Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER |
610492356 | 3 | Yes | 256,391 | 0 | |
| (B)
EMHFL |
611388556 | 3 | Yes | 249 | 0 | |
| (C)
EPHRAIM MCDOWELL HEALTH RESOURCE |
311545520 | 3 | Yes | 960 | 0 | |
| (D)
JAMES B HAGGIN MEMORIAL HOSPITAL |
610510934 | 3 | Yes | 0 | 0 | |
| (E)
MCDOWELL HOME HEALTH AGENCY |
610715227 | 3 | Yes | 2,074 | 0 | |
| (F)
EPHRAIM MCDOWELL HEALTH INC |
611324736 | 3 | Yes | 0 | 0 | |
|
Total 6
|
259,674 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part IV, Section C, Line 1 Majority director detail | ALTHOUGH A MAJORITY OF EPHRAIM MCDOWELL HEALTH CARE FOUNDATION'S DIRECTORS WERE NOT A MAJORITY OF THE ORGANIZATION'S BOARD MEMBERS, THERE ARE SEVERAL DIRECTORS WHO OVERLAP TO ENSURE THE HEALTH CARE FOUNDATION IS VESTED IN THE SAME PERSONS/ORGANIZATIONS. |
| Software ID: | 22016089 |
| Software Version: | 2022v5.0 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 4a PROGRAM SERVICE NARRATIVE | The Foundation's primary mission is to raise, invest, and distribute funds in support of EMH's tax exempt health care services. Earnings from investments go to the exempt organizations operating within EMH for capital improvements and enhancements, services, products, education and/or scholarships that would not be possible if it were not for the Foundation. A community-based, uncompensated board of directors who determine how Foundation funds are used to enhance health care in this region. The Chairperson of the EMHCF reports the activities of the Foundation to the EMH Board. Programs currently supported fully or in part by the Foundation include: The AED Grant, a grant setup to provide automated external defibrillator devices to entities within our community who do not have a device, or need additional devices, and serve a large number of people. The grant services non-profit or for-profit entities whose location is within our service region. In addition to the grant of the device, we also provide training for staff members of the award location. In 2023, EMHCF awarded $5714 in devices to various organizations. The Chaplain's Discretionary Fund, a valuable source of assistance for patients who are discharged from any EMH hospital and are unable to purchase certain vital medications, durable medical equipment, or other medical supplies needed to aid their recovery. In FY23, the Foundation received $2703 in funding for the Chaplain's Fund and paid out $1719.83 in support of the Chaplain's Fund. EMH Community Services Department conducts health screenings, community health risk assessments and builds coalitions to address priority needs in the population. In FY23, EMHCF providing $6800 of funding for colorectal screening kits and sun screen to be distributed, free of charge, in our service region. EMHCF provides significant support to Kids Can Do Pediatric Therapy Center. Their programs, Camp Can Do, a day camp for children with special needs; Camp Healthy Kids, a day camp for children with food aversions; and Sensory Santa, an opportunity for children with sensory issues to meet Santa; all developed by pediatric therapists, are funded by EMHCF. In FY23, These initiatives received contributions of $1,700 and funded $35,806 in philanthropic support. The Associates Assistance First Fund, launched in October 2020, a valuable source of assistance for EMH Associates to assist with immediate or catastrophic needs. In FY23, the Foundation received $36,249.80 in funding for the Associates First Fund and paid out $10,296. Funding of technology that supports enhanced patient clinical services and better health outcomes is a primary focus of EMHCF. In FY23, the foundation funded $204,000 for the da Vinci robotic surgical system, allowing surgeons to perform complex minimally invasive surgical procedures with precision and accuracy. Additionally, a digital monitoring system was purchased for the Sleep Center for a total contribution of $16,152.50. As a part of our Cancer Program, EMHCF provides survivors of the disease, who are patients of EMH, a complimentary lifetime membership to McDowell Wellness Center. In FY23, funded $460 for these efforts. Using data from the COVID-19 pandemic, EMH saw a need to better fit our associates with personal protective equipment, reducing the risk of the spread of infectious disease. These efforts were funded with a $16,256.35 contribution. Finally, in an effort to enhance patient experience, EMHCF funded bedside tables throughout Fort Logan Hospital for a total cost of $6,605.39. The Ephraim McDowell Health Care Foundation collaborates with other reputable organizations in the region to increase the benefits that EMH facilities provide. Our annual partners is 2022 were Farmers National Bank, Whitaker Bank, Trim Masters Charitable Foundation, Republic Services, and Danville Office Equipment. Ephraim McDowell Health Care Foundation Grants for FY23 include: - $10,000 - Republic Services unrestricted grant. - $3,000 - Enterprise Rental Car unrestricted grant. |
| Form 990, Part V, Line 2a COMMON PAYMASTER | EPHRAIM MCDOWELL REGIONAL MEDICAL CENTER IS THE COMMON PAYMASTER FOR EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. ALL SALARIES AND PAYROLL TAXES ARE REPORTED ON A CONSOLIDATED FORM 941. THE EIN ON THE FORM 941 IS 61-0492356. |
| Form 990, Part VI, Line 15a PROCESS FOR DETERMINING COMPENSATION | EPHRAIM MCDOWELL HEALTH CARE FOUNDATION IS PART OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM WHOSE PARENT IS EPHRAIM MCDOWELL HEALTH, INC. COMPENSATION FOR ALL AFFILIATES IS OVERSEEN AND COORDINATED THROUGH EPHRAIM MCDOWELL HEALTH, INC. THE MERCER GROUP, INDEPENDENT CONSULTANTS, CONDUCTED A REVIEW IN 2018 FOR ESTABLISHING REASONABLE COMPENSATION OF THE CEO. FOR OTHER OFFICERS AND KEY EMPLOYEES, THE ORGANIZATION ALSO UTILIZED COMPENSATION STUDIES. THE COMPENSATION IS APPROVED BY THE COMPENSATION COMMITTEE OF THE EPHRAIM MCDOWELL HEALTH, INC. BOARD OF DIRECTORS. THE DECISION AND PROCESS IS DOCUMENTED BY THE COMMITTEE. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | EPHRAIM MCDOWELL HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. EPHRIAM MCDOWELL HEALTH, INC., A RELATED 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. EPHRAIM MCDOWELL HEALTH, INC. ELECTS BOARD MEMBERS OF EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. ON AN ANNUAL BASIS. THE BYLAWS OF EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. REQUIRE APPROVAL OF CERTAIN TRANSACTIONS BY EPHRAIM MCDOWELL HEALTH, INC. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | EPHRAIM MCDOWELL HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. EPHRIAM MCDOWELL HEALTH, INC., A RELATED 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. EPHRAIM MCDOWELL HEALTH, INC. ELECTS BOARD MEMBERS OF EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. ON AN ANNUAL BASIS. THE BYLAWS OF EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC.REQUIRE APPROVAL OF CERTAIN TRANSACTIONS BY EPHRAIM MCDOWELL HEALTH, INC. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | EPHRAIM MCDOWELL HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. EPHRIAM MCDOWELL HEALTH, INC., A RELATED 501(C)(3) ENTITY, IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. EPHRAIM MCDOWELL HEALTH, INC. ELECTS BOARD MEMBERS OF EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC. ON AN ANNUALBASIS. THE BYLAWS OF EPHRAIM MCDOWELL HEALTH CARE FOUNDATION, INC.REQUIRE APPROVAL OF CERTAIN TRANSACTIONS BY EPHRAIM MCDOWELL HEALTH, INC. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | COPIES OF THE FORM 990 ARE SUBMITTED TO THE FULL BOARD VIA EMAIL PRIOR TO FILING. |
| Form 990, Part VI, Line 12c Conflict of interest policy | ANNUALLY, BOARD OF DIRECTORS, SENIOR LEADERSHIP, AND MEDICAL STAFF LEADERS COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE. COMPLETION OF THE ANNUAL QUESTIONNAIRE IS COORDINATED BY GENERAL COUNSEL AND EPHRAIM MCDOWELL'S CORPORATE COMPLIANCE OFFICER. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE SENIOR LEADERSHIP AND THE CORPORATE COMPLIANCE OFFICER. THE CHAIRMAN OF THE BOARD OF DIRECTORS IS MADE AWARE OF CONFLICTS WHICH HAVE BEEN DISCLOSED ON ANNUAL STATEMENTS. IF CONFLICTS EXIST, THE CONFLICT IS DISCLOSED AND THE INDIVIDUAL WITH THE CONFLICT DOES NOT PARTICIPATE OR VOTE ON ACTIVITIES WHERE A CONFLICT OF INTEREST IS PRESENT. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS - 36996; ROUNDING - 1; |
| Software ID: | 22016089 |
| Software Version: | 2022v5.0 |