2024-11-13T14:37:24-06:00 2023-12-31 882730877 CHERRY BEKAERT ADVISORY LLC 101 SOUTH 5TH STREET STE 2100 LOUISVILLE KY 40202 990 2023-01-01 311096217 LICKING MEMORIAL HEALTH FOUNDATION LICK 2205644000 1320 WEST MAIN STREET NEWARK OH 430553699 CYNTHIA L WEBSTER VP FINANCIAL SERVICES 2205644000 2024-11-12 1 1 MELANIE MCPEAK P01346034 8885871719 2023 2024-10-15 13:58:12Z ROBERT MONTAGNESE 1320 WEST MAIN STREET NEWARK OH 430553699 22415126 0 X N/A X 1984 OH PROVIDE FUNDING FOR HEALTHCARE PROGRAMS & MAJOR COMMUNITY SERVICE PROGRAMS OF THE HEALTH SYSTEM. 12 12 0 13 0 0 1448401 1980203 0 0 -136146 3464358 3731812 2917264 5044067 8361825 643989 789797 0 0 0 0 0 0 464222 4358466 4480437 5002455 5270234 41612 3091591 142765267 158715902 8576618 10059305 134188649 148656597 LICKING MEMORIAL HEALTH FOUNDATION EXISTS TO IMPROVE THE HEALTH OF THE COMMUNITY. 0 0 4573457 789797 WORKING IN CONJUNCTION WITH LICKING MEMORIAL HEALTH SYSTEMS, THE FOUNDATION STRIVES TO SUPPORT THE AVAILABILITY OF SOPHISTICATED STATE-OF-THE-ART HEALTHCARE TO THE CENTRAL-OHIO COMMUNITY OF LICKING COUNTY. 4573457 1 1 0 0 0 0 1 0 0 1 1 0 0 1 1 1 0 1 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 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X DREW LINK 2205644533 1320 WEST MAIN STREET NEWARK OH 43055 ROBERT MONTAGNESE PRESIDENT/EX OFFICIO W/O V 1.00 39.00 X 0 876674 49933 CINDY WEBSTER VP FINANCIAL SERVICES 1.00 39.00 X 0 330431 19926 VERONICA PATTON VP PR & DEVELOPMENT 26.00 14.00 X 0 264357 12471 NANCY NEELY CHAIR 1.30 2.60 X X 0 0 0 MICHAEL MASSARO VICE CHAIR 1.30 2.60 X X 0 0 0 CRAIG R BALDWIN SECRETARY/TREASURER 1.30 2.60 X X 0 0 0 PATRICK M JEFFRIES DIRECTOR 1.30 2.60 X 0 0 0 PATRICK D GUANCIALE DIRECTOR 1.30 2.60 X 0 0 0 JOYCE MALAINY DIRECTOR 1.30 2.60 X 0 0 0 LINDA K DALGARN DIRECTOR 1.30 2.60 X 0 0 0 BRIAN MORTELLARO DIRECTOR 1.30 2.60 X 0 0 0 DAVID E DONEY DIRECTOR 1.30 2.60 X 0 0 0 GORDON WILKEN DIRECTOR 1.30 0.00 X 0 0 0 DANIEL HUNT DIRECTOR 1.30 2.60 X 0 0 0 CHRISTOPHER MAYER DIRECTOR 1.30 2.60 X 0 0 0 ESCHOL CURL JR DIRECTOR (PARTIAL YEAR) 1.30 2.60 X 0 0 0 0 1471462 82330 0 0 1 0 0 230750 902613 846840 1980203 1589182 1589182 2915734 0 2915734 2915734 2915734 15916388 14041212 1875176 1875176 1875176 13619 230750 12089 1530 1530 8361825 0 0 6381622 789797 789797 224237 224237 259913 168083 8274 83556 557795 557795 247 247 8386 8386 2243498 2243498 81942 81942 SHARED SALARY EXPENSE 839037 605504 233533 SHARED PURCHASED SERVIC 210592 105296 105296 FOOD 41791 41791 BAD DEBT EXPENSE 12865 12865 134 44 44 46 5270234 4573457 232555 464222 3121298 3108432 96154777 30161183 63710981 65993594 68117821 80719151 7815167 8894725 142765267 158715902 46945 35619 8529673 10023686 8576618 10059305 X 130565440 144944340 3623209 3712257 134188649 148656597 142765267 158715902 X 3091591 8521940 2854417 X X 0 1 X 1 0 X X 1 LICKING MEMORIAL HOSPITAL 314379519 3 1 4573457 0 1 4573457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PART IV, SECTION A, LINE 1 THE STATED PURPOSE CONTAINED WITHIN THE ARTICLES OF INCORPORATION IS TO CONDUCT FUNDRAISING ACTIVITIES TO BE OPERATED FOR THE BENEFIT AND SUPPORT OF THE LICKING MEMORIAL HEALTH SYSTEM, ITS SUCCESSOR AND ANY ENTITY CONTROLLED OR RELATED TO IT. THIS INDICATES THAT THE FOUNDATION WILL ALSO PROVIDE SUPPORT TO LICKING MEDICAL HOSPITAL, LICKING MEMORIAL HEALTH PROFESSIONALS AND LICKING MEMORIAL TWIGS. PART IV, SECTION B, LINE 1 NEITHER THE ARTICLES OR BYLAWS SPECIFICALLY STATE THAT ONE OR MORE OF THE SUPPORTED ORGANIZATIONS MAY ELECT OR APPOINT DIRECTORS OF THE ORGANIZATION. THE BYLAWS DO HOWEVER REQUIRE THAT AN INDIVIDUAL MUST BE A MEMBER OF LICKING MEMORIAL HEALTH SYSTEMS TO BE A DIRECTOR OF THE CORPORATION. NO INDIVIDUAL BUSINESS, SERVICE, OR PROFESSION SHALL HAVE MORE THAN TWO REPRESENTATIVES ON THE BOARD OF THE FOUNDATION AT ANY ONE TIME. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 1 0.50 0 0 0 1 0 0.00 0 1 431607 15163 446770 427764 3843 431607 427683 81 427764 439711 1280 13308 427683 433828 5883 439711 1.00000 0 0 26594664 26594664 65642655 26966587 38676068 2027025 1751388 275637 1890433 1443208 447225 65993594 RECEIVABLE FROM LICKING MEMORIAL HEALTH PROFESSIONALS 8854379 L/T RENT RECEIVABLE 40346 8894725 DUE TO LICKING MEMORIAL HOSPITAL 10023686 10023686 X PART V, LINE 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO USE THE EARNINGS FOR CAPITAL EQUIPMENT PURCHASES FOR LICKING MEMORIAL HOSPITAL. PART X, LINE 2: THE INTERNAL REVENUE SERVICE HAS RULED THAT THE SYSTEM, HOSPITAL, FOUNDATION, AND LICKING MEMORIAL HEALTH PROFESSIONALS ARE TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GAAP REQUIRES THE SYSTEM TO EVALUATE ITS TAX POSITIONS AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF IT HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS). THE SYSTEM HAS EVALUATED ITS TAX POSITIONS AND HAS CONCLUDED THAT THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. SCHEDULE D, PART II, LINE 9: CLIENT ACQUIRED THIS EASEMENT AS PART OF A LAND PURCHASE; THEREFORE, NO REVENUE OR EXPENSES ASSOCIATED WITH IT ARE INCLUDED IN THEIR FINANCIAL STATEMENTS. GOLF GALA 244369 230750 13619 4997 4025 3067 244369 230750 13619 4997 4025 3067 12089 1530 1 AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 17500 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. BIG BROTHERSBIG SISTERS 62 WEST LOCUST ST NEWARK OH 43055 310860010 501(C)(3) 10500 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. BOYS AND GIRLS CLUB OF NEWARK 1108 CITY PARK AVENUE SUITE 301 COLUMBUS OH 43206 314387575 501(C)(3) 10000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. BUCKEYE VALLEY YMCA 470 WEST CHURCH ST NEWARK OH 43055 316053101 501(C)(3) 10000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. CENTER FOR DISABILITY SERVICES 667 HOPEWELL DRIVE HEATH OH 43056 316402437 501(C)(3) 10000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. FOOD PANTRY OF NEWARK 135 BRICE STREET NEWARK OH 43055 311028761 501(C)(3) 5723 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. GRANVILLE ATHLETIC BOOSTERS PO BOX 655 GRANVILLE OH 43023 311131723 501(C)(3) 10000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. HABITAT FOR HUMANITY 3140 WESTERVILLE RD COLUMBUS OH 43224 311217994 501(C)(3) 35000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. LICKING COUNTY COALITION OF CARE 105 JEFFERSON STREET PO BOX 8663 NEWARK OH 43058 510522123 501(C)(3) 7500 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. LICKING COUNTY TRANSIT 745 EAST MAIN STREET NEWARK OH 43055 GOVERNMENT 50000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. KNOX COUNTY CHAMBER OF COMMERCE 1435 WEST MAIN STREET NEWARK OH 43055 314259860 GOVERNMENT 41797 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. NEWARK CAMPUS DEVELOPMENT FUND 25 WALNUT STREET NEWARK OH 43055 311062282 501(C)(3) 100000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. NEWARK CATHOLIC SCHOOLS 1 GREEN WAVE DRIVE NEWARK OH 43055 314426601 501(C)(3) 30000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. NEWARK DEVELOPMENT PARTNERS PO BOX 4532 NEWARK OH 43058 461551173 501(C)(3) 75000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. NEWARK MIDLAND THEATRE 36 NORTH PARK PLACE NEWARK OH 43055 311734034 501(C)(3) 20000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. OHIO COUNTY & INDEPENDENT AGRICULTURAL SOCIETIES 14028 FAIRGROUNDS ROAD CROTON OH 43013 316060327 501(C)(3) 7000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. SOCIETY OF SAINT VINCENT DE PAUL HOUSING FACILITY INC 115 WILSON STREET NEWARK OH 43055 800191758 501(C)(3) 10000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. THOMAS J EVANS FOUNDATION 25 EAST WALNUT STREET NEWARK OH 43058 316055767 501(C)(3) 13000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. UNITED WAY OF LICKING COUNTY 50 SOUTH 2ND STREET NEWARK OH 43055 314379455 501(C)(3) 50000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. THE WORKS OHIO CENTER OF HISTORY ART & TECHNOLOGY 55 SOUTH FIRST STREET NEWARK OH 43055 311395941 501(C)(3) 10000 0 SPONSORSHIP OF AN EVENT THAT FURTHERS THEIR EXEMPT PURPOSE. 20 0 PART I, LINE 2: THE ORGANIZATION GIVES GRANTS TO OTHER 501(C)(3) ORGANIZATIONS BASED ON REQUESTS AND ACTIVITIES IN THE COMMUNITY. THE ORGANIZATION MONITORS THE USE OF GRANTS BY MONITORING RECIPIENTS ACTIVITIES IN THE COMMUNITY. 0 1 0 0 0 0 0 0 0 ROBERT MONTAGNESE PRESIDENT/EX OFFICIO W/O V 0 785504 0 80000 0 11170 0 7779 0 42154 0 926607 0 0 CINDY WEBSTER VP FINANCIAL SERVICES 0 328786 0 0 0 1645 0 2932 0 16994 0 350357 0 0 VERONICA PATTON VP PR & DEVELOPMENT 0 260598 0 0 0 3759 0 2346 0 10125 0 276828 0 0 PART I, LINE 3 THE RELATED ORGANIZATION USES THE FOLLOWING TO ESTABLISH COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE INDEPENDENT COMPENSATION CONSULTANT FORM 990 OF OTHER ORGANIZATIONS WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY APPROVAL OF THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B ROBERT A. MONTAGNESE, PRESIDENT & CEO, PARTICIPATES IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). NO CONTRIBUTIONS WERE MADE TO THE PLAN ON HIS BEHALF FOR THE 2022 YEAR. 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 VICE PRESIDENT OF FINANCIAL SERVICES OF LICKING MEMORIAL HEALTH SYSTEMS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ALL BOARD MEMBERS AND KEY EMPLOYEES TO SIGN A CONFLICT OF INTEREST STATEMENT ONCE A YEAR. THE ORGANIZATION DOES NOT PERMIT BOARD MEMBERS TO HAVE A CONFLICT OF INTEREST. IF A BOARD MEMBER HAS A CONFLICT OF INTEREST THEY ARE ASKED TO RESIGN FROM THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS AN INDEPENDENT COMPENSATION COMMITTEE THAT DETERMINES THE COMPENSATION FOR THE CEO THAT IS THEN APPROVED BY THE BOARD. THE CEO DETERMINES THE COMPENSATION FOR THE OTHER OFFICERS BASED UPON INDEPENDENT SALARY SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER FROM RELATED 501(C)(3) 2,854,417. FORM 990, PAGE 12, PART XII, LINE 2C: THERE WAS NO CHANGE IN THE OVERSIGHT PROCESS OR SELECTION PROCESS OF THE INDEPENDENT AUDITOR FROM PRIOR YEAR. LICKING MEMORIAL HEALTH FOUNDATION CONTINUES TO BE AUDITED AS A PART OF THE LICKING MEMORIAL HEALTH SYSTEMS CONSOLIDATED GROUP. LICKING MEMORIAL HEALTH FOUNDATION IS INCLUDED IN THE LICKING MEMORIAL HEALTH SYSTEMS CONSOLIDATED FINANCIAL STATEMENTS. LICKING MEMORIAL HEALTH SYSTEMS HAS A FINANCE COMMITTEE THAT OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT AUDITOR. 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 N/A 0 LICKING MEMORIAL HEALTH PROFESSIONALS 1320 WEST MAIN STREET NEWARK OH 43055 311425530 HEALTHCARE ORGANIZATION OH 501(C)(3) LINE 10 LICKING MEMORIAL HEALTH SYSTEM 0 LICKING MEMORIAL HOSPITAL 1320 WEST MAIN STREET NEWARK OH 43055 314379519 HEALTHCARE ORGANIZATION OH 501(C)(3) LINE 3 LICKING MEMORIAL HEALTH SYSTEM 0 LICKING MEMORIAL TWIGS 1320 WEST MAIN STREET NEWARK OH 43055 463190381 TO SUPPORT THE OPERATIONS OF LICKING MEMORIAL HEALTH SYSTEMS OH 501(C)(3) LINE 12A, I LICKING MEMORIAL HEALTH SYSTEM 0 0 1 1 1 0 0 0 0 0 1 0 1 0 1 1 1 0 1 1