2024-11-13T15:52:29-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 4334 MUNSON STREET SUITE 200 CANTON OH 44718 990 2023-01-01 463060489 NORTH CANTON MEDICAL FOUNDATION NORT 3304331411 6046 WHIPPLE AVE NW NORTH CANTON OH 44720 JOHN HUMPHREY MD EXECUTIVE DIRECTOR 3304331411 2024-11-12 1 1 JENNIFER COLEMAN P00743188 3304972000 2024-11-12 2023 2024-10-15 13:58:12Z JOHN HUMPHREY MD 6046 WHIPPLE AVE NW NORTH CANTON OH 44720 12256728 0 X WWW.NCMF.COM X 2013 OH TO IMPROVE COMMUNITY HEALTH AND WELLNESS THROUGH COLLABORATION AND FINANCIAL SUPPORT. 19 18 2 18 0 0 116707 132077 0 0 -208276 486615 554490 130 462921 618822 382596 422439 0 0 101228 113672 0 0 0 157027 155902 640851 692013 -177930 -73191 22064104 23946181 101300 0 21962804 23946181 NORTH CANTON MEDICAL FOUNDATION'S MISSION IS TO IMPROVE THE HEALTH AND WELLNESS OF OUR COMMUNITY THROUGH COLLABORATION AND FINANCIAL SUPPORT. 0 0 545284 422439 0 NORTH CANTON MEDICAL FOUNDATION COLLABORATES WITH AND SPONSORS PROGRAMS THAT PROVIDE FOR HEALTH AND WELLNESS FOR THE COMMUNITY, INCLUDING AN EMPHASIS ON THE UNDERSERVED IN OUR COMMUNITY. EXAMPLES OF PROGRAMS WE CURRENTLY FUND INCLUDE INVOLVEMENT IN AND SUPPORT OF THE HARTVILLE MIGRANT MEDICAL CLINIC; INVOLVEMENT IN AND SUPPORT OF ACCESS HEALTH STARK COUNTY; MELANOMA AWARENESS EDUCATION PROGRAMS; AND A CANCER RELIEF FUND THAT PROVIDES TEMPORARY FINANCIAL SUPPORT TO CANCER PATIENTS NEEDING ASSISTANCE WITH CANCER TREATMENT-RELATED COSTS. ITS MISSION IS TO EASE THE SUFFERING OF CANCER PATIENTS BY PROVIDING FOR THEIR IMMEDIATE NEEDS IN WAYS NOT PROVIDED FOR BY OTHER PROGRAMS AND TO SUPPORT RETIRED PHYSICIANS WHO VOLUNTEER IN THE COMMUNITY THROUGH THE RETIRED PHYSICIANS PROGRAM. 545284 1 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 18 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X STACY REMARK 3304331411 6046 WHIPPLE AVE NW NORTH CANTON OH 44720 DR JOHN HUMPHREY MD EXECUTIVE DIRECTOR 30.00 X X 80000 0 0 LISA WARBURTON-GREGORY CHAIRMAN 2.00 X X 0 0 0 EILEEN IVAN VICE CHAIRMAN 2.00 X X 0 0 0 ROD A MOORE SECRETARY 2.00 X X 0 0 0 WILLIAM R COOK TREASURER 2.00 X X 0 0 0 BRIAN BELDEN BOARD MEMBER 2.00 X 0 0 0 DR WILLIAM FAYEN BOARD MEMBER 2.00 X 0 0 0 GEORGE FILM BOARD MEMBER 2.00 X 0 0 0 TIFFANY GOOD WITMER BOARD MEMBER 2.00 X 0 0 0 DR MATTHEW HIESTAND BOARD MEMBER 2.00 X 0 0 0 CHUCK HOOVER BOARD MEMBER 2.00 X 0 0 0 STACY KELLY BOARD MEMBER 2.00 X 0 0 0 DR PAUL MANUSZAK BOARD MEMBER 2.00 X 0 0 0 M MARCY MERTES BOARD MEMBER 2.00 X 0 0 0 WILLIAM SCHAUER BOARD MEMBER 2.00 X 0 0 0 JOHN SCHUSTER BOARD MEMBER 2.00 X 0 0 0 SARA TIMKEN BOARD MEMBER 2.00 X 0 0 0 SCOTT WARBURTON BOARD MEMBER 2.00 X 0 0 0 LISA ZELLERS BOARD MEMBER 2.00 X 0 0 0 80000 0 0 0 0 0 0 0 132077 132077 452961 452961 11671560 11637906 33654 33654 33654 MISCELLANEOUS REVENUE 900099 130 130 130 618822 0 0 486745 422439 422439 80000 80000 24750 24750 8922 8922 11823 11823 114668 114668 5250 5250 13759 1402 12357 1363 1363 2525 2525 CANCER RELIEF FUND 6223 6223 MISCELLANEOUS 291 185 106 692013 545284 146729 0 133584 112725 25870 521006 5624 19792 153690 7371398 21745336 15921260 22064104 23946181 1300 0 100000 0 101300 0 X 19769399 21305832 2193405 2640349 21962804 23946181 22064104 23946181 X -73191 1981312 14167 61089 X 1 X 0 0 0 X 51209 94012 91591 116707 132077 485596 51209 94012 91591 116707 132077 485596 149371 336225 212057 119832 169150 418990 452961 1372990 117 401770 7086 554490 130 963593 2822179 0.11910 0.16830 X ORGANIZATION HISTORY:ORGANIZED IN 2013, NORTH CANTON MEDICAL FOUNDATION (NCMF) AWARDS GRANTS TO ORGANIZATIONS THAT FOCUS ON PROGRAMS OR SERVICES THAT WILL HAVE A POSITIVE, SUSTAINABLE IMPACT ON THE HEALTH OF OUR COMMUNITY. FORMERLY A MEDICAL CARE FACILITY STARTED BY RALPH T. WARBURTON, M.D. AND FOUR OTHER STARK COUNTY PHYSICIANS TO NOW A GRANT-GIVING ORGANIZATION, NCMF STILL HOLDS TRUE TO ITS LEGACY AND MISSION OF "IMPROVING THE HEALTH AND WELLNESS OF OUR COMMUNITY THROUGH COLLABORATIONS AND FINANCIAL SUPPORT". THEY CURRENTLY SUPPORT THE HARTVILLE MIGRANT MEDICAL CLINIC, ACCESS HEALTH STARK COUNTY, MELANOMA AWARENESS EDUCATION PROGRAMS, A CANCER RELIEF FUND AND PHYSICAL REHABILITATION PROGRAMS FOR CANCER PATIENTS.CUMULATIVELY THROUGH 2023, GRANTS HAVE BEEN AWARDED TOTALING $7,840,410.SOURCES OF SUPPORT:NORTH CANTON MEDICAL FOUNDATION HAS A FUNDRAISING PLAN IN PLACE TO GENERATE CONTRIBUTIONS INCLUDING REQUESTS FROM THE WEBSITE, BOARD CONTRIBUTIONS, FUNDRAISING ACTIVITIES, GRANT WRITING AND VARIOUS COLLABORATION EFFORTS WITH COMMUNITY PARTNERS. GOVERNING BODY:NORTH CANTON MEDICAL FOUNDATION CURRENTLY HAS ONE PAID EXECUTIVE DIRECTOR AND EIGHTEEN UNPAID VOLUNTEER BOARD MEMBERS/DIRECTORS REPRESENTING A BROAD CROSS SECTION OF THE GENERAL PUBLIC. THESE MEMBERS/DIRECTORS INCLUDE LOCAL PHYSICIANS, BUSINESS OWNERS, ATTORNEYS, CPAS, AND COMMUNITY LEADERS. REPLACEMENT BOARD MEMBERS/DIRECTORS ARE NOMINATED BASED ON THEIR COMMUNITY INVOLVEMENT AND ABILITY TO REPRESENT A BROAD CROSS-SECTION OF THE GENERAL PUBLIC.PUBLICLY SUPPORTED ORGANIZATION:THE NORTH CANTON MEDICAL FOUNDATION SERVES THE INTERESTS OF THE GENERAL COMMUNITY, THE BOARD OF DIRECTORS REPRESENTS THE INTERESTS OF THE GENERAL COMMUNITY, AND THE ORGANIZATION HAD A PLAN IN PLACE TO GENERATE CONTRIBUTIONS FROM THE GENERAL PUBLIC. THE ORGANIZATION BELIEVES THE FACTS-AND-CIRCUMSTANCES TEST IS MET THUS CONTINUING ITS QUALIFICATION AS A PUBLICLY SUPPORTED ORGANIZATION. ORGANIZATION. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13977622 2561996 344921 96678 16098019 16254767 53467 -2194001 64311 72300 13977622 14138085 2502371 288000 97689 16254767 13157425 2 1059671 79013 14138085 11695061 2092772 550000 80408 13157425 0.93905 0.04997 0.01098 1 0 0 INVESTMENTS HELD WITH STARK COMMUNITY FOUNDATION 15116792 F BENEFICIAL INTEREST IN CHARITABLE TRUST 804468 F MINERAL RIGHTS 1 C 15921261 PART V, LINE 4: AS DIRECTED BY THE GOVERNING BODY OF THE FOUNDATION, THE ORGANIZATION'S ENDOWMENT FUNDS ARE INTENDED TO BE USED TO PROVIDE GRANT FUNDING AND COLLABORATIVE SUPPORT TO IMPROVE THE OVERALL HEALTH AND WELLNESS OF OUR COMMUNITY. 1 ACCESS HEALTH STARK COUNTY INC 408 9TH ST SW CANTON OH 44707 462949527 501(C)(3) 100000 0 COMMUNITY HEALTH WORKER PROJECT AULTMAN HEALTH FOUNDATION 2600 6TH ST SW CANTON OH 44710 340714538 501(C)(3) 50000 0 SERENITY PROGRAM BEACON CHARITABLE PHARMACY 2525 13TH ST NW CANTON OH 44708 200797475 501(C)(3) 20000 0 MEDICATION ACCESS COMPASSION DELIVERED 1320 BEL AIR DR NW NORTH CANTON OH 44720 815174934 501(C)(3) 5752 0 VOLUNTEER COORDINATION TECHNOLOGY CRAHEC 6000 FRANK AVENUE NW NORTH CANTON OH 44720 341392513 501(C)(3) 34000 0 AHEC SCHOLARS HARTVILLE MIGRANT MINISTRY 3980 SWAMP ST NE HARTVILLE OH 44632 340899100 501(C)(3) 25000 0 EXPANDING HEALTH POSSIBILITIES/SUPPLIES HEALTH POLICY INSTITUTE OF OHIO 140 E TOWN ST STE 1000 COLUMBUS OH 43215 300186863 501(C)(3) 30000 0 GENERAL OPERATING SUPPORT GRANT MALONE UNIVERSITY 2600 CLEVELAND AVE NW CANTON OH 44709 340737794 501(C)(3) 15000 0 MEDICATION ADMINISTRATION TRAINING EQUIPMENT MARGARET B SHIPLEY CHILD HEALTH CLINIC 919 2ND ST NE 1132 CANTON OH 44704 340714781 501(C)(3) 16120 0 MEDICAL SUPPLIES & UW LOSS UNITED WAY OF GREATER STARK COUNTY INC 401 MARKET AVENUE NORTH SUITE 300 CANTON OH 44702 134254191 501(C)(3) 33333 0 STRONG NEIGHBORHOODS, STRONG FAMILIES 10 0 PART I, LINE 2: GRANT RECIPIENTS ARE REQUIRED TO RESPOND TO THE FOLLOWING QUESTIONS SIX MONTHS AFTER THE GRANT IS RECEIVED AND PROVIDE A FINAL REPORT 12 MONTHS AFTER THE GRANT IS RECEIVED. THE FINAL REPORT IS TO PROVIDE DOCUMENTATION OF HOW THE GRANT FUNDS WERE SPENT. GRANT RECIPIENT QUESTIONS: A. WHAT WERE THE OUTCOMES IN RELATION TO THE GOALS AND OBJECTIVES OF THE GRANT? WHAT HAS CHANGED, IMPROVED, OR HAPPENED AS A RESULT OF YOUR EFFORTS? WAS THERE IMPACT MADE? B. EXPLAIN ANY DIFFERENCES BETWEEN THE PROPOSED AND ACTUAL OUTCOMES OF THE GOALS AND OBJECTIVES. HOW IS YOUR ORGANIZATION USING THESE OUTCOMES AND LESSONS LEARNED TO IMPROVE ORGANIZATIONAL EFFECTIVENESS? C. DESCRIBE THE VALUE OF THIS PROJECT TO THE COMMUNITY AND TO THE ORGANIZATION. D. BRIEFLY SUMMARIZE THE PROJECT'S EVALUATION PROCESS. HOW DID YOU EVALUATE THE PROJECT, AND WHAT DID YOU LEARN FROM THE EVALUATION? E. COMPLETE FINANCIAL REPORT THAT INCLUDES A DESCRIPTION OF THE USE OF THE FUNDS THAT THE ORGANIZATION WAS GRANTED. THE REPORT MUST INCLUDE AN ITEMIZED BUDGET AND/OR RECEIPTS FOR EQUIPMENT OR MATERIALS THAT WERE PURCHASED. F. ATTACH ANY BROCHURES, NEWSPAPER ARTICLES, OR ADDITIONAL INFORMATION THAT ILLUSTRATES THE OUTCOMES AND ACCOMPLISHMENTS FROM THE GRANT. FORM 990, PART VI, SECTION A, LINE 2 DR. MATTHEW HIESTAND AND MARCY MERTES HAVE A FAMILY RELATIONSHIP. LISA WARBURTON-GREGORY AND SCOTT WARBURTON HAVE A FAMILY RELATIONSHIP. THE FOLLOWING BOARD MEMBERS ARE AFFILIATED WITH AULTMAN HEALTH FOUNDATION, A MAJOR CONTRIBUTOR OF THE NORTH CANTON MEDICAL FOUNDATION AND ALSO A GRANT RECIPIENT. - DR. JOHN HUMPHREY, M.D. - AULTMAN HEALTH FOUNDATION BOARD MEMBER - TIFFANY GOOD WITMER - AULTMAN HEALTH FOUNDATION EMPLOYEE - DR. MATTHEW HIESTAND - AULTMAN HEALTH FOUNDATION EMPLOYEE - LISA ZELLERS - AULTMAN HEALTH FOUNDATION EMPLOYEE - LISA WARBURTON-GREGORY - AULTMAN FOUNDATION BOARD MEMBER FORM 990, PART VI, SECTION B, LINE 11B A DRAFT 990 IS REVIEWED BY THE FINANCE & INVESTMENT COMMITTEE AND THE OUTSIDE ACCOUNTING FIRM AND THE FINAL 990 IS EMAILED TO THE BOARD BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE EACH YEAR. THE QUESTIONNAIRES ARE REVIEWED BY OUR EXECUTIVE DIRECTOR AND CONFLICTS ARE NOTED. MEMBERS WHO HAVE AFFILIATIONS WITH POTENTIAL GRANT RECIPIENTS ALWAYS ABSTAIN FROM GRANT VOTING. BEYOND THE QUESTIONNAIRE, IF A POTENTIAL CONFLICT ARISES, THE INTERESTED PERSON IS REQUIRED TO DISCLOSE ALL MATERIAL FACTS RELATING TO THE POTENTIAL CONFLICT TO THE CHAIRMAN OF THE BOARD. THE CHAIRMAN THEN HAS THE DISCRETION TO DETERMINE WHETHER THE CONFLICT MERITS DISCLOSURE TO THE BOARD AS A WHOLE, MAKING SURE TO ERR ON THE SIDE OF DISCLOSURE. IF THE CHAIRMAN ELECTS TO DISCLOSE THE POTENTIAL CONFLICT TO THE BOARD, THE BOARD DISCUSSES THE POTENTIAL CONFLICT AT ITS NEXT REGULAR MEETING. THE INTERESTED PERSON IS REQUIRED TO LEAVE THE MEETING ROOM DURING THE DISCUSSION. THE REMAINING BOARD MEMBERS THEN VOTE ON WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF A CONFLICT IS DETERMINED TO EXIST, THE INTERESTED PERSON MAKES A FULL STATEMENT OF FACTS REGARDING THE CONFLICT, INCLUDING ITS POSSIBLE OR ACTUAL RELATIONSHIP TO THE FOUNDATION'S ACTIVITIES. IF APPROPRIATE, A NON-INTERESTED BOARD MEMBER OR OTHER INDIVIDUAL MAY BE APPOINTED BY THE CHAIRMAN OF THE BOARD TO INVESTIGATE ALTERNATIVES TO ANY PROPOSED TRANSACTION RELATED TO THE FOUNDATION INVOLVING THE CONFLICT. ANY ACTION BY THE BOARD TO ENGAGE IN A TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT MUST BE BY A MAJORITY VOTE OF THE NON-INTERESTED MEMBERS OF THE BOARD THAT THE TRANSACTION IS IN THE FOUNDATION'S BEST INTERESTS AND IS FAIR AND REASONABLE TO THE FOUNDATION. TO PROTECT THE INTERESTS OF THE FOUNDATION, THE BOARD OF DIRECTORS SHALL TAKE APPROPRIATE DISCIPLINARY ACTION WITH RESPECT TO A PERSON WHO VIOLATES THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 PRIOR TO DECISIONS BEING MADE REGARDING COMPENSATION, THERE ARE COMPARISONS DONE, INCLUDING MGMA COMPENSATION SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGES TO BENEFICIAL INTERESTS IN CHARITABLE TRUST HELD BY OTHERS 61,089.