MERCY MEDICAL CENTER MERCED FOUNDATION: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MERCY MEDICAL CENTER MERCED FOUNDATION (EIN 77-0035928)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-07
- IRS object ID
- 201311279349301701
- 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 | 2013-05-07T16:43:40-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 SECOND STREET SUITE 1400 | AddressLine1 |
| City | SAN FRANCISCO | City |
| State | CA | State |
| ZIP Code | 94105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 770035928 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mercy Medical Center Merced Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % BARRY PRISAZNIK - FINANCE DE | InCareOfName |
| Name Control | MERC | NameControl |
| Phone | 2093846734 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2740 M STREET | AddressLine1 |
| City | MERCED | City |
| State | CA | State |
| ZIP Code | 95340 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL STRASSER | Name |
| Title | CFO | Title |
| Date Signed | 2013-05-06 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4159635100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DOREEN HARTMANN CFO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2740 M STREET | AddressLine1 |
| City | MERCED | City |
| State | CA | State |
| ZIP Code | 95340 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1453293 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.dignityhealth.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1984 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE FINANCIAL ASSISTANCE AND SUPPORTING SERVICES FOR DIGNITY HEALTH (DBA: MERCY MEDICAL CENTER MERCED). | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 58 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 663150 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1388711 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 12534 | InvestmentIncomePriorYear |
| Investment Income Current Year | 11972 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -3991 | OtherRevenuePriorYear |
| Other Revenue Current Year | -38317 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 671693 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1362366 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 751302 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1461016 | 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 | 125483 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 339459 | OtherExpensePriorYear |
| Other Expenses Current Year | 451268 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1090761 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1912284 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -419068 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -549918 | RevenuesLessExpensesCY |
| Total Assets BOY | 1602071 | TotalAssetsBOY |
| Total Assets EOY | 1040002 | TotalAssetsEOY |
| Total Liabilities BOY | 10855 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 15250 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1591216 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1024752 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | To provide financial assistance and supporting services for Dignity Health (dba: Mercy Medical Center Merced). The financial support provided by the Foundation contribute 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 1597950 | Expense |
| Grants | 1461016 | Grants |
| Revenue | 0 | Revenue |
| Description | 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. | Description |
| Total Program Service Expense | 1597950 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BARRY PRISAZNIK - FINANCE DE | NamePerson |
| Telephone Number | 2095644284 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2740 M STREET | AddressLine1 |
| City | MERCED | City |
| State | CA | State |
| ZIP Code | 95340 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| Anna Bolling | ||||||
| Director | 1.0 | X | 0 | 0 | 0 | |
| Kathleen M Crookham | ||||||
| Director | 1.0 | X | 0 | 0 | 0 | |
| David Dunham | ||||||
| Ex-officio board member | 1.0 | X | 0 | 520256 | 73917 | |
| Helen Evans | ||||||
| Director | 1.0 | X | 0 | 0 | 0 | |
| Ric Kirby | ||||||
| Director | 1.0 | X | 0 | 0 | 0 | |
| Cyril Lawrence | ||||||
| Director | 1.0 | X | 0 | 0 | 0 | |
| Carol Madruga | ||||||
| Ex-officio board member | 1.0 | X | 0 | 104425 | 15652 | |
| Nellie McGarry | ||||||
| Director | 1.0 | X | 0 | 0 | 0 | |
| Dr Shailesh Patel | ||||||
| Director | 1.0 | X | 0 | 0 | 0 | |
| Margaret Pia | ||||||
| Director | 1.0 | X | 0 | 0 | 0 | |
| Marilyn Reese | ||||||
| Director | 1.0 | X | 0 | 0 | 0 | |
| Marcee Samberg | ||||||
| Director | 1.0 | X | 0 | 1166 | 0 | |
| Jim Cunningham | ||||||
| Board Chairman | 3.0 | X | 0 | 0 | 0 | X |
| Dan Holmes | ||||||
| Vice Chairman of Fund Developm | 2.0 | X | 0 | 0 | 0 | X |
| Dr Daniel Ikemiyashiro | ||||||
| Secretary | 2.0 | X | 0 | 0 | 0 | X |
| Christine Long | ||||||
| Vice Chair of Marketing | 2.0 | X | 0 | 0 | 0 | X |
| Garth Pecchenino | ||||||
| Vice Chair of Board Developmen | 2.0 | X | 0 | 0 | 0 | X |
| Lorelei Stapp | ||||||
| Treasurer | 2.0 | X | 0 | 0 | 0 | X |
| Doreen Hartmann | ||||||
| CFO (thru 11/28/11) | 2.0 | 0 | 280435 | 32707 | X | |
| Lisa Wegley | ||||||
| Foundation Director | 50.0 | 0 | 88988 | 9295 | X | |
| Michael Strasser | ||||||
| CFO (start 12/30/11) | 2.0 | 0 | 0 | 0 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 995270 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 131571 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 159175 | FundraisingEvents |
| Related Organizations | 530365 | RelatedOrganizations |
| All Other Contributions | 699171 | AllOtherContributions |
| Noncash Contributions | 6180 | NoncashContributions |
| Total Contributions | 1388711 | TotalContributions |
| Total Program Service Revenue | 0 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11972 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $11,972 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 52610 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 159175 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 90927 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -38317 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$38,317 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1362366 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$26,345 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1461016 | Total |
| Program Services | 1461016 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2004 | Total |
| Program Services | 1002 | ProgramServices |
| Management And General | 1002 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7500 | Total |
| Management And General | 7500 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 346695 | Total |
| Program Services | 104024 | ProgramServices |
| Management And General | 154990 | ManagementAndGeneral |
| Fundraising | 87681 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14333 | Total |
| Program Services | 12900 | ProgramServices |
| Fundraising | 1433 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32449 | Total |
| Program Services | 7866 | ProgramServices |
| Management And General | 1869 | ManagementAndGeneral |
| Fundraising | 22714 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13596 | Total |
| Program Services | 6798 | ProgramServices |
| Management And General | 6798 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13383 | Total |
| Management And General | 10716 | ManagementAndGeneral |
| Fundraising | 2667 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5464 | Total |
| Program Services | 2732 | ProgramServices |
| Management And General | 2732 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 312 | Total |
| Management And General | 312 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 74 | Total |
| Program Services | 74 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2004 | Total |
| Management And General | 2004 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| VOLUNTEER DEVELOPMENT | 6911 | 0 | 0 | 6911 |
| DONOR RECOGNITION | 3312 | 0 | 0 | 3312 |
| FOOD SUPPLIES | 1538 | 1538 | 0 | 0 |
| DUES & SUBSCRIPTIONS | 813 | 0 | 813 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 880 | Total |
| Management And General | 115 | ManagementAndGeneral |
| Fundraising | 765 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1912284 | Total |
| Program Services | 1597950 | ProgramServices |
| Management And General | 188851 | ManagementAndGeneral |
| Fundraising | 125483 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 500 | BOY |
| EOY | 500 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 619325 | BOY |
| EOY | 594992 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 482441 | BOY |
| EOY | 444510 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 15282 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 15282 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74 | BOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 499731 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1602071 | BOY |
| EOY | 1040002 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10855 | BOY |
| EOY | 15250 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10855 | BOY |
| EOY | 15250 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -655637 | BOY |
| EOY | 227931 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2246853 | BOY |
| EOY | 796821 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1591216 | BOY |
| EOY | 1024752 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1602071 | BOY |
| EOY | 1040002 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -549918 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -16546 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1285725 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1039865 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1506017 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 633150 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1388711 | CurrentTaxYear |
| Total | 5853468 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1285725 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1039865 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1506017 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 633150 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1388711 | CurrentTaxYear |
| Total | 5853468 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 209706 | AmountsSubstContributorsTotal |
| Public Support Total170 | 5643762 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 28402 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13596 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6831 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12534 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11972 | CurrentTaxYear |
| Total | 73335 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 37040 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7711 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 62490 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12003 | CurrentTaxYearMinus1Year |
| Current Tax Year | 52610 | CurrentTaxYear |
| Total | 171854 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 6098657 | TotalSupport |
| Public Support Pertcentage170 | 0.92541 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.87253 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| General Explanation | 2007 2008 2009 2010 2011 Fundraising Events 37,040 7,711 62,490 12,003 52,610 | GeneralExplanation |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 289649 | BeginningOfYearBalance |
| Contributions | 7200 | Contributions |
| Investment Earnings Or Losses | 36651 | InvestmentEarningsOrLosses |
| End Of Year Balance | 333500 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 267025 | BeginningOfYearBalance |
| Contributions | 24500 | Contributions |
| Investment Earnings Or Losses | -1876 | InvestmentEarningsOrLosses |
| End Of Year Balance | 289649 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Land | Land | |
| Buildings | Buildings | |
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15282 | OtherCostOrOtherBasis |
| Depreciation | 15282 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Sch D, Part V, line 4 | Identifier |
| Explanation | The Foundation Board has designated the funds for special projects; the intention is to grow the corpus to a set amount (tentatively $300K) and use the earnings to fund special programs each year. In January 2012 the Hospital President made a request to use these funds to help with the initial costs of a new spine program. The Foundation operating board approved the request. | Explanation |
Schedule G IRS990ScheduleG
Fundraiser Activity Information FundraiserActivityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Individual | THE GREENWOOD CO | NameOfIndividual |
| Activity | CAPITAL CAMPAIGN | Activity |
| Fundraiser Control Of Funds | false | FundraiserControlOfFunds |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | SPURS/STILLETOS | NameOfEvent1 |
| Gross Receipts Event1 | 211785 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 159175 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 52610 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 2550 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 16690 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 39681 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 5400 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 26606 | OtherDirectExpensesEvent1 |
| Name Of Event2 | NONE | NameOfEvent2 |
| Gross Receipts Event2 | 0 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 0 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 0 | GrossRevenueEvent2 |
| Cash Prizes Event2 | 0 | CashPrizesEvent2 |
| Non Cash Prizes Event2 | 0 | NonCashPrizesEvent2 |
| Rent Facility Costs Event2 | 0 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 0 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 0 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 0 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 0 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 0 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 0 | GrossRevenueOtherEvents |
| Cash Prizes Other Events | 0 | CashPrizesOtherEvents |
| Non Cash Prizes Other Events | 0 | NonCashPrizesOtherEvents |
| Rent Facility Costs Other Events | 0 | RentFacilityCostsOtherEvents |
| Food And Beverage Other Events | 0 | FoodAndBeverageOtherEvents |
| Entertainment Other Events | 0 | EntertainmentOtherEvents |
| Other Direct Expenses Other Events | 0 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 211785 | GrossReceiptsTotal |
| Charitable Contributions Total | 159175 | CharitableContributionsTotal |
| Gross Revenue Total Events | 52610 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 0 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 2550 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 16690 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 39681 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 5400 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 26606 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 90927 | DirectExpenseSummaryEvents |
| Net Income Summary | -38317 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dignity Health dba Mercy Medical Center Merced | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 333 Mercy Ave | AddressLine1 |
| City | Merced | City |
| State | CA | State |
| ZIP Code | 95340 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 941196203 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 1461016 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 0 | AmountOfNonCashAssistance |
| Method Of Valuation | N/A | MethodOfValuation |
| Description Of Non Cash Assistance | N/A | DescriptionOfNonCashAssistance |
| Purpose Of Grant | Hospital Support | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART I, LINE 2 | Identifier |
| Explanation | 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. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| David Dunham | |||||||||||||
| 0 | 316389 | 0 | 188582 | 0 | 15285 | 0 | 36551 | 0 | 37366 | 0 | 594173 | 0 | 0 |
| Doreen Hartmann | |||||||||||||
| 0 | 231015 | 0 | 39966 | 0 | 9454 | 0 | 19601 | 0 | 13106 | 0 | 313142 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| 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. |
| PART I, LINE 4a | The organization's officers and highest compensated employees 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 2011. |
| 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 under this formula 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 2011. 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 2011 pursuant to this plan. |
| PART II, SUPPLEMENTAL DISCLOSURES | 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. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART V, VI AND XI | FORM 990, PART V, Line 2 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. FORM 990, PART VI, SECTION A, LINE 6: The sole corporate member is Dignity Health, a 501(c)(3) exempt organization. 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. 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. FORM 990, PART VI, SECTION B, LINE 11A: 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. FORM 990, PART VI, SECTION B, LINE 12c: The Foundation has adopted Dignity Health's Conflicts of Interest Policy. The Foundation's Board is charged with monitoring proposed or ongoing transactions for conflicts of interest and addressing any potential or actual conflicts. Pursuant to these policies, an annual conflict of interest disclosure statement, aimed at determining any family and business relationships and transactions, or other transactions that may pose a potential conflict, is distributed to all covered persons (e.g., board members, officers and executive leadership, key employees and all management personnel whose responsibilities include business decisions which may give rise to conflicts of interest). Covered persons are also required to disclose real or potential conflicts at the time such conflicts arise. When an individual becomes a covered person and annually thereafter, each covered person is required to submit an updated disclosure statement and to sign a statement affirming that he/she: (1) has received a copy of the policy applicable to their 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 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 must be approved by a majority of disinterested persons, based on certain criteria; 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. FORM 990, PART VI, SECTION B, LINE 15 For 2011 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 key executives. Compensation was also reviewed annually as part of the merit increase process. 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. FORM 990, PART XI, LINE 5 Change in unrealized gains/(losses) in the amount of $(16,546) | |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:David Dunham TITLE:Ex-officio board member HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Carol Madruga TITLE:Ex-officio board member HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Marcee Samberg TITLE:Director HOURS:10 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Doreen Hartmann TITLE:CFO (thru 11/28/11) HOURS:40 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:Michael Strasser TITLE:CFO (start 12/30/11) HOURS:40 | FORM 990 PART VII |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dignity Health dba Mercy Med Ctr Merced | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 185 Berry Street | AddressLine1 |
| City | San Francisco | City |
| State | CA | State |
| ZIP Code | 94107 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941196203 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivities |
| Legal Domicile State | CA | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 3 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | na | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NONE | BusinessNameLine1 |
Comments