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Nonprofiteer
← MEMORIAL COMMUNITY HOSPITAL FOUNDATION CORPORATION

Form 990 for tax year 2023

Filed by MEMORIAL COMMUNITY HOSPITAL FOUNDATION CORPORATION.

Totals

Total revenue
$95,298
Total expenses
$72,514
Contributions and grants received
$40,472
Grants paid
$72,160
Program service revenue
$0
Investment income
$55,118
Other revenue
-$292
Total assets, end of year
$1,508,435
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$1,508,435
Program services expenses (Part IX)
$72,514
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$72,514

Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1c · Fundraising events

    $25,182

  • 1f · All other contributions, gifts and grants

    $15,290

  • 3 · Investment income

    total $55,118 · excluded $55,118

  • 8a · Fundraising events: gross income

    $0

  • 8a · Fundraising events: contributions included on line 1c

    $25,182

  • 8b · Fundraising events: direct expenses

    $292

  • 8c · Net income from fundraising events

    total -$292 · excluded -$292

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $72,160 · program services $72,160

  • 13 · Office expenses

    total $354 · program services $354

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $287,956 · end of year $255,961

  • 2 · Savings and temporary cash investments

    beginning of year $1,154,271 · end of year $1,252,474

  • 17 · Accounts payable and accrued expenses

    beginning of year $50,070 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $1,303,708 · end of year $1,415,109

  • 28 · Net assets with donor restrictions

    beginning of year $88,449 · end of year $93,326

Mission and programs · 2023

Mission

THE FOUNDATION AIDS MEMORIAL COMMUNITY HOSPITAL AND HEALTH SYSTEM, BLAIR, NEBRASKA BY SOLICITING CONTRIBUTIONS FOR THE USE AND BENEFIT OF THE HOSPITAL'S PROGRAMS AND SERVICES. THE HOSPITAL PROVIDES ACUTE PREVENTIVE AND CLINICAL HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND DOES NOT LIMIT ITS SERVICES OR DISCRIMINATE BASED ON RACE, SEX, NATIONAL ORIGIN OR RELIGION.

Activities or mission (Part I)

CARRY OUT THE HEALTH CARE MISSION OF MEMORIAL COMMUNITY HOSPITAL.

  • FUNDRAISING FOR THE CAPITAL EQUIPMENT AND OTHER SPECIAL PROGRAM NEEDS OF MEMORIAL COMMUNITY HOSPITAL. THIS WILL BE CARRIED OUT THROUGH COMMUNITY FUNDRAISING DRIVES TO THE BUSINESSES AND INDIVIDUALS OF BLAIR, NEBRASKA, AND OTHER SURROUNDING COMMUNITIES. THESE FUNDRAISING EFFORTS WILL BE CARRIED OUT BY VOLUNTEERS OF THE FOUNDATION AND COMMUNITY.

    Expenses $72,514 · Grants $72,160

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Tawnya Roberts

    PRESIDENT/CHAIR

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Jim Sandvold

    VICE PRESIDENT

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Annette Clark

    TREASURER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Jonna Branz

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Alicia Koziol

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Carl Falk

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Dr John Simonson

    BOARD MEMBER

    Total calculated
    $321,092
    From this org
    $0
    From related orgs
    $312,627
    Other
    $8,465
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $223,693 related
    Bonus
    $0 + $88,934 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $8,465 related
    Filer's total
    $0 + $321,092 related

  • Kyle Acre

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Pat Rogers

    MCH AUXILIARY REP

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • Manuela Banner-Wolf

    CEO

    Total calculated
    $0
    Hours/week
    1 + 40 related

  • Molly Dahlgren

    FOUNDATION EXECUTIVE DIRECTOR

    Total calculated
    $85,409
    From this org
    $0
    From related orgs
    $85,409
    Other
    $0
    Hours/week
    40 + 1 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
DURING THE CALENDAR YEAR 2023, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CHI HEALTH, AN UNRELATED ORGANIZATION. CHI HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION SURVEY OR STUDY, (2) INDEPENDENT COMPENSATION CONSULTANT, AND (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2023
Filed
14 November 2024
IRS schema version
2023v5.1
Source object
202423199349306857

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