2024-09-03T16:02:04-05:00 2022-12-31 273858252 DEAN DORTON ALLEN FORD PLLC 435 N WHITTINGTON PKWY STE 400 LOUISVILLE KY 40222 990 2022-01-01 310933781 FLOYD MEMORIAL FOUNDATION INC FLOY 8129495519 2626 CHARLESTOWN RD NEW ALBANY IN 47150 JESSICA TANDY STATEN EXECUTIVE DIRECTOR 8126205422 2024-09-03 1 0 AMELIA SEBASTIAN P01251828 5025896050 2022 2024-08-08 14:25:15Z X JESSICA TANDY STATEN 2626 CHARLESTOWN RD NEW ALBANY IN 47150 1346597 0 X WWW.FLOYDFOUNDATION.ORG X 1978 IN TO PROVIDE PHILANTHROPIC SUPPORT TO BAPTIST HEALTH FLOYD HOSPITAL TO ENHANCE THE QUALITY OF HEALTH OF THE COMMUNITY THROUGH HEALTHIER COMMUNITY INITIATIVE PROGRAMS, SCHOLARSHIPS, AND SUPPORT OF OTHER HOSPITAL PROGRAMS. 19 19 0 50 0 0 261857 402137 0 0 1068365 408809 56982 48675 1387204 859621 534660 550120 0 0 0 0 0 0 16388 253467 215145 788127 765265 599077 94356 21158210 17885178 606231 531964 20551979 17353214 THE MISSION OF THE FOUNDATION IS TO PROVIDE PHILANTHROPIC SUPPORT TO BAPTIST HEALTH FLOYD AND SOUTHERN INDIANA HEALTHCARE INITIATIVES THAT ENHANCE THE QUALITY OF CARE AVAILABLE TO THE COMMUNITY. 0 0 571100 550120 30373 THE FOUNDATION FINANCIALLY SUPPORTS THE HOSPITAL BY FUNDING VARIOUS PROGRAMS RELATED TO THE HOSPITAL'S EXEMPT PURPOSE, INCLUDING FUNDS FOR HCI, EDUCATIONAL PROGRAMS, MEDICAL RESOURCES, TECHNOLOGY AND HEALTH SCREENINGS WHICH ARE PROVIDED TO THE COMMUNITY TO PROMOTE WELLNESS AND A HEALTHIER LIFESTYLE. THE FOUNDATION USES FUNDS TO HELP HOSPITAL EMPLOYEES EXPERIENCING PERSONAL HARDSHIP. THE FOUNDATION PROVIDES SCHOLARSHIPS TO HOSPITAL EMPLOYEES PURSUING CAREERS IN HEALTHCARE. 571100 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 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 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 19 19 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 IN X EMILY BYRD 8129495519 2626 CHARLESTOWN RD NEW ALBANY IN 47150 ADAM SMITH SECRETARY 1.00 X 0 0 0 JAKE ARCHIBALD BOARD MEMBER 1.00 X 0 0 0 JOE DABLOW TREASURER 1.00 X 0 0 0 DAYNA ASHLEY BOARD MEMBER 1.00 X 0 0 0 MICHAEL SCHROYER PRESIDENT 1.00 X 0 0 0 AMBER BANET BOARD MEMBER 1.00 X 0 0 0 HON MARIA GRANGER BOARD MEMBER 1.00 X 0 0 0 DR BRAIDI HUECKER BOARD MEMBER 1.00 X 0 0 0 EMILY BYRD PHILANTHROPY COORDINATOR 1.00 X 0 0 0 CHRISTOPHER LANE ESQ BOARD MEMBER 1.00 X 0 0 0 JAMES Y MCCULLOUGH JR MD BOARD MEMBER 1.00 X 0 0 0 JOSEPH GLOVER CHAIRMAN 1.00 X 0 0 0 CORY COCHRAN BOARD MEMBER 1.00 X 0 0 0 MEREDITH LAMBE EXECUTIVE DIRECTOR 1.00 X 0 0 0 BRIAN LENFERT BOARD MEMBER 1.00 X 0 0 0 CLAYTON ROSE BOARD MEMBER 1.00 X 0 0 0 KRISHNA KONIJETI MD BOARD MEMBER 1.00 X 0 0 0 PATRICK FALVEY COO BOARD MEMBER 1.00 X 0 0 0 BEAU ZOELLER ESQ BOARD MEMBER 1.00 X 0 0 0 MATT MILLIES VICE CHAIRMAN 1.00 X 0 0 0 TATE SMITH RN BOARD MEMBER 1.00 X 0 0 0 LACIE COUZIN PHD RN BOARD MEMBER 1.00 X 0 0 0 ERYNN MCINNIS PHILANTHROPY OFFICER 1.00 X 0 0 0 0 0 0 0 0 0 0 0 42383 359754 402137 163505 163505 676423 431119 245304 245304 245304 74159 42383 55857 18302 18302 OTHER INCOME 900099 30373 30373 30373 859621 30373 0 427111 550120 550120 383 383 90120 90120 18336 720 17553 63 14200 5609 868 7723 9755 5030 3037 1688 4671 4671 2315 2315 3059 3059 8503 8503 MISCELLANEOUS 36748 2226 27608 6914 PROGRAM 27055 2724 24331 765265 571100 177777 16388 1271171 1663510 13761 5915 6155 19818988 16168133 48375 47380 21158210 17885178 18922 2194 587309 529770 606231 531964 X 19888367 16710769 663612 642445 20551979 17353214 21158210 17885178 94356 -3293121 0 X X 0 1 X 0 0 X 1158556 997743 3827884 261857 359754 6605794 1158556 997743 3827884 261857 359754 6605794 150041 6455753 83719 99274 298575 372201 163505 1017274 15049 17156 12013 291 30373 74882 7697950 0.83860 0.89670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 754472 126496 627976 670861 150144 66533 754472 636083 153984 119206 670861 453240 262824 79981 636083 418406 53077 18243 453240 0.06000 0.29000 0.65000 0 0 0 -2127943 -3293121 339820 55857 -2897444 769501 90120 90120 859621 1070822 339820 55857 395677 675145 90120 90120 765265 PART XI, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISER EXPENSES 55,857. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISER EXPENSES 55,857. GOLF CLASSIC 71387 10800 60587 1965 1624 11254 WHITE COAT DINNER 45155 31583 13572 2309 19848 3000 15857 116542 42383 74159 4274 21472 3000 27111 55857 18302 0 YMCA 33 STATE STREET SUITE 311 NEW ALBANY IN 47150 610444843 7470 0 CASH SUPPORT FOR STAFF & PEER LEADER TRAINING & COVER COSTS TO OFFER COOMPLIMENTARY MOOD LIFTERS PROGRAM VULNERABLE ADULT CARE ADVOCATES 33 STATE STREE SUITE 311 NEW ALBANY IN 47150 844740620 30000 0 CASH OPERATIONS, COURT COSTS AND VOLUNTEER TRAINING THE BREAKAWAY 1514 E SPRING STREET NEW ALBANY IN 47150 815418476 11000 0 CASH PURCHASE SITE RECOVERY DYNAMICS PROGRAM LICENSE AND PROGRAM SUPPLIES AND MATERIALS, "LIFE RECOVERY BIBLE" & "AA BIG BOOK DICTIONARY" FOR RESIDENTS; PURCHASE DRUG TESTING CUPS PERSONAL COUNSELING SERVICES 1205 APPLEGATE LANE CLARKSVILLE IN 47129 310919635 15000 0 CASH FREE COUNSELING SERVICES NEW ROOTS INC 1800 PORTLAND AVENUE LOUISVILLE KY 40203 270700459 10000 0 CASH PROVIDE MATCHED FUNDING FOR THE SNAP BENEFITS PROGRAM AND THE NEW ALBANY FRESH STOP MARKET TO PAY FARMERS FAIR WAGES LET US LEARN 427 HIGHLAND AVENUE NEW ALBANY IN 47150 814032329 16000 0 CASH CONTINUE TO PROVIDE FUNDING FOR VEGGIE RESCUE MARKETING, MARKET GARDEN AND STAFFING TO PROMOTE FOOD SECURITY AMONG DISADVANTAGED COMMUNITY MEMBERS. INDIANA UNIVERSITY SOUTHEAST 4201 GRANT LINE ROAD NEW ALBANY IN 47150 356001673 6000 0 CASH FUNDING TO COVER COSTS FOR 3-DAY MENTAL HEALTH FIRST AID TRAINING FOR DR. WILLIAMS TRAINING HOPE SOUTHERN INDIANA 1200 BONO ROAD NEW ALBANY IN 47150 351128300 10000 0 CASH FINANCIAL ASSISTANCE FOR FAMILIES DISPLACED/AFFECTED BY COVID HOMELESS COALITION OF SOUTHERN INDIANA 1015 E MARKET STREET NEW ALBANY IN 47150 811637476 10000 0 CASH WHITE FLAG PROGRAM FLOYD COUNTY PARKS & RECREATION 620 PARK EAST BOULEVARD NEW ALBANY IN 47150 356000144 50000 0 CASH PROVIDE FUNDING TO SUPPORT THE INSTALLATION OF A PLAYGROUND AND POURED IN PLACE RUBBER SURFACE FOR ALL FLOYD COUNTY RESIDENTS FAMILY HEALTH CENTER 1319 DUNCAN AVENUE JEFFERSONSVILLE IN 47130 351842342 28000 0 CASH OPERATIONAL EXPENSES INCLUDING WOMEN'S PROVIDER AND PPE SUPPLIES FAMILY ARK 101 NOAHS LANE JEFFERSONVILLE IN 47130 351292608 15000 0 CASH RENOVATE EXISTING SPACE INTO COUNSELING CENTER FOR ADDICTED MOTHERS FAMILY & CHILDREN'S PLACE 525 ZANE STREET LOUISVILLE KY 40203 610549561 14990 0 CASH FORENSIC INTERVIEWS, MEDICAL EVALUATIONS, MENTAL HEALTH SERVICES AND FAMILY ADVOCATE SERVICES CHRISTIAN FORMATION MINISTRIES PO BOX 1575 NEW ALBANY IN 47150 760785022 20000 0 CASH PROVIDE SCHOLARSHIPS FOR MYCAMP ATTENDEES WHOSE PARENTS ARE INCARCERATED ($625 PER CHILD) CAMP QUALITY KENTUCKIANA PO BOX 1894 NEW ALBANY IN 47150 382208796 6000 0 CASH PROVIDE SUPPORT FOR GENERAL OPERATING FOR WEEKLONG SUMMER CAMP FOR 105 CHIDREN DIAGNOSED WITH CANCER OR IN RECOVERY, 105 VOLUNTEERS, 7 NURSES & 25 FULL-TIME STAFF BLESSINGS IN A BACKPACK 1839 BROWNSBORO ROAD LOUISVILLE KY 40206 202552199 35000 0 CASH PROVIDE FUNDING FOR FOOD FOR 38 WEEKENDS IN THE SCHOOL YEAR FOR CHILDREN SUFFERING FROM FOOD INSECURITY BIG BROTHERS BIG SISTERS OF KENTUCKIANA 1519 GARDINER LANE LOUISVILLE KY 40218 616057856 15000 0 CASH PROVIDE FUNDING FOR ENROLLING SCREEING AND TRAINING VOLUNTEERS TO BECOME MENTORS; ASSESS, MATCH AND EVALUATE 40 YOUTH IN FLOYD, HARRISON & CLARK COUNTIES; PLAN & COORDINATE ACTIVITIES BAPTIST HEALTH FLOYD 1850 STATE STREET NEW ALBANY IN 47150 610444707 245660 0 CASH MEDICAL EQUIPMENT, TECHNOLOGY, RESOURCES FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS FORM 990, PART VI, SECTION A, LINE 7A THE NON-HOSPITAL MEMBERS, VOTING AS A CLASS, SHALL ELECT THE REMAINING BOARD OF DIRECTORS. EACH NON-HOSPITAL MEMBER SHALL BE ENTITLED TO ONE VOTE IN THE ELECTION OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE NON-HOSPITAL MEMBERS, VOTING AS A CLASS, SHALL ELECT THE REMAINING BOARD OF DIRECTORS. EACH NON-HOSPITAL MEMBER SHALL BE ENTITLED TO ONE VOTE IN THE ELECTION OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE PROCESS OF REVIEW OF THE FORM 990 CONSISTS OF A DETAILED REVIEW BY THE FOUNDATION'S MANAGEMENT. THE GOVERNING BODY RECEIVES A COPY VIA EMAIL OF THE FORM 990 FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION ABIDES BY THE POLICIES OF BAPTIST HEALTH FLOYD WHICH INCLUDES THE HOSPITAL'S CONFLICT OF INTEREST POLICY. THAT POLICY IS REGULARLY AND CONSISTENTLY ENFORCED AND MONITORED BY THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE HOSPITAL. THE SCOPE OF THE POLICY INCLUDES TRUSTEES; DIRECTORS; MEDICAL EXECUTIVE COMMITTEE MEMBERS; AND ADMINISTRATORS. THE POLICY SERVES TO IDENTIFY AND PREVENT CONFLICTS OF INTEREST. THE COVERED PERSONS ARE TO REFRAIN FROM ACCEPTING GIFTS THAT MIGHT INFLUENCE ONE'S JUDGEMENT CONCERNING ISSUES BEFORE THE HOSPITAL AND THE FOUNDATION; USING INSIDE INFORMATION RELATING TO THE HOSPITAL OR THE FOUNDATION FOR PERSONAL PROFIT AND ADVANTAGE; AND ANY OTHER ACTIVITY WHICH WOULD BE PERCEIVED AS A CONFLICT OF INTEREST. A WRITTEN DISCLOSURE FORM IS REQUIRED OF EACH COVERED PERSON WHICH IS SUBMITTED TO THE HOSPITAL'S GENERAL LEGAL COUNSEL ON ANY POTENTIAL CONFLICT OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2: THE AUDIT WAS NOT COMPLETE AT THE TIME OF FILING AND AN AMENDED RETURN WAS FILED ONCE THE AUDITED FINANCIAL STATEMENTS BECAME AVAILABLE. STATEMENT OF REVENUE, BALANCE SHEET, AND ALL SCHEDULES CHANGED. BAPTIST HEALTH FLOYD 1850 STATE STREET NEW ALBANY IN 47150 610444707 HOSPITAL IN 501C 3 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 BAPTIST HEALTH FLOYDFLOYD MEM HOSP B 318688 COST BAPTIST HEALTH FLOYDFLOYD MEM HOSP C 339820 COST