MONTEFIORE NYACK HOSPITAL FOUNDATION INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- MONTEFIORE NYACK HOSPITAL FOUNDATION INC (EIN 13-3245804)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-12
- IRS object ID
- 201823169349303197
- Schema version
- 2017v2.3
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-12T13:35:52-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 TIMES SQUARE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 133245804 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NYACK HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % RONALD RATIGAN | InCareOfNm |
| Business Name Control | NYAC | BusinessNameControlTxt |
| Phone | 8453482107 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 160 NORTH MIDLAND AVENUE | AddressLine1Txt |
| City | NYACK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 109601912 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN S BURKE | PersonNm |
| Person Title | Treasurer/CFO | PersonTitleTxt |
| Phone | 8453482107 | PhoneNum |
| Signature | 2018-11-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRISTOPHER B BOGGS | PreparerPersonNm |
| PTIN | P00032493 | PTIN |
| Phone | 2127733000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 164.57.159.254 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 26308520183165000013 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-11-12 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 24558E047A149CE0743DDA4F89040DC2FD5B7974 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D7645E384763AEB8339B885771554B833BC3ADBE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK GELLER MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 160 NORTH MIDLAND AVENUE | AddressLine1Txt |
| City | NYACK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 109601912 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $866,610 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | https://www.nyackhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | To financially support healthcare initiatives of Nyack Hospital whose services benefit the residents of Rockland County. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 2 | TotalEmployeeCnt |
| Total Volunteers | 55 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $475,920 | PYContributionsGrantsAmt |
| CY Contributions Grants | $761,037 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $26,940 | CYInvestmentIncomeAmt |
| PY Other Revenue | $35,078 | PYOtherRevenueAmt |
| CY Other Revenue | $697 | CYOtherRevenueAmt |
| PY Total Revenue | $510,998 | PYTotalRevenueAmt |
| CY Total Revenue | $788,674 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,180,107 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $883,172 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $166,867 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $303,953 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $360,896 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $54,973 | PYOtherExpensesAmt |
| CY Other Expenses | $66,884 | CYOtherExpensesAmt |
| PY Total Expenses | $1,401,947 | PYTotalExpensesAmt |
| CY Total Expenses | $1,254,009 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$890,949 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$465,335 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,381,019 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,079,233 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,731 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $126,093 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,358,288 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,953,140 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO FINANCIALLY SUPPORT HEALTHCARE INITIATIVES OF NYACK HOSPITAL WHOSE SERVICES BENEFIT THE RESIDENTS OF ROCKLAND COUNTY. THE FOUNDATION RAISES FUNDS FOR NYACK HOSPITAL AND ASSISTS THE HOSPITAL IN PURCHASING STATE-OF-THE-ART EQUIPMENT, DEVELOPING PROGRAMS AND SERVICES, AND AIDING IN FACILITY IMPROVEMENT INITIATIVES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $893,113 | ExpenseAmt |
| Grant | $883,172 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | TO RAISE FUNDS FOR NYACK HOSPITAL, A RELATED ORGANIZATION EXEMPT UNDER IRC SECTION 501(C)(3). THE FOUNDATION ASSISTS THE HOSPITAL IN PURCHASING STATE-OF-THE-ART EQUIPMENT, DEVELOPING PROGRAMS AND SERVICES, AND AIDING IN FACILITY IMPROVEMENT INITIATIVES. DURING 2017, THE FOUNDATION DISTRIBUTED $878,942 TO NYACK HOSPITAL. | Desc |
| Total Program Service Expenses | $893,113 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 2 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RONALD RATIGAN | PersonNm |
| Phone | 8453486522 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 160 NORTH MIDLAND AVENUE | AddressLine1Txt |
| City | NYACK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 109601912 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| MARK JACOBS | |||||||
| CHAIRMAN | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MITCHELL COHN MD | |||||||
| VICE CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| EDWARD S FISHER DDS | |||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| VINCENT ABBATECOLA | |||||||
| TRUSTEE | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| FRANK BORELLI JR | |||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| MARK GELLER MD | |||||||
| PRESIDENT & CEO | 1.0 | 49.0 | Yes (X) | Yes (X) | $0 | $901,057 | $57,210 |
| DANIEL M JUECHTER | |||||||
| TRUSTEE | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| ROGER RAICHELSON MD | |||||||
| TRUSTEE | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| BRIGITTE SIMON | |||||||
| TRUSTEE | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| WILLIAM M TRUST JR | |||||||
| TRUSTEE | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| Paul Adler Esq | |||||||
| trustee | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| Cynthia Branca | |||||||
| Trustee (Elected 7/31/17) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Tiombe Tallie Carter Esq | |||||||
| Trustee (Elected 10/17/17) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Christopher Conover | |||||||
| Trustee (Elected 7/31/17) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Vanessa Reggiardo | |||||||
| Trustee (Elected 7/31/17) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| JOHN S BURKE | |||||||
| TREASURER/CFO | 1.0 | 49.0 | Yes (X) | $0 | $559,511 | $49,070 | |
| Johnnie M Cucco-Malloy | |||||||
| Exec Director/Chief Dev Off | 50.0 | 0.0 | Yes (X) | $147,994 | $0 | $29,393 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $147,994 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,460,568 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $135,673 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $267,444 | FundraisingAmt |
| Related Organizations | $15,000 | RelatedOrganizationsAmt |
| All Other Contributions | $478,593 | AllOtherContributionsAmt |
| Total Contributions | $761,037 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,940 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $26,940 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $64,583 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $267,444 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $77,936 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$13,353 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$13,353 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $14,050 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,050 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,050 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $788,674 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $27,637 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $883,172 | TotalAmt |
| Program Services | $883,172 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,387 | TotalAmt |
| Fundraising | $177,387 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,517 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $84,517 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,049 | TotalAmt |
| Fundraising | $42,049 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,407 | TotalAmt |
| Fundraising | $18,407 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,881 | TotalAmt |
| Fundraising | $15,881 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,051 | TotalAmt |
| Fundraising | $4,051 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $765 | TotalAmt |
| Fundraising | $765 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| DUES & SUBSCRIPTIONS | $11,868 | $0 | $0 | $11,868 |
| COMMUNITY INITIATIVES | $9,941 | $9,941 | $0 | $0 |
| PURCHASED SERVICES | $4,870 | $0 | $0 | $4,870 |
| OTHER MISCELLANEOUS | $1,101 | $0 | $0 | $1,101 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,254,009 | TotalAmt |
| Program Services | $893,113 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $360,896 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100 | BOYAmt |
| EOY | $100 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $525,272 | BOYAmt |
| EOY | $288,094 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,454,839 | BOYAmt |
| EOY | $1,172,171 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,585 | BOYAmt |
| EOY | $59,584 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,803,700 | BOYAmt |
| EOY | $3,004,934 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $537,523 | BOYAmt |
| EOY | $554,350 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,381,019 | BOYAmt |
| EOY | $5,079,233 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,094 | BOYAmt |
| EOY | $8,887 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,637 | BOYAmt |
| EOY | $117,206 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,731 | BOYAmt |
| EOY | $126,093 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,681,484 | BOYAmt |
| EOY | $1,768,785 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,476,804 | BOYAmt |
| EOY | $2,984,355 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,000 | BOYAmt |
| EOY | $200,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,358,288 | BOYAmt |
| EOY | $4,953,140 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,381,019 | BOYAmt |
| EOY | $5,079,233 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$465,335 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $60,187 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,006,474 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $334,996 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $563,970 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $475,920 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $761,037 | CurrentTaxYearAmt |
| Total | $3,142,397 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,006,474 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $334,996 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $563,970 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $475,920 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $761,037 | CurrentTaxYearAmt |
| Total | $3,142,397 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $1,073,059 | SubstantialContributorsTotAmt |
| Public Support Total170 | $2,069,338 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $36,439 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,352 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $44,728 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $26,940 | CurrentTaxYearAmt |
| Total | $127,459 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,269,856 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $478,461 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.63285 | PublicSupportCY170Pct |
| Public Support PY170 | 0.50539 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $200,000 | BeginningYearBalanceAmt |
| End Year Balance | $200,000 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $200,000 | BeginningYearBalanceAmt |
| End Year Balance | $200,000 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $200,000 | BeginningYearBalanceAmt |
| End Year Balance | $200,000 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $200,000 | BeginningYearBalanceAmt |
| End Year Balance | $200,000 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $200,000 | BeginningYearBalanceAmt |
| End Year Balance | $200,000 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CSV OF INSURANCE POLICIES | Desc |
| Book Value | $554,350 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $554,350 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $117,206 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $117,206 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4 | FormAndLineReferenceDesc |
| Explanation | INTENDED USE OF ENDOWMENT FUND: THE INTENDED USE OF THE FOUNDATION'S ENDOWMENT IS TO PROVIDE FUNDS TO BE USED FOR INDIGENT CARE BREAST HEALTH. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Golf Outing | Event1Nm |
| Gross Receipts Event1 | $278,275 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $218,462 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $59,813 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $253 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $51,548 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $10,275 | OtherDirectExpensesEvent1Amt |
| Event2 | 5K/10K Race | Event2Nm |
| Gross Receipts Event2 | $39,945 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $39,945 | CharitableContriEvent2Amt |
| Non Cash Prizes Event2 | $591 | NonCashPrizesEvent2Amt |
| Other Direct Expenses Event2 | $3,924 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $13,807 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $9,037 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $4,770 | GrossRevenueOtherEventsAmt |
| Non Cash Prizes Other Events | $0 | NonCashPrizesOtherEventsAmt |
| Rent Fclty Costs Other Events | $1,692 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $8,584 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $1,069 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $332,027 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $267,444 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $64,583 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $844 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $53,240 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $8,584 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $15,268 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $77,936 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$13,353 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NYACK HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 160 NORTH MIDLAND AVENUE | AddressLine1Txt |
| City | NYACK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10960 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 131740119 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $878,942 | CashGrantAmt |
| Purpose Of Grant | GENERAL SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART II, LINE 1 | FormAndLineReferenceDesc |
| Explanation | The Foundation distributes funds to Nyack Hospital for operational support. These grants are monitored by the organization's finance personnel and are based on the Foundation's operational activities. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN S BURKE | ||||||||||||||
| TREASURER/CFO | $0 | $557,635 | $0 | $0 | $0 | $1,876 | $0 | $8,100 | $0 | $40,970 | $0 | $608,581 | $0 | $0 |
| MARK GELLER MD | ||||||||||||||
| PRESIDENT & CEO | $0 | $897,445 | $0 | $0 | $0 | $3,612 | $0 | $16,200 | $0 | $41,010 | $0 | $958,267 | $0 | $0 |
| Johnnie M Cucco-Malloy | ||||||||||||||
| Exec Director/Chief Dev Off | $145,724 | $0 | $0 | $0 | $2,270 | $0 | $373 | $0 | $29,020 | $0 | $177,387 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION'S Board of Directors includes the President and CEO of Nyack Hospital, the top management official of the corporation, whose compensation is determined by the Hospital. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, Part VI, Line 6 | The elected Trustees of Nyack Hospital are the members of the Corporation. |
| FORM 990, PART VI, LINES 7A | The elected trustees of Nyack hospital, the members of the corporation, has the power to elect the directors of the Foundation's Board and remove any director, with or without cause, by a majority vote of the members. |
| FORM 990, PART VI, LINE 11B | The Form 990 was prepared by the Montefiore's tax department working closely with Nyack's Finance team and assisted by various departments throughout the Health System. The Form 990 was reviewed and approved by Montefiore's Vice President-Finance and the Nyack's hospital senior leadership including the Chief Financial Officer. In addition, an independent accounting firm was engaged to review the Form 990. Upon completion of the various reviews, the Form 990 was presented to the Nyack Foundation Board of Trustees for review and approval prior to filing. |
| FORM 990, PART VI, LINE 12C | THE FOUNDATION HAS ADOPTED THE CONFLICT OF INTEREST POLICY MAINTAINED BY NYACK HOSPITAL, THE PARENT ORGANIZATION. ALL MONITORING AND ENFORCEMENT OF THE CONFLICT OF INTEREST POLICY IS PERFORMED BY THE HOSPITAL ON BEHALF OF THE Foundation. The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy by means of an annual conflict of interest disclosure form that is distributed by the Hospital to all officers, trustees and key employees of the Foundation to complete. Should a possible conflict of interest arise in their responsibilities, the employee or Board member is required to notify their supervisor or the Director of Compliance, if an employee, or the Chair of the Board, if a Board Member, and abstain from any participation in the matter until the Hospital can determine whether an actual conflict exists and how that conflict shall be resolved. All identified conflicts of interests are presented to the Hospital's Board of Trustee's Audit and Compliance Committee for their review and decision when an actual conflict is determined. |
| FORM 990, PART VI, LINE 19 | The conflict of interest policy and governing documents are made available upon request. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (27 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| NYACK HOSPITAL | ||||||||||
| 160 NORTH MIDLAND AVENUE | NYACK | NY | 10960 | 131740119 | HOSPITAL | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| MONTEFIORE HEALTH SYSTEM INC | ||||||||||
| 555 SOUTH BROADWAY | TARRYTOWN | NY | 10591 | 201615393 | SUPPORT SERV | NY | 501(C)(3) | 12B TYPE II | MMAHS | Yes (true) |
| MONTEFIORE MEDICAL CENTER | ||||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 131740114 | ACD MED CTR | NY | 501(c)(3) | 3 | MHS | Yes (true) |
| MMC CORPORATION | ||||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 133430322 | REAL ESTATE | NY | 501(C)(3) | 12A TYPE I | MMC | Yes (true) |
| MMC RESIDENTIAL CORP I INC | ||||||||||
| 3411 WAYNE AVENUE | BRONX | NY | 10467 | 911943271 | STAFF HOUSING | NY | 501(C)(2) | MMC | Yes (true) | |
| MONTEFIORE HOSP HOUSING SECTION II Inc | ||||||||||
| 3450 Wayne Avenue | Bronx | NY | 10467 | 237160641 | Staff Housing | NY | 501(c)(2) | MMC | Yes (true) | |
| MOSHOLU PRESERVATION CORPORATION | ||||||||||
| 3400 RESEVOIR OVAL EAST | BRONX | NY | 10467 | 133109387 | COMMUNITY SER | NY | 501(C)(3) | 12A TYPE I | MMC | Yes (true) |
| GUN HILL MRI PC | ||||||||||
| 200 EAST GUNHILL ROAD | BRONX | NY | 10467 | 133734486 | DIAG SERVICES | NY | 501(C)(3) | 12A TYPE I | MMC | Yes (true) |
| MONTEFIORE NORTH AMBULATORY CARE CENTER | ||||||||||
| 4234 BRONX BOULEVARD | BRONX | NY | 10466 | 010796859 | AMB SERVICES | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| MONTEFIORE NEW ROCHELLE HOSPITAL | ||||||||||
| 16 GUION PLACE | NEW ROCHELLE | NY | 10801 | 462931956 | HOSPITAL | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| MONTEFIORE MOUNT VERNON HOSPITAL | ||||||||||
| 12 NORTH SEVENTH AVENUE | MOUNT VERNON | NY | 10550 | 462916938 | HOSPITAL | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| SCHAFFER EXTENDED CARE CENTER | ||||||||||
| 16 GUION PLACE | NEW ROCHELLE | NY | 10801 | 462929888 | NURSING HOME | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| MONTEFIORE FOUNDATION INC | ||||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 471600439 | INACTIVE | NY | 501(C)(3) | 7 | MMAHS | Yes (true) |
| ALBERT EINSTEIN COLLEGE OF MEDICINE | ||||||||||
| 1300 MORRIS PARK AVENUE | BRONX | NY | 10461 | 472209056 | MED COLLEGE | NY | 501(C)(3) | 2 | MMAHS | Yes (true) |
| MONTEFIORE MEDICINE ACAD HLTH SYST INC | ||||||||||
| 555 SOUTH BROADWAY | TARRYTOWN | NY | 10591 | 471582973 | SYS PARENT | NY | 501(C)(3) | 12B TYPE II | na | Yes (true) |
| WHITE PLAINS HOSPITAL MEDICAL CENTER | ||||||||||
| 41 EAST POST ROAD | WHITE PLAINS | NY | 10601 | 131740130 | HOSPITAL | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| AECOM STUDENT HOUSING CO INC | ||||||||||
| 1300 MORRIS PARK AVENUE | BRONX | NY | 10461 | 237075620 | STUDENT Hous | NY | 501(C)(2) | AECOM | Yes (true) | |
| MONTEFIORE CERC OPERATIONS INC | ||||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 474853506 | REHAB CENTER | NY | 501(C)(3) | 3 | MMC | Yes (true) |
| WHITE PLAINS HOSPITAL CTR FOUNDATIONINC | ||||||||||
| 41 EAST POST ROAD DAVIS AVE | WHITE PLAINS | NY | 10601 | 133281507 | FUNDRAISING | NY | 501(C)(3) | 12A TYPE I | WPHMC | Yes (true) |
| THE WINFFRED MASTERSON BURKE REHAB HOSP | ||||||||||
| 785 MAMARONECK AVENUE | WHITE PLAINS | NY | 10605 | 131739937 | REHAB HOSP | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| ST LUKE'S CORNWALL HOSPITAL | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 125504851 | 141340054 | HOSPITAL | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| HUDSON VISTA MEDICAL PC | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 125504851 | 452526738 | HEALTHCARE | NY | 501(C)(3) | 12a TYPE I | SLCH | Yes (true) |
| HUDSON VISTA PHYSICIAN SERVICES PC | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 125504851 | 272020746 | HEALTHCARE | NY | 501(C)(3) | 12A TYPE I | SLCH | Yes (true) |
| ST LUKE'S CORNWALL HEALTH SYSTEM INC | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 125504851 | 223026261 | HOLDING COMP | NY | 501(C)(3) | 12A TYPE I | MHS | Yes (true) |
| ST LUKE'S CORNWALL HEALTH SYS FOUNDATION | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 125504851 | 223026263 | FUNDRAISING | NY | 501(C)(3) | 7 | SLCHS | Yes (true) |
| AMOS AND SARAH HOLDEN HOME | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 125504851 | 141365995 | ASST LIVING | NY | 501(C)(3) | PF | SLCHS | Yes (true) |
| GOLDSMITH S AND MARY B JOHNES HOME | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 125504851 | 141364666 | HOME FOR AGED | NY | 501(C)(3) | 10 | SLCHS | Yes (true) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HIGHLAND MEDICAL PC | |||||||||
| 160 NORTH MIDLAND AVENUE | NYACK | NY | 10960 | 134034481 | HEALTHCARE SERV | NY | NA | C CORP | Yes (true) |
| UNIVERSITY BEHAVIORAL ASSOCIATES INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 133877781 | MGMT SERVICES | NY | NA | C CORP | Yes (true) |
| THE MONTEFIORE IPA INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 134114915 | INTEG PROVR ASSOC | NY | NA | C CORP | Yes (true) |
| MMC GI HOLDING EAST INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 721610013 | HOLDING COMPANY | NY | NA | C CORP | Yes (true) |
| MMC GI HOLDINGS WEST INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 721610015 | HOLDING COMPANY | NY | NA | C CORP | Yes (true) |
| MONTEFIORE BEHAVIORAL CARE IPA NO 1 INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 133952750 | INTEG PROVR ASSOC | NY | NA | C CORP | Yes (true) |
| BRONX ACCOUNTABLE CARE NETWORK IPA INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 300689571 | INTEG PROVR ASSOC | NY | NA | C CORP | Yes (true) |
| MONTEFIORE CONSOLIDATED VENTURES INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 611728539 | HOLDING COMPANY | NY | NA | C CORP | Yes (true) |
| MONTEFIORE INSURANCE COMPANY INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 320436594 | INACTIVE | NY | NA | C CORP | Yes (true) |
| HUDSON VALLEY IPA INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 383978087 | INACTIVE | NY | NA | C CORP | Yes (true) |
| MONTEFIORE INNOVATIONS INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 475106910 | INACTIVE | NY | NA | C CORP | Yes (true) |
| 8 LONGVIEW DEVELOPMENT CORP | |||||||||
| DAVIS AVENUE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 263321278 | HOUSING | NY | NA | C CORP | Yes (true) |
| WHITE PLAINS MEDICAL DIAGNOSTIC SVCS PC | |||||||||
| 41 EAST POST ROAD | WHITE PLAINS | NY | 10601 | 453164626 | HEALTHCARE SERV | NY | NA | C CORP | Yes (true) |
| CANCER AND BLOOD MEDICAL SERVICES OF NY | |||||||||
| 41 EAST POST ROAD | WHITE PLAINS | NY | 10601 | 462021804 | HEALTHCARE SERV | NY | NA | C CORP | Yes (true) |
| DAVIS AVENUE CORP | |||||||||
| DAVIS AVENUE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 133331643 | INACTIVE | NY | NA | C CORP | Yes (true) |
| WHITE PLAINS MANAGEMENT CO INC | |||||||||
| 41 EAST POST ROAD | WHITE PLAINS | NY | 10601 | 133331641 | INACTIVE | NY | NA | C CORP | Yes (true) |
| WPHC BUILDINGS CORP | |||||||||
| 41 EAST POST ROAD | WHITE PLAINS | NY | 10601 | 133676932 | INACTIVE | NY | NA | C CORP | Yes (true) |
| WHITE PLAINS MEDICAL SERVICES | |||||||||
| DAVIS AVENUE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 815369152 | HEALTHCARE SERV | NY | NA | C CORP | Yes (true) |
| WHITE PLAINS PHYSICIAN SERVICES | |||||||||
| DAVIS AVENUE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 815309615 | HEALTHCARE SERV | NY | NA | C CORP | Yes (true) |
| CHARITABLE REMAINDER TRUST (5) | |||||||||
| CHARIT REMR TRUST | NY | NA | TRUST | Yes (true) | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NYACK HOSPITAL | ||
| B | $878,942 | Current value |
| NYACK HOSPITAL | ||
| P | $311,621 | COST |
Comments