STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

ANDERSON HOSPITAL FOUNDATION: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
ANDERSON HOSPITAL FOUNDATION (EIN 27-4548522)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-10
IRS object ID
202243149349302809
Schema version
2021v4.2
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)
Return2022-11-10T09:42:07-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FORVIS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1211 N BROADWAY SUITE 600AddressLine1Txt
CityST LOUISCityNm
State AbbreviationMOStateAbbreviationCd
ZIP631022733ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN274548522EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANDERSON HOSPITAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MICHAEL MARSHALLInCareOfNm
Business Name ControlANDEBusinessNameControlTxt
Phone6183916400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16800 STATE ROUTE 162AddressLine1Txt
CityMARYVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62062ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL MARSHALLPersonNm
Person TitleTREASURERPersonTitleTxt
Phone6183916401PhoneNum
Signature2022-05-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMichaelPersonFirstNm
Person LastMarshallPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDONNA J LARSONPreparerPersonNm
PTINP00043751PTIN
Phone3142315544PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKEITH PAGEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16800 STATE ROUTE 162AddressLine1Txt
CityMARYVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62062ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$649,674GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ANDERSONHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2011FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionTHE FOUNDATION ESTABLISHES LONGEVITY OF A DONOR GIFT THROUGH DONATIONS FOR INVESTMENTS, PLANNED GIVING, GRANTS, MEMORIALS, BEQUESTS, NAMING RIGHTS, AND CAMPAIGNS.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$230,104PYContributionsGrantsAmt
CY Contributions Grants$386,748CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$419,638PYInvestmentIncomeAmt
CY Investment Income$230,786CYInvestmentIncomeAmt
PY Other Revenue$30,539PYOtherRevenueAmt
CY Other Revenue-$36,887CYOtherRevenueAmt
PY Total Revenue$680,281PYTotalRevenueAmt
CY Total Revenue$580,647CYTotalRevenueAmt
PY Grants And Similar Paid$200PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$99,731PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$110,937CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$175,380CYTotalFundraisingExpenseAmt
PY Other Expenses$41,946PYOtherExpensesAmt
CY Other Expenses$64,943CYOtherExpensesAmt
PY Total Expenses$141,877PYTotalExpensesAmt
CY Total Expenses$175,880CYTotalExpensesAmt
PY Revenues Less Expenses$538,404PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$404,767CYRevenuesLessExpensesAmt
Total Assets BOY$7,489,598TotalAssetsBOYAmt
Total Assets EOY$8,699,795TotalAssetsEOYAmt
Total Liabilities BOY$10,324TotalLiabilitiesBOYAmt
Total Liabilities EOY$16,973TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,479,274NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,682,822NetAssetsOrFundBalancesEOYAmt
MissionANDERSON HOSPITAL FOUNDATION PROVIDES FUNDING FOR ANDERSON HOSPITAL CAPITAL IMPROVEMENTS TO ADDRESS EXCELLENCE IN HEALTHCARE AND WELLNESS SERVICES IN PARTNERSHIP WITH THE COMMUNITIES IT SERVES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
DescTHE ORGANIZATION UNDERTAKES VARIOUS FUNDRAISING CAMPAIGNS AND SPECIAL EVENTS TO RAISE FUNDS TO SUPPORT THE HEALTH CARE ACTIVITIES OF ANDERSON HOSPITAL.Desc
Total Program Service Expenses$0TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMICHAEL MARSHALLPersonNm
Phone6183916402PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16800 STATE ROUTE 162AddressLine1Txt
CityMARYVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62062ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
KEITH PAGE
DIRECTOR5.035.0Yes (X)$0$505,014$110,804
MICHAEL MARSHALL
TREASURER5.035.0Yes (X)$0$295,860$51,890Yes (X)
K MAX EAKIN
CO-CHAIR2.00.32Yes (X)$0$230,444$0Yes (X)
LENDELL PHELPS
DIRECTOR2.00.28Yes (X)$0$0$0
JOE NEWMAN
DIRECTOR2.00.0Yes (X)$0$0$0
NANCY LEVAULT
DIRECTOR2.00.0Yes (X)$0$0$0
JEFF WESTERHOLD
DIRECTOR2.00.0Yes (X)$0$0$0
MARK SHASHEK
DIRECTOR2.00.72Yes (X)$0$0$0
JASON WEISS
CO-CHAIR2.00.0Yes (X)$0$0$0Yes (X)
JASON GEMINN
DIRECTOR2.00.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,031,318TotReportableCompRltdOrgAmt
Total Other Compensation$162,694TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$303,476FundraisingAmt
All Other Contributions$83,272AllOtherContributionsAmt
Total Contributions$386,748TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$140,964TotalRevenueColumnAmt
Exclusion$140,964ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$89,822SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$89,822SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$89,822TotalRevenueColumnAmt
Exclusion$89,822ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$32,140FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$303,476ContriRptFundraisingEventAmt
Fundraising Direct Expenses$69,027FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$36,887TotalRevenueColumnAmt
Exclusion-$36,887ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$580,647TotalRevenueColumnAmt
Exclusion$193,899ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$89,222TotalAmt
Fundraising$89,222FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$21,715TotalAmt
Fundraising$21,715FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$500TotalAmt
Management And General$500ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$17,004TotalAmt
Fundraising$17,004FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,623TotalAmt
Fundraising$2,623FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtFundraisingFundraisingAmt
DUES & SUBSCRIPTIONS$4,769$4,769
FUNDRAISING EXPENSES$35,687$35,687
MISCELLANEOUS EXPENSE$601$601
BANK FEES$3,759$3,759

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$175,880TotalAmt
Program Services$0ProgramServicesAmt
Management And General$500ManagementAndGeneralAmt
Fundraising$175,380FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$327,080BOYAmt
EOY$229,806EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,894BOYAmt
EOY$1,559EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,466BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$7,158,158BOYAmt
EOY$8,468,430EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$7,489,598BOYAmt
EOY$8,699,795EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,209BOYAmt
EOY$3,743EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,115BOYAmt
EOY$13,230EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,324BOYAmt
EOY$16,973EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,476,805BOYAmt
EOY$8,680,353EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,469BOYAmt
EOY$2,469EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,479,274BOYAmt
EOY$8,682,822EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,489,598BOYAmt
EOY$8,699,795EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$404,767ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$798,781NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$196,717CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$493,833CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$347,649CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$230,104CurrentTaxYearMinus1YearAmt
Current Tax Year$386,748CurrentTaxYearAmt
Total$1,655,051TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$196,717CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$493,833CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$347,649CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$230,104CurrentTaxYearMinus1YearAmt
Current Tax Year$386,748CurrentTaxYearAmt
Total$1,655,051TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$526,483SubstantialContributorsTotAmt
Public Support Total170$1,128,568PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$105,998CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$132,402CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$163,597CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$126,313CurrentTaxYearMinus1YearAmt
Current Tax Year$140,964CurrentTaxYearAmt
Total$669,274TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$118,284CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$154,486CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$112,116CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$30,539CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$415,425TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$2,739,750TotalSupportAmt
Public Support CY1700.41192PublicSupportCY170Pct
Public Support PY1700.36438PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp
EquipmentEquipmentGrp
Other Land BuildingsOtherLandBuildingsGrp
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO ANDERSON HOSPDesc
Amt$13,230Amt
FieldValueIRS element (for citing)
Total Liability$13,230TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2FormAndLineReferenceDesc
ExplanationUNCERTAIN TAX POSITIONS UNDER FIN 48 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GALAEvent1Nm
Gross Receipts Event1$224,856GrossReceiptsEvent1Amt
Charitable Contri Event1$200,056CharitableContriEvent1Amt
Gross Revenue Event1$24,800GrossRevenueEvent1Amt
Other Direct Expenses Event1$35,770OtherDirectExpensesEvent1Amt
Event2GOLFEvent2Nm
Gross Receipts Event2$51,960GrossReceiptsEvent2Amt
Charitable Contri Event2$51,920CharitableContriEvent2Amt
Gross Revenue Event2$40GrossRevenueEvent2Amt
Cash Prizes Event2$2,880CashPrizesEvent2Amt
Non Cash Prizes Event2$4,436NonCashPrizesEvent2Amt
Rent Facility Costs Event2$5,880RentFacilityCostsEvent2Amt
Food And Beverage Event2$5,508FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$369OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$58,800GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$51,500CharitableContriOtherEventsAmt
Gross Revenue Other Events$7,300GrossRevenueOtherEventsAmt
Non Cash Prizes Other Events$1,989NonCashPrizesOtherEventsAmt
Rent Fclty Costs Other Events$10,530RentFcltyCostsOtherEventsAmt
Oth Direct Expnss Other Events$1,665OthDirectExpnssOtherEventsAmt
Gross Receipts Total$335,616GrossReceiptsTotalAmt
Charitable Contributions Tot$303,476CharitableContributionsTotAmt
Gross Revenue Total Events$32,140GrossRevenueTotalEventsAmt
Cash Prizes Total Events$2,880CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$6,425NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$16,410RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$5,508FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$37,804OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$69,027DirectExpenseSummaryEventsAmt
Net Income Summary-$36,887NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
KEITH PAGE
DIRECTOR$0$462,811$0$0$0$42,203$0$90,454$0$20,350$0$615,818
MICHAEL MARSHALL
TREASURER$0$282,738$0$0$0$13,122$0$22,481$0$29,409$0$347,750
K MAX EAKIN
CO-CHAIR$0$230,060$0$0$0$384$0$0$0$0$0$230,444

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 4BKEITH PAGE PARTICIPATES IN A SEC. 457(F) PLAN ADMINISTERED BY A RELATED ORGANIZATION. A CONTRIBUTION IN THE AMOUNT OF $19,500 WAS ACCRUED FOR 2021.
SCHEDULE J, PART I, LINE 3METHOD USED TO ESTABLISH COMPENSATION OF EXECUTIVE DIRECTOR THE EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY ANDERSON HOSPITAL, A RELATED ENTITY. COMPENSATION IS REVIEWED AND DETERMINED BY THE TREASURER OF THE FOUNDATION.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6ORGANIZATION'S GOVERNING BODY THE BYLAWS OF THE ORGANIZATION WERE AMENDED ON MARCH 15, 2018 TO NAME ANDERSON HOSPITAL AS THE SOLE CORPORATE MEMBER OF THE FOUNDATION. ANDERSON HOSPITAL APPOINTS THE DIRECTORS OF THE ORGANIZATION AND APPROVES SIGNIFICANT DECISIONS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7AANDERSON HOSPITAL HAS THE RIGHT TO APPOINT MEMBERS OF THE ORGANIZATION'S GOVERNING BODY AND TO APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING CORPORATE POWERS AND RESPONSIBILITIES SHALL BE RESERVED TO ANDERSON HOSPITAL, THE SOLE CORPORATE MEMBER: REVISIONS TO THE MISSION AND VALUES OF THE FOUNDATION; AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FOUNDATION, AND ORGANIZING DOCUMENTS OF ANY AFFILIATE OF THE FOUNDATION; APPOINTMENT AND REMOVAL OF MEMBERS OF THE BOARD; APPROVAL OF THE STRATEGIC PLAN, GOALS AND OBJECTIVES; APPROVAL OF ALL BUDGETS; APPROVAL OF UNBUDGETED EXPENDITURES IN EXCESS OF $25,000; APPROVAL OF THE ASSIGNMENT, TRANSFER OR SALE OF ANY ASSETS IN EXCESS OF $25,000; APPROVAL OF THE LEASE ON ANY OF THE ASSETS OF THE FOUNDATION IN EXCESS OF $25,000; AUTHORIZATION AND APPROVAL OF THE INCURRENCE OF DEBT, GRANT OF SECURITY INTEREST, ENCUMBRANCES OR COVENANTS; APPROVAL OF A PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION; APPROVAL OF THE AFFILIATION WITH ANOTHER HOSPITAL OR HEALTH CARE FACILITY OR SYSTEM; APPROVAL OF THE CREATION, OWNERSHIP OR ACQUISITION OF ANOTHER ORGANIZATION; APPROVAL OF DECISIONS TO INDEMNIFY AN INDIVIDUAL.
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 IS REVIEWED BY THE CEO AND THE CFO OF THE HOSPITAL.
FORM 990, PART VI, SECTION B, LINE 12CPROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE COMPLIANCE OFFICER REVIEWS AND MONITORS THE POLICY ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 15A & 15BREVIEW OF CEO OR TOP MANAGEMENT OFFICIAL COMPENSATION NEITHER THE ORGANIZATION, NOR A RELATED ORGANIZATION, COMPENSATED A CEO OR TOP MANAGEMENT OFFICIAL DURING 2021.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
FRIENDS OF COMMUNITY MEMORIAL HOSPITAL
400 N CALDWELL STREETSTAUNTONIL62088363913722FUNDRAISINGIL501(C)(3)10CHSfalse
ANDERSON HOSPITAL
6800 STATE ROUTE 162MARYVILLEIL62062370662561HEALTH CAREIL501(C)(3)3ANDERSON HCfalse
COMMUNITY HOSPITAL OF STAUNTON
400 CALDWELL STREETSTAUNTONIL62088370624255HEALTH CAREIL501(C)(3)3ANDERSON HCfalse
ANDERSON HEALTHCARE
6800 STATE ROUTE 162MARYVILLEIL62062843965822HEALTH CAREIL501(C)(3)12C, III-FINAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
ANDERSON SURGERY CENTER LLC
6800 STATE ROUTE 162MARYVILLEIL62062834200085SURGERYILANDERSON HSPN/A
ANDERSON REHABILITATION INSTITUTE
680 S 4TH STLOUISVILLEKY40202832844780HEALTH CAREILANDERSON HSPN/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd