2023-08-29T07:47:11-05:00 2022-12-31 481026809 Wendling Noe Nelson & Johnson LLC 623 SW 10th Ave Suite 300 Topeka KS 66612 990 2022-01-01 480981990 Coffeyville Regional Medical Center Foundation Inc COFF 6202521674 1400 W 4th Street Coffeyville KS 67337 Lisa Kuehn Director of Development 6202521674 2023-08-19 1 Lisa Kuehn 999009999 0 Ashley R Davis P01483470 7852334226 2023-08-19 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Lisa Kuehn 1400 W 4th Street Coffeyville KS 67337 416331 0 X www.crmcinc.org X 1984 KS To provide support and financial assistance to Coffeyville Regional Medical Center to achieve and maintain excellence as a healthcare provider and leader for the community served. 10 10 0 35 0 0 277732 313403 0 0 101298 70542 4515 10362 383545 394307 126149 403881 0 0 0 0 18026 0 10270 34978 53617 179153 457498 204392 -63191 2701431 2272789 210 221 2701221 2272568 To provide support and financial assistance to Coffeyville Regional Medical Center to achieve and maintain excellence as a healthcare provider and leader for the community served. 0 0 392606 392606 Purchase medical equipment and furnishings for Coffeyville Regional Medical Center and forgive loan due from Coffeyville Regional Medical Center. 4588 1925 Assistance to Coffeyville Regional Medical Center employees. 9350 9350 Scholarship program established to provide individuals who are studying a health-related program with financial assistance. 406544 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X Lisa Kuehn 6202521674 1400 W 4th Street Coffeyville KS 67337 Doug Bell Vice President 1.00 X X 0 0 0 Jeff Gossard Secretary/Treasurer 1.00 X X 0 0 0 Jim Lawrence Trustee 1.00 X 0 0 0 Marlon Thornburg Trustee 1.00 X 0 0 0 Ann Marie Vannoster Trustee 1.00 X 0 0 0 LaKisha Johnson Trustee 1.00 X 0 0 0 Laura Nicastro Trustee 1.00 X 0 0 0 Jodi Hayse President 1.00 X X 0 0 0 Stephanie Richardson Trustee 1.00 X 0 0 0 Richard Voss Trustee 1.00 X 0 0 0 Lisa Kuehn Director of Foundation 32.00 X 0 80422 11586 0 80422 11586 0 0 0 0 0 14626 298777 313403 57835 57835 12707 0 12707 12707 12707 32386 14626 22024 10362 10362 394307 0 0 80904 392606 392606 11275 11275 8208 8208 18989 18989 2239 2239 20 20 559 559 Miscellaneous 20939 10669 10270 Other Program Activitie 2663 2663 457498 406544 40684 10270 181530 139160 388577 388577 56249 53408 44167 2841 2069671 1724565 17486 17646 2701431 2272789 210 221 210 221 X 2008146 1576068 693075 696500 2701221 2272568 2701431 2272789 -63191 -365462 0 X X 1 X 0 1 0 X 273776 183257 163834 265639 298779 1185285 273776 183257 163834 265639 298779 1185285 444679 740606 59845 61742 66631 52425 57833 298476 1483761 0.49910 0.48470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 400668 10883 10883 400668 400668 62314 62314 400668 370668 30000 17809 17809 400668 370668 22011 22011 370668 370668 28901 28901 370668 1.00000 0 0 32533 29692 2841 23716 23716 0 2841 Part V, Line 4: The intended use of the Foundation's endowment funds are to provide students who need financial assistance and have a great desire to become a dietitian with an educational scholarship. Unallocated earnings can be used at the discretion of the Board. Mum sales 18122 18122 10533 Golf Tournament 22009 14626 7383 890 4237 2973 260 1 6881 6881 3131 47012 14626 32386 890 4237 2973 13924 22024 10362 1 Coffeyville Regional Medical Center Inc 1400 W 4th Street Coffeyville KS 67337 481178846 501(c)(3) 147288 245318 Property appraisal Real estate To give property and purchase medical equipment and furnishings for Coffeyville Regional Medical Center. Tuition assistance for students enrolled in a health care field and grants to CRMC employees for emergency assistance. 22 11275 Cash paid Part I, Line 2: Amounts dispersed to the Medical Center and Medical Center employees for emergency assistance are made in response to specific requests. These requests are considered and approved by the Foundation's board. Tuition assistance is approved for disbursement from the Foundation board based on a review of scholarship applications. Disbursements for scholarships are written to the student's university. X 1 170000 Property appraisal 0 0 1 1 Part I, Line 32b: The CRMC Foundation uses the appropriate third party to process and sell any non-cash contribution received. Form 990, Part VI, Section B, line 11b Form 990 was provided to the organization's governing body before it was filed. Form 990, Part VI, Section B, line 12c The organization reviews concerns as they are brought to the attention of management. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon written request. Form 990, Part XII, line 2c The board is provided a copy of the financial statement review report for review and approval. Coffeyville Regional Medical Center Inc 1400 W 4th Street Coffeyville KS 67337 481178846 Acute care hospital providing medical care and services. KS 501(c)(3) Line 3 0 0 1 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0