2025-11-14T11:30:21-06:00 2024-12-31 450250958 EIDE BAILLY LLP 18081 BURT ST STE 200 OMAHA NE 680224722 990 2024-01-01 470686476 CHEYENNE COUNTY HOSPITAL & HEALTH CENTER FOUNDATION CHEY 3082545825 1000 POLE CREEK CROSSING SIDNEY NE 69162 JULIE SHOEMAKER SECRETARY/EXECUTIVE DIRECTOR 3082545825 2025-11-13 1 1 MEGAN L KOZIOL CPA P01544037 4023302660 2025-11-13 2024 2025-03-06 01:10:19Z JULIE SHOEMAKER 1000 POLE CREEK CROSSING SIDNEY NE 69162 190923 0 X WWW.SIDNEYRMC.COM/HEALTH-CENTER-FOUNDATION X 1985 NE TO SUPPORT SIDNEY REGIONAL MEDICAL CENTER. 13 11 0 15 0 0 31191 51751 0 0 39915 112598 -532 5802 70574 170151 59236 306980 0 0 0 0 0 0 58443 17408 58443 76644 365423 -6070 -195272 1815696 1698507 4041 2069 1811655 1696438 TO ASSURE THERE IS, AND ALWAYS WILL BE, A STRONG FINANCIAL FOUNDATION SUPPORTING OUR HEALTH CARE COMMUNITY. 0 0 304480 304480 PROVIDE SUPPORT TO CHEYENNE COUNTY HOSPITAL ASSOCIATION, D/B/A SIDNEY REGIONAL MEDICAL CENTER, TO FURTHER THEIR QUEST TO PROVIDE THE MOST UP-TO-DATE FACILITIES, EQUIPMENT AND SERVICE. 2500 2500 PROVIDE FUNDING TO SUPPORT SCHOLARSHIPS FOR INDIVIDUALS CURRENTLY STUDYING IN THE HEALTH CARE FIELD. 306980 1 1 0 0 0 0 0 0 0 0 1 0 0 0 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 13 11 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 X JULIE SHOEMAKER 3082545825 1000 POLE CREEK CROSSING SIDNEY NE 69162 DR JAMES POPOVICH MEMBER 1.00 39.00 X 0 667835 58579 BILL BUTKUS PRESIDENT 1.00 0.00 X X 0 0 0 KURT KAISER VICE PRESIDENT 1.00 0.00 X X 0 0 0 SEAN DOYLE TREASURER 1.00 0.00 X X 0 0 0 JULIE SHOEMAKER SECRETARY/EXECUTIVE DIRECTOR 10.00 30.00 X X 0 113943 41774 STAN BELIEU MEMBER 1.00 4.00 X 0 0 0 NANCI MCCASLIN MEMBER 1.00 4.00 X 0 0 0 SHANE COCHRAN MEMBER 1.00 0.00 X 0 0 0 NICKY RADCLIFFE MEMBER 1.00 0.00 X 0 0 0 SHIRLEY WILSON MEMBER 1.00 0.00 X 0 0 0 BECKY BUTKUS MEMBER 1.00 0.00 X 0 0 0 ERIKA REVORD MEMBER 1.00 0.00 X 0 0 0 KIM PHILLIPS MEMBER 1.00 0.00 X 0 0 0 0 781778 100353 0 0 1 0 0 26644 5000 20107 51751 21194 21194 47193 49215 0 5004 47193 44211 91404 91404 6396 26644 7914 -1518 -1518 9502 7854 1648 1648 5672 5672 5672 170151 7320 0 111080 X 304480 304480 2500 2500 6770 6770 38459 38459 102 102 2923 2923 909 909 1504 1504 OKTOBERFEST RUN 5157 5157 2619 2619 365423 306980 0 58443 1072978 829823 127402 919 135005 126483 607713 742201 1815696 1698507 4041 0 0 2069 4041 2069 X 1570201 1437879 241454 258559 1811655 1696438 1815696 1698507 -195272 80055 0 X X 0 1 X 1 0 X X 1 CHEYENNE COUNTY HOSPITAL ASSOCIATION INC 470408242 3 1 304480 0 1 304480 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 SECTION D, LINE 3: THE SUPPORTED ORGANIZATION, CHEYENNE COUNTY HOSPITAL ASSOCIATION, INC., APPOINTS 2 MEMBERS OF ITS BOARD OF DIRECTORS TO SIT ON THE BOARD OF DIRECTORS OF THE CHEYENNE COUNTY HOSPITAL AND HEALTH CENTER FOUNDATION. THESE DIRECTORS SERVE TO ASSIST IN THE DIRECTION OF THE FOUNDATION AND LEND A SIGNIFICANT VOICE TO ALL POLICIES AND PROCEDURES AND SERVE DURING THE ENTIRE YEAR. ADDITIONALLY, THE CFO OF THE CHEYENNE COUNTY HOSPITAL ASSOCIATION SERVES ON THE BOARD AS A FINANCIAL REPRESENTATIVE GIVING GUIDANCE TO THE BOARD AS NEEDED. SECTION E, LINE 2A: THE PURPOSE OF THE ORGANIZATION IS TO SUPPORT THE CHEYENNE COUNTY HOSPITAL ASSOCIATION TO ASSURE THAT THERE IS AND ALWAYS WILL BE A STRONG FOUNDATION SUPPORTING HEALTH CARE IN CHEYENNE COUNTY. DURING 2024, THE FOUNDATION'S ACTIVITIES WERE FOCUSED ON THE SUPPORT OF THE HEALTHCARE MISSION AND INCREASING COMMUNITY AWARENESS OF THE FOUNDATION ITSELF. SIDNEY REGIONAL MEDICAL CENTER REQUESTED SUPPORT FROM THE FOUNDATION IN THE FORM OF FUNDING FOR EDUCATION AND SCHOLARSHIPS. THE FOUNDATION ALSO FUNDED AND HOSTED INTERNS WHO FURTHERED THEIR HEALTHCARE EDUCATION BY SHADOWING AND WORKING WITHIN THE HOSPITAL ORGANIZATION. MANY OF THESE INTERNS, AS WELL AS SCHOLARSHIP RECIPIENTS OF THE FOUNDATION, GO ON AND SUCCEED IN THEIR HEALTHCARE PROFESSIONS AND RETURN TO THE SIDNEY, NEBRASKA AREA AFTER THEIR TRAINING AND EDUCATION IS COMPLETE. SECTION E, LINE 2B: IF THE FOUNDATION DIDN'T EXIST THERE WOULD STILL NEED TO BE A MECHANISM FOR ACCEPTING BEQUESTS AND OTHER GIFTS FROM PATIENTS, AS WELL AS FUNDRAISING FOR NEEDED EQUIPMENT AND FACILITIES IMPROVEMENTS. THE INTERN PROGRAM WOULD CONTINUE IN ORDER TO FURTHER THE RECRUITING EFFORTS BY THE HOSPITAL. THESE DEEPLY ROOTED EVENTS WOULD NEED TO CONTINUE TO BE HELD WITHIN THE COMMUNITY IN ORDER TO PROMOTE HEALTHY LIVING ACTIVITIES AND HOSPITAL COMMUNITY BENEFITS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 126483 126483 919 919 0 126483 DUE TO RELATED PARTIES 2069 2069 X PART X, LINE 2: THE ORGANIZATION ACCOUNTS FOR UNCERTAINTIES IN ACCOUNTING FOR INCOME TAX ASSETS AND LIABILITIES USING GUIDANCE INCLUDED IN FASB ASC 740, INCOME TAXES. THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. AT DECEMBER 31, 2024 AND 2023, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS ACCRUED. GOLF TOURNAMENT 33040 26644 6396 3000 1560 1086 750 1518 33040 26644 6396 3000 1560 1086 750 1518 7914 -1518 1 CHEYENNE COUNTY HOSPITAL ASSOCIATION INC 1000 POLE CREEK CROSSING SIDNEY NE 69162 470408242 501(C)(3) 304480 0 FURTHER QUEST TO PROVIDE THE MOST UP-TO-DATE FACILITIES, EQUIPMENT AND SERVICE 1 0 PART I, LINE 2: CHEYENNE COUNTY HOSPITAL & HEALTH CENTER FOUNDATION PROVIDES FUNDS TO CHEYENNE COUNTY HOSPITAL ASSOCIATION, D/B/A SIDNEY REGIONAL MEDICAL CENTER, A RELATED ENTITY. GRANTS CAN BE EASILY MONITORED THROUGH THE USE OF SHARED ACCOUNTING SERVICES. 0 0 0 0 0 0 0 0 0 DR JAMES POPOVICH MEMBER 0 637835 0 30000 0 0 0 23000 0 35723 0 726558 0 0 JULIE SHOEMAKER SECRETARY/EXECUTIVE DIRECTOR 0 113943 0 0 0 0 0 6113 0 35677 0 155733 0 0 PART I, LINE 3 JULIE SHOEMAKER, EXECUTIVE DIRECTOR, IS COMPENSATED BY CHEYENNE COUNTY HOSPITAL ASSOCIATION, INC. FOR SERVICES TO THE FOUNDATION. CHEYENNE COUNTY HOSPITAL ASSOCIATION USES ONE OR MORE OF THE METHODS ON LINE 3 TO DETERMINE THE EXECUTIVE DIRECTOR'S COMPENSATION. FORM 990, PART VI, SECTION A, LINE 2 JULIE SHOEMAKER, DR. JAMES POPOVICH, STAN BELIEU, AND NANCI MCCASLIN HAVE A BUSINESS RELATIONSHIP. BILL BUTKUS, PRESIDENT, AND BECKY BUTKUS, MEMBER, SHARE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 8B THERE IS NO COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 INFORMATION IS ACCUMULATED BY THE ACCOUNTING DEPARTMENT AND SUBMITTED TO THE INDEPENDENT PUBLIC ACCOUNTANTS FOR FURTHER REVIEW AND PREPARATION. COMMUNICATIONS BETWEEN THE INDEPENDENT PUBLIC ACCOUNTANTS AND THE ACCOUNTING DEPARTMENT FINALIZE THE PREPARATION OF THE FORM 990. AFTER THE PREPARATION IS COMPLETE, THE CFO OF CHEYENNE COUNTY HOSPITAL ASSOCIATION, D/B/A SIDNEY REGIONAL MEDICAL CENTER, REVIEWS THE FORM 990. UPON APPROVAL, THE FORM 990 IS E-MAILED TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR THEIR REVIEW. ONCE THE FORM 990 HAS BEEN REVIEWED BY ALL PARTIES, IT WILL BE SUBMITTED TO THE IRS ON OR BEFORE THE EXTENDED DUE DATE. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ALL BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. ANY DUALITY OF INTEREST OR POTENTIAL CONFLICT OF INTEREST ON THE PART OF ANY OFFICER, DIRECTOR, COMMITTEE MEMBER, OR KEY EMPLOYEE IS REQUIRED TO BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF BOARD RECORD WHENEVER IT ARISES, OR WHENEVER IT INVOLVES A MATTER OF BOARD ACTION. ANY OFFICER, DIRECTOR, COMMITTEE MEMBER, OR KEY EMPLOYEE HAVING A DUALITY OF INTEREST OR A POSSIBLE CONFLICT OF INTEREST IN ANY MATTER ABSTAINS FROM DISCUSSION AND THE VOTE. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS, BUT NOT ITS CONFLICY OF INTEREST POLICY, AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15: AS THE ORGANIZATION DOES NOT HAVE ANY EMPLOYEES, THERE IS NO INDEPENDENT REVIEW AND APPROVAL OF COMPENSATION. FORM 990, PART IX, LINE 11G PAYROLL REIMBURSEMENT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 28,579. TOTAL EXPENSES 28,579. INTERN WAGES REIMBURSEMENT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 9,880. TOTAL EXPENSES 9,880. CHEYENNE COUNTY HOSPITAL ASSOCIATION INC 1000 POLE CREEK CROSSING SIDNEY NE 69162 470408242 PROVIDING HEALTH CARE TO THOSE IN THE COMMUNITY NE 501(C)(3) LINE 3 N/A 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 1 1 1 0 0