CHEYENNE COUNTY HOSPITAL & HEALTH CENTER FOUNDATION

Address
1000 POLE CREEK CROSSING
SIDNEY, NE 69162
Contact
Website: http://www.sidneyrmc.com
Phone: +1 (308) 254-5825
Nonprofit
NTEE: E112 - Health care
EIN: 47-0686476

Mission

TO ASSURE THERE IS, AND ALWAYS WILL BE, A STRONG FINANCIAL FOUNDATION SUPPORTING OUR HEALTH CARE COMMUNITY.
 20162015201420132012
Basic features of the organization
Year of formation1985
Form of organization
CorporationTrue
Human resources, including compensation
Summary compensation info
Sum of reportable (W2/1099) compensation$0.00$0.00$0.00$0.00$0.00
Number of employees00000
Number of people compensated >$100k00000
Number of volunteers756464100109
Number of highly compensated contractors0000 
Personnel
Belieu, Stan
TitleMEMBERMEMBERMEMBERMEMBERMEMBER
Name of key/compensated personSTAN BELIEUSTAN BELIEUSTAN BELIEUSTAN BELIEUSTAN BELIEU
Position of compensated person
Current individual trustee or directorTrueTrueTrueTrueTrue
Average hours per week working for org1.001.001.001.001.00
Reportable compensation from org$0.00$0.00$0.00$0.00$0.00
Other comp, non-reportable, from org and related orgs$0.00$0.00$0.00$0.00$0.00
Corresponding comp from related orgs
Reportable compensation from related orgs $0.00$0.00$0.00$0.00$0.00
Average hours per week working for related orgs4.004.000.000.000.00
Berlage, Gerald
TitleMEMBERMEMBERMEMBERMEMBERMEMBER
Name of key/compensated personGERALD BERLAGEGERALD BERLAGEGERALD BERLAGEGERALD BERLAGEGERALD BERLAGE
Position of compensated person
Current individual trustee or directorTrueTrueTrueTrueTrue
Average hours per week working for org1.001.001.001.001.00
Reportable compensation from org$0.00$0.00$0.00$0.00$0.00
Other comp, non-reportable, from org and related orgs$0.00$0.00$0.00$0.00$0.00
Corresponding comp from related orgs
Reportable compensation from related orgs $0.00$0.00$0.00$0.00$0.00
Average hours per week working for related orgs0.000.000.000.000.00
Butkis, Bill
Title    TREASURER
Name of key/compensated person    BILL BUTKIS
Position of compensated person
Current individual trustee or director    True
Average hours per week working for org    1.00
Reportable compensation from org    $0.00
Other comp, non-reportable, from org and related orgs    $0.00
Corresponding comp from related orgs
Reportable compensation from related orgs     $0.00
Average hours per week working for related orgs    0.00
Butkus, Bill
TitlePRESIDENTPRESIDENTPRESIDENTTREASURER 
Name of key/compensated personBILL BUTKUSBILL BUTKUSBILL BUTKUSBILL BUTKUS 
Position of compensated person
Current individual trustee or directorTrueTrueTrueTrue 
Average hours per week working for org1.001.001.001.00 
Reportable compensation from org$0.00$0.00$0.00$0.00 
Other comp, non-reportable, from org and related orgs$0.00$0.00$0.00$0.00 
Corresponding comp from related orgs
Reportable compensation from related orgs $0.00$0.00$0.00$0.00 
Average hours per week working for related orgs0.000.000.000.00 
Castner, Kim
TitleVICE PRESIDENTVICE PRESIDENTVICE PRESIDENTVICE PRESIDENTVICE PRESIDENT
Name of key/compensated personKIM CASTNERKIM CASTNERKIM CASTNERKIM CASTNERKIM CASTNER
Position of compensated person
Current individual trustee or directorTrueTrueTrueTrueTrue
Average hours per week working for org1.001.001.001.001.00
Reportable compensation from org$0.00$0.00$0.00$0.00$0.00
Other comp, non-reportable, from org and related orgs$0.00$0.00$0.00$0.00$0.00
Corresponding comp from related orgs
Reportable compensation from related orgs $0.00$0.00$0.00$0.00$0.00
Average hours per week working for related orgs0.000.000.000.000.00
Doyle, Sean
TitleTREASURERTREASURERTREASURERMEMBERMEMBER
Name of key/compensated personSEAN DOYLESEAN DOYLESEAN DOYLESEAN DOYLESEAN DOYLE
Position of compensated person
Current individual trustee or directorTrueTrueTrueTrueTrue
Average hours per week working for org1.001.001.001.001.00
Reportable compensation from org$0.00$0.00$0.00$0.00$0.00
Other comp, non-reportable, from org and related orgs$0.00$0.00$0.00$0.00$0.00
Corresponding comp from related orgs
Reportable compensation from related orgs $0.00$0.00$0.00$0.00$0.00
Average hours per week working for related orgs0.000.000.000.000.00
Ehler, Sheri
TitleMEMBERMEMBERMEMBERMEMBERMEMBER
Name of key/compensated personSHERI EHLERSHERI EHLERSHERI EHLERSHERI EHLERSHERI EHLER
Position of compensated person
Current individual trustee or directorTrueTrueTrueTrueTrue
Average hours per week working for org1.001.001.001.001.00
Reportable compensation from org$0.00$0.00$0.00$0.00$0.00
Other comp, non-reportable, from org and related orgs$0.00$0.00$0.00$0.00$0.00
Corresponding comp from related orgs
Reportable compensation from related orgs $0.00$0.00$0.00$0.00$0.00
Average hours per week working for related orgs0.000.000.000.000.00
Hlavinka, Leasa
TitleSECRETARYMEMBERMEMBER MEMBER
Name of key/compensated personLEASA HLAVINKALEASA HLAVINKALEASA HLAVINKA LEASA HLAVINKA
Position of compensated person
Current individual trustee or directorTrueTrueTrue True
Average hours per week working for org1.001.001.00 1.00
Reportable compensation from org$0.00$0.00$0.00 $0.00
Other comp, non-reportable, from org and related orgs$0.00$0.00$0.00 $0.00
Corresponding comp from related orgs
Reportable compensation from related orgs $0.00$0.00$0.00 $0.00
Average hours per week working for related orgs0.000.000.00 0.00
McGown, Megan
Title SECRETARYSECRETARYSECRETARYSECRETARY
Name of key/compensated person MEGAN MCGOWNMEGAN MCGOWNMEGAN MCGOWNMEGAN MCGOWN
Position of compensated person
Current individual trustee or director TrueTrueTrueTrue
Average hours per week working for org 1.001.001.001.00
Reportable compensation from org $0.00$0.00$0.00$0.00
Other comp, non-reportable, from org and related orgs $0.00$0.00$0.00$0.00
Corresponding comp from related orgs
Reportable compensation from related orgs  $0.00$0.00$0.00$0.00
Average hours per week working for related orgs 0.000.000.000.00
Miller, Merry
Title    MEMBER
Name of key/compensated person    MERRY JEAN MILLER
Position of compensated person
Current individual trustee or director    True
Average hours per week working for org    1.00
Reportable compensation from org    $0.00
Other comp, non-reportable, from org and related orgs    $0.00
Corresponding comp from related orgs
Reportable compensation from related orgs     $0.00
Average hours per week working for related orgs    0.00
Muhs, Mitch
Title   PRESIDENTPRESIDENT
Name of key/compensated person   MITCH MUHSMITCH MUHS
Position of compensated person
Current individual trustee or director   TrueTrue
Average hours per week working for org   1.001.00
Reportable compensation from org   $0.00$0.00
Other comp, non-reportable, from org and related orgs   $6,419.00$3,752.00
Corresponding comp from related orgs
Reportable compensation from related orgs    $122,876.00$95,587.00
Average hours per week working for related orgs   39.0039.00
Robinson, Rob
Title    MEMBER
Name of key/compensated person    ROB ROBINSON
Position of compensated person
Current individual trustee or director    True
Average hours per week working for org    1.00
Reportable compensation from org    $0.00
Other comp, non-reportable, from org and related orgs    $0.00
Corresponding comp from related orgs
Reportable compensation from related orgs     $0.00
Average hours per week working for related orgs    0.00
Smith, Vicki
Title   MEMBERMEMBER
Name of key/compensated person   VICKI SMITHVICKI SMITH
Position of compensated person
Current individual trustee or director   TrueTrue
Average hours per week working for org   1.001.00
Reportable compensation from org   $0.00$0.00
Other comp, non-reportable, from org and related orgs   $0.00$0.00
Corresponding comp from related orgs
Reportable compensation from related orgs    $0.00$0.00
Average hours per week working for related orgs   0.000.00
Smith, Vickie
TitleMEMBERMEMBERMEMBER  
Name of key/compensated personVICKIE SMITHVICKIE SMITHVICKIE SMITH  
Position of compensated person
Current individual trustee or directorTrueTrueTrue  
Average hours per week working for org1.001.001.00  
Reportable compensation from org$0.00$0.00$0.00  
Other comp, non-reportable, from org and related orgs$0.00$0.00$0.00  
Corresponding comp from related orgs
Reportable compensation from related orgs $0.00$0.00$0.00  
Average hours per week working for related orgs0.000.000.00  
Utley, Kelly
TitleEXECUTIVE DIRECTOREXECUTIVE DIRECTOREXECUTIVE DIRECTOREXECUTIVE DIRECTOREXECUTIVE DIRECTOR
Name of key/compensated personKELLY UTLEYKELLY UTLEYKELLY UTLEYKELLY UTLEYKELLY UTLEY
Position of compensated person
Average hours per week working for org1.001.001.001.001.00
Reportable compensation from org$0.00$0.00$0.00$0.00$0.00
Other comp, non-reportable, from org and related orgs$9,975.00$35,718.00$25,947.00$24,219.00$26,510.00
Corresponding comp from related orgs
Reportable compensation from related orgs $167,994.00$153,804.00$147,564.00$136,952.00$121,816.00
Average hours per week working for related orgs39.0039.0039.0039.0039.00
Wamsley, Julie
TitleMEMBERMEMBERMEMBERMEMBER 
Name of key/compensated personJULIE WAMSLEYJULIE WAMSLEYJULIE WAMSLEYJULIE WAMSLEY 
Position of compensated person
Current individual trustee or directorTrueTrueTrueTrue 
Average hours per week working for org1.001.001.001.00 
Reportable compensation from org$0.00$0.00$0.00$0.00 
Other comp, non-reportable, from org and related orgs$0.00$0.00$0.00$0.00 
Corresponding comp from related orgs
Reportable compensation from related orgs $0.00$0.00$0.00$0.00 
Average hours per week working for related orgs4.004.000.000.00 
Purpose: mission, activities, & accomplishments
Mission or significant activitiesHEALTH CENTER FOUNDATION SUPPORTS SIDNEY REGIONAL MEDICAL CENTER IN THEIR QUEST TO PROVIDE THE MOST UP-TO-DATE FACILITIES, EQUIPMENT AND SERVICES. THROUGH OUR RESPONSIBLE DONATION MANAGEMENT, WE ARE HELPING TO ASSURE THAT OUR COMMUNITY WILL CONTINUE TO HAVE LOCAL, QUALITY HEALTH CARE AND CURRENT STATE-OF-THE-ART TECHNOLOGIES, IN A FACILITY MAINTAINED AND UPDATED TO MEET THE EMERGING AND GROWING NEEDS OF CHEYENNE COUNTY AND THE SURROUNDING REGIONS.HEALTH CENTER FOUNDATION SUPPORTS SIDNEY REGIONAL MEDICAL CENTER IN THEIR QUEST TO PROVIDE THE MOST UP-TO-DATE FACILITIES, EQUIPMENT AND SERVICES. THROUGH OUR RESPONSIBLE DONATION MANAGEMENT, WE ARE HELPING TO ASSURE THAT OUR COMMUNITY WILL CONTINUE TO HAVE LOCAL, QUALITY HEALTH CARE AND CURRENT STATE-OF-THE-ART TECHNOLOGIES, IN A FACILITY MAINTAINED AND UPDATED TO MEET THE EMERGING AND GROWING NEEDS OF CHEYENNE COUNTY AND THE SURROUNDING REGIONS.HEALTH CENTER FOUNDATION SUPPORTS SIDNEY REGIONAL MEDICAL CENTER IN THEIR QUEST TO PROVIDE THE MOST UP-TO-DATE FACILITIES, EQUIPMENT AND SERVICES. THROUGH OUR RESPONSIBLE DONATION MANAGEMENT, WE ARE HELPING TO ASSURE THAT OUR COMMUNITY WILL CONTINUE TO HAVE LOCAL, QUALITY HEALTH CARE AND CURRENT STATE-OF-THE-ART TECHNOLOGIES, IN A FACILITY MAINTAINED AND UPDATED TO MEET THE EMERGING AND GROWING NEEDS OF CHEYENNE COUNTY AND THE SURROUNDING REGIONS.HEALTH CENTER FOUNDATION SUPPORTS SIDNEY REGIONAL MEDICAL CENTER IN THEIR QUEST TO PROVIDE THE MOST UP-TO-DATE FACILITIES, EQUIPMENT AND SERVICES. THROUGH OUR RESPONSIBLE DONATION MANAGEMENT, WE ARE HELPING TO ASSURE THAT OUR COMMUNITY WILL CONTINUE TO HAVE LOCAL, QUALITY HEALTH CARE AND CURRENT STATE-OF-THE-ART TECHNOLOGIES, IN A FACILITY MAINTAINED AND UPDATED TO MEET THE EMERGING AND GROWING NEEDS OF CHEYENNE COUNTY AND THE SURROUNDING REGIONS.HEALTH CENTER FOUNDATION SUPPORTS SIDNEY REGIONAL MEDICAL CENTER IN THEIR QUEST TO PROVIDE THE MOST UP-TO-DATE FACILITIES, EQUIPMENT AND SERVICES. THROUGH OUR RESPONSIBLE DONATION MANAGEMENT, WE ARE HELPING TO ASSURE THAT OUR COMMUNITY WILL CONTINUE TO HAVE LOCAL, QUALITY HEALTH CARE AND CURRENT STATE-OF-THE-ART TECHNOLOGIES, IN A FACILITY MAINTAINED AND UPDATED TO MEET THE EMERGING AND GROWING NEEDS OF CHEYENNE COUNTY AND THE SURROUNDING REGIONS.
Program service expenses, total$19,268.00$233,701.00$56,602.00$43,868.00$39,133.00
Programs, including revenue & expenses
PROVIDE FUNDING TO ASSIST WITH DENTAL PROCEDURES FOR THOSE IN NEED.
Program expenses$8,197.00$7,452.00$10,245.00$7,383.00$5,005.00
Grants and allocations made$8,197.00$7,452.00$10,245.00$7,383.00$5,005.00
Program descriptionPROVIDE FUNDING TO ASSIST WITH DENTAL PROCEDURES FOR THOSE IN NEED.PROVIDE FUNDING TO ASSIST WITH DENTAL PROCEDURES FOR THOSE IN NEED.PROVIDE FUNDING TO ASSIST WITH DENTAL PROCEDURES FOR THOSE IN NEED.PROVIDE FUNDING TO ASSIST WITH DENTAL PROCEDURES FOR THOSE IN NEED.ASSISTANCE FOR DENTAL PROCEDURES
PROVIDE FUNDING TO SUPPORT SCHOLARSHIPS AND INTERN PROGRAMS FOR INDIVIDUALS CURRENTLY STUDYING IN THE HEALTH CARE FIELD.
Program expenses$3,939.00$11,413.00$6,651.00$9,307.00$7,932.00
Grants and allocations made$3,939.00$11,413.00$6,651.00$9,307.00$7,932.00
Program descriptionPROVIDE FUNDING TO SUPPORT SCHOLARSHIPS AND INTERN PROGRAMS FOR INDIVIDUALS CURRENTLY STUDYING IN THE HEALTH CARE FIELD.PROVIDE FUNDING TO SUPPORT SCHOLARSHIPS AND INTERN PROGRAMS FOR INDIVIDUALS CURRENTLY STUDYING IN THE HEALTH CARE FIELD.PROVIDE FUNDING TO SUPPORT SCHOLARSHIPS AND INTERN PROGRAMS FOR INDIVIDUALS CURRENTLY STUDYING IN THE HEALTH CARE FIELD.PROVIDE FUNDING TO SUPPORT SCHOLARSHIPS AND INTERN PROGRAMS FOR INDIVIDUALS CURRENTLY STUDYING IN THE HEALTH CARE FIELD.SUPPORT FOR SCHOLARSHIP AND INTERN PROGRAMS
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.
Program expenses$7,132.00$214,836.00$39,706.00$27,178.00$26,196.00
Grants and allocations made$7,132.00$214,836.00$39,706.00$27,178.00$26,196.00
Program descriptionPROVIDE 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.PROVIDE SUPPORT TO CHEYENNE COUNTY HOSPITAL ASSOCIATION (SIDNEY REGIONAL MEDICAL CENTER) TO FURTHER THEIR QUEST TO PROVIDE THE MOST UP-TO-DATE FACILITIES, EQUIPMENT AND SERVICE.PROVIDE SUPPORT TO CHEYENNE COUNTY HOSPITAL ASSOCIATION (SIDNEY REGIONAL MEDICAL CENTER) TO FURTHER THEIR QUEST TO PROVIDE THE MOST UP-TO-DATE FACILITIES, EQUIPMENT AND SERVICE.PROVIDE SUPPORT TO CHEYENNE COUNTY HOSPITAL ASSOCIATION (SIDNEY REGIONAL MEDICAL CENTER) TO FURTHER THEIR QUEST TO PROVIDE THE MOST UP-TO-DATE FACILITIES, EQUIPMENT AND SERVICE.SUPPORT OF CHEYENNE COUNTY HOSPITAL ASSOCIATION
Financial data
Revenue
Total revenue$52,674.00$66,195.00$113,970.00$100,395.00$45,360.00
Revenue from contributions (total)$58,070.00$61,065.00$106,146.00$65,112.00$33,503.00
Investment income, current yr$17,036.00$19,890.00$21,639.00$15,790.00$8,762.00
Total revenue from grants, etc., current yr$58,070.00$61,065.00$106,146.00$65,112.00$33,503.00
Total unrelated business revenue$0.00$0.00$0.00$0.00$0.00
Other revenue, current yr-$22,432.00-$14,760.00-$13,815.00$19,493.00$3,095.00
Net unrelated business taxable revenue$0.00$0.00$0.00$0.00$0.00
Program service revenue (total) $0.00$0.00$0.00$0.00
Gross receipts$105,374.00$108,774.00$159,647.00$145,005.00$51,957.00
Sources of contributions
Revenue from fundraising events$26,166.00$33,617.00$23,000.00$13,000.00 
Revenue from all other contributions$31,904.00$27,448.00$83,146.00$52,112.00$33,503.00
Other types of revenue
Income from dividends, interest, and similar investments$7,459.00$7,713.00$8,349.00$15,790.00$8,762.00
Net rental income-$386.00-$406.00-$532.00-$416.00-$406.00
Net income from fundraising events-$22,046.00-$14,354.00-$13,283.00$19,909.00$3,501.00
Expense categories (totals)
Total functional expenses: sum of all$27,105.00$241,312.00$62,653.00$52,628.00$52,475.00
Total functional expenses: program service $19,268.00$233,701.00$56,602.00$43,868.00$39,133.00
Total functional expenses: management and general$0.00$0.00$0.00$0.00$0.00
Total functional expenses: fundraising$7,837.00$7,611.00$6,051.00$8,760.00$13,342.00
Fees for services
Fundraising service fees (total)$0.00$0.00$0.00$0.00$0.00
Assets and liabilities
Total assets$1,524,398.00$1,663,514.00$1,677,003.00$1,624,368.00$1,537,286.00
Total assets, beginning of year$1,663,514.00$1,677,003.00$1,624,368.00$1,537,286.00$1,528,260.00
Total liabilities$1,286.00$174,036.00$657.00$2,792.00$7,609.00
Total liabilities, beginning of year$174,036.00$657.00$2,792.00$7,609.00$18,039.00
Unrestricted net assets, end of yr$1,280,448.00$1,257,556.00$1,446,048.00$1,386,370.00$1,325,652.00
Temporarily restricted net assets$242,664.00$231,922.00$230,298.00$235,206.00$204,025.00
Net assets$1,523,112.00$1,489,478.00$1,676,346.00$1,621,576.00$1,529,677.00
Net assets, beginning of year$1,489,478.00$1,676,346.00$1,621,576.00$1,529,677.00$1,510,221.00
Other liabilities$1,286.00$168,641.00$657.00$2,792.00$5,038.00
Other assets   $0.00$15.00
Investments: publicly traded securities$299,264.00$276,779.00$272,010.00$251,021.00$195,387.00
Cash: non-interest bearing   $0.00$225,675.00
Cash: non-interest bearing, beginning of year   $225,675.00$229,396.00
Inventories for sale or use    $0.00
Other financial variables
Revenue less expenses$25,569.00-$175,117.00$51,317.00$47,767.00-$7,115.00
Savings & temp cash investment$1,040,686.00$1,198,223.00$1,212,417.00$1,176,706.00$915,504.00
Accounts payable & accrued expenses$0.00$5,395.00 $0.00$2,571.00
Total net assets or fund balances$1,523,112.00$1,489,478.00$1,676,346.00$1,621,576.00$1,529,677.00
Depreciation, depletion, amortization$4,064.00$4,064.00$4,064.00$4,064.00$4,064.00
Governance and accountability
Number of voting members910101012
Number of independent voting members91010911
Financial sheets auditedTrueTrueTrueTrueTrue
Audit on consolidated basisTrueTrueTrueTrueTrue
Accrual accountingTrueTrueTrueTrueTrue
Tax year start date2016-01-012015-01-012014-01-012013-01-012012-01-01
Tax year end date2016-12-012015-12-012014-12-012013-12-012012-12-01
Indicators for schedules (selected)
Grants to domestic org/gov't >$5kTrueTrueTrueTrueTrue
Metadata about the filing
E-return type: 990, 990EZ, or 990PF990990990990990
Reason for form submission
Address change True   
Date e-filing submitted2017-12-282017-04-122016-02-102014-12-292013-12-30
IRS schema version2016v3.02015v2.12014v5.02013v3.02012v2.1
Filing identifier201703199349301835201643199349309544201543079349300609201443189349307889201343189349305394
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