2023-11-15T15:01:38-06:00 2022-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2022-01-01 392029106 OSCEOLA COMMUNITY HEALTH FOUNDATION INC OSCE 7152942111 2600 65TH AVENUE OSCEOLA WI 54020 KELLY MACKEN-MARBLE CEO 7152942111 2023-11-15 1 KELLY MACKEN-MARBLE 999009999 0 MICHAEL J PETERSON CPA P01833529 2187224705 2023-11-09 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z KELLY MACKEN-MARBLE 2600 65TH AVENUE OSCEOLA WI 54020 665122 0 X MYOCHF.COM X 2001 WI THE FOUNDATION WORKS TO IDENTIFY NEEDS AND PROVIDE HEALTH RELATED SERVICES TO RESIDENTS OF OUR COMMUNITY. USING PHILANTHROPIC ASSISTANCE, WE STRIVE TO SUPPORT THE MEDICAL CENTER AND IMPLEMENT HEALTH RELATED PROGRAMS THAT BENEFIT ALL AGE GROUPS. 10 10 0 45 0 0 88553 552702 0 0 2165 7347 28904 34325 119622 594374 145584 459755 0 0 0 0 0 0 0 16461 6636 162045 466391 -42423 127983 609886 709451 76139 111291 533747 598160 THE GOAL OF THE OSCEOLA COMMUNITY HEALTH FOUNDATION IS TO BUILD HEALTHY COMMUNITIES BY FOSTERING CHARITABLE SUPPORT FOR THE OSCEOLA MEDICAL CENTER AND THE HEALTH-RELATED NEEDS OF THE PEOPLE IN THE UPPER ST. CROIX VALLEY. 0 0 459755 459755 0 TO ACCUMULATE, MANAGE, AND EXPEND FUNDS FOR THE BENEFIT AND ADVANCEMENT OF THE OSCEOLA MEDICAL CENTER AND OTHER COMMUNITY HEALTH ACTIVITIES.FIVE EVENTS WERE HELD TO RAISE DOLLARS TO SUPPORT OMC WITH VARIOUS PROJECTS AND PROGRAMS. OTHER DOLLARS WERE GRANTED BACK TO NONPROFIT ORGANIZATION'S IN THE COMMUNITY WITH A HEALTH RELATED MISSION. 459755 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 WI MN X KELLY MACKEN-MARBLE 7152942111 2600 65TH AVENUE OSCEOLA WI 54020 X KIMBERLY ERICSON CFO 1.00 40.00 X 0 209077 17329 MISTY CHARLIER CAO 1.00 40.00 X 0 172850 40080 MATTHEW FORGE CEO (THRU JULY 2022) 1.00 40.00 X 0 162303 10719 JILL LEAHY FOUNDATION DIRECTOR 40.00 X 0 96471 3633 KELLY MACKEN-MARBLE CEO (FROM SEP 2022) 1.00 40.00 X 0 73963 2822 TIM PAULEY CHAIR 0.50 X X 0 0 0 TOM TINKHAM VICE CHAIR/TREASURER 0.50 X X 0 0 0 MARY HAZZARD SECRETARY 0.50 X X 0 0 0 JARED CUTTS DIRECTOR 0.50 X 0 0 0 CHRISTINA DELONG DIRECTOR 0.50 X 0 0 0 LALA GRAF DIRECTOR 0.50 X 0 0 0 KIERSTEN JUSTINGER DIRECTOR 0.50 1.00 X 0 0 0 MARK LUEBKER DIRECTOR 0.50 X 0 0 0 JEN MAGNELSON DIRECTOR 0.50 X 0 0 0 BONNIE MCKINNEY DIRECTOR (TERMED) 0.50 X 0 0 0 RENE PELLETIER DIRECTOR 0.50 X 0 0 0 0 714664 74583 0 0 1 0 0 26350 526352 40051 552702 7347 7347 105073 26350 70748 34325 34325 594374 0 0 41672 458755 458755 1000 1000 6636 6636 466391 459755 6636 0 609886 599690 109761 609886 709451 41139 111291 35000 0 76139 111291 X 533747 598160 533747 598160 609886 709451 127983 -65670 2100 0 X 0 1 X 0 0 X X 1 LADD MEMORIAL HOSPITAL INC DBA OSCEOLA MEDICAL CENTER 390773970 3 1 371025 0 1 371025 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 SECTION A, LINE 6 THE SUPPORT INCLUDED $4,200 TO OTHER ORGANIZATIONS TO SUPPORT THE HEALTH OF THE LOCAL COMMUNITY SUCH AS LOCAL NOT-FOR-PROFIT ORGANIZATIONS THAT FOCUS ON MENTAL HEALTH, LONG-TERM CARE, EMERGENCY MEDICAL CARE, AND OTHER ACTIVITIES INCLUDED IN THE MISSION OF LADD MEMORIAL HOSPITAL, INC. THE FOLLOWING DONATIONS WERE AWARDED: WILD RIVER FITNESS - $4,200 ALL OF THESE DONATIONS ARE PART OF THE SAME CHARITABLE CLASS OR PURPOSE OF LADD MEMORIAL HOSPITAL, INC. IF IT WERE NOT FOR THE FOUNDATION PROVIDING THESE DONATIONS, LADD MEMORIAL HOSPITAL, INC. WOULD PROVIDE THESE DIRECTLY. SECTION B, LINE 2 OSCEOLA COMMUNITY HEALTH FOUNDATION, INC GRANTED FUNDS TO OTHER LOCAL NOT-FOR-PROFIT ORGANIZATIONS THAT FURTHER THE MISSION OF LADD MEMORIAL HOSPITAL, INC. THE SERVICES THAT THESE ORGANIZATIONS PROVIDE INCLUDE MENTAL HEALTH SERVICES, PROGRAMS THAT ADDRESS THE HEALTH ISSUES OF CHILDREN, AND OTHER HEALTH RELATED SERVICES. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED GALA 53503 16875 36628 9980 2008 9469 150 2067 GOLF TOURNEY 29905 9475 20430 931 3860 4176 2881 1851 3 48015 48015 33375 131423 26350 105073 931 13840 6184 12350 150 37293 70748 34325 1 OSCEOLA MEDICAL CENTER 2600 65TH AVENUE OSCEOLA WI 54020 390773970 501(C)3 371025 0 TO SUPPORT THE ACTIVITIES OF THE HOSPITAL 1 0 PART I, LINE 2: GRANTS ARE AWARDED TO LOCAL ORGANIZATIONS OR INDIVIDUALS BASED ON APPLICATIONS RECEIVED AND ARE EVALUATED AS TO MERIT AND FITTING THE FOUNDATION'S GOALS BEFORE BEING AWARDED. THE FOUNDATION DOES NOT MONITOR THE USE OF ALL GRANT FUNDS. HOWEVER, THE FOUNDATION DOES REQUEST EITHER DOCUMENTATION REGARDING THE USE OF CERTAIN FUNDS OR PERSONAL PRESENTATIONS TO THE BOARD OF DIRECTORS REGARDING THE USE OF GRANT FUNDS. 0 0 0 0 0 0 0 0 0 KIMBERLY ERICSON CFO 0 208377 0 700 0 0 0 6494 0 10835 0 226406 0 0 MISTY CHARLIER CAO 0 172150 0 700 0 0 0 5436 0 34644 0 212930 0 0 MATTHEW FORGE CEO (THRU JULY 2022) 0 162303 0 0 0 0 0 4673 0 6046 0 173022 0 0 SCHEDULE J, PART II THE SALARY REPORTED FOR MATTHEW FORGE, KELLY MACHEN-MARBLE, AND MISTY CHARLIER ARE FOR SERVICES RENDERED TO LADD MEMORIAL HOSPITAL, INC. D/B/A OSCEOLA MEDICAL CENTER IN THEIR POSITION, NOT FOR SERVICES PERFORMED FOR OSCEOLA COMMUNITY HEALTH FOUNDATION. LADD MEMORIAL HOSPITAL, INC. USES THE FOLLOWING TO ESTABLISH COMPENSATION OF THE CEO AND CAO. -COMPENSATION COMMITTEE -FORM 990 OF OTHER ORGANIZATIONS -WRITTEN EMPLOYMENT CONTRACT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE X ICE CASTLE FISH HOUSE (AUCTION) 1 25000 RETAIL FMV X PRIZES AND IN-KIND DONATIONS FOR FUNDRAISING EVENT 134 15051 RETAIL COMPARABLE 0 0 0 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS IN PART I, COLUMN (B). FORM 990, PART VI, SECTION B, LINE 11B THE CFO OF LADD MEMORIAL HOSPITAL, INC. REVIEWS FORM 990 AND A COPY IS PROVIDED TO ALL BOARD MEMBERS FOR THEIR REVIEW BEFORE FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE BOARD MEMBERS ARE PROVIDED WITH A COPY OF THE CONFLICT OF INTEREST POLICY. THE BOARD MEMBERS ALSO SIGN AND DATE A STATEMENT THAT THEY UNDERSTAND AND ARE COMPLYING WITH THE CONFLICT OF INTEREST POLICY. IF A BOARD MEMBER BELIEVES THEY HAVE A CONFLICT ON ANY MATTER UP FOR A VOTE, THEY EXCUSE THEMSELVES FROM VOTING ON THAT MATTER. FORM 990, PART VI, SECTION C, LINE 19 OSCEOLA COMMUNITY HEALTH FOUNDATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15: THE FOUNDATION DOES NOT COMPENSATE ANY INDIVIDUAL FOR SERVICES PROVIDED TO THE FOUNDATION. EMPLOYEES OF LADD MEMORIAL HOSPITAL, INC. PROVIDE SERVICES TO THE FOUNDATION AT NO CHARGE. FORM 990, PART VI, SECTION B, LINE 13 THE FOUNDATION ANSWERED "YES" TO THE QUESTION REGARDING A WRITTEN WHISTLEBLOWER POLICY BECAUSE THIS ORGANIZATION FOLLOWS THE WHISTLEBLOWER POLICY OF LADD MEMORIAL HOSPITAL, INC. BUT DOES NOT HAVE A SPECIFIC POLICY IN PLACE. FORM 990, PART VI, SECTION B, LINE 14 THE FOUNDATION ANSWERED "YES" TO THE QUESTION REGARDING A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY BECAUSE THIS ORGANIZATION FOLLOWS THE DOCUMENT RETANTION AND DESTRUCTION POLICY OF LADD MEMORIAL HOSPITAL, INC. BUT DOES NOT HAVE A SPECIFIC POLICY IN PLACE. FORM 990, PART VII: THE DEVELOPMENT DIRECTOR, CHIEF EXECUTIVE OFFICER, AND CHIEF FINANCIAL OFFICER ARE EMPLOYEES OF LADD MEMORIAL HOSPITAL, INC., AN ORGANIZATION SUPPORTED BY THE FOUNDATION. THEY CONTRIBUTE A PORTION OF THEIR TIME TO FOUNDATION ACTIVITIES AS NEEDED. LADD MEMORIAL HOSPITAL INC DBA OSCEOLA MEDICAL CENTER 2600 65TH AVENUE OSCEOLA WI 54020 390773970 HOSPITAL WI 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0