2025-01-16T11:37:26-06:00 2024-06-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2023-07-01 421412025 FRANKLIN GENERAL HOSPITAL FOUNDATION FRAN 6414565013 1720 CENTRAL AVENUE EAST HAMPTON IA 504411859 KIM PRICE CEO 6414565013 2025-01-16 1 0 RYAN ENGEBRETSON P01585625 6123764500 2025-01-16 2023 2024-10-15 13:58:12Z KIM PRICE 1720 CENTRAL AVENUE EAST HAMPTON IA 504411859 79699 0 X N/A X 1992 IA SOLICIT/ADMINISTER CONTRIBUTIONS/GIFTS FOR THE GENERAL WELFARE OF FRANKLIN HOSPITAL 13 13 0 85 0 0 52626 73656 0 0 23619 6043 0 0 76245 79699 149966 78807 0 0 37469 35469 0 0 0 247 3272 187682 117548 -111437 -37849 1418191 1533046 6542 8138 1411649 1524908 SOLICIT AND ADMINISTER CONTRIBUTIONS AND GIFTS FOR THE GENERAL WELFARE OF FRANKLIN GENERAL HOSPITAL, AND TO PROMOTE AND ADVANCE AREA - WIDE PROGRAMS DESIGNED TO IMPROVE THE HEALTH OF THE PEOPLE IN THE COMMUNITIES SERVED BY FRANKLIN GENERAL HOSPITAL. 0 0 78807 78807 0 SINCE 1992, FGH FOUNDATION HAS BEEN RAISING FUNDS FOR FRANKLIN GENERAL HOSPITAL. APPROXIMATELY $4.3M HAS BEEN RAISED FOR FGH PROJECTS. THIS PAST FISCAL YEAR THE FGH FOUNDATION PROVIDED FUNDING FOR THREE EMPLOYEE ADVANCEMENT GRANTS AND PURCHASED NEEDED EQUIPMENT FOR OUR AMBULANCES, OUR MED/SURG AND EMERGENCY DEPARTMENTS, AND NUMEROUS RESIDENT ENTERTAINMENT/QUALITY OF LIFE ITEMS FOR OUR NURSING FACILITY AND ASSISTED LIVING. 78807 1 1 0 0 0 0 0 0 0 1 0 1 0 0 1 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 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 X BECKY STROTHER 6414565013 1720 CENTRAL AVE E HAMPTON IA 50441 KIM PRICE CEO - FRANKLIN GENERAL HOSPITAL 0.30 40.00 X X 0 0 0 JOHN TREWIN PRESIDENT 0.30 0.00 X X 0 0 0 MARGE SCHURMAN VICE PRESIDENT 0.30 0.00 X X 0 0 0 RON RANEY TREASURER/SECRETARY 0.30 0.00 X X 0 0 0 MARIEA PLENDL AUXILIARY REP 0.30 0.00 X 0 0 0 JOHN LYMAN TRUSTEE 0.30 0.00 X 0 0 0 KYLE WHALEN DIRECTOR 0.30 0.00 X 0 0 0 MARLENE SEVERE DIRECTOR 0.30 0.00 X 0 0 0 DAVE HEUBERGER DIRECTOR 0.30 0.00 X 0 0 0 VALERIA GONZALEZ DIRECTOR 0.30 0.00 X 0 0 0 JONATHAN SUKUP DIRECTOR 0.30 0.00 X 0 0 0 KRISTA DUNT DIRECTOR 0.30 0.00 X 0 0 0 REBEKAH AULT DIRECTOR 0.30 40.00 X 0 116848 45273 NICOLE POOCK FOUNDATION MANAGER 20.00 20.00 X 0 75332 30614 0 192180 75887 0 0 1 0 0 73656 73656 6043 6043 79699 0 0 6043 78807 78807 35469 35469 3272 3272 117548 78807 38741 0 378261 377546 71 765452 874279 274407 281221 1418191 1533046 319 357 6223 7781 6542 8138 X 1126134 1236244 285515 288664 1411649 1524908 1418191 1533046 X -37849 108827 42281 X 0 1 X 1 0 X 50760 56104 159142 52626 73656 392288 50760 56104 159142 52626 73656 392288 129810 262478 13262 177608 16948 23619 6043 237480 629768 0.41680 0.41910 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 256703 18259 10279 2255 262428 255346 13774 10182 2235 256703 275872 -6495 9972 4059 255346 221165 67186 9483 2996 275872 238527 -4765 9495 1070 2032 221165 0.00000 1.00000 0.00000 0 0 0 FOUND-ENDOWMENT FUND-MN FOUND 262428 F FOUND-ENDOWMENT FUND-NE IA FDN 18793 F 281221 OTHER LIABILITIES 7781 7781 X PART V, LINE 4: INTEREST FROM THE ENDOWMENT FUNDS IS USED AS NEEDED FOR HOSPITAL PURCHASES REQUESTED OF THE FOUNDATION. PART X, LINE 2: THE FOUNDATION IS AN IOWA NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE FOUNDATION IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE, AS APPLICABLE. THE FOUNDATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. THE FOUNDATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE IF SUCH INTEREST AND PENALTIES ARE INCURRED. 1 FRANKLIN GENERAL HOSPITAL 1720 CENTRAL AVENUE EAST HAMPTON IA 50441 420869203 FRANKLIN COUNTY 78807 0 N/A N/A GENERAL SUPPORT AND REIMBURSEMENT FOR CERTAIN PURCHASES AND EXPENSES 1 0 PART I, LINE 2: FRANKLIN GENERAL HOSPITAL FOUNDATION EXCLUSIVELY SUPPORTS FRANKLIN GENERAL HOSPITAL TO ASSIST IN THE HEALTH CARE NEEDS OF THE PEOPLE IN THE FRANKLIN COUNTY REGION. THE FOUNDATION APPROVES THE PURCHASES THE HOSPITAL INTENDS TO MAKE. RECEIPTS ARE GIVEN TO THE FOUNDATION TO REIMBURSE THE HOSPITAL FOR THE ITEMS PURCHASED THEREFORE, THE FOUNDATION IS ASSURED THE FUNDS WERE USED APPROPRIATELY. 0 0 0 0 0 0 0 0 0 REBEKAH AULT DIRECTOR 0 116848 0 0 0 0 0 11616 0 33657 0 162121 0 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE CONSISTS OF TWO (2) OR MORE CORPORATION DIRECTORS ELECTED BY THE CORPORATION BOARD OF DIRECTORS. THE COMMITTEE HAS THE POWERS AND DUTIES DELEGATED TO IT BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS FRANKLIN GENERAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS CONSIST OF THE CEO OF FRANKLIN GENERAL HOSPITAL, 2 MEMBERS OF THE HOSPITAL BOARD OF TRUSTEES, AND THE PRESIDENT OF THE HOSPITAL AUXILIARY. THE REMAINING DIRECTORS ARE APPOINTED FROM A LIST OF PERSONS NOMINATED BY THE HOSPITAL'S NOMINATING COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B APPROVAL BY THE SOLE MEMBER, FRANKLIN GENERAL HOSPITAL, IS REQUIRED TO APPROVE ANY AMENDMENT OF THE ARTICLES OF INCORPORATION OR THE BY LAWS, TO APPROVE ANY DISSOLUTION, CONSOLIDATION, OR MERGER OF FRANKLIN GENERAL HOSPITAL FOUNDATION, TO APPROVE THE ACQUISITION OR CREATION OF ANY WHOLLY-OWNED OR CONTROLLED CORPORATIONS, TO APPROVE ALL INDEBTEDNESS IN EXCESS OF $25,000, TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS AND ALL MATERIAL VARIATIONS FROM THE BUDGETS, TO APPROVE ALL NON-BUDGETED CAPITAL EXPENDITURES, TO APPROVE ALL LOANS, TO APPROVE COMPENSATION, IF ANY, OF DIRECTORS, AND TO APPROVE THE APPOINTMENT OF THE PRESIDENT OF THE FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS RECEIVES A COPY OF THE 990 BEFORE IT IS FILED. THE MARKETING/FOUNDATION DIRECTOR REVIEWS THE 990 BEFORE IT IS SHARED WITH BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST POLICY ANNUALLY. ANY DIRECTOR OR OFFICER HAVING AN EXISTING OR POTENTIAL INTEREST IN A CONTRACT OR OTHER TRANSACTION PRESENTED TO THE BOARD OF DIRECTORS MUST MAKE A PROMPT, FULL AND FRANK DISCLOSURE OF THE INTEREST TO THE BOARD PRIOR TO ITS ACTING ON SUCH CONTRACT OR TRANSACTION. THE BOARD OF DIRECTORS DETERMINES, BY MAJORITY VOTE, WHETHER THE DISCLOSURE SHOWS THAT THE NON-VOTING AND NON-PARTICIPATION PROVISIONS MUST BE OBSERVED. IF SO, THE INDIVIDUAL CANNOT VOTE ON, OR USE HIS/HER PERSONAL INFLUENCE ON, OR PARTICIPATE IN THE DISCUSSIONS OR DELIBERATIONS WITH RESPECT TO THE CONTRACT OR TRANSACTION. THE INDIVIDUAL MAY BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM. THE MINUTES OF THE MEETING SHOULD REFLECT THE DISCLOSURE MADE. THE ABSTENTION FROM VOTING AND PARTICIPATION, AND WHETHER A QUORUM WAS PRESENT. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS DETERMINED BY FRANKLIN GENERAL HOSPITAL, A RELATED ORGANIZATION AND MERCY MEDICAL CENTER - NORTH IOWA. THE HOSPITAL AND MERCY MEDICAL CENTER - NORTH IOWA HAVE A MASTER AFFILIATION AGREEMENT. THE FOUNDATION DIRECTOR'S COMPENSATION IS DETERMINED BY FRANKLIN GENERAL HOSPITAL, A RELATED ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FINANCIAL INFORMATION CAN BE OBTAINED BY VIEWING THE PUBLIC DISCLOSURE COPY OF THE 990. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST 6,814. TRANSFER FROM FRANKLIN GENERAL HOSPITAL 35,467. FORM 990, PART IX, LINE 5: THE FOUNDATION DOES NOT HAVE ANY EMPLOYEES. WAGES ARE PAID BY FRANKLIN GENERAL HOSPITAL, A RELATED ORGANIZATION. WAGES FOR THE FOUNDATION MANAGER ARE ALLOCATED FROM FRANKLIN GENERAL HOSPITAL TO FRANKLIN GENERAL HOSPITAL FOUNDATION. FRANKLIN GENERAL HOSPITAL 1720 CENTRAL AVENUE EAST HAMPTON IA 504411859 420869203 PROVISION OF HEALTHCARE SERVICES IA GOVT LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1 0