2025-05-13T14:33:51-05:00 2024-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-07-01 391605953 FOUNDATION FOR RIPON MEDICAL CENTER INC FOUN 9209264959 430 EAST DIVISION STREET FOND DU LAC WI 54935 DINA BOYLE REGIONAL DIR. PHILANTHROPY SERVICES 9209264959 2025-05-12 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-05-12 2024 2025-03-06 01:10:19Z X DINA BOYLE 430 EAST DIVISION STREET FOND DU LAC WI 54935 58148 0 X WWW.RIPONMEDICALCENTER.COM X 1988 WI THE FOUNDATION FOR RIPON MEDICAL CENTER SERVES TO ENHANCE THE HEALTH OF THE PEOPLE OF THE GREATER RIPON AREA BY LENDING ITS FINANCIAL SUPPORT TO RIPON MEDICAL CENTER. X 9 9 0 10 0 0 105221 5655 0 0 54935 52493 -39 0 160117 58148 48231 110119 0 0 0 0 0 0 0 14259 24178 62490 134297 97627 -76149 1408233 0 28997 0 1379236 0 THE FOUNDATION FOR RIPON MEDICAL CENTER SERVES TO ENHANCE THE HEALTH OF THE PEOPLE OF THE GREATER RIPON AREA BY LENDING ITS FINANCIAL SUPPORT TO RIPON MEDICAL CENTER. 0 0 110119 110119 0 THE FOUNDATION FOR RIPON MEDICAL CENTER OPERATES TO SUPPORT, BENEFIT, PROMOTE AND OTHERWISE ASSIST THE HEALTH CARE ACTIVITIES OF RIPON MEDICAL CENTER, INC., ITS EMPLOYEES AND THE CITY OF RIPON THROUGH SUBSIDIZING OPERATING ACTIVITIES, CAPITAL PURCHASES, REPAIRS AND MAINTENANCE OR ANY OTHER NECESSARY ITEMS. 110119 1 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 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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 0 1 0 1 1 0 0 1 1 1 1 0 0 0 0 0 WI X NICOLE DOESCHER 9209264959 430 EAST DIVISION STREET FOND DU LAC WI 54935 X DR STEPHANIE GLOD PRESIDENT 0.50 X X 0 0 0 BOBBIE POLLESCH TREASURER 0.50 X X 0 0 0 DENISE MARTINEZ SECRETARY 0.50 X X 0 0 0 RYAN AVERY BOARD MEMBER 0.50 X 0 0 0 GARY BORN BOARD MEMBER 0.50 X 0 0 0 JEFF HOPP BOARD MEMBER 0.50 X 0 0 0 ELIZABETH ROY BOARD MEMBER 0.50 X 0 0 0 PETER SENSENBRENNER BOARD MEMBER 0.50 X 0 0 0 CHRIS STIEBER BOARD MEMBER 0.50 X 0 0 0 KIM LAWS DIRECTOR OF DEVELOPMENT 3.00 X 0 0 0 0 0 0 0 0 0 0 0 938 4717 5655 52493 0 52493 52493 52493 0 938 0 0 58148 0 0 52493 110119 110119 13778 13778 8400 8400 696 696 840 840 BOARD GIFTS 464 464 134297 110119 24178 0 0 175997 0 0 0 0 0 0 0 0 0 0 0 0 1232236 0 0 0 0 0 1408233 0 28997 0 28997 0 X 1234704 0 144532 0 1379236 0 1408233 0 X -76149 -1303087 X 0 0 0 X 16471 49620 32992 105221 5655 209959 16471 49620 32992 105221 5655 209959 44439 165520 19723 24200 27334 32192 103449 313408 10678 0.52810 0.46150 X PART III: THE ORGANIZATION HAS A SHORT-YEAR PERIOD ENDED 12/31/2024 FOR ITS CURRENT YEAR, 2024. THIS IS DUE TO THE ORGANIZATION FILING A FINAL YEAR RETURN FOR THE SHORT PERIOD. 20306 20306 16032 4000 274 20306 15806 226 16032 16417 -611 15806 16709 708 1000 16417 0.00000 0.00000 0.00000 0 0 0 PART V, LINE 4: THE FOUNDATION'S ENDOWMENT CONSISTS OF TWO FUNDS ESTABLISHED BY DONORS TO FUND SCHOLARSHIPS AND CAPITAL IMPROVEMENTS AND THE BOARD-DESIGNATED ENDOWMENT FUND. THE ENDOWMENTS ARE ESTABLISHED TO BENEFIT THE FOUNDATION FOR A VARIETY OF PURPOSES RESTRICTED BY DONORS. 1 RIPON MEDICAL CENTER INC 845 PARKSIDE STREET RIPON WI 54971 391101287 501(C)(3) 110119 0 EQUIPMENT, PROGRAMS AND COMMUNITY SUPPORT 1 0 PART I, LINE 2: THE ORGANIZATION HAS AN EXCELLENT APPLICATION FORM THAT CAN BE COMPLETED FOR REQUESTS. IN ADDITION, REQUESTS FROM THE HOSPITAL FOR FUNDS ARE TAKEN UP BY THE BOARD OF DIRECTORS. THE BOARD MAKES THE FINAL DECISION IN REGARD TO REQUESTS. ACTUAL EXPENDITURES ARE MONITORED BY THE FINANCE DEPARTMENT. MERGED ALL ASSETS INTO AHCF 2024-12-31 1303087 CASH 391684956 AGNESIAN HEALTHCARE FOUNDATION 430 EAST DIVISION STREET FOND DU LAC WI 53014 501(C)(3) 1 0 0 0 1 1 1 0 0 PART I, LINE 2E: PERSON(S) INVOLVED: GARY BORNELIZABETH ROY PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: BOTH BOARD MEMBERS BECAME NEW AGNESIAN HEALTHCARE FOUNDATION BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A SIX (6) DIRECTORS SHALL BE APPOINTED BY THE MEDICAL CENTER AND SIX (6) DIRECTORS SHALL BE APPOINTED BY THE FOUNDATION FOR RIPON MEDICAL CENTER. AN ACTION REQUIRED OR PERMITTED TO BE TAKEN AT A MEETING OF THE BOARD OF DIRECTORS MAY BE TAKEN WITHOUT A MEETING IF CONSENT VIA EMAIL OR IN WRITING SETTING FORTH THE ACTION IS SIGNED BY AT LEAST TWO-THIRDS OF THE DIRECTORS THEN IN OFFICE. THE INTEREST OF ANY DIRECTOR OR OFFICER IN THE CORPORATION SHALL NOT BE ASSIGNABLE INTERVIVOS, NOR SHALL IT PASS TO ANY PERSONAL REPRESENTATIVE, HEIR OR DEVISEE. FORM 990, PART VI, SECTION B, LINE 11B THE EXECUTIVE DIRECTOR REVIEWS THE FORM 990 WITH THE DIRECTOR OF FINANCE OF AGNESIAN HEALTHCARE PRIOR TO ITS FILING. IN ADDITION, THE FORM 990 IS DISTRIBUTED VIA E-MAIL TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY, DISCLOSING ANY CONFLICT THAT MAY EXIST. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY DIRECTOR SHALL BE DISCLOSED TO THE OTHER DIRECTORS OF THE BOARD AND MADE A MATTER OF RECORD THROUGH AN ANNUAL PROCEDURE, AND ALSO WHEN THE INTEREST BECOMES A MATTER OF BOARD ACTION. ANY DIRECTOR HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER, EVEN WHERE PERMITTED BY LAW. THE MINUTES OF THE MEETING SHALL REFLECT THAT A DISCLOSURE WAS MADE AND THE ABSTENTION FROM VOTING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION BELIEVES THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE A PART OF THE ORGANIZATION AND ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS UPON DISSOLUTION -1,303,087.