2014-05-02T18:01:29-05:00 2013-06-30 135565207 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2012-07-01 770035928 MERCY MEDICAL CENTER MERCED FOUNDATION MERC 2098346734 2740 M Street Merced CA 95340 MICHAEL STRASSER 2014-04-21 true VALERIE J BALL P00178114 4159635100 2012 2015-11-30 17:44:51Z MICHAEL STRASSER CFO 2740 M Street Merced CA 95340 964762 false X WWW.SUPPORTMERCYMERCED.ORG X 1984 CA TO PROVIDE FINANCIAL ASSISTANCE AND SUPPORTING SERVICES FOR DIGNITY HEALTH (DBA: MERCY MEDICAL CENTER MERCED). 19 16 0 30 0 0 1388711 961462 0 0 11972 680 -38317 -18713 1362366 943429 1461016 524493 0 0 0 0 0 10000 107408 451268 422933 1912284 957426 -549918 -13997 1040002 1056159 15250 45404 1024752 1010755 TO PROVIDE FINANCIAL ASSISTANCE AND SUPPORTING SERVICES FOR DIGNITY HEALTH (DBA: MERCY MEDICAL CENTER MERCED). THE FINANCIAL SUPPORT PROVIDED BY THE FOUNDATION CONTRIBUTES TO THE HOSPITAL'S MISSION OF DELIVERING COMPASSIONATE, HIGH-QUALITY, AFFORDABLE HEALTH SERVICES; SERVING AND ADVOCATING FOR OUR SISTERS AND BROTHERS WHO ARE POOR AND DISENFRANCHISED; AND PARTNERING WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE. false false 737244 524493 0 THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTION OF, OR TO CARRY OUT THE PURPOSES OF DIGNITY HEALTH DBA MERCY MEDICAL CENTER MERCED, "HOSPITAL", WHICH INCLUDE MAKING PAYMENTS DIRECTLY TO THE HOSPITAL. 737244 true true false false false false false false false true false false false true true false true false false false false false false true false false true false true false false false false false false false false false true false false false true false false false false true X 0 0 0 false false false false false true true false false false false X 19 16 false false false false true true true true true false false false true true true true true false false false CA X Lara Harrow Finance Dept 2095644284 3400 Data Drive Sacramento CA 95670 CHRISTINE LONG 1.00 0 X X 0 0 0 DAN HOLMES 1.00 0 X X 0 0 0 GARTH PECCHENINO 1.00 0 X X 0 0 0 JIM CUNNINGHAM 1.00 0 X X 0 0 0 LORELEI STAPP 1.00 0 X X 0 0 0 MARILYN REESE 1.00 0 X X 0 0 0 ANNA BOLLING 1.00 0 X 0 0 0 CYRIL LAWRENCE 1.00 0 X 0 0 0 DANIEL IKEMIYASHIRO MD 1.00 0 X 0 0 0 DAVID DUNHAM 1.00 40.00 X 0 441900 76761 HELEN EVANS 1.00 0 X 0 0 0 KATHLEEN M CROOKHAM 1.00 0 X 0 0 0 KATIE FAVIER 1.00 0 X 0 0 0 KELSEY RIGGS 1.00 40.00 X 0 95119 12723 MARCEE SAMBERG 1.00 20.00 X 0 30845 0 NELLIE MCGARRY 1.00 0 X 0 0 0 RIC KIRBY 1.00 0 X 0 0 0 SHAILESH PATEL MD 1.00 0 X 0 0 0 STEVE KOENIG 1.00 0 X 0 0 0 LISA WEGLEY 40.00 0.00 X 0 109096 13970 MICHAEL STRASSER 1.00 40.00 X 0 220216 37075 DOREEN HARTMANN 0.00 40.00 X 0 308367 36369 0 1205544 176898 0 false true false 0 62681 454269 444512 3845 961462 0 0 0 0 0 0 0 0 0 0 680 680 0 0 0 0 0 0 0 0 2620 62681 21333 -18713 -18713 0 0 0 0 0 0 0 0 0 0 943429 0 0 -18033 524493 524493 0 0 0 0 0 0 0 0 0 0 2034 2034 8049 8049 0 10000 10000 0 328687 195929 53263 79495 12831 5538 7293 15649 5300 8951 1398 23256 23256 0 6604 5283 1321 4900 2137 2388 375 0 55 55 0 0 0 0 1503 1503 VOLUNTEER DEVELOPMENT 13020 13020 DUES & SUBSCRIPTIONS 1158 864 294 FOOD EXPENSE 1059 924 135 DONOR CULTIVATION 787 787 3341 2004 325 1012 957426 737244 112774 107408 0 500 500 594992 750713 444510 268710 0 0 15282 15282 0 0 0 0 0 0 0 36236 1040002 1056159 15250 36310 0 0 9094 15250 45404 X 227931 374329 796821 636426 1024752 1010755 1040002 1056159 -13997 0 X false true X true false X 1039865 1506017 633150 1388711 961462 5529205 0 0 1039865 1506017 633150 1388711 961462 5529205 207135 5322070 13596 6831 12534 11972 680 45613 0 7711 62490 12003 52610 2620 137434 5712252 0 0.93160 0.92540 X OTHER INCOME, SCHEDULE A, PART II, LINE 10, DESCRIPTION - FUNDRAISING EVENTS, COLUMN A - 7711, COLUMN B - 62490, COLUMN C - 12003, COLUMN D - 52610, COLUMN E - 2620, COLUMN F - 137434;, RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 15282 15282 0 0 0 0 OTHER LIABILITIES 9094 9094 X FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 DIGNITY HEALTH REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. A TASTE OF MERCED 65301 62681 2620 0 0 10496 2984 5829 2024 NONE 0 0 0 65301 62681 2620 0 0 10496 2984 5829 2024 21333 -18713 true DIGNITY HEALTH DBA MERCY MERCED MEDICAL CENTER 333 MERCY AVENUE MERCED CA 95340 941196203 501(C)(3) 524493 0 N/A N/A HOSPITAL SUPPORT 1 0 Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTION OF, OR TO CARRY OUT THE PURPOSES OF THE GRANTEE LISTED IN PART II, ITEM 1 (DIGNITY HEALTH DBA MERCY MEDICAL CENTER MERCED), WHICH INCLUDE MAKING PAYMENTS DIRECTLY TO THE BENEFICIARY ORGANIZATION, TRANSFERRING AND MONITORING THAT RESTRICTIONS ARE MET BEFORE RELEASE OF FUNDS AND EXPENDITURE OF SUCH FUNDS. false true false false false false false false false DAVID DUNHAM 0 316119 0 109632 0 16149 0 35234 0 41526 0 518661 0 0 DOREEN HARTMANN 0 242308 0 54488 0 11572 0 23440 0 12929 0 344737 0 0 MICHAEL STRASSER 0 203514 0 15911 0 791 0 14143 0 22932 0 257291 0 0 Arrangement used to establish the top management official's compensation Schedule J, Part I, Line 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, DIGNITY HEALTH,THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. SEVERANCE SCHEDULE J, PART I, LINE 4A THE ORGANIZATION'S OFFICERS PARTICIPATE IN A SEVERANCE PLAN ESTABLISHED BY ITS SUPPORTED ORGANIZATION. THE PLAN PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 6 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE PLAN. NO PAYMENTS WERE MADE UNDER THIS PLAN DURING 2012. Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b CERTAIN LISTED PERSONS ARE ELIGIBLE TO PARTICIPATE IN A NONQUALIFIED 457(F) PLAN THAT IS SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. NO BENEFIT WILL VEST UNDER THIS 457(F) PLAN BEFORE THE ATTAINMENT OF AGE 62 OR THE COMPLETION OF 15 YEARS OF SERVICE. NO PAYMENTS WERE MADE UNDER THIS PLAN DURING 2012. CERTAIN LISTED PERSONS PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. NO PAYMENTS WERE MADE TO ANY LISTED PERSONS DURING 2012 PURSUANT TO THIS PLAN. VESTED AMOUNTS, IF ANY, FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR VESTING OCCURS (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS W-2 REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)). SUPPLEMENTAL DISCLOSURES SCHEDULE J, PART II ALTHOUGH THE ORGANIZATION DOES NOT DIRECTLY EMPLOY ANY PERSONNEL, THE SUPPORTED ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO FULFILL THE ORGANIZATION'S MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES THE ORGANIZATION SERVES, PROMOTING EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE COMPENSATION AND BENEFITS COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND THE ORGANIZATION'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE AND REVENUE. X 1 1685 MARKET VALUE X FOOD AND WINE 4 2160 MARKET VALUE Explanations of reporting method for number of contributions Schedule M, Part I ART - WORKS OF ART: NUMBER OF ITEMS RECEIVED OTHER: NUMBER OF CONTRIBUTIONS Number of contributions or items contributed. Schedule M, part I, column (b), Line 1 NUMBER OF ITEMS RECEIVED Number of contributions or items contributed. Schedule M, part I, column (b), Line other=FOOD AND WINE NUMBER OF CONTRIBUTIONS NUMBER OF EMPLOYEES REPORTED ON FORM W-3 FORM 990, PART V, LINE 2A THE ORGANIZATION DOES NOT HAVE EMPLOYEES. THE FOUNDATION OPERATES FOR THE BENEFIT OF THE HOSPITAL AND UTILIZES THE EMPLOYEES OF THAT HOSPITAL. THE PROPORTIONATE SALARIES AND BENEFITS FOR THESE INDIVIDUALS ARE ALLOCATED TO THE FOUNDATION. THE SALARIES OF THESE EMPLOYEES ARE INCLUDED IN THE HOSPITAL ENTITY'S FORM W-3 AND FEDERAL EMPLOYMENT TAX RETURNS. Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE SOLE CORPORATE MEMBER IS DIGNITY HEALTH, A 501(C)(3) EXEMPT ORGANIZATION. Members or stockholders electing members of governing body Form 990, Part VI, Section A, Line 7a DIGNITY HEALTH, AS THE SOLE CORPORATE MEMBER, RATIFIES THE SELECTION OF MEMBERS AND THE DIGNITY HEALTH BOARD APPROVES NEW BOARD MEMBERS OF THE FOUNDATION. Decisions requiring approval by members or stockholders Form 990, Part VI, Section A, Line 7b RESERVED RIGHTS OF THE CORPORATE MEMBER INCLUDE ADOPTION OF MISSION AND PHILOSOPHY STATEMENTS, AMENDMENT OR RESTATEMENT OF ARTICLES OF INCORPORATION AND BYLAWS, DISSOLUTION OF THE CORPORATION, ACQUISITION OF ANOTHER CORPORATION, CREATION OF A NEW SUBSIDIARY, MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION, PARTICIPATION AS A GENERAL OR LIMITED PARTNER IN ANY VENTURE, INCURRING LONG-TERM INDEBTEDNESS IN EXCESS OF NORMAL OPERATING REQUIREMENTS, RATIFICATION OF BOARD MEMBER APPOINTMENTS AND DISMISSALS, SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, AND TRANSACTIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11b THE BOARD OF DIRECTORS HAS DELEGATED THE INITIAL PREPARATION AND REVIEW OF THE FORM 990 INCLUDING COMPENSATION INFORMATION TO DIGNITY HEALTH DBA MERCY MEDICAL CENTER OF MERCED'S VP OF FINANCE AND DIRECTOR OF FINANCE. THE VP OF FINANCE AND THE DIRECTOR OF FINANCE WORKED CLOSELY WITH THE DIGNITY HEALTH CORPORATE TAX TEAM AND AN INDEPENDENT ACCOUNTING FIRM ENGAGED TO REVIEW THE PREPARATION OF THE FORM 990. THE FINAL FORM 990, INCLUDING COMPENSATION INFORMATION, WAS PRESENTED TO AND REVIEWED WITH THE FINANCE COMMITTEE OF THE BOARD, AND A SUMMARY REPORT WAS PROVIDED TO THE ENTIRE BOARD OF DIRECTORS BEFORE THE FORM 990 WAS FILED. Conflict of interest policy Form 990, Part VI, Section B, Line 12c THE FOUNDATION HAS ADOPTED DIGNITY HEALTH'S CONFLICTS OF INTEREST POLICY. UNDER SUCH POLICIES, THE EVP/GENERAL COUNSEL IS RESPONSIBLE FOR COLLECTING, REVIEWING AND VALIDATING ANNUAL DISCLOSURES OF ALL COVERED PERSONS (I.E., BOARD AND BOARD COMMITTEE MEMBERS, OFFICERS AND EXECUTIVE LEADERSHIP, KEY EMPLOYEES, MANAGEMENT PERSONNEL AT THE DIRECTOR LEVEL AND ABOVE, AND ANY OTHER PERSONNEL AT HIS OR HER DISCRETION). THE ORGANIZATION'S BOARD IS CHARGED WITH MONITORING PROPOSED OR ONGOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND ADDRESSING ANY POTENTIAL OR ACTUAL CONFLICTS. ALL COVERED PERSONS ARE REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS ARISING FROM BUSINESS, FINANCIAL AND PERSONAL INTERESTS HELD BY SUCH COVERED PERSONS OR THEIR FAMILY MEMBERS. COVERED PERSONS ARE REQUIRED TO DISCLOSE TO THEIR SUPERIORS AND TO RELEVANT DECISION MAKERS ANY INTEREST THAT MAY PRESENT A CONFLICT OR THE APPEARANCE OF A CONFLICT OF INTEREST. SUCH DISCLOSURE IS REQUIRED ON A TRANSACTIONAL BASIS AT THE TIME SUCH CONFLICTS ARISE, WHEN AN INDIVIDUAL BECOMES A COVERED PERSON, AND ANNUALLY THEREAFTER. EACH COVERED PERSON IS REQUIRED TO CERTIFY AT LEAST ANNUALLY THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE POLICY APPLICABLE TO HIS/HER POSITION; (2) HAS READ THE POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY, INCLUDING COMPLETING THE CONFLICTS OF INTEREST DISCLOSURE STATEMENT AS REQUIRED BY THE POLICY. THE PRESIDENT/CEO AND EVP/GENERAL COUNSEL PREPARE ANNUAL REPORTS OF REPORTED CONFLICTS OF INTEREST WHICH ARE PROVIDED TO THE BOARD OF DIRECTORS, COMMITTEE CHAIRS, AND KEY LEADERS OF THE ORGANIZATION TO ENABLE RESPONSIBLE INDIVIDUALS TO MONITOR AND MANAGE DISCLOSED CONFLICTS OF INTEREST AND ASSURE DECISIONS ARE MADE IN THE ORGANIZATION'S BEST INTERESTS. THE PROCEDURES FOR ADDRESSING ANY CONFLICT OF INTEREST RELATED TO A PROPOSED TRANSACTION INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: (1) THE CONFLICTING INTEREST IS FULLY DISCLOSED TO THE BOARD; (2) THE INTERESTED PERSON RESPONDS TO FACTUAL QUESTIONS RELATED TO THE SUBSTANCE OF THE TRANSACTION OR ARRANGEMENT BEING CONSIDERED, AFTER WHICH HE/SHE SHALL LEAVE THE MEETING; (3) THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION; (4) IF WARRANTED, ALTERNATIVES TO THE PROPOSED TRANSACTION ARE INVESTIGATED, AND COMPETITIVE BIDS OR COMPARABLE VALUATIONS ARE OBTAINED; (5) THE TRANSACTION OR ACTION IS APPROVED BY A MAJORITY OF DISINTERESTED PERSONS, AND CONSISTENT WITH ANY REQUIREMENTS OF BYLAWS OR POLICIES ; AND (6) ANY CONFLICTING ISSUES ARISING DURING THE COURSE OF A BOARD MEETING WHICH CANNOT BE RESOLVED MAY BE REFERRED TO AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS. THERE ARE ALSO CONFLICTS OF INTEREST PROVISIONS UNDER THE STANDARDS OF CONDUCT APPLICABLE TO ALL EMPLOYEES, AND WHICH ARE ADMINISTERED BY THE CHIEF COMPLIANCE OFFICER WHO HAS REPORTING RESPONSIBILITY TO THE AUDIT & COMPLIANCE COMMITTEE. PART VI, SECTION B, LINE 15 FORM 990, PART VI, LINE 15A FOR 20112 COMPENSATION, THE PARENT ORGANIZATION'S HUMAN RESOURCES DEPARTMENT CONDUCTED AN ANNUAL REVIEW AND ANALYSIS TO PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGE OF THE TOP MANAGEMENT OFFICIAL. COMPENSATION WAS ALSO REVIEWED ANNUALLY AS PART OF THE MERIT INCREASE PROCESS. Governing documents, conflict of interest policy and financial statements available to the public Form 990, Part VI, Section C, Line 19 FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE ON ITS WEBSITE AND UPON REQUEST. Other Expenses Form 990, Part IX, Line 11g ADMINISTRATIVE SERVICES - TOTAL EXPENSE: 289257, PROGRAM SERVICE EXPENSE: 184308, MANAGEMENT AND GENERAL EXPENSES: 25454, FUNDRAISING EXPENSES: 79495; OTHER PURCHASED SERVICES - TOTAL EXPENSE: 39430, PROGRAM SERVICE EXPENSE: 11621, MANAGEMENT AND GENERAL EXPENSES: 27809, FUNDRAISING EXPENSES: ; DIGNITY HEALTH DBA MERCY MED CTR MERCED 185 BERRY STREET SAN FRANCISCO CA 94107 HOSPITAL CA 501(C)(3) 3 NA false false true true false false false false false false false false true false false false false false false false