Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HUNTSVILLE HOSPITAL FOUNDATIONINC
Employer identification number
63-0752604
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2,291,816
2,978,907
3,186,255
3,527,197
3,667,711
15,651,886
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
444,131
483,510
605,712
633,632
674,180
2,841,165
4
Total. Add lines 1 through 3..
2,735,947
3,462,417
3,791,967
4,160,829
4,341,891
18,493,051
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
18,493,051
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
2,735,947
3,462,417
3,791,967
4,160,829
4,341,891
18,493,051
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
378,334
500,238
671,265
400,020
717,451
2,667,308
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
21,160,359
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
1,321,143
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
87.390 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
87.090 %
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HUNTSVILLE HOSPITAL FOUNDATIONINC
Employer identification number
63-0752604
Identifier
Return Reference
Explanation
ORGANIZATION MISSION STATEMENT
FORM 990 PART I, LINE 1
HUNTSVILLE HOSPITAL FOUNDATION WAS ESTABLISHED IN 1978 AS THE 501 (C)(3) NON-PROFIT FUNDRAISING ARM OF HUNTSVILLE HOSPITAL, ALSO A NOT-FOR-PROFIT ENTITY. HUNTSVILLE HOSPITAL, ESTABLISHED IN 1895, HAS GROWN TO BE THE REGIONAL TERTIARY CARE CENTER FOR NORTH ALABAMA AND SOUTH CENTRAL TENNESSEE, AND IS THE NINTH LARGEST PUBLICLY-OWNED HOSPITAL IN THE COUNTRY WITH 941 LICENSED ACUTE CARE BEDS, AND MORE THAN 750 PHYSICIANS WHO ARE SUPPORTED BY 7,000 HOSPITAL EMPLOYEES. IN FISCAL YEAR 2011, WE ADMITTED 43,005 PATIENTS, TREATED 543,628 OUTPATIENTS, AND PROVIDED MORE THAN $551 MILLION IN UNCOMPENSATED MEDICAL CARE. THE HOSPITAL PROVIDES QUALITY, LEADING-EDGE HEALTHCARE TO A SERVICE AREA OF MORE THAN 1.1 MILLION PEOPLE, REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDE THE AREAS ONLY REGIONAL TRAUMA PROGRAM AND THE BUSIEST EMERGENCY DEPARTMENT IN THE STATE OF ALABAMA, CARDIOVASCULAR SERVICES (LARGEST CATH LAB IN THE STATE OF ALABAMA, AND CARDIOVASCULAR SURGERY PROGRAM WHICH IS RANKED IN THE TOP 10% IN THE NATION), PRIMARY STROKE CENTER DESIGNATION, JOINT CAMP (NATIONALLY RECOGNIZED JOINT REPLACEMENT PROGRAM), PERFECT RATING FOR THE MAMMOGRAPHY PROGRAM, APPROVED ONCOLOGY PROGRAM WITH COMMENDATION, AND EXCEPTIONAL LAB ACCREDITATION. HUNTSVILLE HOSPITAL FOR WOMEN AND CHILDREN IS HOME TO THE ONLY FULL-SERVICE PEDIATRIC UNIT, PEDIATRIC EMERGENCY DEPARTMENT, PEDIATRIC ICU, AND THE ONLY LEVEL III NEONATAL ICU BETWEEN BIRMINGHAM AND NASHVILLE. THE HOSPITAL ALSO HOUSES ONE OF ONLY SIX ST. JUDE AFFILIATE CLINICS IN THE COUNTRY. THE HOSPITAL SYSTEM'S FACILITIES INCLUDE HUNTSVILLE HOSPITAL, HUNTSVILLE HOSPITAL FOR WOMEN & CHILDREN, MADISON HOSPITAL, AN OUTPATIENT MEDICAL MALL, AND A 70-BED REHABILITATION HOSPITAL LOCATED ON THE CAMPUS. AS A NOT-FOR-PROFIT HOSPITAL THAT RECEIVES NO TAX SUPPORT FROM CITY, STATE OR FEDERAL GOVERNMENTS, HUNTSVILLE HOSPITAL RELIES ON PHILANTHROPY TO FUND ITS CAPITAL AND OPERATIONAL NEEDS. THE HUNTSVILLE HOSPITAL FOUNDATION ACCEPTS CHARITABLE CONTRIBUTIONS ON THE HOSPITAL'S BEHALF AND WORKS TO FUND BOTH PRESENT AND FUTURE EQUIPMENT AND PROGRAM NEEDS. CONTRIBUTIONS OF ANY AMOUNT ARE GRATEFULLY ACCEPTED AND MAY BE UNRESTRICTED GIFTS OR DESIGNATED FOR A SPECIFIC HOSPITAL UNIT OR PROGRAM. CONTRIBUTIONS TO THE FOUNDATION ARE TAX DEDUCTIBLE, WITH 100% OF ALL GIFTS BENEFITING THE HOSPITAL PROGRAM OR DEPARTMENT DESIGNATED BY ITS DONORS.
ORGANIZATION MISSION STATEMENT
FORM 990 PART III, LINE 1
HUNTSVILLE HOSPITAL FOUNDATION'S MISSION IS TO DEVELOP RELATIONSHIPS AND FINANCIAL RESOURCES TO SUPPORT THE HEALTHCARE PROGRAMS, PROJECTS AND SERVICES OF HUNTSVILLE HOSPITAL. THE HOSPITAL'S MISSION IS TO PROVIDE QUALITY CARE THAT WILL IMPROVE THE HEALTH OF THOSE WE SERVE. OUR VISION IS TO BE ONE OF THE BEST HOSPITALS IN THE UNITED STATES AND TO BE CONSISTENTLY RECOGNIZED FOR CLINICAL AND SERVICE EXCELLENCE. THE HOSPITAL AND FOUNDATION EXTEND THE MISSION OF HUNTSVILLE HOSPITAL THROUGH EXTENSIVE OUTREACH PROGRAMS. IN 2011 WE OFFERED FREE SCREENINGS AND HEALTH INFORMATION AT NEARLY 150 COMMUNITY EVENTS. HOSPITAL STAFF AND PHYSICIANS ALSO PRESENTED MORE THAN 100 PROGRAMS TO LOCAL CLUBS, BUSINESSES AND SCHOOLS. ALTHOUGH HUNTSVILLE HOSPITAL IS A REGIONAL HEALTHCARE FACILITY, IT IS VERY MUCH A COMMUNITY HOSPITAL. THE FOUNDATION STAFF STRIVES TO INVOLVE ANYONE WHO WISHES TO SUPPORT THE HOSPITAL WITH GIFTS OF TIME, TALENT AND RESOURCES: FROM THE 5-YEAR OLD CHILD WHO SWIMS LAPS AND RAISES FUNDS FOR THE NEONATAL ICU, TO THE CORPORATE TEAM THAT RUNS IN OUR ANNUAL 5K BREAST CANCER RUN, TO THE YOUNG PROFESSIONAL WHO SERVES IN AN ADVOCACY ROLE THROUGH MEMBERSHIP IN THE FOUNDATION'S DEVELOPMENT COUNCIL, TO THE BABY BOOMER WHO CHAIRS AN EVENT COMMITTEE OR MAKES A SIGNIFICANT CHARITABLE CONTRIBUTION THAT PROVIDES A PIECE OF LIFESAVING TECHNOLOGY. EACH GIFT IS INVALUABLE AND APPRECIATED; AND OUR STAFF, VOLUNTEERS AND DONORS JOIN HANDS TO SUPPORT THIS CROWN JEWEL IN OUR COMMUNITY. STEWARDSHIP, ACCOUNTABILITY AND TRANSPARENCY ARE OUR WATCHWORDS, FOR WE KNOW THAT WE SERVE THE COMMUNITY THROUGH OUR WORK AT THE FOUNDATION. DONATIONS MAY BE RESTRICTED TO A PARTICULAR HOSPITAL DEPARTMENT OR PROGRAM, OR THEY MAY BE GIVEN TO THE AREA OF GREATEST NEED. REGARDLESS, 100% OF EACH GIFT (WITH THE EXCEPTION OF SPECIAL EVENT DONATIONS) BENEFITS THE AREA DESIGNATED BY THE DONOR BECAUSE HUNTSVILLE HOSPITAL COVERS THE OVERHEAD EXPENSES OF THE FOUNDATION.
NEW PROGRAM SERVICES
FORM 990, PART III, LINE 2
EACH YEAR THE FOUNDATION PROVIDES FUNDING TO HUNTSVILLE HOSPITAL BASED ON AREAS OF NEED AND DONOR RESTRICTIONS. AS A RESULT, PROGRAM SERVICES ARE CONSTANTLY CHANGING. SCHEDULE O PROVIDES A LIST OF THE CURRENT YEAR PROGRAM SERVICE ACCOMPLISHMENTS.
PROGRAM SERVICE STATEMENT
FORM 990 PART III, LINE 4A
HUNTSVILLE HOSPITAL IS A PARTNERSHIP OF PEOPLE WHO CARE. ORIGINALLY BUILT THROUGH GENEROUS COMMUNITY VOLUNTEERISM AND CONTRIBUTIONS, THIS CARE HAS EXTENDED TO GENERATIONS OF FAMILIES IN THE TENNESSEE VALLEY SINCE 1895. NOW MORE THAN EVER, HUNTSVILLE HOSPITAL RELIES ON PHILANTHROPY TO MEET THE HEALTHCARE NEEDS OF THE REGION. THOUSANDS OF INDIVIDUALS, CLUBS, SCHOOLS, LOCAL BUSINESSES AND NATIONAL CORPORATIONS HAVE JOINED TOGETHER TO SUPPORT EXCELLENCE IN HEALTHCARE FOR NORTH ALABAMA. THANKS TO THE GENEROSITY OF OUR DONORS, HUNTSVILLE HOSPITAL FOUNDATION PROVIDED RECORD FUNDING FOR HUNTSVILLE HOSPITAL AND ITS PATIENTS IN FISCAL YEAR 2011. THE FOUNDATION MANAGES MORE THAN 300 DESIGNATED FUNDS REPRESENTING VIRTUALLY EVERY DEPARTMENT AND NURSING UNIT AT THE HOSPITAL, AND DISTRIBUTES FUNDS AS NEEDED TO PROVIDE CUTTING-EDGE TECHNOLOGY AND LIFESAVING PROGRAMS THAT OTHERWISE WOULD NOT BE POSSIBLE. PHILANTHROPY PROVIDED $2,665,700 TO FUND EQUIPMENT AND PROGRAM NEEDS. THE BALANCE OF THE FUNDS RAISED WAS TRANSFERRED TO THE FOUNDATION'S GENERAL ENDOWMENT WHICH WILL PROVIDE FOR HUNTSVILLE HOSPITAL INTO PERPETUITY. WOMEN & CHILDREN'S SERVICES: IN FISCAL YEAR 2011, THE FOUNDATION PROVIDED $1,119,565 (45% OF THE TOTAL FUNDS DISTRIBUTED) TO HUNTSVILLE HOSPITAL FOR WOMEN & CHILDREN. EXAMPLES OF EQUIPMENT PURCHASED, THANKS TO PHILANTHROPY, INCLUDE: A. BREAST SPECIFIC GAMMA IMAGING (BSGI) FOR THE BREAST CENTER B. BREAST MRI FUNDING C. DEFIBRILLATORS (9) LOCATED HOUSEWIDE AT HUNTSVILLE HOSPITAL FOR WOMEN & CHILDREN D. ULTRASOUND SYSTEM FOR THE PEDIATRIC ICU E. GIRAFFE INCUBATORS AND WARMERS FOR THE NEONATAL ICU F. DOPPLAR ULTRASOUND SYSTEM FOR THE PEDIATRIC ONCOLOGY AND HEMATOLOGY DEPARTMENT
PROGRAM SERVICE STATEMENT
FORM 990 PART III, LINE 4B
MEDICAL SERVICE LINE: THE FOUNDATION PROVIDED $373,198 (14% OF THE TOTAL FUNDS DISTRIBUTED) FOR VARIOUS CLINICAL DEPARTMENTS. EXAMPLES INCLUDE: A. TEG ANALYZERS FOR THE PATHOLOGY LAB B. MRI IV PUMP FOR RADIOLOGY C. DIAGNOSTIC ULTRASOUND SYSTEM FOR MEDICAL ICU D. DEFIBRILLATOR FOR THE PAIN CENTER E. BLADDER SCANNER FOR THE BEHAVIORAL HEALTH UNIT F. BRAIN MONITOR FOR NEURO ICU G. PATIENT MANIKIN FOR THE SIMULATION LAB (TRAINING LAB FOR HOSPITAL EMPLOYEES)
PROGRAM SERVICE STATEMENT
FORM 990 PART III, LINE 4C
MOBILE MEDICAL UNIT: THE FOUNDATION PROVIDED $244,021 (9% OF THE TOTAL FUNDS DISTRIBUTED) FOR A MOBILE MEDICAL UNIT THAT IS UTILIZED FOR COMMUNITY OUTREACH AND DISASTER RESPONSE. THE MMU TRAVELS ACROSS NORTH ALABAMA FOR COMMUNITY SCREENINGS AND HEALTH EDUCATION; AND CAN ALSO BE DEPLOYED AS A DISASTER RESPONSE UNIT IN CASES OF REGIONAL DISTRESS.
FORM 990, PART VI, SECTION B, LINE 11
FORM 990 WAS REVIEWED IN DETAIL BY THE PRESIDENT AND DIRECTOR OF ACCOUNTING. THE RETURN WAS ALSO MADE AVAILABLE TO THE BOARD FOR REVIEW AT ITS MONTHLY BOARD MEETING PRIOR TO BEING FILED.
FORM 990, PART VI, SECTION B, LINE 12C
ON AN ANNUAL BASIS BOARD MEMBERS ARE SUPPLIED WITH A COPY OF THE CONFLICT OF INTEREST POLICY AND REQUIRED TO COMPLETE AND SIGN THE ACKNOWLEDGEMENT AND DISCLOSURE FORM.
FORM 990, PART VI, SECTION B, LINE 15
SALARIES ARE REVIEWED BY INDEPENDENT PERSONS AND ARE BASED ON COMPENSATION LEVELS OF SIMILAR ORGANIZATIONS.
FORM 990, PART VI, SECTION C, LINE 19
ALL DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
NET UNREALIZED GAINS ON INVESTMENTS: 3,128,573.
FORM 990 PART XII LINE 2 C
THERE WAS NO CHANGE IN THE OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.