Civic Intelligence

Unknown Organization

990 • Fiscal year 2013 • EIN 39-1702534

Jan 01, 2013 to Dec 31, 2013 • Filed on Oct 15, 2014

2600 S Heritage Woods Drive54915

(920) 738-3000

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on this filing.

Source year 2013

Liabilities / Revenue

14th percentile

0.00x

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

2013 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2013

Net Margin

89th percentile

44%

Higher net margin than 89% of similar nonprofits.

2013 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2013

Top Officer Pay

38th percentile

$0

Higher top officer pay than 38% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

2013 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2013

Asset Growth

1st percentile

-100%

Faster asset growth than 1% of similar nonprofits.

2013 filings • 501(c)3 • $1M-$5M 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 $1,518,329 (-100%) from 2012

Net Assets

Down

$0

Down $1,517,826 (-100%) from 2012

Liabilities

Down

$0

Down $503 (-100%) from 2012

Revenue

$123,475

No earlier filing loaded for comparison.

Expenses

Up

$68,880

Up $11,710 (+20%) from 2012

Net Income

$54,595

No earlier filing loaded for comparison.

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$2.0M$1.5M$1.0M$500K$0Assets 2010: $1,335,230Liabilities 2010: $395Net Assets 2010: $1,334,8352010Assets 2011: $1,249,460Liabilities 2011: $301Net Assets 2011: $1,249,1592011Assets 2012: $1,518,329Liabilities 2012: $503Net Assets 2012: $1,517,8262012Assets 2013: $0Liabilities 2013: $0Net Assets 2013: $02013

Highlighted filing

2013

Assets$0
Liabilities$0
Net Assets$0

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$150K$100K$50K$0Expenses 2010: $87,0882010Expenses 2011: $62,7752011Expenses 2012: $57,1702012Revenue 2013: $123,475Expenses 2013: $68,880Net Income 2013: $54,5952013

Highlighted filing

2013

Revenue$123,475
Expenses$68,880
Net Income$54,595
Jump To
Filing Snapshot
Filing Period
Jan 1, 2013 to Dec 31, 2013
Signed
Oct 15, 2014
Return Version
2013v3.0
Gross Receipts
$1,046,945
Mission and Program Overview

Mission

Supporting organizations controlled by its sole voting member, appleton medical center, inc., a member of the thedacare, inc. Group, in support of long-term health care.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$1,191,109$0▼ $1,191,109
Investments Other Securities$192,733$0▼ $192,733
Savings and Temporary Cash Investments$134,487$0▼ $134,487
Cash and Non-Interest-Bearing Accounts-$0-
Accounts Receivable-$0-
Other Notes and Loans Receivable, Net-$0-
Pledges and Grants Receivable-$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$1,518,329$0▼ $1,518,329
Other Assets Total-$0-
Liabilities
Accounts Payable and Accrued Expenses$503$0▼ $503
Total Liabilities$503$0▼ $503
Net Assets / Fund Balance
Temporarily Rstr Net Assets$1,042,644$0▼ $1,042,644
Permanently Rstr Net Assets$298,970$0▼ $298,970
Unrestricted Net Assets$176,212$0▼ $176,212
Total Net Assets Fund Balance$1,517,826$0▼ $1,517,826
Total Liabilities and Net Assets / Fund Balance$1,518,329$0▼ $1,518,329

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2013$1,093,971-▲ $206,261--
2012$1,004,927-▲ $138,059-$1,093,971
2011$1,080,017-▼ $25,083-$1,004,927
2010$1,009,438-▲ $123,856-$1,080,017
2009$873,406-▲ $136,032-$1,009,438
Compensation and Service Providers

Board Members and Trustees

NameTitle
LarsonjohnPresident
StrangemaryVice President
AronsondavidDirector
BarkmeierdianeDirector
Diederich Mary KDirector
RiesterjeffDirector
ValentineryanDirector
ValkcarolDirector
BielinskijosephSecretary
KellerjohnTreasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$33,705
Program Service Revenue
$0
Investment Income
$89,770
Other Revenue
$0
All Other Contributions
$33,705
Change in Net Assets
$54,595

Audited Revenue Reconciliation

Revenue per Audited Statements
$123,475
Revenue Not Reported on Financial Statements
$0
Revenue Not Reported on Form 990
$182,289
Total Revenue per Audited Statements
$305,764
Total Revenue per Form 990
$123,475
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$56,798
Other Expenses$12,082
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Grants to Domestic Orgs$55,798--$55,798
Fees for Services Accounting-$10,500-$10,500
Fees for Service Investment Mgmnt Fees-$1,582-$1,582
Grants to Domestic Individuals$1,000--$1,000
Total Functional Expenses$56,798$12,082$0$68,880

Audited Expense Reconciliation

Line ItemAmount
Expenses Not Reported on Financial Statements$0
Expenses Not Reported on Form 990$0
Expenses per Audited Statements$0
Total Expenses per Audited Statements$0
Total Expenses per Form 990$0
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
39-1509362-501(c)(3)Support of Long Term Residential Care at Peabody Manor, Part of the Senior Care Division of Thedacare, Inc.$52,753
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
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
Audit committee
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
No
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 6

George peabody foundation, inc.'s sole member of the single class of voting members is appleton medical center, inc.

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

Appleton medical center, inc. Has voting rights with respect to the election of directors.

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

Appleton medical center, inc. Has voting rights with respect to: 1. Amendment of the articles of incorporation 2. Amendment of the bylaws of this corporation 3. Dissolution of this corporation 4. Alteration of any gift or fund restriction by a two-thirds vote of members and directors

Form 990, Part VI, Section B, Line 11

Board of directors reviews form 990 draft prior to final submission.

Form 990, Part VI, Section B, Line 12

Board members are required to update and sign conflict of interest forms annually. Forms are reviewed annually at a board meeting. All employees and board members are covered under the conflict of interest policy. The corporate compliance committee reviews the potential conflict and the cfo/board of trustees review all conflicts. After disclosure of the conflict, the employee shall not participate in the decision whether to engage in the transaction in which the employee has an interest.

Form 990, Part VI, Section B, Line 15

The compensation process for top officials of the organization is managed by their employer for payroll purposes, thedacare, inc., a related organization. Management of thedacare, inc. Determines a fair and reasonable compensation for these individuals based on market and comparability data provided by human resources. No other officers of the organization receive any compensation.

Form 990, Part VI, Section C, Line 19

Form 990 and related documents are available to any member of the public upon request.

Filing and Contact Details

Filer

EIN
39-1702534
Phone
9207383000

Signing Officer

Name
John Larson
Title
President
Phone
9207383000
Signed
2014-10-15
Discuss with paid preparer
Yes

Organization Details

Principal Officer
John Larson
Formed
1991
Legal Domicile
Wi
Voting Board Members
10
Independent Board Members
10
Employees
0
Volunteers
0

Preparer

Preparer
Terri Rexrode CPA Mst
Phone
9206620016
Supplemental Narrative

Additional Explanations

FORM 990, PART XI, LINE 9:

Net assets transferred to thedacare family of foundations, inc. -1,754,797.

Form 990, Part XII, Line 2C

Oversight of the audit: this process has not changed from the prior year.

Financial Statement Notes

PART V, LINE 4:

The foundation has adopted investment and spending policies that attempt to provide a predictable stream of funding to programs supported by its endowment while seeking to maintain the purchasing power of the endowment assets. All funds are used in support of effective elderly health care.

PART X, LINE 2:

In order to account for any uncertain tax positions, the foundation determines whether it is more likely than not that a tax position will be sustained upon examination of the technical merits of the position, assuming the taxing authority has full knowledge of all information. If the tax position does not meet the more-likely-than-not recognition threshold, the benefit of that position is not recognized in the financial statements. The foundation recorded no assets or liabilities related to uncertain tax positions in 2013 or 2012. Federal tax returns for the years ended 2009 and beyond remain subject to examination by the internal revenue service.

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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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IRS990ScheduleA/SupportedOrgInformationGrp/SupportedOrganizationName/BusinessNameLine10APPLETON MEDICAL CENTER INC
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IRS990ScheduleA/SupportedOrgInformationGrp/USOrganizedInd01
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IRS990ScheduleA/SupportSumAmt055798
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IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990/ScheduleBRequiredInd01
IRS990ScheduleD/CYEndwmtFundGrp/AdministrativeExpensesAmt056381
IRS990ScheduleD/CYEndwmtFundGrp/BeginningYearBalanceAmt01093971
IRS990ScheduleD/CYEndwmtFundGrp/GrantsOrScholarshipsAmt01243851
IRS990ScheduleD/CYEndwmtFundGrp/InvestmentEarningsOrLossesAmt0206261
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/BeginningYearBalanceAmt01004927
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/EndYearBalanceAmt01093971
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/GrantsOrScholarshipsAmt049015
IRS990ScheduleD/CYMinus1YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt0138059
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/BeginningYearBalanceAmt01080017
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/EndYearBalanceAmt01004927
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/GrantsOrScholarshipsAmt050007
IRS990ScheduleD/CYMinus2YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt0-25083
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/BeginningYearBalanceAmt01009438
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/EndYearBalanceAmt01080017
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/GrantsOrScholarshipsAmt053277
IRS990ScheduleD/CYMinus3YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt0123856
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/BeginningYearBalanceAmt0873406
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/EndYearBalanceAmt01009438
IRS990ScheduleD/CYMinus4YrEndwmtFundGrp/InvestmentEarningsOrLossesAmt0136032
IRS990ScheduleD/EndowmentsHeldRelatedOrgInd00
IRS990ScheduleD/EndowmentsHeldUnrelatedOrgInd00
IRS990ScheduleD/ExpensesNotReportedAmt00
IRS990ScheduleD/ExpensesNotRptFinclStmtAmt00
IRS990ScheduleD/ExpensesSubtotalAmt00
IRS990ScheduleD/FootnoteTextInd0X
IRS990ScheduleD/NetUnrealizedGainsInvstAmt0182289
IRS990ScheduleD/RevenueNotReportedAmt0182289
IRS990ScheduleD/RevenueNotReportedFinclStmtAmt00
IRS990ScheduleD/RevenueSubtotalAmt0123475
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt0THE FOUNDATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT ASSETS. ALL FUNDS ARE USED IN SUPPORT OF EFFECTIVE ELDERLY HEALTH CARE.
IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt1IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE FOUNDATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE FOUNDATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2013 OR 2012. FEDERAL TAX RETURNS FOR THE YEARS ENDED 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc0PART V, LINE 4:
IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc1PART X, LINE 2:
IRS990ScheduleD/TotalBookValueLandBuildingsAmt00
IRS990ScheduleD/TotalExpensesPerForm990Amt00
IRS990ScheduleD/TotalRevenuePerForm990Amt0123475
IRS990ScheduleD/TotalRevEtcAuditedFinclStmtAmt0305764
IRS990ScheduleD/TotExpnsEtcAuditedFinclStmtAmt00
IRS990ScheduleI/GrantRecordsMaintainedInd01
IRS990ScheduleI/RecipientTable/CashGrantAmt052753
IRS990ScheduleI/RecipientTable/IRCSectionDesc0501(C)(3)
IRS990ScheduleI/RecipientTable/PurposeOfGrantTxt0SUPPORT OF LONG TERM RESIDENTIAL CARE AT PEABODY MANOR, PART OF THE SENIOR CARE DIVISION OF THEDACARE, INC.
IRS990ScheduleI/RecipientTable/RecipientBusinessName/BusinessNameLine10THEDACARE INC
IRS990ScheduleI/RecipientTable/RecipientEIN0391509362
IRS990ScheduleI/RecipientTable/USAddress/AddressLine10122 E COLLEGE AVE
IRS990ScheduleI/RecipientTable/USAddress/City0APPLETON
IRS990ScheduleI/RecipientTable/USAddress/State0WI
IRS990ScheduleI/RecipientTable/USAddress/ZIPCode054912
IRS990ScheduleI/SupplementalInformationDetail/ExplanationTxt0GRANTS ARE BASED ON CRITERIA ESTABLISHED BY THE BOARD OF DIRECTORS IN SUPPORT OF EFFECTIVE ELDERLY HEALTH CARE.
IRS990ScheduleI/SupplementalInformationDetail/FormAndLineReferenceDesc0PART I, LINE 2:
IRS990ScheduleI/Total501c3OrgCnt01
IRS990ScheduleI/TotalOtherOrgCnt00
IRS990/ScheduleJRequiredInd00
IRS990ScheduleN/AssetsDistributedInd01
IRS990ScheduleN/AttorneyGeneralNotifiedInd01
IRS990ScheduleN/BondsOutstandingInd00
IRS990ScheduleN/DirectorOfSuccessorInd01
IRS990ScheduleN/EmployeeOfSuccessorInd01
IRS990ScheduleN/LiabilitiesPaidInd01
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc0CASH
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc1OTHER ACCOUNTS RECEIVABLE
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/AssetsDistriOrExpnssPaidDesc2INVESTMENTS
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine10THEDACARE FAMILY OF FOUNDATIONS INC
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine11THEDACARE FAMILY OF FOUNDATIONS INC
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/BusinessName/BusinessNameLine12THEDACARE FAMILY OF FOUNDATIONS INC
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt02013-12-31
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt12013-12-31
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt22013-12-31
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IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/EIN1464112255
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IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt08938
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt1-552
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/FairMarketValueOfAssetAmt21746411
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/IRCSectionTxt0501(C)(3)
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/IRCSectionTxt1501(C)(3)
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/IRCSectionTxt2501(C)(3)
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt0ACTUAL COST
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt1BOOK VALUE
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/MethodOfFMVDeterminationTxt2FAIR MARKET VALUE
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine101818 N MEADE ST PO BOX 1222
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine111818 N MEADE ST PO BOX 1222
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/AddressLine121818 N MEADE ST PO BOX 1222
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/City0APPLETON
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/City1APPLETON
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/City2APPLETON
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/State0WI
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/State1WI
IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/USAddress/State2WI
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IRS990ScheduleN/OwnerOfSuccessorInd00
IRS990ScheduleN/ReceiveCompensationInd00
IRS990ScheduleN/RequiredToNotifyAGInd01
IRS990ScheduleN/SupplementalInformationDetail/ExplanationTxt0EXPLANATION OF INVOLVEMENT: RYAN VALENTINE, DIRECTOR OF GEORGE F PEABODY FOUNDATION BECAME A DIRECTOR OF THE TRANSFEREE ORGANIZATION, THEDACARE FAMILY OF FOUNDATIONS, INC.CAROL VALK, DIRECTOR OF GEORGE F PEABODY FOUNDATION BECAME A DIRECTOR OF THE TRANSFEREE ORGANIZATION, THEDACARE FAMILY OF FOUNDATIONS, INC.
IRS990ScheduleN/SupplementalInformationDetail/ExplanationTxt1DURING 2013, THEDACARE, INC. FORMED A NEW FOUNDATION, THEDACARE FAMILY OF FOUNDATIONS, INC., IN ORDER TO CONSOLIDATE THE ACTIVITIES OF THEIR MULTIPLE FOUNDATIONS INTO ONE ORGANIZATION. ACCORDINGLY, THE FOUNDATION'S BOARD OF DIRECTORS APPROVED A PLAN OF DISSOLUTION WHEREBY EFFECTIVE DECEMBER 31, 2013, IN WHICH THE FOUNDATION'S NET ASSETS WERE TRANSFERRED TO THEDACARE FAMILY OF FOUNDATIONS, INC.
IRS990ScheduleN/SupplementalInformationDetail/FormAndLineReferenceDesc0PART I, LINE 2E:
IRS990ScheduleN/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, SCHEDULE N
IRS990/ScheduleORequiredInd01
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0GEORGE PEABODY FOUNDATION, INC.'S SOLE MEMBER OF THE SINGLE CLASS OF VOTING MEMBERS IS APPLETON MEDICAL CENTER, INC.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1APPLETON MEDICAL CENTER, INC. HAS VOTING RIGHTS WITH RESPECT TO THE ELECTION OF DIRECTORS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2APPLETON MEDICAL CENTER, INC. HAS VOTING RIGHTS WITH RESPECT TO: 1. AMENDMENT OF THE ARTICLES OF INCORPORATION 2. AMENDMENT OF THE BYLAWS OF THIS CORPORATION 3. DISSOLUTION OF THIS CORPORATION 4. ALTERATION OF ANY GIFT OR FUND RESTRICTION BY A TWO-THIRDS VOTE OF MEMBERS AND DIRECTORS
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3BOARD OF DIRECTORS REVIEWS FORM 990 DRAFT PRIOR TO FINAL SUBMISSION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4BOARD MEMBERS ARE REQUIRED TO UPDATE AND SIGN CONFLICT OF INTEREST FORMS ANNUALLY. FORMS ARE REVIEWED ANNUALLY AT A BOARD MEETING. ALL EMPLOYEES AND BOARD MEMBERS ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE CORPORATE COMPLIANCE COMMITTEE REVIEWS THE POTENTIAL CONFLICT AND THE CFO/BOARD OF TRUSTEES REVIEW ALL CONFLICTS. AFTER DISCLOSURE OF THE CONFLICT, THE EMPLOYEE SHALL NOT PARTICIPATE IN THE DECISION WHETHER TO ENGAGE IN THE TRANSACTION IN WHICH THE EMPLOYEE HAS AN INTEREST.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5THE COMPENSATION PROCESS FOR TOP OFFICIALS OF THE ORGANIZATION IS MANAGED BY THEIR EMPLOYER FOR PAYROLL PURPOSES, THEDACARE, INC., A RELATED ORGANIZATION. MANAGEMENT OF THEDACARE, INC. DETERMINES A FAIR AND REASONABLE COMPENSATION FOR THESE INDIVIDUALS BASED ON MARKET AND COMPARABILITY DATA PROVIDED BY HUMAN RESOURCES. NO OTHER OFFICERS OF THE ORGANIZATION RECEIVE ANY COMPENSATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6FORM 990 AND RELATED DOCUMENTS ARE AVAILABLE TO ANY MEMBER OF THE PUBLIC UPON REQUEST.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7NET ASSETS TRANSFERRED TO THEDACARE FAMILY OF FOUNDATIONS, INC. -1,754,797.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8OVERSIGHT OF THE AUDIT: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION A, LINE 6
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION A, LINE 7A
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION A, LINE 7B
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION B, LINE 11
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PART VI, SECTION B, LINE 12
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5FORM 990, PART VI, SECTION B, LINE 15
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6FORM 990, PART VI, SECTION C, LINE 19

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