HEYWOOD HEALTHCARE INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- HEYWOOD HEALTHCARE INC (EIN 22-2720658)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-14
- IRS object ID
- 201222279349302422
- Schema version
- 2010v3.4
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-14T13:08:20-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOLLUS LYNCH LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 89 SHREWSBURY STREET | AddressLine1 |
| City | WORCESTER | City |
| State | MA | State |
| ZIP Code | 01604 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222720658 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER QUABBIN HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | GREA | NameControl |
| Phone | 9782493511 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2033 MAIN STREET | AddressLine1 |
| City | ATHOL | City |
| State | MA | State |
| ZIP Code | 01331 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES MEEHAN | Name |
| Title | CHAIRMAN OF THE BOARD | Title |
| Phone | 9782493511 | Phone |
| Date Signed | 2012-08-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BARBARA E KING | Name |
| Phone | 5087557107 | Phone |
| Date Prepared | 2012-08-07 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAMES MEEHAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2033 MAIN STREET | AddressLine1 |
| City | ATHOL | City |
| State | MA | State |
| ZIP Code | 01331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1817778 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1986 | YearFormation |
| State Legal Domicile | MA | StateLegalDomicile |
| Activity Or Mission Description | TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF ATHOL MEMORIAL HOSPITAL, INC AND TO CONDUCT FUND-RAISING, COORDINATE PLANNING, AND MANAGE STRATEGIC DEVELOPMENT FUNCTIONS FOR THE HOSPITAL. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 21 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 21 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1240 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1980 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 51826 | InvestmentIncomePriorYear |
| Investment Income Current Year | 228593 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 53066 | TotalRevenuePriorYear |
| Total Revenue Current Year | 230573 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 13375 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 500 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 38950 | OtherExpensePriorYear |
| Other Expenses Current Year | 6074 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 52325 | TotalExpensesPriorYear |
| Total Expenses Current Year | 6574 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 741 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 223999 | RevenuesLessExpensesCY |
| Total Assets BOY | 3276379 | TotalAssetsBOY |
| Total Assets EOY | 3406565 | TotalAssetsEOY |
| Total Liabilities BOY | 12000 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3264379 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3406565 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO BENEFIT ATHOL MEMORIAL HOSPITAL, AN ACUTE CARE, NOT FOR PROFIT COMMUNITY HOSPITAL, FOUNDED TO PROVIDE INPATIENT, OUTPATIENT, EMERGENCY CARE, AND HOME SERVICES FOR RESIDENTS OF NORTH WORCESTER COUNTY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 6574 | Expense |
| Description | TO BENEFIT ATHOL MEMORIAL HOSPITAL, AN ACUTE CARE, NOT FOR PROFIT COMMUNITY HOSPITAL, FOUNDED TO PROVIDE INPATIENT, OUTPATIENT, EMERGENCY CARE, AND HOME SERVICES FOR RESIDENTS OF NORTH WORCESTER COUNTY. | Description |
| Total Program Service Expense | 6574 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 21 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 21 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9782493511 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2033 MAIN STREET | AddressLine1 |
| City | ATHOL | City |
| State | MA | State |
| ZIP Code | 01331 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| WILLIAM MEEHAN | ||||||
| FIRST VICE CHAIRMAN | 2.00 | X | 0 | 0 | 0 | |
| DOUGLAS A STARRETT | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| LAUREY KENERSON | ||||||
| CLERK | 2.00 | X | 0 | 0 | 0 | |
| CHENEY CASTINE | ||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | |
| JAMES MEEHAN JR | ||||||
| CHAIRMAN | 2.00 | X | 0 | 0 | 0 | |
| MOHSEN NORELDIN MD | ||||||
| SECOND VICE CHAIRMAN | 2.00 | X | 0 | 0 | 0 | |
| DANILO FUNA MD | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| ROBIN BROOKS | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| JANET KRAFT | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| ROY LAKE | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| DONALD MRUK MD | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| CURTIS RAND | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| TIMOTHY SOULE-REGINE MD | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| YOGENDRA THAKER MD | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| WAYNE MILLER MD | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| ROBERT KNIGHT MD | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| LAWRENCE ESTELLE JR | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| REBECCA BIALECKI | ||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |
| STEVEN PENKA | ||||||
| PRESIDENT/CEO | 40.00 | 125955 | 0 | 13084 | X | |
| DEAN FLEMING | ||||||
| TREASURER | 40.00 | 108037 | 0 | 5284 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 233992 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 18368 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 1980 | AllOtherContributions |
| Total Contributions | 1980 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 30909 | TotalRevenueColumn |
| Exclusion | $30,909 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1784889 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1587205 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 197684 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 197684 | TotalRevenueColumn |
| Exclusion | $197,684 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 230573 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $228,593 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 500 | Total |
| Program Services | 500 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6000 | Total |
| Program Services | 6000 | ProgramServices |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| FEES/DUES | 70 | 70 |
| MISCELLANEOUS | 4 | 4 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6574 | Total |
| Program Services | 6574 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58723 | BOY |
| EOY | 54501 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14270 | BOY |
| EOY | 4746 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1140476 | BOY |
| EOY | 512427 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 982910 | BOY |
| EOY | 102026 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1080000 | BOY |
| EOY | 2732865 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3276379 | BOY |
| EOY | 3406565 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12000 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12000 | 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 | 2413558 | BOY |
| EOY | 2555744 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 850821 | BOY |
| EOY | 850821 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3264379 | BOY |
| EOY | 3406565 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3276379 | BOY |
| EOY | 3406565 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 223999 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -81813 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 38000 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus2 Years | 29349 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1240 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1980 | CurrentTaxYear |
| Total | 70569 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 38000 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus2 Years | 29349 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1240 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1980 | CurrentTaxYear |
| Total | 70569 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 70569 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 119266 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 140163 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 61330 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 34488 | CurrentTaxYearMinus1Year |
| Current Tax Year | 30909 | CurrentTaxYear |
| Total | 386156 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 456725 | TotalSupport |
| Public Support Pertcentage170 | 0.15450 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.59120 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests PY170 | X | ThirtyThreePercntTestsPY170 |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1662962 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 30485 | InvestmentEarningsOrLosses |
| Other Expenditures | 54971 | OtherExpenditures |
| End Of Year Balance | 1638476 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1573920 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 105254 | InvestmentEarningsOrLosses |
| Other Expenditures | 16212 | OtherExpenditures |
| End Of Year Balance | 1662962 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1750212 | BeginningOfYearBalance |
| Investment Earnings Or Losses | -157893 | InvestmentEarningsOrLosses |
| Other Expenditures | -18399 | OtherExpenditures |
| End Of Year Balance | 1573920 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE FROM AFFILIATE | Description |
| Book Value | 2732865 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2732865 | TotalBookValueOtherAssets |
| Total Revenue | 230573 | TotalRevenue |
| Total Expenses | 6574 | TotalExpenses |
| Excess Or Deficit For Year | 223999 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -81813 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -81813 | TotalAdjustments |
| Excess Or Deficit Per FS | 142186 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 148760 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -81813 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -81813 | RevenueNotRptdF990 |
| Revenue Subtotal | 230573 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 230573 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 6574 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 6574 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 6574 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ORGANIZATION'S ENDOWMENT INCLUDES BOTH DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD TO FUNCTION AS ENDOWMENTS. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED OR LEGAL RESTRICTIONS. ENDOWMENT FUNDS INCLUDE INVESTED GIFTS. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, THE ORGANIZATION CLASSIFIES AS PERMANENTLY RESTRICTED NET ASSETS (A) THE ORIGINAL VALUE OF GIFTS DONATED TO THE PERMANENT ENDOWMENT, (B) THE ORIGINAL VALUE OF SUBSEQUENT GIFTS TO THE PERMANENT ENDOWMENT, AND (C) ACCUMULATIONS TO THE PERMANENT ENDOWMENT MADE IN ACCORDANCE WITH THE DIRECTION OF THE APPLICABLE DONOR GIFT INSTRUMENT AT THE TIME THE ACCUMULATION IS ADDED TO THE FUND. THE REMAINING PORTION OF THE DONOR-RESTRICTED ENDOWMENT FUND THAT IS NOT CLASSIFIED IN PERMANENTLY RESTRICTED NET ASSETS IS CLASSIFIED AS TEMPORARILY RESTRICTED NET ASSETS UNTIL THOSE AMOUNTS ARE APPROPRIATED FOR EXPENDITURE BY THE ORGANIZATION IN A MANNER CONSISTENT WITH THE STANDARD OF PRUDENCE PRESCRIBED BY STATE LAW. IN ACCORDANCE WITH THE UNIFORM PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT, THE ORGANIZATION CAN CONSIDER THE FOLLOWING FACTORS IN MAKING A DETERMINATION TO APPROPRIATE OR ACCUMULATE DONOR-RESTRICTED ENDOWMENT FUNDS: -THE DURATION AND PRESERVATION OF THE FUND -THE PURPOSES OF THE ORGANIZATION AND THE DONOR-RESTRICTED ENDOWMENT FUND -GENERAL ECONOMIC CONDITIONS -THE POSSIBLE EFFECT OF INFLATION AND DEFLATION -THE EXPECTED TOTAL RETURN FROM INCOME AND THE APPRECIATION OF INVESTMENTS -OTHER RESOURCES OF THE ORGANIZATION -THE INVESTMENT POLICIES OF THE ORGANIZATION. THE ORGANIZATION HAS ADOPTED INVESTMENT AND SPENDING POLICIES FOR ITS BOARD-DESIGNATED AND OTHER ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING FOR ITS PROGRAMS WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT ASSETS. UNDER THIS POLICY, AS APPROVED BY THE BOARD, THE ENDOWMENT ASSETS ARE INVESTED IN A MANNER THAT IS INTENDED TO PRODUCE RESULTS THAT EXCEED THE PRICE AND YIELD RESULTS OF THE S&P 500 INDEX WHILE ASSUMING A MODERATE LEVEL OF INVESTMENT RISK. THE ORGANIZATION EXPECTS ITS ENDOWMENT FUNDS, OVER TIME, TO PROVIDE AN AVERAGE RATE OF RETURN OF APPROXIMATELY 8% ANNUALLY. ACTUAL RETURNS IN ANY GIVEN YEAR MAY VARY FROM THIS AMOUNT. TO SATISFY ITS LONG-TERM RATE-OF-RETURN OBJECTIVES, THE ORGANIZATION RELIES ON A TOTAL RETURN STRATEGY IN WHICH INVESTMENT RETURNS ARE ACHIEVED THROUGH BOTH CAPITAL APPRECIATION (REALIZED AND UNREALIZED) AND CURRENT YIELD (INTEREST AND DIVIDENDS). THE ORGANIZATION HAS INVESTED IN A PORTFOLIO THAT TARGETS A DIVERSIFIED ASSET ALLOCATION, PLACING A GREATER EMPHASIS ON EQUITY-BASED INVESTMENTS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN PRUDENT RISK CONSTRAINTS. THE ORGANIZATION HAS A POLICY OF APPROPRIATING FOR DISTRIBUTION EACH YEAR 4.5 TO 5% OF ITS ENDOWMENT FUND'S AVERAGE FAIR VALUE OVER THE PRIOR TWELVE QUARTERS OF THE YEAR PROCEEDING THE YEAR IN WHICH THE DISTRIBUTION IS PLANNED. IN ESTABLISHING THIS POLICY, THE ORGANIZATION CONSIDERED THE LONG-TERM EXPECTED RETURN ON ITS ENDOWMENT. ACCORDINGLY, OVER THE LONG TERM, THE ORGANIZATION EXPECTS THE CURRENT SPENDING POLICY TO ALLOW ITS ENDOWMENT TO GROW AT AN AVERAGE OF 2.5 - 3% ANNUALLY. THIS IS CONSISTENT WITH THE ORGANIZATION'S OBJECTIVE TO MAINTAIN THE PURCHASING POWER OF ITS ENDOWMENT. FROM TIME TO TIME, THE FAIR VALUE OF ASSETS ASSOICATED WITH INDIVIDUAL DONOR-RESTRICTED ENDOWMENT FUNDS MAY FALL BELOW THE LEVEL THAT THE DONOR IMPOSED RESTRICTIONS REQUIRE THE ORGANIZATION TO RETAIN AS A FUND OF PERPETUAL DURATION. IN ACCORANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, DEFICIENCIES OF THIS NATURE ARE REPORTED IN UNRESTRICTED NET ASSETS. SUCH DEFICIENCIES AMOUNTS TO $(180,560) AND $(226,988) AS OF SEPTEMBER 30, 2011 AND 2010, RESPECTIVELY. |
| PART X, QUESTION 2: MANAGEMENT ANNUALLY REVIEWS FOR UNCERTAIN TAX POSITIONS ALONG WITH ANY RELATED INTEREST AND PENALTIES AND BELIEVES THAT THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT WOULD HAVE A MATERIAL EFFECT, INDIVIDUALLY OR IN THE AGGREGATE, UPON THE ORGANIZATION'S STATEMENT OF FINANCIAL POSITION, OR THE RELATED STATEMENTS OF ACTIVITIES, OR CASH FLOWS. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | JAMES MEEHAN, JR. CHAIRMAN AND WILLIAM MEEHAN, VICE CHAIRMAN ARE BROTHERS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 WILL BE CIRCULATED TO THE BOARD IN ELECTRONIC FORMAT PRIOR TO FILING. COMMENTS AND QUESTIONS WILL BE ADDRESSED BY THE CFO AND ONCE APPROVED, THE RETURN WILL BE FINALIZED. | |
| THE BOARD OF TRUSTEE REVIEW THE ORGANIZATION'S CONFLICT OF INTEREST POLICY ANNUALLY IN ORDER TO ENSURE THAT THE ORGANIZATION BOARD OF TRUSTEES AND OFFICERS ARE REGULARLY AND CONSISTENTLY MONITORING AND ENFORCING IT. | FORM 990, PART VI, SECTION B, LINE 12C | |
| REQUESTS FOR REVIEW OF THE FORM 990 ARE FORWARDED TO THE CFO WHO MAKES ARRANGEMENTS FOR THE REVIEW. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED LOSSES ON INVESTMENTS: -81,813. | FORM 990, PART XI, LINE 5: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| ATHOL MEMORIAL HOSPITAL | ||||||||||
| 2033 MAIN STREET | ATHOL | MA | 01331 | 042126583 | HOSPITAL | MA | 501(C)(3) | 170(B)(1)(A)(VI) | GREATER QUABBIN HEALTH SYSTEMS INC | 0 |
| QUABBINCARE INC | ||||||||||
| 2033 MAIN STREET | ATHOL | MA | 01331 | 222720562 | INACTIVE | MA | 501(C)(3) | 170(B)(1)(A)(VI) | GREATER QUABBIN HEALTH SYSTEMS INC | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ATHOL MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | D | TransactionType |
| Amount Involved | 2732865 | AmountInvolved |
| Method Of Amt Determination | GAAP | MethodOfAmtDetermination |
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