2025-08-14T12:57:40-05:00 2024-09-30 420714325 RSM US LLP 227 WEST FIRST STREET SUITE 700 DULUTH MN 55802 990 2023-10-01 412001411 ELY HEALTH AND HOSPITAL FOUNDATION ELYH 2183653271 328 W CONAN ST ELY MN 55731 TIMOTHY BALTHAZOR CFO 2183653271 2025-08-13 1 1 JULIE BOYER P01278549 2187275025 2025-08-13 2023 2025-03-06 01:10:19Z PATTI BANKS 328 W CONAN ST ELY MN 55731 694207 0 X HTTPS://WWW.EBCH.ORG/ABOUT-US/FOUNDATION X 2000 MN TO PROVIDE FINANCIAL RESOURCES TO SUPPORT THE MISSION OF EBCH IN ITS COMMITMENT TO CARE FOR AND ENHANCE THE HEALTH AND WELLBEING OF THE COMMUNITY IT SERVES. 9 9 0 11 0 0 25823 98294 0 0 18954 33984 0 0 44777 132278 0 425000 0 0 0 0 0 0 0 1967 2235 1967 427235 42810 -294957 975906 837176 0 0 975906 837176 TO PROVIDE FINANCIAL RESOURCES TO SUPPORT THE MISSION OF EBCH IN ITS COMMITMENT TO CARE FOR AND ENHANCE THE HEALTH AND WELLBEING OF THE COMMUNITY IT SERVES. 0 0 425000 425000 SUPPORT OF THE ELY-BLOOMENSON COMMUNITY HOSPITAL IN ORDER FOR THEM TO IMPROVE THE QUALITY OF HEALTH CARE IN THE ELY COMMUNITY. 425000 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 0 MN X PATTI BANKS 2183653271 328 W CONAN ST ELY MN 55731 MARY ANN SMITH DIRECTOR 0.25 1.25 X 0 0 0 RIANA HEGMAN DIRECTOR 0.25 1.25 X 0 0 0 JO LANGAN DIRECTOR UNTIL 12/31/23 0.25 1.25 X 0 0 0 STEPHEN PETERSON SR DIRECTOR 0.25 1.25 X 0 0 0 JOHN SAW DIRECTOR 0.25 1.25 X 0 0 0 ROB WILMUNEN DIRECTOR 0.25 1.25 X 0 0 0 TODD HEIMAN TREASURER 0.25 1.25 X X 0 0 0 KELLY KLUN SECRETARY UNTIL 12/31/23 0.25 1.25 X X 0 0 0 BARB SODERBERG SECRETARY 0.25 1.25 X X 0 0 0 DEVON LUTHENS PRESIDENT 0.25 1.25 X X 0 0 0 TIM RILEY VICE PRESIDENT 0.25 1.25 X X 0 0 0 PATTI BANKS CEO 0.25 39.75 X 0 248682 43202 0 248682 43202 0 0 1 0 0 98294 98294 26579 26579 569334 561929 7405 7405 7405 132278 0 0 33984 425000 425000 2235 2235 427235 425000 2235 0 162931 261828 812975 575348 975906 837176 0 0 X 898406 759676 77500 77500 975906 837176 975906 837176 -294957 156226 1 0 X 0 1 X 0 0 X X 1 ELY-BLOOMENSON COMMUNITY HOSPITAL 410808719 3 1 425000 0 1 425000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 77500 56 56 77500 77500 9 9 77500 77500 2 2 77500 77500 462 462 77500 77500 1594 1594 77500 0.00000 1.00000 0.00000 0 0 0 X 286269 156226 -2235 153991 132278 0 132278 425000 0 425000 2235 2235 427235 PART V, LINE 4: RESTRICTED BY DONORS FOR ENDOWMENT FUND: DONOR CONTRIBUTIONS TO THE ENDOWMENT FUND ARE RESTRICTED TO INVESTMENTS IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT THE PURPOSE OF THE FUND. RESTRICTED BY DONORS FOR SPECIFIC PURPOSES: THESE FUNDS ARE RESTRICTED BY DONORS FOR LIBRARY EXPENSES. PART X, LINE 2: THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. MANAGEMENT EVALUATED THE FOUNDATION'S TAX POSITIONS AND CONCLUDED THE ORGANIZATION HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THE GUIDANCE. GENERALLY, THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2021. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT EXPENSE -2,235. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT EXPENSE 2,235. 0 ELY-BLOOMENSON COMMUNITY HOSPITAL 328 WEST CONAN STREET ELY MN 55731 410808719 501(C)(3) 425000 0 PURCHASE OF A HOUSE TO IMPLEMENT CHILDCARE AND PROMOTE EMPLOYEE RETENTION. 1 0 PART I, LINE 2: ALL GRANTS ARE PAID DIRECTLY TO U.S. GRANT RECIPIENTS. THERE IS NO FURTHER MONITORING OF GRANT FUNDS. 0 0 0 0 0 0 0 0 0 PATTI BANKS CEO 0 248553 0 0 0 129 0 10255 0 32947 0 291884 0 0 PART I, LINE 3 ELY HEALTH AND HOSPITAL FOUNDATION DOES NOT COMPENSATE ANY EMPLOYEES. THE CEO IS COMPENSATED BY THE ELY-BLOOMENSON COMMUNITY HOSPITAL, A RELATED ORGANIZATION. THE COMPENSATION IS ESTABLISHED USING: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVERY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 PEOPLE IN THE COMMUNITY CAN BECOME A MEMBER OF ELY HEALTH AND HOSPITAL FOUNDATION BY PAYING A $100 MEMBERSHIP FEE. FORM 990, PART VI, SECTION A, LINE 7A THE FOUNDATION IS MANAGED BY A BOARD OF DIRECTORS WHO ARE ELECTED BY THE MEMBERS OF THE FOUNDATION AT THE ANNUAL MEETING. FORM 990, PART VI, SECTION A, LINE 7B THERE ARE CERTAIN ISSUES THAT MUST BE APPROVED BY ALL MEMBERS, SUCH AS BY-LAW CHANGES AND TRANSFERS OF SUBSTANTIAL AMOUNTS OF ASSETS. ALL MEMBERS HAVE VOTING RIGHTS. FORM 990, PART VI, SECTION A, LINE 8B NO COMMITTEE EXISTS WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE REVIEWED BY THE FOUNDATION'S CFO AND SUBMITTED TO THE BOARD OF DIRECTORS FOR APPROVAL. THE 990 WILL BE AVAILABLE TO MEMBERS UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 12C ELY HEALTH & HOSPITAL FOUNDATION WILL UTILIZE A CONFLICT OF INTEREST POLICY SO THAT THE MEMBERS OF THE BOARD OF DIRECTORS CAN EASILY RECOGNIZE AND DECLARE A CONFLICT OF INTEREST. DECLARATION OF CONFLICT OF INTEREST - EACH DIRECTOR OF THE ELY HEALTH & HOSPITAL FOUNDATION IS EXPECTED TO DECLARE A CONFLICT OF INTEREST AS SOON AS THE DIRECTOR IS AWARE OF SUCH A CONFLICT. ONCE A CONFLICT OF INTEREST HAS BEEN DECLARED, THE BOARD OF DIRECTORS SHALL FOLLOW THE PROCEDURE OUTLINED IN THE PROCEDURE PARAGRAPH OF THIS POLICY. DETERMINATION OF CONFLICT OF INTEREST - ANY OFFICER OR MEMBER OF THE BOARD OF DIRECTORS OF ELY HEALTH & HOSPITAL FOUNDATION WHO BELIEVES THAT A BOARD MEMBER HAS A CONFLICT OF INTEREST SHALL STATE TO THE BOARD OF DIRECTORS THE BASIS FOR SUCH BELIEF. IF THE PERSON BELIEVED TO HAVE THE CONFLICT OF INTEREST DOES NOT AGREE THAT SUCH A CONFLICT EXISTS, SUCH PERSON SHALL BE GIVEN AN OPPORTUNITY TO RESPOND. IF IT IS NOT AGREED THAT A CONFLICT DOES EXIST THEN THE BOARD OF DIRECTORS SHALL VOTE TO DETERMINE WHETHER OR NOT SUCH CONFLICT EXISTS. ANY DIRECTOR WHO IS ENTITLED TO VOTE MAY REQUEST THAT THE VOTE BE BY CLOSED BALLOT AND UPON SUCH REQUEST THE CHAIRPERSON SHALL DECLARE THE VOTE BY CLOSED BALLOT. A SIMPLE MAJORITY OF THE MEMBERS PRESENT AND VOTING SHALL BE SUFFICIENT TO ESTABLISH THAT A CONFLICT OF INTEREST DOES EXIST. PROCEDURE UPON DETERMINATION OF CONFLICT - ONCE A CONFLICT OF INTEREST HAS BEEN DECLARED OR DETERMINED BY THE BOARD, THE INTERESTED PERSON OR PERSONS SHALL BE EXCUSED FROM THE MEETING UNTIL SUCH TIME AS A VOTE HAS BEEN TAKEN BY THE BOARD IN REGARD TO THE ISSUE WITH WHICH THE INTERESTED MEMBER HAS A CONFLICT. ONCE A CONFLICT OF INTEREST HAS BEEN DECLARED OR DETERMINED, THE INTERESTED MEMBER SHALL NOT PARTICIPATE IN ANY DISCUSSION IN REGARD TO THE SUBJECT MATTER AND MAY ONLY RESPOND TO QUESTIONS DIRECTED TO HIM/HER BY ANY ONE OR MORE OF THE DIRECTORS. THE INTERESTED DIRECTOR SHALL NOT BE COUNTED IN THE QUORUM AND SHALL ABSTAIN FROM VOTING. THE STATEMENT REGARDING THE CONFLICT OF INTEREST MUST BE ENTERED INTO THE MINUTES. ONCE A DIRECTOR OR OFFICER HAS DECLARED OR BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST, SUCH CONFLICT SHALL BE DEEMED TO CONTINUE UNTIL THE FINAL VOTE HAS BEEN TAKEN BY THE BOARD OF DIRECTORS IN REGARD TO THE SUBJECT MATTER IN WHICH SUCH DIRECTOR HAS CONFLICT. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOUSURE AS SET FORTH IN SECTION 6104(D). ELY-BLOOMENSON COMMUNITY HOSPITAL 328 WEST CONAN STREET ELY MN 55731 410808719 TO PROVIDE HEALTHCARE TO THE RESIDENTS AND VISITORS TO THE ELY, MN AREA MN 501(C)(3) LINE 3 ELY HEALTH AND HOSPITAL FOUNDATION 1 ELY HEALTH & HOSPITAL FUND 328 WEST CONAN STREET ELY MN 55731 461836177 TO PROVIDE SUPPORT TO ELY-BLOOMENSON COMMUNITY HOSPITAL FOR HEALTHCARE MN 501(C)(3) LINE 12B, II ELY HEALTH AND HOSPITAL FOUNDATION 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 ELY-BLOOMENSON COMMUNITY HOSPITAL B 425000 CASH