2012-05-15T11:50:24-05:00 2011-12-31 351724750 BUCHERI MCCARTY & METZ LLP PO BOX 2147 KOKOMO IN 469042147 990 2011-01-01 237309596 HOWARD REGIONAL HEALTH SYSTEM FOUNDATION INC HOWA 7654538458 PO BOX 9011 KOKOMO IN 469049011 JOE DUNBAR 7654538066 2012-05-07 1 G A MCCARTY CPA P00040892 7652362300 2011 2016-02-24 21:20:13Z DR SUE SCIAME-GIESECKE PO BOX 9011 KOKOMO IN 469049011 1482206 0 X WWW.HOWARDREGIONAL.ORG X 1958 IN TO IMPROVE THE QUALITY AND AVAILABILITY OF HEALTHCARE PROVIDED TO ALL PERSONS SERVED BY HOWARD REGIONAL HEALTH SYSTEM 29 0 0 14 0 0 421905 183257 30567 19220 109720 117683 28107 18309 590299 338469 399048 520504 0 0 82604 84186 0 0 9515 78121 73971 559773 678661 30526 -340192 4044389 3281871 569169 256881 3475220 3024990 THE MISSION OF THE HOWARD REGIONAL HEALTH SYSTEM FOUNDATION IS TO IMPROVE THE QUALITY AND AVAILABILITY OF HEALTHCARE PROVIDED TO ALL PERSONS SERVED BY HOWARD REGIONAL HEALTH SYSTEM. 0 0 464409 464409 67629 TO RECEIVE AND MAINTAIN FUNDS FOR THE CONSTRUCTION, FURNISHING, EQUIPPING AND IMPROVEMENT OF THE FACILITIES AND SERVICES OF THE HOWARD REGIONAL HEALTH SYSTEM (HOSPITAL). TO PROVIDE FINANCIAL ASSISTANCE FOR THE IMPROVEMENT OF THE HEALTH, SAFETY, AND GENERAL WELFARE, AND TO AID IN THE ALLEVIATION OF HUMAN SUFFERING OF ALL PERSONS CONNECTED WITH OR USING THE FACILITIES AND SERVICES OF THE HOSPITAL. 56095 56095 TO AID AND PROMOTE EDUCATION AND SCIENTIFIC RESEARCH IN THE ADVANCEMENT OF KNOWLEDGE RELATING TO THE DISCOVERY, PREVENTION, AND THE TREATMENT OF DISEASE. TO PROVIDE SCHOLARSHIPS TO STUDENTS PURSUING DEGREES AND CERTIFICATES IN HEALTH CARE PROFESSIONS. 520504 1 1 0 0 0 0 0 0 1 1 0 0 0 1 0 1 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 2 0 1 0 0 0 0 0 0 0 0 0 X 29 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 IN X BETHANY QUINN 7654538066 3500 S LAFOUNTAIN KOKOMO IN 46902 DR SUE SCIAME-GEISECKE 1.00 X X 0 0 0 REBECCA VENT 1.00 X X 0 0 0 GREG GRISWOLD 1.00 X X 0 0 0 JOE DUNBAR 1.00 X X 0 0 0 JAMES ALENDER 1.00 X 0 387061 13810 TED BROWN 1.00 X 0 222337 12417 RALPH BAER X 0 0 0 MARSHA BOWLING 1.00 X 0 0 0 DR WALTER BROWN X 0 0 0 JEFF CARDWELL X 0 0 0 TAMMIE MEADOWS X 0 0 0 DR BERNARD FOGELSON X 0 0 0 BOB FUNK 1.00 X 0 0 0 RANDY MORRIS X 0 0 0 SHERRY HORNER 1.00 X 0 0 0 AARON HUNLEY 1.00 X 0 0 0 CELESTINE JOHNSON X 0 0 0 KIM LAFOLLETTE X 0 0 0 GREG SULLIVAN X 0 0 0 CHANDA MALOTT X 0 0 0 ALAN WARNER X 0 0 0 DR ROBERT MILLER X 0 0 0 DR LAURIE PETERS X 0 0 0 JUNE SCOGGINS X 0 0 0 BRIAN SHEARER X 0 0 0 DWIGHT SINGER X 0 0 0 DAWN SMITH X 0 0 0 RICK SMITH X 0 0 0 MATT TATE X 0 0 0 BOB MASSEY X 0 0 0 KELLY GOAD 40.00 X 0 52549 8571 0 661947 34798 0 0 1 0 0 64023 119234 183257 CAPITAL LEASE 532000 19220 19220 19220 69274 69274 1181369 1132960 48409 48409 48409 29086 10777 18309 18309 338469 67629 0 87583 464409 464409 56095 56095 61120 61120 21900 21900 1166 1166 12750 12750 14219 14219 11717 11717 2903 2903 17945 17945 85 85 OTHER FUNDRAISING EXPEN 9515 9515 PROVISION FOR UNCOLLECT 3897 3897 DUES AND SUBSCRIPTIONS 940 940 678661 520504 148642 9515 430151 310865 461220 395182 51620 36295 548298 214281 510 510 85 0 2381969 2162356 171046 162892 4044389 3281871 2236 1738 23482 4244 499124 210037 44327 40862 569169 256881 X 2808909 2401411 510127 467395 156184 156184 3475220 3024990 4044389 3281871 X -340192 -110038 X 0 1 0 X 0 X 250435 219996 205117 421905 183257 1280710 250435 219996 205117 421905 183257 1280710 245802 1034908 234042 100145 72574 116496 69274 592531 1873241 580143 0.55250 0.66020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 156184 156184 156184 156184 156184 156184 156184 156184 0 0 510 510 0 0 ACCRUED INTEREST 939 LIABILITY UNDER TRUST AGREEMENT 39923 40862 338469 678661 -340192 -108047 -1991 -110038 -450230 239208 -108047 8786 -99261 338469 0 338469 689438 10777 10777 678661 0 678661 PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN VALUE OF CHARITABLE REMAINDER TRUST -1,991. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE FOR CHARITABLE REMAINDER TRUST -1,991. FUNDRAISING COSTS (NETTED ON 990) 10,777. PART XIII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING COSTS (NETTED ON 990) 10,777. ANNUAL GOLF OUTING 29086 29086 1950 8827 29086 29086 1950 8827 10777 18309 0 HOWARD REGIONAL HEALTH SYSTEM 3500 S LAFOUNTAIN ST KOKOMO IN 46902 351128451 501(C)(3) 464409 BOOK VALUE TO RECEIVE AND MAINTAIN FUNDS FOR THE CONSTRUCTION, FURNISHING, EQUIPPING AND IMPROVEMENT OF THE FACILITIES AND SERVICES OF THE HOWARD GIONAL HEALTH SYSTEM (HOSPITAL). TO PROVIDE FINANCIAL ASSISTANCE FOR THE IMPROVEMENT OF THE HEALTH, SAFETY, AND GENERAL WELFARE, AND TO AID IN THE ALLEVIATION OF HUMAN SUFFERING OF ALL PERSONS CONNECTED WITH OR USING THE FACILITIES AND SERVICES OF THE HOSPITAL. 1 TO PROMOTE EDUCATION BY PROVIDING FINANCIAL ASSISTANCE WITH CONTINUING EDUCATION. TO PROVIDE SCHOLARSHIPS TO STUDENTS PURSUING DEGRESS AND CERTIFICATES IN HEALTH CARE PROFESSIONS. 58 56095 0 0 0 0 0 0 0 0 0 JAMES ALENDER 0 387061 0 0 0 0 0 0 0 13810 0 400871 0 0 TED BROWN 0 222337 0 0 0 0 0 0 0 12417 0 234754 0 0 JAMES ALENDER BOARD OF DIRECTOR EMPLOYEE AND OFFICER OF HOWARD REGIONAL HEALTH SYSTEM (RELATED ORGANIZATION - SEE SCHEDULE R) 0 TED BROWN BOARD OF DIRECTOR EMPLOYEE AND OFFICER OF HOWARD REGIONAL HEALTH SYSTEM (RELATED ORGANIZATION - SEE SCHEDULE R) 0 FORM 990, PART VI, SECTION B, LINE 11 THE FINANCE COMMITTEE OF THE GOVERNING BODY REVIEWS THE FORM 990 PRIOR TO ITS SIGNING AND SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL INTERESTED PERSONS ARE REQUIRED TO DISLOSE ANY CONFLICTS OF INTEREST, OR POSSIBLE CONFLICTS OF INTEREST THAT MIGHT POTENTIALLY AFFECT THEIR JUDGMENT IN MAKING DECISIONS ON BEHALF OF THE FOUNDATION BY COMPLETING A CONFLICT OF INTEREST/DISCLOSURE STATEMENT ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -108,047. CHANGE IN VALUE OF CHARITABLE REMAINDER TRUST -1,991. TOTAL TO FORM 990, PART XI, LINE 5: -110,038. LEASED EMPLOYEES: FORM 990, PART V, LINE 2A: THE ORGANIZATION LEASES THE FOUNDATION SPECIALIST FROM A RELATED ENTITY, HOWARD REGIONAL HEALTH SYSTEM. HOWARD REGIONAL HEALTH SYSTEM 3500 S LAFOUNTAIN ST KOKOMO IN 46902 351128451 HOSPITAL IN 501(C)(3) 170(B)(1)(A)III N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 HOWARD REGIONAL HEALTH SYSTEM N 84186 COST BASIS HOWARD REGIONAL HEALTH SYSTEM M 2903 COST ALLOCATION