2023-11-14T08:00:23-06:00 2022-12-31 271235638 MCM CPAS & ADVISORS LLP 101 S FIFTH STREET SUITE 2100 LOUISVILLE KY 40202 990 2022-01-01 463190381 LICKING MEMORIAL TWIGS LICK 2205644528 1320 WEST MAIN STREET NEWARK OH 43055 CYNTHIA L WEBSTER VP FINANCIAL SERVICES, LMHS 2205644528 2023-11-10 1 CYNTHIA WEBSTER 999009999 0 THERESA BATLINER CPA P00543162 5027491900 2023-11-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARILYN WEBER 1320 WEST MAIN STREET NEWARK OH 43055 174013 0 X N/A X 2013 OH TO SUPPORT LICKING MEMORIAL HOSPITAL 9 7 0 155 0 0 1248 2514 7880 9767 1 1 66143 80537 75272 92819 86200 49000 0 0 0 0 0 0 0 6974 5994 93174 54994 -17902 37825 48281 86106 0 0 48281 86106 TO RAISE FUNDS TO SUPPORT CAPITAL IMPROVEMENTS AT LICKING MEMORIAL HOSPITAL 0 0 54994 49000 9767 TWIGS PROVIDES VOLUNTEER SERVICES AND FINANCIAL SUPPORT FOR LICKING MEMORIAL HOSPITAL. THE TWIGS EXECUTIVE BOARD AND EACH INDIVIDUAL TWIG COMMITTEE DETERMINES HOW MUCH MONEY TO CONTRIBUTE. THE INITIAL CONTRIBUTION IS MADE TO LICKING MEMORIAL HOSPITAL FOUNDATION; HOWEVER, THE FOUNDATION IS ONLY AN INTERMEDIARY. THE FOUNDATION ULTIMATELY PROVIDES THE CONTRIBUTED AMOUNT TO LICKING MEMORIAL HOSPITAL TO FUND CAPITAL IMPROVEMENTS. 54994 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 0 0 0 0 0 0 0 X 9 7 0 0 0 0 1 0 1 1 1 0 1 1 1 0 0 0 0 0 0 X DREW LINK 2205644533 1320 WEST MAIN STREET NEWARK OH 43055 VERONICA PATTON HOSPITAL LIAISON 1.30 38.70 X X 0 249459 19204 STEVE SCHLICHER ADVISORY BOARD 1.30 X 0 0 0 JANET WELLS RECORDING SECRETARY 1.30 X X 0 86294 11637 SHARON WILLS ADVISORY BOARD 1.30 X 0 0 0 LYNNE ROTRUCK ADVISORY BOARD 1.30 X 0 0 0 PAM FROELICH ADVISORY BOARD 1.30 X 0 0 0 MARILYN WEBER CHAIR 1.30 X X 0 0 0 EUDORA SUKI NEWHOUSE VICE CHAIR/ASSISTANT TREAS 1.30 X X 0 0 0 DARLENE BAKER TREASURER 1.30 X X 0 0 0 0 335753 30841 0 0 1 0 0 916 1598 2514 OTHER INCOME 900099 9767 9767 9767 1 1 161731 81194 80537 80537 92819 9767 0 80538 49000 49000 MISCELLANEOUS 3725 3725 SALES TAX 2269 2269 54994 54994 0 0 15001 57124 33280 28982 48281 86106 0 0 X 48281 86106 48281 86106 48281 86106 37825 0 X 0 0 0 X X X 1 LICKING MEMORIAL HEALTH SYSTEM 311096218 7 1 49000 0 1 49000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 PART IV, SECTION B, LINE 1 THE SUPPORTED ORGANIZATION, LICKING MEMORIAL HEALTH SYSTEMS DOES NOT APPOINT OR ELECT DIRECTORS OR TRUSTEES OF THE ORGANIZATION. UNDER THE CODE OF REGULATIONS, EACH TWIGS COMMITTEE SHALL NOMINATE A PERSON TO FILL ONE DIRECTOR POSITION PROVIDED, HOWEVER THAT SHOULD THE TOTAL NUMBER OF TWIGS COMMITTEES FALL TO THREE OR FEWER, THEN EACH TWIGS COMMITTEE SHALL NOMINATE TWO PERSONS TO FILL THE DIRECTOR POSITIONS. SUBSEQUENTLY, A SUB-COMMITTEE OF OFFICERS OF LICKING MEMORIAL HEALTH SYSTEMS SHALL APPROVE OR DISAPPROVE THE APPOINTMENT OF EACH NOMINEE AS A DIRECTOR. IN THE EVENT THAT THE SUB-COMMITTEE SHOULD DISAPPROVE A NOMINEE, IT MAY EITHER 1) REQUEST THE TWIGS COMMITTEE TO NOMINATE ANOTHER PERSON OR 2) APPOINT AS A DIRECTOR ANOTHER PERSON THEN SERVING ON THE TWIGS COMMITTEE. THE PERSONS APPOINTED BY THE SUB-COMMITTEE OF OFFICERS OF LICKING MEMORIAL HEALTH SYSTEMS SHALL COMPRISE THE DIRECTORS. AS FOR THE REMAINING ORGANIZATIONS, LMHF, LMH AND LMPC, AN INDIVIDUAL MUST BE A MEMBER OF LMHS TO BE A DIRECTOR OF THE CORPORATION. NO INDIVIDUAL BUSINESS, SERVICE OR PROFESSION SHALL HAVE MORE THAN TWO REPRESENTATIVES ON THE RESPECTIVE BOARDS AT ANY ONE TIME. 1 LICKING MEMORIAL HEALTH FOUNDATION 1320 MAIN STREET NEWARK OH 43055 311096217 501(C)(3) 49000 0 TO PROVIDE FUNDS FOR CAPITAL IMPROVEMENTS FOR THE HOSPITAL. 1 0 PART I, LINE 2: THE TWIGS EXECUTIVE BOARD DETERMINES AND EACH INDIVIDUAL TWIG COMMITTEE DETERMINES HOW MUCH MONEY TO CONTRIBUTE. THE INITIAL CONTRIBUTION IS MADE TO LICKING MEMORIAL HOSPITAL FOUNDATION; HOWEVER, THE FOUNDATION IS ONLY AN INTERMEDIARY. THE FOUNDATION ULTIMATELY PROVIDES THE CONTRIBUTED AMOUNT TO LICKING MEMORIAL HOSPITAL. ONCE THE CONTRIBUTION IS MADE, THERE IS NO ONGOING MONITORING OF THE FUNDS. THE ORGANIZATION RECEIVING THE CONTRIBUTION ACKNOWLEDGES RECEIPT OF THE FUNDS AND OFTEN INCLUDES A PLACARD IN THE AREA OF DONATED EQUIPMENT, RENOVATED AREAS, ETC. 0 0 0 0 0 0 0 0 0 VERONICA PATTON HOSPITAL LIAISON 0 247459 0 2000 0 0 0 10413 0 8791 0 268663 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE BOARD ARE SUBJECT TO THE MEMBERS APPROVAL. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE RETURN IS REVIEWED FIRST BY INTERNAL MANAGEMENT. AFTER INTERNAL MANAGEMENT HAS REVIEWED THE RETURN AND ANY CHANGES ARE MADE A DRAFT IS MADE AVAILABLE FOR REVIEW AND PRESENTATION TO THE BOARD. ONCE THE COMMENTS FROM THE BOARD ARE REVIEWED THE FINAL RETURN IS PREPARED AND SIGNED BY THE V.P. OF FINANCIAL SERVICES OF LICKING MEMORIAL HOSPITAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. LICKING MEMORIAL HOSPITAL 1320 WEST MAIN STREET NEWARK OH 43055 314379519 HEALTHCARE ORGANIZATION OH 501(C)(3) LINE 3 LICKING MEMORIAL HEALTH SYTEMS 0 LICKING MEMORIAL HEALTH SYSTEMS 1320 WEST MAIN STREET NEWARK OH 43055 311096218 PARENT COMPANY FOR THE NONPROFIT OPERATION OF HEALTHCARE ORGANIZATIONS OH 501(C)(3) LINE 12C, III-FI 0 LICKING MEMORIAL HEALTH FOUNDATION 1320 WEST MAIN STREET NEWARK OH 43055 311096217 PROVIDE FUNDING FOR HEALTHCARE PROGRAMS OH 501(C)(3) LINE 12A, I LICKING MEMORIAL HEALTH SYTEMS 0 LICKING MEMORIAL PROFESSIONAL CORPORATION 1320 WEST MAIN STREET NEWARK OH 43055 311425530 HEALTHCARE ORGANIZATION OH 501(C)(3) LINE 10 LICKING MEMORIAL HEALTH SYTEMS 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0