BATH COMMUNITY HOSPITAL FOUNDATION: Form 990EZ, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BATH COMMUNITY HOSPITAL FOUNDATION (EIN 57-1137401)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-12
IRS object ID
201342249349200014
Schema version
2012v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-12T08:11:44-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN540504608EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BROWN EDWARDS & COMPANY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1124 NEWMAN AVENUEAddressLine1
CityHARRISONBURGCity
StateVAState
ZIP Code22801ZIPCode
FieldValueIRS element (for citing)
Return Type990EZReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN571137401EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BATH COUNTY COMMUNITY HOSPITAL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBATHNameControl
Phone5408397104Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO DRAWER ZAddressLine1
CityHOT SPRINGSCity
StateVAState
ZIP Code24445ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFRANZ VON SCHILLINGName
TitleCHAIRMANTitle
Phone5408392425Phone
Date Signed2013-08-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAMES R FRIESName
PTINP01320612PTIN
Phone5404346736Phone
Date Prepared2013-07-29DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Web SiteN/AWebSite
Organization501c3XOrganization501c3
Gross Receipts38715GrossReceipts
Info In Schedule O Part IXInfoInScheduleOPartI
Contributions Gifts Grants Etc37955ContributionsGiftsGrantsEtc
Investment Income760InvestmentIncome
Total Revenue38715TotalRevenue
Grants And Similar Amounts Paid36000GrantsAndSimilarAmountsPaid
Fees And Oth Pymt To Ind Contractors736FeesAndOthPymtToIndContractors
Total Expenses36736TotalExpenses
Excess Or Deficit For Year1979ExcessOrDeficitForYear
Net Assets Or Fund Balances BOY139742NetAssetsOrFundBalancesBOY
Other Changes In Net Assets0OtherChangesInNetAssets
Net Assets Or Fund Balances EOY141721NetAssetsOrFundBalancesEOY

Cash Savings And Investments CashSavingsAndInvestments

FieldValueIRS element (for citing)
BOY139742BOY
EOY141721EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY139742BOY
EOY141721EOY

Sum Of Total Liabilities SumOfTotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Net Assets Or Fund Balances NetAssetsOrFundBalances

FieldValueIRS element (for citing)
BOY139742BOY
EOY141721EOY
FieldValueIRS element (for citing)
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Primary Exempt PurposeTO SUPPORT BATH COUNTY COMMUNITY HOSPITAL'S PLANS FOR DEVELOPMENT AND COMMUNITY PROGRAMS THROUGH PHILANTHROPY.PrimaryExemptPurpose

Program Service Accomplishment ProgramServiceAccomplishment

FieldValueIRS element (for citing)
Description Program Service AccomTO ASSIST BATH COMMUNITY HOSPITAL IN PURCHASE OF MAJOR MEDICAL EQUIPMENT.DescriptionProgramServiceAccom
Grants And Allocations36000GrantsAndAllocations
Program Service Expenses36736ProgramServiceExpenses
FieldValueIRS element (for citing)
Total Program Service Expenses36736TotalProgramServiceExpenses

Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (9 entries)

TitleTitleAvg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPositionCompensationCompensationContri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtcExpense Account Other AllowancesExpenseAccountOtherAllowances
JOANNE INGALLS
CO-CHARIMAN0.00000
FRANZ VON SCHILLING
CO-CHAIRMAN0.00000
LIZ MCCARTHY
DIRECTOR0.00000
AMORY MELLEN III
DIRECTOR0.00000
GEORGE PHILLIPS
DIRECTOR0.00000
SUSAN PHILLIPS
DIRECTOR0.00000
JAMES REDINGTON MD
DIRECTOR0.00000
JEAN HOWELL
DIRECTOR0.00000
CARL BEHRENS
DIRECTOR0.00000
FieldValueIRS element (for citing)
Info In Schedule O Part VXInfoInScheduleOPartV
Activities Not Previously Rpt0ActivitiesNotPreviouslyRpt
Made Changes To Orgnzng Etc Doc0MadeChangesToOrgnzngEtcDoc
Organization Had UBI0OrganizationHadUBI
Subject To Proxy Tax0SubjectToProxyTax
Organization Dissolved Etc0OrganizationDissolvedEtc
Direct Indirect Political Expend0DirectIndirectPoliticalExpend
Made Loans To From Officers0MadeLoansToFromOfficers
Tax Imposed Under IRC49110TaxImposedUnderIRC4911
Tax Imposed Under IRC49120TaxImposedUnderIRC4912
Tax Imposed Under IRC49550TaxImposedUnderIRC4955
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTrans
Amount Of Tax Imposed On Org Mgr0AmountOfTaxImposedOnOrgMgr
Amount Of Tax Reimbursed By Org0AmountOfTaxReimbursedByOrg
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJASON PARETNamePerson

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1106 PARK DRAddressLine1
CityHOT SPRINGSCity
StateVAState
ZIP Code24445ZIPCode
FieldValueIRS element (for citing)
Telephone Number5408397059TelephoneNumber
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccount
Foreign Office0ForeignOffice
Maintain Any Donor Advised Funds0MaintainAnyDonorAdvisedFunds
Does Org Have Hospital0DoesOrgHaveHospital
Tanning Services Provided0TanningServicesProvided
Related Org Controlled Entity0RelatedOrgControlledEntity
Engage Political Cmpgn Activities0EngagePoliticalCmpgnActivities
Engage In Lobbying Activities0EngageInLobbyingActivities
Operating School0OperatingSchool
Trnsfrs Exempt Non Char Related Org0TrnsfrsExemptNonCharRelatedOrg
Part VI Of Comp Of Highest Paid EmplNONEPartVIOfCompOfHighestPaidEmpl
Part VIA Hghst Paid Cntrct Prof SerNONEPartVIAHghstPaidCntrctProfSer
Filed Schedule A1FiledScheduleA

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1BATH COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
EIN540505913EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$36,000Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts36000SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER INVESTMENT INCOMEFORM 990-EZ, PART I, LINE 4INTEREST INCOME 760..
PAYMENTS TO AFFILIATESFORM 990-EZ, PART I, LINE 10AFFILIATE NAME: BATH COUNTY COMMUNITY HOSPITAL. AFFILIATE ADDRESS: P.O. DRAWER Z HOT SPRINGS, VA 24445. PURPOSE OF PAYMENT: FOR PURCHASE OF EQUIPMENT. AMOUNT OF PAYMENT: 36,000.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.Declaration

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