Civic Intelligence

Memorial Hospital Foundation

EIN 34-1435328 • 501(c)3

Profile

Memorial hospital foundation is organized and operated for the purpose of promoting and supporting, by grants, gifts-in-aid, or otherwise, the purposes, activities and related programs of memorial hspital and the nonprofit health care entities which memorial hospital controls.

715 South Taft Avenue43420

www.memorialhcs.org

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on the latest valid filing.

Source year 2013

Liabilities / Revenue

61st percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • <$500k nonprofits • Source year 2013

Net Margin

85th percentile

36%

Higher net margin than 85% of similar nonprofits.

501(c)3 • <$500k nonprofits • Source year 2013

Top Officer Pay

Score unavailable

No value available

No filing with officer rows is available for this organization yet.

Asset Growth

9th percentile

-100%

Faster asset growth than 9% of similar nonprofits.

501(c)3 • <$500k nonprofits • Annualized from 2012 to 2013

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2013

Assets

Down

$0

Down $3,505,579 (-100%) from 2012

Liabilities

Down

$0

Down $1,194,982 (-100%) from 2012

Net Assets

Down

$0

Down $2,310,597 (-100%) from 2012

Revenue

$95,385

No earlier filing loaded for comparison.

Expenses

Down

$61,381

Down $125,979 (-67%) from 2012

Net Income

$34,004

No earlier filing loaded for comparison.

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$4.0M$3.0M$2.0M$1.0M$0Assets 2010: $3,464,591Liabilities 2010: $1,684,587Net Assets 2010: $1,780,0042010Assets 2011: $2,970,833Liabilities 2011: $1,250,245Net Assets 2011: $1,720,5882011Assets 2012: $3,505,579Liabilities 2012: $1,194,982Net Assets 2012: $2,310,5972012Assets 2013: $0Liabilities 2013: $0Net Assets 2013: $02013

Highlighted filing

2013

Assets$0
Liabilities$0
Net Assets$0

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$400K$300K$200K$100K$0Expenses 2010: $396,1252010Expenses 2011: $270,2142011Expenses 2012: $187,3602012Revenue 2013: $95,385Expenses 2013: $61,381Net Income 2013: $34,0042013

Highlighted filing

2013

Revenue$95,385
Expenses$61,381
Net Income$34,004

Filings

Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Oct 1, 2013 to Dec 31, 2013
Signed
Nov 14, 2014
Return Version
2013v3.0
Gross Receipts
$95,385
Mission and Program Overview

Mission

Memorial hospital foundation is organized and operated for the purpose of promoting and supporting, by grants, gifts-in-aid, or otherwise, the purposes, activities and related programs of memorial hspital and the nonprofit health care entities which memorial hospital controls.

The following services were supported: mobile meals,hospice dept., hospice patients' heart's desire, hospice caregiver stipend, hospice bereavement programs, golden threads, memorial hospital patient needs, memorial hospital employee emergency, kommen mammogram fund, kramer/heflinger pediatric endowment, medical student loans, ob dept., pediatric dept., physical medicine dept., home health dept. Kids fest, center for physical health, & celebrating women & wellness event.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$2,991,386$0▼ $2,991,386
Savings and Temporary Cash Investments$808,454$0▼ $808,454
Investments Other Securities$212,568$0▼ $212,568
Pledges and Grants Receivable$45,244$0▼ $45,244
Cash and Non-Interest-Bearing Accounts-$0-
Accounts Receivable-$0-
Other Notes and Loans Receivable, Net-$0-
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc-$0-
Investments Program Related-$0-
Land, Buildings, and Equipment, Net-$0-
Intangible Assets-$0-
Inventories for Sale or Use-$0-
Prepaid Expenses and Deferred Charges-$0-
Total Assets$4,064,555$0▼ $4,064,555
Other Assets Total$6,903$0▼ $6,903
Liabilities
Accounts Payable and Accrued Expenses$1,113,565--
Total Liabilities$1,113,565$0▼ $1,113,565
Net Assets / Fund Balance
Unrestricted Net Assets$1,758,265$0▼ $1,758,265
Temporarily Rstr Net Assets$862,525$0▼ $862,525
Permanently Rstr Net Assets$330,200$0▼ $330,200
Total Net Assets Fund Balance$2,950,990$0▼ $2,950,990
Total Liabilities and Net Assets / Fund Balance$4,064,555$0▼ $4,064,555

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2012$1,476,750$574,592▲ $153,932-$2,205,274
2011$1,217,174$51,751▲ $207,825-$1,476,750
2010$1,361,775$56,821-$201,422$1,217,174
2009$1,179,657$32,762▲ $149,356-$1,361,775
Compensation and Service Providers

Board Members and Trustees

Revenue and Support

Revenue Composition

Contributions and Grants
$68,032
Program Service Revenue
$0
Investment Income
$23,092
Other Revenue
$4,261
All Other Contributions
$68,002
Change in Net Assets
$34,004
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$38,720
Grants and Similar Amounts Paid$22,661
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Grants to Domestic Orgs$19,373--$19,373
Other Expenses$4,475$985-$5,460
Grants to Domestic Individuals$3,288--$3,288
Office Expenses-$120-$120
Total Functional Expenses$60,276$1,105$0$61,381
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
34-4430849-501(c)(3)To Accomplish the Mission of the Memorial Hospital Foundation to Support Memorial Hospital Through Funding of Capital Improvements and Patient Care. Also to Support the Community Service Programs Conducted by Memorial Hospital$19,373
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Gross Income$2,974
Fundraising Direct Expenses$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees-$0-
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 6

The sole member of memorial hospital foundation is memorial hospital, a nonprofit corporation.

Form 990, Part VI, Section A, Line 7A

During the month of january of each year, the sole member of the corporation shall elect trustees of the corporation as provided in the articles of incorporation of the foundation, shall receive the report of the chairman and other officers of the corporation, shall review the budget, policies and activities of the corporation, and shall transact such other business as the sole member of the corporation deems appropriate.

Form 990, Part VI, Section B, Line 11

990 will be presented to the board for review and discussion.

Form 990, Part VI, Section B, Line 12C

The written conflict of interest policy is regularly and consistently monitored and compliance enforced by memorial hospital's compliance officer. The scope of this policy includes any trustee, principal officer, member of a committee, leader or key manager with board delegated powers who has a direct or indirect financial interest, as defined in the policy, is an interested person who should disclose potential conflict of interest to be evaluated by the board of trustees. The policy is in place to to protect the foundation's interest when it is contemplating entering into a transaction or arrangement that might benefit the private interest of an officer or trustee of the foundation. The covered persons are to refrain from financial transactions that could jeopardize corporations tax exempt status. A self disclosure from covered persons to memorial hospital ceo is required on any potential conflicts of interest. The covered persons are to recuse themselves from participating in any deliberation or decisions on such transactions.

Form 990, Part VI, Section C, Line 19

The organization makes its documents available upon request.

Filing and Contact Details

Filer

EIN
34-1435328
Phone
4193327321

Signing Officer

Name
Pamela Jensen
Title
President
Phone
4193327321
Signed
2014-11-14
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Pamela Jensen
Formed
1984
Legal Domicile
Oh
Voting Board Members
13
Independent Board Members
11
Employees
0
Volunteers
18

Preparer

Preparer
Stephen a Sheridan
Phone
6148852583
Supplemental Narrative

Additional Explanations

FORM 990, PART XI, LINE 9:

Balance transfer to affiliates -3,124,905.

Financial Statement Notes

SCHEDULE D: PART V, LINE 1

As part of the termination, the funds have been transfered to promedica memorial foundation.

SCHEDULE D: PART I, LINE 5

Each fund has a policy in place which describes the specific use of any contrubutions to such fund.

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This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/OtherExpensesGrp/TotalAmt115308
IRS990/OtherExpensesGrp/TotalAmt25460
IRS990/OtherRevenueMiscGrp/BusinessCd0900099
IRS990/OtherRevenueMiscGrp/Desc0MISCELLANEOUS
IRS990/OtherRevenueMiscGrp/ExclusionAmt01287
IRS990/OtherRevenueMiscGrp/TotalRevenueColumnAmt01287
IRS990/OtherRevenueTotalAmt01287
IRS990/OthNotesLoansReceivableNetGrp/EOYAmt00
IRS990/PartialLiquidationInd00
IRS990/PayPremiumsPrsnlBnftCntrctInd00
IRS990/PermanentlyRstrNetAssetsGrp/BOYAmt0330200
IRS990/PermanentlyRstrNetAssetsGrp/EOYAmt00
IRS990/PledgesAndGrantsReceivableGrp/BOYAmt045244
IRS990/PledgesAndGrantsReceivableGrp/EOYAmt00
IRS990/PoliciesReferenceChaptersInd01
IRS990/PoliticalCampaignActyInd00
IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt00
IRS990/PrincipalOfficerNm0PAMELA JENSEN
IRS990/ProfessionalFundraisingInd00
IRS990/ProgSrvcAccomActy2Grp/Desc0MAMMOGRAM FUND - PROVIDED MAMMOGRAMS TO 71 PATIENTS AT NO COST WHO MET THE FINANCIAL NEED REQUIREMENTS OF THE PROGRAMS.
IRS990/ProgSrvcAccomActy2Grp/ExpenseAmt07875
IRS990/ProgSrvcAccomActy3Grp/Desc0MOBILE MEALS - TO PROVIDE PREPARED AND DELIVERED MEALS TO MEMBERS OF THE COMMUNITY IN ORDER TO MEET THEIR NUTRITIONAL NEEDS OFTEN AT A DISCOUNTED PRICE. TO FACILITATE THE MOBILE MEALS PROGRAM, THE MEALS ARE ALL PLANNED AND PREPARED BY MEMORIAL HOSPITAL'S DIETITIAN AND DIETARY DEPARTMENT TO MEET SUBSCRIBERS' NUTRITIONAL NEEDS. A TYPICAL HOT MEAL INCLUDES MEAT, POTATO, VEGETABLE, SALAD, DESSERT, AND MILK. VOLUNTEERS DELIVER THESE HOT MEALS MONDAY THROUGH FRIDAY, USING THEIR PERSONAL CARS, OPERTING AT THEIR OWN EXPENSE.
IRS990/ProgSrvcAccomActy3Grp/ExpenseAmt02199
IRS990/ProgSrvcAccomActy3Grp/RevenueAmt026013
IRS990/ProgSrvcAccomActyOtherGrp/Desc0OTHER PROGRAM SERVICES
IRS990/ProgSrvcAccomActyOtherGrp/ExpenseAmt021044
IRS990/ProgSrvcAccomActyOtherGrp/GrantAmt019373
IRS990/ProgSrvcAccomActyOtherGrp/RevenueAmt015218
IRS990/ProhibitedTaxShelterTransInd00
IRS990/PYBenefitsPaidToMembersAmt00
IRS990/PYContributionsGrantsAmt0515841
IRS990/PYExcessBenefitTransInd00
IRS990/PYGrantsAndSimilarPaidAmt080654
IRS990/PYInvestmentIncomeAmt0163671
IRS990/PYOtherExpensesAmt074587
IRS990/PYOtherRevenueAmt08524
IRS990/PYProgramServiceRevenueAmt00
IRS990/PYRevenuesLessExpensesAmt0532795
IRS990/PYSalariesCompEmpBnftPaidAmt00
IRS990/PYTotalExpensesAmt0155241
IRS990/PYTotalProfFndrsngExpnsAmt00
IRS990/PYTotalRevenueAmt0688036
IRS990/QuidProQuoContributionsInd00
IRS990/RcvblFromDisqualifiedPrsnGrp/EOYAmt00
IRS990/RcvFndsToPayPrsnlBnftCntrctInd00
IRS990/ReceivablesFromOfficersEtcGrp/EOYAmt00
IRS990/ReconcilationRevenueExpnssAmt034004
IRS990/RegularMonitoringEnfrcInd01
IRS990/RelatedEntityInd01
IRS990/RelatedOrganizationCtrlEntInd00
IRS990/ReportInvestmentsOtherSecInd00
IRS990/ReportLandBuildingEquipmentInd00
IRS990/ReportOtherAssetsInd00
IRS990/ReportOtherLiabilitiesInd00
IRS990/ReportProgramRelatedInvstInd00
IRS990/RevenueAmt029744
IRS990/SavingsAndTempCashInvstGrp/BOYAmt0808454
IRS990/SavingsAndTempCashInvstGrp/EOYAmt00
IRS990ScheduleA/Form990ScheduleAPartIVGrp/ExplanationTxt0THE ORGANIZATION'S CURRENT YEAR IS A SHORT YEAR FROM 10/1/13 - 12/31/13.
IRS990ScheduleA/Form990ScheduleAPartIVGrp/FormAndLineReferenceDesc0SCHEDULE A: PART IV
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearAmt068032
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus1YearAmt0416064
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus2YearsAmt0393611
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus3YearsAmt0183461
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/CurrentTaxYearMinus4YearsAmt0354697
IRS990ScheduleA/GiftsGrantsContriRcvd170Grp/TotalAmt01415865
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearAmt03623
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus1YearAmt016046
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus2YearsAmt091474
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus3YearsAmt051551
IRS990ScheduleA/GrossInvestmentIncome170Grp/CurrentTaxYearMinus4YearsAmt026447
IRS990ScheduleA/GrossInvestmentIncome170Grp/TotalAmt0189141
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearAmt023729
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus1YearAmt0108301
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus2YearsAmt0138917
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus3YearsAmt036791
IRS990ScheduleA/OtherIncome170Grp/CurrentTaxYearMinus4YearsAmt022863
IRS990ScheduleA/OtherIncome170Grp/TotalAmt0330601
IRS990ScheduleA/PublicOrganization170Ind0X
IRS990ScheduleA/PublicSupportCY170Pct00.73150
IRS990ScheduleA/PublicSupportPY170Pct00.65310
IRS990ScheduleA/PublicSupportTotal170Amt01415865
IRS990ScheduleA/ThirtyThrPctSuprtTestsCY170Ind0X
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearAmt068032
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus1YearAmt0416064
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus2YearsAmt0393611
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus3YearsAmt0183461
IRS990ScheduleA/TotalCalendarYear170Grp/CurrentTaxYearMinus4YearsAmt0354697
IRS990ScheduleA/TotalCalendarYear170Grp/TotalAmt01415865
IRS990ScheduleA/TotalSupportAmt01935607
IRS990ScheduleB/ContributorInformationGrp/ContributorBusinessName/BusinessNameLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/City0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990/ScheduleBRequiredInd01
IRS990ScheduleD/BoardDesignatedBalanceEOYPct00.76660
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/BeginningYearBalanceAmt01476750
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/ContributionsAmt0574592
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/EndYearBalanceAmt02205274
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt0153932
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/BeginningYearBalanceAmt01217174
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/ContributionsAmt051751
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/EndYearBalanceAmt01476750
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt0207825
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/BeginningYearBalanceAmt01361775
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/ContributionsAmt056821
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/EndYearBalanceAmt01217174
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/OtherExpendituresAmt0201422
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/BeginningYearBalanceAmt01179657
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/ContributionsAmt032762
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/EndYearBalanceAmt01361775
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt0149356
IRS990ScheduleD/PrmnntEndowmentBalanceEOYPct00.14970
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0AS PART OF THE TERMINATION, THE FUNDS HAVE BEEN TRANSFERED TO PROMEDICA MEMORIAL FOUNDATION.
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt1EACH FUND HAS A POLICY IN PLACE WHICH DESCRIBES THE SPECIFIC USE OF ANY CONTRUBUTIONS TO SUCH FUND.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0SCHEDULE D: PART V, LINE 1
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc1SCHEDULE D: PART I, LINE 5
IRS990ScheduleD/TermEndowmentBalanceEOYPct00.08370
IRS990ScheduleD/TotalBookValueLandBuildingsAmt00
IRS990ScheduleI/GrantRecordsMaintainedInd01
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/CashGrantAmt03288
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/GrantTypeTxt0HOSPICE CAREGIVER FUND STIPEND
IRS990ScheduleI/GrantsOtherAsstToIndivInUSGrp/RecipientCnt01
IRS990ScheduleI/RecipientTable/CashGrantAmt019373
IRS990ScheduleI/RecipientTable/IRCSectionDesc0501(C)(3)
IRS990ScheduleI/RecipientTable/PurposeOfGrantTxt0TO ACCOMPLISH THE MISSION OF THE MEMORIAL HOSPITAL FOUNDATION TO SUPPORT MEMORIAL HOSPITAL THROUGH FUNDING OF CAPITAL IMPROVEMENTS AND PATIENT CARE. ALSO TO SUPPORT THE COMMUNITY SERVICE PROGRAMS CONDUCTED BY MEMORIAL HOSPITAL
IRS990ScheduleI/RecipientTable/RecipientBusinessName/BusinessNameLine10MEMORIAL HOSPITAL
IRS990ScheduleI/RecipientTable/RecipientEIN0344430849
IRS990ScheduleI/RecipientTable/USAddress/AddressLine10715 S TAFT AVENUE
IRS990ScheduleI/RecipientTable/USAddress/City0FREMONT
IRS990ScheduleI/RecipientTable/USAddress/State0OH
IRS990ScheduleI/RecipientTable/USAddress/ZIPCode043420
IRS990ScheduleI/SupplementalInformationDetail/ExplanationTxt0SUPPORT DOCUMENTS ARE MAINTAINED BY THE FOUNDATION DEVELOPMENT DIRECTOR AND IN ACCOUNTING DEPT. RECORDS. FOUNDATION DEVELOPMENT DIRECTOR APPROVES ALL FOUNDATION FUND RELATED EXPENSES AND DENOTES WHICH FUND IS UTILIZED FOR THE RECIPIENTS OF THE FUNDS. EACH FUND HAS A SPECIFIC PURPOSE/POLICY OF USAGE, OF WHICH HOSPITAL PROGRAMS BENEFIT.
IRS990ScheduleI/SupplementalInformationDetail/FormAndLineReferenceDesc0PART I, LINE 2:
IRS990ScheduleI/Total501c3OrgCnt01
IRS990ScheduleJ/AnyNonFixedPaymentsInd00
IRS990ScheduleJ/CompBasedOnRevenueOfFlngOrgInd00
IRS990ScheduleJ/CompBsdNetEarnsFlngOrgInd00
IRS990ScheduleJ/CompBsdNetEarnsRltdOrgsInd00
IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd00
IRS990ScheduleJ/EquityBasedCompArrngmInd00
IRS990ScheduleJ/InitialContractExceptionInd00
IRS990/ScheduleJRequiredInd01

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