2020-10-01T14:31:56-05:00 2019-12-31 481026809 Wendling Noe Nelson & Johnson LLC 534 S Kansas Ave Suite 1500 Topeka KS 666033491 990 2019-01-01 480981990 Coffeyville Regional Medical Center Foundation COFF 6202521674 PO Box 305 Coffeyville KS 67337 Stephanie Richardson President 6202521674 2020-09-16 1 Eric L Otting P00298454 7852334226 2020-09-16 98.172.114.81 2020-09-16 07:50:39 CD P 231F5351FFCE24D6429EC3617081DE3E5F614D64 DD624716CB6FA551C680B6371A13340D49C622CD 2019 2021-01-29 14:40:06Z Stephanie Richardson PO Box 305 Coffeyville KS 67337 379617 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. 11 11 0 45 0 0 273776 187556 0 0 108561 181352 3879 -3726 386216 365182 52207 525023 0 0 0 0 0 0 7115 29550 25765 81757 550788 304459 -185606 2523862 2496733 0 0 2523862 2496733 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 512393 512393 Purchase medical equipment and furnishings for Coffeyville Regional Medical Center. 2130 2130 Cash assistance to Coffeyville Regional Medical Center employees. 10500 10500 Scholarship program established to provide individuals who are studying a health-related program with financial assistance. 525023 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 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 X Lisa Kuehn 6202521594 1400 W 4th Street Coffeyville KS 67337 Doug Bell Trustee 1.00 X 0 0 0 Jeff Gossard Secretary/Treasurer 1.00 X X 0 0 0 Jim Lawrence Trustee 1.00 X 0 0 0 Steve Miller DO 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 Trustee 1.00 X 0 0 0 Stephanie Richardson President 1.00 X X 0 0 0 Richard Voss Vice President 1.00 X X 0 0 0 Cari Redden Director of Foundation 32.00 X 0 30572 31720 0 30572 31720 0 0 0 0 0 18273 169283 187556 61744 61744 119608 0 119608 119608 119608 10709 18273 14435 -3726 -3726 365182 0 0 177626 512393 512393 12630 12630 1685 1685 8990 8990 390 390 75 75 102 102 32 32 2169 2169 Miscellaneous 10717 3602 7115 Amortization 1500 1500 Dues and Subscriptions 105 105 550788 525023 18650 7115 493738 367400 600000 56249 50793 7625 5456 1995946 1487245 26553 36632 2523862 2496733 0 0 X 1419789 1447285 1104073 1049448 2523862 2496733 2523862 2496733 -185606 158477 0 X X 1 X 0 1 0 X 37372 67082 44344 273776 183257 605831 37372 67082 44344 273776 183257 605831 146226 459605 69859 45208 49491 59845 61742 286145 891976 0.51530 0.39870 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 370668 370668 370668 370668 370668 370668 370668 370668 370668 370668 1.00000 0 0 32533 27077 5456 23716 23716 0 5456 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. Golf Tournament 24929 15523 9406 12180 1 4053 2750 1303 2255 28982 18273 10709 14435 14435 -3726 1 Coffeyville Regional Medical Center Inc 1400 W 4th Street Coffeyville KS 67337 481178846 501(c)(3) 512393 To purchase medical equipment and furnishings for Coffeyville Regional Medical Center. 1 Tuition assistance for students enrolled in a health care field and grants to CRMC employees for emergency assistance. 16 12630 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. 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