Floyd Valley Hospital Foundation in Le Mars, Iowa (IA)

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Floyd Valley Hospital Foundation
Employer Identification Number (EIN)204095776
Name of OrganizationFloyd Valley Hospital Foundation
In Care of NameMichael Donlin
Address714 Lincoln St Ne, Le Mars, IA 51031-3314
SubsectionCharitable Organization
Ruling Date09/2007
DeductibilityContributions are deductible
FoundationOrganizations operated solely for the benefit of and in conjunction with organizations described in 10 through 16 above
OrganizationCorporation
Exempt Organization StatusUnconditional Exemption
Tax Period06/2014
Assets$1,000,000 to $4,999,999
Income$1,000,000 to $4,999,999
Filing Requirement990 (all other) or 990EZ return
Asset Amount$1,701,604
Amount of Income$2,550,887
Form 990 Revenue Amount$2,510,176
National Taxonomy of Exempt Entities (NTEE)Health - General and Rehabilitative: Single Organization Support


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Amount of income in 2014: $2,550,887 (it was $218,192 in 2013)
Floyd Valley Hospital Foundation: 

 $2,550,887
Other organizations performing similar types of work: 

 $423,049

Assets in 2014: $1,701,604 (it was $442,700 in 2013)
Floyd Valley Hospital Foundation: 

 $1,701,604
Other organizations performing similar types of work: 

 $987,793

Expenses in 2013: $50,687
Floyd Valley Hospital Foundation: 

 $50,687
Other organizations performing similar types of work: 

 $213,481

Income to expenses ratio in 2013: 50.3
This organization: 

 50.3
Other organizations performing similar types of work: 

 2.8

Grants share in income in 2013: 62.9%
This organization: 

 62.9%
Other organizations performing similar types of work: 

 52.7%

Financial snapshot ($)

Revenue for 2013

Assets at the end of 2013

Functional expenses for 2013

Checklist
20122013
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?Yes
Is the organization required to complete Schedule B, Schedule of Contributors?Yes
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office?No
Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year?No
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19?No
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts?No
Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures?No
Did the organization maintain collections of works of art, historical treasures, or other similar assets?No
Did the organization report an amount for escrow or custodial account liability; serve as a custodian or provide credit counseling, debt management, credit repair, or debt negotiation services?No
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments?Yes
Did the organization report an amount for land, buildings, and equipment?No
Did the organization report an amount for investments-other securities that is 5% or more of its total assets?Yes
Did the organization report an amount for investments-program related that is 5% or more of its total assets?No
Did the organization report an amount for other assets that is 5% or more of its total assets?No
Did the organization report an amount for other liabilities?No
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)?Yes
Did the organization obtain separate, independent audited financial statements for the tax year?No
Was the organization included in consolidated, independent audited financial statements for the tax year?Yes
Is the organization a school described in section 170(b)(1)(A)(ii)?No
Did the organization maintain an office, employees, or agents outside of the United States?No
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more?No
Did the organization report more than $5,000 of grants or other assistance to or for any foreign organization?No
Did the organization report more than $5,000 of aggregate grants or other assistance to or for foreign individuals?No
Did the organization report a total of more than $15,000 of expenses for professional fundraising services?Yes
Did the organization report more than $15,000 total of fundraising event gross income and contributions?Yes
Did the organization report more than $15,000 of gross income from gaming activities?No
Did the organization operate one or more hospital facilities?No
Did the organization attach a copy of its audited financial statements?No
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government?No
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals?No
Did the organization answer 'Yes' about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees?No
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002?No
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?No
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?No
Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year?No
Did the organization engage in an excess benefit transaction with a disqualified person during the year?No
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?No
Did the organization report any amount for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?No
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons?No
Was the organization a party to a business transaction with one of the following parties
A current or former officer, director, trustee, or key employee?No
A family member of a current or former officer, director, trustee, or key employee?No
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner?No
Did the organization receive more than $25,000 in non-cash contributions?No
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions?No
Did the organization liquidate, terminate, or dissolve and cease operations?No
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?No
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?No
Was the organization related to any tax-exempt or taxable entity?No
Did the organization have a controlled entity within the meaning of section 512(b)(13)?No
Did the organization make any transfers to an exempt non-charitable related organization?No
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes?No
Statements Regarding Other IRS Filings and Tax Compliance
201120122013
The number reported in Box 3 of Form 10960
The number of Forms W-2G0
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?No
The number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return0
Did the organization file all required federal employment tax returns?No
Did the organization have unrelated business gross income of $1,000 or more during the year?No
Has it filed a Form 990-T for this year?No
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?No
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?No
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?No
Did the organization file Form 8886-T?No
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?No
Did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?No
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?Yes
Did the organization notify the donor of the value of the goods or services provided?Yes
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?No
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?No
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?No
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?No
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?No
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?No
Did the sponsoring organization make any taxable distributions under section 4966?No
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?No
Initiation fees and capital contributions$0
Gross receipts for public use of club facilities $0
Gross income from members or shareholders$0
Gross income from other sources$0
Is the organization filing Form 990 in lieu of Form 1041?No
The amount of tax-exempt interest received or accrued during the year$0
Is the organization licensed to issue qualified health plans in more than one state?No
The amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans$0
The amount of reserves on hand$0
Did the organization receive any payments for indoor tanning services during the tax year?No
Has it filed a Form 720 to report these payments?No
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
20122013
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
Total reportable compensation from the organization$0
Total reportable compensation from related organizations$0
Total estimated amount of other compensation from the organization and related organizations$0
Total number of individuals who received more than $100,000 of reportable compensation from the organization0
Total number of independent contractors who received more than $100,000 of compensation from the organization0
Statement of Revenue
201120122013
Total revenue$155,773
Contributions, Gifts, Grants and Other Similar Amounts$97,926
Program Service Revenue$0
Other Revenue
Investment income (including dividends, interest, and other similar amounts)$35,495
Income from investment of tax-exempt bond proceeds$0
Royalties$0
Net rental income$0
Net gain/loss from sales of assets other than inventory$0
Net income/loss from fundraising events$-3,234$55,401$22,352
Gross income from fundraising events$84,771
Less: direct expenses$62,419
Net income/loss from gaming activities$0
Net income/loss from sales of inventory$0
Miscellaneous Revenue$0
Statement of Functional Expenses
201120122013
Total functional expenses$50,687
Grants and other assistance to domestic organizations and domestic governments$3,027
Grants and other assistance to domestic individuals$0
Grants and other assistance to foreign organizations, foreign governments, and foreign individuals$0
Benefits paid to or for members$0
Compensation of current officers, directors, trustees, and key employees$0
Compensation not included above, to disqualified persons$0
Other salaries and wages$0
Pension plan accruals and contributions$0
Other employee benefits$0
Payroll taxes$0
Fees for services (non-employees)
Management$0
Legal$0
Accounting$0
Lobbying$0
Professional fundraising services$32,545
Investment management fees$0
Other$0
Advertising and promotion$0
Office expenses$3,558
Information technology$0
Royalties$0
Occupancy$0
Travel$0
Payments of travel or entertainment expenses for any federal, state, or local public officials$0
Conferences, conventions, and meetings$0
Interest$0
Payments to affiliates$0
Depreciation, depletion, and amortization$0
Insurance$0
Other expenses$11,557
Balance Sheet
201120122013
Total assets$404,053$294,754$442,700
Cash - non-interest-bearing$24,697
Savings and temporary cash investments$0
Pledges and grants receivable, net$1,674
Accounts receivable, net$0
Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees$0
Loans and other receivables from other disqualified persons, persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations$0
Notes and loans receivable, net$0
Inventories for sale or use$0
Prepaid expenses and deferred charges$0
Land, buildings, and equipment: cost or other basis$0
Investments - publicly traded securities$0
Investments - other securities$416,329
Investments - program-related$0
Intangible assets$0
Other assets$0
Total liabilities$31$254$43,114
Accounts payable and accrued expenses$43,114
Grants payable$0
Deferred revenue$0
Tax-exempt bond liabilities$0
Escrow or custodial account liability$0
Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons$0
Secured mortgages and notes payable to unrelated third parties$0
Unsecured notes and loans payable to unrelated third parties$0
Other liabilities (including federal income tax, payables to related third parties, and other liabilities)$0
Total net assets or fund balances$399,586
Unrestricted net assets$208,968
Temporarily restricted net assets$177,141
Permanently restricted net assets$13,477
Capital stock or trust principal, or current funds$0
Paid-in or capital surplus, or land, building, or equipment fund$0
Retained earnings, endowment, accumulated income, or other funds$0
Reason for Public Charity Status (for 2013)
The organization is not a private foundation because it is:An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2)
Number of organizations supported1
Sum of amounts of support$3,027
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Organizations performing similar types of work
IdNameAddressStateEstablishedTotal Income
1St Bernard Foundation326 W 64th St, Chicago, IL 60621-3114IL1946-03$61,670,906
2Grmc Foundation Corp1221 S Gear Ave, W Burlington, IA 52655-1679IA1984-08$53,197,848
3St Anthony FoundationPO BOX 628, Carroll, IA 51401-0628IA1946-03$4,538,605
4Risb Foundation2415 De La Vina St, Santa Barbara, CA 93105-3819CA2007-10$3,691,314
5Texas Hospital Association Foundation1108 Lavaca St Ste 700, Austin, TX 78701-2180TX2008-05$3,393,875
6Mercy Health Foundation Springfield1235 E Cherokee St, Springfield, MO 65804-2203MO1946-03$2,688,983
7Spring Valley Inc610 10th St, Perry, IA 50220-2221IA1975-06$1,134,465
8Grinnell General Hospital Auxiliary210 4th Ave, Grinnell, IA 50112-1898IA1970-07$293,124
9The Elizabeth Blackwell Foundation Inc525 E 68th St Box 156, New York, NY 10065-4870NY1987-09$15,612
10Sinai Health SystemCalifornia Ave 15th St, Chicago, IL 60608IL1982-01$145,745,330
11Sibley Memorial Hospital Foundation5255 Loughboro Rd Nw, Washington, DC 20016-2633DC2008-03$59,456,527
12Courage Kenny FoundationPO BOX 43, Minneapolis, MN 55440-0043MN2000-03$40,441,978
13Memorial Foundation Of Allen Hospital1825 Logan Ave, Waterloo, IA 50703-1916IA1991-09$6,724,494
14Floyd Valley Hospital Foundation714 Lincoln St Ne, Le Mars, IA 51031-3314IA2007-09$2,550,887
15Mercy Auxiliary Of Central Iowa1111 6th Avenue, Des Moines, IA 50314-2610IA1956-11$2,232,974
16Dubuque Mercy Health Foundation250 Mercy Dr, Dubuque, IA 52001-7320IA2008-09$654,815
17Baum Harmon Mercy Hospital And Clinics Foundation255 N Welch Ave, Primghar, IA 51245-7765IA2010-01$157,056
18Pocahontas Community Healthcare Foundation606 Nw 7th St, Pocahontas, IA 50574-1028IA2001-01$133,932
19Audubon County Hospital Foundation515 Pacific Ave, Audubon, IA 50025-1056IA1994-11$95,192
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Number of organizations performing similar types of work
Alaska4
Alabama1
Arkansas8
Arizona8
California43
Colorado13
Connecticut5
District of Columbia4
Delaware1
Florida21
Georgia18
Hawaii8
Iowa14
Idaho4
Illinois37
Indiana12
Kansas8
Kentucky12
Louisiana13
Massachusetts16
Maryland8
Maine2
Michigan25
Minnesota18
Missouri24
Mississippi1
Montana4
North Carolina19
North Dakota6
Nebraska7
New Hampshire1
New Jersey14
New Mexico1
Nevada4
New York47
Ohio29
Oklahoma13
Oregon12
Pennsylvania21
Rhode Island5
South Carolina12
South Dakota4
Tennessee7
Texas49
Utah5
Virginia20
Vermont3
Washington16
Wisconsin17
West Virginia6
Wyoming5
International10
Total665

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