2015-11-09T07:02:20-06:00 2015-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1000 COMMERCE PARK DRIVE SUITE 430 WILLIAMSPORT PA 17701 990 2014-07-01 251290546 SHADYSIDE HOSPITAL FOUNDATION SHAD 4126236603 532 SOUTH AIKEN AVENUE NO 302 PITTSBURGH PA 15232 LOUISE R BROWN EXECUTIVE DIRECTOR 4126236603 2015-11-06 1 STEPHANIE HOLLICK CPA P01528458 5706511718 2014 2016-03-07 17:11:31Z LOUISE R BROWN 532 SOUTH AIKEN AVENUE NO 302 PITTSBURGH PA 15232 6414841 0 X N/A X 1975 PA TO RAISE FUNDS FOR UPMC-PRESBYTERIAN/SHADYSIDE-TO IMPROVE AND ADVANCE MEDICINE. 45 45 3 49 47925 30084 732307 541311 0 0 7115049 4622286 337784 369414 8185140 5533011 1773674 1430830 0 0 339969 345655 0 0 6986 155251 173687 2268894 1950172 5916246 3582839 77096866 75663440 1127942 1067131 75968924 74596309 TO RAISE FUNDS FOR THE BENEFIT OF UPMC-PRESBYTERIAN/SHADYSIDE. THE FUNDS RAISED ARE USED TO FURTHER IMPROVE AND ADVANCE THE SCIENCE OR ART OF HEALTHCARE DELIVERY AND ASSIST IN THE ADVANCEMENT OF MEDICAL EDUCATION AND RESEARCH. 0 0 1430830 1430830 PROVIDE FUNDING FOR DEPARTMENT OF MEDICINE (EDUCATION PROGRAMS), VARIOUS LECTURESHIP FUNDS, CANCER CARE AND EDUCATION, QUALITY PROGRAMS, AND OTHER MISCELLANEOUS PROGRAMS. 1430830 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 0 0 3 1 1 1 0 0 0 0 0 0 0 0 0 X 45 45 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X MARGARET LAUGHLIN 4126236603 532 SOUTH AIKEN AVENUE SUITE 302 PITTSBURGH PA 15232 H VAUGHAN BLAXTER III CHAIR 1.00 X X 0 0 0 NANCY B FOSTER TREASURER 1.00 X X 0 0 0 LOUISE R BROWN EXEC. DIRECTOR/SECRETARY (NONVOTING) 39.00 1.00 X X 0 248000 23179 AUDREY HILLMAN FISHER VICE CHAIR 1.00 X 0 0 0 TORRENCE M HUNT JR VICE CHAIR 1.00 X 0 0 0 MARK J LASKOW VICE CHAIR 1.00 1.00 X 0 0 0 JOHN M PIERCE DDS VICE CHAIR 1.00 X 0 0 0 MIKELL COOPER SCHENCK VICE CHAIR 1.00 X 0 0 0 W CRAIG ESTERLY ASSISTANT TREASURER & SECRETARY 1.00 X 0 0 0 LAWRENCE N ADLER MD BOARD MEMBER 1.00 X 0 0 0 CAROLINE D BARMEN BOARD MEMBER 1.00 X 0 0 0 G NICHOLAS BECKWITH III BOARD MEMBER 1.00 1.00 X 0 0 0 COURTNEY B BORNTRAEGER BOARD MEMBER 1.00 X 0 0 0 AH BURCHFIELD III BOARD MEMBER 1.00 X 0 0 0 JENNIFER G CALIHAN BOARD MEMBER 1.00 X 0 0 0 ROBERT B CHALLINOR MD BOARD MEMBER 1.00 X 0 0 0 PAUL EUWER JR BOARD MEMBER 1.00 X 0 0 0 STEVEN EVANS MD BOARD MEMBER 1.00 X 0 0 0 NANCY C FALES BOARD MEMBER 1.00 X 0 0 0 SHEILA FINE BOARD MEMBER 1.00 X 0 0 0 MONA N GENERETT PHD BOARD MEMBER 1.00 X 0 0 0 JAMES A GLEASON MD BOARD MEMBER 1.00 X 0 0 0 CLINTON GUYAUX BOARD MEMBER 1.00 X 0 0 0 JOHN F HENSLER BOARD MEMBER 1.00 X 0 0 0 JAMES F HILLIARD BOARD MEMBER 1.00 X 0 0 0 AURA R HULME BOARD MEMBER 1.00 X 0 0 0 LEO A KEEVICAN JR BOARD MEMBER 1.00 X 0 0 0 DONNA L KNUPP MD BOARD MEMBER 1.00 X 0 0 0 KATE W MACVEAN BOARD MEMBER 1.00 X 0 0 0 CHARLES V MASTERSON III BOARD MEMBER 1.00 X 0 0 0 W DUFF MCCRADY BOARD MEMBER 1.00 X 0 0 0 JOHN MCSORLEY III MD BOARD MEMBER 1.00 X 0 0 0 COOPER SCHENCK MUNROE BOARD MEMBER 1.00 X 0 0 0 JENNIFER J MUSE BOARD MEMBER 1.00 X 0 0 0 JOEL B NELSON MD BOARD MEMBER 1.00 X 0 0 0 RICHARD A PAGLIARI BOARD MEMBER 1.00 X 0 0 0 DANIEL W PITUCH DMD MD BOARD MEMBER 1.00 X 0 0 0 WILLIAM M ROBINSON BOARD MEMBER 1.00 X 0 0 0 JOHN A RUDOLF BOARD MEMBER 1.00 X 0 0 0 S MURRAY RUST III BOARD MEMBER 1.00 X 0 0 0 BLAKE L RUTTENBERG BOARD MEMBER 1.00 X 0 0 0 NORMAN M STEERE BOARD MEMBER 1.00 X 0 0 0 MARK A STUDER BOARD MEMBER 1.00 X 0 0 0 JOSEPH C WALTON BOARD MEMBER 1.00 X 0 0 0 JOEL H WEINBERG MD BOARD MEMBER 1.00 X 0 0 0 W DENNIS ZEREGA EDD BOARD MEMBER 1.00 X 0 0 0 DAVID S ZORUB MD ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 DOROTHY B BECKWITH ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 MARY BRIGNANO ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 WILLIAM M COOPER III ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 PATRICIA M DUGGAN ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 CLARICE K HORNE ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 JOHN P INNOCENTI ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 JOAN KENNEY ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 HENRY A MORDOH ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 DANIEL P PETRO MD ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 MURRAY SACHS MD ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 WILLIAM M SWARTZ MD ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 MICHAEL WATSON ADVISORY BOARD (NONVOTING) 1.00 X 0 0 0 0 248000 23179 0 0 1 0 0 541311 541311 703359 47925 655434 4800757 881830 3918927 3918927 3918927 BIPT DISTRIBUTIONS 900099 364713 364713 ADMINISTRATIVE FEES 900099 4701 4701 369414 5533011 0 47925 4943775 1430830 1430830 345655 345655 34950 34950 10618 10618 32338 32338 40304 36274 4030 29563 26607 2956 6049 6049 3480 3480 14366 14366 DUES & SUBSCRIPTIONS 2019 2019 1950172 1430830 512356 6986 631546 792146 110302 8000 1000 6668 7698 72227 72212 2598 15 76448054 74752279 77096866 75663440 28686 33700 994564 949357 104692 84074 1127942 1067131 X 49834409 48631585 1785365 1877068 24349150 24087656 75968924 74596309 77096866 75663440 X 3582839 -5042417 86963 X 0 1 X 1 0 X X 1 UPMC PRESBYTERIANSHADYSIDE HOSPITAL 250965480 3 1 1430830 0 1 1430830 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X 1 1 PART IV, SECTION D, LINE 3: THE PRESIDENT OF UPMC PRESBYTERIAN/SHADYSIDE HOSPITAL SERVES AS A DIRECTOR ON THE BOARD OF SHADYSIDE HOSPITAL FOUNDATION. PART IV, SECTION E, LINE 2A CONTRIBUTIONS/GIFTS THAT ARE PROVIDED TO THE HOSPITAL FOUNDATION (THE "FOUNDATION") WITH A SPECIFIC DESIGNATION ARE SENT TO UPMC PRESBYERIAN/SHADYSIDE HOSPITAL (THE "HOSPITAL") FOR THAT PURPOSE. IN ADDITION, THE HOSPITAL MAY SEND A WRITTEN PROPOSAL FOR FUNDS THAT REQUIRES APPROVAL BY THE GRANT COMMITTEE. ONCE APPROVED THE FUNDS ARE TRANSFERRED TO THE HOSPITAL FOR THAT PURPOSE. THE FOUNDATION DOES NOT PERFORM ANY ACTIVIES OUTSIDE OF RAISING FUNDS ON BEHALF OF THE HOSPITAL. PART IV, SECTION E, LINE 2B THE FOUNDATION INCURS EXPENSES FOR TWO INDIVIDUAL IMPROVEMENT SPECIALISTS SALARIES THAT ARE FOCUSED ON THE HOSPITAL PROCESS IMPROVEMENTS. IF THE FOUNDATION DID NOT INCUR THIS EXPENSE, THE HOSPITAL WOULD. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17164051 5665 -127566 254152 16787998 15532088 30458 2066369 464864 17164051 14076743 32702 1784654 362011 15532088 14267888 29980 148983 370108 14076743 12279232 13634 2401654 426632 14267888 0.00470 0.95400 0.04130 0 0 72227 72212 15 15 COMMON FUNDS 66679159 F SPLIT INTEREST AGREEMENTS 8073120 F 74752279 RESTRICTED CONTRIBUTION PAYABLE 84074 84074 X 577557 -5042417 86963 -4955454 5533011 0 5533011 1950172 0 1950172 0 1950172 PART V, LINE 4: FOR THE BENEFIT OF UPMC PRESBYTERIAN/SHADYSIDE TO IMPROVE AND ADVANCE HEALTHCARE DELIVERY AND MEDICAL RESEARCH AND EDUCATION. PART X, LINE 2: THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR FEDERAL AND STATE INCOME TAXES IS REQUIRED. THE FOUNDATION IS NOT A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE, BECAUSE IT IS AN ORGANIZATION AS DESCRIBED IN SECTION 509(A)(3). THE FOUNDATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2015 AND 2014. THE FOUNDATION'S FEDERAL INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION BY FEDERAL TAXING AUTHORITIES FOR FISCAL YEARS BEFORE JUNE 30, 2012. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 86,963. 1 UPMC-PRESBYTERIANSHADYSIDE 5230 CENTRE AVENUE PITTSBURGH PA 15232 250965480 501(C)(3) 1430830 PATIENT CARE, EMPLOYEE EDUCATION AND SUPPORT, OUTREACH, RESEARCH AND OTHER MISCELLANEOUS PROGRAMS. 1 PART I, LINE 2: GRANTS ARE DISTRIBUTED ANNUALLY TO RELATED, CHARITABLE ORGANIZATIONS IN COMPLIANCE WITH A SPENDING POLICY SET BY THE BOARD OF DIRECTORS. INDIVIDUAL GRANTS ARE TO BE REPORTED ON A 6-MONTH INTERVAL & AT THE END OF THE GRANT YEAR. GRANTEES ARE TO REPORT ON THE USE OF THE FUNDS, PROGRESS OF THE PROJECT & BENEFITS DERIVED. ACCORDING TO FOUNDATION POLICY, UNSPENT MONEYS ARE TO BE RETURNED TO THE FOUNDATION. 0 0 0 0 0 0 0 0 0 LOUISE R BROWN EXEC. DIRECTOR/SECRETARY (NONVOTING) 0 248000 0 0 0 0 0 7405 0 15774 0 271179 0 0 PART I, LINE 3 THE EXECUTIVE DIRECTOR, LOUISE R. BROWN, IS COMPENSATED BY UPMC PRESBYTERIAN/SHADYSIDE, A RELATED TAX-EXEMPT ORGANIZATION. UPMC PRESBYTERIAN/SHADYSIDE USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: COMPENSATION COMMITTEE, FORM 990 OF OTHER ORGANIZATIONS AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART V, LINE 2: SHADYSIDE HOSPITAL FOUNDATION DOES NOT HAVE ANY OF ITS OWN EMPLOYEES PROVIDING SERVICES TO THE ORGANIZATION. THE ORGANIZATION DOES NOT FILE ITS OWN FORM W-3. THE EMPLOYEES PROVIDING SERVICES TO SHADYSIDE HOSPITAL FOUNDATION ARE EMPLOYED BY UPMC PRESBYTERIAN/SHADYSIDE, THE ORGANIZATION'S AFFILIATED ENTITY. THESE EMPLOYEES RECEIVE A W-2 FROM UPMC PRESBYTERIAN/SHADYSIDE. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING FAMILY RELATIONSHIPS WERE IDENTIFIED BETWEEN BOARD MEMBERS: -G. NICHOLAS BECKWTIH, III AND DOROTHY B. BECKWITH -WILLIAM M. COOPER, III, MIKELL COOPER SCHENCK, AND COOPER SCHENCK MUNROE -JAMES F. HILLIARD, AUDREY HILLMAN FISHER, AND PATRICA DUGGAN -W. DUFF MCCRADY AND JOHN A. RUDOLF FORM 990, PART VI, SECTION B, LINE 11 THE FOUNDATION MANAGER REVIEWS THE 990 FOR COMPLETENESS AND ACCURACY AND A COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO ISSUANCE. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY COMPLETED BY BOARD MEMBERS AND RETAINED IN THE FOUNDATION OFFICES. THE EXECUTIVE DIRECTOR MONITORS THE PROCESS. THE EXECUTIVE DIRECTOR AND THE CHAIRMAN REVIEW ANY IDENTIFIED CONFLICTS. IF DURING THE COURSE OF ANY GIVEN YEAR A COVERED PERSON BECOMES AWARE OF A NEW OR POTENTIAL OR OTHERWISE UNDISCLOSED INDIVIDUAL INTEREST, THE COVERED PERSON MUST PROMPTLY AND APPROPRIATELY UPDATE THE CONFLICT OF INTEREST DISCLOSURE STATEMENT. ANY BOARD MEMBER OR OFFICER HAVING AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST SHALL NOT BE PRESENT DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION PROGRAM FOR ALL EMPLOYEES MEETS THE UNIQUE NEEDS OF THE ORGANIZATION AND HAS THE GOAL OF PROVIDING A COMPENSATION PROGRAM THAT IS MARKET-COMPETITIVE AND EQUITABLE WITH THE PURPOSE OF ATTRACTING AND RETAINING QUALIFIED STAFF MEMBERS AND TO ENSURE THAT COMPENSATION DOES NOT EXCEED FAIR MARKET VALUE. THE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION OF THE EXECUTIVE DIRECTOR. THE COMMITTEE COMPARES THE COMPENSATION WITH OTHER ORGANIZATIONS IN THE AREA. THE PROCESS AND APPROVAL IS DOCUMENTED IN THE COMMITTEE MINUTES. FOR OTHER EMPLOYEES, COMPENSATION IS DOCUMENTED AND DETERMINED BY THE CHIEF OF HUMAN RESOURCES, ADMINISTRATIVE SERVICE OFFICER AND CHAIRPERSON TO THE BOARD OF DIRECTORS OF THE SHADYSIDE HOSPITAL FOUNDATION. 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 XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 86,963. UPMC PRESBYTERIANSHADYSIDE 5230 CENTRE AVENUE PITTSBURGH PA 15232 250965480 HOSPITAL PA 501(C)(3) 170(B)(1)(A)(III) N/A 0 SHADYSIDE HOSPITAL SUPPORTING FOUNDATION 532 SOUTH AIKEN AVENUE PITTSBURGH PA 15232 260303394 RAISE FUNDS FOR UPMC SHADYSIDE PA 501(C)(3) 509(A)(3) N/A 0 ADDISON F HOLLIDAY TRUST PNC BANK 620 LIBERTY AVENUE PITTSBURGH PA 15265 BENIFICIAL INTEREST IN PERPETUAL TRUST PA T 90227 2050107 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0