2026-04-15T09:21:25-05:00 2025-05-31 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2024-06-01 731719218 MADELIA HEALTH FOUNDATION MADE 5076425224 121 DREW AVE SE MADELIA MN 56062 ALEXANDRA KIECKER EXECUTIVE DIRECTOR 5076425224 2026-04-14 1 0 JUSTIN HARTERT P02236744 5074467100 2026-04-13 2024 2025-03-06 01:10:19Z ALEXANDRA KIECKER 121 DREW AVE SE MADELIA MN 56062 175458 0 X WWW.MADELIAHEALTH.ORG/FOUNDATION X 2004 MN IN COLLABORATION WITH PHILANTHROPY, FUNDRAISING AND SERVICE, MADELIA HEALTH FOUNDATION EXISTS TO SUPPORT CONTINUAL IMPROVEMENT OF HEALTHCARE FOR THE PATIENTS AND COMMUNITIES WE SERVE. MADELIA HEALTH FOUNDATION HAS TWO MAJOR FUNDRAISERS WHICH SUPPORT VARIOUS PROJECTS, EQUIPMENT AND INITIATIVES. ONE, THE FALL GALA, (HELD EVERY OTHER YEAR) AND THE OTHER, THE GOLF OUTING HELD EACH YEAR IN EARLY JUNE. ALTHOUGH THE FOUNDATION HAS ADDED SEVERAL OTHER GIVING OPPORTUNITIES AND COMMUNITY EVENTS IN RECENT YEARS, THESE SIGNATURE EVENTS ARE KEY TO PROVIDING FINANCIAL SUPPORT FOR LOCAL HEALTHCARE. 11 9 0 55 0 0 108823 130743 0 0 27445 39875 -534 -1024 135734 169594 273977 18402 0 0 66096 59365 0 0 68886 57716 20264 397789 98031 -262055 71563 614778 1054173 0 30000 614778 1024173 MADELIA HEALTH FOUNDATION EXISTS TO BE STEWARDS OF DONATIONS GIVEN TO SUPPORT THE STATE-OF-THE-ART HEALTH SERVICES PROVIDED BY MADELIA HEALTH. THE FOUNDATION SERVES AS THE BRIDGE BETWEEN MADELIA HEALTH, ITS PATIENTS, AREA FRIENDS AND SUPPORTERS. 0 0 9902 9902 0 IN FISCAL YEAR 2025, TOTAL CONTRIBUTIONS REACHED $142,410, SUPPORTING VITAL EQUIPMENT, EDUCATION, AND PATIENT CARE INITIATIVES.FUNDRAISING EVENTS INCLUDING THE GOLF OUTING, 5K RUN/WALK, AND TREE OF REMEMBRANCE BROUGHT PEOPLE TOGETHER IN SUPPORT OF OUR MISSION.THANKS TO DONOR CONTRIBUTIONS, THE FOUNDATION FUNDED OR SUPPORTED KEY PROJECTS THIS YEAR, INCLUDING A MEETING OWL FOR IMPROVED COLLABORATION, A PODIATRY PROCEDURE CHAIR, RANGER FLUID WARMER AND TUBING, AND SUPPORT FOR THE LIVING MEADOWS TRANSPORTATION VAN, WHICH BENEFITS MADELIA HEALTH PATIENTS. THE FOUNDATION ALSO PROVIDED A GRANT FOR CONCUSSION SOFTWARE, ENABLING MADELIA HEALTH PHYSICAL THERAPY TO COLLABORATE WITH MADELIA SCHOOLS TO ENHANCE CONCUSSION PROTOCOLS AND STUDENT SAFETY. 8500 8500 0 INVESTING IN THE NEXT GENERATION OF HEALTHCARE PROFESSIONALS REMAINS A PRIORITY. THE FOUNDATION AWARDED FOUR RENEWABLE SCHOLARSHIPS, SUPPORTING ELEVEN STUDENTS IN THEIR HEALTHCARE EDUCATION WITH A TOTAL OF $8,500 DISTRIBUTED THIS YEAR. 18402 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 1 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 1 1 0 0 0 0 0 0 X 11 9 0 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 0 0 0 MN X ALEXANDRA KIECKER 5076425224 121 DREW AVE SE MADELIA MN 56062 DAVID WALZ MH CEO 0.20 40.00 X X 0 239671 23012 ALEXANDRA KIECKER VICE CHAIR/EXECUTIVE DIRECTOR 32.00 0.00 X X 0 49665 1965 MELANIE KNAAK-GUYER CHAIR 0.20 0.00 X 0 0 0 JIM HOPMAN CHAIR ( THRU 12/31/2024) 0.20 0.00 X X 0 0 0 JENNIFER BUTLER VICE CHAIR 0.20 0.00 X X 0 0 0 GLENDA ARNDT SECRETARY 0.20 0.00 X X 0 0 0 ANDREW ARDUSER TREASURER 0.20 0.00 X X 0 0 0 PHIL CARTER DIRECTOR 0.20 0.00 X 0 0 0 JACOB DENN DIRECTOR 0.20 0.00 X 0 0 0 CONNIE MILLER DIRECTOR 0.20 0.00 X 0 0 0 KELSEY COOLING DIRECTOR 0.20 0.00 X 0 0 0 CARINA PACE DIRECTOR (THRU 11/14/24) 0.20 0.00 X 0 0 0 WENDY HENNIGAR DIRECTOR 0.20 1.00 X 0 0 0 JORDAN RICHARDSON MH CFO 0.20 40.00 X 0 92124 4514 0 381460 29491 0 0 1 0 0 26868 103875 130743 39875 39875 2765 26868 5364 -2599 -2599 2075 500 1575 1575 169594 0 0 38851 X 9902 9902 8500 8500 52975 52975 2031 2031 4359 4359 5684 5684 4898 4898 1263 1263 2372 2372 2602 62 2540 273 273 COMMUNITY OUTREACH 3073 3073 MISCELLAENOUS EXPENSE 99 99 98031 18402 10743 68886 76877 494267 537901 559906 614778 1054173 30000 0 30000 X 254829 543042 359949 481131 614778 1024173 614778 1054173 71563 8283 329549 0 X 0 1 X 0 0 X X X 1 MADELIA HEALTH INC 410758512 3 1 9902 0 1 9902 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION A, LINE 6: SCHOLARSHIPS ARE AWARDED TO INDIVIDUALS IN THE HEALTHCARE FIELD WHICH SUPPORTS MADELIA HEALTH'S MISSION. A GRANT WAS ALSO GIVEN TO LIVING MEADOWS FOR THE PURCHASE OF A VAN TO TRANSPORT THEIR RESIDENTS, MANY OF WHICH ARE MADELIA HEALTH PATIENTS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 422340 552 8500 414392 427523 817 6000 422340 415694 390 18439 7000 427523 359949 55745 415694 359949 61458 421407 0.00000 0.41000 0.59000 0 0 0 X PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS ARE TO BE PERIODICALLY DETERMINED BY THE FOUNDATION BOARD OF DIRECTORS TO SUPPORT THE PURPOSE OF THE FOUNDATION. PART X, LINE 2: MADELIA HEALTH FOUNDATION (THE FOUNDATION) WAS FORMED FOR THE BENEFIT OF THE HOSPITAL AND IS ORGANIZED AS A MINNESOTA NONPROFIT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE IRC. GOLF OUTING 25628 24728 900 500 500 2540 25628 24728 900 500 500 2540 3540 -2640 1 MADELIA HEALTH 121 DREW AVE SE MADELIA MN 56062 410758512 501(C)(3) 9902 0 N/A N/A FUNDING FOR EQUIPMENT, SUPPLIES, IMPROVEMENTS 1 0 SCHOLARSHIPS 11 8500 N/A N/A PART I, LINE 2: ALL GRANTS ARE MADE TO A RELATED ORGANIZATION THAT IS UNDER COMMON MANAGEMENT WHO REGULARLY MONITORS THE ACTIVITIES, REVENUES AND EXPENDITURES OF THE RELATED ORGANIZATION. SCHOLARHIPS ARE AWARDED TO INDIVIDUALS IN THE HEALTHCARE FIELD WHICH SUPPORT MADELIA HEALTH'S MISSION. 0 0 0 0 0 0 0 0 0 DAVID WALZ MH CEO 0 215483 0 24188 0 0 0 23012 0 0 0 262683 0 0 PART I, LINE 3 COMPENSATION FOR THE CEO IS DETERMINED BY MADELIA HEALTH. MADELIA HEALTH ENSURES THAT THE COMPENSATION PAID TO ITS CEO BE CONSISTENT WITH POLICY AND PROVIDE EQUITABLE STANDARDS FOR WAGE AND BENEFITS BASED ON ANNUAL REGIONAL SURVEY OF COMPARABLE ENTITIES. THE GOVERNING BOARD REVIEWS ANNUALLY THE CEO'S PERFORMANCE AND THE BASIS IS THE ANNUAL MN HOSPITAL ASSOCIATON SURVEY. THE BOARD DETERMINES THE CEO'S BASE SALARY, IN ITS SOLE DISCRETION. THE CEO EVALUATES COMPENSATION OF OTHER OFFICERS AND EMPLOYEES ANNUALLY BASED ON THEIR PERFORMANCE. ANNUAL INCREASES ARE BASED ON A REGIONAL SURVEY OF COMPARABLE ENTITIES WITH SIMILAR POSITIONS ALONG WITH YEARS OF SERVICE AND NUMBER SUPERVISED. THE SURVEY RESULTS AND THE EMPLOYEES PERFORMANCE ARE EVALUATED FOR AN INCREASE IF DEEMED APPROPRIATE. FORM 990, PART VI, SECTION A, LINE 1A EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRPERSON, THE VICE CHAIRPERSON, THE EXECUTIVE DIRECTOR, THE SECRETARY, AND THE TREASURER AS EX OFFICIO VOTING MEMBERS THEREOF. THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE THE FULL AUTHORITY OF THE BOARD EXCEPT AS OTHERWISE LIMITED BY LAW, BY THE BOARD, OR BY THESE BYLAWS. THE EXECUTIVE COMMITTEE SHALL TRANSACT THE BUSINESS OF THE FOUNDATION DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD, PROVIDED THAT ANY ACTION TAKEN SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD. THE EXECUTIVE COMMITTEE SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE FOUNDATION IS MADELIA HEALTH. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER IS ALLOWED TO ELECT MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS SUBSEQUENT TO FILING THE FORM 990 WITH THE IRS. THE FORM 990 WILL BE PRESENTED BY FINANCE AT THE REGULAR MEETING OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL MEMBERS OF THE BOARD AND CORPORATE OFFICERS, AGENTS AND EMPLOYEES OF THE FOUNDATION. IT IS THE OBLIGATION OF THE FOUNDATION'S MANAGEMENT TO PUBLICIZE THIS POLICY TO ALL SUCH PARTIES ON A RECURRING BASIS. THE CONFLICT OF INTEREST POLICY AND AN ANNUAL DISCLOSURE STATEMENT ARE CIRCULATED TO DIRECTORS AND OFFICERS TO ASSIST THEM IN CONSIDERING SUCH DISCLOSURES, BUT DISCLOSURE IS APPROPIRATE WHENEVER A CONFLICT MAY OCCUR. THE WRITTEN NOTICES OF DISCLOSURE OF CONFLICTS OR DUALITIES OF INTEREST ARE FILED WITH THE EXECUTIVE DIRECTOR OR ANY OTHER OFFICER. IF A CONFLICT OF INTEREST EXISTS, THE CONFLICTED INDIVIDUAL REFRAINS FROM BOTH DISCUSSION AND VOTING ON THE MATTER. FORM 990, PART VI, SECTION C, LINE 19 MADELIA HEALTH FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC AT THE ANNUAL CORPORATION MEETING AND UPON REQUEST. FORM 990, PART IX, LINE 5 TO LINE 10: MADELIA HEALTH FOUNDATION DOES NOT HAVE ANY EMPLOYEES. THE SALARY AND BENEFITS EXPENSES ON PAGE 10 OF THE 990 ARE AMOUNTS THAT ARE ALLOCATED TO MADELIA HEALTH FOUNDATION FROM MADELIA HEALTH FOR THE FOUNDATION'S PORTION OF THE EXPENSES. MADELIA HEALTH 121 DREW AVENUE SE MADELIA MN 56062 410758512 HOSPITAL MN 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1