WESTFIELD MEMORIAL HOSPITAL FOUNDATION INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
WESTFIELD MEMORIAL HOSPITAL FOUNDATION INC (EIN 22-2270533)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-12
IRS object ID
202123169349302677
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-11-12T07:07:37-08:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1JAMES W VANSTROM & COMPANYBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 532AddressLine1Txt
CityFALCONERCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14733ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN222270533EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WESTFIELD MEMORIAL HOSPITAL FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWESTBusinessNameControlTxt
Phone7167932338PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1189 EAST MAIN STREETAddressLine1Txt
CityWESTFIELDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14787ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKATHRYN BRONSTEINPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone7167932338PhoneNum
Signature2021-11-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstKATHRYNPersonFirstNm
Person LastBRONSTEINPersonLastNm

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHAROLD L BRUNACINI CPAPreparerPersonNm
PTINP01281305PTIN
Phone7166613960PhoneNum
Preparation2021-11-12PreparationDt
Self EmployedYes (X)SelfEmployedInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPATRICIA DIPALMAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1189 E MAIN STREETAddressLine1Txt
CityWESTFIELDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14787ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$241,414GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.westfieldhospitalfoundation.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1978FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTHE FOUNDATION IS OPERATED FOR THE PURPOSE OF PROMOTING COMMUNITY PHILANTHROPIC SUPPORT OF WESTFIELD MEMORIAL HOSPITAL AND TO PROVIDE FUNDING FOR EXPANSION AND MODERNIZATION OF THE HOSPITAL'S EQUIPMENT AND FACILITIES.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers18TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$274,595PYContributionsGrantsAmt
CY Contributions Grants$228,711CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$18,567PYInvestmentIncomeAmt
CY Investment Income$12,703CYInvestmentIncomeAmt
PY Other Revenue-$31,841PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$261,321PYTotalRevenueAmt
CY Total Revenue$241,414CYTotalRevenueAmt
PY Grants And Similar Paid$171,332PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$24,757CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$60,156CYTotalFundraisingExpenseAmt
PY Other Expenses$91,749PYOtherExpensesAmt
CY Other Expenses$81,145CYOtherExpensesAmt
PY Total Expenses$263,081PYTotalExpensesAmt
CY Total Expenses$105,902CYTotalExpensesAmt
PY Revenues Less Expenses-$1,760PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$135,512CYRevenuesLessExpensesAmt
Total Assets BOY$721,035TotalAssetsBOYAmt
Total Assets EOY$862,557TotalAssetsEOYAmt
Total Liabilities BOY$90,000TotalLiabilitiesBOYAmt
Total Liabilities EOY$90,000TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$631,035NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$772,557NetAssetsOrFundBalancesEOYAmt
MissionTHE FOUNDATION IS OPERATED FOR THE PURPOSE OF PROMOTING COMMUNITY PHILANTHROPIC SUPPORT OF WESTFIELD MEMORIAL HOSPITAL AND TO PROVIDE FUNDING FOR EXPANSION AND MODERNIZATION OF THE HOSPITAL'S EQUIPMENT AND FACILITIES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$31,948ExpenseAmt
Grant$24,757GrantAmt
Revenue$228,711RevenueAmt
DescPROVIDED GRANT FUNDING TOTALING $24,757 TO WESTFIELD MEMORIAL HOSPITAL FOR NECESSARY EQUIPMENT PURCHASES.Desc
Total Program Service Expenses$31,948TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonWESTFIELD MEMORIAL HOSPITAL FOUNDATPersonNm
Phone7167932338PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1189 EAST MAIN STREETAddressLine1Txt
CityWESTFIELDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP147871126ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
KATHRYN BRONSTEIN
PRESIDENT15.00Yes (X)Yes (X)$0$0$0
JON NORTHROP
VICE PRESIDENT2.00Yes (X)Yes (X)$0$0$0
CHRISTINE ADAMS
TREASURER15.00Yes (X)Yes (X)$0$0$0
COLLEEN MEEDER
SECRETARY2.00Yes (X)Yes (X)$0$0$0
ROSE VAN VOLKENBURG
DIRECTOR0.50Yes (X)$0$0$0
MARILYN HEMMER
DIRECTOR0.50Yes (X)$0$0$0
DIANA S HOLT
DIRECTOR0.50Yes (X)$0$0$0
DAN SMITH
DIRECTOR0.50Yes (X)$0$0$0
SHARA POST
DIRECTOR0.50Yes (X)$0$0$0
JORDAN STEVES
DIRECTOR0.50Yes (X)$0$0$0
MARY ANN WOLEBEN
DIRECTOR0.50Yes (X)$0$0$0
RALPH WALTON MD
DIRECTOR0.50Yes (X)$0$0$0
PATRICIA DIPALMA
DIR. OF DEVELOPMENT35.00Yes (X)$0$60,557$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$60,557TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Related Organizations$50,000RelatedOrganizationsAmt
All Other Contributions$178,711AllOtherContributionsAmt
Total Contributions$228,711TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,703TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$241,414TotalRevenueColumnAmt
Related Or Exempt Func Income$12,703RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$24,757TotalAmt
Program Services$24,757ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,965TotalAmt
Program Services$0ProgramServicesAmt
Management And General$2,965ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,045TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$2,045FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,456TotalAmt
Program Services$647ProgramServicesAmt
Management And General$647ManagementAndGeneralAmt
Fundraising$5,162FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,003TotalAmt
Program Services$0ProgramServicesAmt
Management And General$1,003ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
OTHER EXPENSES$3,240$0$2,639$601
SEE ATTACHED SCHEDULE$65,436$6,544$6,544$52,348

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$105,902TotalAmt
Program Services$31,948ProgramServicesAmt
Management And General$13,798ManagementAndGeneralAmt
Fundraising$60,156FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$84,714BOYAmt
EOY$103,931EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$470,938BOYAmt
EOY$53,129EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$75,725BOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$633,670EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$89,658BOYAmt
EOY$71,827EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$721,035BOYAmt
EOY$862,557EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$90,000BOYAmt
EOY$90,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$90,000BOYAmt
EOY$90,000EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$4,476BOYAmt
EOY$157,062EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$635,511BOYAmt
EOY$615,495EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$631,035BOYAmt
EOY$772,557EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$721,035BOYAmt
EOY$862,557EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$135,512ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$6,010NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedfalseFSAuditedInd
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type3 Func IntYes (X)SupportingOrgType3FuncIntInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1WESTFIELD MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN160743222EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$21,227SupportAmt
Other Support$3,530OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$21,227SupportSumAmt
Other Support Sum$3,530OtherSupportSumAmt
Public Support CY1700PublicSupportCY170Pct
Public Support Total509$0PublicSupportTotal509Amt
Public Support CY5090PublicSupportCY509Pct
Investment Income CY0InvestmentIncomeCYPct

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Excess Business HoldingsfalseExcessBusinessHoldingsInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp

FieldValueIRS element (for citing)
Timely Provided DocumentsYes (true)TimelyProvidedDocumentsInd
Officers Close RelationshipfalseOfficersCloseRelationshipInd
Supported Org Voice InvestmentfalseSupportedOrgVoiceInvestmentInd

Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp

FieldValueIRS element (for citing)
Activities TestYes (X)ActivitiesTestInd
Activities Further Exempt PrpsYes (true)ActivitiesFurtherExemptPrpsInd
Activities Engaged Org InvlmntYes (true)ActivitiesEngagedOrgInvlmntInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt IV Sec D Ln 2MANAGEMENT OF THE SUPPORTED ORGANIZATION ARE INVITED TO ATTEND MEETINGS OF THE FOUNDATION BOARD OF DIRECTORS AND ARE PROVIDED WITH MONTHLY FINANCIAL STATEMENTS.
Pt IV Sec E Ln 2aTHE FOUNDATION IS OPERATED FOR THE PURPOSE OF PROMOTING COMMUNITY PHILANTHROPIC SUPPORT OF WESTFIELD MEMORIAL HOSPITAL AND TO PROVIDE FUNDING FOR EXPANSION AND MODERNIZATION OF THE HOSPITAL'S EQUIPMENT AND FACILITIES, WHICH ARE KEY TO FURTHERING THE HOSPITAL'S EXEMPT PURPOSES. THE FOUNDATION IS RESPONSIVE TO THE HOSPITAL THROUGH ONGOING DISCUSSIONS REGARDING THE HOSPITAL'S NEEDS.
Pt IV Sec E Ln 3bTHE FOUNDATION'S ACTIVITIES INCLUDE FUNDRAISING ACTIVITIES TO PROVIDE FUNDING FOR EXPANSION AND MODERNIZATION OF THE HOSPITAL'S EQUIPMENT AND FACILITIES, AS WELL AS COMMUNITY EDUCATION AND AWARENESS ACTIVIES REGARDING PUBLIC HEALTH ISSUES. THESE ARE ALL ACTIVIES THAT WOULD BE CONDUCTED BY THE HOSPITAL, WAS IT NOT FOR THE INVOLVEMENT OF THE FOUNDATION.

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$89,658BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$10,129InvestmentEarningsOrLossesAmt
Grants Or Scholarships$27,119GrantsOrScholarshipsAmt
Administrative Expenses$841AdministrativeExpensesAmt
End Year Balance$71,827EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$74,652BeginningYearBalanceAmt
Contributions$400ContributionsAmt
Investment Earnings Or Losses$14,606InvestmentEarningsOrLossesAmt
End Year Balance$89,658EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$79,860BeginningYearBalanceAmt
Investment Earnings Or Losses-$5,208InvestmentEarningsOrLossesAmt
End Year Balance$74,652EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$70,211BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$9,649InvestmentEarningsOrLossesAmt
End Year Balance$79,860EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$64,489BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$5,722InvestmentEarningsOrLossesAmt
End Year Balance$70,211EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.01000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.99000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescENDOWMENT FUNDDesc
Book Value$71,827BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$71,827TotalBookValueOtherAssetsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePt V, Line 4FormAndLineReferenceDesc
ExplanationAN ENDOWMENT FUND IS HELD AT THE NORTHERN CHAUTAUQUA COMMUNITY FOUNDATION FOR THE PURPOSE OF PROMOTING PHILANTHROPIC SUPPORT OF WESTFIELD MEMORIAL HOSPITAL AND TO PROVIDE FUNDING FOR THE EXPANSION AND MODERNIZATION OF THE HOSPITAL'S EQUIPMENT AND FACILITIES.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1WESTFIELD MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1189 E MAIN STREETAddressLine1Txt
CityWESTFIELDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14787ZIPCd
FieldValueIRS element (for citing)
Recipient EIN160743222RecipientEIN
Cash Grant$21,227CashGrantAmt
Non Cash Assistance$3,530NonCashAssistanceAmt
Valuation Method UsedFMVValuationMethodUsedDesc
Non Cash AssistanceSTAFF SUPPORTNonCashAssistanceDesc
Purpose Of GrantEQUIPMENTPurposeOfGrantTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt VI, Line 11bFORM 990 IS REVIEWED IN DETAIL BY THE ORGANIZATION'S EXECUTIVE OFFICERS PRIOR TO FILING, WHO REVIEW IT WITH THE BOARD OF DIRECTORS SUBSEQUENT TO FILING.
Pt VI, Line 12cCOMPLIANCE IS MONITORED ON AN ANNUAL BASIS THROUGH UPDATED DISCLOSURES.
Pt VI, Line 19DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1WESTFIELD MEMORIAL HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1189 MAIN STAddressLine1Txt
CityWESTFIELDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14787ZIPCd
FieldValueIRS element (for citing)
EIN160743222EIN
Primary ActivitiesHEALTH CAREPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Exempt Code Section501 (c)(3)ExemptCodeSectionTxt
Public Charity Status3PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NONEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
WESTFIELD MEMORIAL HOSPITAL INC
B$24,757ACTUAL COST
WESTFIELD MEMORIAL HOSPITAL INC
P$65,436ACTUAL COST
HIGHMARK HEALTH
C$50,000ACTUAL COST

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