2023-11-15T15:29:02-06:00 2022-12-31 450250958 EIDE BAILLY LLP 2950 E HARMONY RD STE 290 FORT COLLINS CO 805283429 990 2022-01-01 840718355 NORTH COLORADO MEDICAL CENTER FOUNDATION NORT 9703569020 815 8TH AVENUE GREELEY CO 80631 JEFFREY CARLSON CHIEF EXECUTIVE OFFICER 9703569020 2023-11-15 1 JEFFREY CARLSON 999009999 0 KYLE FRITCH CPA P01313374 9702238825 2023-11-15 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z WELD LEGACY FOUNDATION JEFFREY CARLSON 815 8TH AVENUE GREELEY CO 80631 4131416 0 X HTTPS://WELDLEGACY.ORG X 1975 CO TO POSITIVELY IMPACT THE HEALTH, EDUCATION, AND WELLNESS OF WELD COUNTY. 11 11 0 200 0 0 979719 1170383 50640 50640 4161244 400873 65705 -85927 5257308 1535969 644691 867673 0 0 0 0 66000 30250 288483 508756 637535 1219447 1535458 4037861 511 33289222 29729233 8501880 7730611 24787342 21998622 X NORTH COLORADO MEDICAL CENTER FOUNDATION PHILANTHROPICALLY CONTRIBUTES TO ENHANCE THE HEALTH AND EDUCATION QUALITY OF CITIZENS OF WELD COUNTY. THROUGH GRANTS TO NONPROFIT ORGANIZATIONS, SCHOOLS, AND GOVERNMENT ENTITIES, THE FOUNDATION AIMS TO POSITIVELY IMPACT THE EDUCATION AND WELLNESS OF WELD COUNTY. 0 0 704465 689680 VARIOUS GRANTS ARE MADE TO ENHANCE NORTH COLORADO MEDICAL CENTER'S ABILITY TO DELIVER HEALTHCARE TO THE NORTHERN COLORADO COMMUNITY. OTHER LOCAL NONPROFIT ORGANIZATIONS ALSO BENEFIT FROM GRANTS MADE BY THE NORTH COLORADO MEDICAL CENTER FOUNDATION (WELD LEGACY FOUNDATION). 88772 82993 50640 MONFORT CHILDREN'S CLINIC THIS PROGRAM PROVIDES HEALTHCARE TO THE CHILDREN OF LOW-INCOME FAMILIES IN WELD COUNTY AND AVERAGES 6,000 PATIENTS AND 13,000 VISITS PER YEAR. IT IS OWNED BY THE FOUNDATION AND WAS OPERATED BY THE FOUNDATION UNTIL OCTOBER 2001. AT THAT TIME, SUNRISE COMMUNITY HEALTH CENTER, AN UNRELATED TAX-EXEMPT ORGANIZATION, LEASED THE CLINIC AND ASSUMED RESPONSIBILITY FOR DAY-TODAY- OPERATIONS. 95000 95000 CURTIS STRONG CENTER FOR THE VISUALLY IMPAIRED - THIS PROGRAM WAS ESTABLISHED IN AUGUST 2004 TO MAXIMIZE REMAINING VISION WHEN THE PATIENT'S VISION CANNOT BE CORRECTED OR MEDICALLY OR SURGICALLY RESTORED. THE CENTER PROVIDES AN ASSESSMENT OF VISION LOSS, IDENTIFIES AIDS TO OPTIMIZE REMAINING VISION, AND OFFERS EDUCATION ON THE USE OF THE DEVICES AS WELL AS LIFE SKILLS AND MOBILITY TRAINING. THE CENTER IS SUPPORTED BY THE FOUNDATION AND IS OPERATED BY ENSIGHT SKILLS CENTER, AN UNRELATED THIRD PARTY. 888237 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 1 0 0 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 18 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 11 11 1 1 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 0 0 CO X RANDIE LIESER 9703569020 815 8TH AVENUE GREELEY CO 80631 X TOM GRANT PRESIDENT & CHAIR 1.00 1.00 X X 0 0 0 BRANDON HOUTCHENS VICE CHAIR 1.00 1.00 X X 0 0 0 ROBERT MURPHY TREASURER 1.00 1.00 X X 0 0 0 MARK LAWLEY SECRETARY 1.00 1.00 X X 0 0 0 VICKI WILSON PHD RN DIRECTOR 1.00 1.00 X 0 0 0 MIKE SIMONE DIRECTOR 1.00 1.00 X 0 0 0 TRAVIS GILLMORE DIRECTOR 1.00 1.00 X 0 0 0 ROSE STOLLER DIRECTOR 1.00 1.00 X 0 0 0 JASON YEATER DIRECTOR 1.00 1.00 X 0 0 0 JOHN DOLLARHIDE DIRECTOR 1.00 1.00 X 0 0 0 TIMOTHY BRYNTESON DIRECTOR 1.00 1.00 X 0 0 0 JEFFREY CARLSON CHIEF EXECUTIVE OFFICER 10.00 40.00 X 0 47959 3827 RAMON SERRANO CHIEF FINANCIAL OFFICER 10.00 40.00 X 0 34568 5074 MIKE BOND CHIEF OPERATING OFFICER 10.00 40.00 X 0 38105 8806 0 120632 17707 0 0 1 0 0 305240 33370 831773 1170383 PROGRAM RENTAL INCOME 621110 50640 50640 50640 437597 437597 2305645 2342369 -36724 -36724 -36724 167151 305240 253078 -85927 -85927 1535969 50640 0 314946 X 771108 771108 96565 96565 30250 30250 28757 28757 309880 5323 178310 126247 115000 5750 55200 54050 10836 541 5202 5093 74864 3743 35935 35186 27898 1395 13391 13112 DUES AND SUBSCRIPTIONS 2385 119 1145 1121 67915 3693 40798 23424 1535458 888237 358738 288483 2298888 2842231 85996 45494 37220 39860 2324781 1969928 417201 354853 25993237 20302108 4042506 5744789 414174 399898 33289222 29729233 149039 172634 102725 468012 339544 321544 7910572 6768421 8501880 7730611 X 7348918 6222980 17438424 15775642 24787342 21998622 33289222 29729233 X 511 -2783502 -5729 X 0 1 X 1 0 X 2101282 2700111 1343384 979719 1170383 8294879 2101282 2700111 1343384 979719 1170383 8294879 2985028 5309851 657079 655460 572180 749688 437597 3072004 8955 5649 14604 11381487 421374 0.46650 0.37460 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13531324 141874 -1622837 229229 199009 11622123 12509640 94774 1335178 20902 387366 13531324 11404347 278739 1305927 185666 293707 12509640 10629392 939598 426706 592715 11402981 10590667 441045 312132 10719580 0.09360 0.41090 0.49550 0 0 51785 51785 2098774 1810535 288239 174222 159393 14829 354853 POOLED INVESTMENT FUNDS 367467 F PRIVATE EQUITY INVESTMENTS 2746639 F HEDGE FUNDS 2630683 F 5744789 GIFT ANNUITIES PAYABLE 43879 FUNDS HELD FOR OTHERS - BRIGHT FUTURES 6724542 6768421 X -436655 -2783502 845364 -5729 -1943867 1507212 28757 28757 1535969 2352065 845364 845364 1506701 28757 28757 1535458 PART V, LINE 4: ENDOWMENT FUNDS CONSIST OF OVER 25 INDIVIDUAL FUNDS ESTABLISHED BY DONORS TO PROVIDE ANNUAL FUNDING FOR SPECIFIC ACTIVITIES AND GENERAL OPERATIONS. THE ENDOWMENT ALSO INCLUDES CERTAIN NET ASSETS WITHOUT DONOR RESTRICTIONS THAT HAVE BEEN DESIGNATED FOR ENDOWMENT BY THE BOARD OF DIRECTORS. PART X, LINE 2: THE FOUNDATION IS ORGANIZED AS A COLORADO NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). THE FOUNDATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION, AND HAS BEEN DETERMINED NOT TO BE A PRIVATE FOUNDATION. THE FOUNDATION IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE FOUNDATION IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO THE EXEMPT PURPOSE. THE FOUNDATION HAS DETERMINED THAT IT IS NOT SUBJECT TO UNRELATED BUSINESS INCOME TAX AND HAVE NOT FILED AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN SPLIT-INTEREST AGREEMENT -5,729. CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS N/A 2014011 0 0 0 0 0 0 2014011 0 2014011 1 0 1 0 0 0 PART I, LINE 3: THE ORGANIZATION IS REPORTING INVESTMENT BALANCES ON AN ACCRUAL BASIS ON SCHEDULE F. PART III ACCOUNTING METHOD: SCHEDULE F, PART IV: THE FOUNDATION REVIEWS ITS DIRECT AND INDIRECT INVESTMENTS DURING THE TAX PERIOD FOR DETERMINING REQUIRED FOREIGN FILINGS. THE FOUNDATION HAS OWNERSHIP INTERESTS IN FOREIGN CORPORATIONS. THE FOUNDATION WOULD FILE FORM 5471 IF THE OWNERSHIP MET THE REQUIREMENTS FOR FILING. THE FOUNDATION'S OWNERSHIP IN FOREIGN CORPORATIONS DID NOT REQUIRE FILING FORM 5471. THE FOUNDATION MAKES DIRECT AND INDIRECT TRANSFERS TO FOREIGN CORPORATIONS. THE FOUNDATION WOULD FILE FORM 926 IF THE TRANSFERS MET THE REQUIREMENTS FOR FILING. THE FOUNDATION'S DIRECT TRANSFERS TO FOREIGN CORPORATIONS RESULTED IN FILING ONE FORM 926. X X X 1 THOMPSON AND ASSOCIATES 112 WESTWOOD PLACE SUITE 250 BRENTWOOD TN 37027 PLANNED GIVING 0 0 30250 0 30250 CO GALA 287023 226873 60150 76859 15975 59687 TURKEY TROT 84680 18680 66000 1200 813 46980 3 100688 59687 41001 500 1811 22513 8766 17974 472391 305240 167151 1700 2624 99372 8766 15975 124641 253078 -85927 1 BANNER HOME MEDICAL EQUIPMENT PO BOX 29325 PHOENIX AZ 85038 841324428 501 (C) (3) 0 6640 PATIENT ASSISTANCE ENSIGHT SKILLS CENTER 1740 S COLLEGE AVENUE FORT COLLINS CO 80525 841598698 501 (C) (3) 0 95000 OPERATIONAL SUPPORT LIFEMED SAFETY INC 6124 E 162ND AVENUE BRIGHTON CO 80602 464017198 0 38573 PATIENT SUPPORT MONFORT FAMILY CLINIC 2930 11TH AVENUE EVANS CO 80620 840613289 501 (C) (3) 0 5720 PATIENT SUPPORT NORTH COLORADO MEDICAL CENTER 1801 16TH STREET GREELEY CO 80631 841287638 501 (C) (3) 0 455446 VARIOUS DEPT. SUPPORT ITEMS BANNER IMAGING SERVICES COLORADO LLC PO BOX 741734 LOS ANGELES CA 90074 844842297 0 26960 PATIENT SUPPORT BARTON CAREY MEDICAL PRODUCTS PO BOX 421 PERRYSBURG OH 43552 341493685 0 17591 PATIENT ASSISTANCE NICHE DESIGN HOUSE 1540 MAIN STREET SUITE 218-311 WINDSOR CO 80550 800941857 0 9620 OPERATIONAL SUPPORT TCC 609 GYRFALCON COURT UNIT D WINDSOR CO 80550 840964449 0 82993 OPERATIONAL SUPPORT 4 5 SCHOLARSHIPS 19 96565 PART I, LINE 2: THE NCMC FOUNDATION (WELD LEGACY FOUNDATION) WILL CONSIDER GRANT REQUESTS FROM NORTH COLORADO MEDICAL CENTER DEPARTMENTS TO FUND EQUIPMENT PURCHASES, CONTINUED EDUCATION OR PROJECTS AT NCMC. TO REQUEST GRANT FUNDING, APPLICANTS MUST COMPLETE THE NCMC FOUNDATION (WELD LEGACY FOUNDATION) GRANT APPLICATION. ON THE APPLICATION THERE IS SPACE PROVIDED FOR THE APPLICANT TO INCLUDE A BRIEF DESCRIPTION OF HOW THE FUNDING REQUESTED WILL ENHANCE THE HEALTH OF THOSE SERVED BY THE NORTH COLORADO MEDICAL CENTER. THE APPLICATION AND SUPPORTING DOCUMENTATION SHOULD BE EMAILED TO THE NCMC FOUNDATION (WELD LEGACY FOUNDATION). IF APPROVED, THE APPLICANT WILL BE ASKED TO SUBMIT PROOF OF PURCHASE TO THE NCMC FOUNDATION (WELD LEGACY FOUNDATION). THE NCMC FOUNDATION (WELD LEGACY FOUNDATION) WILL CONSIDER REQUESTS FROM COMMUNITY ORGANIZATIONS FOR PROJECTS AND PROGRAMS THAT STRIVE TO IMPROVE AND ENHANCE HEALTH AND EDUCATION IN OUR COMMUNITY. THE COLORADO COMMON GRANT APPLICATION IS USED FOR THESE GRANTS. THE APPLICATION CAN BE FOUND ON THE NCMC FOUNDATION (WELD LEGACY FOUNDATION) WEBSITE AND SUPPORTING DOCUMENTATION CAN BE UPLOADED ON THE WEBSITE. REQUESTS ARE REVIEWED PERIODICALLY THROUGHOUT THE YEAR. 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL BE COMPRISED OF NOT LESS THAN THREE AND NOT MORE THAN SIX INDIVIDUALS, WHICH SHALL INCLUDE THE FOLLOWING OFFICERS: THE CHAIR AND PRESIDENT OF THE BOARD, THE VICE PRESIDENT(S), IF ANY, THE SECRETARY, THE TREASURER, AND THE IMMEDIATE PAST PRESIDENT. THE EXECUTIVE COMMITTEE SHALL PERFORM OR CAUSE TO BE PERFORMED THE FOLLOWING FUNCTIONS (EXCEPT AS SET FORTH BELOW): (I) REVIEW AND EVALUATE THE ON-GOING PERFORMANCE OF THE BOARD EXECUTIVE, MEMBERS OF THE BOARD (BOTH INDIVIDUALLY AND COLLECTIVELY), AND CHAIRS, AND PROCURE ANNUAL CONFLICT OF INTEREST STATEMENTS FROM RELATED PARTIES EACH YEAR; (II) DIRECT THE ON-GOING BUSINESS AND AFFAIRS OF THE CORPORATION IN THE INTERIM BETWEEN REGULARLY SCHEDULED BOARD MEETINGS, PROVIDING ADVICE AND COUNSEL TO THE CHAIR AND PRESIDENT AND TO THE BOARD EXECUTIVE OFFICER AND ACTING ON PENDING MATTERS ON BEHALF OF THE BOARD WHEN IT IS NOT IN SESSION; (III) MAINTAIN THE "GOOD STANDING" OF THE CORPORATION AS A LEGAL COLORADO ENTITY AND ITS TAX-EXEMPT, NON-PROFIT STATUS UNDER FEDERAL AND STATE TAX LAWS. NOTWITHSTANDING THE PRECEDING, THE EXECUTIVE COMMITTEE SHALL NOT HAVE THE AUTHORITY TO APPROVE ANY OF THE FOLLOWING ACTIONS: (A) APPOINT, REMOVE OR FILL VACANCIES IN THE BOARD; (B) ANY AMENDMENT TO THE ARTICLES OR BYLAWS OF THE ORGANIZATION; (C) ADOPT A PLAN OF MERGER OR CONSOLIDATION WITH ANOTHER ORGANIZATION; (D) AUTHORIZE THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE ORGANIZATION; (E) AUTHORIZE THE VOLUNTARY DISSOLUTION OF THE ORGANIZATION OR REVOKING PROCEEDINGS THEREFOR; (F) AMENDING, ALTERING OR REPEALING ANY RESOLUTION OF THE BOARD WHICH BY ITS TERMS PROVIDES THAT IT SHALL NOT BE AMENDED, ALTERED OR REPEALED BY SUCH COMMITTEE; OR (G) APPOINT, OTHER THAN ON A TEMPORARY OR INTERIM BASIS, THE CHAIR AND PRESIDENT OF THE BOARD OR CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2 THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND THE CHIEF OPERATING OFFICER ARE OFFICERS OF AND EMPLOYED BY THE WELD TRUST, A RELATED TAX-EXEMPT ORGANIZATION. MEMBERS OF THE BOARD ARE ALSO MEMBERS OF THE BOARD OF DIRECTORS OF THE WELD TRUST. THEREFORE, BUSINESS RELATIONSHIPS EXIST BETWEEN THESE INDIVIDUALS. FORM 990, PART VI, SECTION A, LINE 3 BEGINNING IN APRIL OF 2020 THE WELD TRUST, A RELATED TAX-EXEMPT ORGANIZATION, PERFORMED EXECUTIVE MANAGEMENT SERVICES INCLUDING CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND CHIEF OPERATING OFFICER SERVICES. SEE FORM 990, PART VII FOR COMPENSATION PAID BY THE RELATED ENTITY FOR THESE SERVICES. FORM 990, PART VI, SECTION A, LINE 8B THE FOUNDATION DOES NOT HAVE ANY COMMITTEE WITH BROAD AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO THE ENTIRE BOARD AND IS REVIEWED BY THE FINANCE COMMITTEE PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS ANNUALLY REVIEWED WITH THE BOARD. EACH BOARD MEMBER IS REQUIRED TO ANNUALLY SIGN A DECLARATION OF POTENTIAL CONFLICTS OF INTEREST. BOARD MEMBERS ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST AT EACH MEETING AND ANY SUCH CONFLICTS ARE DOCUMENTED IN THE MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION PAID TO THE CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER, AND OTHER EMPLOYEES IS PAID BY THE WELD TRUST, A RELATED TAX-EXEMPT ORGANIZATION. THE WELD TRUST USES A COMPENSATION SURVEY, COMPARABILITY SALARY DATA FOR SIMILAR POSITIONS AT SIMILARLY SITUATED ORGANIZATION, AND APPROVAL BY THE BOARD OF DIRECTORS TO DETERMINE COMPENSATION LEVELS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE IN THE NORTH COLORADO MEDICAL CENTER FOUNDATION OFFICES AT 815 8TH AVENUE, GREELEY, COLORADO. THEY ARE AVAILABLE FOR THE PUBLIC REVIEW AT THIS SITE ONLY. FORM 990, PART VII, SECTION A, LINE 1A: THE CHIEF EXECUTIVE OFFICER (CEO), CHIEF FINANCIAL OFFICER (CFO), AND THE CHIEF OPERATING OFFICER (COO) PERFORM SERVICES FOR BOTH THE WELD TRUST AND NORTH COLORADO MEDICAL CENTER FOUNDATION (D/B/A WELD LEGACY FOUNDATION), A RELATED TAX-EXEMPT ORGANIZATION. COMPENSATION AND BENEFITS PAID TO THE CEO, CFO, AND COO REPORTED ON FORM 990, PART VII, SECTION A, LINE 1A, REPRESENTS ONLY THE PORTION OF COMPENSATION AND BENEFITS PAID TO THESE INDIVIDUALS FOR SERVICES TO THE WELD TRUST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,889. MANAGEMENT AND GENERAL EXPENSES 18,130. FUNDRAISING EXPENSES 17,752. TOTAL EXPENSES 37,771. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 3,434. MANAGEMENT AND GENERAL EXPENSES 160,180. FUNDRAISING EXPENSES 108,495. TOTAL EXPENSES 272,109. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENT -5,729. THE WELD TRUST 1801 16TH STREET GREELEY CO 80631 742358522 ENHANCE THE HEALTH AND EDUCATION OF WELD COUNTY CO 501(C)(3) LINE 12B, II N/A 0 CHARITABLE LEAD TRUST 1801 16TH STREET GREELEY CO 80631 CHARITABLE LEAD TRUST CO N/A 1 SPLIT INTEREST TRUST 1801 16TH STREET GREELEY CO 80631 SPLIT INTEREST TRUST CO N/A 1 0 0 1 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 1