BELLEVUE HOSPITAL FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
BELLEVUE HOSPITAL FOUNDATION (EIN 34-1745374)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201233199349304658
Schema version
2011v1.2
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)
Timestamp2012-11-14T14:02:59-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN381357951EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line165 EAST STATE ST STE 600AddressLine1
CityCOLUMBUSCity
StateOHState
ZIP Code43215ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN341745374EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BELLEVUE HOSPITAL FOUNDATION THEBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBELLNameControl
Phone4194834040Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11400 WEST MAIN STREETAddressLine1
CityBELLEVUECity
StateOHState
ZIP Code44811ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGARY STEINLEName
TitleCHAIRPERSONTitle
Phone4194834040Phone
Date Signed2012-11-05DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameBERNIE OSTROWSKIName
PTINP00366367PTIN
Phone6148493000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGARY STEINLENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11400 WEST MAIN STREETAddressLine1
CityBELLEVUECity
StateOHState
ZIP Code44811ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1531038GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1993YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTHE BELLEVUE HOSPITAL FOUNDATION CONTINUES TO SPONSOR PROGRAMS, PROJECTS AND SERVICES WITH BENEFIT TO THE BELLEVUE HOSPITAL.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers18TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year150207ContributionsGrantsPriorYear
Contributions Grants Current Year298652ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year26553InvestmentIncomePriorYear
Investment Income Current Year244255InvestmentIncomeCurrentYear
Other Revenue Prior Year13331OtherRevenuePriorYear
Other Revenue Current Year61214OtherRevenueCurrentYear
Total Revenue Prior Year190091TotalRevenuePriorYear
Total Revenue Current Year604121TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year109463GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY120807GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year60179SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year32052TotalFundrsngExpCurrentYear
Other Expense Prior Year162696OtherExpensePriorYear
Other Expenses Current Year72441OtherExpensesCurrentYear
Total Expenses Prior Year272159TotalExpensesPriorYear
Total Expenses Current Year253427TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-82068RevenuesLessExpensesPriorYear
Revenues Less Expenses CY350694RevenuesLessExpensesCY
Total Assets BOY1382223TotalAssetsBOY
Total Assets EOY1607037TotalAssetsEOY
Total Liabilities BOY270350TotalLiabilitiesBOY
Total Liabilities EOY363850TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1111873NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1243187NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionNONEMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense60000Expense
Grants60000Grants
Revenue0Revenue
DescriptionRELEASED FUNDS TO HOSPITAL FOR DIGITAL MAMMOGRAPHY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense22500Expense
Grants22500Grants
Revenue0Revenue
DescriptionRELEASED FUNDS TO HOSPITAL FOR EMPLOYEE CHILDREN'S SCHOLARSHIP.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense38307Expense
Grants38307Grants
Revenue0Revenue
DescriptionMISCELLANEOUS PATIENT ITEMS PURCHASED FOR HOSPITAL.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense12035Expense
Grants0Grants
Revenue0Revenue
DescriptionOTHERDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp12035TotalOfOtherProgramServiceExp
Total Program Service Expense132842TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming1Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1DEBORAH J FREEMANBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4194834040TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11400 W MAIN STREETAddressLine1
CityBELLEVUECity
StateOHState
ZIP Code44811ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
GARY STEINLE
CHAIRPERSON1.00XX000
CAROLYN FARRAR
VICE CHAIRPERSON1.00XX000
CHRIS CAPUTO
TREASURER1.00XX000
MARIE ARCHER
SECRETARY1.00XX000
KATE HERRING
FOUNDATION DIRECTOR12.00XX0396351800
HANNAH AUXTER
TRUSTEE1.00X000
MARCIA BRAUN MD
TRUSTEE1.00X000
PETE CALLAGHAN
TRUSTEE1.00X000
RODNEY COOK
TRUSTEE1.00X000
DINAH DWYER
TRUSTEE1.00X000
GREGG ELCHERT
TRUSTEE1.00X000
CHRISTINE GREILICH
TRUSTEE1.00X000
DAN HIGGINS
TRUSTEE1.00X000
ROSEANN HOPKINS
TRUSTEE1.00X000
REV NANCY HULL
TRUSTEE1.00X000
DAVE JARVIS
TRUSTEE1.00X000
BRAD SMITH
TRUSTEE1.00X000
STEVE WASSERMAN
TRUSTEE1.00X000
BETTE WOODS
TRUSTEE1.00X000
MICHAEL WINTHROP
TRUSTEE1.00X043996223294
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs479597TotalReportableCompFrmRltdOrgs
Total Other Compensation25094TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions298652AllOtherContributions
Total Contributions298652TotalContributions

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column32303TotalRevenueColumn
Exclusion$32,303ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1018378Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities806426Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities211952Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column211952TotalRevenueColumn
Exclusion$211,952ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming181705GrossIncomeGaming
Gaming Direct Expenses120491GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column61214TotalRevenueColumn
Exclusion$61,214ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column604121TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$305,469ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total120807Total
Program Services120807ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total60179Total
Program Services12035ProgramServices
Management And General18054ManagementAndGeneral
Fundraising30090Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3100Total
Management And General3100ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total10790Total
Management And General10790ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3906Total
Management And General3599ManagementAndGeneral
Fundraising307Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total154Total
Fundraising154Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total44317Total
Management And General44317ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3177Total
Management And General3177ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total3411Total
Management And General3411ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total528Total
Management And General528ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total849Total
Management And General849ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total708Total
Management And General708ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalFundraisingFundraising
FUNDRAISING10421042
SPONSORSHIP459459

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total253427Total
Program Services132842ProgramServices
Management And General88533ManagementAndGeneral
Fundraising32052Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY312206BOY
EOY161512EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY233671EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY51109BOY
EOY3349EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3971BOY
EOY3125EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6356LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6356LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY709BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY1014228BOY
EOY1205380EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1382223BOY
EOY1607037EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2038BOY
EOY214EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY268312BOY
EOY363636EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY270350BOY
EOY363850EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY264049BOY
EOY205507EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY670260BOY
EOY676258EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY177564BOY
EOY361422EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1111873BOY
EOY1243187EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1382223BOY
EOY1607037EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses350694ReconcilationRevenueExpenses
Reconcilation Other Changes-219380ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE BELLEVUE HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
EIN344428205EIN
Type Of Organization3TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$110,480Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts110480SumOfAmounts
General ExplanationSCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: NONCASH SUPPORT WAS PROVIDED TO THE BELLEVUE HOSPITAL IN THE FORM OF PATIENT EQUIPMENT TOTALING $10,327.GeneralExplanation

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 D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance181484BeginningOfYearBalance
Contributions182758Contributions
End Of Year Balance364242EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance178664BeginningOfYearBalance
Contributions2820Contributions
End Of Year Balance181484EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance177564BeginningOfYearBalance
Contributions1100Contributions
End Of Year Balance178664EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance177564BeginningOfYearBalance
End Of Year Balance177564EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6356OtherCostOrOtherBasis
Depreciation6356Depreciation
Book Value0BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
MUTUAL FUNDS900801F
CASH & CASH EQUIVALENTS134033F
REAL ESTATE INSURANCE TRUSTS167484F
OTHER INVESTMENTS3062F
FieldValueIRS element (for citing)
Total Of Book Value Program Related1205380TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
INTERCOMPANY PAYABLES$273,083
INTERCOMPANY PLEDGES PAYABLE$90,553
FieldValueIRS element (for citing)
Total Of Amounts363636TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:ENDOWMENT FUND INVESTMENTS THAT ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS UNRESTRICTED.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE FOUNDATION AND RECOGNIZE A TAX LIABILITY IF THE FOUNDATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES.

Schedule G IRS990ScheduleG

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming181705GrossRevenueOtherGaming
Cash Prizes Other Gaming57895CashPrizesOtherGaming
Other Direct Expenses Other Gaming62596OtherDirectExpensesOtherGaming
Volunteer Labor Other Gaming1VolunteerLaborOtherGaming
Volunteer Labor Prcnt Other Gaming0.05000VolunteerLaborPrcntOtherGaming
Gross Revenue Total Gaming181705GrossRevenueTotalGaming
Cash Prizes Total Gaming57895CashPrizesTotalGaming
Other Direct Expenses Total Gaming62596OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming120491DirectExpenseSummaryGaming
Net Gaming Income Summary61214NetGamingIncomeSummary
FieldValueIRS element (for citing)
States Where Gaming ConductedOHStatesWhereGamingConducted
Licensed0Licensed
Explanation If NoIN THE STATE OF OHIO, A CHARITABLE ORGANIZATION THAT IS EXEMPT FROM FEDERAL INCOME TAXATION UNDER SUBSECTION 501(A) AND IS DESCRIBED IN SUBSECTION 501(C)(3) IS NOT REQUIRED TO OBTAIN A GAMING LICENSE TO CONDUCT A RAFFLE TO RAISE MONEY FOR THE ORGANIZATION. OHIO REVISED CODE 2915.092.ExplanationIfNo
License Suspended Etc0LicenseSuspendedEtc
Gaming With Nonmembers1GamingWithNonmembers
Member Of Other Entity0MemberOfOtherEntity
Percentage Of Gaming Own Facility0.67000PercentageOfGamingOwnFacility
Percentage Of Gaming Othr Facility0.33000PercentageOfGamingOthrFacility
Name Of Gaming Rec Keeper PersonDEBORAH FREEMANNameOfGamingRecKeeperPerson

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line11400 WEST MAIN STREETAddressLine1
CityBELLEVUECity
StateOHState
ZIP Code44811ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam Rev0ContractWith3rdPartyForGamRev
Gaming Manager Name PersonKATE HERRINGGamingManagerNamePerson
Gaming Manager Compensation41435GamingManagerCompensation
Gaming Manager Services ProvidedCOORDINATION OF ALL ACTIVITIES, SUCH AS, ADVERTISING, MAILINGS, TICKET PURCHASES, TICKET SALES, DRAWINGS, AND WORKING WITH THE BOARD MEMBERS TO HOLD A CORVETTE FOR THE WINNER.GamingManagerServicesProvided
Gaming Manager Is Director OfficerXGamingManagerIsDirectorOfficer
Charitable Distrib Required0CharitableDistribRequired

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
THE BELLEVUE HOSPITAL
1400 WEST MAIN STREETBELLEVUEOH44811344428205501(C)(3)110480RELATED PARTY GENERAL SUPPORT FOR PURCHASE OF MEDICAL EQUIPMENT AND FUNDS TO DISTRIBUTE FOR SCHOLARSHIPS.
THE BELLEVUE HOSPITAL
1400 WEST MAIN STREETBELLEVUEOH44811344428205501(C)(3)RELATED PARTY MEDICAL SUPPORT AND WALKING TRAIL IMPROVEMENTS10327BOOKMISCELLANEOUS PATIENT EQUIPMENT AND LAND IMPROVEMENTS
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE FOUNDATION IS A SUPPORTING ORGANIZATION TO THE BELLEVUE HOSPITAL. IT REGULARLY TRANSFERS FUNDS TO FURTHER THE HOSPITAL'S EXEMPT PURPOSES.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonMICHAEL WINTHROPNamePerson
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs399230CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs30000BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs10732OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs8605DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs14689NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs463256TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs93300CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationPART I, LINE 3: COMPENSATION PAID TO THE ORGANIZATION'S PRESIDENT IS ESTABLISHED BY A RELATED ORGANIZATION AND INCLUDES USE OF A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE BELLEVUE HOSPITAL FOUNDATION IS ORGANIZED AS A SUBSIDIARY OF THE BELLEVUE HOSPITAL, THE PARENT ORGANIZATION AND SOLE VOTING MEMBER FOR THE CONSOLIDATED GROUP.
FORM 990, PART VI, SECTION A, LINE 7BDECISIONS MADE BY THE BELLEVUE HOSPITAL FOUNDATION'S BOARD OF DIRECTORS CAN BE OVERRULED BY THE BELLEVUE HOSPITAL'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF FORM 990 IS MADE AVAILABLE TO THE BELLEVUE HOSPITAL'S PRESIDENT & EXECUTIVE VICE PRESIDENT/CFO AT THE FINANCE MEETING FOR REVIEW AS WELL AS PRESENTATION TO THE BOARD OF DIRECTORS AT THE OCTOBER MEETING. IN ADDITION, EACH BOARD MEMBER RECEIVES A COPY OF FORM 990 PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE FOUNDATION DOES NOT HAVE ITS OWN CONFLICT OF INTEREST POLICY. HOWEVER, THE FOUNDATION FOLLOWS THE BELLEVUE HOSPITAL'S POLICY WHEN APPLICABLE AS DESCRIBED BELOW. ON AN ANNUAL BASIS, THE PRESIDENT SHALL SEND TO ALL EXECUTIVE STAFF AND SELECTED EMPLOYEES, A COPY OF THE BOARD OF TRUSTEES CONFLICT OF INTEREST POLICY TO BE COMPLETED AND RETURNED. IN ADDITION, NEW BOARD MEMBERS THAT JOIN DURING THE YEAR FILL OUT AND COMPLETE THE CONFLICT OF INTEREST POLICY WHEN THEY FIRST JOIN. AN APPROPRIATE REPORT SHALL BE SUBMITTED TO THE BOARD OF TRUSTEES CONCERNING ANY INTERESTS TO BE DISCLOSED. IF ANY CONFLICTS DO ARISE, THAT TRUSTEE WILL ABSTAIN FROM VOTING ON THE ISSUE. PERIODIC REVIEWS ARE ALSO CONDUCTED TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES, AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX. THE BOARD OF DIRECTORS REVIEW THE COMPLETED CONFLICT OF INTEREST POLICIES INCLUDING THE PRESIDENT'S. THE BOARD OF DIRECTORS REVIEW THE PRESIDENT'S COMPLETED CONFLICT OF INTEREST POLICY ONCE THE PRESIDENT LEAVES THE ROOM.
FORM 990, PART VI, SECTION B, LINE 15THE FOUNDATION DOES NOT HAVE ITS OWN COMPENSATION, WHISTLEBLOWER, OR DOCUMENT RETENTION POLICIES. HOWEVER, THE FOUNDATION FOLLOWS THE BELLEVUE HOSPITAL'S POLICIES WHEN APPLICABLE AS DESCRIBED BELOW. THE BOARD HAS A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT DIRECTORS. THE COMMITTEE UTILIZES AN OUTSIDE HEALTHCARE COMPENSATION CONSULTING COMPANY COMPARING COMPARABLE SIZED ORGANIZATIONS CONSISTENT WITH THE BOARD OF TRUSTEE COMPENSATION PHILOSOPHY STATEMENT. RECOMMENDATIONS ARE MADE FROM THE COMPENSATION COMMITTEE TO THE BOARD OF TRUSTEES. ANY COMPENSATION DECISIONS THAT ARE MADE ARE DOCUMENTED IN THE MINUTES OF THE EXECUTIVE COMPENSATION COMMITTEE AND EXECUTIVE SESSION MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN NOVEMBER 2011.
FORM 990, PART VI, SECTION C, LINE 19THE FOUNDATION MAKES ITS FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PAGE 6, PART VI, LINE 7A:THE BELLEVUE HOSPITAL FOUNDATION'S BOARD OF DIRECTORS ARE NOT ELECTED BY THE BELLEVUE HOSPITAL'S BOARD OF DIRECTORS, HOWEVER THE BELLEVUE HOSPITAL'S BOARD OF DIRECTORS RATIFY THE ELECTED TRUSTEES AT THEIR ANNUAL MEETING.
FORM 990, PAGE 7, PART VII:THE FOLLOWING TRUSTEE DEVOTED TIME TO BELLEVUE HOSPITAL: MICHAEL WINTHROP 40 HOURS
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -219,380.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PAGE 12, PART XII, LINE 2CTHE BELLEVUE HOSPITAL HAS A COMMITTEE RESPONSIBLE FOR SELECTION OF THE INDEPENDENT ACCOUNTANT AND OVERSIGHT OF THE AUDIT. THE PROCESS FOR OVERSIGHT OF THE AUDIT AS WELL AS SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
BELLEVUE HOSPITAL
1400 WEST MAIN STREETBELLEVUEOH44811344428205HEALTH CAREOH501(C)3LINE 3N/A0
THE BELLEVUE HOSPITAL ASSOCIATION
1400 WEST MAIN STREETBELLEVUEOH44811753102199ADMINISTRATIVE SUPPORTOH501(C)3LINE 11A, I1THE BELLEVUE HOSPITAL

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1BELLEVUE HEALTH NETWORKBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11400 W MAIN STREETAddressLine1
CityBELLEVUECity
StateOHState
ZIP Code44811ZIPCode
FieldValueIRS element (for citing)
EIN341870470EIN
Primary ActivityINSURANCE CONTRACTSPrimaryActivity
Legal Domicile StateOHLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1BELLEVUE PROFESSIONAL SERVICES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11400 W MAIN STREETAddressLine1
CityBELLEVUECity
StateOHState
ZIP Code44811ZIPCode
FieldValueIRS element (for citing)
EIN341828724EIN
Primary ActivityPHYSICIAN SERVICESPrimaryActivity
Legal Domicile StateOHLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
BELLEVUE HOSPITAL
B110480CASH TRANSACTION
BELLEVUE HOSPITAL
B10327BOOK VALUE TRANSACTION

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