2023-12-20T13:19:05-06:00 2023-06-30 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2022-07-01 391605953 FOUNDATION FOR RIPON MEDICAL CENTER INC FOUN 9209264959 430 EAST DIVISION STREET FOND DU LAC WI 54935 SHAWN FISHER EXECUTIVE DIRECTOR 9209264959 2023-12-20 1 SHAWN FISHER 999009999 1 TERRI REXRODE CPA MST P00096513 9206620016 2023-12-20 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z SHAWN FISHER 430 EAST DIVISION STREET FOND DU LAC WI 54935 1669160 0 X WWW.RIPONMEDICALCENTER.COM X 1988 WI THE FOUNDATION FOR RIPON MEDICAL CENTER SERVES TO ENHANCE THE HEALTH OF THE PEOPLE OF THE GREATER RIPON AREA BY LENDING ITS FINANCIAL SUPPORT TO RIPON MEDICAL CENTER. 12 12 0 14 0 0 49620 32992 0 0 60179 -124000 2842 3127 112641 -87881 244442 197505 0 0 0 0 0 0 0 13474 13798 257916 211303 -145275 -299184 1365086 1371597 83875 161175 1281211 1210422 THE FOUNDATION FOR RIPON MEDICAL CENTER SERVES TO ENHANCE THE HEALTH OF THE PEOPLE OF THE GREATER RIPON AREA BY LENDING ITS FINANCIAL SUPPORT TO RIPON MEDICAL CENTER. 0 0 197505 197505 0 THE FOUNDATION FOR RIPON MEDICAL CENTER OPERATES TO SUPPORT, BENEFIT, PROMOTE AND OTHERWISE ASSIST THE HEALTH CARE ACTIVITIES OF RIPON MEDICAL CENTER, INC., ITS EMPLOYEES AND THE CITY OF RIPON THROUGH SUBSIDIZING OPERATING ACTIVITIES, CAPITAL PURCHASES, REPAIRS AND MAINTENANCE OR ANY OTHER NECESSARY ITEMS. 197505 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 0 0 0 0 0 WI X NICOLE DOESCHER 9209264959 430 EAST DIVISION STREET FOND DU LAC WI 54935 X ELLEN SORENSEN PRESIDENT 0.50 X X 0 0 0 CONNOR HANSON VICE PRESIDENT - THRU 12/31/22 0.50 X X 0 0 0 DR STEPHANIE GLOD INTERIM PRESIDENT 0.50 X X 0 0 0 BOBBIE POLLESCH TREASURER 0.50 X X 0 0 0 DENISE MARTINEZ SECRETARY 0.50 X X 0 0 0 RYAN AVERY BOARD MEMBER 0.50 X 0 0 0 GARY BORN BOARD MEMBER 0.50 X 0 0 0 DR STEVE EILER BOARD MEMBER - THRU 12/31/22 0.50 X 0 0 0 JEFF HOPP BOARD MEMBER 0.50 X 0 0 0 ELIZABETH ROY BOARD MEMBER 0.50 X 0 0 0 LEAH SCHRAEDER BOARD MEMBER 0.50 X 0 0 0 PETER SENSENBRENNER BOARD MEMBER 0.50 X 0 0 0 CHRIS STIEBER BOARD MEMBER 0.50 X 0 0 0 KAREN STONE BOARD MEMBER 0.50 X 0 0 0 JOANN STRANDELL BOARD MEMBER - THRU 12/31/22 0.50 X 0 0 0 SHAWN FISHER EXECUTIVE DIRECTOR 3.00 X 0 0 0 0 0 0 0 0 0 1 0 10370 22622 32992 27334 27334 1605484 1756818 -151334 -151334 -151334 0 10370 223 -223 -223 3350 0 3350 3350 -87881 0 0 -120873 197505 197505 10200 10200 2656 2656 840 840 102 102 211303 197505 13798 0 236259 141667 636 0 22898 22898 0 0 1128191 1229930 1365086 1371597 83875 161175 83875 161175 X 1136997 1064297 144214 146125 1281211 1210422 1365086 1371597 -299184 228395 0 X 0 1 X 1 0 X 34957 60588 16471 49620 32992 194628 34957 60588 16471 49620 32992 194628 78752 115876 29318 33953 19723 24200 27334 134528 329156 13345 0.35200 0.41170 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15806 226 16032 16417 -611 15806 16709 708 1000 16417 16654 55 16709 17580 74 1000 16654 0.59420 0.38050 0.02530 0 0 22898 22898 0 0 144532 228395 6451 234846 -90314 2656 -223 2433 -87881 215321 6451 223 6674 208647 2656 2656 211303 PART V, LINE 4: THE FOUNDATION'S ENDOWMENT CONSISTS OF TWO FUNDS ESTABLISHED BY DONORS TO FUND SCHOLARSHIPS AND CAPITAL IMPROVEMENTS AND THE BOARD-DESIGNATED ENDOWMENT FUND. THE ENDOWMENTS ARE ESTABLISHED TO BENEFIT THE FOUNDATION FOR A VARIETY OF PURPOSES RESTRICTED BY DONORS. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -223. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 223. FRMC RAFFLE 6770 6770 209 ANNUAL APPEAL 3600 3600 14 10370 10370 223 223 -223 1 RIPON MEDICAL CENTER INC 845 PARKSIDE STREET RIPON WI 54971 391101287 501(C)(3) 197505 0 EQUIPMENT, PROGRAMS AND COMMUNITY SUPPORT 1 0 PART I, LINE 2: THE ORGANIZATION HAS AN EXCELLENT APPLICATION FORM THAT CAN BE COMPLETED FOR REQUESTS. IN ADDITION, REQUESTS FROM THE HOSPITAL FOR FUNDS ARE TAKEN UP BY THE BOARD OF DIRECTORS. THE BOARD MAKES THE FINAL DECISION IN REGARD TO REQUESTS. ACTUAL EXPENDITURES ARE MONITORED BY THE FINANCE DEPARTMENT. 0 0 0 0 0 0 0 0 0 FORM 990, PART VII, LINE 5 SHAWN FISHER, EXECUTIVE DIRECTOR, RECEIVED COMPENSATION FROM AN UNRELATED ORGANIZATION, SSM HEALTH FOR SERVICES RENDERED TO THE FOUNDATION. TOTAL COMPENSATION OF $124,258 OF W-2 WAGES AND $10,140 OF OTHER COMPENSATION. FORM 990, PART VI, SECTION A, LINE 7A SIX (6) DIRECTORS SHALL BE APPOINTED BY THE MEDICAL CENTER AND SIX (6) DIRECTORS SHALL BE APPOINTED BY THE FOUNDATION FOR RIPON MEDICAL CENTER. AN ACTION REQUIRED OR PERMITTED TO BE TAKEN AT A MEETING OF THE BOARD OF DIRECTORS MAY BE TAKEN WITHOUT A MEETING IF CONSENT VIA EMAIL OR IN WRITING SETTING FORTH THE ACTION IS SIGNED BY AT LEAST TWO-THIRDS OF THE DIRECTORS THEN IN OFFICE. THE INTEREST OF ANY DIRECTOR OR OFFICER IN THE CORPORATION SHALL NOT BE ASSIGNABLE INTERVIVOS, NOR SHALL IT PASS TO ANY PERSONAL REPRESENTATIVE, HEIR OR DEVISEE. FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE DIRECTOR REVIEWS THE FORM 990 WITH THE DIRECTOR OF FINANCE OF AGNESIAN HEALTHCARE PRIOR TO ITS FILING. IN ADDITION, THE FORM 990 IS DISTRIBUTED VIA E-MAIL TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY, DISCLOSING ANY CONFLICT THAT MAY EXIST. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY DIRECTOR SHALL BE DISCLOSED TO THE OTHER DIRECTORS OF THE BOARD AND MADE A MATTER OF RECORD THROUGH AN ANNUAL PROCEDURE, AND ALSO WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. ANY DIRECTOR HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE AND THE ABSTENTION FROM VOTING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION BELIEVES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE A PART OF THE ORGANIZATION AND ARE NOT AVAILABLE TO THE PUBLIC.