2024-08-01T08:21:19-05:00 2023-09-30 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2022-10-01 470707315 BOONE COUNTY HEALTH CENTER FOUNDATION C/O BOONE COUNTY HEALTH CENTER BOON 4023953252 723 WEST FAIRVIEW STREET ALBION NE 68620 MANDY LUETTEL CO-SECRETARY/TREASURER 4023953252 2024-07-31 1 1 MEGAN L KOZIOL CPA P01544037 4023302660 2024-07-29 2022 2024-08-08 14:25:15Z SARAH GRAPE 723 WEST FAIRVIEW STREET ALBION NE 68620 357330 0 X WWW.BOONECOHEALTH.ORG X 1988 NE SOLICIT AND RECEIVE CONTRIBUTIONS FOR THE BENEFIT OF BOONE COUNTY HEALTH CENTER. 10 10 0 25 0 0 647509 211898 128035 99245 8366 33737 -2970 -11457 780940 333423 295628 216837 0 0 0 0 0 0 13413 23807 19485 319435 236322 461505 97101 3076938 3137656 176598 10650 2900340 3127006 X TO SEEK, RECEIVE AND ADMINISTER DONATIONS AND GIFTS WHICH SUPPORT HEALTH CARE OFFERED TO THE SERVICE AREA BY BOONE COUNTY HEALTH CENTER AND CLINICS. 1 0 206980 206980 99245 THE FOUNDATION WAS FOUNDED AND EXISTS TO SOLICIT AND RECEIVE CONTRIBUTIONS, GIFTS, GRANTS, DEVISES OR BEQUESTS OF REAL OR PERSONAL PROPERTY FROM VARIOUS INDIVIDUALS AND ENTITIES AND TO MAINTAIN, USE AND APPLY THE WHOLE OR ANY PART OF THIS INCOME AND THE PRINCIPAL EXCLUSIVELY FOR THE BENEFIT OF BOONE COUNTY HEALTH CENTER. CASH WAS TRANSFERRED TO BOONE COUNTY HEALTH CENTER FOR EQUIPMENT AND VARIOUS OTHER HOSPITAL SUPPLIES. 7107 7107 DONATIONS MADE TO LOCAL COMMUNITY ORGANIZATIONS. 5745 THE FOUNDATION RAISES FUNDS FOR KIDS IN THE SERVICE AREA TO SIGN UP FOR THE DOLLY PARTON LIBRARY PROGRAM AND RECEIVE FREE BOOKS UNTIL THEY ARE 5. 2750 2750 0 SCHOLARSHIPS GIVEN TO COLLEGE STUDENTS PURSUING A CAREER IN NURSING. 2750 2750 0 222582 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 10 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X BOONE COUNTY HEALTH CENTER 4023952191 PO BOX 151 723 W FAIRVIEW ST ALBION NE 68620 SARAH GRAPE EXECUTIVE DIRECTOR 15.00 25.00 X 0 37593 128 BEV SCHUELE CO-PRESIDENT 1.00 0.00 X X 0 0 0 KENNETH KURTENBACH CO-PRESIDENT 1.00 0.00 X X 0 0 0 SUSAN KALHOFF VICE PRESIDENT (THRU 06/2023) 1.00 0.00 X X 0 0 0 TORI PETSCHE BOARD MEMBER / VICE PRESIDENT 0.50 0.00 X X 0 0 0 MANDY LUETTEL CO-SECRETARY/TREASURER 1.50 0.00 X X 0 0 0 KATE SEIER CO-SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 KAREN GLESINGER BOARD MEMBER 0.50 0.00 X 0 0 0 RALPH HORACEK BOARD MEMBER 0.50 0.00 X 0 0 0 HAILEY ECKSTEIN BOARD MEMBER 0.50 0.00 X 0 0 0 LINDSEY CHRISTMAN BOARD MEMBER 0.50 0.00 X 0 0 0 SHEILA FOWLKES BOARD MEMBER 0.50 0.00 X 0 0 0 0 37593 128 0 0 0 0 0 46437 165461 211898 NE PURCHASING GROUP 900099 98885 98885 SAFE KIDS 900099 360 360 99245 33737 33737 12450 46437 23907 -11457 -11457 333423 99245 0 22280 214087 214087 2750 2750 2177 2177 2959 2959 327 327 1260 1260 FUNDRAISING EXPENSES 5922 5922 DOLLY PARTON LIBRARY PR 5745 5745 TRAINING 688 688 TAXES 274 274 133 133 236322 222582 327 13413 1057907 862840 1177928 1401084 28000 21000 723488 759786 89615 92946 3076938 3137656 176598 10650 176598 10650 X 2375843 2334169 524497 792837 2900340 3127006 3076938 3137656 97101 138175 -8610 0 X 0 0 0 X X 1 BOONE COUNTY HEALTH CENTER 476000611 3 1 206980 0 1 206980 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, LINE 6: THE ORGANIZATION PROVIDED SUPPORT TO ORGANIZATIONS OTHER THAN ITS SUPPORTED ORGANIZATION, BOONE COUNTY HEALTH CENTER (BCHC), DURING THE YEAR. THESE ORGANIZATIONS ARE NOT ALL OTHER SUPPORTING ORGANIZATIONS, BUT BENEFIT THE COMMUNITY OF BOONE COUNTY THAT IS SERVED BY BOTH THE ORGANIZATION AND BCHC. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 104805 14810 2676 116939 132531 -24978 2748 104805 108081 1367 25352 2269 132531 100146 8406 471 108081 100000 1032 886 100146 1.00000 0.00000 0.00000 1 0 0 NEBRASKA PURCHASING GROUP 642848 F NEBRASKA COMMUNITY FOUNDATION 116938 F 759786 PART V, LINE 4: THE FUND AGREEMENT MADE BETWEEN NEBRASKA COMMUNITY FOUNDATION (NCF), A NEBRASKA NONPROFIT CORPORATION AND 501(C)(3) PUBLIC CHARITY, AND BOONE COUNTY HEALTH CENTER FOUNDATION (BCHCF), A 501(C)(3) PUBLIC CHARITY, TO ESTABLISH AN AFFILIATED FUND AS A COMPONENT OF NCF TO ALLOW BCHCF TO BUILD AND CONTRIBUTE TO AN ENDOWMENT FUND FOR ITS OWN BENEFIT. THIS FUND AND ALL GIFTS TO THE FUND ARE IRREVOCABLE. ALL ASSETS TO THE FUND ARE FOR CHARITABLE PURPOSES, CONSISTENT WITH SECTION 170 AND 501(C)(3) OF THE INTERNAL REVENUE SERVICE. ALL GIFTS WILL BE ADDED TO THE PRINCIPAL OF THE ACCOUNT, WITH ONLY THE PORTION ALLOWED BY NCF POLICIES FOR DISBURSEMENT. ALBION GOLF TOURNAMENT 25755 19755 6000 1875 2473 2394 3621 2255 GALA 33132 26682 6450 1750 280 3651 800 4808 58887 46437 12450 1875 4223 2674 7272 800 7063 23907 -11457 1 BOONE COUNTY HEALTH CENTER 723 WEST FAIRVIEW ALBION NE 68620 476000611 501(C)(3) 206980 0 PURCHASE OF PROPERTY AND EQUIPMENT 1 0 PART I, LINE 2: REQUESTS BY BOONE COUNTY HEALTH CENTER FOR SUPPORT FROM THE BOONE COUNTY HEALTH CENTER FOUNDATION ARE SUBSTANTIATED BY DOCUMENTATION OF THE EXPENSE AND A FORMAL REQUEST FORM SIGNED BY THE RELEVANT DEPARTMENT HEAD. THAT REQUEST IS THEN BROUGHT BEFORE THE FOUNDATION BOARD, DISCUSSED, VOTED UPON, AND SIGNED, IF APPROVED, BEFORE THE TRANSFER OF FUNDS IS MADE. FORM 990, PART III, LINE 2 DURING THE CURRENT YEAR, THE FOUNDATION STARTED RAISING FUNDS TO BECOME A PART OF THE DOLLY PARTON LIBRARY PROGRAM. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE, CONSISTING OF AT LEAST THREE DIRECTORS DESIGNATED BY THE BOARD, SHALL HAVE THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY IN THE INTERVAL BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF TRUSTEES OF BOONE COUNTY COMMUNITY HOSPITAL SHALL HAVE THE POWER TO CANCEL THE NOMINATION OF ANY CANDIDATE FOR THE BOARD OF DIRECTORS PRIOR TO SUCH PERSON'S ELECTION AS DIRECTOR, PURSUANT TO PROCEDURES DETERMINED FROM TIME TO TIME BY THE BOARD OF DIRECTORS. NO PERSON WHOSE CANDIDACY HAS BEEN EXPRESSLY DISAPPROVED BY SAID BOARD OF TRUSTEES MAY SERVE AS A DIRECTOR OF THIS CORPORATION UNLESS SUCH PERSON HAS BEEN RE-NOMINATED WITHOUT SUBSEQUENT CANCELLATION, OR THE CANCELLATION HAS BEEN REVOKED. FORM 990, PART VI, SECTION B, LINE 11B THE CFO OF BOONE COUNTY HEALTH CENTER REVIEWS, APPROVES AND FILES THE FOUNDATION'S FORM 990 WITH THE IRS BEFORE THE DUE DATE. IN THE ABSENCE OF A BOARD MEETING IN THE RIGHT TIMEFRAME, A COMPLETE COPY OF THE FORM 990 IS E-MAILED TO EACH MEMBER OF THE BOARD FOR REVIEW BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE POLICY IS REVIEWED AND REAFFIRMED ANNUALLY. MEMBERS WILL ABSTAIN FROM VOTING ON ANY ISSUES DURING THE COURSE OF THE YEAR THAT MAY APPEAR TO BE A VIOLATION OF THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 BOONE COUNTY HEALTH CENTER FOUNDATION HAS NO EMPLOYEES; THEREFORE, THERE IS NO COMPENSATION POLICY TO DETERMINE COMPENSATION FOR A CEO, EXECUTIVE DIRECTOR, TOP MANAGEMENT OFFICIAL, OTHER OFFICERS OR KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 BOONE COUNTY HEALTH CENTER FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. BOONE COUNTY HEALTH CENTER 723 WEST FAIRVIEW ALBION NE 68620 476000611 HOSPITAL NE 501(C)(3) 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0