MARIN GENERAL HOSPITAL FOUNDATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MARIN GENERAL HOSPITAL FOUNDATION (EIN 94-6127213)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-14
- IRS object ID
- 201723189349304672
- Schema version
- 2016v3.0
- 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 | 2017-11-14T13:41:59-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Moss Adams LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 Second Street Suite 900 | AddressLine1Txt |
| City | San Francisco | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 946127213 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Marin General Hospital Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MARI | BusinessNameControlTxt |
| Phone | 4159257770 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100B Drakes Landing Road No 255 | AddressLine1Txt |
| City | Greenbrae | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94904 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | James McManus | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4159257770 | PhoneNum |
| Signature | 2017-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Joua V Lo | PreparerPersonNm |
| PTIN | P01225144 | PTIN |
| Phone | 4159561500 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 73.90.206.235 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-13 | IPDt |
| IP Tm | 19:19:02 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 189799C539B232A8D1FA5D0851A612580EB85C47 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Elizabeth Kolcun | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100B Drakes Landing Road No 255 | AddressLine1Txt |
| City | Greenbrae | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,084,161 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.maringeneral.org/foundation-new | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1966 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO SUPPORT AND COORDINATE FUNDRAISING FOR HOSPITAL PROGRAMS, FACILITIES, EQUIPMENT, AND OTHER RELATED HEALTHCARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 24 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 22 | VotingMembersIndependentCnt |
| Total Employee | 5 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $17,346,256 | PYContributionsGrantsAmt |
| CY Contributions Grants | $16,672,975 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $382,124 | PYInvestmentIncomeAmt |
| CY Investment Income | $225,631 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$284,450 | PYOtherRevenueAmt |
| CY Other Revenue | -$434,533 | CYOtherRevenueAmt |
| PY Total Revenue | $17,443,930 | PYTotalRevenueAmt |
| CY Total Revenue | $16,464,073 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,063,703 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,114,073 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $494,766 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $29,855 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $390,000 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $613,201 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $806,504 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $437,433 | PYOtherExpensesAmt |
| CY Other Expenses | $340,955 | CYOtherExpensesAmt |
| PY Total Expenses | $5,385,902 | PYTotalExpensesAmt |
| CY Total Expenses | $4,098,084 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $12,058,028 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $12,365,989 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $33,779,187 | TotalAssetsBOYAmt |
| Total Assets EOY | $45,729,199 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $868,671 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $247,720 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $32,910,516 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $45,481,479 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To support and coordinate fundraising for hospital programs, facilities, equipment, and other related healthcare services. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $219,794 | ExpenseAmt |
| Grant | $219,794 | GrantAmt |
| Desc | Support for operations of Haynes Cardiovascular Center. The Haynes Center encompasses all cardiac-related programs and services at Marin General Hospital. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,764,843 | ExpenseAmt |
| Grant | $1,764,843 | GrantAmt |
| Desc | Funds transferred to the hospital to purchase of Linear Accelerator used for cancer treatment. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $232,639 | ExpenseAmt |
| Grant | $232,639 | GrantAmt |
| Desc | OPERATIONS OF THE OUTPATIENT BRADEN DIABETES CENTER. The center provides care for diabetes patients. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $910,684 | ExpenseAmt |
| Grant | $896,797 | GrantAmt |
| Desc | Support to the hospital for various other programs including, but not limited to: - GENITOURINARY PROGRAM - VASCULAR RESEARCH - COMMUNITY HEALTH FUND - DIABETES FUND - WOMEN AND CHILDREN'S SERVICES - INDIGENT FUND - SPINE & BRAIN FUND - STROKE CENTER | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $910,684 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $896,797 | TotalOtherProgSrvcGrantAmt |
| Total Program Service Expenses | $3,127,960 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 5 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 24 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 22 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jean Noonan | PersonNm |
| Phone | 4159257449 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100B DRAKES LANDING SUITE 190 | AddressLine1Txt |
| City | GREENBRAE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 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 | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ANDREA SCHULTZ | ||||||||
| CHAIR | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KAREN PELL | ||||||||
| VICE CHAIR | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BRUCE BRADEN | ||||||||
| TREASURER | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TUCKY POGUE | ||||||||
| SECRETARY | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PAT ABRAMS | ||||||||
| BOARD MEMBER-AT-LARGE | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN GILARDI | ||||||||
| BOARD MEMBER-AT-LARGE | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LYDIA CAMERON | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JEFFREY DIETZ MD | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SHARON EARLY | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT ELLIS MD | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| PATTY GARBARINO | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BOBBIE HEAD MD | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| NANCY KNIESCHE | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GEOFFREY KOBLICK | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MARIA PITCAIRN | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| HELEN PRINCIPE RN | ||||||||
| BOARD MEMBER | 0.50 | 40.00 | Yes (X) | $0 | $126,115 | $47,656 | ||
| SALLY SHEKOU | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID SPERLING MD | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| MIKE STONE | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| BRIAN SU MD | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SPENCER WANG | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CATHIE BENNETT WARNER | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| H WARD WOLFF | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LEE DOMANICO | ||||||||
| MGH CEO (Ex Officio) | 2.00 | 48.00 | Yes (X) | $0 | $1,219,042 | $18,421 | ||
| ELIZABETH KOLCUN | ||||||||
| MGH Foundation President | 46.00 | 4.00 | Yes (X) | $0 | $158,920 | $20,965 | ||
| JON D FRIEDENBERG | ||||||||
| MGH COO (Ex Officio) | 2.00 | 48.00 | Yes (X) | $0 | $516,333 | $48,173 | ||
| JAMES P MCMANUS | ||||||||
| MGH CHIEF FINANCIAL OFFICER | 2.00 | 48.00 | $0 | $552,593 | $43,567 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,573,003 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $178,782 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Deborah Mann Productions | |||||
| 3255 Jackson Street | San Francisco | CA | 94118 | Event Planning | $437,787 |
| Community Counseling Service Inc | |||||
| 100 Montgomery Street Suite 2270 | San Francisco | CA | 94104 | Fundraising Consulting | $390,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $966,120 | FundraisingAmt |
| All Other Contributions | $15,706,855 | AllOtherContributionsAmt |
| Total Contributions | $16,672,975 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $225,631 | TotalRevenueColumnAmt |
| Exclusion | $225,631 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $185,555 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $966,120 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $620,088 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$434,533 | TotalRevenueColumnAmt |
| Exclusion | -$434,533 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,464,073 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$208,902 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,114,073 | TotalAmt |
| Program Services | $3,114,073 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,855 | TotalAmt |
| Program Services | $11,046 | ProgramServicesAmt |
| Management And General | $11,345 | ManagementAndGeneralAmt |
| Fundraising | $7,464 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,250 | TotalAmt |
| Management And General | $47,250 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $613,201 | TotalAmt |
| Fundraising | $613,201 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,722 | TotalAmt |
| Management And General | $6,722 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,841 | TotalAmt |
| Program Services | $2,841 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,086 | TotalAmt |
| Fundraising | $160,086 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,831 | TotalAmt |
| Management And General | $96,542 | ManagementAndGeneralAmt |
| Fundraising | $17,289 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,761 | TotalAmt |
| Management And General | $1,761 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,464 | TotalAmt |
| Fundraising | $8,464 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,098,084 | TotalAmt |
| Program Services | $3,127,960 | ProgramServicesAmt |
| Management And General | $163,620 | ManagementAndGeneralAmt |
| Fundraising | $806,504 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,212,785 | BOYAmt |
| EOY | $9,498,661 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,723,256 | BOYAmt |
| EOY | $5,434,610 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,997,114 | BOYAmt |
| EOY | $22,230,644 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,059,276 | BOYAmt |
| EOY | $7,718,248 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $786,756 | BOYAmt |
| EOY | $847,036 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,779,187 | BOYAmt |
| EOY | $45,729,199 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $868,671 | BOYAmt |
| EOY | $247,720 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $868,671 | BOYAmt |
| EOY | $247,720 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,167,545 | BOYAmt |
| EOY | $4,754,493 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,528,328 | BOYAmt |
| EOY | $40,512,343 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $214,643 | BOYAmt |
| EOY | $214,643 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,910,516 | BOYAmt |
| EOY | $45,481,479 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,779,187 | BOYAmt |
| EOY | $45,729,199 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $12,365,989 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $144,694 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $60,280 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Marin General Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942823538 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $3,114,073 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $3,114,073 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (1) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | 0 | OperateBenefitNonSuprtOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $678,407 | BeginningYearBalanceAmt |
| Contributions | $213,788 | ContributionsAmt |
| Investment Earnings Or Losses | $29,333 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $267,443 | OtherExpendituresAmt |
| End Year Balance | $654,085 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $620,908 | BeginningYearBalanceAmt |
| Contributions | $233,835 | ContributionsAmt |
| Investment Earnings Or Losses | -$16,089 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $160,247 | OtherExpendituresAmt |
| End Year Balance | $678,407 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $582,900 | BeginningYearBalanceAmt |
| Contributions | $184,518 | ContributionsAmt |
| Investment Earnings Or Losses | $29,449 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $175,959 | OtherExpendituresAmt |
| End Year Balance | $620,908 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $519,843 | BeginningYearBalanceAmt |
| Contributions | $232,321 | ContributionsAmt |
| Investment Earnings Or Losses | $6,277 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $175,541 | OtherExpendituresAmt |
| End Year Balance | $582,900 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $423,897 | BeginningYearBalanceAmt |
| Contributions | $95,946 | ContributionsAmt |
| Investment Earnings Or Losses | $6,847 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $6,847 | OtherExpendituresAmt |
| End Year Balance | $519,843 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.67180 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.32820 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Payable to Marin General Hospital | Desc |
| Amt | $247,720 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $247,720 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $17,829,135 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $144,694 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $540,000 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $60,280 | OtherRevenueAmt |
| Revenue Not Reported | $744,974 | RevenueNotReportedAmt |
| Revenue Subtotal | $17,084,161 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$620,088 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$620,088 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $16,464,073 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,258,172 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $540,000 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $620,088 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,160,088 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,098,084 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,098,084 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Endowment funds are to be used for operational support for Marin General Hospital. |
| Part X, Line 2: | The Foundation is exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code and 23701(d) of the California Franchise Tax Board except to the extent of unrelated business taxable income as defined under IRC sections 511 through 515. Therefore, no provision for income taxes has been provided in these financial statements. |
| Part XI, Line 2d - Other Adjustments: | CHANGE IN SPLIT INTEREST GIFT AGREEMENTS 60,280. |
| Part XI, Line 4b - Other Adjustments: | RECLASSIFICATION OF SPECIAL EVENT EXPENSES from expenses -620,088. |
| Part XII, Line 2d - Other Adjustments: | Reclassification of special event expenses to revenues 620,088. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | ActivityActivityTxt | Fundraiser Control Of FundsFundraiserControlOfFundsInd | Gross ReceiptsGrossReceiptsAmt | Retained By ContractorRetainedByContractorAmt | Net To OrganizationNetToOrganizationAmt |
|---|---|---|---|---|---|---|---|---|
| Community Counseling Service Inc | ||||||||
| 100 MONTGOMERY STREET 2270 | San Francisco | CA | 94104 | Capital Campaign Fundraising Consultants | 0 | $6,811,382 | $300,000 | $6,511,382 |
| Deborah Mann Productions | ||||||||
| 3255 Jackson Street | San Francisco | CA | 94118 | Fundraising Event Productions | 0 | $1,151,675 | $313,201 | $838,474 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $7,963,057 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $613,201 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $7,349,856 | TotalNetToOrganizationAmt |
| Licensed States | CA | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF TOURNAMENT | Event1Nm |
| Gross Receipts Event1 | $377,250 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $298,750 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $78,500 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $46,663 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $51,632 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $47,882 | OtherDirectExpensesEvent1Amt |
| Event2 | GALA | Event2Nm |
| Gross Receipts Event2 | $774,425 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $667,370 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $107,055 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $237,874 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $129,417 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $39,095 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $67,525 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $1,151,675 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $966,120 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $185,555 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $284,537 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $181,049 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $39,095 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $115,407 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $620,088 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$434,533 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Marin General Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 Bon Air Road | AddressLine1Txt |
| City | Greenbrae | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 942823538 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $3,114,073 | 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 | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | There is no specific procedure for monitoring the use of funds to Marin General Hospital, a related organization. As a part of the overall operation of the related organization, Marin General Hospital keeps careful track of the use of funds granted from Marin General Hospital Foundation. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HELEN PRINCIPE RN | ||||||||||||||
| BOARD MEMBER | $0 | $126,115 | $0 | $0 | $0 | $0 | $0 | $38,339 | $0 | $9,317 | $0 | $173,771 | $0 | $0 |
| LEE DOMANICO | ||||||||||||||
| MGH CEO (Ex Officio) | $0 | $758,922 | $0 | $242,621 | $0 | $217,499 | $0 | $18,421 | $0 | $0 | $0 | $1,237,463 | $0 | $0 |
| ELIZABETH KOLCUN | ||||||||||||||
| MGH Foundation President | $0 | $158,657 | $0 | $0 | $0 | $263 | $0 | $8,308 | $0 | $12,657 | $0 | $179,885 | $0 | $0 |
| JON D FRIEDENBERG | ||||||||||||||
| MGH COO (Ex Officio) | $0 | $392,462 | $0 | $67,519 | $0 | $56,352 | $0 | $18,257 | $0 | $29,916 | $0 | $564,506 | $0 | $0 |
| JAMES P MCMANUS | ||||||||||||||
| MGH CHIEF FINANCIAL OFFICER | $0 | $399,341 | $0 | $95,448 | $0 | $57,804 | $0 | $13,651 | $0 | $29,916 | $0 | $596,160 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | The Marin General Hospital Foundation President is an employee of Marin General Hospital, the organization's sole member and a related organization. Marin General Hospital utilized the following methods to determine compensation of the Marin General Hospital Foundation President: independent compensation consultant and approval by the Board. |
| Part II, Column (b)(iii): | The other reportable compensation received by the Marin General Hospital Executive Team includes benefits such as health and welfare disability, long-term care insurance, and life insurance. These amounts were included on each individual's 2016 Form W-2 as taxable compensation. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | Marin General Hospital Foundation (MGHF) has one member, Marin General Hospital (MGH). |
| Form 990, Part VI, Section A, line 7a | The Board of Directors of MGHF is appointed or elected by its sole member, MGH. |
| Form 990, Part VI, Section A, line 7b | The Board, nor any officer of MGHF, may not take any of the following actions without first obtaining the authority of MGH, the organization's sole member: (i) the merger, consolidation, reorganization, or dissolution of MGHF; (ii) the amendment or restatement of the Articles of Incorporation or the bylaws of MGHF; (iii) the adoption of operating budgets for MGHF; (iv) the adoption of capital budgets for MGHF; (v) aggregate operating expenditures on an annual basis which exceed approved operating budgets by a dollar amount which is at least 5% of the approved operating budget of MGHF or aggregate capital expenditures on an annual basis which exceed approved capital budgets by a dollar amount which is at least 20% of MGHF approved capital budget; (vi) long-term borrowing; (vii) the purchase, sale, lease, disposition, hypothecation, exchange, gift, pledge, or encumbrance by MGHF of any asset, real or personal, with a fair market value in excess of a dollar amount equal to 10% of the consolidated fund balance of MGHF (if the transaction is not included in an approved capital budget); (viii) appointment of an independent auditor and approval of independent counsel; (ix) the creation or acquisition of any subsidiary or affiliate entity; (x) contracting with an unrelated third party for all or substantially all of the management of the assets or operations of MGHF; and (xi) approval of major new programs of MGHF. |
| Form 990, Part VI, Section B, line 11b | The MGH Foundation President reviewed the organization's Form 990. A copy of the Form was sent to all voting members of the governing body for their review before the return was filed with the Internal Revenue Service. |
| Form 990, Part VI, Section B, line 12c | The organization's conflict of interest policy applies to officers, directors and immediate family members and requires disclosures to the Board of any financial interests in a proposed transaction or agreement. If the Board determines that the financial interest is a conflict of interest, the interested director will not be a voting member on the issue in question. A disinterested person or committee can also be appointed to identify alternatives to the proposal. The policy requires an annual distribution to officers and directors as well as periodic reviews as needed. |
| Form 990, Part VI, Section C, line 19 | The organization makes its governing documents, conflict of interest policy and financial statements available upon request. |
| Form 990, PART VII and Part IX, line 7 | The employees are employed and compensated by Marin General Hospital (MGH), a related organization. MGH reports 100% of the individual's compensation on W-2's which are issued by MGH. The employees are assigned duties to other related organizations. |
| form 990, PART VII | Helen Principe, RN is a member of the board. She devoted an average of one half hour per week relating to her activities associated with serving on the Board of Directors. The reportable compensation is related to medical services provided to Marin General Hospital and is unrelated to the average number of hours per week for her duties as a board member. |
| Form 990, Part XI, line 9: | Changes in Split Interest Gift Agreements 60,280. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Marin Healthcare District | |||||||||||
| 100B Drakes Landing Road Suite 250 | Greenbrae | CA | 94904 | 911886269 | HEALTHCARE | CA | HC District Entity | N/A | 0 | ||
| MARIN GENERAL HOSPITAL | |||||||||||
| 250 Bon Air Road | Greenbrae | CA | 94904 | 942823538 | Hospital | CA | 501(c)(3) | 0 | Line 3 | Marin Healthcare District | |
| Prima Medical Foundation | |||||||||||
| 9 Commercial Blvd Suite 200 | Novato | CA | 94949 | 271376321 | Medical Foundation | CA | 501(c)(3) | 0 | Line 10 | Marin General Hospital | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| MGHSCA LLC | |||||||
| 100B Drakes Landing Road Suite 190 | Greenbrae | CA | 94904 | 383861395 | Outpatient Surgery Center | CA | N/A |
| Marin Magnetic Resonance Imaging Center LLC | |||||||
| 1260 South Eliseo Drive | Greenbrae | CA | 94904 | 680055977 | Outpatient Imaging | CA | N/A |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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