2021-12-01T10:09:48-06:00 2021-06-30 420794029 DENMAN & COMPANY LLP 1601 22ND STREET SUITE 400 WEST DES MOINES IA 502661453 990 2020-07-01 263296941 CLARKE COUNTY HOSPITAL FOUNDATION CLAR 6413425342 MIKE THILGES OSCEOLA IA 502131694 MIKE THILGES CFO 6413425342 2021-12-01 1 MIKE THILGES XXX-XX-XXXX STEVE SCHWEIZER P01238619 5152258400 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MIKE THILGES 800 S FILLMORE STREET OSCEOLA IA 50213 79310 0 X N/A X 2008 IA TO PROMOTE AND ADVANCE THE WELFARE OF THE CLARKE COUNTY HOSPITAL. 6 6 0 18 0 0 158413 65779 11263 954 380 184 13403 12393 183459 79310 255010 97970 0 0 0 0 0 0 0 10793 7064 265803 105034 -82344 -25724 314358 288634 0 0 314358 288634 TO PROMOTE AND TO ADVANCE THE WELFARE OF THE CLARKE COUNTY HOSPITAL. 0 0 100988 93970 954 TO PROMOTE AND ADVANCE THE WELFARE OF CLARKE COUNTY PUBLIC HOSPITAL. 4000 4000 TO PROVIDE SCHOLARSHIPS TO STUDENTS PURSUING A CAREER IN THE MEDICAL FIELD. 104988 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 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 6 6 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X MIKE THILGES 6413425342 800 S FILLMORE STREET OSCEOLA IA 50213 X BRIAN EVANS PRESIDENT 1.00 X X 0 0 0 RON SCHLICHTE VICE PRESIDENT 1.00 X X 0 0 0 KIM WHITE SECRETARY/TREASURER 1.00 X X 0 0 0 DR JIM KIMBALL DIRECTOR 0.50 X 0 0 0 ROSIE BRAND DIRECTOR 0.50 X 0 0 0 JANET JORGENSON DIRECTOR 0.50 X 0 0 0 0 0 0 0 0 0 0 0 65779 65779 GIFT SHOP REVENUE 453220 577 577 SNACK SHOP REVENUE 722210 377 377 954 184 184 12393 0 12393 12393 79310 954 0 12577 93970 93970 4000 4000 46 46 SPRING FLOWER AND PLANT 2316 2316 MISCELLANEOUS EXPENSE 2263 2263 LADIES IN BLOOM EXPENSE 1350 1350 SNACK SHOP EXPENSE 778 778 311 311 105034 104988 46 0 314358 288634 314358 288634 0 0 X 314358 288634 314358 288634 314358 288634 -25724 0 X X 0 1 X 1 0 X X 1 CLARKE COUNTY HOSPITAL 426037982 3 0 93970 0 1 93970 0 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 0 X PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) FOR AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS EVALUATED THEIR MATERIAL TAX POSITIONS AND DETERMINED THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURES IN THE FINANCIAL STATEMENTS. THE FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAX AUTHORITIES; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES THE FOUNDATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2017. 0 CLARKE COUNTY PUBLIC HOSPITAL 800 S FILLMORE STREET OSCEOLA IA 50213 426037982 93970 TO PROMOTE AND TO ADVANCE THE WELFARE OF THE CLARKE COUNTY PUBLIC HOSPITAL FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT AND THE BOARD OF DIRECTORS REVIEW THE FORM 990 BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE UPDATED ANNUALLY BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL RECORDS AND OTHER OFFICIAL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: THERE HAS BEEN NO CHANGE IN THE SELECTION OR OVERSIGHT OF THE INDEPENDENT ACCOUNTANT FROM THE PRIOR REPORTING PERIOD. CLARKE COUNTY PUBLIC HOSPITAL 800 S FILLMORE STREET OSCEOLA IA 50213 426037982 HEALTHCARE IA 115 MUNICIPAL HOSPITAL 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 CLARKE COUNTY PUBLIC HOSPITAL B 93970 CASH DISBURSEMENTS