STRATEGY STUDIO / PUBLIC DATA EXPLORER

RONALD MCDONALD HOUSE CHARITIES OF MARSHFIELD INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
RONALD MCDONALD HOUSE CHARITIES OF MARSHFIELD INC (EIN 93-0833012)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-06-08
IRS object ID
201321599349300402
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-06-08T11:16:46-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN390912608EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1HAWKINS ASH BAPTIE AND CO LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1101 WEST 29TH STREET SUITE 101AddressLine1
CityMARSHFIELDCity
StateWIState
ZIP Code544495250ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930833012EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1RONALD MCDONALD HOUSE CHARITIESBusinessNameLine1
Business Name Line2OF MARSHFIELD INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlRONANameControl
Phone7153875899Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1803 WEST NORTH STREETAddressLine1
CityMARSHFIELDCity
StateWIState
ZIP Code54449ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRONALD L FISHName
TitleTREASURERTitle
Phone7153875899Phone
Date Signed2013-05-28DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMATTHEW P ECKELBERG CPAName
PTINP00583770PTIN
Phone7153871131Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRONALD L FISHNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1803 WEST NORTH STREETAddressLine1
CityMARSHFIELDCity
StateWIState
ZIP Code54449ZIPCode
FieldValueIRS element (for citing)
Gross Receipts546268GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.RMHC-MARSHFIELD.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION SUPPORTS THE WELL BEING OF CHILDREN, INCLUDING(A) PROVIDING TEMPORARY LODGING PRIMARILY FOR SERIOUSLY ILL CHILDREN AND THEIR FAMILIES WHILE RECEIVING TREATMENT IN OR VISITING A HOSPITAL OR SIMILAR TREATMENT FACILITY AND (B) MAKING CONTRIBUTIONS AND GRANTS, THROUGH THE PARTNERSHIP WITH CHILDREN'S MIRACLE NETWORK, TO OTHER NONPROFIT ORGANIZATIONS THAT ARE ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, OR EDUCATIONAL PURPOSES AND WHICH ENGAGE IN WHOLE OR IN PART IN (I)EDUCATING CHILDREN OR (II)PROVIDING FOR THE ESSENTIAL NEEDS OF CHILDREN OR (III)CARRYING ON RESEARCH AS TO PHYSICAL AND MENTAL DISEASES AND OTHER DISORDERS, OR THE DIAGNOSIS, PREVENTION, AND TREATMENT THEREOF.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees11TotalNbrEmployees
Total Nbr Volunteers21TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year301160ContributionsGrantsPriorYear
Contributions Grants Current Year236430ContributionsGrantsCurrentYear
Program Service Revenue Prior Year8927ProgramServiceRevenuePriorYear
Program Service Revenue CY9175ProgramServiceRevenueCY
Investment Income Prior Year36652InvestmentIncomePriorYear
Investment Income Current Year53412InvestmentIncomeCurrentYear
Other Revenue Prior Year5965OtherRevenuePriorYear
Other Revenue Current Year6266OtherRevenueCurrentYear
Total Revenue Prior Year352704TotalRevenuePriorYear
Total Revenue Current Year305283TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year17000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY17500GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year126128SalariesEtcPriorYear
Salaries Etc Current Year128138SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year14313TotalFundrsngExpCurrentYear
Other Expense Prior Year155970OtherExpensePriorYear
Other Expenses Current Year187752OtherExpensesCurrentYear
Total Expenses Prior Year299098TotalExpensesPriorYear
Total Expenses Current Year333390TotalExpensesCurrentYear
Revenues Less Expenses Prior Year53606RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-28107RevenuesLessExpensesCY
Total Assets BOY1724126TotalAssetsBOY
Total Assets EOY1802430TotalAssetsEOY
Total Liabilities BOY21287TotalLiabilitiesBOY
Total Liabilities EOY12209TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1702839NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1790221NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE ORGANIZATION SUPPORTS THE WELL BEING OF CHILDREN, INCLUDING(A) PROVIDING TEMPORARY LODGING PRIMARILY FOR SERIOUSLY ILL CHILDREN AND THEIR FAMILIES WHILE RECEIVING TREATMENT IN OR VISITING A HOSPITAL OR SIMILAR TREATMENT FACILITY AND (B) MAKING CONTRIBUTIONS AND GRANTS, THROUGH THE PARTNERSHIP WITH CHILDREN'S MIRACLE NETWORK, TO OTHER NONPROFIT ORGANIZATIONS THAT ARE ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, OR EDUCATIONAL PURPOSES AND WHICH ENGAGE IN WHOLE OR IN PART IN (I)EDUCATING CHILDREN OR (II)PROVIDING FOR THE ESSENTIAL NEEDS OF CHILDREN OR (III)CARRYING ON RESEARCH AS TO PHYSICAL AND MENTAL DISEASES AND OTHER DISORDERS OF CHILDREN, OR THE DIAGNOSIS, PREVENTION, AND TREATMENT THEREOF.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense270228Expense
Grants17500Grants
Revenue9462Revenue
DescriptionRONALD MCDONALD HOUSE CHARITIES'(RMHC) MISSION IS TO LIFT CHILDREN AND FAMILIES TO A BETTER TOMORROW. THE RONALD MCDONALD HOUSE IS THE CORNERSTONE PROGRAM OF RMHC BUT CAN ONLY HELP TEN FAMILIES AT A TIME. TO MEET THE BROADER MISSION OF THE ORGANIZATION, RMHC PARTNERED WITH CHILDREN'S MIRACLE NETWORK TO PROVIDE SMALL GRANTS TO NONPROFITS IN CENTRAL WISCONSIN. MONEY USED FOR GRANT MAKING COMES FROM SPECIAL PROMOTIONS HELD BY OUR LOCAL MCDONALD'S FRANCHISEES, SPECIAL DESIGNATED FUNDRAISING ACTIVITIES AND A MATCHING GRANT ACCOUNT FUNDED BY THE NATIONAL CHAPTER OF RMHC IN OAK BROOK, ILLINOIS. RMHC OF MARSHFIELD OPERATES A HOUSE PROVIDING TEMPORARY LODGING TO FAMILIES OF SERIOUSLY ILL CHILDREN WHILE THOSE CHILDREN ARE PATIENTS AT THE MARSHFIELD CLINIC/ST. JOSEPH'S HOSPITAL. FAMILIES OF SERIOUSLY ILL CHILDREN ARE ALLOWED TO STAY IN THE HOUSE FOR A DONATION OF $5 PER NIGHT PER FAMILY. NO FAMILY IS TURNED AWAY BECAUSE OF A LACK OF FUNDS. THE HOUSE PROVIDED A "HOME AWAY FROM HOME" FOR 294 NEW FAMILIES AND 58 RETURNING FAMILIES FOR A TOTAL OF 352 FAMILIES IN 2012. THESE FAMILIES USED THE HOUSE FOR A TOTAL OF 523 VISITS. THE HOUSE IS STAFFED BY 20+ VOLUNTEERS ON A REGULAR BASIS WHO ASSIST THE FAMILIES WITH MEALS, OFFICE ASSISTANCE, LIGHT HOUSEKEEPING AND OTHER MAINTENANCE. THE HOUSE RECEIVES MANY IN-KIND DONATIONS SUCH AS PAPER PRODUCTS, FOOD AND BEVERAGES, AND CLEANING AND LAUNDRY SUPPLIES TO BE USED BY THE FAMILIES WHILE THEY ARE A GUEST AT THE RONALD MCDONALD HOUSE.Description
Total Program Service Expense270228TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10965NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees11NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1SANDRA ZYGARLICKEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7153875899TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1803 W NORTH STREETAddressLine1
CityMARSHFIELDCity
StateWIState
ZIP Code54449ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (13 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
CAROL ADLER
PRESIDENT1.00XX000
PAMELA ACKER
VICE PRESIDENT1.00XX000
CAROL WILLFAHRT
SECRETARY1.00XX000
RON FISH
TREASURER2.00XX000
PATTI SHAFTO-CARLSON
DIRECTOR1.00X000
HEIDI GIESE
DIRECTOR1.00X000
JOE DOLEZAL
DIRECTOR1.00X000
JIM BARTELT
FINANCIAL ADVISOR1.00X000
LISA ROY
DIRECTOR1.00X000
ELIZABETH KRACHT
DIRECTOR1.00X000
KEVIN KRAUTKRAMER
DIRECTOR1.00X000
DR ADRIENNE CRUZ
DIRECTOR1.00X000
SANDRA ZYGARLICKE
HOUSE DIRECTOR32.00X3796100
FieldValueIRS element (for citing)
Total Reportable Comp From Org37961TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events8869FundraisingEvents
All Other Contributions227561AllOtherContributions
Noncash Contributions32355NoncashContributions
Total Contributions236430TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionROOM REVENUEDescription
Business Code624100BusinessCode
Total Revenue Column9175TotalRevenueColumn
Related Or Exempt Function Income9175RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue9175TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column22170TotalRevenueColumn
Exclusion$22,170ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities272227Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities240985Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities31242Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column31242TotalRevenueColumn
Exclusion$31,242ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events5979GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events8869CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses0FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column5979TotalRevenueColumn
Exclusion$5,979ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionPROMOTIONAL ITEMSDescription
Business Code453220BusinessCode
Total Revenue Column287TotalRevenueColumn
Related Or Exempt Function Income287RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue287TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column305283TotalRevenueColumn
Related Or Exempt Function Income9462RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$59,391ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total17500Total
Program Services17500ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total37961Total
Program Services30369ProgramServices
Management And General5694ManagementAndGeneral
Fundraising1898Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total81071Total
Program Services79501ProgramServices
Management And General1570ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total9106Total
Program Services8405ProgramServices
Management And General556ManagementAndGeneral
Fundraising145Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total13900Total
Management And General13900ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total5572Total
Management And General5572ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total20713Total
Program Services8285ProgramServices
Management And General2071ManagementAndGeneral
Fundraising10357Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total10113Total
Program Services7087ProgramServices
Management And General1573ManagementAndGeneral
Fundraising1453Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total21366Total
Program Services21366ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total1098Total
Program Services439ProgramServices
Management And General549ManagementAndGeneral
Fundraising110Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total15308Total
Management And General15308ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total29292Total
Program Services29292ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total9143Total
Program Services9143ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
DONATED SUPPLIES34958328601748350
REPAIRS & MAINTENANCE2446124461
MISCELLANEOUS837529308
AWARDS635635

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total356Total
Program Services356ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total333390Total
Program Services270228ProgramServices
Management And General48849ManagementAndGeneral
Fundraising14313Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY27139BOY
EOY14570EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY213229BOY
EOY138538EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis993332LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec671811LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY342382BOY
EOY321521EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY344905BOY
EOY390596EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY770433BOY
EOY911068EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY26038BOY
EOY26137EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1724126BOY
EOY1802430EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY21287BOY
EOY12209EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY21287BOY
EOY12209EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY349086BOY
EOY332309EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY853753BOY
EOY957912EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY500000BOY
EOY500000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1702839BOY
EOY1790221EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1724126BOY
EOY1802430EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-28107ReconcilationRevenueExpenses
Reconciliation Unrealized Invest115489ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years235224CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years201200CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years234996CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year301160CurrentTaxYearMinus1Year
Current Tax Year236430CurrentTaxYear
Total1209010Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years235224CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years201200CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years234996CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year301160CurrentTaxYearMinus1Year
Current Tax Year236430CurrentTaxYear
Total1209010Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total4662AmountsSubstContributorsTotal
Public Support Total1701204348PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years67332CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years20368CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years12172CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year19789CurrentTaxYearMinus1Year
Current Tax Year22170CurrentTaxYear
Total141831Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5823CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2320CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5362CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4254CurrentTaxYearMinus1Year
Current Tax Year5979CurrentTaxYear
Total23738Total
FieldValueIRS element (for citing)
Total Support1374579TotalSupport
Gross Receipts From Admissions Etc64572GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.87620PublicSupportPertcentage170
Public Support Pertcent Prior Year0.81520PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: NET FUNDRAISING REVENUEGeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1328270BeginningOfYearBalance
Investment Earnings Or Losses166725InvestmentEarningsOrLosses
Other Expenditures57500OtherExpenditures
Administrative Expenses5572AdministrativeExpenses
End Of Year Balance1431923EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1525756BeginningOfYearBalance
Investment Earnings Or Losses-21424InvestmentEarningsOrLosses
Other Expenditures170000OtherExpenditures
Administrative Expenses6062AdministrativeExpenses
End Of Year Balance1328270EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1445806BeginningOfYearBalance
Investment Earnings Or Losses143037InvestmentEarningsOrLosses
Other Expenditures57500OtherExpenditures
Administrative Expenses5587AdministrativeExpenses
End Of Year Balance1525756EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1181420BeginningOfYearBalance
Investment Earnings Or Losses279254InvestmentEarningsOrLosses
Other Expenditures10000OtherExpenditures
Administrative Expenses4868AdministrativeExpenses
End Of Year Balance1445806EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1502723BeginningOfYearBalance
Investment Earnings Or Losses-310846InvestmentEarningsOrLosses
Other Expenditures5000OtherExpenditures
Administrative Expenses5457AdministrativeExpenses
End Of Year Balance1181420EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.35000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.65000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis898970OtherCostOrOtherBasis
Depreciation583597Depreciation
Book Value315373BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis27320OtherCostOrOtherBasis
Depreciation24580Depreciation
Book Value2740BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis67042OtherCostOrOtherBasis
Depreciation63634Depreciation
Book Value3408BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings321521TotalOfBookValueLandBuildings

Other Securities OtherSecurities (6 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
DAVIS NY VENTURE FD INC CL Y159668F
DODGE AND COX STOCK FD139539F
AM FDS GROWTH FD OF AMERICA CL F1152468F
HARBOR CAPITAL APPRECIATION FD173490F
ASSOCIATED INTERMEDIATE TERM BOND FUND (PT)143677F
ASSOCIATED SHORT TERM BOND FUND (PT)142226F
FieldValueIRS element (for citing)
Total Of Book Value Securities911068TotalOfBookValueSecurities
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt436220TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments115489NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities21020DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990136509RevenueNotRptdF990
Revenue Subtotal299711RevenueSubtotal
Investment Expenses Not Included5572InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt5572RevenueNotRptdOnFinStmt
Total Revenue Per Form990305283TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt348838TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities21020DonatedServicesUseOfFacilities
Expenses Not Rptd F99021020ExpensesNotRptdF990
Expenses Subtotal327818ExpensesSubtotal
Investment Expenses Not Included25572InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt5572ExpensesNotRptdOnFinStmt
Total Expenses Per Form990333390TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE PRINCIPLE OR PERMANENT ENDOWMENT OF $500,000 MUST BE KEPT IN A PERPETUAL ENDOWMENT FUND. THE INCOME EARNED BY THIS ENDOWMENT IS TO BE USED FOR HOUSE OPERATING EXPENSES AS APPROVED BY THE BOARD OF DIRECTORS. ANY UNUSED INVESTMENT EARNINGS ARE REINVESTED AND INCLUDED IN THE TERM ENDOWMENT UNTIL APPROPRIATED FOR EXPENDITURE BY THE BOARD.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:U.S. GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2012 AND 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE ORGANIZATION WILL RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN INCOME TAX EXPENSE IF INCURRED. THE ORGANIZATION IS NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2009 AND STATE EXAMINATIONS FOR YEARS BEFORE 2008. THE DETERMINATION OF TAX-EXEMPT IS CONSIDERED TO BE A TAX POSITION TAKEN WITH RESPECT TO THE PROVISIONS OF U.S. GAAP.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1SAINT JOSEPH'S CHILDREN'S HOSPITAL-CHILDREN'S MIRACLE NETWORKBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1611 ST JOSEPH AVEAddressLine1
CityMARSHFIELDCity
StateWIState
ZIP Code54449ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient391684957EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant16500AmountOfCashGrant
Purpose Of GrantTO IMPROVE THE HEALTHCARE OF CHILDREN AGES 0-18 IN OUR 17 COUNTY AREA.PurposeOfGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
ExplanationPART I, LINE 2: THE ORGANIZATION PARTNERS WITH SAINT JOSEPH'S HOSPITAL-CHILDREN'S MIRACLE NETWORK TO OFFER GRANTS TO OTHER NONPROFIT ORGANIZATIONS THAT ARE ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, OR EDUCATIONAL PURPOSES AND WHICH ENGAGE IN WHOLE OR IN PART IN (1)EDUCATING CHILDREN, (2)PROVIDING FOR THE ESSENTIAL NEEDS OF CHILDREN OR (3)CARRYING ON RESEARCH AS TO PHYSICAL AND MENTAL DISEASES AND OTHER DISORDERS OF CHILDREN, OR THE DIAGNOSIS, PREVENTION AND TREATMENT THEREOF. THE ORGANIZATION'S BOARD OF DIRECTORS PROVIDES A GRANT TO THE CHILDREN'S MIRACLE NETWORK. THE CHILDREN'S MIRACLE NETWORK THEN COMPILES AND PRESENTS A LIST OF POTENTIAL GRANTEES TO THE ORGANIZATION'S BOARD WHO APPROVES THE GRANTS. CHILDREN'S MIRACLE NETWORK IS THEN RESPONSIBLE FOR DISBURSING THE GRANT FUNDS AND FOR FOLLOWING UP WITH THE GRANTEE TO ENSURE THAT THE GRANT FUNDS WERE USED FOR THE PURPOSE GRANTED.Explanation

Schedule M IRS990ScheduleM

Clothing And Household Goods ClothingAndHouseholdGoods

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Noncash Contribs Rptd F99032355NoncashContribsRptdF990
Method Of Determining RevenuesDONOR-DECLARED VALUEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE BOARD RELIES ON THE HOUSE DIRECTOR, PRESIDENT, AND TREASURER TO REVIEW THE FORM 990 BEFORE IT IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, BOARD MEMBERS AND KEY EMPLOYEES ARE GIVEN PAPERWORK TO UPDATE THEIR CONFLICT OF INTEREST STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 15ATHE BOARD OF DIRECTORS USES GUIDELINES ESTABLISHED BY RONALD MCDONALD HOUSE CHARITIES, GLOBAL, INC. FOR HOUSE DIRECTOR PERFORMANCE APPRAISAL AND COMPENSATION INCREASES.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.