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
ST JOSEPH MEDICAL CENTER FOUNDATION INC
Employer identification number
52-1681044
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.") ....
5,593,368
4,811,771
2,770,853
2,454,339
3,818,889
19,449,220
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
0
4
Total. Add lines 1 through 3..
5,593,368
4,811,771
2,770,853
2,454,339
3,818,889
19,449,220
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)..
4,819,000
6
Public Support. Subtract line 5 from line 4.
14,630,220
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..
5,593,368
4,811,771
2,770,853
2,454,339
3,818,889
19,449,220
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
518,926
484,656
217,153
49,580
58,731
1,329,046
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
109,650
463,393
279,900
287,483
14,554
1,154,980
11
Total support (Add lines 7 through 10).
21,933,246
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
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
66.700 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
64.400 %
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
OTHER INCOME, SCHEDULE A, PART II, LINE 10, GROSS INCOME FROM FUNDRAISING EVENTS: 2006 - $109,650 2007 - $463,393 2008 - $279,900 2009 - $287,483 2010 - $13,804 GROSS INCOME FROM GAMING ACTIVITIES: 2010 - $750,
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
10000128
Software Version:
v2010.1.0
-
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
ST JOSEPH MEDICAL CENTER FOUNDATION INC
Employer identification number
52-1681044
Identifier
Return Reference
Explanation
PROGRAM DESCRIPTION
FORM 990, PART III, LINE 4A
ST. JOSEPH MEDICAL CENTER FOUNDATION, INC. SOLICTS, RECEIVES, AND DISTRIBUTES CHARITABLE GIFTS, FUNDS, AND OTHER ASSETS EXCLUSIVELY TO FURTHER THE RELIGIOUS, CHARITABLE, EDUCATIONAL, AND SCIENTIFIC ACTIVITIES OF ST. JOSEPH MEDICAL CENTER, INC. THESE FUNDS ARE USED SOLELY TO ENHANCE THE MEDICAL AND HEALTH CARE SERVICES PROVIDED BY ST. JOSEPH MEDICAL CENTER, INC. TO THE PEOPLE OF THE SURROUNDING AREA. FUNDS ARE RAISED UNDER THE OVERALL DIRECTION OF AN UNPAID BOARD OF DIRECTORS WHO, WORKING WITH A GROUP OF VOLUNTEERS, CONDUCT VARIOUS FUNDRAISING CAMPAIGNS AND CHARITABLE EVENTS THROUGHOUT THE YEAR. SOLICITATIONS ARE MADE FOR VARIOUS CAPITAL NEEDS OF ST. JOSEPH MEDICAL CENTER, INC., AS WELL AS, FOR PROGRAMS AND SERVICE ENHANCEMENTS.
CARMEN DEYESU AND VICKI DEYESU - FAMILY RELATIONSHIP
Classes of members or stockholders
Form 990, Part VI, Section A, Line 6
ACCORDING TO THE BYLAWS OF ST. JOSEPH MEDICAL CENTER FOUNDATION, INC., THE ENTITY'S SOLE MEMBER IS ST. JOSEPH MEDICAL CENTER, INC. A MARYLAND NONPROFIT CORPORATION.
Members or stockholders electing members of governing body
Form 990, Part VI, Section A, Line 7a
ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS.
Decisions requiring approval by members or stockholders
Form 990, Part VI, Section A, Line 7b
THE ORGANIZATION'S CORPORATE MEMBER IS ST. JOSEPH MEDICAL CENTER, INC. PURSUANT TO SECTION 6.1 OF THE ORGANIZATION'S BYLAWS, BOTH ST. JOSEPH MEDICAL CENTER AND CATHOLIC HEALTH INITIATIVES ("CHI") (ST. JOSEPH MEDICAL CENTER'S SOLE CORPORATE MEMBER) HAVE RESERVED POWERS AS OUTLINED IN THE CHI GOVERNANCE MATRIX. PURSUANT TO THE GOVERNANCE MATRIX THE FOLLOWING RIGHTS ARE HELD BY THE ST. JOSEPH MEDICAL CENTER BOARD: *APPROVE MEMBERS OF ST. JOSEPH MEDICAL CENTER FOUNDATION BOARD *AMENDMENT OF THE CORPORATE DOCUMENTS OF ST. JOSEPH MEDICAL CENTER FOUNDATION *APPROVE REMOVAL OF A MEMBER OF THE GOVERNING BODY OF ST. JOSEPH MEDICAL CENTER FOUNDATION *ADOPTION OF LONG RANGE AND STRATEGIC PLANS FOR ST. JOSEPH MEDICAL CENTER FOUNDATION THE FOLLOWING RIGHTS ARE RESERVED TO THE CHI BOARD DIRECTLY OR THROUGH POWERS DELEGATED TO THE CHI CHIEF EXECUTIVE OFFICER: *SUBSTANTIAL CHANGE IN THE MISSION OR PHILOSOPHY OF ST. JOSEPH MEDICAL CENTER FOUNDATION *REMOVAL OF A MEMBER OF THE GOVERNING BODY OF ST. JOSEPH MEDICAL CENTER FOUNDATION *APPROVAL OF ISSUANCE OF DEBT BY ST. JOSEPH MEDICAL CENTER FOUNDATION *APPROVAL OF PARTICIPATION OF ST. JOSEPH MEDICAL CENTER FOUNDATION IN A JOINT VENTURE *APPROVAL OF FORMATION OF A NEW CORPORATION BY ST. JOSEPH MEDICAL CENTER FOUNDATION *APPROVAL OF A MERGER INVOLVING ST. JOSEPH MEDICAL CENTER FOUNDATION *APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF ST. JOSEPH MEDICAL CENTER FOUNDATION *TO REQUIRE THE TRANSFER OF ASSETS BY THE ST. JOSEPH MEDICAL CENTER FOUNDATION TO CHI TO ACCOMPLISH CHI'S GOALS AND OBJECTIVES, AND TO SATISFY CHI DEBTS. PURSUANT TO SECTION 5.5.2 OF THE ORGANIZATION'S BYLAWS, ST. JOSEPH MEDICAL CENTER OR CHI MAY, IN EXERCISE OF THEIR APPROVAL POWERS, GRANT OR WITHHOLD APPROVAL IN WHOLE OR IN PART, OR MAY, IN ITS COMPLETE DISCRETION, AFTER CONSULTATION WITH THE BOARD AND ITS PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION, RECOMMEND SUCH OTHER OR DIFFERENT ACTIONS AS IT DEEMS APPROPRIATE.
Review of form 990 by governing body
Form 990, Part VI, Section B, Line 11a
ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE TREASURER AND THE DIRECTOR OF ACCOUNTING AT ST. JOSEPH MEDICAL CENTER, THE ORGANIZATION'S CORPORATE MEMBER. THE TREASURER PRESENTS THE RETURN TO THE ST. JOSEPH MEDICAL CENTER FOUNDATION'S FINANCE COMMITTEE FOR REVIEW AND THEN A COPY OF THE RETURN IS PROVIDED TO EVERY MEMBER OF THE GOVERNING BODY. SUBSEQUENT TO THE RETURN BEING PROVIDED TO THE BOARD THE TAX DEPARTMENT FILES THE RETURN WITH THE APPROPRIATE FEDERAL AND STATE AGENCIES, MAKING ANY NON-SUBSTANTIVE CHANGES NECESSARY TO EFFECT E-FILING. ANY SUCH CHANGES ARE NOT RE-SUBMITTED TO THE BOARD.
Conflict of interest policy
Form 990, Part VI, Section B, Line 12c
ANNUAL DISCLOSURE FORMS ARE REQUIRED TO BE COMPLETED BY BOARD MEMBERS AND OFFICERS. THESE ARE REVIEWED BY THE TREASURER. THE FOLLOWING ACTIONS MAY BE TAKEN WITH RESPECT TO EMPLOYEES WITH CONFLICTS: 1) ASKING THE EMPLOYEE TO DIVEST THEMSELVES OF OWNERSHIP, INTEREST, OR STOCK IN THE OTHER ENTITY; 2) REASSIGNING THE EMPLOYEE TO A DIFFERENT POSITION; AND 3) HAVING THE EMPLOYEE ABSTAIN FROM MAKING A DECISION RELATED TO THE CONFLICTING ENTITY. THE DIVISIONAL VICE PRESIDENT AND THE VP OF HUMAN RESOURCES OF A RELATED ORGANIZATION, ST. JOSEPH MEDICAL CENTER IMPLEMENTS THE REQUIRED ACTIONS. A RANDOM SAMPLE OF EMPLOYEE FILES IS REVIEWED ANNUALLY TO ENSURE COMPLIANCE WITH THIS POLICY.
Process used to establish compensation of top management official
Form 990, Part VI, Section B, Line 15a
THE ORGANIZATION'S CEO'S COMPENSATION IS PAID BY CHI. CHI HAS A DEFINED COMPENSATION PHILOSOPHY. BOTH THE EXECUTIVE AND NON-EXECUTIVE COMPENSATION STRUCTURES AND RANGES ARE REVIEWED ANNUALLY IN COMPARISON TO MARKET DATA. CHI USES THE HAY GROUP AS THE INDEPENDENT THIRD PARTY TO ASSESS EXECUTIVE COMPENSATION PROGRAMS AND TO ENSURE THE REASONABLENESS OF ACTUAL SALARIES AND TOTAL COMPENSATION PACKAGES. COMPENSATION OF THE SENIOR MOST EXECUTIVES IS REVIEWED ANNUALLY. THE HAY GROUP REVIEWS BOTH CASH AND TOTAL COMPENSATION FOR OVERALL REASONABLENESS, FOR ADHERENCE TO CHIS COMPENSATION PHILOSOPHY, AND FOR COMPARABILITY TO THE NOT-FOR-PROFIT HEALTHCARE MARKET. THIS INDEPENDENT REVIEW IS DELIVERED BY HAY GROUP TO THE HR COMMITTEE OF THE CHI BOARD OF STEWARDSHIP TRUSTEES ANNUALLY AT THEIR SEPTEMBER MEETING AND MINUTES ARE SHARED WITH THE FULL BOARD AT THE DECEMBER MEETING. THE LAST REVIEW WAS SEPTEMBER, 2011. IN ADDITION, IN DECEMBER 2009, HAY GROUP COMPLETED A COMPREHENSIVE REVIEW OF ALL POSITIONS AT THE LEVEL OF VICE PRESIDENT AND ABOVE TO DETERMINE AND VALIDATE APPROPRIATE COMPENSATION LEVELS.
Process used to establish compensation of other officers/key employees
Form 990, Part VI, Section B, Line 15b
DURING THE TAX YEAR ENDED 6/30/11, NO OTHER OFFICERS, DIRECTORS OR TRUSTEES RECEIVED COMPENSATION FROM THE ORGANIZATION. ANY EXECUTIVE COMPENSATION PAID TO OFFICERS, DIRECTORS OR TRUSTEES BY RELATED ORGANIZATIONS WAS SET BY THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE UTILIZING BOTH AN INDEPENDENT CONSULTANT AND COMPARABILITY STUDIES TO DETERMINE COMPENSATION.
Public Disclosure
Form 990, Part VI, Section C, Line 19
THE ARTICLES OF INCORPORATION ARE AVAILABLE AT THE DEPT OF ASSESSMENTS AND TAXATION WEBSITE AT HTTP://SDATCERT3.RESIUSA.ORG/UCC-CHARTER/DEFAULT.ASPX. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. THE ST. JOSEPH MEDICAL CENTER FOUNDATION FINANCIAL STATEMENTS ARE INCLUDED IN THE CATHOLIC HEALTH INITIATIVES' CONSOLIDATED AUDITED FINANCIAL STATEMENTS THAT ARE AVAILABLE AT WWW.CATHOLICHEALTHINIT.ORG OR AT WWW.DACBOND.COM.
EXECUTIVE COMMITTEE COMPOSITION AND AUTHORITY
FORM 990, PART VI, LINE 1A
PURSUANT TO ARTICLE VII, SECTION 8.6 OF THE BYLAWS OF THE ST. JOSEPH MEDICAL CENTER FOUNDATION, THE EXECUTIVE COMMITTEE SHALL CONSIST OF ONLY DIRECTORS OF THE CORPORATION AND SHALL BE COMPOSED OF THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON OF THE BOARD, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATION, AND THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE CORPORATE MEMBER, EACH OF WHOM SHALL SERVE AS AN EX OFFICIO VOTING MEMBER OF THE EXECUTIVE COMMITTEE. EXCEPT AS PROVIDED BY LAW, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE SUCH POWERS AS MAY BE DELEGATED TO IT BY THE BOARD OF DIRECTORS. ALL ACTIONS TAKEN BY THE EXECUTIVE COMMITTEE SHALL BE PROMPTLY REPORTED TO THE BOARD OF DIRECTORS AT THE NEXT REGULAR MEETING OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL KEEP REGULAR MINUTES OF ITS PROCEEDINGS AND REPORT THE SAME TO THE BOARD OF DIRECTORS AT EACH REGULAR MEETING OF THE BOARD.
POLICIES
FORM 990, PART VI, LINES 12 AND 14
THE ORGANIZATION'S BOARD OF DIRECTORS HAS NOT FORMALLY ADOPTED A WRITTEN DOCUMENT RETENTION & DESTRUCTION POLICY. THE ORGANIZATION HAS STANDARD PROCEDURES THAT ARE FOLLOWED BUT THE ORGANIZATION'S BOARD HAS NOT OFFICIALLY ADOPTED THIS POLICY. THE ORGANIZATION'S BOARD WILL ADOPT A DOCUMENT RETENTION & DESTRUCTION POLICY DURING THE YEAR ENDED JUNE 30, 2012.
ESTIMATE OF HOURS DEVOTED TO RELATED ORGANIZATIONS
FORM 990, PART VII
COMPENSATION REPORTED ON THE FORM 990, PART VII, WAS PAID TO THESE INDIVIDUALS BY RELATED ORGANIZATIONS IN FULFILLMENT OF THEIR DUTIES AS FULL TIME, 60 HOUR PER WEEK EMPLOYEES OF THE RELATED ORGANIZATION.
Other changes in net assets or fund balances
Form 990, Part XI, Line 5
NET UNREALIZED GAINS (LOSSES) ON INVESTMENTS - 187422; CONTRIBUTION RELEASED TO AFFILIATE - -9187;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.