KENT HOSPITAL FOUNDATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- KENT HOSPITAL FOUNDATION (EIN 05-0514640)
- Tax period
- 2011-10-01 to 2012-09-30
- Filed
- 2013-08-13
- IRS object ID
- 201302259349303200
- Schema version
- 2011v1.5
- 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) |
|---|---|---|
| Timestamp | 2013-08-13T15:58:11-05:00 | Timestamp |
| Tax Period End Date | 2012-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 453994797 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LGC&D LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TEN WEYBOSSET STREET - SUITE 700 | AddressLine1 |
| City | PROVIDENCE | City |
| State | RI | State |
| ZIP Code | 02903 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050514640 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENT HOSPITAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | KENT | NameControl |
| Phone | 4016811150 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 TOLL GATE ROAD | AddressLine1 |
| City | WARWICK | City |
| State | RI | State |
| ZIP Code | 02886 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PAUL BEAUDOIN | Name |
| Title | SVP FINANCE | Title |
| Phone | 4016811150 | Phone |
| Date Signed | 2013-07-24 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LYNN O'MARRA ESQUIRE | Name |
| PTIN | P00821716 | PTIN |
| Phone | 4014214800 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | PAUL BEAUDOIN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 TOLL GATE ROAD | AddressLine1 |
| City | WARWICK | City |
| State | RI | State |
| ZIP Code | 02886 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 3689351 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | KENTRI.ORG/WAYSTOGIVE/FOUNDATION | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | RI | StateLegalDomicile |
| Activity Or Mission Description | TO SERVE THE HEALTH CARE NEEDS OF OUR REGION THROUGH KENT COUNTY MEMORIAL HOSPITAL BY ENCOURAGING AND FACILITATING PHILANTHROPIC GENEROSITY AND SPIRIT OF VOLUNTEERISM. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 24 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 18 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 66 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3480397 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3169537 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2488 | InvestmentIncomePriorYear |
| Investment Income Current Year | 25576 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 113815 | OtherRevenuePriorYear |
| Other Revenue Current Year | 68437 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 3596700 | TotalRevenuePriorYear |
| Total Revenue Current Year | 3263550 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1113750 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 930706 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4435 | OtherExpensePriorYear |
| Other Expenses Current Year | 2358 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1118185 | TotalExpensesPriorYear |
| Total Expenses Current Year | 933064 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2478515 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2330486 | RevenuesLessExpensesCY |
| Total Assets BOY | 4733108 | TotalAssetsBOY |
| Total Assets EOY | 7344544 | TotalAssetsEOY |
| Total Liabilities BOY | 465333 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 667051 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4267775 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6677493 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF THE KENT HOSPITAL FOUNDATION IS TO SERVE THE HEALTH CARE NEEDS OF OUR REGION THROUGH KENT COUNTY MEMORIAL HOSPITAL BY ENCOURAGING AND FACILITATING PHILANTHROPIC GENEROSITY AND SPIRIT OF VOLUNTEERISM. THE KENT HOSPITAL FOUNDATION SERVES AS THE PHILANTHROPIC ARM OF KENT COUNTY MEMORIAL HOSPITAL BY ACCEPTING, ACKNOWLEDGING AND RECOGNIZING CHARITABLE CONTRIBUTIONS FROM INDIVIDUALS, BUSINESSES, FOUNDATIONS AND GOVERNMENTAL SOURCES THAT SUPPORT THE HOSPITAL'S MISSION AND WORK IN THE COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 933064 | Expense |
| Grants | 930706 | Grants |
| Description | CULTIVATE FUNDS DEVELOPMENT ON BEHALF OF KENT COUNTY MEMORIAL HOSPITAL. | Description |
| Total Program Service Expense | 933064 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 1 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 24 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 18 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAUL A BEAUDOIN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4017377000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 TOLL GATE ROAD | AddressLine1 |
| City | WARWICK | City |
| State | RI | State |
| ZIP Code | 02886 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (26 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| JAMES A HOPKINS | ||||||
| CHAIRMAN - DIRECTOR | 1.00 | X | X | 0 | 0 | 0 |
| JONATHAN K FARNUM | ||||||
| VICE CHAIR - DIRECTOR | 1.00 | X | X | 0 | 0 | 0 |
| GERARD R GOULET | ||||||
| SECRETARY - DIRECTOR | 1.00 | X | X | 0 | 0 | 0 |
| RAYMOND J BOLSTER II | ||||||
| TREASURER - DIRECTOR | 1.00 | X | X | 0 | 0 | 0 |
| REID S APPLEBY JR MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ROBERT E BAUTE MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JANICE M CAIANIELLO RN | ||||||
| DIRECTOR | 55.00 | X | 0 | 108048 | 22349 | |
| THOMAS J CELONA | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| SANDRA L COLETTA | ||||||
| DIRECTOR - PRESIDENT/CEO KCMH | 55.00 | X | 0 | 831551 | 184361 | |
| EDWARD J COONEY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MICHAEL J DACEY MD | ||||||
| DIRECTOR - SR VP MED AFFAIRS | 55.00 | X | 0 | 454101 | 91423 | |
| CANDACE L DYER MD | ||||||
| DIRECTOR | 55.00 | X | 0 | 370392 | 1915 | |
| ANDREW M ERICKSON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LAURA J HILDERLEY MS RN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| ANDREA M HOPKINS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JOHN J HYNES ESQ | ||||||
| DIRECTOR - FORMER PRES/CEO CNE | 1.00 | X | 0 | 2088769 | 78515 | |
| KENNETH L MACNAUGHT | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| GERALD G MCCLURE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| STEPHEN A ROOKS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| GEORGE W SHUSTER | ||||||
| DIRECTOR | 1.00 | X | 0 | 2189 | 0 | |
| JOSEPH W SPINALE DO FACC FACP | ||||||
| DIRECTOR | 55.00 | X | 0 | 176296 | 17832 | |
| JAMES M VESEY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| MARIBETH Q WILLIAMSON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| VINCENT J YAKAVONIS MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 2098 | 0 | |
| PAUL A BEAUDOIN | ||||||
| ASST TREASURER/SR VP FINAN | 55.00 | X | 0 | 418067 | 94987 | |
| ELIZABETH ZIMA | ||||||
| ASST SECRETARY/DIR OF DEV | 55.00 | X | 0 | 108898 | 24632 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4560409 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 516014 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 21718 | FundraisingEvents |
| All Other Contributions | 3147819 | AllOtherContributions |
| Noncash Contributions | 1888 | NoncashContributions |
| Total Contributions | 3169537 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12319 | TotalRevenueColumn |
| Exclusion | $12,319 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 362628 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 349371 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 13257 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13257 | TotalRevenueColumn |
| Exclusion | $13,257 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 129507 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 21718 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 68186 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 61321 | TotalRevenueColumn |
| Exclusion | $61,321 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 15360 | GrossIncomeGaming |
| Gaming Direct Expenses | 8244 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7116 | TotalRevenueColumn |
| Exclusion | $7,116 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3263550 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $94,013 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 930706 | Total |
| Program Services | 930706 | ProgramServices |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER - *SEE SCHED O | Description |
| Total | 2358 | Total |
| Program Services | 2358 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 933064 | Total |
| Program Services | 933064 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2344234 | BOY |
| EOY | 2636509 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2388874 | BOY |
| EOY | 4708035 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4733108 | BOY |
| EOY | 7344544 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147351 | BOY |
| EOY | 125029 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 317982 | BOY |
| EOY | 542022 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 465333 | BOY |
| EOY | 667051 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 543418 | BOY |
| EOY | 619152 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3487098 | BOY |
| EOY | 5814369 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 237259 | BOY |
| EOY | 243972 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4267775 | BOY |
| EOY | 6677493 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4733108 | BOY |
| EOY | 7344544 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 2330486 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 79232 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENT COUNTY MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050258896 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | 1 | ListedInGoverningDoc |
| Supported Organization Notified | 1 | SupportedOrganizationNotified |
| Organized In US | 1 | OrganizedInUS |
| Amount | $930,706 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 930706 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2388874 | BeginningOfYearBalance |
| Contributions | 2945664 | Contributions |
| Investment Earnings Or Losses | 106059 | InvestmentEarningsOrLosses |
| Other Expenditures | 728949 | OtherExpenditures |
| Administrative Expenses | 3612 | AdministrativeExpenses |
| End Of Year Balance | 4708036 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1939843 | BeginningOfYearBalance |
| Contributions | 1566260 | Contributions |
| Investment Earnings Or Losses | -5842 | InvestmentEarningsOrLosses |
| Other Expenditures | 1106952 | OtherExpenditures |
| Administrative Expenses | 4435 | AdministrativeExpenses |
| End Of Year Balance | 2388874 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1550305 | BeginningOfYearBalance |
| Contributions | 1640754 | Contributions |
| Investment Earnings Or Losses | 33649 | InvestmentEarningsOrLosses |
| Other Expenditures | 1282443 | OtherExpenditures |
| Administrative Expenses | 2422 | AdministrativeExpenses |
| End Of Year Balance | 1939843 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2084487 | BeginningOfYearBalance |
| Contributions | 1455590 | Contributions |
| Investment Earnings Or Losses | 14793 | InvestmentEarningsOrLosses |
| Other Expenditures | 2002706 | OtherExpenditures |
| Administrative Expenses | 1859 | AdministrativeExpenses |
| End Of Year Balance | 1550305 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.93000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.07000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO KENT COUNTY MEMORIAL HOSPITAL | Description |
| Amount | $542,022 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 542022 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE FOUNDATION'S ENDOWMENTS CONSIST OF NUMEROUS INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE PURPOSES INCLUDE GENERAL PURPOSE, HEALTHCARE SERVICES, INDIGENT CARE, HEALTH EDUCATION AND PROPERTY AND EQUIPMENT. |
| TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X, LINE 2: THE ORGANIZATION IS AN AFFILIATE OF CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES, A TAX-EXEMPT, INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S PARENT ENTITY IS CARE NEW ENGLAND HEALTH SYSTEM. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CARE NEW ENGLAND HEALTH SYSTEM AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND SEPTEMBER 30, 2011, RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CERTAIN CONSOLIDATING SCHEDULES. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN FOOTNOTE DISCLOSURE RELATED TO THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48. THE ORGANIZATION COMPLETED AN ASSESSMENT OF THE ESTIMATED LIABILITY FOR UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2012 AND CONCLUDED THAT THE ESTIMATED LIABILITY WAS NOT MATERIAL TO THE ORGANIZATION'S FINANCIAL STATEMENTS. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GALA | NameOfEvent1 |
| Gross Receipts Event1 | 151225 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 21718 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 129507 | GrossRevenueEvent1 |
| Food And Beverage Event1 | 30910 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 4500 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 32776 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 151225 | GrossReceiptsTotal |
| Charitable Contributions Total | 21718 | CharitableContributionsTotal |
| Gross Revenue Total Events | 129507 | GrossRevenueTotalEvents |
| Food And Beverage Total Events | 30910 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 4500 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 32776 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 68186 | DirectExpenseSummaryEvents |
| Net Income Summary | 61321 | NetIncomeSummary |
Gaming Information GamingInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Revenue Other Gaming | 15360 | GrossRevenueOtherGaming |
| Non Cash Prizes Other Gaming | 6440 | NonCashPrizesOtherGaming |
| Other Direct Expenses Other Gaming | 1804 | OtherDirectExpensesOtherGaming |
| Volunteer Labor Other Gaming | 1 | VolunteerLaborOtherGaming |
| Volunteer Labor Prcnt Other Gaming | 0.75000 | VolunteerLaborPrcntOtherGaming |
| Gross Revenue Total Gaming | 15360 | GrossRevenueTotalGaming |
| Non Cash Prizes Total Gaming | 6440 | NonCashPrizesTotalGaming |
| Other Direct Expenses Total Gaming | 1804 | OtherDirectExpensesTotalGaming |
| Direct Expense Summary Gaming | 8244 | DirectExpenseSummaryGaming |
| Net Gaming Income Summary | 7116 | NetGamingIncomeSummary |
| Field | Value | IRS element (for citing) |
|---|---|---|
| States Where Gaming Conducted | RI | StatesWhereGamingConducted |
| Licensed | 1 | Licensed |
| License Suspended Etc | 0 | LicenseSuspendedEtc |
| Gaming With Nonmembers | 0 | GamingWithNonmembers |
| Member Of Other Entity | 0 | MemberOfOtherEntity |
Name Of Gaming Rec Keeper Bus NameOfGamingRecKeeperBus
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELIZABETH ZIMA | BusinessNameLine1 |
Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 TOLL GATE ROAD | AddressLine1 |
| City | WARWICK | City |
| State | RI | State |
| ZIP Code | 02886 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contract With3rd Party For Gam Rev | 0 | ContractWith3rdPartyForGamRev |
| Gaming Manager Name Person | ELIZABETH ZIMA | GamingManagerNamePerson |
| Gaming Manager Compensation | 0 | GamingManagerCompensation |
| Gaming Manager Services Provided | GAMING RECORDS AND BOOKEEPER. | GamingManagerServicesProvided |
| Gaming Manager Is Director Officer | X | GamingManagerIsDirectorOfficer |
| Charitable Distrib Required | 0 | CharitableDistribRequired |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENT COUNTY MEMORIAL HOSPITAL | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 TOLL GATE ROAD | AddressLine1 |
| City | WARWICK | City |
| State | RI | State |
| ZIP Code | 02886 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 050258896 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 930706 | AmountOfCashGrant |
| Purpose Of Grant | HOSPITAL SUPPORT | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 1 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SANDRA L COLETTA | |||||||||||||
| 0 | 512074 | 0 | 148400 | 0 | 171077 | 0 | 172496 | 0 | 11865 | 0 | 1015912 | 0 | 0 |
| MICHAEL J DACEY MD | |||||||||||||
| 0 | 315419 | 0 | 76414 | 0 | 62268 | 0 | 79572 | 0 | 11851 | 0 | 545524 | 0 | 0 |
| CANDACE L DYER MD | |||||||||||||
| 0 | 332269 | 0 | 13664 | 0 | 24459 | 0 | 0 | 0 | 1915 | 0 | 372307 | 0 | 0 |
| JOHN J HYNES ESQ | |||||||||||||
| 0 | 836844 | 0 | 242250 | 0 | 1009675 | 0 | 26950 | 0 | 51565 | 0 | 2167284 | 0 | 712624 |
| JOSEPH W SPINALE DO FACC FACP | |||||||||||||
| 0 | 78210 | 0 | 0 | 0 | 98086 | 0 | 0 | 0 | 17832 | 0 | 194128 | 0 | 0 |
| PAUL A BEAUDOIN | |||||||||||||
| 0 | 291796 | 0 | 69000 | 0 | 57271 | 0 | 74275 | 0 | 20712 | 0 | 513054 | 0 | 39053 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SUPPLEMENTAL INFORMATION | Identifier |
| Return Reference | PART III | ReturnReference |
| Explanation | COMPENSATION INFORMATION PART VII AND SCHEDULE J TAXABLE COMPENSATION REPORTED HEREIN IS DERIVED FROM 2011 FORMS W-2 AND 1099 (IF APPLICABLE). COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 4B: THE AMOUNT REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN A LONG-TERM INCENTIVE PLAN WHICH ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JOHN J. HYNES, ESQ., $712,624 AND PAUL A. BEAUDOIN, $39,053. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE FOLLOWING INDIVIDUALS INCLUDES UNVESTED BENEFITS IN A LONG-TERM INCENTIVE PLAN WHICH ARE SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. ACCORDINGLY, THE INDIVIDUALS MAY NEVER ACTUALLY RECEIVE THE UNVESTED BENEFIT AMOUNT. THE AMOUNTS OUTLINED HEREIN WERE NOT INCLUDED IN THE INDIVIDUAL'S 2011 FORM W-2, AS TAXABLE WAGES: SANDRA L. COLETTA, $156,571; PAUL A. BEAUDOIN, $55,900 AND MICHAEL J. DACEY, M.D., $62,422. SCHEDULE J, PART I, LINES 6A & 6B: THE EXECUTIVE COMPENSATION PACKAGE FOR VARIOUS INDIVIDUALS REPORTED ON THIS FORM 990 CONSISTS OF BOTH A FIXED SALARY AND ADDITIONAL AT-RISK COMPENSATION THAT IS BASED ON SEVERAL QUALITATIVE AND QUANTITATIVE COMPONENTS. THE AT-RISK COMPENSATION IS COMPRISED OF BOTH SHORT-TERM AND LONG-TERM FACTORS AS FOLLOWS: THE SHORT-TERM INCENTIVE PROGRAM PROVIDES AN OPPORTUNITY FOR PROGRAM PARTICIPANTS TO EARN AN INCENTIVE AWARD BASED ON THE ACHIEVEMENT OF CRITICAL STRETCH GOALS THAT RECOGNIZE PERFORMANCE ABOVE EXPECTATIONS. THESE GOALS ARE MEASURED FOR EACH FISCAL PERIOD IN THE FOLLOWING CRITICAL AREAS: QUALITY, FINANCIAL AND PATIENT SATISFACTION. THE LONG-TERM INCENTIVE PROGRAM PROVIDES AN OPPORTUNITY FOR PROGRAM PARTICIPANTS TO EARN AN INCENTIVE AWARD BASED ON THE ACCOMPLISHMENT OF CRITICAL MULTI-YEAR SYSTEM PERFORMANCE OBJECTIVES. AWARDS ARE EARNED BY MEASURING SYSTEM PERFORMANCE OVER THREE-YEAR OVERLAPPING PERFORMANCE PERIODS AND ARE MEASURED IN REFERENCE TO GOALS IN THE FOLLOWING CRITICAL AREAS: NET INCOME FROM OPERATIONS, MARKET SHARE, PATIENT SATISFACTION AND STRATEGIC OBJECTIVE. COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 7: CERTAIN INDIVIDUALS INCLUDED IN SCHEDULE J, PART II RECEIVED A BONUS DURING CALENDAR YEAR 2011 WHICH AMOUNTS WERE INCLUDED IN COLUMN B(II) HEREIN AND IN EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES. PLEASE REFER TO THIS SECTION OF THE FORM 990, SCHEDULE J FOR THIS INFORMATION BY PERSON BY AMOUNT. COMPENSATION INFORMATION SCHEDULE J, PART II, COLUMN F: THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUALS INCLUDES VESTED BENEFITS IN A LONG-TERM INCENTIVE PLAN BECAUSE THE AMOUNT WAS NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THIS AMOUNT WAS TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S 2011 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: JOHN J. HYNES, ESQ., $712,624 AND PAUL A. BEAUDOIN, $39,053. THESE AMOUNTS WERE REPORTED ON PRIOR YEAR FORMS 990 AS AT-RISK NON-TAXABLE DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | JONATHAN K. FARNUM AND GEORGE W. SHUSTER - BUSINESS RELATIONSHIP; ANDREW M. ERICKSON AND MARIBETH Q. WILLIAMSON - BUSINESS RELATIONSHIP; JONATHAN K. FARNUM, JAMES A. HOPKINS, ANDREA M. HOPKINS AND RAYMOND J. BOLSTER, II - BUSINESS RELATIONSHIP; JAMES A. HOPKINS AND ANDREA M. HOPKINS - FAMILY RELATIONSHIP. | |
| FORM 990, PART VI, SECTION A, LINE 6 | KENT COUNTY MEMORIAL HOSPITAL ("KCMH") IS THE SOLE MEMBER OF THIS ORGANIZATION. | |
| FORM 990, PART VI, SECTION A, LINE 7A | KCMH HAS THE ULTIMATE AUTHORITY TO ELECT THE MEMBERS OF THIS ORGANIZATION'S BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | KCMH DETERMINES PROGRAM OBJECTIVES OF THIS ORGANIZATION AND APPROVES CHANGES TO THE BYLAWS OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED AND REVIEWED BY A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION. DURING THAT PROCESS THE FORM 990 IS PROVIDED TO CERTAIN MEMBERS OF MANAGEMENT FOR REVIEW. A COMPLETE AND ACCURATE COPY OF THE FORM 990 IS THEN PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO THE FILING OF THE FORM WITH THE INTERNAL REVENUE SERVICE. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AND REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH THAT POLICY. THE POLICY REQUIRES THAT A CONFLICT OF INTEREST DISCLOSURE FORM CONSISTENT WITH BEST GOVERNANCE PRACTICES AND INTERNAL REVENUE SERVICE GUIDELINES BE CIRCULATED TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY. IF A DIRECTOR DISCLOSES AN INTEREST THAT COULD GIVE RISE TO A CONFLICT, THE DIRECTOR'S POTENTIAL CONFLICT IS REFERRED TO THE BOARD OR THE COMMITTEE, WHICH EVALUATES THE CONFLICT AND ITS POTENTIAL IMPACT ON THE DIRECTOR'S PARTICIPATION ON THE BOARD OR ON CERTAIN ISSUES THAT MAY COME BEFORE THE BOARD. AFTER CONSULTATION WITH COUNSEL, THE COMMITTEE WILL TAKE ACTION, IF APPROPRIATE AND NECESSARY, TO ADDRESS ANY SUCH CONFLICT IN A MANNER CONSISTENT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS OF CARE NEW ENGLAND HEALTH SYSTEM ("CNE") HAS A COMMITTEE OF DIRECTORS KNOWN AS THE CNE COMPENSATION COMMITTEE ("THE COMMITTEE"). THE COMMITTEE IS RESPONSIBLE FOR DISCHARGING THE BOARD'S RESPONSIBILITIES REGARDING THE TOTAL COMPENSATION PROGRAM FOR EXECUTIVES AND KEY PHYSICIANS IN CONJUNCTION WITH THE KENT COUNTY MEMORIAL HOSPITAL PRESIDENT AND CHIEF EXECUTIVE OFFICER. THE COMMITTEE AT ALL TIMES CONDUCTS ITSELF FREE FROM EXECUTIVE MANAGEMENT IN ITS DECISION MAKING PROCESS EXCEPT WITH RESPECT TO DECISIONS RELATING TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER WHICH ARE MADE IN CONJUNCTION WITH THE CARE NEW ENGLAND HEALTH SYSTEM CHIEF EXECUTIVE OFFICER. THE ACTIONS TAKEN BY THE COMMITTEE ENABLE THE ORGANIZATION TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS FOR PURPOSES OF INTERNAL REVENUE CODE SECTION 4958 WITH RESPECT TO THE TOTAL COMPENSATION OF CERTAIN MEMBERS OF THE SENIOR MANAGEMENT TEAM, INCLUDING THE PRESIDENT AND CEO. THE THREE FACTORS WHICH MUST BE SATISFIED IN ORDER TO RECEIVE THE REBUTTABLE PRESUMPTION OF REASONABLENESS ARE THE FOLLOWING: 1. THE COMPENSATION ARRANGEMENT IS APPROVED IN ADVANCE BY AN "AUTHORIZED BODY" OF THE APPLICABLE TAX-EXEMPT ORGANIZATION WHICH IS COMPOSED ENTIRELY OF INDIVIDUALS WHO DO NOT HAVE A "CONFLICT OF INTEREST" WITH RESPECT TO THE COMPENSATION ARRANGEMENT; 2. THE AUTHORIZED BODY OBTAINED AND RELIED UPON "APPROPRIATE DATA AS TO COMPARABILITY" PRIOR TO MAKING ITS DETERMINATION; AND 3. THE AUTHORIZED BODY "ADEQUATELY DOCUMENTED THE BASIS FOR ITS DETERMINATION" CONCURRENTLY WITH MAKING THAT DETERMINATION. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF DIRECTORS EACH OF WHO ARE INDEPENDENT AND ARE FREE FROM ANY CONFLICTS OF INTEREST. THE COMMITTEE RELIED UPON APPROPRIATE COMPARABLE DATA; SPECIFICALLY THE COMMITTEE OBTAINED A WRITTEN COMPENSATION STUDY FROM AN INDEPENDENT FIRM WHICH SPECIALIZES IN THE REVIEWING OF HOSPITAL AND HEALTHCARE SYSTEM EXECUTIVE COMPENSATION AND BENEFITS THROUGHOUT THE UNITED STATES. THIS STUDY USED COMPARABLE GEOGRAPHIC AND DEMOGRAPHIC MARKET DATA INCLUDING BUT NOT LIMITED TO SIMILARLY SIZED HEALTHCARE SYSTEMS AND HOSPITALS, NUMBER OF LICENSED BEDS AND NET PATIENT SERVICE REVENUE. THE COMMITTEE ADEQUATELY DOCUMENTED ITS BASIS FOR ITS DETERMINATION THROUGH THE TIMELY PREPARATION OF WRITTEN MINUTES OF THE COMPENSATION COMMITTEE MEETINGS DURING WHICH THE EXECUTIVE COMPENSATION AND BENEFITS WERE REVIEWED AND SUBSEQUENTLY APPROVED. THE ACTIONS OUTLINED ABOVE WITH RESPECT TO THE COMMITTEE AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS APPLIES TO CERTAIN SENIOR MANAGEMENT PERSONNEL, INCLUDING, BUT NOT LIMITED TO, THE PRESIDENT AND CEO. THE COMPENSATION AND BENEFITS OF CERTAIN OTHER INDIVIDUALS CONTAINED IN THIS FORM 990 ARE ALSO REVIEWED BY THE CARE NEW ENGLAND HEALTH SYSTEM COMPENSATION COMMITTEE. IN ADDITION, THE KENT COUNTY MEMORIAL HOSPITAL PRESIDENT AND CEO, WITH ASSISTANCE FROM THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT, ALSO REVIEW THE COMPENSATION AND BENEFITS OF OTHER PEOPLE INCLUDED IN THIS FORM 990 IN CONJUNCTION WITH EACH INDIVIDUAL'S JOB PERFORMANCE DURING THE YEAR AND IS BASED UPON OTHER OBJECTIVE FACTORS DESIGNED TO ENSURE THAT REASONABLE AND FAIR MARKET VALUE COMPENSATION IS PAID BY THE ORGANIZATION. OTHER OBJECTIVE FACTORS INCLUDE MARKET SURVEY DATA FOR COMPARABLE POSITIONS, INDIVIDUAL GOALS AND OBJECTIVES, PERSONNEL REVIEWS, EVALUATIONS, SELF-EVALUATIONS AND PERFORMANCE FEEDBACK MEETINGS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | KENT HOSPITAL FOUNDATION'S CORPORATE DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY MAIL UPON WRITTEN REQUEST. | |
| CORE FORM, PART VII, SECTION A, COLUMN B | THIS ORGANIZATION IS AN AFFILIATE OF CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES; A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM INCLUDES BOTH FOR-PROFIT AND NOT FOR-PROFIT ORGANIZATIONS. CERTAIN BOARD OF DIRECTOR MEMBERS, OFFICERS AND/OR DIRECTORS LISTED ON CORE FORM, PART VII AND SCHEDULE J OF THIS FORM 990 MAY HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES WITHIN THE SYSTEM. THE HOURS SHOWN ON THIS FORM 990 FOR BOARD MEMBERS WHO RECEIVE NO COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, REPRESENTS THE ESTIMATED HOURS DEVOTED PER WEEK FOR THIS ORGANIZATION. TO THE EXTENT THESE INDIVIDUALS SERVE AS A MEMBER OF THE BOARD OF DIRECTORS OF OTHER RELATED ORGANIZATIONS IN THE SYSTEM, THEIR RESPECTIVE HOURS PER WEEK PER ORGANIZATION ARE APPROXIMATELY ONE HOUR. THE HOURS REFLECTED ON PART VII OF THIS FORM 990, FOR BOARD MEMBERS WHO RECEIVE COMPENSATION FOR SERVICES RENDERED IN A NON-BOARD CAPACITY, PAID OFFICERS AND KEY EMPLOYEES, REFLECT TOTAL HOURS WORKED PER WEEK ON BEHALF OF THE SYSTEM; NOT SOLELY THIS ORGANIZATION. | |
| PART VII AND SCHEDULE J REFLECT CERTAIN BOARD MEMBERS AND OFFICERS RECEIVING COMPENSATION AND BENEFITS FROM THIS ORGANIZATION OR A RELATED ORGANIZATION. PLEASE NOTE THIS REMUNERATION WAS FOR SERVICES RENDERED AS FULL-TIME OR PART-TIME EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR A RELATED ORGANIZATION AND NOT FOR SERVICES RENDERED AS A VOTING MEMBER OR OFFICER OF THIS ORGANIZATION'S BOARD OF DIRECTORS. | ||
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 79,232. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2: | THE ORGANIZATION IS AN AFFILIATE OF CARE NEW ENGLAND HEALTH SYSTEM AND AFFILIATES, A TAX-EXEMPT, INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM"). THE SYSTEM'S PARENT ENTITY IS CARE NEW ENGLAND HEALTH SYSTEM. AN INDEPENDENT BIG FOUR CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF CARE NEW ENGLAND HEALTH SYSTEM AND ALL ENTITIES WITHIN THE SYSTEM FOR THE YEARS ENDED SEPTEMBER 30, 2012 AND SEPTEMBER 30, 2011, RESPECTIVELY, AND ISSUED A CONSOLIDATED FINANCIAL STATEMENT WITH CONSOLIDATED SCHEDULES BY ENTITY. AN UNQUALIFIED OPINION WAS ISSUED EACH YEAR BY THE INDEPENDENT CPA FIRM. CARE NEW ENGLAND HEALTH SYSTEM'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT AUDITOR. | AUDITED FINANCIAL STATEMENTS |
| FORM 990, PART IX, LINE 24: | ADDITIONAL FUNDRAISING EXPENSES ARE REPORTED ON KENT COUNTY MEMORIAL HOSPITAL, EIN: 05-0258896. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (11 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BUTLER HOSPITAL | |||||||||||
| 345 BLACKSTONE BLVD | PROVIDENCE | RI | 02906 | 050258812 | HEALTHCARE | RI | 501(C)(3) | HOSPITAL | CNE | 0 | |
| CARE NEW ENGLAND HEALTH SYSTEM | |||||||||||
| 45 WILLARD AVENUE | PROVIDENCE | RI | 02905 | 050490997 | HEALTHCARE | RI | 501(C)(3) | 509(A)(3) | 0 | N/A | |
| HEALTHTOUCH INC | |||||||||||
| 51 HEALTH LANE | WARWICK | RI | 02886 | 050514949 | HEALTHCARE | RI | 501(C)(3) | 509(A)(2) | KCVNA | 0 | |
| KENT COUNTY MEMORIAL HOSPITAL | |||||||||||
| 455 TOLL GATE ROAD | WARWICK | RI | 02886 | 050258896 | HEALTHCARE | RI | 501(C)(3) | HOSPITAL | CNE | 0 | |
| KENT COUNTY VISITING NURSE ASSOCIATION DBA VNA OF CNE | |||||||||||
| 51 HEALTH LANE | WARWICK | RI | 02886 | 050242659 | HEALTHCARE | RI | 501(C)(3) | 170B1AVI | CNE | 0 | |
| PALOMAR GROUP INC | |||||||||||
| 300 RICHMOND STREET | PROVIDENCE | RI | 02903 | 050462378 | PARKING FACILITY | RI | 501(C)(3) | 509(A)(2) | WIC | 0 | |
| WIH FACULTY PHYSICIANS INC | |||||||||||
| 67 BRIGHAM STREET | NEW BEDFORD | MA | 02740 | 043579432 | HEALTHCARE | MA | 501(C)(3) | 509(A)(2) | WIH | 0 | |
| WOMEN & INFANTS CORPORATION | |||||||||||
| 300 RICHMOND STREET | PROVIDENCE | RI | 02903 | 022885807 | HEALTHCARE | RI | 501(C)(3) | 509(A)(3) | CNE | 0 | |
| WOMEN & INFANTS DEVELOPMENT FOUNDATION | |||||||||||
| 300 RICHMOND STREET | PROVIDENCE | RI | 02903 | 222885815 | HEALTHCARE | RI | 501(C)(3) | 509(A)(3) | WIC | 0 | |
| WOMEN & INFANTS HOSPITAL OF RHODE ISLAND | |||||||||||
| 300 RICHMOND STREET | PROVIDENCE | RI | 02903 | 050258937 | HEALTHCARE | RI | 501(C)(3) | 509(A)(1) | WIC | 0 | |
| BUTLER HOSPITAL FOUNDATION | |||||||||||
| 345 BLACKSTONE BLVD | PROVIDENCE | RI | 02906 | 454530540 | SUPPORT ORG | RI | 501(C)(3) | 509(A)(3) | BH | 0 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|
| TOLL GATE INDEMNITY LTD | |||||||
| 23 LIME TREE BAY AVENUE PO BOX 105 | GRAND CAYMAN | CJ | 342028514 | FINANCIAL VEHICLE | CJ | KCMH | C |
| W & I INDEMNITY LTD | |||||||
| 23 LIME TREE BAY AVENUE PO BOX 105 | GRAND CAYMAN | CJ | 980159342 | FINANCIAL VEHICLE | CJ | WIH | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| KENT COUNTY MEMORIAL HOSPITAL | ||
| B | 930706 | COST |
| KENT COUNTY MEMORIAL HOSPITAL | ||
| C | 276000 | COST |
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