2024-05-08T10:45:50-05:00 2023-06-30 FORVIS LLP 1201 Walnut Suite 1700 Kansas City MO 641062246 990 2022-07-01 421446683 WASHINGTON COUNTY HOSPITAL FOUNDATION % ANDREW BILLHARDT WASH 3198633920 400 EAST POLK STREET WASHINGTON IA 52353 SHELLI CLEVERLEY CFO 3198633920 2024-05-15 true SHELLI CLEVERLEY XXX-XX-XXXX Michael J Engle P00482834 8162216300 2024-05-15 3 2022 2023-04-26 12:10:37Z JOHN WOODWARD 400 EAST POLK STREET WASHINGTON IA 52353 1322828 false X WWW.WCHC.ORG X 1996 IA TO ENCOURAGE, ACCEPT, AND STEWARD ALL PUBLIC AND PRIVATE GIFTS, GRANTS, AND CONTRIBUTIONS IN SUPPORT OF WASHINGTON COUNTY HOSPITAL AND CLINICS. 11 8 2 8 0 0 488416 383977 0 0 454205 796719 3225 15531 945846 1196227 401977 342197 0 0 25138 105240 0 0 89406 43353 91341 470468 538778 475378 657449 7018247 8235149 0 0 7018247 8235149 TO ENCOURAGE, ACCEPT, AND STEWARD ALL PUBLIC AND PRIVATE GIFTS, GRANTS, AND CONTRIBUTIONS IN SUPPORT OF WASHINGTON COUNTY HOSPITAL AND CLINICS. false false 334176 334176 0 WCH FOUNDATION ENCOURAGES AND ACCEPTS PUBLIC AND PRIVATE GIFTS, GRANTS, AND CONTRIBUTIONS THROUGH AN ANNUAL DIRECT MAIL CAMPAIGN, EMPLOYEE GIVING CAMPAIGN, SPECIAL EVENTS, AND MEMORIALS AND HONORARIUMS IN SUPPORT OF WASHINGTON COUNTY HOSPITAL AND CLINICS. 8021 8021 0 FUND EMERGENCY TRANSPORTATION AND PRESCRIPTION NEEDS FOR WCHC PATIENTS. 342197 true true false false false false false false false true false false false false false false false true false false false false false false true false false true false true false false false false false false false false false false false false false true false true false true X 6 0 true 2 true false false false false false true true false false false false false false X 11 8 true false false false false true true true true false false true true true true true true false false false IA X ANDREW BILLHARDT 3198633920 400 EAST POLK STREET WASHINGTON IA 52353 STEPHEN SCHOMER DIRECTOR/VICE CHAIR/HOSP. CMO 1.0 39.0 X X 0 557735 58483 TODD PATTERSON HOSPITAL CEO 1.0 39.0 X X 0 380542 54805 SHELLI CLEVERLEY TREASURER/HOSPITAL CFO 1.0 39.0 X X 0 177369 41065 JOHN WOODWARD MAJOR GIFTS DEVELOPMT OFFICER 40.0 0.0 X 74244 0 23586 ANN HARRIS DIRECTOR/CHAIR 1.0 0.0 X X 0 0 0 DAVID BRUNS DIRECTOR/TRUSTEE 1.0 0.0 X 0 0 0 ED WEEKS DIRECTOR/TRUSTEE 1.0 0.0 X 0 0 0 GENE DRISCOLL DIRECTOR 1.0 0.0 X 0 0 0 MIKE MOORE DIRECTOR 1.0 0.0 X 0 0 0 SUE BASTEN DIRECTOR/TRUSTEE 1.0 0.0 X 0 0 0 WILLIE STONE DIRECTOR 1.0 0.0 X 0 0 0 LEISHA LINGE DIRECTOR 1.0 0.0 X 0 0 0 74244 1115646 177939 0 false true false 0 31393 105239 247345 383977 0 129080 129080 0 0 0 0 0 676093 8454 676093 -8454 667639 667639 60724 31393 74505 -13781 -13781 0 0 0 72954 43642 29312 29312 0 1196227 0 0 812250 342197 342197 0 0 0 105240 52620 52620 0 0 0 0 0 0 0 32638 32638 0 0 0 0 0 32284 16816 15468 5101 5101 0 0 0 0 0 0 0 0 0 Miscellaneous 21318 21318 538778 342197 107175 89406 910 1910 1122441 1120266 75183 75183 0 0 0 0 0 0 0 0 20446 25486 0 0 8454 0 5790813 7012304 0 0 0 0 0 0 0 0 7018247 8235149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6472758 7556074 545489 679075 7018247 8235149 7018247 8235149 657449 559453 X false true X false false X 180120 218521 280376 488416 383977 1551410 0 0 180120 218521 280376 488416 383977 1551410 473431 1077979 122110 118261 94750 93188 129080 557389 0 0 2108799 547149 0.51118 0.47163 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 545489 133586 679075 422249 136494 13254 545489 317392 162557 57700 422249 243425 75017 1050 317392 155740 128098 40413 243425 1.00000 false false 1848359 559453 92679 652132 1196227 1196227 631457 92679 92679 538778 538778 SCHEDULE D, PART V, LINE 4 AT JUNE 30, 2023 AND 2022, THE $679,075 AND $545,489 OF RESTRICTED NONEXPENDABLE NET ASSETS ARE REQUIRED TO BE MAINTAINED IN PERPETUITY BY THE DONOR FOR Provider Recruitment and Retention, Specific Operating activities and Capital Acquisition. SCHEDULE D, PART X, LINE 2 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D FUNDRAISING EXPENSES $ 74,505 IN-KIND CONTRIBUTION $ (10,000) GIFT SHOP MERCHANDISE $ 28,174 __________ $ 92,679 SCHEDULE D, PART XII, LINE 2D FUNDRAISING EXPENSES $ 74,505 IN-KIND CONTRIBUTION $ (10,000) GIFT SHOP MERCHANDISE $ 28,174 __________ $ 92,679 Golf Classic 58120 18971 39149 11400 26670 10609 1700 0 Clay Shoot 33997 12422 21575 5000 16155 2971 0 0 0 92117 31393 60724 16400 42825 13580 1700 0 74505 -13781 true WASHINGTON COUNTY HOSPITAL 400 EAST POLK STREET WASHINGTON IA 52353 426037892 GOVERNMENT 342197 SUPPORT MISSION 1 0 SCHEDULE I, PART I, LINE 2 ALL GRANTS ARE APPROVED BY THE FOUNDATION'S BOARD OF DIRECTORS. MAJOR GRANTS GREATER THAN $5,000 ARE ALSO APPROVED BY THE WASHINGTON COUNTY HOSPITAL TRUSTEES. false false false false false false false false false SHELLI CLEVERLEY TREASURER/HOSPITAL CFO 0 151372 0 25997 0 0 0 14085 0 26980 0 218434 0 0 STEPHEN SCHOMER DIRECTOR/VICE CHAIR/HOSP. CMO 0 547735 0 10000 0 0 0 28792 0 29691 0 616218 0 0 TODD PATTERSON HOSPITAL CEO 0 324347 0 56195 0 0 0 28792 0 26013 0 435347 0 0 FORM 990, PART VII, PART I & SCHEDULE J, PART II COMPENSATION FOR STEPHAN SCHOMER, SHELLI CLEVERLEY, AND TODD PATTERSON IS PROVIDED BY WASHINGTON COUNTY HOSPITAL, A RELATED ORGANIZATION. FORM 990, PART V, LINE 2A THE W-2 WAS FILED BY WASHINGTON COUNTY HOSPITAL ON BEHALF OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 2 SHELLI CLEVERLEY, TODD PATTERSON, AND STEPHEN SCHOMER HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 7A THE WASHINGTON COUNTY HOSPITAL BOARD OF TRUSTEES HAS THE RIGHT TO APPROVE THE DIRECTORS OF THE CORPORATION AT ALL TIMES. FORM 990, PART VI, SECTION A, LINE 7B WASHINGTON COUNTY HOSPITAL'S BOARD OF TRUSTEES SHALL HAVE THE POWER AND RIGHT TO APPROVE OR DISAPPROVE ANNUAL BUDGETS, TO ESTABLISH LEVELS OF AUTHORITY FOR THE FOUNDATION, AND TO APPROVE IN ADVANCE ANY PROPOSED DISSOLUTION AND/OR LIQUIDATION OF THE CORPORATION OR SALE OF ALL OR SUBSTANTIALLY ALL OF ITS ASSETS. FORM 990, PART VI, SECTION B, LINE 11B THE MAJOR GIFTS DEVELOPMENT OFFICER GATHERS INFORMATION TO PREPARE THE FORM 990 TAX RETURN. THIS INFORMATION IS THEN GIVEN TO AN INDEPENDENT ACCOUNTING FIRM WHO PREPARES AND REVIEWS THE FORM 990. THE INDEPENDENT ACCOUNTING FIRM THEN PROVIDES THE FOUNDATION'S MAJOR GIFTS DEVELOPMENT OFFICER A DRAFT OF THE FORM 990 FOR COMMENT AND APPROVAL. PRIOR TO FILING THE FORM 990, ALL GOVERNING BOARD MEMBERS RECEIVE A COPY OF THE 990 ALONG WITH A RESPONSE TIME FOR QUESTIONS AND COMMENTS. ALL ISSUES ARE RESOLVED AND THE FORM 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C AT THE TIME OF HIRE OR ELECTION (IN THE CASE OF DIRECTORS) AND ANNUALLY THEREAFTER, THE OFFICERS, DIRECTORS, AND KEY EMPLOYEES 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. IF A CONFLICT ARISES, THE OFFICER, DIRECTOR, OR KEY EMPLOYEE ABSTAINS FROM THE VOTE OF THE CONFLICTED POSITION. ANNUAL MONITORING AND REVIEW PROCEDURES SHALL BE PART OF THE ORGANIZATION'S COMPLIANCE PLAN. AN APPROPRIATE REPORT SHALL BE SUBMITTED TO THE EXECUTIVE BOARD CONCERNING ANY INTEREST DISCLOSED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. 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