2024-05-07T11:08:35-05:00 2023-06-30 135565207 KPMG LLP 191 WEST NATIONWIDE BLVD SUITE 500 COLUMBUS OH 432152568 990 2022-07-01 391635057 COMMUNITY MEMORIAL FOUNDATION OF MENOMONEE FALLS INC COMM 2622511000 W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 ALICIA M MAITLAND SVP - FINANCE 2622511000 2024-05-07 1 ALICIA MAITLAND XXX-XX-XXXX 0 MOLLIE P LONGHOUSE P00294881 6142492300 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z FROEDTERT MENOMONEE FALLS HOSPITAL F JESSICA MULLIGAN W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 4650846 0 X SEE SCHEDULE O X 1989 WI COMMUNITY MEMORIAL FOUNDATION IS COMMITTED TO SOLICITING CONTRIBUTIONS AND PERFORMING FUNDRAISING ACTIVITIES TO PROVIDE FINANCIAL SUPPORT TO COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC,; AND GRANTING SCHOLARSHIPS TO STUDENTS PURSUING AN EDUCATION IN THE MEDICAL FIELD. 20 19 0 87 0 0 930336 810609 0 0 436248 364304 21343 25686 1387927 1200599 526326 467680 0 0 402384 421537 0 0 299186 19149 34105 947859 923322 440068 277277 10022252 10998340 625980 675071 9396272 10323269 X COMMUNITY MEMORIAL FOUNDATION IS COMMITTED TO SOLICITING CONTRIBUTIONS AND PERFORMING FUNDRAISING ACTIVITIES TO PROVIDE FINANCIAL SUPPORT TO COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC,; AND GRANTING SCHOLARSHIPS TO STUDENTS PURSUING AN EDUCATION IN THE MEDICAL FIELD. 0 0 373280 373280 0 FUNDRAISING IN SUPPORT OF COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC.(CMH) AND ITS PROGRAMS. 94400 94400 0 SCHOLARSHIPS AWARDED FOR STUDENTS PURSUING EDUCATION IN MEDICAL FIELD. 467680 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 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 20 19 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X DAVID DIRKSMEYER 4148053000 N74 W12501 LEATHERWOOD CT MENOMONEE FALLS WI 53051 LUX TERESA DIRECTOR & CMH PRESIDENT 1.00 49.00 X X 0 736401 124943 BABUSUKUMAR UMESH MD DIRECTOR (START JUL22) 1.00 0.00 X 0 0 0 BROWN CARL DIRECTOR 1.00 0.00 X 0 0 0 DAVIS MARK J DIRECTOR 1.00 0.00 X 0 0 0 DORAN DAVID DIRECTOR (START JUL22) 1.00 0.00 X 0 0 0 FINERTY JOHN JR DIRECTOR (START JUL22) 1.00 0.00 X 0 0 0 HINTON DAWN DIRECTOR 1.00 0.00 X 0 0 0 KOMAS RONALD DIRECTOR 1.00 0.00 X 0 0 0 GLYNN MICHELLE DIRECTOR 1.00 0.00 X 0 0 0 LAUER MICHAEL DIRECTOR 1.00 0.00 X 0 0 0 MAYS CEDRIC DIRECTOR 1.00 0.00 X 0 0 0 MOORE MICHAEL DIRECTOR 1.00 0.00 X 0 0 0 NEU HARVEY DIRECTOR 1.00 0.00 X 0 0 0 PULVERMACHER JANINE DIRECTOR 1.00 0.00 X 0 0 0 RECHLICZ CHRISTOPHER DIRECTOR 1.00 1.00 X 0 0 0 SHEPHERD DENNIS MD DIRECTOR 1.00 0.00 X 0 0 0 WICK JERRY DIRECTOR 1.00 0.00 X 0 0 0 BECKER BRYAN DIRECTOR & BOD V CHAIR 1.00 0.00 X X 0 0 0 TEMPLIN SUSAN DIRECTOR & BOD CHAIR 1.00 0.00 X X 0 0 0 VAN WINKLE GREGORY MD DIRECTOR & BOD SECRETARY 1.00 0.00 X X 0 0 0 MALZEWSKI MICHAEL TREASURER (TERM JUN23) 1.00 49.00 X 0 352212 43529 MULLIGAN JESSICA EXECUTIVE DIRECTOR 1.00 49.00 X 0 169956 41601 FREIBERG KERRY FORMER - OFFICER (VP COMM ENG) 0.00 50.00 X 0 414064 23055 0 1672633 233128 0 1 1 0 0 78530 268780 50000 85429 327870 34819 810609 299972 299972 3388510 3324178 64332 64332 64332 151755 268780 126069 25686 25686 1200599 0 0 389990 318112 318112 149568 149568 421537 155510 266027 946 946 DONOR RECOGNITION EXPEN 21783 21783 FUND RAISING EXPENSE 10220 10220 CREDIT CARD/CHKG/STOCK 1156 1156 923322 467680 156456 299186 831428 991468 3216 1445 0 0 0 0 0 0 0 0 0 0 21943 9000 0 0 0 0 9165665 9996427 0 0 0 0 0 0 0 0 10022252 10998340 39236 0 363184 442427 0 0 0 0 0 0 0 0 0 0 0 0 223560 232644 625980 675071 X 8641909 9533168 754363 790101 9396272 10323269 10022252 10998340 X 277277 493027 421537 -264844 X 0 1 X 1 0 X 839909 595981 870042 930336 810609 4046877 839909 595981 870042 930336 810609 4046877 228073 184254 173382 242804 161704 990217 0 228073 184254 173382 242804 161704 990217 3056660 199375 237434 174480 195319 299972 1106580 199375 237434 174480 195319 299972 1106580 4406 8227 14500 21343 25686 74162 1043690 841642 1059022 1146998 1136267 5227619 0.58470 0.61060 0.21170 0.19210 X SCHEDULE A, PART VI, LIST OF UNUSUAL GRANTS: DESCRIPTION: AMOUNT: 0. PART-III LINE-12 DESCRIPTION: 2018 2019 2020 2021 2022 LINE 8C - FUND RAISING 4,406 8,227 14,500 21,343 25,686 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8614155 605522 856382 467680 261426 957 9345996 8973060 1365028 -1049030 526326 148577 0 8614155 7598551 774955 1396032 410861 384001 1616 8973060 7585233 703700 62097 402620 333816 16043 7598551 7212833 557712 435421 367073 250321 3339 7585233 1.00000 0 0 0 DUE TO AFFILIATES 232644 232644 X PART V, LINE 4: THE BOARD DESIGNATED ENDOWMENT FUND WAS CREATED TO SUPPORT LONG RANGE FINANCIAL NEEDS OF CMH AND ITS PROGRAMS. PART X, LINE 2: FROEDTERT HEALTH, INC. (FH), THE ENTITY INTO WHICH THE FINANCIALS OF COMMUNITY MEMORIAL FOUNDATION ARE CONSOLIDATED, APPLIES ASC TOPIC 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC TOPIC 740 PRESCRIBES A MORE-LIKELY THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC TOPIC 740, TAX POSITIONS ARE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2023 AND 2022, COMMUNITY MEMORIAL FOUNDATION DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED INCOME TAX POSITIONS. 0 SPRING SPLENDOR 225730 158602 67128 25382 16347 17150 3300 7695 GOLF CLASSIC 111260 71680 39580 359 17481 13008 10507 1 83545 38498 45047 350 894 2600 250 10746 420535 268780 151755 26091 34722 32758 3550 28948 126069 25686 1 COMMUNITY MEMORIAL HOSPITAL W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 390987025 501(C)3 41832 3931 DONOR'S FMV WIGS/ACCESSORIES FINANCIAL SUPPORT COMMUNITY OUTPATIENT HEALTH SERVICES W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 391743056 501(C)3 272349 0 CASH N/A FINANCIAL SUPPORT 2 0 SCHOLARSHIPS FOR MEDICAL STUDENTS 33 94400 FREE COLORECTAL SCREENINGS 4 7577 CANCER CARE WELLNESS PROGRAM 61 1408 PATIENT ASSISTANCE PROGRAM 3 2318 ALTRUSA PRESCRIPTION PROGRAM 8 1347 COMMUNITY OUTREACH FLU SHOT CLINICS 97 3294 HOLIDAY GUEST MEALS 44 283 WIG KIT/LOAN PROGRAM 56 801 FIT KIT COLON CANCER SCREENING MAILING 9580 38140 PART I, LINE 2: CMH DEPARTMENT MANAGERS SUBMIT REQUESTS TO THE FOUNDATION. ALL GRANT EXPENSES ARE APPROVED BY THE COMMUNITY MEMORIAL FOUNDATION BOARD AND /OR DIRECTOR. ALL EXPENSES ARE PAID DIRECTLY BY THE FOUNDATION BASED UPON RECEIVING PROPER DOCUMENTATION OF EXPENSES. SCHOLARSHIP WINNERS ARE SELECTED BASED ON QUALIFYING CRITERIA BY THE SCHOLARSHIP COMMITTEE. THEY ARE REQUIRED TO SUBMIT PROOF OF CONTINUED EDUCATION AND PASSING GRADES BEFORE ANY PAYMENTS ARE MADE. PART-III LINE-(B) NUMBER OF RECIPIENTS FOR GRANTS PAID ON BEHALF OF INDIVIDUALS IS AN ACTUAL COUNT DETERMINED AT TIME OF EXPENDITURE OR ATTENDANCE AT EVENT. 0 1 0 0 0 0 0 0 0 LUX TERESA DIRECTOR & CMH PRESIDENT 0 424095 0 199668 0 112638 0 110037 0 14906 0 861344 0 90937 FREIBERG KERRY FORMER - OFFICER (VP COMM ENG) 0 173348 0 103176 0 137540 0 14045 0 9010 0 437119 0 121111 MALZEWSKI MICHAEL TREASURER (TERM JUN23) 0 256759 0 67118 0 28335 0 20750 0 22779 0 395741 0 0 MULLIGAN JESSICA EXECUTIVE DIRECTOR 0 130359 0 31362 0 8235 0 9215 0 32386 0 211557 0 0 PART I, LINE 4B 457(F) DISTRIBUTIONS: FREIBERG, KERRY - $121,111 LUX, TERESA - $90,937 NON-QUALIFIED DISTRIBUTIONS: FREIBERG, KERRY - $12,897 (OF WHICH $0 WAS REPORTED AS DEFERRED ON A PRIOR FORM 990) 457(F) PLAN PARTICIPANTS: FREIBERG, KERRY LUX, TERESA NON-QUALIFIED PARTICIPANTS: FREIBERG, KERRY PART II, COLUMN (B)(II): BONUS AND INCENTIVE COMPENSATION AMOUNTS INCLUDE INCENTIVE COMPENSATION PAID. PART II, COLUMN (B)(III): OTHER REPORTABLE COMPENSATION INCLUDES 457(F) DEFERRED COMPENSATION PLAN DISTRIBUTIONS PAID TO INDIVIDUALS, AND OTHER MISCELLANEOUS COMPENSATION. X 11569 DONOR'S FMV X 3 9784 FMV X 1 30 DONOR'S FMV X AUCTION/RAFFLE ITEMS 23 13436 DONOR'S FMV 0 0 1 0 PART I, COLUMN (B): ON SCHEDULE M PART I COLUMN B, WE ARE RECORDING THE NUMBER OF CONTRIBUTIONS RECEIVED NOT THE NUMBER OF ITEMS RECEIVED. PART 1, LINE J WWW.FROEDTERT.COM/COMMUNITY-MEMORIAL/FOUNDATION FORM 990, PART VI, SECTION A, LINE 7A A MAJORITY OF COMMUNITY MEMORIAL FOUNDATION OF MENOMONEE FALLS, INC. BOARD MEMBERS MUST BE APPOINTED BY THE COMMUNITY OF MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC. BOARD. FORM 990, PART VI, SECTION A, LINE 7B CMH AND, IF APPROPRIATE, FROEDTERT HEALTH, INC., MUST APPROVE ANY PLAN OF DISSOLUTION OF THE FOUNDATION. CERTAIN ACTIONS TO BE TAKEN BY THE FOUNDATION WITH RESPECT TO ITS OPERATIONS AND MANAGEMENT MUST FIRST BE APPROVED BY CMH. FORM 990, PART VI, SECTION B, LINE 11B FH ACCOUNTING STAFF PREPARE FORM 990 WHICH IS REVIEWED BY FH'S FINANCIAL LEADERS. THE 990 IS THEN REVIEWED BY KPMG, FH'S OUTSIDE ACCOUNTING FIRM. NEXT, THE 990 IS PROVIDED TO FH'S AUDIT COMMITTEE AND BOARD OF DIRECTORS. FINALLY THE 990 IS FILED AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS ALL OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DATA IS COMPILED, AND THE FH VICE PRESIDENT - CHIEF COMPLIANCE OFFICER (CCO), THE SENIOR VICE PRESIDENT - GENERAL COUNSEL AND/OR DELEGATE WILL REVIEW ALL FORMS AND NOTIFICATIONS TO DETERMINE IF ANY CONFLICTS OF INTERESTS EXIST IN THE DISCLOSURE DOCUMENTS. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THEN THE PERSON MAKING THE DISCLOSURE SHALL BE RELIEVED OF HIS/HER OBLIGATIONS ON BEHALF OF COMMUNITY MEMORIAL FOUNDATION, WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT THAT CREATES THE CONFLICT OF INTEREST. A REPORT OF ALL CONFLICTS OF INTEREST WILL BE MADE BY THE CCO AT LEAST ANNUALLY TO THE FH FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A - COMPENSATION REVIEW & APPROVAL PROCESS - CEO & TOP MANAGEMENT COMPENSATION OF TOP MANAGEMENT IS PAID BY A RELATED ORGANIZATION BUT A REVIEW IS PERFORMED. IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED, COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA, PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE FH (THE RELATED ORGANIZATION) BOARD OF DIRECTORS. IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. LINE 15B - COMPENSATION REVIEW & APPROVAL PROCESS - OFFICERS & KEY EMPLOYEES COMPENSATION OF OFFICERS AND KEY EMPLOYEES IS PAID BY A RELATED ORGANIZATION BUT A REVIEW IS PERFORMED. IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED, COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA, PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE FH (THE RELATED ORGANIZATION) BOARD OF DIRECTORS. IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL INFORMATION: FH'S QUARTERLY FINANCIAL INFORMATION IS MADE AVAILABLE TO THE PUBLIC ONLINE THROUGH THE DIGITAL ASSURANCE CORPORATION, INC. WEBSITE. ANYONE CAN REGISTER TO RECEIVE ONGOING ACCESS TO AND NOTIFICATIONS REGARDING FINANCIAL STATEMENTS AT THE ONLINE WEBSITE. ADDITIONALLY, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE CORPORATE OFFICE UPON REQUEST. FORM 990, PART XI, LINE 9: NET TRANSFER TO AFFILIATES -261,426. PLEDGES WRITTEN OFF -3,418. FROEDTERT HEALTH INC 9200 WEST WISCONSIN AVENUE MILWAUKEE WI 532263596 392014409 MGMT SERVICES WI 501 (C) (3) LN 12, III N/A 0 COMMUNITY MEMORIAL HOSPITAL OF MF W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 390987025 HOSPITAL WI 501 (C) (3) 3 FH INC 0 COMMUNITY OUTPATIENT HEALTH SERVICES W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 391743056 OP/DENTAL SRV WI 501 (C) (3) 3 CMH 0 ST JOSEPH'S COMMUNITY FOUNDATION 3200 PLEASANT VALLEY ROAD WEST BEND WI 530953868 392034296 HEALTH PROMO WI 501 (C) (3) LINE 7 SJH 0 FROEDTERT HOSPITAL FOUNDATION INC 9200 WEST WISCONSIN AVENUE MILWAUKEE WI 532263596 391431192 HEALTH PROMO WI 501 (C) (3) LINE 7 FMLH 0 FROEDTERT MEMORIAL LUTHERAN HOSPITAL 9200 WEST WISCONSIN AVENUE MILWAUKEE WI 532263596 396105970 HOSPITAL WI 501 (C) (3) 3 FH INC 0 ST JOSEPH'S COMMUNITY HOSPITAL INC 3200 PLEASANT VALLEY ROAD WEST BEND WI 530953868 390806302 HOSPITAL WI 501 (C) (3) 3 FH INC 0 HOLY FAMILY MEMORIAL INC 2300 WESTERN AVE PO BOX 1450 MANITOWOC WI 542211450 390806395 HOSPITAL WI 501 (C) (3) 3 FH INC 0 QHS 1 INC 9200 WEST WISCONSIN AVENUE MILWAUKEE WI 532263596 202636686 HLTHCARE SRVS WI 501 (C) (3) LN 12, 1 FH INC 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0