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. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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 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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
3,527,197
3,667,711
3,839,067
4,366,032
4,844,202
20,244,209
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..
633,632
674,180
803,830
776,408
765,818
3,653,868
4
Total. Add lines 1 through 3
4,160,829
4,341,891
4,642,897
5,142,440
5,610,020
23,898,077
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.
23,898,077
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
4,160,829
4,341,891
4,642,897
5,142,440
5,610,020
23,898,077
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
400,020
717,451
572,645
665,595
1,083,695
3,439,406
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
11
Total support (Add lines 7 through 10).
27,337,483
12
Gross receipts from related activities, etc. (see instructions)
..................
12
1,653,163
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
87.420 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
87.940 %
16a
33 1/3% support test—2013.
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—2012.
If the organization did not check a 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—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013
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.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
HUNTSVILLE HOSPITAL FOUNDATIONINC
Employer identification number
63-0752604
Return Reference
Explanation
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 FIFTH 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 2014, HUNTSVILLE HOSPITAL ADMITTED 42,735 INPATIENTS; TREATED 579,477 OUTPATIENTS; DELIVERED 5,189 INFANTS; TREATED 151,795 PATIENTS IN THE EMERGENCY DEPARTMENT; AND PROVIDED MORE THAN $55 MILLION IN UNCOMPENSATED MEDICAL CARE. THE HOSPITAL PROVIDES QUALITY, LEADING-EDGE HEALTH CARE TO A SERVICE AREA OF MORE THAN 1 MILLION PEOPLE, REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDE THE AREA'S 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. 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. 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. MADISON HOSPITAL PROVIDES COMPREHENSIVE HEALTH CARE SERVICES TO MORE THAN 122,000 RESIDENTS OF THE CITY OF MADISON AND COMMUNITIES IN WESTERN MADISON COUNTY. SERVICES PROVIDED BY THE 60-BED HOSPITAL INCLUDE OBSTETRICAL, MEDICAL-SURGICAL, INPATIENT AND OUTPATIENT SURGERY, DIAGNOSTIC IMAGING, AND 24/7 EMERGENCY CARE. AS A NOT-FOR-PROFIT HOSPITAL THAT RECEIVES NO TAX SUPPORT FROM CITY, STATE OR FEDERAL GOVERNMENTS, HUNTSVILLE HOSPITAL SYSTEM 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.
FORM 990 PART III, LINE 1
HUNTSVILLE HOSPITAL FOUNDATION'S MISSION IS TO DEVELOP RELATIONSHIPS AND FINANCIAL RESOURCES TO SUPPORT THE HEALTH CARE PROGRAMS, PROJECTS AND SERVICES OF HUNTSVILLE HOSPITAL SYSTEM. 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 SYSTEM THROUGH EXTENSIVE OUTREACH PROGRAMS. DURING THE YEAR, WE OFFER FREE SCREENING EVENTS, SEMINARS, HEALTH FAIRS AND DIRECT CARE PROGRAMS FOR COMMUNITY BENEFIT. ALTHOUGH HUNTSVILLE HOSPITAL IS A REGIONAL HEALTH CARE 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 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.
FORM 990 PART III, LINE 4A
HUNTSVILLE HOSPITAL SYSTEM 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 SYSTEM RELIES ON PHILANTHROPY TO MEET THE HEALTH CARE NEEDS OF THE REGION. THOUSANDS OF INDIVIDUALS, CLUBS, SCHOOLS, LOCAL BUSINESSES AND NATIONAL CORPORATIONS HAVE JOINED TOGETHER TO SUPPORT EXCELLENCE IN HEALTH CARE FOR NORTH ALABAMA. 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 $3,246,607 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 2014, THE FOUNDATION PROVIDED $745,507 TO HUNTSVILLE HOSPITAL FOR WOMEN & CHILDREN. EXAMPLES OF EQUIPMENT PURCHASED, THANKS TO PHILANTHROPY INCLUDE: A. HARDWARE/SOFTWARE UPDATES FOR BREAST DENSITY TO THE MAMMOGRAPHY SYSTEM B. GIRAFFE BEDS, INCUBATOR, WARMING BED AND SYRINGE PUMPS FOR THE NEONATAL ICU C. FETAL MONITORS AND MOTION CHAIRS FOR LABOR & DELIVERY D. LED PHOTOTHERAPY SYSTEMS AND SLEEP SACKS FOR MOTHER/BABY E. VITAL SIGNS MACHINE AND MUSIC THERAPY FOR PEDIATRIC ONCOLOGY F. WEIGHT/BALL SYSTEM AND BALANCE BEAMS FOR PEDIATRIC THERAPY
FORM 990 PART III, LINE 4B
CARDIOLOGY: IN FISCAL YEAR 2014, THE FOUNDATION PROVIDED $658,966 FOR TECHNOLOGY SUCH AS: A. ULTRASOUND (4D) SYSTEM B. ULTRASOUND (4D) SYSTEM AND VEIN ILLUMINATOR SYSTEMS FOR THE HEART CENTER C. EKG CARTS FOR THE CARDIAC NURSING UNIT D. SURGICAL HEADLAMPS FOR THE CARDIOVASCULAR OPERATING ROOMS E. GLIDESCOPE FOR THE CARDIAC INTENSIVE CARE UNIT F. STRETCHERS FOR CARDIAC TESTING AREAS
FORM 990 PART III, LINE 4C
LAB/RADIOLOGY: IN FISCAL YEAR 2014, THE FOUNDATION PROVIDED $415,952 FOR TECHNOLOGY SUCH AS: A. CYTOLOGY SYSTEM FOR THE PATHOLOGY LAB B. SLIDE PRINTERS AND MICROTOMES FOR THE PATHOLOGY LAB C. MRI INJECTOR SYSTEM AND MONITOR SYSTEMS FOR RADIOLOGY D. DISINFECTION SYSTEMS FOR RADIOLOGY
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.
FORM 990 PART XII, LINE 2C
NO CHANGES WERE MADE TO THE PROCESSES RELATED TO THE SELECTION OF THE INDEPENDENT ACCOUNTANT OR THE OVERSIGHT OF THE AUDIT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.