Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
STURDY MEMORIAL HOSPITAL INC |
042768252 | Yes | 117,960 | 0 | ||
Total 1
|
117,960 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 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 | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 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 VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| ORGANIZATION MISSION (Continued) | FORM 990, PART III, LINE 1 STURDY MEMORIAL FOUNDATION, Inc. IS ORGANIZED TO SUPPORT THE ADVANCEMENT OF THE KNOWLEDGE AND PRACTICE OF, AND EDUCATION AND RESEARCH IN MEDICINE, SURGERY, NURSING AND ALL OTHER SUBJECTS RELATING TO THE CARE, TREATMENT AND HEALING OF HUMANS, TO IMPROVE THE HEALTH AND WELFARE OF ALL PERSONS, AND TO SPONSOR, DEVELOP AND PROMOTE SERVICES AND PROGRAMS WHICH ARE CHARITABLE, SCIENTIFIC OR EDUCATIONAL AND WHICH ADDRESS THE PHYSICAL AND MENTAL NEEDS OF THE COMMUNITY AT LARGE. THIS CORPORATION SHALL OPERATE EXCLUSIVELY FOR THE BENEFIT OF STURDY MEMORIAL HOSPITAL, INC. AND ITS AFFILIATED ORGANIZATIONS, IN THE CONDUCT OF THEIR CHARITABLE, EDUCATIONAL AND SCIENTIFIC FUNCTIONS. IN ORDER TO FULFILL ITS HEALTH CARE MISSION IN THE TWELVE COMMUNITIES THAT IT SERVES, THE FOUNDATION SOLICITS FUNDS FROM A WIDE VARIETY OF RESOURCES. DURING THE PAST TWENTY FIVE YEARS, THE FOUNDATION HAS SPENT OVER $ 10.2 MILLION TO PURCHASE LAND, BUILD, AND MAINTAIN EIGHT NEW MEDICAL CENTERS IN THE TOWNS OF FOXBORO, NORTON, NORTH ATTLEBORO, REHOBOTH, AND IN THE CITY OF ATTLEBORO. THE FOUNDATION HAS ALSO PROVIDED $23,250,000 OVER THE PAST 32 YEARS TO THE STURDY MEMORIAL ASSOCIATES TO FUND THE START-UP COSTS FOR THE NOW EXISTING FIFTY-NINE PHYSICIAN GROUP PRACTICE. THE PHYSICIAN GROUP PRACTICE WAS DEVELOPED TO MEET THE NEED FOR PRIMARY CARE SERVICES IN OUR SERVICE AREA. program service accomplishments (Continued) FORM 990, PART III, LINE 4A During FY 2015, the Foundation raised approximately $1,796,991. Of the total contributions, $1,500,000 was an endowment donation whose income is restricted for the benefit of Sturdy Memorial Hospital. Of the remaining $296,991 in donations, $111,454 was raised in direct support of Sturdy Memorial Hospital, Inc. Employees reported on Form W-3 Form 990, Part V, Line 2a Study Memorial Hospital, Inc. is the common paymaster for Sturdy Memorial Foundation, Inc. Form W-3 is filed under Sturdy Memorial Hospital's employee identification number. Federal Employment tax Returns Form 990, Part V, Line 2b Sturdy Memorial Hospital, Inc. is the common paymaster for Sturdy Memorial Foundation, Inc. and files all required federal employment forms. Authority Delegated to Executive Committee Form 990, Part VI, Section A, Line 1a The by-laws of Sturdy Memorial Foundation, Inc. state that "the Executive Committee shall have the power to transact all regular business of the Corporation during the interim between the meetings of the Board of Directors except for such matters as are specified in Section 55 of the (Massachusetts) General Laws, Chapter 156B". The Executive Committee consists only of members of the Board of Directors of Sturdy Memorial Foundation, Inc. Business Relationship with Governing Body Form 990, Part VI, Section A, Line 2 Dennis Kelly and Patricia Cochrane have a business relationship. |
| Members or stockholders | Form 990, Part VI, Section A, Line 6 and 7a Foundation Members are eligible to attend all meetings of the Corporation and to hold office. New Members are elected to membership by the existing Members for 3 year terms. Members also vote for a President, Treasurer, and a Clerk for one year terms. |
| FORM 990 REVIEW PROCESS | Form 990, Part VI, Section B, Line 11b The Form 990 is prepared by Sturdy Memorial's tax providers, Grant Thornton LLP, using information provided by management upon completion of the annual independent audit. The information provided is the responsibility of the CFO and the Sturdy Fiscal Services department. The return is reviewed by Grant Thornton LLP, the Controller and CFO, and compensation and benefit sections are specifically reviewed by the Vice President of Human Resources for Sturdy Memorial Hospital, Inc. Prior to filing the Form 990 with the Internal Revenue Service, the complete form and all schedules are provided to every board member and any questions are answered. |
| CONFLICT OF INTEREST POLICY MONITORING AND ENFORCEMENT | Form 990, Part VI, SECTION B, Line 12c Sturdy Memorial Foundation, Inc. is the Parent of Sturdy Memorial Hospital, Inc. and follows the hospital's Conflict of Interest Policy. Under the direction of the hospital's Integrity Officer, all managers and supervisors (including officers and key employees) must complete and sign an annual Conflict of Interest Disclosure Statement. The Statement requires disclosure of any outside Interests in any business, outside activity, gifts or entertainment that may have influenced the employee. In addition, the employee must disclose if they have shared any hospital information for their own personal advantage or if they had knowledge of any integrity or ethical issues not previously reported. These signed Statements are reviewed by the Integrity Officer and any potential conflicts are resolved. The Integrity Officer discusses disclosed conflicts with the reporter, so that the reporter knows what business activities they cannot participate in (e.g., purchasing decisions, board votes, etc.). Any gifts received that create a conflict or are in violation of the Conflict of Interest Policy must be returned or paid for by the individual at fair market value. Conflicted individuals are not allowed to vote on areas related to their conflict or participate in other decisions surrounding the entity they have a conflict with. The Integrity Officer reports annually to the Board of Directors of any new conflicts. Article V, Section 12 of the Foundation by-laws requires Board members to disclose any potential conflict. Board members, officers, and key employees must attest in writing each year, to any potential conflict. The conflict of interest statements are reviewed by the Hospital's President and Chief Financial Officer and any potential conflicts are resolved. DOCUMENT RETENTION AND DESTRUCTION POLICY Form 990, Part VI, Section B, Line 14 Sturdy Memorial Foundation, Inc. does not have a written document retention and destruction policy but does comply with Massachusetts law with respect to record retention requirements. Where state law does not require retention limits, the Foundation uses the "Business Records Retention Schedule" from the Office of the Federal Register and other relevant and reliable sources (such as attorney letters and recommendations from accounting firms). A formal policy is being considered. |
| PROCESS OF DETERMINING COMPENSATION | Form 990, Part VI, Section B, Line 15a The CEO (Executive Director) is compensated entirely through Sturdy Memorial Hospital, Inc. which is why there is no compensation on Form 990, Part VII, Column D. The CEO is compensated on a merit system, as part of their compensation review in Sturdy Memorial Hospital, Inc. The CEO and senior managers prepare goals at the start of each fiscal year and are evaluated for merit increases based on those goals and their accomplishments relative to the goals. The CEO's accomplishments (relative to the established goals) are documented in an annual report which is submitted to the Chairman of the Board of Managers. The Board Chairman is provided with comparative market data, obtained through compensation surveys, prepared by an Independent consultant specializing in such matters. The comparative data is for similar hospitals in Massachusetts and is sent directly from the independent consultant to the Board Chairman. The data includes comprehensive salary and benefits information for CEOs and senior managers (key employees) including comparison of base pay, incentive pay, benefits and total compensation. In addition, the Chairman is provided with performance information for Massachusetts hospitals obtained through the Massachusetts Center for Health Information and Analysis. The Hospital's Vice President of Human Resources provides the Chairman with the CEO's current actual salary and benefits. The Chairman of the Board of Managers provides the above information along with the annual report of the CEO's accomplishments (relative to established goals including the hospital and the Associates) and a history of the CEO's compensation to the Executive Committee, which serves as the Compensation Committee for this purpose. The Executive Committee reviews the comparative data for CEO base salary, bonus and total compensation, along with the survey data for benefits. Based on the goals achieved and the comparative data provided, the Executive Committee votes to approve the salary, bonus and benefits of the CEO. A summary of the discussion and the decision of the Executive Committee are reflected in the meeting minutes. The Chairman of the Board of Managers communicates the decision regarding compensation changes in a letter to the Vice President of Human Resources to execute the change. The CEO uses comparative market data, obtained from an independent consultant, for the Foundation Director of Development. The CEO compares the Director of Development's current base salary and bonus (incentive pay) to the survey data. The Director of Development's performance is evaluated based on the goals established at the start of the year. The CEO determines the base pay amount and bonus for the Director of Development based on performance and the compensation survey. Base salary and bonus payments, including survey information, are reviewed with the Executive Committee by the CEO. The Executive Committee votes to accept the recommendations of the CEO. |
| HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC | Form 990, Part VI, SECTION C, Line 19 Sturdy Memorial Foundation, Inc. makes available copies of its by-laws, the conflict of interest policy of Sturdy Memorial Hospital, Inc. and financial statements to the public upon request. Other changes in net assets Form 990, Part XI, Line 9 Net assets released from restrictions: ($600) Contribution raised for Sturdy Memorial Hospital, Inc.: ($111,455) ------------- Total: ($112,054) |
| OTHER CHANGES IN NET ASSETS | FORM 990, PART XI, LINE 9 TRANSFER FROM AFFILIATE 2,500,000 |
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