WESTFIELD MEMORIAL HOSPITAL FOUNDATION INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
WESTFIELD MEMORIAL HOSPITAL FOUNDATION INC (EIN 22-2270533)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-12
IRS object ID
202013179349301856
Schema version
2019v5.1
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)
Return2020-11-12T06:41:44-08:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

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 Begin2019-01-01TaxPeriodBeginDt

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
Signature2020-11-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHAROLD L BRUNACINI CPAPreparerPersonNm
PTINP01281305PTIN
Phone7166613960PhoneNum
Preparation2020-11-12PreparationDt
Self EmployedYes (X)SelfEmployedInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address64.66.125.6IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-12IPDt
IP Tm06:41:35IPTm
IP TimezonePSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id4FC0228D3F5335B01130870EAA13853B4B2CECBFAtSubmissionCreationDeviceId
At Submission Filing Device Id4FC0228D3F5335B01130870EAA13853B4B2CECBFAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

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$308,293GrossReceiptsAmt
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 Body17VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers18TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$326,628PYContributionsGrantsAmt
CY Contributions Grants$274,595CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income-$2,656PYInvestmentIncomeAmt
CY Investment Income$18,567CYInvestmentIncomeAmt
PY Other Revenue-$46,496PYOtherRevenueAmt
CY Other Revenue-$31,841CYOtherRevenueAmt
PY Total Revenue$277,476PYTotalRevenueAmt
CY Total Revenue$261,321CYTotalRevenueAmt
PY Grants And Similar Paid$44,254PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$171,332CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$70,509CYTotalFundraisingExpenseAmt
PY Other Expenses$90,517PYOtherExpensesAmt
CY Other Expenses$91,749CYOtherExpensesAmt
PY Total Expenses$134,771PYTotalExpensesAmt
CY Total Expenses$263,081CYTotalExpensesAmt
PY Revenues Less Expenses$142,705PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,760CYRevenuesLessExpensesAmt
Total Assets BOY$660,491TotalAssetsBOYAmt
Total Assets EOY$721,035TotalAssetsEOYAmt
Total Liabilities BOY$27,696TotalLiabilitiesBOYAmt
Total Liabilities EOY$90,000TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$632,795NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$631,035NetAssetsOrFundBalancesEOYAmt
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$179,813ExpenseAmt
Grant$171,332GrantAmt
Revenue$261,321RevenueAmt
DescPROVIDED GRANT FUNDING TOTALING $171,332 TO WESTFIELD MEMORIAL HOSPITAL FOR NECESSARY EQUIPMENT PURCHASES.Desc
Total Program Service Expenses$179,813TotalProgramServiceExpensesAmt
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 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
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 ContriYes (true)DeductibleNonCashContriInd
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 ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclfalseQuidProQuoContriDisclInd
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 Members17GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
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 (17 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
ROBERT BATTAGLIN
VICE PRESIDENT2.00Yes (X)Yes (X)$0$0$0
TERESA L CASLER
TREASURER15.00Yes (X)Yes (X)$0$0$0
KELLY DIMITRI
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
LINDA PROBST
DIRECTOR0.50Yes (X)$0$0$0
MARY ANN WOLEBEN
DIRECTOR0.50Yes (X)$0$0$0
DEBORAH L PERRY
DIRECTOR0.50Yes (X)$0$0$0
COLLEEN MEEDER
DIRECTOR0.50Yes (X)$0$0$0
JON NORTHROP
DIRECTOR0.50Yes (X)$0$0$0
MARK ODELL
DIRECTOR0.50Yes (X)$0$0$0
JORDAN STEVES
DIRECTOR0.50Yes (X)$0$0$0
RALPH WALTON MD
DIRECTOR0.50Yes (X)$0$0$0
PATRICIA DIPALMA
DIR. OF DEVELOPMENT35.00Yes (X)$0$59,861$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$59,861TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Fundraising$74,345FundraisingAmt
Related Organizations$50,000RelatedOrganizationsAmt
All Other Contributions$150,250AllOtherContributionsAmt
Noncash Contributions$31,568NoncashContributionsAmt
Total Contributions$274,595TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,567TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$15,131FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$74,345ContriRptFundraisingEventAmt
Fundraising Direct Expenses$46,972FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$31,841TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$31,841ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$261,321TotalRevenueColumnAmt
Related Or Exempt Func Income$18,567RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$31,841ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$171,332TotalAmt
Program Services$171,332ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,978TotalAmt
Program Services$0ProgramServicesAmt
Management And General$2,978ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,067TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$1,067FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,726TotalAmt
Program Services$673ProgramServicesAmt
Management And General$673ManagementAndGeneralAmt
Fundraising$5,380FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$869TotalAmt
Program Services$0ProgramServicesAmt
Management And General$869ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
OTHER EXPENSES$2,030$0$431$1,599
SEE ATTACHED SCHEDULE$78,079$7,808$7,808$62,463

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$263,081TotalAmt
Program Services$179,813ProgramServicesAmt
Management And General$12,759ManagementAndGeneralAmt
Fundraising$70,509FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$37,683BOYAmt
EOY$84,714EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$466,926BOYAmt
EOY$470,938EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$81,230BOYAmt
EOY$75,725EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$74,652BOYAmt
EOY$89,658EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$660,491BOYAmt
EOY$721,035EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,822BOYAmt
EOY$0EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$24,874BOYAmt
EOY$90,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$27,696BOYAmt
EOY$90,000EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$104,485BOYAmt
EOY-$4,476EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$737,280BOYAmt
EOY$635,511EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$632,795BOYAmt
EOY$631,035EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$660,491BOYAmt
EOY$721,035EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,760ReconcilationRevenueExpnssAmt
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$81,332SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$81,332SupportSumAmt
Other Support Sum$0OtherSupportSumAmt
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$74,652BeginningYearBalanceAmt
Contributions$400ContributionsAmt
Investment Earnings Or Losses$14,606InvestmentEarningsOrLossesAmt
End Year Balance$89,658EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$64,489BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$5,722InvestmentEarningsOrLossesAmt
End Year Balance$70,211EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$62,715BeginningYearBalanceAmt
Contributions$3,650ContributionsAmt
Investment Earnings Or Losses-$1,876InvestmentEarningsOrLossesAmt
End Year Balance$64,489EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.31820BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.68180PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescENDOWMENT FUNDDesc
Book Value$89,658BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$89,658TotalBookValueOtherAssetsAmt

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 G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF TOURNAMENTEvent1Nm
Gross Receipts Event1$89,476GrossReceiptsEvent1Amt
Charitable Contri Event1$74,345CharitableContriEvent1Amt
Gross Revenue Event1$15,131GrossRevenueEvent1Amt
Non Cash Prizes Event1$30,202NonCashPrizesEvent1Amt
Rent Facility Costs Event1$6,658RentFacilityCostsEvent1Amt
Food And Beverage Event1$7,324FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$2,788OtherDirectExpensesEvent1Amt
Gross Receipts Total$89,476GrossReceiptsTotalAmt
Charitable Contributions Tot$74,345CharitableContributionsTotAmt
Gross Revenue Total Events$15,131GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$30,202NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$6,658RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$7,324FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$2,788OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$46,972DirectExpenseSummaryEventsAmt
Net Income Summary-$31,841NetIncomeSummaryAmt

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$81,332CashGrantAmt
Valuation Method UsedFMVValuationMethodUsedDesc
Purpose Of GrantEQUIPMENTPurposeOfGrantTxt

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
DescGOLF TOURNAMENT EXPENSEDesc
Contribution122ContributionCnt
Noncash Contributions Rpt F990$31,568NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

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$171,332CASH GRANT, FMV
SAINT VINCENT HEALTH SYSTEM
C$50,000CASH GRANT
WESTFIELD MEMORIAL HOSPITAL INC
P$78,079ACTUAL COST

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