2025-10-16T13:31:43-05:00 2024-12-31 410746749 CLIFTONLARSONALLEN LLP 4334 MUNSON STREET SUITE 200 CANTON OH 44718 990 2024-01-01 463060489 NORTH CANTON MEDICAL FOUNDATION NORT 3304331411 6046 WHIPPLE AVE NW NORTH CANTON OH 44720 JOHN HUMPHREY MD EXECUTIVE DIRECTOR 3304331411 2025-10-02 1 1 JENNIFER COLEMAN P00743188 3304972000 2025-10-02 2024 2025-03-06 01:10:19Z JOHN HUMPHREY MD 6046 WHIPPLE AVE NW NORTH CANTON OH 44720 10183820 0 X WWW.NCMF.COM X 2013 OH TO IMPROVE COMMUNITY HEALTH AND WELLNESS THROUGH COLLABORATION AND FINANCIAL SUPPORT. 18 17 2 19 0 0 132077 102554 0 0 486615 603709 130 896200 618822 1602463 422439 10312679 0 0 113672 124632 0 0 0 155902 188956 692013 10626267 -73191 -9023804 23946181 16646850 0 0 23946181 16646850 NORTH CANTON MEDICAL FOUNDATION'S MISSION IS TO IMPROVE THE HEALTH AND WELLNESS OF OUR COMMUNITY THROUGH COLLABORATION AND FINANCIAL SUPPORT. 0 0 10449448 10312679 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. 10449448 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 1 1 1 0 0 1 0 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 17 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 OH X NORTH CANTON MEDICAL FOUNDATION OFFICE 3304331411 6046 WHIPPLE AVE NW NORTH CANTON OH 44720 DR JOHN HUMPHREY MD EXECUTIVE DIRECTOR 25.00 5.00 X X 80000 0 0 LISA WARBURTON-GREGORY CHAIRMAN 2.00 2.00 X X 0 0 0 EILEEN IVAN VICE CHAIRMAN 2.00 2.00 X X 0 0 0 ROD A MOORE SECRETARY THRU DEC 2024 2.00 2.00 X X 0 0 0 WILLIAM R COOK TREASURER 2.00 2.00 X X 0 0 0 BRIAN BELDEN BOARD MEMBER 2.00 2.00 X 0 0 0 DR WILLIAM FAYEN BOARD MEMBER 2.00 2.00 X 0 0 0 GEORGE FILM BOARD MEMBER 2.00 2.00 X 0 0 0 TIFFANY GOOD WITMER BOARD MEMBER 2.00 2.00 X 0 0 0 DR MATTHEW HIESTAND BOARD MEMBER 2.00 2.00 X 0 0 0 CHUCK HOOVER BOARD MEMBER 2.00 2.00 X 0 0 0 STACY KELLY BOARD MEMBER 2.00 2.00 X 0 0 0 DR PAUL MANUSZAK BOARD MEMBER 2.00 2.00 X 0 0 0 M MARCY MERTES BOARD MEMBER 2.00 2.00 X 0 0 0 WILLIAM SCHAUER BOARD MEMBER 2.00 2.00 X 0 0 0 JOHN SCHUSTER BOARD MEMBER 2.00 2.00 X 0 0 0 SARA TIMKEN BOARD MEMBER 2.00 2.00 X 0 0 0 SCOTT WARBURTON BOARD MEMBER 2.00 2.00 X 0 0 0 LISA ZELLERS BOARD MEMBER 2.00 2.00 X 0 0 0 80000 0 0 0 0 0 0 0 102554 102554 116514 116514 9068552 8581357 487195 487195 487195 STARKAP DISTRIBUTION 900099 896153 896153 MISCELLANEOUS REVENUE 900099 47 47 896200 1602463 0 0 1499909 10312679 10312679 80000 80000 34896 34896 9736 9736 15120 15120 137971 137971 6250 6250 14751 2704 12047 1455 1455 2812 2812 CANCER RELIEF FUND 6485 6485 MISCELLANEOUS 2619 2619 RETIRED PHYSICIANS PROG 1493 1493 10626267 10449448 176819 0 112725 128732 521006 870 19792 7917 7371398 0 15921260 16509331 23946181 16646850 0 0 X 21305832 13792811 2640349 2854039 23946181 16646850 23946181 16646850 X -9023804 1675290 -11875 61058 X 1 X 0 0 0 X 94012 91591 116707 132077 102554 536941 94012 91591 116707 132077 102554 536941 112486 424455 119832 169150 418990 452961 116514 1277447 401770 7086 554490 130 896200 1859676 3674064 0.11550 0.11910 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, AND MARGARET SHIPLEY CHILD HEALTH CLINIC AND CANTON REGIONAL AHEC SCHOLARS.CUMULATIVELY THROUGH 2024, GRANTS HAVE BEEN AWARDED TOTALING $8,409,923.SOURCES OF SUPPORT:NORTH CANTON MEDICAL FOUNDATION HAS A PLAN IN PLACE TO GENERATE CONTRIBUTIONS INCLUDING REQUESTS FROM THE WEBSITE, BOARD CONTRIBUTIONS, AND VARIOUS COLLABORATION EFFORTS WITH COMMUNITY PARTNERS. GOVERNING BODY:NORTH CANTON MEDICAL FOUNDATION CURRENTLY HAS ONE PAID EXECUTIVE DIRECTOR AND NINETEEN 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 WILL CONTINUE 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. IN AUGUST 2024, A NEW SUPPORTING ORGANIZATION, NORTH CANTON SUPPORTING FOUNDATION (NCSF), WAS CREATED TO HOLD THE INVESTMENTS OF NORTH CANTON MEDICAL FOUNDATION. IN OCTOBER OF 2024 NCSF APPLIED FOR TAX EXEMPT STATUS AS A 501(C)(3), TYPE I SUPPORTING ORGANIZATION UNDER IRC SECTION 509(A)(3). THE IRS DETERMINATION LETTER WAS RECEIVED IN MAY 2025. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 16098019 1572670 865526 103450 16701713 13977622 2561996 344921 96678 16098019 16254767 53467 -2194001 64311 72300 13977622 14138085 2502371 288000 97689 16254767 13157425 2 1059671 79013 14138085 0.98848 0.00000 0.01152 1 0 0 INVESTMENTS HELD WITH STARK COMMUNITY FOUNDATION 16509330 F MINERAL RIGHTS 1 C 16509331 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 AKRON-CANTON REGIONAL FOODBANK 350 OPPORTUNITY PARKWAY AKRON OH 44307 341369388 501(C)(3) 20000 0 ANNUAL DONATION AULTMAN COLLEGE OF NURSING AND HEALTH SCIENCES 2600 6TH ST SW CANTON OH 44710 201359433 501(C)(3) 45000 0 RADIOLOGY LAB GRANT BEACON CHARITABLE PHARMACY 2525 13TH ST NW CANTON OH 44708 200797475 501(C)(3) 20000 0 MEDICATION ACCESS COMMQUEST SERVICES INC 625 CLEVELAND AVENUE NW CANTON OH 44702 340737793 501(C)(3) 50000 0 MENTAL HEALTH & SUD PREVENTION COMPASSION DELIVERED 1320 BEL AIR DR NW NORTH CANTON OH 44720 815174934 501(C)(3) 6000 0 VOLUNTEER COORDINATION TECHNOLOGY DOMESTIC VIOLENCE PROJECT INC PO BOX 9459 CANTON OH 44711 341263226 501(C)(3) 6000 0 DVPI'S MEDICAL ADVOCACY PROGRAM HARTVILLE MIGRANT MINISTRY 3980 SWAMP ST NE HARTVILLE OH 44632 340899100 501(C)(3) 65000 0 ACCESS TO CARE FOR MIGRANTS HEALTH POLICY INSTITUTE OF OHIO 140 E TOWN ST STE 1000 COLUMBUS OH 43215 300186863 501(C)(3) 35000 0 GOLD LEVEL FORUM SERIES SPONSOR HEART OF OHIO DIAPER BANK PO BOX 35452 CANTON OH 44735 832493514 501(C)(3) 7930 0 DIAPERS FOR BABIES MARGARET B SHIPLEY CHILD HEALTH CLINIC 919 2ND ST NE 1132 CANTON OH 44704 340714781 501(C)(3) 10000 0 ACCESS TO CARE FOR CHILDREN NORTH CANTON SUPPORTING FOUNDATION 6046 WHIPPLE AVE NW NORTH CANTON OH 44720 995099167 501(C)(3) 0 9743166 FMV INVESTMENT ACCOUNTS TRANSFER OF INVESTMENTS TO SUPPORTING ORGANIZATION NORTHEAST OHIO MEDICAL UNIVERSITY FOUNDATION 4209 ST RT 44 PO BOX 95 ROOTSTOWN OH 44272 341264220 501(C)(3) 22000 0 NEOMED HEALTH COACH PROGRAM STARK COUNTY HEALTH DEPARTMENT 7235 WHIPPLE AVE NW NORTH CANTON OH 44720 GOVERNMENT 7650 0 STARK COUNTY HEALTH SUMMIT STARK STATE COLLEGE FOUNDATION 6200 FRANK AVE NW S306 NORTH CANTON OH 44720 341577595 501(C)(3) 28000 0 DENTAL HYGIENE CLINIC EQUIPMENT MODERNIZATION UNITED WAY OF GREATER STARK COUNTY INC 401 MARKET AVENUE NORTH SUITE 300 CANTON OH 44702 134254191 501(C)(3) 33333 0 COMMUNITY HEALTH WORKER PROVIDED TO ASSIST PARENTS AND CHILDREN WITH SOCIAL DETERMINANTS OF HEALTH YMCA OF CENTRAL STARK COUNTY 4700 DRESSLER RD NW CANTON OH 44718 340714392 501(C)(3) 75000 0 GIBBS CHILDCARE CENTER 16 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 1A THE EXECUTIVE COMMITTEE IS COMPOSED OF THE CHAIRMAN, VICE CHAIRMAN, TREASURER, SECRETARY, EXECUTIVE DIRECTOR, AND OTHER DULY ELECTED OFFICERS, ALL OF WHOM ARE VOTING MEMBERS OF THE GOVERNING BODY. THE EXECUTIVE COMMITTEE IS EMPOWERED TO TRANSACT ALL BUSINESS AND PERFORM ALL ACTIONS THAT MAY BE UNDERTAKEN BY THE FULL BOARD OF DIRECTORS BETWEEN REGULAR MEETINGS, WITH THE EXCEPTION OF ELECTING OFFICERS OR FILLING BOARD VACANCIES. ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE ARE REPORTED TO THE FULL BOARD AT THE NEXT SCHEDULED MEETING. 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 15A 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, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGES TO BENEFICIAL INTERESTS IN CHARITABLE TRUST HELD BY OTHERS 61,058. NORTH CANTON SUPPORTING FOUNDATION 6046 WHIPPLE AVE NE NORTH CANTON OH 44720 995099167 SUPPORTING FOUNDATION OH 501(C)(3) LINE 12A, I NORTH CANTON MEDICAL FOUNDATION 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 NORTH CANTON SUPPORTING FOUNDATION B 9743166 FMV