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FULCRUM FOUNDATION INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
FULCRUM FOUNDATION INC (EIN 39-2016506)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-04-06
IRS object ID
201800969349301015
Schema version
2016v3.0
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)
Return2018-04-06T16:58:44-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line111 SCOTT STREETAddressLine1Txt
CityWAUSAUCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54403ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN392016506EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Memorial Member Association IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMEMOBusinessNameControlTxt
Phone7157488100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 South Gibson StAddressLine1Txt
CityMedfordCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54451ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonGreg ShawPersonNm
Person TitleCFOPersonTitleTxt
Phone7157488100PhoneNum
Signature2018-03-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKathleen J LaBrake CPAPreparerPersonNm
PTINP00164006PTIN
Phone7158453111PhoneNum
Preparation2018-03-10PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address50.50.56.238IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-03-10IPDt
IP Tm11:52:28IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdFEDE6E2ED2B59B1C13DC36E78E84E5663127854CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRick NeversPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 South Gibson StAddressLine1Txt
CityMedfordCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54451ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,716,810GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2001FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionMEMORIAL MEMBER ASSOCIATION'S PURPOSE IS PROMOTING LOCAL HEALTH CARE AND SUPPORTING OUR LOCAL ORGANIZATIONS.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$35PYContributionsGrantsAmt
CY Contributions Grants$85CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$1,723PYInvestmentIncomeAmt
CY Investment Income$396,700CYInvestmentIncomeAmt
PY Other Revenue$2,663,186PYOtherRevenueAmt
CY Other Revenue$6,201,031CYOtherRevenueAmt
PY Total Revenue$2,664,944PYTotalRevenueAmt
CY Total Revenue$6,597,816CYTotalRevenueAmt
PY Grants And Similar Paid$168,805PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$24,769CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$20,410PYOtherExpensesAmt
CY Other Expenses$13,687CYOtherExpensesAmt
PY Total Expenses$189,215PYTotalExpensesAmt
CY Total Expenses$38,456CYTotalExpensesAmt
PY Revenues Less Expenses$2,475,729PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,559,360CYRevenuesLessExpensesAmt
Total Assets BOY$51,299,113TotalAssetsBOYAmt
Total Assets EOY$58,213,862TotalAssetsEOYAmt
Total Liabilities BOY$12,500TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,162TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$51,286,613NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$58,212,700NetAssetsOrFundBalancesEOYAmt
MissionPROMOTE LOCAL HEALTH CARE AND PROVIDE REPRESENTATION AND OVERSIGHT TO Aspirus Medford Hospital & Clinics, Inc. AND THE ASSOCIATION REPRESENTS THE HEALTH CARE INTERESTS OF OUR COMMUNITIES AND MANAGES THE FINANCIAL ASSETS ENTRUSTED TO US.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$24,769ExpenseAmt
Grant$24,769GrantAmt
Revenue$6,201,031RevenueAmt
DescMEMORIAL MEMBER ASSOCIATION'S PURPOSE IS PROMOTING LOCAL HEALTH CARE AND SUPPORTING OUR LOCAL ORGANIZATIONS. DURING THE FISCAL YEAR, THE ORGANIZATION PROVIDED FINANCIAL DONATIONS TOWARDS A NEW AMBULANCE FOR PRICE COUNTY, IMPACT TESTING FOR TWO SCHOOL DISTRICTS' ATHLETES AND TO NORTHCENTRAL TECHNICAL COLLEGE FOR HEALTHCARE SCHOLARSHIPS. THEY ALSO DONATED TO ASPIRUS MEDFORD HOSPITAL & CLINICS, INC. FOR SUPPORT OF THEIR COMMUNITY NEEDS PROGRAM THAT INCLUDED A CHILDRENS MUSEUM, TAYLOR COUNTY DEMENTIA COUNCIL, TAYLOR COUNTY WELLNESS COUNCIL, BIKE HELMETS AND A SNOWSHOE CLUB GROOMER.Desc
Total Program Service Expenses$24,769TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Greg Shaw CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7157488100PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1135 SOUTH GIBSON STREETAddressLine1Txt
CityMEDFORDCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54451ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
MICHAEL J RIGGLE DVM
DireCTOR1.001.00Yes (X)$0$0$0
MICHAEL E PLOOY
Vice Chair1.001.00Yes (X)$0$0$0Yes (X)
LEONARD W HAMMAN
Treasurer1.001.00Yes (X)$0$0$0Yes (X)
ROBERT F CARPENTER
SECRETARY1.001.00Yes (X)$0$0$0Yes (X)
DEBBIE A WOODS
Chair1.001.00Yes (X)$0$0$0Yes (X)
PERRY A ARNDT OD
DIRECTOR1.001.00Yes (X)$0$0$0
DAVID E KOESTER
dIRECTOR1.001.00Yes (X)$0$0$0
MICHAEL A SCHAEFER
DIRECTOR1.001.00Yes (X)$0$0$0
MARY K SARVER
DIRECTOR1.001.00Yes (X)$0$0$0
Susan Frazier MD
Director/Physician1.001.00Yes (X)$0$0$0
Mitch Mertens
Director1.002.00Yes (X)$0$0$0
Randy Juedes
Director1.002.00Yes (X)$0$0$0
Rick Nevers
Interim President/CEO1.001.00$0$0$0Yes (X)
Greg Shaw
CFO1.002.00$0$0$0Yes (X)
Greg Olson - termed 21417
CEO1.001.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Membership Dues$85MembershipDuesAmt
Total Contributions$85TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$198,570TotalRevenueColumnAmt
Exclusion$198,570ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,317,124SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,118,994SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$198,130SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$198,130TotalRevenueColumnAmt
Exclusion$198,130ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
INVESTMENT INCOME - AMHC621110$6,193,843$6,193,843
INVESTMENT INCOME - AMF621110$130,509$130,509
INVESTMENT INCOME - AES621110-$123,321-$123,321
FieldValueIRS element (for citing)
Other Revenue Total$6,201,031OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,597,816TotalRevenueColumnAmt
Related Or Exempt Func Income$6,201,031RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$396,700ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$24,769TotalAmt
Program Services$24,769ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$6,800TotalAmt
Management And General$6,800ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,000TotalAmt
Management And General$2,000ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$1,290TotalAmt
Management And General$1,290ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,276TotalAmt
Management And General$3,276ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$84TotalAmt
Management And General$84ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$237TotalAmt
Management And General$237ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$38,456TotalAmt
Program Services$24,769ProgramServicesAmt
Management And General$13,687ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,725BOYAmt
EOY$218,308EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$761,632BOYAmt
EOY$761,905EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,814,310BOYAmt
EOY$6,287,594EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$44,717,527BOYAmt
EOY$50,937,899EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$919BOYAmt
EOY$8,156EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$51,299,113BOYAmt
EOY$58,213,862EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$12,500BOYAmt
EOY$1,162EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,500BOYAmt
EOY$1,162EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$50,744,721BOYAmt
EOY$57,605,455EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$421,892BOYAmt
EOY$487,245EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$120,000BOYAmt
EOY$120,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$51,286,613BOYAmt
EOY$58,212,700EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$51,299,113BOYAmt
EOY$58,213,862EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$6,559,360ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$347,386NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$19,341OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Aspirus Medford Hospital FoundationBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN391777081EIN
Organization Type7OrganizationTypeCd
Governing Document Listed0GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing Doc0ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported Org0MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SECTION A, LINE 1Memorial Member Association's governing documents do not list Aspirus Medford Foundation, Inc; however, the governing documents indicate Memorial Member Association may support other organizations exempt from taxation and qualifed as non-private foundations as may be affiliated with Memorial Member Association. The purposes of Memorial Member Association includes but is not limited to: - Organized and operated for the benefit of, perform the functions of, and carry out the purposes of Aspirus Medford Hospital & Clinics, Inc., a tax exempt organization. - Solicit, receive, or otherwise acquire, hold, manage, invest, and expend endowment funds and other gifts, grants and bequests, whether consisting of real estate or personal property, and whether subject to directions or conditions imposed by the donor, exclusively for the benefit and advancement of the Supported Organizations, and such of its research, education, charitable programs, or activities as the Board of Directors of this Corporation from time to time deem to be suitable and appropriate. Through the support given by Memorial Member Association to Aspirus Medford Foundation, Inc., Memorial Member Association lives out its exempt purpose as the Foundation supports the needs of Aspirus Medford Hospital & Clinics, Inc. In addition Memorial Member Association is the sole corporate member of Aspirus Medford Foundation, Inc.
Part IV, Section C, Line 1ALTHOUGH THE ORGANIZATION'S DIRECTORS DURING THE TAX YEAR WERE NOT ALSO A MAJORITY OF THE DIRECTORS OF THE FOUNDATION, AS THE SOLE MEMBER OF ASPIRUS MEDFORD FOUNDATION, INC., MEMORIAL MEMBER ASSOCIATION RETAINS THE POWER TO DO THE FOLLOWING: TO REVIEW AND APPROVE AUDITED FINANCIAL REPORTS OF THE FOUNDATION; TO APPROVE THE TRANSFER, MERGER OR DISSOLUTION OF THE FOUNDATION OR SALE, LEASE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE FOUNDATION; TO SELECT THE INDEPENDENT AUDITING FIRM; TO APPROVE ANY ACTION WHICH WOULD CHANGE THE CHARACTER OF THE FOUNDATION; TO APPROVE ALL AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THE FOUNDATION; TO APPROVE THE APPOINTMENT OR TERMINATION OF THE EXECUTIVE DIRECTOR OF THE FOUNDATION; TO APPROVE LONG-TERM BORROWING OF MONEY AND OTHER FORMS OF LONG-TERM INDEBTEDNESS; TO APPOINT AND REMOVE ALL MEMBERS OF THE BOARD OF DIRECTORS OF THE FOUNDATION.

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

FieldValueIRS element (for citing)
Book Value$50,937,899BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$50,937,899TotalBookValueSecuritiesAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1Central Price County Ambulance Service IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1315 S Avon AvenueAddressLine1Txt
CityPhillipsCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54555ZIPCd
FieldValueIRS element (for citing)
Recipient EIN391138281RecipientEIN
IRC Section501(c)4IRCSectionDesc
Cash Grant$10,000CashGrantAmt
Purpose Of GrantNew AmbulancePurposeOfGrantTxt
FieldValueIRS element (for citing)
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationMEMORIAL MEMBER ASSOCIATION, Inc.'S BOARD OF DIRECTORS APPROVES GRANTS TO ORGANIZATIONS BASED ON BOTH THE NEED OF THE ORGANIZATION AND THAT THE GRANT FULFILLS THE MISSION OF MEMORIAL MEMBER ASSOCIATION, Inc.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 3Memorial Member Assocation delegates control of management duties to Aspirus Medford Hospital & Clinics, Inc., a 501(c)(3) organization.
Form 990, Part VI, Section A, line 6THE ORGANIZATION HAS THREE CLASSES OF MEMBERSHIP (1) MEMBERS ADMITTED BY APPLICATION (NO DUES REQUIRED) - INCLUDING BONA FIDE CIVIC, CHARITABLE, FRATERNAL, VETERANS, TRADE, AND PROFESSIONAL ORGANIZATIONS, (2) MEMBERS ADMITTED BY PAYMENT OF MEMBERSHIP FEE - THOSE WHO CONTRIBUTE $500 OR MORE TO THE ORGANIZATION OR TO Aspirus Medford Hospital & Clinics, INC., ARE CONSIDERED LIFE MEMBERS WITH LIFETIME VOTING RIGHTS, YEAR-LONG MEMBERSHIP IS GRANTED FOR $5 DONATED TO THE ORGANIZATION, AND (3) SPECIAL MEMBERSHIP - ALL MEMBERS OF THE AMHC VOLUNTEERS MEMBERSHIP CRITERIA IS FURTHER DEFINED BY THE ORGANIZATION'S BYLAWS.
Form 990, Part VI, Section A, line 7aTHE MEMBERS ELECT THE BOARD OF DIRECTORS.
Form 990, Part VI, Section A, line 7bTHE MEMBERS MUST APPROVE ALL AMENDMENTS TO, OR RESTATEMENTS OF, THE ARTICLES OF INCORPORATION AND THE BYLAWS OF THE CORPORATION.
Form 990, Part VI, Section B, line 11bTHE ACCOUNTING DEPARTMENT ACCUMULATES ALL 990 INFORMATION. THESE DOCUMENTS ARE REVIEWED BY THE CFO. THE 990 IS REVIEWED BY OTHER SENIOR MANAGEMENT PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE AND ARE MADE AVAILABLE TO THE BOARD OF DIRECTORS THROUGH DIRECTOR'S DESK OR OTHER MEANS OF ELECTRONIC RETRIEVAL.
Form 990, Part VI, Section B, line 12cTHE BOARD OR COMMITTEE TO WHICH SUCH DISCLOSURE IS MADE SHALL THEREUPON DETERMINE, BY MAJORITY VOTE, WHETHER THE DISCLOSURE SHOWS THAT A CONFLICT OF INTEREST EXISTS OR CAN REASONABLY BE CONSTRUED TO EXIST. IF A CONFLICT IS DEEMED TO EXIST, SUCH PERSON SHALL NOT VOTE ON, NOR USE PERSONAL INFLUENCE ON, OR PARTICIPATE (OTHER THAN TO PRESENT FACTUAL INFORMATION TO OR RESPOND TO QUESTIONS) IN THE DISCUSSIONS AND DELIBERATIONS WITH RESPECT TO SUCH CONTRACT OR TRANSACTIONS. SUCH PERSON MAY BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM AT ANY MEETING WHERE THE CONTRACT OR TRANSACTION IS UNDER DISCUSSIONS OR IS BEING VOTED UPON. THE MINUTES OF THE MEETING SHALL REFLECT THE DISCLOSURE MADE, THE VOTE THEREON AND, WHERE APPLICABLE, THE ABSTENTION FROM VOTING AND PARTICIPATION, AND WHETHER A QUORUM WAS PRESENT.
Form 990, Part VI, Section B, line 15FOR PURPOSES OF DETERMINING COMPENSATION, MEMORIAL MEMBER ASSOCIATION, INC. RELIED ON RELATED ORGANIZATIONS TO ESTABLISH THE COMPENSATION OF THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE RELATED ORGANIZATIONS USED THE FOLLOWING PRACTICES FOR ESTABISHING COMPENSATION FOR SUCH INDIVIDUALS: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Form 990, Part VI, Section C, line 19THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, GOVERNING DOCUMENTS, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION A, LINE 3:AT THE OPTION OF THE BOARD OF DIRECTORS, AN EXECUTIVE COMMITTEE MAY BE CREATED, TO CONSIST OF THE CHAIRMAN, VICE CHAIRMAN, SECRETARY, AND TREASURER OF THE CORPORATION IF ESTABLISHED, THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD OF DIRECTORS. IN ADDITION, THE EXECUTIVE COMMITTEE SHALL RECOMMEND TO THE FULL BOARD OF DIRECTORS THE APPOINTMENT OF A PERSON OR PERSONS TO FILL ANY VACANCY AMONG THE DIRECTORS OF Aspirus Medford Hospital & Clinics, INC. THAT ARE APPOINTED BY THE CORPORATION.
FORM 990, PART VII, SECTION AALL MEMBERS OF MEMORIAL MEMBER ASSOCIATION, INC.'S BOARD OF DIRECTORS SERVE ON THE BOARD OF CEDAR COURT APARTMENTS, Inc. MATTERS INVOLVING CEDAR COURT APARTMENTS, Inc. ARE RESOLVED DURING REGULARLY SCHEDULED MEETINGS OF MEMORIAL MEMBER ASSOCIATION, Inc.'S BOARD, AS SUCH, NO ADDITIONAL TIME HAS BEEN ALLOCATED TO THE RELATED ORGANIZATION.
Form 990, Part XI, line 9:EQUITY ADJUSTMENT - AMHC 88,409. Equity Adjustment - AES -69,068.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Aspirus Medford Foundation Inc
135 S GIBSON STMEDFORDWI54451391777081CHARITABLE FUNDRAISINGWI501(c)(3)Line 12c, III-FIMEMORIAL MEMBER ASSOCIATION INCYes (1)
CEDAR COURT APARTMENTS INC
135 S GIBSON STMEDFORDWI54451391412339LOW INCOME HOUSINGWI501(c)(3)Line 7MEMORIAL MEMBER ASSOCIATION INCYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd