2024-08-14T16:11:28-05:00 2023-09-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-01-01 421032878 PALMER MEMORIAL FOUNDATION PALM 5634223811 112 JEFFERSON ST WEST UNION IA 52175 BRENDA MOSER CFO 5634223811 2024-08-14 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2024-08-03 2023 2024-08-08 14:25:15Z BRENDA MOSER 112 JEFFERSON ST WEST UNION IA 52175 414827 0 X HTTPS://WWW.GUNDERSENHEALTH.ORG/PALMER/FOUNDATION X 1975 IA TO SUPPORT GUNDERSEN PALMER LUTHERAN HOSPITAL AND CLINICS. 14 14 0 24 0 0 99410 398174 0 0 -7626 5216 10980 8301 102764 411691 36265 5595 0 0 0 0 0 0 0 29315 12806 65580 18401 37184 393290 714329 1112821 20 5222 714309 1107599 TO SUPPORT GUNDERSEN PALMER LUTHERAN HOSPITAL AND CLINICS. 0 0 13047 5595 0 PALMER MEMORIAL FOUNDATION WAS ESTABLISHED IN 1975 AS A NON-PROFIT ORGANIZATION WHOSE SOLE OBJECTIVE AND PURPOSE IS TO FUND THE HEALTHCARE NEEDS OF NORTHEAST IOWA. OVER THE YEARS, GIFTS LARGE AND SMALL HAVE ASSISTED THE FOUNDATION IN PROVIDING NEW TECHNOLOGY, EDUCATION, SERVICES AND PROGRAMS TO THE COMMUNITY AND PALMER LUTHERAN HEALTH CENTER. DURING 2023, PALMER MEMORIAL FOUNDATION GRANTED FUNDS FOR THE FOLLOWING ITEMS: A MATTRESS, MONITORS, BOOKS AND WALKERS FOR HOSPICE PATIENTS, A FLAG AND FLAG POLE TO SUPPORT THE HOSPICE WE HONOR VETERANS PROGRAM BEREAVEMENT GIFTS FOR HOSPICE FAMILIES, HEARING DEVICES FOR SENIOR LIFE SOLUTIONS PATIENTS, UPGRADES TO INFUSION PATIENT ROOMS, MEALS FOR OB PATIENT FAMILIES, AND SUPPLIES FOR A TEDDY BEAR CLINIC. 13047 1 1 0 0 0 0 0 0 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 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 1 0 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 0 0 0 X BRENDA MOSER 5634223811 112 JEFFERSON ST WEST UNION IA 52175 X TANYA ROHWER PRESIDENT 0.50 X X 0 0 0 MATT COWLEY TREASURER 0.50 X X 0 0 0 TINA JACOBS SECRETARY 0.50 X X 0 0 0 PATRICE KUENNEN ADMINISTRATOR 0.50 X 0 0 0 ABBY AMBROSON DIRECTOR 0.50 X 0 0 0 CLINT AMBROSON DIRECTOR 0.50 X 0 0 0 CHRISTAL GAMM DIRECTOR 0.50 X 0 0 0 DEREK HEINS DIRECTOR 0.50 X 0 0 0 CAROL KATSUMES DIRECTOR 0.50 X 0 0 0 KEITH KOVARIK DIRECTOR 0.50 X 0 0 0 CYNDII LAMPHIER DIRECTOR 0.50 X 0 0 0 LYNN LAUER DIRECTOR 0.50 X 0 0 0 BETSY NEFZGER DIRECTOR 0.50 X 0 0 0 VIC PAVLOVEC DIRECTOR 0.50 X 0 0 0 CATHY HARRIS FOUNDATION SPECIALIST (THRU 8/23) 0.50 X 0 0 0 JAMIE HOEY FOUNDATION DIRECTOR 0.50 X 0 0 0 BRENDA MOSER FINANCE ADMINISTRATOR 0.50 X 0 0 0 0 0 0 0 0 0 0 0 398174 398174 1137 1137 4079 0 4079 4079 4079 10495 3136 7359 7359 942 942 942 411691 0 0 13517 5595 5595 5354 5354 COMMUNITY OUTREACH 5073 5073 EMPLOYEE RECOGNITION 1736 1736 FUND REQUEST 643 643 18401 13047 5354 0 473889 518302 240440 594519 714329 1112821 20 5222 20 5222 X 714309 1107599 714309 1107599 714329 1112821 393290 0 X X 0 0 0 X 115227 105974 228142 99410 49830 598583 115227 105974 228142 99410 49830 598583 214605 383978 2673 1717 1393 1934 1137 8854 942 942 608379 0.63110 0.63790 X PART II, SHORT YEAR EXPLANATION: THE ORGANIZATION WAS INCLUDED IN A SHORT YEAR CONSOLIDATED AUDIT FOR THE 10-MONTH PERIOD DECEMBER 1, 2022 THROUGH SEPTEMBER 30, 2023. THE ANSWERS FOR PART IV, LINE 12B AND PART XII, LINES 2A-2C HAVE BEEN ANSWERED YES EVEN THOUGH THE FORM 990 COVERS THE 9-MONTH PERIOD JANUARY 1, 2023 THROUGH SEPTEMBER 30, 2023. THE REASON FOR THIS CHANGE IS DUE TO A MERGER WITH THE BELLIN GUNDERSEN HEALTH SYSTEM RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 PALMER LUTHERAN HEALTH CENTER INC 112 JEFFERSON ST WEST UNION IA 52175 421320763 501(C)(3) 5595 0 PURCHASE OF MEDICAL EQUIPMENT 1 0 PART I, LINE 2: DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN ORDER FOR PALMER LUTHERAN HEALTH CENTER TO RECEIVE GRANT FUNDING FROM THE ORGANIZATION, IT IS REQUIRED TO PROVIDE PROOF OF PURCHASE PRIOR TO PURCHASING THE ITEM THE GRANT FUNDING IS FOR. FORM 990, PART VI, SECTION A, LINE 2 JAMIE HOEY & TINA JACOBS ARE SISTERS. DEREK HEINS IS COMMERCIAL/AG OFFICER AT BANK 1ST, WHERE THE FOUNDATION DOES THEIR BANKING. FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP IN THIS CORPORATION INCLUDES THOSE CITIZENS, EIGHTEEN (18) YEARS OF AGE OR OLDER, WHO HAVE PURCHASED AN ANNUAL TWENTY-FIVE DOLLAR ($25.00) VOTING MEMBERSHIP OR WHO HAVE CONTRIBUTED AN ANNUAL MINIMUM OF TWENTY-FIVE DOLLARS ($25.00) AS A DONATION TO THIS CORPORATION. MEMBERSHIP MAY ALSO INCLUDE AN ORGANIZATION, GROUP OR FAMILY CONTRIBUTING A MINIMUM OF TWENTY-FIVE ($25.00) AS A DONATION OR MEMORIAL TO THIS CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A EACH MEMBERSHIP SHALL AUTHORIZE THE HOLDER TO CAST ONE (1) VOTE PER VOTING MEMBERSHIP AT ANY DULY CALLED MEETING OF THE MEMBERSHIP OF THE CORPORATION. IN THE EVENT THAT THE MEMBERSHIP IS A GROUP, ORGANIZATION OR FAMILY, THE VOTE SHALL BE CAST BY ITS PRESIDENT OR DESIGNEE. THIS MEMBERSHIP WILL ALSO QUALIFY THE VOTING MEMBER TO HOLD ANY OFFICE IN THE CORPORATION TO WHICH HE OR SHE MAY BE ELECTED OR APPOINTED. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE DIRECTOR AND THE FOUNDATION DIRECTOR REVIEW THE 990 BEFORE IT IS FILED. THE ENTIRE BOARD OF DIRECTORS RECEIVES A COPY OF THE 990 AFTER IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REQUIRED TO BE SIGNED ANNUALLY BY OFFICERS, DIRECTORS, AND KEY EMPLOYEES. THE SIGNED POLICIES ARE REVIEWED BY PALMER LUTHERAN HEALTH CENTER'S COMPLIANCE COMMITTEE. BOARD MEMBERS ARE NOT ALLOWED TO VOTE ON AREAS WHERE THERE IS CONFLICT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IV, LINE 12B AND PART XIII, LINE 2: THE ORGANIZATION WAS INCLUDED IN A SHORT YEAR CONSOLIDATED AUDIT FOR THE 10-MONTH PERIOD DECEMBER 1, 2022 THROUGH SEPTEMBER 30, 2023. THE ANSWERS FOR PART IV, LINE 12B AND PART XII, LINES 2A-2C HAVE BEEN ANSWERED YES EVEN THOUGH THE FORM 990 COVERS THE 9-MONTH PERIOD JANUARY 1, 2023 THROUGH SEPTEMBER 30, 2023. THE REASON FOR THIS CHANGE IS DUE TO A MERGER WITH THE BELLIN GUNDERSEN HEALTH SYSTEM