2023-11-14T11:54:28-06:00 2022-12-31 990 2022-01-01 371200267 PEKIN MEMORIAL HOSPITAL FOUNDATION PEKI 3093530700 600 SOUTH 13TH STREET PEKIN IL 61554 AMY DARLING BOARD SECRETARY/TREASURER 3093530700 2023-10-23 AMY DARLING XXX-XX-XXXX 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z TIMMOTHY SCHWARTZ DDS 600 SOUTH 13TH STREET PEKIN IL 61554 4354519 0 X N/A X 1985 IL IMPROVE HEALTH AND WELL-BEING OF COMMUNITY WITH LOVE, COMPASSION AND EXTRAORDINARY MEDICAL CARE. 7 7 0 7 0 0 85491 83005 0 0 921152 587181 0 0 1006643 670186 23809 1901997 0 0 54000 54000 0 0 77897 18652 23897 96461 1979894 910182 -1309708 5451146 3133957 12625 68842 5438521 3065115 TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY AND TO DO SO WITH LOVE, COMPASSION AND EXTRAORDINARY MEDICAL CARE. 0 0 1901997 1901997 0 PEKIN MEMORIAL HOSPITAL FOUNDATION IS RESOLUTE TO BOTH PRESERVING AND NURTURING THE FUNDAMENTAL MISSION OF PEKIN HOSPITAL AS A COMMUNITY HOSPITAL, AND OTHER FACILITIES AS NECESSARY PROVIDING INPATIENT AND OUTPATIENT, DIAGNOSTIC, THERAPEUTIC, AND EDUCATIONAL SERVICES. MOREOVER, PEKIN MEMORIAL HOSPITAL FOUNDATION WILL ALWAYS KEEP THE ESSENTIAL WELFARE AND PRIORITY OF THE PATIENTS, WHO ARE SERVED BY PEKIN HOSPITAL, UPPERMOST IN MIND AS IT PLANS, ALLOCATES RESOURCES, AND DEVELOPS PROGRAMS IN THE DELIVERY OF HEALTH SERVICES. 0 0 0 PEKIN MEMORIAL HOSPITAL FOUNDATION IS ORGANIZED TO FOSTER, PROMOTE, SUPPORT, DEVELOP, ENCOURAGE AND ACCEPT FUNDS FOR THE CONSTRUCTION, BUILDING, REMODELING, SUPPORT, ADMINISTRATION, STAFFING AND ANY OTHER LEGITIMATE PURPOSE OR FUNCTION OF PEKIN MEMORIAL HOSPITAL AND PROGRESSIVE HEALTH SYSTEMS, WHICH ARE BOTH NOT-FOR-PROFIT CORPORATIONS IN THE STATE OF ILLINOIS, AND ARE EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986. 1901997 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X MARCY BECKER CARL HEALTH-PEKIN 3096712100 600 SOUTH 13TH STREET PEKIN IL 61554 X AMY DARLING BOARD SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 D NEALE BUSTER HANLEY II BOARD VICE CHAIR 1.00 0.00 X X 0 0 0 LOUIS MILLER BOARD MEMBER 1.00 0.00 X 0 0 0 TIMMOTHY SCHWARTZ DDS BOARD CHAIR 1.00 0.00 X X 0 0 0 JACK STEGER BOARD MEMBER 1.00 0.00 X 0 0 0 PATRICK J TAPHORN BOARD MEMBER 1.00 0.00 X 0 0 0 TIFFANY WHITE BOARD MEMBER 1.00 0.00 X 0 0 0 0 0 0 0 0 0 0 0 83005 83005 60002 60002 4211512 3684333 527179 527179 527179 670186 0 0 587181 1899997 1899997 2000 2000 45000 45000 9000 9000 14100 14100 5896 5896 235 235 3666 3666 1979894 1901997 0 77897 2170164 1727113 10000 3280982 1396844 5451146 3133957 12625 68842 12625 68842 X 5182745 2887956 255776 177159 5438521 3065115 5451146 3133957 -1309708 -1063698 0 X 0 1 X 1 0 X 232436 386365 255859 85491 83005 1043156 232436 386365 255859 85491 83005 1043156 136570 906586 114690 117489 163364 113670 60002 569215 1612371 51701 0.56230 0.55000 X THE ORGANIZATION WILL MAINTAIN A CONTINUOUS PROGRAM FOR THE PURPOSE OF SOLICITING FUNDS FROM THE GENERAL PUBLIC AND OTHER PUBLIC CHARITIES; HOWEVER, FUNDRAISING ACTIVITIES PERFORMED BY THE VOLUNTEERS HAVE NOW CEASED. THE FOUNDATION IS IN THE PROCESS OF TERMINATING AND WILL TRANSFER ALL REMAINING ASSETS TO THE METHODIST MEDICAL CENTER FOUNDATION EFFECTIVE 1/1/2024, IN ACCORDANCE WITH DISSOLUTION REQUIREMENTS OF THE GOVERNING DOCUMENTS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X -399164 -1063698 -1063698 664534 5652 5652 670186 1974242 0 1974242 5652 5652 1979894 PART X, LINE 2: THE FOUNDATION IS A NONPROFIT ORGANIZATION THAT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT ON INCOME UNRELATED TO THE FOUNDATION'S CHARITABLE PURPOSE. THE FOUNDATION CURRENTLY HAS NO UNRELATED BUSINESS INCOME. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED. THE FOUNDATION HAS ADOPTED THE PROVISIONS OF THE FINANCIAL ACCOUNTING STANDARDS BOARD STANDARD FOR ACCOUNTING FOR UNCERTANITY IN INCOME TAXES. MANAGEMENT HAS EVALUATED THE FOUNDATION'S TAX POSITIONS TAKEN AND CONCLUDED THAT THERE ARE NO UNCERTAIN TAX POSITIONS REQUIRING ADJUSTMENT TO THE FINANCIAL STATEMENTS. PEKIN MEMORIAL HOSPITAL FOUNDATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE FOUNDATION BELIEVES IT IS NO LONGER SUBJECT TO TAX EXAMINATIONS FOR TAX YEARS ENDING PRIOR TO DECEMBER 31, 2019. 1 PEKIN MEMORIAL HOSPITAL 600 S 13TH STREET PEKIN IL 61554 370692351 501(C)(3) 1899997 0 PROGRAM SUPPORT 1 0 PART I, LINE 2: THE ORGANIZATION MAKES GRANTS TO A DESIGNATED ILLINOIS NOT-FOR-PROFIT CORPORATION FOR PRE-APPROVED PROGRAMS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE IOWA HEALTH SYSTEM TAX DEPARTMENT USING INFORMATION GATHERED FROM VARIOUS FUNCTIONAL AREAS OF THE ORGANIZATION. EACH SECTION OF THE RETURN IS REVIEWED BY THE RESPONSIBLE FUNCTIONAL AREA ALONG WITH THE TAX DEPARTMENT. A FULL COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C A DESIGNATED PERSON WITHIN THE ORGANIZATION AND OTHER RELATED ORGANIZATIONS SUBJECT TO THIS POLICY SHALL SEND DISCLOSURE QUESTIONNAIRES TO ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHLY COMPENSATED EMPLOYEES. PERSONS REQUIRED TO REPORT WHO HAVE NOT RETURNED QUESTIONNAIRES WILL BE CONTACTED AND FOLLOW-UP WILL CONTINUE ON A REGULAR BASIS IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE INFORMATION DISCLOSED WILL BE USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICARE QUESTIONNAIRES. THE DUTY TO IDENTIFY AND DISCLOSE POTENTIAL CONFLICTS OF INTEREST IS A DUTY THAT IS ONGOING. ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND HIGHLY COMPENSATED EMPLOYEES SHALL IMMEDIATELY DISCLOSE SUCH POTENTIAL CONFLICT OR DUALITY OF INTEREST AS SOON AS THE INTEREST OCCURS. DISCLOSURE SHOULD BE MADE TO THE COVERED PERSON'S SUPERVISOR, THE CHIEF EXECUTIVE OFFICER OF THE COMPANY, OR THE BOARD CHAIR OF THE COMPANY, AS APPLICABLE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.