2012-11-15T12:24:30-06:00 2011-12-31 351178661 BLUE & CO LLC 8800 LYRA DRIVE SUITE 450 COLUMBUS OH 43240 990 2011-01-01 237374256 MCCULLOUGH-HYDE MEMORIAL INC ENDOWMENT FUND MCCU 5135232111 110 NORTH POPLAR OXFORD OH 45056 JOHN CLEMENTS 5135245310 2012-10-19 1 NANCY KIRCHNER P00386751 6148852583 2011 2016-02-24 21:20:13Z JOHN CLEMENTS 110 NORTH POPLAR STREET OXFORD OH 45056 1764099 0 X WWW.MHMH.ORG X 1942 OH TO SUPPORT HEALTH, EDUCATIONAL, AND BUILDING PROGRAMS OF MCCULLOUGH-HYDE MEMORIAL HOSPITAL 10 10 0 0 0 0 104610 296717 0 0 -31224 380590 79964 70895 153350 748202 18773 15575 0 0 0 0 0 0 26219 595997 547170 614770 562745 -461420 185457 10419036 10167153 1268390 1701503 9150646 8465650 X SUPPORT THE HOSPITAL WITH HEALTH PROGRAMS, EDUCATION ASSISTANCE, BUILDING AND EQUIPMENT NEEDS 0 0 184384 SUPPORT FOR MHMH DEVELOPMENT OFFICE 72044 SUPPORT FOR MHMH CAPITAL NEEDS 81246 SUPPORT FOR EDUCATION PROGRAMS 28266 15575 SUPPORT FOR HEALTH PROGRAMS 28266 15575 365940 1 1 0 0 0 1 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 17 0 1 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X JAMES MILLER CONTROLLER 5135245310 110 NORTH POPLAR STREET OXFORD OH 45056 JOHN HARLAND MD 1.00 X 0 0 0 SUSAN CROSS LIPNICKEY 1.00 X 0 0 0 JACK MANN 1.00 X 0 0 0 RICHARD M NORMAN 1.00 X 0 0 0 ALAN OAK 1.00 X 0 0 0 WILLIAM R RICHARDSON 1.00 X 0 0 0 WILLIAM DOUGLAS ROSS DO 1.00 X 0 0 0 MICHAEL RUDOLPH 1.00 X 0 0 0 THOMAS W SPEH 1.00 X 0 0 0 PAIGE WOOD 1.00 X 0 0 0 BRYAN HEHEMANN 40.00 X 0 202613 14797 JOHN CLEMENTS 40.00 X 0 96330 4938 PAMELA COLLINS 40.00 X 0 127687 7511 TAMMY WOOD 40.00 X 0 118501 14378 KENNETH KELLER 40.00 X 0 244989 3654 MATTHEW BIRKLE 40.00 X 0 247235 3686 RODNEY HOLDERMAN 40.00 X 0 121681 15560 MARK CRISTELL 40.00 X 0 126735 15632 MATTHEW DAGGY 40.00 X 0 111347 1708 0 1397118 81864 0 0 1 0 0 296717 296717 277302 277302 69664 0 69664 69664 69664 1119185 1015897 103288 103288 103288 MISCELLANEOUS 900099 1231 1231 1231 748202 1231 0 450254 15575 15575 200 200 49981 49981 11527 298 11229 25734 25734 49459 49459 1078 1078 32905 32905 TRUST FUNDED DEVELOPMEN 135202 135202 BUILDING AND FACILITY P 98263 72044 26219 EDUCATION PROGRAMS 81246 81246 HEALTH PROGRAM FUNDING 61575 61575 562745 365940 170586 26219 490123 787997 33990 19275 8500 43207 736546 434629 334823 301917 9551600 9014757 10419036 10167153 27097 21759 1241293 1679744 1268390 1701503 X 7177347 6488323 223380 176893 1749919 1800434 9150646 8465650 10419036 10167153 X 185457 -870452 X 0 1 1 X 0 X X 0 0 0 MCCULLOUGH-HYDE MEMORIAL HOSPITAL INC 310650283 509(A)(3)(A) 0 1 1 277226 1 277226 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9 138512 58905 153974 1 1 9551600 296717 -706525 127035 9014757 8626691 137514 970829 183434 9551600 7180113 372373 1080059 5854 8626691 8858166 1086641 -2429378 335316 7180113 1 0 87300 87300 604395 409305 195090 13870 12516 1354 30981 12808 18173 301917 DUE TO RELATED MCCULLOUGH-HYDE MEMORIAL HOSPITAL 1679744 1679744 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: HEALTH EDUCATION, HOSPITAL EQUIPMENT, COMMUNITY HEALTH 0 OXFORD FREE CLINIC PO BOX 18818 FAIRFIELD OH 45018 311604036 15575 HEALTH CLINIC 1 X 1 1 0 0 0 0 0 0 0 0 0 BRYAN HEHEMANN 0 198026 0 0 0 4587 0 938 0 13859 0 217410 0 0 KENNETH KELLER 0 240419 0 0 0 4570 0 0 0 3654 0 248643 0 0 MATTHEW BIRKLE 0 247235 0 0 0 0 0 0 0 3686 0 250921 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PROVIDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW AND APPROVAL. THE RETURN IS THEN PRESENTED TO THE ENTIRE BOARD FOR FINAL APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL QUESTIONAIRE FROM CORPORATE COMPLIANCE COMMITTEE FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -870,452. MCCULLOUGH-HYDE MEMORIAL HOSPITAL INC 110 N POPLAR STREET OXFORD OH 45056 310650283 HOSPITAL OH 501(C)(3) LINE 3 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0