FULCRUM FOUNDATION INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- FULCRUM FOUNDATION INC (EIN 39-2016506)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2012-11-28
- IRS object ID
- 201213339349300016
- Schema version
- 2011v1.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-28T13:59:01-06:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390758449 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 SCOTT STREET | AddressLine1 |
| City | WAUSAU | City |
| State | WI | State |
| ZIP Code | 54403 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 392016506 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL MEMBER ASSOCIATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MEMO | NameControl |
| Phone | 7157488100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 135 SOUTH GIBSON ST | AddressLine1 |
| City | MEDFORD | City |
| State | WI | State |
| ZIP Code | 54451 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LORI PECK | Name |
| Title | CFO, MEMORIAL HEALTH CENTER | Title |
| Phone | 7157488100 | Phone |
| Date Signed | 2012-11-19 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KATHLEEN J LABRAKE CPA | Name |
| PTIN | P00164006 | PTIN |
| Phone | 7158453111 | Phone |
| Date Prepared | 2012-11-19 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BRUCE CZECH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 135 SOUTH GIBSON ST | AddressLine1 |
| City | MEDFORD | City |
| State | WI | State |
| ZIP Code | 54451 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1849684 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2001 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | MEMORIAL MEMBER ASSOCIATION PURPOSE IS PROMOTING LOCAL HEALTH CARE AND SUPPORTING OUR LOCAL ORGANIZATIONS. DURING THE FISCAL YEAR, THE ORGANIZATION PROVIDED FINANCIAL DONATIONS FOR IMPACT CONCUSSION TESTING FOR THREE LOCAL SCHOOL DISTRICTS TO PROMOTE ATHLETIC SAFETY AND FOR A STEPPING ON PROGRAM THROUGH THE COMMISSION ON AGING TO PROVIDE EDUCATION ON FALL PREVENTION. FINANCIAL DONATIONS WERE ALSO GIVEN FOR INFANT CRIBS TO OUR LOCAL NON-PROFIT DAYCARE CENTER AND THE CONSTRUCTION FOR THE RIVER WALK BRIDGE. THE ORGANIZATION ALSO SUPPORTED OUR COUNTY AMBULANCE AND FIRE PROGRAM THROUGH A FINANCIAL DONATION FOR THE UPGRADE OF THE TRANSMISSION SYSTEM. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 11 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 70 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 85 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 356257 | InvestmentIncomePriorYear |
| Investment Income Current Year | 216028 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4446776 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1633571 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 4803103 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1849684 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 9272 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 156560 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 28618 | OtherExpensePriorYear |
| Other Expenses Current Year | 23302 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 37890 | TotalExpensesPriorYear |
| Total Expenses Current Year | 179862 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4765213 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1669822 | RevenuesLessExpensesCY |
| Total Assets BOY | 30320389 | TotalAssetsBOY |
| Total Assets EOY | 31833939 | TotalAssetsEOY |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2180 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 30320389 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 31831759 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROMOTE LOCAL HEALTH CARE AND PROVIDE REPRESENTATION AND OVERSIGHT TO MEMORIAL HEALTH CENTER AND THE ASSOCIATION REPRESENTS THE HEALTH CARE INTERESTS OF OUR COMMUNITIES AND MANAGES THE FINANCIAL ASSETS ENTRUSTED TO US. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 156560 | Expense |
| Grants | 156560 | Grants |
| Revenue | 1633571 | Revenue |
| Description | MEMORIAL MEMBER ASSOCIATION'S PURPOSE IS PROMOTING LOCAL HEALTH CARE AND SUPPORTING OUR LOCAL ORGANIZATIONS. DURING THE FISCAL YEAR, THE ORGANIZATION PROVIDED FINANCIAL DONATIONS FOR IMPACT CONCUSSION TESTING FOR THREE LOCAL SCHOOL DISTRICTS TO PROMOTE ATHLETIC SAFETY AND FOR A STEPPING ON PROGRAM THROUGH THE COMMISSION ON AGING TO PROVIDE EDUCATION ON FALL PREVENTION. FINANCIAL DONATIONS WERE ALSO GIVEN FOR INFANT CRIBS TO OUR LOCAL NON-PROFIT DAYCARE CENTER AND THE CONSTRUCTION FOR THE RIVER WALK BRIDGE. THE ORGANIZATION ALSO SUPPORTED OUR COUNTY AMBULANCE AND FIRE PROGRAM THROUGH A FINANCIAL DONATION FOR THE UPGRADE OF THE TRANSMISSION SYSTEM. | Description |
| Total Program Service Expense | 156560 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 1 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LORI PECK CFO MEMORIAL HEALTH CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7157488100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 135 SOUTH GIBSON STREET | AddressLine1 |
| City | MEDFORD | City |
| State | WI | State |
| ZIP Code | 54451 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| BRUCE P CZECH | ||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 |
| DEBBIE A WOODS | ||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 |
| ROBERT F CARPENTER | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| MICHAEL J RIGGLE | ||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| PERRY A ARNDT | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| GRAHAM COURTNEY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LEONARD W HAMMAN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DAVID E KOESTER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DR CATHERINE F REUTER | ||||||
| DIRECTOR | 1.00 | X | 0 | 101454 | 3023 | |
| MICHAEL A SCHAEFER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MICHAEL E PLOOY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MARY K SARVER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ROBERT BERNKLAU | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| WILLIAM GRUNEWALD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 101454 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 3023 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Membership Dues | 85 | MembershipDues |
| Total Contributions | 85 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 184159 | TotalRevenueColumn |
| Exclusion | $184,159 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 31869 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 31869 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 31869 | TotalRevenueColumn |
| Exclusion | $31,869 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| INVESTMENT INCOME - MH | 621110 | 1718593 | 1718593 |
| INVESTMENT INCOME - MH | 621110 | -4250 | -4250 |
| INVESTMENT INCOME - AE | 621110 | -80772 | -80772 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1633571 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1849684 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1633571 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $216,028 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 156560 | Total |
| Program Services | 156560 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6800 | Total |
| Management And General | 6800 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1500 | Total |
| Management And General | 1500 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13974 | Total |
| Management And General | 13974 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 160 | Total |
| Management And General | 160 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 868 | Total |
| Management And General | 868 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 179862 | Total |
| Program Services | 156560 | ProgramServices |
| Management And General | 23302 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10188 | BOY |
| EOY | 19732 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 677218 | BOY |
| EOY | 760999 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5506455 | BOY |
| EOY | 5268649 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24120516 | BOY |
| EOY | 25780631 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6012 | BOY |
| EOY | 3928 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30320389 | BOY |
| EOY | 31833939 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 2180 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 2180 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30175290 | BOY |
| EOY | 31663409 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25099 | BOY |
| EOY | 48350 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120000 | BOY |
| EOY | 120000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30320389 | BOY |
| EOY | 31831759 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30320389 | BOY |
| EOY | 31833939 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1669822 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -158452 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL HEALTH CTR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390964813 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 0 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Closely Held Equity Interests CloselyHeldEquityInterests
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 25780631 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 25780631 | TotalOfBookValueSecurities |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TAYLOR COUNTY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 540 E COLLEGE AVENUE | AddressLine1 |
| City | MEDFORD | City |
| State | WI | State |
| ZIP Code | 54451 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 396005746 | EINOfRecipient |
| IRC Section | TAYLOR COUNTY | IRCSection |
| Amount Of Cash Grant | 150000 | AmountOfCashGrant |
| Method Of Valuation | N/A | MethodOfValuation |
| Description Of Non Cash Assistance | N/A | DescriptionOfNonCashAssistance |
| Purpose Of Grant | CRITICAL SERVICE UPGRADE INVOLVING TOWERS AND REPEATERS THAT TRANSMIT THE AMBULANCE AND FIRE SIGNALS. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: MEMORIAL MEMBER ASSOCIATION'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. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (7 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| MARK REUTER MD | |||
| FAMILY MEMBER OF DIRECTOR, CATHERINE REUTER, M.D. | 253738 | EMPLOYMENT COMPENSATION - FISCAL YEAR 2011 COMPENSATION PAID BY MEMORIAL HEALTH CENTER, A RELATED ORGANIZATION. | 0 |
| JEAN LUDWIG | |||
| FAMILY MEMBER OF DIRECTOR, MIKE SCHAEFER | 55013 | EMPLOYMENT COMPENSATION - FISCAL YEAR 2011 COMPENSATION PAID BY MEMORIAL HEALTH CENTER, A RELATED ORGANIZATION. | 0 |
| SUSAN COURTNEY | |||
| FAMILY MEMBER OF DIRECTOR, GRAHAM COURTNEY | 81880 | EMPLOYMENT COMPENSATION - FISCAL YEAR 2011 COMPENSATION PAID BY MEMORIAL HEALTH CENTER, A RELATED ORGANIZATION. | 0 |
| SARA NIEMI | |||
| FAMILY MEMBER OF DIRECTOR, BOB CARPENTER | 40343 | EMPLOYMENT COMPENSATION - FISCAL YEAR 2011 COMPENSATION PAID BY MEMORIAL HEALTH CENTER, A RELATED ORGANIZATION. | 0 |
| REBECCA NICHOLS | |||
| FAMILY MEMBER OF DIRECTOR, BOB CARPENTER | 41280 | EMPLOYMENT COMPENSATION - FISCAL YEAR 2011 COMPENSATION PAID BY MEMORIAL HEALTH CENTER, A RELATED ORGANIZATION. | 0 |
| MEGAN COURTNEY | |||
| FAMILY MEMBER OF DIRECTOR, GRAHAM COURTNEY | 28207 | EMPLOYMENT COMPENSATION - FISCAL YEAR 2011 COMPENSATION PAID BY MEMORIAL HEALTH CENTER, A RELATED ORGANIZATION. | 0 |
| SUSAN STREBIG | |||
| FAMILY MEMBER OF DIRECTOR, BOB CARPENTER | 43455 | EMPLOYMENT COMPENSATION - FISCAL YEAR 2011 COMPENSATION PAID BY MEMORIAL HEALTH CENTER, A RELATED ORGANIZATION. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE 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 MEMORIAL HEALTH CENTER, 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 MHC VOLUNTEERS MEMBERSHIP CRITERIA IS FURTHER DEFINED BY THE ORGANIZATION'S BYLAWS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS ELECT THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | THE 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 11 | THE CFO OF MEMORIAL HEALTH CENTER, INC, A RELATED ORGANIZATION, WILL CONDUCT A DETAIL REVIEW OF THE FORM 990. THE CFO OF MEMORIAL HEALTH CENTER, INC. WILL PRESENT THE FORM 990 TO THE BOARD OF DIRECTORS AT THE NEXT AVAILABLE MEETING FOR REVIEW AND APPROVAL PRIOR TO THE FILING OF THE RETURN WITH THE IRS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OR COMMITIEE 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 MAYBE 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 C, LINE 19 | THE 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 2: | 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 MEMORIAL HEALTH CENTER, INC. THAT ARE APPOINTED BY THE CORPORATION. | |
| FORM 990, PART VII | GRAHAM COURTNEY WORKED APPROXIMATELY 2 HOURS PER WEEK AS FOLLOWS: MEMORIAL HEALTH CENTER, INC. - 1 HOUR MEMORIAL MEMBER ASSOCIATION, INC. - 1 HOUR BRUCE CZECH WORKED APPROXIMATELY 2 HOURS PER WEEK AS FOLLOWS: MEMORIAL HEALTH CENTER, INC. - 1 HOUR MEMORIAL MEMBER ASSOCIATION, INC. - 1 HOUR DEBBIE WOODS WORKED APPROXIMATELY 2 HOURS PER WEEK AS FOLLOWS: MEMORIAL HEALTH CENTER, INC. - 1 HOUR MEMBORIAL MEMBER ASSOCIATION, INC. - 1 HOUR LEONARD HAMMAN WORKED APPROXIMATELY 2 HOURS PER WEEK AS FOLLOWS: MEMORIAL HEALTH CENTER, INC. - 1 HOUR MEMORIAL MEMBER ASSOCIATION, INC. - 1 HOUR DR. CATHERINE REUTER WORKED APPROXIMATELY 31 HOURS PER WEEK AS FOLLOWS: MEMORIAL HEALTH CENTER, INC. - 30 HOURS MEMORIAL MEMBER ASSOCIATION, INC. - 1 HOUR ALL MEMBERS OF MEMORIAL MEMBER ASSOCIATION, INC.'S BOARD OF DIRECTORS SERVE ON THE BOARD OF CEDAR COURT APARTMENTS. MATTERS INVOLVING CEDAR COURT APARTMENTS ARE RESOLVED DURING REGULARLY SCHEDULED MEETINGS OF MEMORIAL MEMBER ASSOCIATION'S BOARD, AS SUCH, NO ADDITIONAL TIME HAS BEEN ALLOCATED TO THE RELATED ORGANIZATION. | EXPLANATION OF HOURS WORKED |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -184,996. EQUITY ADJUSTMENT - MHC 26,544. TOTAL TO FORM 990, PART XI, LINE 5: -158,452. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MEMORIAL HEALTH CENTER INC | |||||||||||
| 135 S GIBSON ST | MEDFORD | WI | 54451 | 390964813 | MEDICAL FACILITY | WI | 501(C)(3) | LINE 3 | N/A | 0 | |
| MEMORIAL HEALTH CENTER FOUNDATION INC | |||||||||||
| 135 S GIBSON ST | MEDFORD | WI | 54451 | 391777081 | CHARITABLE FUNDRAISING | WI | 501(C)(3) | LINE 11C, III-FI | 1 | MEMORIAL MEMBER ASSOCIATION INC | |
| CEDAR COURT APARTMENTS INC | |||||||||||
| 135 S GIBSON ST | MEDFORD | WI | 54451 | 391412339 | LOW INCOME HOUSING | WI | 501(C)(3) | LINE 7 | 1 | MEMORIAL MEMBER ASSOCIATION INC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |