2011-05-03T15:34:08-05:00 2010-06-30 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2009-07-01 953818027 Marian Medical Center Foundation MARI 8057393688 1400 East Church Street Santa Maria CA 93454 SUE ANDERSEN 2011-05-02 4159635100 2009 2016-02-24 21:20:13Z SUE ANDERSEN 1400 East Church Street Santa Maria CA 93454 5671287 false 0928 X WWW.CHWHEALTH.ORG X 1982 CA TO PROVIDE FINANCIAL ASSISTANCE AND SUPPORT SERVICES FOR CATHOLIC HEALTHCARE WEST (DBA: MARIAN MEDICAL CENTER). 18 16 0 3 0 0 3192884 2471310 0 0 -405449 740924 -86810 -46979 2700625 3165255 3468523 1952488 0 0 258771 248855 118437 105535 126924 259654 231710 4105385 2538588 -1404760 626667 15229976 16212426 828816 203932 14401160 16008494 FOUNDATION EXISTS TO SUPPORT THE VALUES OF CHW, DBA MARIAN MEDICAL CENTER. THE FOUNDATION IS RESPONSIBLE FOR THE RECEIPT, MAINTENANCE, AND TRANSFER OF MONEY AND PROPERTY FOR THE BENEFIT OF CHW. FOUNDATION SUPPORT ALLOWS THE HOSPITAL TO FURTHER ITS MISSION OF DELIVERING COMPASSIONATE, HIGH-QUALITY, AFFORDABLE HEALTH SERVICES; SERVING AND ADVOCATING FOR OUR SISTERS AND BROTHERS WHO ARE POOR AND DISENFRANCHISED; AND PARTNERING WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE. false false 2145057 1952488 0 The Foundation is an IRC Sec 509(a)(3) supporting organization to Catholic Healthcare West, dba Marian Medical Center ("Hospital"). As a supporting organization, the Foundation operates exclusively for the benefit of, to perform the function of, or to carry out the purposes of the Hospital which include making payments directly to the Hospital. 2145057 true true false false false false false false true true false true false false false false false true true false false true false true false false false false false false false false true true false false false true false false false true 0 0 true 0 false false false false false true true false false false 18 16 false false false false true true true true true false false false true true true true true false false false CA X FINANCE DEPTBILL FINLEY 8057393686 1400 EAST CHURCH STREET Santa Maria CA 93454 X Dr Dennis Blackburn 1.0 X Bill Burress 1.0 X Ron Cossa 1.0 X Maggie Daane 1.0 X Fred Donati 1.0 X Sister Pius Fahlstrom OSF 1.0 X 0 0 5359 Donna France 1.0 X Angelica Gutierrez 1.0 X X Lauren Pincot 1.0 X Andrew Rice 1.0 X Jane Rooney 1.0 X Dr Al Schultz 1.0 X Cynthia Schur 1.0 X Raul Segura Sr 1.0 X X Mary Spallino 1.0 X Chuck Cova 1.0 X X 0 629346 68921 Dr Mark Juretic 1.0 X X 0 241647 0 Carol Reiner 1.0 X X Sue Andersen 1.0 X 0 350472 41470 Lynette Muscio 40.0 X 0 117631 15171 Bill M Finley 2.0 X 0 196914 26144 William Fuchs X 0 1681267 631899 0 3217277 788964 0 true true false NETZEL ASSC INC 9696 CULVER BLVD SUITE 105 CULVER CITY CA 902322737 Fundraising 105535 SE2 770 SHERMAN ST DENVER CO 80203 Professional Consult 100748 2 170948 548902 13163 1738297 26586 2471310 0 365805 0 365805 0 0 2794297 2419178 375119 375119 375119 39875 170948 86854 -46979 -46979 0 0 0 3165255 0 693945 1952488 1952488 0 0 0 0 0 192237 77052 106627 8558 0 47821 19167 26525 2129 8797 3526 4879 392 0 0 0 0 105535 105535 124051 49721 68807 5523 68613 27501 38057 3055 11586 4644 6426 516 1989 1840 149 0 0 21816 8744 12101 971 1471 589 816 66 0 0 0 0 0 0 TAXES AND LICENSES 150 150 DUES AND SUBSCRIPTIONS 684 275 379 30 OTHER EXPENSES 1350 1350 2538588 2145057 266607 126924 50310 50000 1136305 848867 1794012 1406078 36996 36996 11141025 12674934 1105401 1232547 2923 0 15229976 16212426 31568 20571 797248 172545 0 10816 828816 203932 X 12603839 13925624 1536778 1822327 260543 260543 14401160 16008494 15229976 16212426 X false true true X false X X X false false false CATHOLIC HEALTHCARE WEST (DBA MARIAN MEDICAL CENTER) 941196203 03 true true true 2538588 1 2538588 The Foundation provided or purchased for the benefit of Catholic Healthcare West dba Marian Medical Center, various services, facilities and goods. See Form 990, Part IX for further details. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3841680 1000 436000 306000 3972680 4154114 59647 -372081 3841680 1.00000 false false 0 36996 36996 POOLED INVESTMENTS 1232547 F 1232547 0 DEFERRED COMPENSATION 10578 DUE TO RELATED PARTIES 238 10816 Sch D, PART V, LINE 4 Endowments are used to support hospital building projects of CHW, dba Marian Medical Center. Sch D , PART X THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS DID NOT INCLUDE A FIN 48 FOOTNOTE DISCLOSURE AS THE LIABILITY WAS DETERMINED NOT MATERIAL FOR REPORTING PURPOSES. X X X X true Netzel Grigsby Associates CONSULTING TRAINING false 757753 105535 652218 757753 105535 652218 CA WAITER'S NIGHT 154442 128797 25645 8675 12120 17823 1300 17603 GOLF TOURNAMNT 36251 22001 14250 4000 6953 9511 1 20150 20150 2759 80 780 5250 210843 170948 39895 8675 18879 24856 2080 32364 86854 -46959 true CHW dba Marian Medical Center 1400 E Church Street Santa Maria CA 93454 941196203 501(c)(3) 1952488 0 N/A N/A Support Hospital SVCS 1 0 PART I, LINE 2 As a Sec. 509(a)(3) supporting organization, the Foundation operates exclusively for the benefit of, to perform the function of, or to carry out the purposes of the grantee listed in Part II, item 1 (CHW dba Marian Medical Center), which include making payments directly to the beneficiary organization, transferring and monitoring that restrictions are met before release of funds and expenditure of such funds. true true false false false false false false false Chuck Cova 0 373348 0 228463 0 27535 0 38898 0 30023 0 698267 0 0 Dr Mark Juretic 0 241647 0 0 0 0 0 0 0 0 0 241647 0 0 Sue Andersen 0 263180 0 69207 0 18085 0 24853 0 16617 0 391942 0 0 Bill M Finley 0 157516 0 29125 0 10273 0 15865 0 10279 0 223058 0 0 William Fuchs 0 306244 0 0 0 1375023 0 612253 0 19646 0 2313166 0 0 Part I, Line 3 The Organization relied on a related organization, Catholic Healthcare West, that used one or more of the methods described in Schedule J, Part I, Line 3, to establish the Organization's top management official's compensation. See Schedule O disclosure for Form 990, Part VI, Section B, Line 15 for additional information. PART I, LINE 4a The organization's key employees and its highest compensated employees participate in a severance plan that provides fair compensation, ranging from payments of 1 week to 2 years of base compensation, depending on the executive's position, in the event of a position elimination or other involuntary termination, in accordance with the guidelines of the plan. Payments and deferred compensation pursuant to the plan arrangement for one former key employee occurred during 2009 related to eliminated positions; W. Fuchs $1,799,810. W. Fuchs' services were provided to a related organization. PART I, LINE 4b Certain listed persons participate in the CHW Excess Benefit Plan, a nonqualified supplemental benefit plan limited to participants in the CHW retirement plan whose benefits are affected by the limitations imposed by Sections 401(a)(17) and 415 of the Internal Revenue Code. Benefit service under this plan was frozen as of January 1, 2008. No payments were made to any listed persons during 2009 pursuant to this plan. Certain listed persons hired prior to June 30, 2006 are eligible to participate in the CHW Executive Deferred Compensation Plan, a nonqualified 457(f) plan which is intended to provide a benefit approximating the difference, if any, between the benefit provided under the CHW excess benefit plan and the benefit provided under the qualified benefit plan that substantially replaced the excess plan. No benefit will vest under the 457(f) plan before the latter of the attainment of age 62 while employed or the completion of 15 years of service. Certain listed persons participate in the CHW Key Employee Share Option Plan (KEYSOP), which was frozen in May 2002. The KEYSOP program was established in 2001 with the purpose of providing income deferral opportunities to employees eligible for the company's key employee retention program. No payments were made to any listed persons during 2009 pursuant to this plan. PART II, SUPPLEMENTAL DISCLOSURES Although the organization does not directly employ any personnel, the supported organization's executive compensation philosophy is designed to assist in attracting and retaining the caliber of executives required to fulfill the organization's mission of providing high quality healthcare for all persons regardless of their ability to pay for services, improving the quality of life in the communities the organization serves, promoting employee satisfaction, and ensuring financial stability. A substantial portion of executive compensation is performance based and is linked to organizational goals approved in advance by the Compensation and Benefits Committee. These goals include attainment of annual and long-term financial performance, certain healthcare quality standards and the organization's commitment to serving the poor and disenfranchised in the communities it serves. Part VII - Sch J-2 Dr. Juretic's compensation is for Medical Directorship services and physcian services provided to Marian Medical Center, a supported organization, and Marian Community Clinics. The organization does not compensate director/officer, Pius Fahlstrom, OSF, for her services as a board member. All compensation and benefits reported for directors represent compensation as an employee by the supported organization. X 2 1000 Average market value X 1 15140 Average market value X Gift certificates and tickets 2 945 Comparable sale X Food and Wine 12 8976 Comparable sale X Sporting Goods 1 525 Comparable sale 0 false true true PART I, LINE 32b Services of a local investment company are used to sell gifts of stock that are received. SCH M, PART I, COLUMN B THE FOUNDATION IS REPORTING BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. PART VI - GOVERNANCE, MANAGEMENT, DISCLOSURE FORM 990, PART VI, SECTION A, LINE 2 Board member Donna France and Board member Andrew Rice have a business relationship FORM 990, PART VI, SECTION A, LINE 6 The organization has a sole corporate member, Catholic Healthcare West, a 501(c)(3) exempt organization. FORM 990, PART VI, SECTION A, LINE 7a CHW, as the sole corporate member, ratifies the selection of members and the CHW Board approves new Board members of the foundation. FORM 990, PART VI, SECTION A, LINE 7b Reserved rights of the corporate member include adoption of mission and philosophy statements, amendment or restatement of articles of incorporation and bylaws, dissolution of the corporation, acquisition of another corporation, creation of a new subsidiary, merger or consolidation with another corporation, participation as a general or limited partner in any venture, incurring long-term indebtedness in excess of normal operating requirements, ratification of board member appointments and dismissals, selection and removal of independent auditors, and transactions outside the ordinary course of business. FORM 990, PART VI, SECTION B, LINE 11A The return was reviewed by the accounting department and an independent accounting firm engaged by the organization to review the return. Management presented the draft of the Form 990 to the Finance Committee. The draft was complete except it excluded compensation information for directors who are also key executives of Catholic Healthcare West, the filing organization's sole member. Compensation by Catholic Healthcare West to those directors has been reviewed by the Compensation and Benefits Committee of the Catholic Healthcare West Board of Directors. The Finance committee reported back to the board regarding its overSIGHT of the Form 990 and the final draft was provided to the board before the return was filed. FORM 990, PART VI, SECTION B, LINE 12C The Foundation has adopted CHW's Conflicts of Interest Policy. The Foundations Board is charged with monitoring proposed or ongoing transaction's for conflicts of interest and addressing any potential or actual conflicts. Pursuant to the Conflicts of Interest Policy, an annual conflict of interest questionnaire, aimed at determining any family and business relationships and transactions or other transactions that may pose a potential conflict, is distributed to all covered persons (e.g., board members, officers and executive leadership, key employees). Covered persons are required to disclose real or potential conflicts at the time such conflicts arise. When someone becomes a covered person and annually thereafter, each covered person is required to sign a statement affirming that he/she: (1) has received a copy of the Conflicts of Interest Policy; (2) has read the Policy and understands said Policy; and (3) agrees to comply with all requirements of the Policy, including completing the conflicts of interest questionnaire. The completed questionnaires are reviewed by CHW's Legal Department and any persons with actual or potential conflicts are informed via written communication. The procedures for addressing any conflict of interest include, but are not limited to, the following: (1) the conflicting interest is fully disclosed to the Board; (2) the interested person responds to factual questions related to the substance of the transaction or arrangement being considered, after which he/she shall leave the meeting; (3) the person with the conflict of interest is excluded from the discussion and approval of such transaction; (4) alternatives to the proposed transaction are investigated, competitive bids or comparable valuations are obtained; (5) any conflicting issues during the course of a Board meeting which cannot be resolved is referred to the Governance Committee; and (6) the transaction or action must be approved by a majority of disinterested persons. All conflicts of interest, whether resolved or unresolved, are reported in the Foundation's Form 990. FORM 990, PART VI, SECTION B, LINE 15 FOR 2009 COMPENSATION, The supported organization's human resources department conductED an annual review and analysis to provide benchmarking data for the total compensation and benefits package of key executives. Compensation is also reviewed annually as part of the merit increase process. FORM 990, PART VI, SECTION C, LINE 19 Federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspection. The organization makes its financial statements available on its website and upon request. PART I, LINE 5 and PART V, LINE 2a The organization does not have employees. As a supporting organization, the foundation operates for the benefit of the hospital and utilizes the employees of that hospital. The proportionate salaries and benefits for these individuals are allocated to the Foundation. The salaries of these employees are included in the hospital entity's Form W-3 and federal employment tax returns. FORM 990, PART VII, SECTION A The following individuals listed on Form 990 Part VII were compensated by Catholic Healthcare West, the supported organization. An estimate of their hours provided to the supported organization is provided: Sister Pius Fahlstrom, OSF; 40 hours Chuck Cova; 40 hours Dr. Mark C. Juretic; 20 hours Sue Andersen; 40 hours Bill M. Finley; 40 hours Catholic Healthcare West 1400 E CHURCH STREET SANTA MARIA CA 93454 941196203 Hospital CA 501(c)(3) 3 na false true true false false false false false false false false false false true true false false false NONE