2011-08-11T07:01:00-05:00 2010-09-30 KPMG LLP 60 South Street Boston MA 02111 990 2009-10-01 260236669 ST JOSEPH HEALTH SERVICES FOUNDATION STJO 4014563346 200 HIGH SERVICE AVENUE NORTH PROVIDENCE RI 02904 MICHAEL CONKLIN JR 4014563322 2011-08-10 6179881000 2009 2016-02-24 21:20:13Z JOSEPH DISTEFANO 200 HIGH SERVICE AVENUE NORTH PROVIDENCE RI 02904 1030306 false X WWW.SAINTJOSEPHRI.COM X 2007 RI THE FOUNDATION'S MISSION IS TO RAISE FUNDS TO SUPPORT THE PROGRAMS AND SERVICES FOR ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND. 6 5 4 0 0 0 1341901 895466 0 0 235646 258 279925 25050 1857472 920774 0 0 0 0 311678 315134 0 0 0 75073 83016 386751 398150 1470721 522624 2350250 622829 943274 653211 1406976 -30382 THE FOUNDATION'S MISSION IS TO RAISE FUNDS TO SUPPORT THE PROGRAMS AND SERVICES OF ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND. false false 386205 THE FOUNDATION IS DEDICATED TO RAISING MONEY TO SUPPORT THE SERVICES PROVIDED AT ST. JOSEPH HEALTH SERVICES OF RHODE ISLAND. 386205 true true false false false false false false true false false true false false false false false false true false false false false true false false false false false false false false false false false false false true false false false true 0 0 4 true false false false false false true true false false false 6 5 true false true false true true true true true false false true true true true true false true true false X KATHLEEN MOORE 4014563322 200 HIGH SERVICE AVENUE NORTH PROVIDENCE RI 02904 X JOSEPH DISTEFANO ESQ 1.0 X X 0 0 0 DANIEL RYAN 1.0 X X 0 0 0 JOHN M FOGARTY 1.0 X X 0 362658 16730 FAYE SANDERS 1.0 X 0 0 0 RICHARD BERETTA ESQ 1.0 X 0 0 0 PATRICIA WEGRZYN MCGREEN 1.0 X 0 0 0 KENNETH BELCHER 1.0 X X 0 463267 94887 MICHAEL CONKLIN JR 1.0 X 0 0 0 0 825925 111617 0 false true false NA 0 227637 465596 202233 0 895466 0 258 258 0 0 0 134582 227637 109532 25050 25050 0 0 0 920774 0 25308 0 0 0 0 86459 83865 2594 0 171648 166499 5149 3420 3317 103 33240 32243 997 20367 19756 611 0 0 0 0 0 0 19321 18741 580 0 43872 42556 1316 0 0 0 0 0 354 343 11 0 0 0 0 MISCELLANEOUS 19469 18885 584 0 398150 386205 11945 0 2350250 431333 0 191496 2350250 622829 943274 653211 943274 653211 X 170800 -523583 1168751 463320 67425 29881 1406976 -30382 2350250 622829 X false true true X false X 2228249 1621826 895466 4745541 2228249 1621826 895466 4745541 4745541 235646 258 235904 453951 421196 25050 900197 5881642 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 67425 10155 20 46340 31260 25200 42225 67425 1.00000 false false SCHEDULE D, PART V, QUESTION 4: TO PROVIDE SCHOLARSHIPS AND SUPPORT THE OVERAL OPERATION OF THE HOSPITAL. BISHOPS BALL 214311 79729 134582 5425 44489 3000 13615 GOLF TOURNAMENT 147908 147908 7011 27062 8290 0 362219 227637 134582 12436 71551 3000 21905 108892 25690 X X X X false true false false false false false false false JOHN M FOGARTY 0 362658 0 0 0 0 0 0 0 16730 0 379388 0 0 KENNETH BELCHER 0 349591 0 105672 0 8004 0 24885 0 70002 0 558154 0 0 SCHEDULE J THE COMPENSATION OF JOHN M. FOGARTY AND KENNETH BELCHER ARE PAID BY RELATED ORGANIZATIONS FOR THEIR SERVICES TO RELATED ORGANIZATIONS, NOT TO ST. JOSEPH HEALTH SERVICES FOUNDATION. NONQUALIFIED SUPPLEMENTAL RETIREMENT 457 (F) PLAN KENNETH BELCHER RECEIVES COMPENSATION FROM ROGER WILLIAMS MEDICAL CENTER, A RELATED ORGANIZATION, AND PARTICIPATED IN A NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN UNDER SECTION 457(F). HE RECEIVED $0 IN DISTRIBUTION FROM THE PLAN DURING THE CALENDAR YEAR. FORM 990, PART VI, SECTION A, LINE 6: ST. JOSEPH HEALTH SERVICES OF RI IS THE SOLE CORPORATE MEMBER FORM 990, PART VI, SECTION A, LINE 7A: THE SOLE CORPORATE MEMBER HAS POWERS OVER ELECTION OF THE FOUR INDEPENDENT DIRECTORS OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7B: THE SOLE CORPORATE MEMBER, IN ADDITION TO HAVING POWERS OVER THE ELECTION OF THE INDEPENDENT DIRECTORS, THEY ALSO HAVE POWERS TO: 1. AUTHORIZATION OR APPROVAL OF ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OF THE FOUNDATION; 2. AUTHORIZATION OR APPROVAL OF ANY AMENDMENT TO THE BY LAWS OF THE FOUNDATION; 3. AUTHORIZATION OR APPROVAL OF ANY NAME CHANGE OF THE FOUNDATION; 4. AUTHORIZATION OR APPROVAL OF ANY MERGER, CONSOLIDATION, RE-ORGANIZATION, SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE FOUNDATION; 5. AUTHORIZATION OR APPROVAL OF ORGANIZATIONAL DOCUMENTS; 6. AUTHORIZATION OR APPROVAL OF ANY PLAN OF DISSOLUTION, LIQUIDATION OR ASSIGNMENT; 7. AUTHORIZATION OR APPROVAL OF ANY DEBT, LOAN, BORROWING, DEBT GUARANTEE ON ANY PROPERTY OR ASSETS OF THE FOUNDATION; 8. AUTHORIZATION OR APPROVAL OF ANY ACQUISITION OR LEASE OF OR INTEREST IN REAL ESTATE BY THE FOUNDATION; 9. AUTHORIZATION OR APPROVAL OF UNDERTAKING ANY EXPENDITURE OUTSIDE OF THE ANNUAL BUDGET WHETHER BY CONTRACT OR OTHERWISE IN EXCESS OF 25,000; 10. AUTHORIZATION OR APPROVAL OF ENTERING INTO ANY CONTRACT OR COMMITMENT WHICH INVOLVES AGGREGATE PAYMENTS IN EXCESS OF 50,000 IN ANY YEAR; AND 11. AUTHORIZATION OR APPROVAL OF THE SETTLEMENT OF ANY LITIGATION OR OTHER DISPUTE INVOLVING THE FOUNDATION FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11A THE COMPLETION OF THE FORM 990 BEGINS WITH AN OPENING MEETING ATTENDED BY THE CONTROLLER OF CHARTERCARE AND KPMG LLP, AN INDEPENDENT TAX CONSULTANT. THE MEETING CONSISTS OF A REVIEW OF THE ORGANIZATIONAL STRUCTURE, SIGNIFICANT CHANGES IN OPERATIONS OR PROGRAM ACTIVITIES FROM THE PRIOR YEAR, AND OVERVIEW OF CHANGES IN THE FORM 990. THE FINANCE DEPARTMENT GATHERS THE REQUIRED INFORMATION AND POPULATES THE FORM 990 IN CONJUNCTION WITH KPMG LLP. ONCE COMPLETED, THE DRAFT FORM 990 IS REVIEWED WITH SENIOR MANAGEMENT TO ENSURE INDIVIDUALS ARE PROVIDEDTIME TO REVIEW AND APPROVE THE FORM 990 PRIOR TO THE DEADLINE. AFTER THE INTERNAL REVIEW IS COMPLETED, THE FORM 990 IS PROVIDED TO THE FINANCE COMMITTEE FOR THEIR REVIEW AND COMMENTS. A MEETING IS HELD TO REVIEW THE FORM 990 AND DISCUSS ANY QUESTIONS AND COMMENTS. UPON FINANCE COMMITTEE APPROVAL, A FINAL COPY OF THE FORM 990 IS DISTRIBUTED TO EACH VOTING BOARD MEMBER AND FILED WITH THE TAXING AUTHORITY. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12 THE CONFLICT OF INTEREST POLICY, IS TO THE PROTECT THE CORPORATIONS INTERESTS WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR AGREEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR TRUSTEE OF THE CORPORATION. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND ALL MATERIAL FACTS TO THE OFFICERS, TRUSTEES AND MEMBERS OF THE BOARD. ON AN ANNUAL BASIS, EACH MEMBER OF THE BOARD IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT AND ALL RESPONSES ARE SUBMITTED AND REVIEWED BY THE PRESIDENT OR THE CHAIRMAN WITH CONSULTATION FROM THE CORPORATE COMPLIANCE OFFICER. ANY ACTUAL AND POSSIBLE CONFLICTS OF INTEREST ARE REVIEWED WITH THE BOARD OF TRUSTEES. COMPENSATION POLICY FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE, BEING INDEPENDENT, ACTED AS THE COMPENSATION COMMITTEE. IN 2009, A MARKET REVIEW WAS CONDUCTED BY A THIRD PARTY, FOR ALL SENIOR EXECUTIVES WITHIN THE SJHS SYSTEM. THIS INDEPENDENT THIRD PARTY IS DEEMED QUALIFIED TO PERFORM COMPENSATION STUDIES AND OPINIONS AND SERVES THEIR OPINION TO THE REASONABLENESS AND COMPARABILITIY OF THE COMPENSATION AS DETERMINED IN ACCORDANCE WITH, AND FOR THE PURPOSES OF, THE RULES GOVERNING INTERMEDIATE SANCTIONS UNDER SECTION 4958 OF THE INTERNAL REVENUE CODE. THE EXECUTIVE COMPENSATION STUDY COMPLETED IN 2009 WAS BASED ONLY ON MARKET DATA FOR BASE SALARY AS SJHS DOES NOT HAVE AN INCENTIVE COMPONENT TO THEIR EXECUTIVE COMPENSATION PROGRAM. IN 2009 THERE WERE NO CHANGES. FOR KEY EMPLOYEES INCLUDING THE HOSPITAL CONDUCTS ANNUAL BENCHMARKING STUDIES FOR KEY POSITIONS USING PUBLISHED COMPENSATION SURVEYS THROUGH A THIRD PARTY AND ADMINISTERS ITS COMPENSATION PROGRAMS AS OUTLINED IN OUR SJHS COMPENSATION GUIDE BASED ON INDUSTRY STANDARDS. PUBLIC DISCLOSURE FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION MAKES ITS TAX RETURN, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ITS TAX RETURN IS ALSO POSTED ON HTTP://WWW.GUIDESTAR.ORG. SIGNIFICANT CHANGES TO THE ORGANIZATION'S DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 SJHSRI, THE PARENT OF ST. JOSEPH HEALTH SERVICES FOUNDATION, EFFECTIVE JANUARY 2010 BECAME A MEMBER OF CHARTERCARE HEALTH PARTNERS, AN AFFILIATED HEALTHCARE ORGANIZATION. BUSINESS RELATIONSHIP FORM 990, PART VI, SECTION A, LINE 2 JOSEPH DISTEFANO AND RICHARD BERETTA HAVE A BUSINESS RELATIONSHIP IN THE ORDINARY COURSE OF BUSINESS. ST JOSEPH HEALTH SERVICES OF RI 200 HIGH SERVICE AVENUE NORTH PROVIDENCE RI 02904 050259026 HEALTHCARE RI 501(C)(3) 7 NA ROGER WILLIAMS MEDICAL CENTER 825 CHALKSTONE AVENUE PROVIDENCE RI 02908 050258959 HEALTHCARE RI 501(C)(3) 3 NA ELMHURST EXTENDED CARE FACILITIES INC 50 MAUDE STREET PROVIDENCE RI 02908 222723407 HEALTHCARE RI 501(C)(3) 3 NA ROGER WILLIAMS REALTY CORPORATION 825 CHALKSTONE AVENUE PROVIDENCE RI 02908 050423855 REAL ESTATE RI 501(C)(3) 11A NA RWGH PHYSICIANS OFFICE BUILDING INC 825 CHALKSTONE AVENUE PROVIDENCE RI 02908 050398588 HEALTHCARE RI 501(C)(3) 11A NA ROGER WILLIAMS MEDICAL ASSOCIATES INC 825 CHALKSTONE AVENUE PROVIDENCE RI 02908 203346936 HEALTHCARE RI 501(C)(3) 11A NA CHARTERCARE HEALTH PARTNERS 825 CHALKSTONE AVENUE PROVIDENCE RI 02908 264235815 HEALTHCARE RI 501(C)(3) 11A NA ST JOSEPH HOSPITAL WORKERS COMP TRUST 200 HIGH SERVICE AVENUE NORTH PROVIDENCE RI 02904 056106574 TRUST RI 501(C)(3) 11D NA ROSEBANK CORPORATION 825 CHALKSTONE AVENUE PROVIDENCE RI 02908 050342046 REAL ESTATE RI NA C Corp ELMHURST HEALTH ASSOCIATES 825 CHALKSTONE AVENUE PROVIDENCE RI 02908 050437610 LABORATORY RI NA C Corp OUR LADY OF FATIMA ANCILLARY SERVICES 200 HIGH SERVICE AVENUE NORTH PROVIDENCE RI 02908 050519862 LABORATORY RI NA C Corp false false false false false false false false false true true false false true false false false false