2013-05-07T16:43:40-05:00 2012-06-30 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2011-07-01 770035928 Mercy Medical Center Merced Foundation % BARRY PRISAZNIK - FINANCE DE MERC 2093846734 2740 M STREET MERCED CA 95340 MICHAEL STRASSER 2013-05-06 true 4159635100 2011 2016-03-07 17:11:31Z DOREEN HARTMANN CFO 2740 M STREET MERCED CA 95340 1453293 false X WWW.dignityhealth.ORG X 1984 CA TO PROVIDE FINANCIAL ASSISTANCE AND SUPPORTING SERVICES FOR DIGNITY HEALTH (DBA: MERCY MEDICAL CENTER MERCED). 18 16 0 58 0 663150 1388711 0 0 12534 11972 -3991 -38317 671693 1362366 751302 1461016 0 0 0 0 0 0 125483 339459 451268 1090761 1912284 -419068 -549918 1602071 1040002 10855 15250 1591216 1024752 X 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. false false 1597950 1461016 0 The Foundation operates exclusively for the benefit of, to perform the function of, or to carry out the purposes of Dignity Health dba Mercy Medical Center Merced, "Hospital", which include making payments directly to the Hospital. 1597950 true true false false false false false false false true true false false false false false false true false false false false false false true false false true false true false false false false false false false false false false false false false true false false false false true X 0 0 0 false false false false false true true false false false false X 18 16 false false false false true true true true true false false false true true true true true false false false CA X BARRY PRISAZNIK - FINANCE DE 2095644284 2740 M STREET MERCED CA 95340 X Anna Bolling 1.0 X 0 0 0 Kathleen M Crookham 1.0 X 0 0 0 David Dunham 1.0 X 0 520256 73917 Helen Evans 1.0 X 0 0 0 Ric Kirby 1.0 X 0 0 0 Cyril Lawrence 1.0 X 0 0 0 Carol Madruga 1.0 X 0 104425 15652 Nellie McGarry 1.0 X 0 0 0 Dr Shailesh Patel 1.0 X 0 0 0 Margaret Pia 1.0 X 0 0 0 Marilyn Reese 1.0 X 0 0 0 Marcee Samberg 1.0 X 0 1166 0 Jim Cunningham 3.0 X X 0 0 0 Dan Holmes 2.0 X X 0 0 0 Dr Daniel Ikemiyashiro 2.0 X X 0 0 0 Christine Long 2.0 X X 0 0 0 Garth Pecchenino 2.0 X X 0 0 0 Lorelei Stapp 2.0 X X 0 0 0 Doreen Hartmann 2.0 X 0 280435 32707 Lisa Wegley 50.0 X 0 88988 9295 Michael Strasser 2.0 X 0 0 0 0 995270 131571 0 false true false 0 159175 530365 699171 6180 1388711 0 11972 0 0 11972 0 0 0 52610 159175 90927 -38317 0 -38317 0 0 0 1362366 0 0 -26345 1461016 1461016 0 0 0 0 0 0 0 0 0 0 2004 1002 1002 7500 7500 0 0 0 346695 104024 154990 87681 14333 12900 1433 32449 7866 1869 22714 13596 6798 6798 0 13383 10716 2667 5464 2732 2732 0 312 312 0 0 74 74 2004 2004 VOLUNTEER DEVELOPMENT 6911 0 0 6911 DONOR RECOGNITION 3312 0 0 3312 FOOD SUPPLIES 1538 1538 0 0 DUES & SUBSCRIPTIONS 813 0 813 0 880 115 765 1912284 1597950 188851 125483 500 500 619325 594992 482441 444510 0 0 0 0 0 0 0 0 0 0 0 0 15282 15282 74 499731 0 0 0 0 0 0 0 0 0 1602071 1040002 10855 15250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10855 15250 X -655637 227931 2246853 796821 0 0 1591216 1024752 1602071 1040002 X -549918 -16546 X false true true X false X 1285725 1039865 1506017 633150 1388711 5853468 1285725 1039865 1506017 633150 1388711 5853468 209706 5643762 28402 13596 6831 12534 11972 73335 37040 7711 62490 12003 52610 171854 6098657 0.92541 0.87253 X 2007 2008 2009 2010 2011 Fundraising Events 37,040 7,711 62,490 12,003 52,610 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 289649 7200 36651 333500 267025 24500 -1876 289649 1.00000 0.00000 0.00000 false false 15282 15282 0 0 Sch D, Part V, line 4 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. THE GREENWOOD CO CAPITAL CAMPAIGN false SPURS/STILLETOS 211785 159175 52610 2550 16690 39681 5400 26606 NONE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211785 159175 52610 0 2550 16690 39681 5400 26606 90927 -38317 true Dignity Health dba Mercy Medical Center Merced 333 Mercy Ave Merced CA 95340 941196203 501(c)(3) 1461016 0 N/A N/A Hospital Support 1 0 PART I, LINE 2 The Foundation operates exclusively for the benefit of, to perform the function of, or to carry out the purposes of the grantee listed in Part II, item 1 (Dignity Health dba Mercy Medical Center Merced), which include making payments directly to the beneficiary organization, transferring and monitoring that restrictions are met before release of funds and expenditure of such funds. false true false false false false false false false David Dunham 0 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 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. 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 FORM 990 PART VII NAME:David Dunham TITLE:Ex-officio board member HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Carol Madruga TITLE:Ex-officio board member HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Marcee Samberg TITLE:Director HOURS:10 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Doreen Hartmann TITLE:CFO (thru 11/28/11) HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Michael Strasser TITLE:CFO (start 12/30/11) HOURS:40 Dignity Health dba Mercy Med Ctr Merced 185 Berry Street San Francisco CA 94107 941196203 HOSPITAL CA 501(c)(3) 3 na false false true true false false false false false false false false true false false false false false false NONE