WINNESHIEK MEDICAL CENTER FOUNDATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: WINNESHIEK MEDICAL CENTER FOUNDATION (EIN 42-1237298)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2016-11-15
IRS object ID: 201633209349308388
Schema version: 2015v2.1
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule I
Schedule M
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-11-15T13:20:45-06:00	ReturnTs
Tax Period End	2016-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	421040336	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	HACKER NELSON & CO PC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 507	AddressLine1Txt
City	DECORAH	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52101	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	421237298	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WINNESHIEK MEDICAL CENTER	BusinessNameLine1Txt
Business Name Line2	FOUNDATION	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	WINN	BusinessNameControlTxt
Phone	5633873037	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	901 MONTGOMERY	AddressLine1Txt
City	DECORAH	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52101	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JOHN NOEL	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	5633873037	PhoneNum
Signature	2016-11-08	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	NEIL W SCHRAEDER	PreparerPersonNm
PTIN	P00070334	PTIN
Phone	5633823637	PhoneNum
Preparation	2016-11-11	PreparationDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2017-02-10 21:41:12Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JOHN NOEL	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	901 MONTGOMERY	AddressLine1Txt
City	DECORAH	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52101	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$563,731	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.WINMEDICAL.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1984	FormationYr
Legal Domicile State	IA	LegalDomicileStateCd
Activity Or Mission	TO RECEIVE CONTRIBUTIONS FOR CAPITAL EXPENDITURES NOT AVAILABLE THROUGH BUDGET PROCESS.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	11	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$134,401	PYContributionsGrantsAmt
CY Contributions Grants	$563,456	CYContributionsGrantsAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$355	PYInvestmentIncomeAmt
CY Investment Income	$275	CYInvestmentIncomeAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$134,756	PYTotalRevenueAmt
CY Total Revenue	$563,731	CYTotalRevenueAmt
PY Grants And Similar Paid	$95,530	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$32,097	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$13,684	CYTotalFundraisingExpenseAmt
PY Other Expenses	$63,696	PYOtherExpensesAmt
CY Other Expenses	$47,262	CYOtherExpensesAmt
PY Total Expenses	$159,226	PYTotalExpensesAmt
CY Total Expenses	$79,359	CYTotalExpensesAmt
PY Revenues Less Expenses	-$24,470	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$484,372	CYRevenuesLessExpensesAmt
Total Assets BOY	$446,118	TotalAssetsBOYAmt
Total Assets EOY	$1,409,147	TotalAssetsEOYAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$446,118	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,409,147	NetAssetsOrFundBalancesEOYAmt
Mission	TO RECEIVE CONTRIBUTIONS FOR CAPITAL EXPENDITURES NOT AVAILABLE THROUGH BUDGET PROCESS.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$49,562	ExpenseAmt
Grant	$32,097	GrantAmt
Desc	TO RECEIVE CONTRIBUTIONS FOR CAPITAL EXPENDITURES NOT AVAILABLE THROUGH LOCAL TAXES AND BUDGET PROCESS.	Desc
Total Program Service Expenses	$49,562	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	false	OperateHospitalInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	false	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (true)	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	false	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	WINNESHIEK MEDICAL CENTER	PersonNm
Phone	5633822911	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	901 MONTGOMERY	AddressLine1Txt
City	DECORAH	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52101	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
DAWN MUHLBAUER
VICE-PRESIDE	1.00	Yes (X)	Yes (X)	$0	$0	$0
JOHN NOEL
PRESIDENT	1.00	Yes (X)	Yes (X)	$0	$0	$0
DAN FRETHEIM
SECRETARY/TR	1.00	Yes (X)	Yes (X)	$0	$0	$0
KERI BODENSTEINER
DIRECTOR	1.00	Yes (X)		$0	$0	$0
JERRY SAMUELSON
DIRECTOR	1.00	Yes (X)		$0	$0	$0
AMY BRUENING
DIRECTOR	1.00	Yes (X)		$0	$0	$0
CHRIS REDENIUS
DIRECTOR	1.00	Yes (X)		$0	$0	$0
KARLA ERDMAN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
BRADLEY ORVIS
DIRECTOR	1.00	Yes (X)		$0	$0	$0
WENDY MIHM-HEROLD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
DAN RYAN
DIRECTOR	1.00	Yes (X)		$0	$0	$0

Field	Value	IRS element (for citing)
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	false	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd
All Other Contributions	$563,456	AllOtherContributionsAmt
Noncash Contributions	$38,833	NoncashContributionsAmt
Total Contributions	$563,456	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$275	TotalRevenueColumnAmt
Related Or Exempt Func Income	$275	RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$563,731	TotalRevenueColumnAmt
Related Or Exempt Func Income	$275	RelatedOrExemptFuncIncomeAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$32,097	TotalAmt
Program Services	$32,097	ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$27,668	TotalAmt
Program Services	$11,372	ProgramServicesAmt
Management And General	$11,208	ManagementAndGeneralAmt
Fundraising	$5,088	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$4,721	TotalAmt
Fundraising	$4,721	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$6,903	TotalAmt
Management And General	$3,028	ManagementAndGeneralAmt
Fundraising	$3,875	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$6,093	TotalAmt
Program Services	$6,093	ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDesc	TotalTotalAmt	Management And GeneralManagementAndGeneralAmt
CREDIT CARD FEES	$1,827	$1,827
BANK FEES	$50	$50

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$79,359	TotalAmt
Program Services	$49,562	ProgramServicesAmt
Management And General	$16,113	ManagementAndGeneralAmt
Fundraising	$13,684	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$44	BOYAmt
EOY	$44	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$446,074	BOYAmt
EOY	$722,981	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$38,833	LandBldgEquipCostOrOtherBssAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
EOY	$38,833	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
EOY	$647,289	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$446,118	BOYAmt
EOY	$1,409,147	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$446,011	BOYAmt
EOY	$761,751	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
EOY	$627,579	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$107	BOYAmt
EOY	$19,817	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$446,118	BOYAmt
EOY	$1,409,147	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$446,118	BOYAmt
EOY	$1,409,147	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$484,372	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$478,657	OtherChangesInNetAssetsAmt
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	false	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Supporting Organization509a3	Yes (X)	SupportingOrganization509a3Ind
Supporting Org Type3 Func Int	Yes (X)	SupportingOrgType3FuncIntInd
Supported Organizations	1	SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	WINNESHIEK MEDICAL CENTER	BusinessNameLine1Txt
Business Name Line2	WINNESHIEK MEDICAL CENTER	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
EIN	420680467	EIN
Organization Type	3	OrganizationTypeCd
Governing Document Listed	Yes (true)	GoverningDocumentListedInd
Support	$32,097	SupportAmt
Other Support	$0	OtherSupportAmt

Field	Value	IRS element (for citing)
Supported Organizations Total	1	SupportedOrganizationsTotalCnt
Support Sum	$32,097	SupportSumAmt
Other Support Sum	$0	OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

Field	Value	IRS element (for citing)
Listed By Name Governing Doc	Yes (true)	ListedByNameGoverningDocInd
Suprt Org No IRS Determination	false	SuprtOrgNoIRSDeterminationInd
Supported Org Section C456	false	SupportedOrgSectionC456Ind
Supported Org Not Organized US	false	SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org	false	OrganizationChangeSuprtOrgInd
Support Non Supported Org	false	SupportNonSupportedOrgInd
Payment Substantial Contribtr	false	PaymentSubstantialContribtrInd
Loan Disqualified Person	false	LoanDisqualifiedPersonInd
Controlled Disqualified Prsn	false	ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int	false	DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int	false	DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules	false	ExcessBusinessHoldingsRulesInd
Contribution Controller	false	ContributionControllerInd
Contribution Family	false	ContributionFamilyInd
Contribution35 Controlled	false	Contribution35ControlledInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

Field	Value	IRS element (for citing)
Timely Provided Documents	false	TimelyProvidedDocumentsInd
Officers Close Relationship	Yes (true)	OfficersCloseRelationshipInd
Supported Org Voice Investment	false	SupportedOrgVoiceInvestmentInd

Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp

Field	Value	IRS element (for citing)
Activities Test	Yes (X)	ActivitiesTestInd
Activities Further Exempt Prps	Yes (true)	ActivitiesFurtherExemptPrpsInd
Activities Engaged Org Invlmnt	Yes (true)	ActivitiesEngagedOrgInvlmntInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART IV, SECTION E, LINE 2A	WINNESHIEK MEDICAL CENTER FOUNDATION PURCHASES MEDICAL EQUIPMENT FOR WINNESHIEK MEDICAL CENTER. IT ALSO ASSISTS WITH EDUCATION AND SUPPORT GROUPS.
PART IV, SECTION E, LINE 2B	WINNESHIEK MEDICAL CENTER FOUNDATION IS TO RECEIVE CONTRIBUTIONS FOR CAPITAL EXPENDITURES NOT AVAILABLE THROUGH LOCAL TAXES AND BUDGET PROCESS.

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$107	BeginningYearBalanceAmt
Contributions	$647,469	ContributionsAmt
End Year Balance	$647,576	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$8,190	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$264	InvestmentEarningsOrLossesAmt
Other Expenditures	$7,819	OtherExpendituresAmt
End Year Balance	$107	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$8,167	BeginningYearBalanceAmt
Investment Earnings Or Losses	$23	InvestmentEarningsOrLossesAmt
End Year Balance	$8,190	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$8,255	BeginningYearBalanceAmt
Investment Earnings Or Losses	$32	InvestmentEarningsOrLossesAmt
Other Expenditures	$120	OtherExpendituresAmt
End Year Balance	$8,167	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$8,540	BeginningYearBalanceAmt
Investment Earnings Or Losses	$65	InvestmentEarningsOrLossesAmt
Other Expenditures	$350	OtherExpendituresAmt
End Year Balance	$8,255	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.96940	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.03060	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (true)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$38,833	OtherCostOrOtherBasisAmt
Book Value	$38,833	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$38,833	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
QUASI ENDOWMENT	$627,579
ENDOWMENT FUND	$19,710

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$647,289	TotalBookValueOtherAssetsAmt

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	false	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WINNESHIEK MEDICAL CTR	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	901 MONTGOMERY ST	AddressLine1Txt
City	DECORAH	CityNm
State Abbreviation	IA	StateAbbreviationCd
ZIP	52101	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	420680467	RecipientEIN
Cash Grant	$32,097	CashGrantAmt
Purpose Of Grant	CLINIC AND MISC	PurposeOfGrantTxt

Schedule M IRS990ScheduleM

Real Estate Other RealEstateOtherGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$38,833	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FAIR MARKET VALUE	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	false	ReviewProcessUnusualNCGiftsInd
Third Parties Used	false	ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 7A	THE CHIEF ADMINISTRATIVE OFFICER OF WINNESHIEK MEDICAL CENTER SHALL SERVE AS AN EX-OFFICIO NONVOTING MEMBER OF THE BOARD.
FORM 990, PAGE 6, PART VI, LINE 11B	THE BOARD WILL REVIEW THE FORM 990 PRIOR TO THE BOARD SECRETARY'S SIGNATURE AND FILING OF THE RETURN.
FORM 990, PAGE 6, PART VI, LINE 12C	ANNUALLY, ALL BOARD MEMBERS RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY. THEY SUBMIT A SIGNED AND DATED FORM THAT AFFIRMS THAT THEY HAVE READ, UNDERSTAND, AND AGREE TO THE STANDARDS SET FORTH IN THE POLICY.
FORM 990, PAGE 6, PART VI, LINE 19	DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9	TO RECORD ASSETS HELD AT COMMUNITY FOUNDATION 478,657 TOTAL 478,657