUPPLIES, IMPROVEMENTS 1 0 PART I, LINE 2: ALL GRANTS ARE MADE TO A RELATED ORGANIZATION THAT IS UNDER COMMON MANAGEMENT WHO REGULARLY MONITORS THE ACTIVITIES, REVENUES, AND EXPENDITURES OF THE RELATED ORGANIZATION. 0 0 0 0 0 0 0 0 0 JAKE REDDEN MCH CEO-EX OFFICIO UNTIL 11/22 0 164392 0 69583 0 0 0 0 0 0 0 233975 0 0 SCHEDULE J PART I LINE 3 THE FOUNDATION RELIED ON THE RELATED ORGANIZATION, MADELIA HEALTH, FOR DETERMINING THE COMPENSATION FOR THE CEO USING THE METHODS DESCRIBED IN PART I, LINE 3. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRPERSON, THE VICE CHAIRPERSON, THE EXECUTIVE DIRECTOR, THE SECRETARY, AND THE TREASURER AS EX OFFICIO VOTING MEMBERS THEREOF. THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE FULL AUTHORITY OF THE BOARD EXCEPT AS OTHERWISE LIMITED BY LAW, BY THE BOARD, OR BY THESE BYLAWS. THE EXECUTIVE COMMITTEE SHALL TRANSACT THE BUSINESS OF THE FOUNDATION DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE FOUNDATION IS MADELIA HEALTH. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER IS ALLOWED TO ELECT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS SUBSEQUENT TO FILING THE FORM 990 WITH THE IRS. THE FORM 990 WILL BE PRESENTED BY FINANCE AT THE REGULAR MEETING OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL MEMBERS OF THE BOARD AND CORPORATE OFFICERS, AGENTS AND EMPLOYEES OF THE FOUNDATION. IT IS THE OBLIGATION OF THE FOUNDATION'S MANAGEMENT TO PUBLICIZE THIS POLICY TO ALL SUCH PARTIES ON A RECURRING BASIS. THE CONFLICT OF INTEREST POLICY AND AN ANNUAL DISCLOSURE STATEMENT ARE CIRCULATED TO DIRECTORS AND OFFICERS TO ASSIST THEM IN CONSIDERING SUCH DISCLOSURES, BUT DISCLOSURE IS APPROPIRATE WHENEVER A CONFLICT MAY OCCUR. THE WRITTEN NOTICES OF DISCLOSURE OF CONFLICTS OR DUALITIES OF INTEREST ARE FILED WITH THE EXECUTIVE DIRECTOR OR ANY OTHER OFFICER. IF A CONFLICT OF INTEREST EXISTS, THE CONFLICTED INDIVIDUAL REFRAINS FROM BOTH DISCUSSION AND VOTING ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 MADELIA HEALTH FOUNDATION STAFFING IS FUNDED THROUGH MADELIA HEALTH. THAT ENSURES THAT THE COMPENSATION PAID TO ITS EMPLOYEES AND ADMINISTRATIVE STAFF BE CONSISTENT WITH POLICY AND PROVIDE EQUITABLE STANDARDS FOR WAGE AND BENEFITS BASED ON ANNUAL REGIONAL SURVEY OF COMPARABLE ENTITIES. THE GOVERNING BOARD REVIEWS ANNUALLY THE FOUNDATION DIRECTOR'S PERFORMANCE AND THE BASIS IS THE ANNUAL MEDISOTA SALARY SURVEY AND RATE INCREASE AS AWARDED TO ALL STAFF. FORM 990, PART VI, SECTION C, LINE 19 MADELIA HEALTH FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THE ANNUAL CORPORATION MEETING AND UPON REQUEST. FORM 990 PART IX, LINE 5 TO LINE 10 MADELIA HEALTH FOUNDATION DOES NOT HAVE ANY EMPLOYEES. THE SALARY AND BENEFITS EXPENSES ON PAGE 10 OF THE 990 ARE AMOUNTS THAT ARE ALLOCATED TO MADELIA HEALTH FOUNDATION FROM MADELIA HEALTH FOR THE FOUNDATION'S PORTION OF THE EXPENSES. MADELIA HEALTH 121 DREW AVENUE SE MADELIA MN 56062 410758512 HOSPITAL MN 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1