2013-11-05T10:58:33-06:00 2012-12-31 431126847 WILLIAMS-KEEPERS LLC 2005 WEST BROADWAY SUITE 100 COLUMBIA MO 65203 990 2012-01-01 030477306 BOONE HOSPITAL FOUNDATION BOON 5738156868 1600 E BROADWAY COLUMBIA MO 65201 BARBARA DANUSER 5738152800 2013-10-31 1 STEPHEN C SMITH P00048938 5734426171 2012 2016-02-24 21:20:13Z BARBARA DANUSER 1600 E BROADWAY COLUMBIA MO 65201 3177214 0 X WWW.BOONE.ORG X 2001 MO SUPPORTS THE EFFORTS OF BOONE HOSPITAL CENTER OF IMPROVING THE HEALTH OF THE PEOPLE AND COMMUNITIES WE SERVE. 5 5 0 0 0 0 431921 350907 0 0 327398 124857 21493 859802 780812 1335566 318250 0 0 0 103262 129733 0 0 0 325625 307433 747137 437166 33675 898400 7874956 8549816 957991 15293 6916965 8534523 X TO SEEK FINANCIAL RESOURCES TO SUPPORT EFFORTS OF BOONE HOSPITAL CENTER IN ITS MISSION TO IMPROVE THE HEALTH AND WELLNESS OF CURRENT AND FUTURE GENERATIONS IN THE COMMUNITIES WE SERVE. 0 0 69196 CARE GIVER EDUCATION: THIS PROGRAM PROVIDES SCHOLARSHIPS FOR ADVANCED TRAINING IN CRITICAL CARE AREAS AND HELPS FUND SPECIAL NURSING CONFERENCES FOR BOONE HOSPITAL NURSES AND CAREGIVERS. THERE WERE NO SCHOLARSHIPS PAID DURING 2012. 34302 COMMUNITY BENEFIT/EDUCATION: THIS PROGRAM SUPPORTS ON-SITE AND OUTREACH ACTIVITIES AND PROVIDES EDUCATION THAT ENCOURAGES COMMUNITY MEMBERS TO LEARN ABOUT AND LEAD A HEALTHIER LIFE STYLE. BELOW ARE TWO ACTIVITIES SUPPORTED FROM THIS FUND IN 2012. - THE KIDS ON TRACK PROGRAM IS TO ENCOURAGE KIDS TO RUN AN INTERMITTENT MARATHON OVER THE SUMMER MEETING OUR MISSION OF IMPROVING THE HEALTH OF OUR COMMUNITY. THERE IS A KICK OFF EVENT IN THE SPRING AND A CELEBRATION EVENT AT THE CONCLUSION OF SUMMER. THE FOUNDATION SUPPORTS THIS EVENT BY PURCHASING T-SHIRTS ($3,157) TO ACKNOWLEDGE KIDS (APPROXIMATELY 750) WHO COMPLETED THIS ACTIVITY. - THE SUPPLIES FOR OUR KNOW YOUR NUMBERS PROGRAM CONDUCTED BOTH ON-SITE AND THROUGH OUR MOBILE HEALTH UNIT PROVIDES FREE HEALTH SCREENINGS TO COMMUNITY MEMBERS. THE FOUNDATION PURCHASES THE CHOLESTECH SLIDES AND THE EQUIPMENT THAT READS THE RESULTS OF THE BLOOD ACQUIRED FROM A FINGER PRICK. THIS PROVIDES COMMUNITY MEMBERS WITH THEIR CHOLESTEROL LEVELS, BLOOD SUGAR LEVELS AND TRIGLYCERIDES ALL OF WHICH CAN BE INDICATORS FOR HEART DISEASE AND DIABETES. COMMUNITY MEMBERS ARE PROVIDED THE RESULTS OF THEIR BLOOD SAMPLE BY A REGISTERED NURSE AND THEN PROVIDED WITH EDUCATIONAL MATERIALS ON HOW TO IMPROVE THEIR NUMBERS. RESULTS ARE PROVIDED AT THE TIME OF THE SERVICE. THE FOUNDATION SUPPORTED $31,145 IN SUPPLIES IN 2012 AND THE APPROXIMATELY 1,919 COMMUNITY MEMBERS WERE SERVED. 88508 TO SEEK FINANCIAL RESOURCES TO SUPPORT EFFORTS OF BOONE HOSPITAL CENTER IN ITS MISSION, WHICH IS TO IMPROVE THE HEALTH AND WELLNESS OF CURRENT AND FUTURE GENERATIONS IN THE COMMUNITIES WE SERVE. 23823 CME FUND: THE FOUNDATION PROVIDED 156 HOURS OF CME ACCREDITED LIVE INSTRUCTION DURING THE YEAR. THIS ENCOMPASSES REGULARLY SCHEDULED COURSES, SUCH AS TUMOR BOARDS AND INFECTIOUS DISEASE COFERENCES; AS WELL AS QUARTERLY GENERAL STAFF MEETINGS; OUTREACH COURSES TO OUTLYING COMMUNITIES, E.G. JEFFERSON CITY PHYSICIANS AND FITZGIBBON HOSPITAL; JOINTLY-SPONSORED CONFERENCES, SUCH AS THE FULL DAY EVIDENCE BASED SURGICAL UPDATES FOR THE PRIMARY CARE PHYSICIAN, PROVIDED JOINTLY WITH BHC AND COLUMBIA SURGICAL ASSOCIATES; AND NEW REGIONAL INITIATIVES, SUCH AS THE CHILDHOOD OBESITY CONFERENCE. 1,370 PHYSICIAN ATTENDEES WERE RECORDED AT THESE EVENTS THROUGH 2012. 6005 THE HEALING GARDEN: THE HEALING GARDEN WAS BUILT TO PROVIDE A CALMING PLACE WHERE PATIENTS, THEIR FAMILIES AND OTHERS CAN FIND BEAUTY, COMFORT AND SOLITUDE. RESEARCH SHOWS THAT GARDENS CAN HAVE A POSITIVE IMPACT ON PATIENT OUTCOMES. THIS HEALING GARDEN HAS WATERFALLS, TREES, FLOWERS, FOOT BRIDGES, PARK BENCHES AND SOOTHING MUSIC, EXTENDING THE HEALING ENVIRONMENT BEYOND THE WALLS OF THE HOSPITAL. PATIENTS AND FAMILY MEMBERS VISIT THIS GARDEN DAILY. 29828 221834 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 16 0 1 0 0 0 0 0 0 0 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 X BARBARA DANUSER 5738152800 1600 E BROADWAY COLUMBIA MO 65201 FRED PARRY 4.00 8.00 X X 0 0 0 BRIAN NEUNER 4.00 8.00 X X 0 0 0 ROBERT WAGNER 4.00 8.00 X X 0 0 0 JAN BECKETT 4.00 8.00 X X 0 0 0 BARBARA WEAVER 4.00 8.00 X 0 0 0 BARBARA DANUSER 40.00 X 81456 0 20267 81456 0 20267 0 0 0 0 0 110396 240511 350907 234380 234380 1335102 1444625 -109523 -109523 -109523 20120 110396 69467 -49347 -49347 436705 327556 109149 109149 RELATED PARTY DEBT FORGIVENESS 900099 800000 800000 800000 1335566 800000 0 184659 96673 96673 21789 21789 4058 4058 7213 7213 944 944 16091 16091 41232 41232 3600 3600 799 799 4824 4824 2966 2966 800 800 369 369 PROGRAM SUPPORT EXPENSE 221834 221834 MISCELLANEOUS EXPENSES 13974 13974 437166 221834 215332 0 550548 227282 60944 109149 7232973 8190425 30491 22960 7874956 8549816 157991 15293 800000 0 957991 15293 X 4537259 6032692 1671756 1793801 707950 708030 6916965 8534523 7874956 8549816 898400 719158 0 X 0 1 X 0 0 X X X 0 0 0 BOARD OF TRUSTEES OF BOONE COUNTY HOSPITAL 431279063 6 0 1 1 0 1 0 SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: BOONE HOSPITAL FOUNDATION TYPICALLY DOES NOT DISTRIBUTE FUNDS TO THE BOARD OF TRUSTEES OF BOONE COUNTY HOSPITAL, THE SUPPORTED ORGANIZATION. INSTEAD THE PROGRAMS FUNDED BY THE FOUNDATION BENEFIT THE PATIENTS DIRECTLY AND SUPPORT THE EFFORTS OF BOONE COUNTY HOSPITAL IN ITS EFFORTS TO IMPROVE THE HEALTH AND WELLNESS OF THE COMMUNITY. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2379706 326060 32514 236449 2501831 2428964 474432 70644 594334 2379706 2335835 212075 228254 347200 2428964 3518946 1185717 147001 2515829 2335835 0.28300 0.71700 0 0 0 2070459 719158 719158 1351301 41232 -56967 -15735 1335566 452901 0 452901 41232 -56967 -15735 437166 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: HEALTH CARE EDUCATIONAL INITIATIVES PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -69,467. REVENUE NETTED AGAINST EXPENSES IN AUDIT 12,500. PART XII, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -69,467. REVENUE NETTED AGAINST EXPENSES IN AUDIT 12,500. GALA 77150 65350 11800 2000 24149 4610 17545 GOLF TOURNAMENT 53366 45046 8320 4950 10230 4395 1588 130516 110396 20120 4950 12230 28544 4610 19133 69467 -49347 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANTS WERE PAID AFTER COSTS WERE INCURRED BY THE RECIPIENTS. GRANTS ONLY PARTIALLY FUNDED THE PROJECTS INVOLVED. FORM 990, PART VI, SECTION B, LINE 11 COPIES OF THE FORM 990 ARE DISTRIBUTED TO THE BOARD OF TRUSTEES ELECTRONICALLY FOR THEIR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY THE EXECUTIVE DIRECTOR DISTRIBUTES THE CONFLICT OF INTEREST QUESTIONNAIRE BY E-MAIL TO THE BOARD OF TRUSTEES AND THEY ARE ASKED TO COMPLETE IT AND RETURN IT TO THE FOUNDATION. THE RETURNED QUESTIONNAIRE IS KEPT ON FILE. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF TRUSTEES AND THE PRESIDENT OF BOONE HOSPITAL CENTER USE BENCHMARK DATA FROM SIMILAR FOUNDATIONS AND REVIEW THE FOUNDATION'S ANNUAL STRATEGIC FUNDRAISING PLAN AND BUDGET. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVIALABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART V, LINE 2A: EMPLOYEES ARE LEASED BY THE FOUNDATION FROM THE ORGANIZATION THAT RUNS THE HOSPITAL UNDER AN AGREEMENT WITH BOONE COUNTY. THEREFORE, THE FOUNDATION HAS SALARY EXPENSE, BUT DOES NOT ISSUE W-2'S. BOARD OF TRUSTEES OF BOONE COUNTY HOSPITAL 1600 E BROADWAY COLUMBIA MO 65201 MO 501(C)(3) LINE 6 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1