WESTFIELD MEMORIAL HOSPITAL FOUNDATION INC: Form 990, tax year 2012
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- Organization
- WESTFIELD MEMORIAL HOSPITAL FOUNDATION INC (EIN 22-2270533)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-01
- IRS object ID
- 201323059349300647
- Schema version
- 2012v2.0
- 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 M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-01T10:43:04-07:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES W VANSTROM & COMPANY | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 532 | AddressLine1 |
| City | FALCONER | City |
| State | NY | State |
| ZIP Code | 147330532 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222270533 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTFIELD MEMORIAL HOSPITAL FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WEST | NameControl |
| Phone | 7167932237 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 189 EAST MAIN STREET | AddressLine1 |
| City | WESTFIELD | City |
| State | NY | State |
| ZIP Code | 14787 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TERESA CASLER | Name |
| Title | TREASURER | Title |
| Phone | 7167932237 | Phone |
| Date Signed | 2013-11-01 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | HAROLD L BRUNACINI CPA | Name |
| Phone | 7166613960 | Phone |
| Date Prepared | 2013-11-01 | DatePrepared |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | PATRICIA DIPALMA | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 189 E MAIN STREET | AddressLine1 |
| City | WESTFIELD | City |
| State | NY | State |
| ZIP Code | 14787 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 226408 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.westfieldhospitalfoundation.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1978 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | THE FOUNDATION IS OPERATED FOR THE PURPOSE OF PROMOTING COMMUNITY PHILANTHROPIC SUPPORT OF WESTFIELD MEMORIAL HOSPITAL AND TO PROVIDE FUNDING FOR EXPANSION AND MODERNIZATION OF THE HOSPITAL'S EQUIPMENT AND FACILITIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 16 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 272531 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 198653 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 816 | InvestmentIncomePriorYear |
| Investment Income Current Year | 6023 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -25252 | OtherRevenuePriorYear |
| Other Revenue Current Year | -25673 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 248095 | TotalRevenuePriorYear |
| Total Revenue Current Year | 179003 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 191207 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 130779 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 65226 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 79291 | OtherExpensePriorYear |
| Other Expenses Current Year | 77058 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 270498 | TotalExpensesPriorYear |
| Total Expenses Current Year | 207837 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -22403 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -28834 | RevenuesLessExpensesCY |
| Total Assets BOY | 456661 | TotalAssetsBOY |
| Total Assets EOY | 398210 | TotalAssetsEOY |
| Total Liabilities BOY | 29617 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 427044 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 398210 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE FOUNDATION IS OPERATED | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 130779 | Expense |
| Grants | 130779 | Grants |
| Revenue | 179003 | Revenue |
| Description | PROVIDED GRANT FUNDING TOTALING $130,779 TO WESTFIELD MEMORIAL HOSPITAL FOR NECESSARY EQUIPMENT PURCHASES. | Description |
| Total Program Service Expense | 130779 | 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 | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | 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 | false | 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 | true | 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 |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiled |
| 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 | false | 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 | 16 | 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 | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | 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 | false | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | WESTFIELD MEMORIAL HOSPITAL FOUNDAT | NamePerson |
| Telephone Number | 7167932237 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 189 EAST MAIN STREET | AddressLine1 |
| City | WESTFIELD | City |
| State | NY | State |
| ZIP Code | 147871126 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| ROSE VAN VOLKENBURG | ||||||
| PRESIDENT | 15.00 | X | X | 0 | 0 | 0 |
| MARY ANN WOLEBEN | ||||||
| VICE PRESIDENT | 2.00 | X | X | 0 | 0 | 0 |
| ANN E WEIDMAN | ||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 |
| DON GREENHOUSE | ||||||
| TREASURER | 15.00 | X | X | 0 | 0 | 0 |
| NANCY HANKS | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| MARILYN HEMMER | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| DIANA S HOLT | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| SID HOYT | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| ROBERT MCCLURE | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| JOHN T RAWLINSON | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| MICHAEL RICKETTS | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| DAN SMITH | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| KIM UNDERWOOD | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| TERESA CASLER | ||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | |
| JERRY RUSSELL | ||||||
| DIRECTOR | 1 | X | ||||
| BRENDA HAYES | ||||||
| DIRECTOR | 1 | X | ||||
| PATRICIA DIPALMA | ||||||
| DIR. OF DEVELOPMENT | 35 | X | 51457 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp Frm Rltd Orgs | 51457 | TotalReportableCompFrmRltdOrgs |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Fundraising Events | 70739 | FundraisingEvents |
| All Other Contributions | 127914 | AllOtherContributions |
| Noncash Contributions | 45656 | NoncashContributions |
| Total Contributions | 198653 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6023 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 17533 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 70739 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 47405 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -29872 | TotalRevenueColumn |
| Exclusion | -$29,872 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER FUNDRAISING EVENT INCOME | Description |
| Business Code | 651499 | BusinessCode |
| Total Revenue Column | 4199 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4199 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4199 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 179003 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10222 | RelatedOrExemptFunctionIncome |
| Exclusion | -$29,872 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 130779 | Total |
| Program Services | 130779 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3746 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 3746 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 927 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 927 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6693 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 669 | ManagementAndGeneral |
| Fundraising | 6024 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 581 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 581 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| OTHER EXPENSES | 361 | 0 | 361 | 0 |
| SEE ATTACHED SCHEDULE | 64750 | 0 | 6475 | 58275 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207837 | Total |
| Program Services | 130779 | ProgramServices |
| Management And General | 11832 | ManagementAndGeneral |
| Fundraising | 65226 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38185 | BOY |
| EOY | 21710 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 56443 | BOY |
| EOY | 20551 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32000 | BOY |
| EOY | 19000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 330033 | BOY |
| EOY | 336949 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 456661 | BOY |
| EOY | 398210 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29617 | BOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29617 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97011 | BOY |
| EOY | 61261 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 287321 | BOY |
| EOY | 294237 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42712 | BOY |
| EOY | 42712 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 427044 | BOY |
| EOY | 398210 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 456661 | BOY |
| EOY | 398210 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -28834 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | true | AccountantCompileOrReview |
| FS Audited | false | FSAudited |
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type3 Func Int | X | SupportingOrg509a3Type3FuncInt |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTFIELD MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 160743222 | EIN |
| Type Of Organization | HOSPITAL | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | true | SupportedOrganizationNotified |
| Organized In US | true | OrganizedInUS |
| Amount | $130,779 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 130779 | SumOfAmounts |
| Public Support Total170 | 0 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Pertcentage170 | 0 | PublicSupportPertcentage170 |
| Public Support Total509 | 0 | PublicSupportTotal509 |
| Public Support Percentage509 | 0 | PublicSupportPercentage509 |
| Investment Income Percentage | 0 | InvestmentIncomePercentage |
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 | 47366 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 4678 | InvestmentEarningsOrLosses |
| End Of Year Balance | 52044 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 48964 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -1598 | InvestmentEarningsOrLosses |
| End Of Year Balance | 47366 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 44745 | BeginningOfYearBalance |
| Contributions | 100 | Contributions |
| Investment Earnings Or Losses | 4119 | InvestmentEarningsOrLosses |
| End Of Year Balance | 48964 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 37279 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 7466 | InvestmentEarningsOrLosses |
| End Of Year Balance | 44745 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 49046 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -11767 | InvestmentEarningsOrLosses |
| End Of Year Balance | 37279 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.79360 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.20640 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | true | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DONOR RESTRICTED PROMISES TO GIVE | 50000 |
| DONOR RESTRICTED CASH AND CASH EQUIVALENTS | 234905 |
| ENDOWMENT FUND | 52044 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 336949 | TotalBookValueOtherAssets |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | AN ENDOWMENT FUND IS HELD AT THE NORTHERN CHAUTAUQUA COMMUNITY FOUNDATION FOR THE PURPOSE OF PROMOTING COMMUNITY PHILANTHROPIC SUPPORT OF WESTFIELD MEMORIAL HOSPITAL AND TO PROVIDE FUNDING FOR EXPANSION AND MODERNIZATION OF THE HOSPITAL'S EQUIPMENT AND FACILITIES. | Explanation |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1 |
| Gross Receipts Event1 | 88272 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 70739 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 17533 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 32166 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 5698 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 9038 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 503 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 88272 | GrossReceiptsTotal |
| Charitable Contributions Total | 70739 | CharitableContributionsTotal |
| Gross Revenue Total Events | 17533 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 32166 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 5698 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 9038 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 503 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 47405 | DirectExpenseSummaryEvents |
| Net Income Summary | -29872 | 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 | WESTFIELD MEMORIAL HOSPITAL | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 189 E MAIN STREET | AddressLine1 |
| City | WESTFIELD | City |
| State | NY | State |
| ZIP Code | 14787 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 160743222 | EINOfRecipient |
| Amount Of Cash Grant | 116779 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 14000 | AmountOfNonCashAssistance |
| Method Of Valuation | FMV | MethodOfValuation |
| Description Of Non Cash Assistance | MED EQUIP | DescriptionOfNonCashAssistance |
| Purpose Of Grant | MED EQUIP | PurposeOfGrant |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable (3 entries)
| DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|
| GOLF TOURN EXPENSES | 92 | 29181 | FAIR MARKET VALUE |
| OTHER GIFTS | 3 | 2475 | FAIR MARKET VALUE |
| MEDICAL EQUIP | 1 | 14000 | FAIR MARKET VALUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | true | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Pt VI, Line 11b | FORM 990 IS REVIEWED IN DETAIL BY THE ORGANIZATION'S |
| TREASURER PRIOR TO FILING, WHO REVIEWS IT WITH THE | |
| BOARD OF DIRECTORS SUBSEQUENT TO FILING. | |
| Pt VI, Line 12c | COMPLIANCE IS MONITORED ON AN ANNUAL BASIS THROUGH |
| UPDATED DISCLOSURES. | |
| Form 990EZ, Part I, Line 16 | MARKETING EXPENSES OTHER ADMINISTRATIVE EXPENSES |
| Form 990EZ, Part II, Line 24 | PROMISES TO GIVE DONOR RESTRICTED ASSETS |
| Form 990EZ, Part II, Line 26 | GRANTS PAYABLE |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTFIELD MEMORIAL HOSPITAL INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 189 MAIN ST | AddressLine1 |
| City | WESTFIELD | City |
| State | NY | State |
| ZIP Code | 14787 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 160743222 | EIN |
| Primary Activities | HEALTH CARE | PrimaryActivities |
| Legal Domicile State | NY | 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 | NONE | 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 |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| 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 | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | 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 (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| WESTFIELD MEMORIAL HOSPITAL INC | ||
| b | 130779 | CASH GRANTS/NONCASH-FMV |
| SAINT VINCENT HEALTH SYSTEM | ||
| c | 50000 | CASH GRANT |
| WESTFIELD MEMORIAL HOSPITAL INC | ||
| p | 64750 | ACTUAL COST |
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