2024-11-14T15:39:23-06:00 2023-12-31 450250958 Eide Bailly LLP 4585 Coleman St Ste 200 Bismarck ND 58503 990 2023-01-01 203161048 Edgerton Hospital Capital Foundation Inc EDGE 6088841401 11101 North Sherman Rd Edgerton WI 53534 Marc Augsburger President 6088841401 2024-11-13 1 1 Lisa Chaffee CPA P00193453 7012551091 2024-11-13 2023 2024-10-15 13:58:12Z Rose Bice 11101 North Sherman Rd Edgerton WI 53534 365128 0 X www.edgertonhospital.com X 2006 WI Provide financial support for Edgerton Hospital and Health Services 12 11 0 11 0 0 231421 328689 0 0 0 36439 0 0 231421 365128 329098 197127 0 0 0 0 0 0 10207 4085 11179 333183 208306 -101762 156822 269463 426285 0 0 269463 426285 X To provide on-going financial support for new advancements in medicine and future efforts to maintain quality healthcare in the Edgerton, Milton and surrounding areas. 0 0 197127 197127 The Edgerton Hospital Capital Foundation, Inc. exists to provide on-going financial support for Edgerton Hospital and Health Services so they can continue to provide quality health care in the Edgerton, Milton and surrounding areas. All funds raised by the Edgerton Hospital Capital Foundation will be used to support the Hospital and its mission.As Edgerton Hospital's fundraising arm, the Capital Foundation's purpose is to secure donations for the funding of special projects, medical equipment, and programs. The Edgerton Capital Foundation, on behalf of the Edgerton Hospital submitted a grant application and secured a $3.8 million Wisconsin Healthcare Infrastructure Grant that funded the new clinic in downtown Edgerton, Senior Life Solutions (a senior-focused counseling center), and upgrades and improvements to Radiology. 197127 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 0 0 0 WI X Ann Heiden 6088841656 11101 North Sherman Road Edgerton WI 53534 Marc Augsburger President 0.30 40.00 X X 0 251370 39691 Rose Mary Bice Chair 0.30 0.00 X X 0 0 0 Fred Falk Vice Chair (Jan-Aug) 0.30 0.00 X X 0 0 0 Vannesa Paulson Secretary/Treasurer 0.30 0.00 X X 0 0 0 Karen Greene Vice Chair (Sept-Dec) 0.30 0.30 X X 0 0 0 Jeff Roethe Director 0.30 0.00 X 0 0 0 Sam Wilcox Director 0.30 0.00 X 0 0 0 Vicki Morris Director 0.30 0.00 X 0 0 0 Claudia Underhill Director 0.30 0.00 X 0 0 0 Becky Fjelstad Director 0.30 0.00 X 0 0 0 Mary Wileman Director 0.30 0.00 X 0 0 0 Pete Sanville Director 0.30 0.00 X 0 0 0 Dennis Pauli Director 0.30 0.00 X 0 0 0 Ann Heiden Executive Director 40.00 0.00 X 0 101907 9628 0 353277 49319 0 0 1 0 0 10207 318482 10207 328689 36439 36439 365128 0 0 36439 197127 197127 10207 10207 Bank Fees 972 972 208306 197127 972 10207 269463 426285 269463 426285 0 0 X 236872 317496 32591 108789 269463 426285 269463 426285 156822 0 X 0 1 X 0 0 X X 1 Edgerton Hospital and Health Services 390919992 3 1 197127 0 1 197127 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X Part X, Line 2: The Organization believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. 1 Edgerton Hospital and Health Services Inc 11101 North Sherman Road Edgerton WI 53534 390819992 501(c)(3) 197127 0 Donation for the purchase of property and equipment 1 0 Part I, Line 2: Edgerton Hospital Capital Foundation, Inc. gives support to Edgerton Hospital & Health Services, Inc., a related organization. The Foundation was established to support the Hospital as indicated by the governing documents. The Board determines the funding based on the need presented by the organization. Documentation of the use of the funds is provided to the Foundation to confirm the funds were used appropriately. 0 0 0 0 0 0 0 0 0 Marc Augsburger President 0 251370 0 0 0 0 0 10319 0 30868 0 292557 0 0 Part I, Line 3 The Organization relied on Edgerton Hospital and Health Services, a related organization, which used one or more of the methods on Part I, Line 3 to establish the President's compensation. Form 990, Part VI, Section A, line 1a The Executive Committee of the Board is a standing committee consisting of the President, Chair, Vice Chair, Secretary and Treasurer. The Executive Committee has all duties and responsibilities of the Board and is authorized to act on behalf of the Board between its regular or special meetings. Any action of the Executive Committee is binding upon the board and reported to the Board at its next meeting. The Committee will meet upon call of its Chair or a majority of its members. Form 990, Part VI, Section A, line 2 Marc Augsburger and Ann Heiden have a business relationship. Form 990, Part VI, Section A, line 6 Edgerton Hospital and Health Services, Inc. is sole member of the organization. Form 990, Part VI, Section A, line 7a Edgerton Hospital and Health Services, Inc. may appoint, from nominees recommended by the Board of Directors, and remove the Directors of the Corporation. Form 990, Part VI, Section A, line 7b Edgerton Hospital & Health Services, Inc., sole member, has the following exclusive powers after review of the recommendations of the Foundation Board: (a) Establish policies for fundraising, spending and investment by the Foundation; (b) Approve unbudgeted expenditures by the Foundation in excess of the corporate spending limit; (c) Accept contributions that impose a material obligation on the Foundation; (d) Select independent auditors, legal counsel and/or other major consultants for the Foundation; (e) Adopt and amend statements of mission, philosophy or purpose; (f) Amend the Foundation's Articles of Incorporation and Bylaws; (g) Appoint, from nominees recommended by the Foundation Board of Directors, and remove, with or without cause, the Directors of the Foundation as provided in Article III; and (h) Appoint, review and remove the President of the Foundation. The President of the Foundation occupies the position of CEO of Edgerton Hospital and Health Services, Inc. After being reviewed and adopted by the Foundation Board of Directors, the following matters must be submitted to the sole member for approval. These actions are not authorized unless approved by the sole member. (a) Capital and operating budgets of the Foundation; (b) Purchases, sales and leases of property by the Foundation in excess of the corporate spending limit; (c) Borrowing by the Foundation in a principal amount in excess of the corporate spending limit, or for a stated term in excess of one year or which is secured by a mortgage of real property; (d) Any major change in the programs and services rendered by the Foundation, including any creation of new or discontinuation of existing programs and services; and (e) Any resolution regarding dissolution, merger or consolidation of the Foundation or the sale, lease, mortgage or transfer of the Foundation's real property, or of all or substantially all of the Foundation's assets. Form 990, Part VI, Section B, line 11b The Form 990 is provided to the governing body before it is filed. The return is reviewed by the Accounting Manager and the CFO of Edgerton Hospital and Health Services, a related organization. Form 990, Part VI, Section B, line 12c Board members and officers of the Board are required to sign a conflict of interest policy annually. The Board Chair and CEO review the potential conflicts of Board members. Board members with conflicts are restricted from voting on such matters. Form 990, Part VI, Section B, line 15 The Organization's top management official is compensated by Edgerton Hospital & Health Services, Inc., a related organization. Edgerton Hospital and Health Services uses these methods to determine compensation for that individual. The Foundation Director's compensation is determined by an annual evaluation conducted through the Hospital's CEO. The process is documented in the Foundation Director's personnel file. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are available upon written request. Part XII Line 2c Edgerton Hospital and Health Services, Inc. assumed responsibility for oversight of the audit for Edgerton Hospital Capital Foundation, Inc. Edgerton Hospital and Health Services Inc 11101 North Sherman Road Edgerton WI 53534 390819992 Provision of health care services WI 501(c)(3) Line 3 N/A 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 0