2025-11-11T14:45:26-06:00 2024-12-31 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2024-01-01 480955489 AMBERWELL HEALTH FOUNDATION AMBE 9133676653 800 RAVEN HILL DRIVE ATCHISON KS 66002 CHASE DUDZINSKI CHIEF FINANCIAL OFFICER 9133676653 2025-11-10 1 1 WENDY R COOLEY CPA P01523804 4023302660 2025-11-10 2024 2025-03-06 01:10:19Z RICHARD BERGER 800 RAVEN HILL DRIVE ATCHISON KS 66002 1440530 0 X N/A X 1983 KS SUPPORT FOR AMBERWELL ATCHISON ASSOCIATION IN ITS MISSION AND TO SUPPORT THE HEALTH OF THE COMMUNITY. 6 5 0 6 -10530 0 0 0 0 0 443085 1150686 7286 -10530 450371 1140156 275000 510000 0 0 0 0 0 0 0 73497 50381 348497 560381 101874 579775 16447408 18550654 0 0 16447408 18550654 SUPPORT FOR AMBERWELL ATCHISON ASSOCIATION IN ITS MISSION AND TO SUPPORT THE HEALTH OF THE COMMUNITY. 0 0 510000 510000 INVEST THE FOUNDATION CORPUS, PROVIDE CAPITAL EXPENDITURE FUNDS ANNUALLY, AND UPON REQUEST AND APPROVAL, PROVIDE FUNDS FOR NEW PROJECTS. 510000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 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 6 5 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 X CHASE DUDZINSKI 9133676653 800 RAVEN HILL DRIVE ATCHISON KS 66002 CHASE DUDZINSKI CFO 1.00 40.00 X 0 279958 45536 JEFFREY PERRY PRESIDENT & CEO THRU 5/24 1.00 40.00 X X 0 293661 14253 JARED ABEL PRESIDENT & CEO AS OF 6/24 1.00 40.00 X X 0 176131 11993 RICHARD N BERGER PRESIDENT 1.00 0.00 X X 0 0 0 MARK WINDSOR TREASURER 1.00 0.00 X X 0 0 0 KEVIN MCDERMED SECRETARY 1.00 0.00 X X 0 0 0 BILL THORNTON DIRECTOR 1.00 0.00 X 0 0 0 LYDIA FUNK DIRECTOR 1.00 0.00 X 0 0 0 0 749750 71782 0 0 1 0 0 319878 319878 1131182 300374 830808 830808 830808 PARTNERSHIP INCOME 525990 -10530 -10530 -10530 1140156 0 -10530 1150686 510000 510000 4825 4825 45556 45556 560381 510000 50381 0 48705 71617 16033900 18240899 336864 210199 27939 27939 16447408 18550654 0 0 X 16447408 18550654 16447408 18550654 16447408 18550654 579775 1523471 0 X X 0 1 X 1 0 X X 1 AMBERWELL ATCHISON ASSOCIATION 480561974 3 1 500000 0 1 500000 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 PART IV, SECTION C, LINE 1: THE CEO SERVES AS A VOTING MEMBER ON THE BOARD OF DIRECTORS FOR THE FOUNDATION AND IS CEO FOR AMBERWELL ATCHISON. CHASE DUDZINSKI, CFO FOR AMBERWELL ATCHISON, ALSO SERVES AS THE TOP FINANCIAL OFFICIAL OF THE FOUNDATION AND OVERSEES THE FINANCIAL ASPECTS OF THE FOUNDATION. WITH THIS OVERSIGHT THE ACTIONS OF THE FOUNDATION ARE MONITORED AND THEY ARE ABLE TO ENSURE THE NEEDS OF THE HOSPITAL ARE MET. PART IV, SECTION A, LINE 6: THE FOUNDATION PROVIDED SUPPORT TO AMBERWELL ATCHISON ASSOCIATION, THE SUPPORTED ORGANIZATION OF THE FOUNDATION, AND VALLEY HOPE IN THE CURRENT YEAR. VALLEY HOPE HAS A SIMILAR MISSION OF SUPPORTING THE HEALTH AND WELFARE OF THE RESIDENTS IN RURAL COMMUNITIES AS AMBERWELL ATCHISON ASSOCIATION. 0 X 2663627 1523471 1523471 1140156 0 1140156 560381 0 560381 0 560381 PART X, LINE 2: THE FOUNDATION ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE FOUNDATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2024 AND 2023, THE FOUNDATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED. 1 AMBERWELL ATCHISON ASSOCIATION 800 RAVEN HILL DRIVE ATCHISON KS 66002 480561974 501(C)(3) 500000 0 PROGRAM SUPPORT VALLEY HOPE 1816 N 2ND ST ATCHISON KS 66002 481236586 501(C)(3) 10000 0 PROGRAM SUPPORT 2 0 PART I, LINE 2: THE FOUNDATION ONLY MAKES GRANTS TO AMBERWELL ATCHISON ASSOCIATION, THE SUPPORTED ORGANIZATION, OR OTHER AFFILIATED HEALTHCARE ORGANIZATIONS WITH SIMILAR MISSIONS. THE CEO, VOTING MEMBER OF THE FOUNDATION BOARD, SERVES AS THE CEO OF BOTH AMBERWELL ATCHISON ASSOCIATION AND HIAWATHA HOSPITAL ASSOCIATION AND IS ABLE TO MONITOR THE USE OF THE GRANT FUNDS THROUGH MANAGEMENT OVERSIGHT. 0 0 0 0 0 0 0 0 0 CHASE DUDZINSKI CFO 0 270858 0 9100 0 0 0 8545 0 37747 0 326250 0 0 JEFFREY PERRY PRESIDENT & CEO THRU 5/24 0 224046 0 69615 0 0 0 5001 0 9631 0 308293 0 0 JARED ABEL PRESIDENT & CEO AS OF 6/24 0 172305 0 3826 0 0 0 0 0 12309 0 188440 0 0 PART I, LINE 3 COMPENSATION FOR THE CEO IS ESTABLISHED BY AMBERWELL ATCHISON ASSOCIATION, A RELATED ENTITY, USING THE FOLLOWING: INDEPENDENT COMPENSATION CONSULTANT, A COMPENSATION STUDY, FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. THE CEO SERVES AS A VOTING MEMBER OF THE FOUNDATION AND CEO OF AMBERWELL ATCHISON. FORM 990, PART VI, SECTION A, LINE 2 JEFFREY PERRY, CEO THRU MAY, AND CHASE DUDZINSKI HAD A BUSINESS RELATIONSHIP. JARED ABEL, CEO AS OF JUNE, AND CHASE DUDZINSKI HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 AMBERWELL HEALTH FOUNDATION HAS THREE CLASSES OF MEMBERS. LIFETIME MEMBERSHIPS CONSISTS OF INDIVIDUAL WHO HAVE AT ANY TIME CONTRIBUTED TO THE CORPORATION $1,000 TO $9,999. SUSTAINING MEMBERSHIP CONSISTS OF INDIVIDUALS WHO HAVE AT ANY TIME CONTRIBUTED TO THE CORPORATION $10,000 OR MORE. CORPORATE MEMBERSHIP CONSISTS OF THOSE BUSINESS ENTITIES WHO HAVE AT ANY TIME CONTRIBUTED TO THE CORPORATION $25,000 OR MORE. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS HAVE THE RIGHT TO ELECT THE MEMBERS OF THE BOARD OF DIRECTORS OF AMBERWELL HEALTH FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B IF THE BOARD RECOMMENDS THE REMOVAL OF A MEMBER FOR ENGAGING IN CONDUCT THAT IS IMMORAL, ILLEGAL, OR OTHERWISE CONTRARY OR DETRIMENTAL TO THE PURPOSE OF THE CORPORATION, THE ISSUE SHALL BE PUT TO A VOTE OF THE MEMBERSHIP. REMOVAL OF A MEMBER SHALL REQUIRE A VOTE OF 2/3 OF ALL MEMBERS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 8B THERE IS NO COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO AND DIRECTOR OF FINANCE. THE 990 IS THEN PROVIDED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C AT THE TIME OF ELECTION AND ANNUALLY THEREAFTER, THE GOVERNING BOARD MEMBERS SHALL PROVIDE THE APPLICABLE CONFLICT OF INTEREST DISCLOSURES WHICH SHALL BE COMPLETED TO IDENTIFY ANY RELATIONSHIPS, POSITIONS, OR CIRCUMSTANCES IN WHICH IT IS BELIEVED A CONFLICT MAY ARISE. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY DIRECTOR SHALL BE DISCLOSED TO THE OTHER DIRECTORS AND MADE A MATTER OF RECORD THROUGH AN ANNUAL PROCEDURE AND ALSO WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTIOIN. IF A CONFLICT ARISES, THE BOARD MEMBER ABSTAINS FROM THE VOTE OF THE CONFLICTED POSITION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XII, LINE 2C THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. AMBERWELL ATCHISON ASSOCIATION 800 RAVEN HILL DRIVE ATCHISON KS 66002 480561974 HOSPITAL KS 501(C)(3) LINE 3 N/A 0 AMBERWELL ATCHISON SUPPORT ORGANIZATION 800 RAVEN HILL DRIVE ATCHISON KS 66002 932800795 SUPPORT AMBERWELL ATCHISON ASSOCIATION KS 501(C)(3) LINE 12A, I AMBERWELL ATCHISON ASSOCIATION 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0