2025-11-14T14:47:37-06:00 2024-12-31 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2024-01-01 113660156 MEMORIAL COMMUNITY HOSPITAL FOUNDATION CORPORATION MEMO 4024262182 810 NORTH 22ND STREET BLAIR NE 68008 TIM SCHNACK EXECUTIVE DIRECTOR 4024262182 2025-11-14 1 0 HEATHER ADKINS P01725376 3032989100 2024 2025-03-06 01:10:19Z COARTNEY DIGIORGIO 810 NORTH 22ND STREET BLAIR NE 68008 102001 0 X WWW.MCHHS.ORG/FOUNDATION X 2000 NE CARRY OUT THE HEALTH CARE MISSION OF MEMORIAL COMMUNITY HOSPITAL. 9 8 0 9 0 0 40472 26737 0 0 55118 75264 -292 0 95298 102001 72160 1762 0 0 0 0 0 0 0 354 9745 72514 11507 22784 90494 1508435 1665402 0 0 1508435 1665402 X THE FOUNDATION AIDS MEMORIAL COMMUNITY HOSPITAL AND HEALTH SYSTEM, BLAIR, NEBRASKA BY SOLICITING CONTRIBUTIONS FOR THE USE AND BENEFIT OF THE HOSPITAL'S PROGRAMS AND SERVICES. THE HOSPITAL PROVIDES ACUTE PREVENTIVE AND CLINICAL HEALTHCARE SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND DOES NOT LIMIT ITS SERVICES OR DISCRIMINATE BASED ON RACE, SEX, NATIONAL ORIGIN OR RELIGION. 0 0 11507 1762 0 FUNDRAISING FOR THE CAPITAL EQUIPMENT AND OTHER SPECIAL PROGRAM NEEDS OF MEMORIAL COMMUNITY HOSPITAL. THIS WILL BE CARRIED OUT THROUGH COMMUNITY FUNDRAISING DRIVES TO THE BUSINESSES AND INDIVIDUALS OF BLAIR, NEBRASKA, AND OTHER SURROUNDING COMMUNITIES. THESE FUNDRAISING EFFORTS WILL BE CARRIED OUT BY VOLUNTEERS OF THE FOUNDATION AND COMMUNITY. 11507 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 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 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 1 0 0 1 1 0 1 1 0 0 0 1 1 1 0 0 0 0 0 X COARTNEY DIGIORGIO 4024262182 810 NORTH 22ND STREET BLAIR NE 68008 X TAWNYA ROBERTS PRESIDENT/CHAIR 1.00 2.00 X X 0 0 0 JIM SANDVOLD VICE PRESIDENT 1.00 2.00 X X 0 0 0 ANNETTE CLARK TREASURER 1.00 1.00 X X 0 0 0 JONNA BRANZ BOARD MEMBER 1.00 0.00 X 0 0 0 ALICIA KOZIOL BOARD MEMBER 1.00 0.00 X 0 0 0 CARL FALK BOARD MEMBER 1.00 0.00 X 0 0 0 DR JOHN SIMONSON BOARD MEMBER 1.00 40.00 X 0 310193 8846 KYLE ACRE BOARD MEMBER 1.00 1.00 X 0 0 0 PAT ROGERS MCH AUXILIARY REP (END 02/24) 1.00 2.00 X 0 0 0 JAN QUIST MCH AUXILIARY REP (BEG 02/24) 1.00 2.00 X 0 0 0 MANUELA BANNER CEO 1.00 40.00 X 0 0 0 MOLLY DAHLGREN FOUNDATION EXECUTIVE DIRECTOR (THRU 06/24) 40.00 1.00 X 0 52597 0 COARTNEY DIGIORGIO FOUNDATION EXECUTIVE DIRECTOR (BEG 08/24) 1.00 40.00 X 0 28076 0 0 390866 8846 0 0 1 1 0 26737 26737 75264 75264 102001 0 0 75264 1762 1762 3478 3478 SOLICITATION CAMPAIGN 6267 6267 11507 11507 0 0 255961 271848 1252474 1393554 1508435 1665402 0 0 X 1415109 1555430 93326 109972 1508435 1665402 1508435 1665402 90494 66473 0 X 0 1 X 1 0 X 24356 67719 23273 40472 26237 182057 24356 67719 23273 40472 26237 182057 182057 25638 86078 48504 55118 75264 290602 472659 0.38520 0.46110 X 64121 23820 87941 38939 25182 64121 19349 19590 38939 18349 19566 18566 19349 16378 19189 17218 18349 0.00000 0.00000 1.00000 0 0 0 X PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS ARE USED FOR THE CAPITAL EQUIPMENT AND OTHER SPECIAL PROGRAM NEEDS OF MEMORIAL COMMUNITY HOSPITAL. PART X, LINE 2: IN ACCORDANCE WITH FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, INCLUDED IN FASB ASC SUBTOPIC 741-10 - INCOME TAXES: THE FOUNDATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. IN 2024 AND 2023, MANAGEMENT DETERMINED THAT THERE ARE NO INCOME TAX POSITIONS REQUIRING RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. 0 0 0 0 0 0 0 0 0 DR JOHN SIMONSON BOARD MEMBER 0 225327 0 84866 0 0 0 0 0 8846 0 319039 0 0 PART I, LINE 3 DURING THE CALENDAR YEAR 2024, COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS ESTABLISHED AND PAID BY CHI HEALTH, AN UNRELATED ORGANIZATION. CHI HEALTH USED THE FOLLOWING TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) COMPENSATION SURVEY OR STUDY, (2) INDEPENDENT COMPENSATION CONSULTANT, AND (3) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 3 COMPENSATION OF THE CEO AND CFO OF MEMORIAL COMMUNITY HOSPITAL FOUNDATION (FOUNDATION) AND CEO AND CFO OF MEMORIAL COMMUNITY HOSPITAL (HOSPITAL) IS PROVIDED BY CHI HEALTH. THE CEO AND CFO ARE EMPLOYEES OF CHI HEALTH AND THE HOSPITAL REIMBURSES CHI HEALTH FOR THE CEO'S AND CFO'S COMPENSATION AND BENEFITS. THE HOSPITAL PAYS CHI HEALTH A MANAGEMENT FEE EQUAL TO THE DIRECT COST OF THE CEO'S AND CFO'S COMPENSATION AND BENEFITS PLUS 10% OF THE HOSPITAL'S EARNINGS BEFORE INTEREST, DEPRECIATION, AND AMORTIZATION OR A MAXIMUM OF $500,000 FOR CHI HEALTH'S SUPPORT. FORM 990, PART VI, SECTION A, LINE 6 MEMORIAL COMMUNITY HOSPITAL FOUNDATION ("FOUNDATION") HAS ONE MEMBER - MEMORIAL COMMUNITY HEALTH SYSTEM, INC. ("MCHS"). FORM 990, PART VI, SECTION A, LINE 7A MCHS IS A 501(C)(3) ORGANIZATION RESPONSIBLE FOR APPOINTING ALL BOARD MEMBERS OF THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B NO REVIEW WAS OR WILL BE CONDUCTED. FORM 990, PART VI, SECTION B, LINE 12C EACH BOARD MEMBER ANNUALLY SIGNS A CONFLICT OF INTEREST STATEMENT AND IS GIVEN A COPY OF THE CONFLICT OF INTEREST POLICY. THE CHAIRMAN OF THE BOARD REVIEWS THESE STATEMENTS AND ENSURES THAT BOARD MEMBERS EXCUSE THEMSELVES FROM DISCUSSIONS AT BOARD MEETINGS ON TOPICS WHERE THEY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE OFFICERS OF THE BOARD ARE NOT COMPENSATED FOR THEIR DUTIES; THEY ARE VOLUNTEERS. THE OFFICERS OF THE CORPORATION (THE EXECUTIVES) ARE COMPENSATED BASED ON RECOMMENDATIONS OF THE COMPENSATION COMMITTEE OF THE BOARD. THE COMPENSATION COMMITTEE OF THE HOSPITAL LOOKS AT COMPARATIVE INDUSTRY SALARY INFORMATION IN SETTING BASE SALARIES, AND REVIEWS AND APPROVES THE INDIVIDUAL GOALS PROPOSED BY THE EXECUTIVE TEAM FOR INCENTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 MEMORIAL COMMUNITY HOSPITAL FOUNDATION'S AUDIT REPORT IS MADE AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A, LINE 1A MANUELA BANNER IS THE CEO OF MEMORIAL COMMUNITY HOSPITAL AND IS PAID BY CHI HEALTH. MEMORIAL COMMUNITY HOSPITAL PAID CHI HEALTH FOR HER SERVICES PROVIDED. THEREFORE, MANUELA BANNER SHOWS $0 REPORTABLE COMPENSATION FROM THE FILING ORGANIZATION AND FROM ANY RELATED ORGANIZATION AS THEY WERE DIRECTLY PAID BY CHI HEALTH. MEMORIAL COMMUNITY HOSPITAL 810 N 22ND STREET BLAIR NE 68008 470426285 HOSPITAL NE 501(C)(3) LINE 3 N/A 0 MEMORIAL COMMUNITY HEALTH SYSTEM 810 N 22ND STREET BLAIR NE 68008 470718840 HEALTH SYSTEM NE 501(C)(3) LINE 7 N/A 0 MCH AUXILIARY THRIFT SHOP 810 N 22ND STREET BLAIR NE 68008 470748162 AUXILIARY NE 501(C)(3) LINE 7 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0