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
GBMC Healthcare Inc
Employer identification number
52-1484872
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.") ....
50,000
50,000
50,000
50,000
50,000
250,000
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..
4
Total. Add lines 1 through 3..
50,000
50,000
50,000
50,000
50,000
250,000
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.
250,000
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..
50,000
50,000
50,000
50,000
50,000
250,000
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
686
469
5
1,160
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
6,141
3,035
8,028
8,381
6,805
32,390
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).
283,550
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
88.170 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
88.660 %
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
GBMC Healthcare Inc
Employer identification number
52-1484872
Identifier
Return Reference
Explanation
Description of Organization Mission:
Form 990, Part III, Line 1
GBMC Healthcare, Inc. is organized and operated exclusively as a nonprofit charitable organization within the meaning of section 501(c)(3) of the code for the following purposes: (1) To establish, maintain, supervise, coordinate, assist and perform planning and other functions for entities to provide health-related services or to carry out the charitable, educational, health care, and scientific purposes of the corporation and its affiliated entities including but not limited to Greater Baltimore Medical Center, Inc., a hospital corporation described under section 501(c)(3) and exempt from tax under section 501(a) of the code, and other entities which may further the charitable, educational, health care, and other purposes of the corporation. (2) To provide supervision and coordination of the activities of affiliated entities, including but not limited to Greater Baltimore Medical Center, Inc.; GBMC Investments, Inc.; GBMC Foundation, Inc.; Ruxton Insurance Company, Ltd.; GBMC Land Corporation; and Gilchrist Hospice Care, Inc. (3) To consider and establish long and short range planning activities for the corporation and its affiliated entities. (4) To raise funds for the benefit of charitable, scientific, health care, and educational activities and functions of the corporation and its affiliated entities. (5) To consult with the appropriate officers of the affiliated entities to promote cooperation among them in order to further the charitable, educational, and scientific activities and functions of those entities. (6) To have and to exercise to the extent necessary or desirable for the accomplishment of any of the aforesaid purposes, and to the extent that they are not inconsistent with the charitable purposes of the corporation and the limitations imposed by section 501(c)(3) of the code, any and all powers conferred upon corporation by the Maryland General Corporation law.
Form 990, Part VI, Section B, line 11
The Audit Committee of GBMC Healthcare, Inc. reviews this Form 990. A copy of the Form 990 is provided to the Board of Directors of GBMC Healthcare for final approval prior to filing.
Form 990, Part VI, Section B, line 12c
Annually, every board member, physician, advanced practitioner and manager (which includes key employees) must complete a comprehensive questionnaire that provides for the disclosure of potential conflicts. All disclosures are reviewed by the compliance officer. Those disclosures that are questionable or may rise to the level of a conflict are discussed with the Chief Legal Officer and appropriate action is taken, if necessary. A summary of disclosures is provided to the audit committee (for management) and to the governance committee (for board members) annually.
Form 990, Part VI, Section B, line 15
GBMC Healthcare's President and Key Employees are compensated by its controlled tax-exempt subsidiary, GBMC Inc., but compensation is determined by a GBMC Healthcare subcommittee of the board of directors. The compensation committee of the board of directors is chartered with the responsibility to assure GBMC pays competitive salaries to the executives. The approach that is taken is based on current market "best practices" for non-profit organizations. The committee meets at least 6 times annually to review and discuss executive's salaries and benefits. The steps taken are as follows: 1) An independent executive compensation consultant was selected based on an RFP process and face to face interviews were conducted 2) Once selected, the compensation consultant compiled, independently, salary survey data of similar size organizations from throughout the country 3) The survey data is presented to the Compensation Committee with all the national survey data; various surveys are categorized by size of organization, academic and non-academic, system and community-based hospitals 4) The data is categorized by executive position, and a salary range is recommended by the compensation consultant 5) Base salary of an individual executive is based on survey results, years of experience, and performance 6) A recommendation is made to the Compensation Committee by the CEO for salary rates for the Vice Presidents 7) The Compensation Committee either accepts or modifies the recommendation from the CEO for base salary adjustments 8) The Compensation Committee determines the salary adjustment for the CEO based on national salary survey data, years of experience, and performance 9) The incentive bonus is determined based on actual results compared with the plan document and recommendation is made to the Compensation Committee for approval or modification 10) The amount of the bonus is determined by the criteria stated in the incentive plan document and is also based on current market practices from national surveys 11) Survey of executive benefits is also reviewed by the compensation consultants to assure reasonableness 12) The compensation consultant provides a written document on the reasonableness of the salaries being paid 13) The board of directors reviews and approves the decisions of the Compensation Committee
Form 990, Part VI, Section C, line 19
The governing documents are located on the State of Maryland Department of Taxation's website. Financial Statements are made public through the State of Maryland Charitable Registration. Financial Statements for GBMC Healthcare, Inc. are also available through the Electronic Municipal Market Access (EMMA) website via the Continuing Disclosure document. The Conflict of Interest policy is not available to the public.
Form 990, Part VII, Section A:
During the fiscal year, these individuals devoted the following estimated hours each week to a related organization: The Honorable Vicki Ballou-Watts: 1 Mrs. Sandra Berman: 1 Robert K. Brookland, M.D.: 1 John B. Chessare, M.D.: 5 Mr. Charles C. Fenwick, Jr.: 1 Mr. Samuel Heffner: 1 Mr. Frederick M. Hudson: 1 Mr. Larry S. Johnson: 1 Mr. Thomas M. Kane: 1 Ms. Patricia J. Mitchell: 1 Mr. Frank R. Palmer: 1 Mrs. Mary Stuart Rodgers: 1 Mr. Stephen T. Scott: 1 Mr. Robert A. Shelton: 1 Mr. Bernard Siegel: 1 Howard L. Siegel, M.D.: 1 Mr. Stuart O. Simms: 1 Ms. Bonnie R. Stein: 1 Mr. James B. Stradtner: 1 Mr. Steven A. Thomas: 1 Ms. Marion G. Thompson: 1 Harold Tucker, M.D.: 1 Ronald F. Trutone, Jr., M.D.: 1 Mrs. Mary B. Wieler: 1 John M. Wogan, M.D.: 1 John Saunders, M.D.: 5 Mr. Eric L. Melchior: 5 Mr. Keith R. Poisson: 5 Mr. Rodney M. Williams: 5 Mr. John W. Ellis: 1 Ms. Joanne Porter: 1 Ms. Tressa B. Springman: 1 Mr. Mark R. Thomas: 5 Mr. George E. Bayless: 1 Mr. Michael A. Forthman: 5 Ms. Catherine Y. Hamel: 5
Changes in Net Assets or Fund Balances:
Form 990, Part XI, line 5:
Prior period adjustments: -4,030,003. Transfers 542,837. Total to Form 990, Part XI, Line 5: -3,487,166.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.